Physiotherapists in Wiltshire treat many different conditions including the condition profiled below.

Neck and Thoracic Posture

The spine is designed to be highly mobile but also to be stable and cope with the very large forces put upon it by movement of the body. At certain points in the spine a stiffer and more stable spinal area meets a mobile and flexible area and in these areas problems can develop. The neck and upper thorax have to manage the weight and movement of the head which is considerable and must be closely controlled so we can use our eyes effectively and interact with others. With time a typical posture develops in the neck and thorax where the head is carried forward of the body and a lump can develop where the neck and thorax meet.

The upper thoracic spine is a stiffer area of the spine and the neck is flexible, causing extra strains on this area which can become painful. The lower part of the neck is flexed more than usual and because we don't want to look down at the floor we lift the head up to look at the world and this extends the upper neck more than appropriate. With time this can develop into neck and arm pain from the lower neck and neck and head pain from the upper.

Hypermobility

We are all born with a genetically determined type of fibrous tissue, the collagen material that makes us all or most of our ligaments, tendons, skin and discs. Our collagen varies greatly in the amount of extensibility it allows due partly due to the amount of elastic material included and the length of our tissues. Normal mobility varies from stiff jointed to very mobile and individuals who show very high degrees of flexibility of their joints are termed hypermobile. Hypermobility may be asymptomatic or can cause significant pain problems in other cases. Benign hypermobility syndrome BHS is diagnosed clinically by testing the patient's joint mobility.

The diagnostic tests are: the little finger can be pulled back to 90 degrees to the hand; with the wrist bent the thumb can be pulled back to touch the forearm; the elbows extend back beyond neutral; the knees extend back beyond neutral and the person can bend over with the knees straight and place their palms on the floor. Each joint gets a score of one if positive and this gives a score out of nine. The score indicates the degree of hypermobility the patient is exhibiting and helps decide whether the joint condition is relevant.

Physiotherapists in Wiltshire have contributed some of the many articles on this site such as the one extracted below.

In some cases of back or leg pain corticosteroid injections may provide some relief and the mechanism may be that the steroid reduces any inflammatory process present in the tissues. Steroids inhibits inflammatory chemicals some of which have been found in elevated levels in operatively removed disc material from humans. Such inflammatory mediators may promote disc degeneration and make the fibres of the annulus more sensitive to stresses. Other chemicals may add to disc related pain problems by making pain nerves more sensitised, reducing synthesis of the water holding proteoglycan chemicals in discs and by increasing the degrading effects on the disc matrix.The lumbar spinal motion segments have nerve structures supplying them which can be come hypersensitised to incoming stimuli, creating pain from what would have formerly been normal sensations. Sciatic leg pain is known as nerve root or radicular pain and can be caused by irritation, inflammation or compression of the spinal nerve...

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