The most common cause of sciatica is a bulging or ruptured disc in the spine pressing against the nerve roots that lead to the sciatic nerve. However, sciatica also can be caused by the nerve tissue being compressed or irritated by very stiff spinal joints, bone spurs (small, bony growths that form along joints) caused by wear and tear arthritis, or even narrowing of the spinal canal (a condition called Spinal Stenosis). Occasionally, the sciatic nerve can be irritated by excess muscle tone deep in the buttock, PIRIFORMIS SYNDROME (pseudo-sciatica). In rare cases, sciatica can also be caused by conditions that do not involve the spine, such as tumors or pregnancy.

What symptoms do you get?

Usually pain, but also tingling and numbness can occur, either constantly or intermittently. You may also experience muscle weakness in the affected leg.

TREATMENT

Our Physiotherapists use a thorough physical examination to determine the cause of the pain, and decide where the nerve irritation is occurring. (Areas of sensation change or muscle weakness in the leg help us to work our which nerves are affected)

Treatment plans are drawn up together with the patient to relieve pain, promote relaxation and restore movement. The treatments offered will vary, depending on the cause of your pain, and may include joint and soft tissue manipulation or mobilisation, traction, electro-therapies and remedial exercises.

There are many types of exercise; we use them to maintain or restore movement and muscle control, to correct posture and improve lifting technique.

We use clinic based treatments to promote recovery, but we are also committed to giving patients confidence & freedom to augment that treatment with home exercises whenever possible: our aim is to teach and educate as much as possible.

We will monitor your progress and progress the treatments as your body responds.

Patients with chronic or recurrent back problems often need to re-establish good CORE STABILITY by retraining muscles; Dynamic Ultrasound scanning enables us to see muscle activity levels as they occur, and gives our patients great encouragement in the form of visual feedback.

We use ultrasound imaging in day to day practice. Call David to discuss how imaging of your injury can reduce your pain more quickly.

Contact us to discuss your imaging needs.

We are seeing a lot of Achilles problems that are actually TENDONOSIS not TENDINITIS; Tendinitis is an inflammation problem, usually quite recent and the usual sports injury treatments (R.I.C.E.) especially ice, anti-inflammatory drugs etc work well. However Tendonosis is a longstanding problem, characterised by tendon thickening and tenderness, early morning stiffness, pain on over use,…. but there’s no true inflammation going on so ice and anti inflammatories don’t help much at all.

Tendonosis of the Achilles tendon is often resistant to all sorts of treatments traditionally given for this problem.

However, In recent years there have been a handful of new research studies suggesting a better approach to treating sore and swollen achilles tendon problems.

Our team will use a detailed examination of the tendon and related joints & tissues, often involving ultrasound imaging of the tendon, to measure any swelling or injury. Following this assessment, we will agree a course of treatment tailored to your needs; it will usually include a prescribed course of exercises.

We will offer shoe advice, other physical therapies and may prescribe orthotics as well, but the course of daily exercises (including ‘eccentric’ exercises) are the centre-point for treatment. There will be regular reviews of your progress to keep you on track to full cure, usually over a period of 12-16 weeks.

Do you have wrist or hand pain?

If you have neck pain or whiplash injuries call reception on: (01403) 276272 to arrange a call with David to discuss possible treatments for your problem

Our Chartered Physiotherapist is trained to perform a detailed examination (called Assessment) of your neck problem. This identifies the cause of the symptoms, so that we can agree a plan of treatment together. This first session takes an hour.

The treatment plan will usually consist of some form of manual therapy, including gentle soft tissue massage, joint manipulation and sometimes manual traction. The manipulation is rarely forceful: more commonly, it will be gentle, rhythmic and soothing, especially in acute conditions. Occasionally, more powerful techniques will be necessary; these are carefully planned and performed, and the effects carefully monitored.

You’ll be given clear instructions on some self help techniques, including remedial exercises, which will help to maintain the improvements from treatment, and promote further recovery.

You may have some postural issues that need to be addressed, in order to reduce strain on your neck; these can relate to longstanding habit, lack of muscle strength, or poor work station design/seating. Either way, we will help you deal with it!

Useful advice links: Arthritis and Rheumatism Council:  http://www.arc.org.uk/arthinfo/patpubs/6024/6024.asp

Do you have a painful shoulder problem? Call David for advice how he can help you.

There are many different problems which can cause shoulder pain, and the treatments vary a great deal, so detailed examination and assessment are essential for accurate diagnosis and planning of suitable treatment. Our assessment sessions take an hour and can include ultrasound scanning to test the integrity of muscles and tendons.

Treatment can include stretching & manipulation for stiff limited joints and tissues, electrotherapy to promote the healing process and muscle strengthening exercises to improve the power and stability of the shoulder complex.

If you have back pain problems, have a chat with David Fraser about how our multidisciplinary approach can give you more effective relief from your pain.

Sixty percent of adults suffer from back pain every year, and half of those can become chronic sufferers.

Back pain is often easily treated by suitably qualified physiotherapists, so it makes good sense to seek advice and treatment when you have a back problem.  It can arise from joint, ligament, disc or muscle problems, often with several overlapping issues.

Back problems are usually caused by bad posture, poor lifting technique or lack of fitness, or results from a specific injury or overuse.

Other causes include inflammation, and rarer, more serious problems such as progressive diseases affecting bones and joints.

Our physiotherapists are trained to carry out a comprehensive assessment to diagnose problems in the joints and soft tissues of the body. We will plan a detailed treatment schedule for your particular problem.

Physiotherapy for back pain includes a wide range of treatments to relieve pain, promote relaxation and restore movement. They include manipulation, mobilisation and massage. Exercises are often used to mobilise stiff joints and tissues, increase general fitness, and to strengthen muscles which support the spine.

We use clinic based treatments to promote recovery, but we are also committed to giving patients confidence & freedom to augment that treatment with home exercises whenever possible.

If you are prone to back pain, we can also offer preventive advice

-useful links:

National Back Pain Association
16 Elmtree Road
Teddington
Middlesex
TW11 8ST
Tel: 020 8977 5474
Fax: 020 8943 5318
Backpain website

If you need help with rehabiltation after hip replacement give reception a call for an appointment

Using a range of exercises, physiotherapists will help you to regain muscle strength and movement so that you can walk normally as soon as possible. They will also teach you how to use crutches, and will ensure that you can carry out basic movements such as standing up, sitting down and going up and down stairs. After discharge from hospital, you will continue to see the physiotherapist until you have optimum function from the new joint.  This process can take several weeks, and will involve a carefully graded, increasing set of exercises designed to improve the range of movement, strength and function. The physio will also help you progress to either one crutch or walking stick at the appropriate time.