Physiotherapists in Swindon treat many different conditions including the issues profiled below.

Ligament-Bone and Tendon-Bone Conditions - Bone Formation

The behaviour of the bone around the joint varies in differing arthritic conditions. In rheumatoid arthritis the inflammatory joint condition is linked with loss of bone and this contributes to the damage to the joint and the disability which ensues. However, in ankylosing spondylitis (AS) the inflammation is accompanied by the formation of new bone at the inflamed sites. This new bone forms at each insertion site, growing together in the spine to form bony bridges across the vertebrae, stiffening the spine in a poor position in some cases which can cause significant disability. Since inflammation usually breaks bone down this is difficult to understand.

New bone typically forms at normal ligament or tendon insertions as we get older, but in arthritis the inflammatory phase which erodes bone does settle and then bony spurs can form as the bone laying down phase occurs next in time. In the case of AS, if a bony formation phase follows the inflammatory phase, then suppressing the inflammatory phase with medication might accelerate the bony formation process, increasing the disability. AS patients may continue to fuse their joints even in the presence of new biological treatments but they may be shown to inhibit bone formation at the insertions and thereby reduce disability.

Lumbar Facet Joint Syndrome

The lumbar spine is a very complex structure made up of a large number of different anatomical structures, many of which can be sources of pain in different situations. One structure which is known to contribute to low back pain is the facet joint, the small synovial joint placed at each side of each disc level. The facet joints are made up of one facet from the vertebra above and one from the vertebra below, with a joint capsule lined with synovial membrane. The joint capsule is well supplied with nerve endings which could transmit pain. In normal backs the facet joints serve to control the movements permitted at the particular part of the spine in which they lie, but do not take large amounts of weight.

With degeneration of the discs the facet joints are pushed together more strongly and forced to take larger amounts of weight, leading to degenerative changes developing within them and then the transmission of pain. The facets are forced to take more weight than they are designed for. Patients with this syndrome particularly dislike extension of the spine which forces the facet joints together and elicits pain. Mobilisations and regular exercises can be helpful from a physio.