What We Treat

Back and Neck Pain

At Total Physiotherapy the majority of patients we see suffer with lower back and neck problems. Low back pain is the most common cause of sickness in the workplace in the UK with up to 80% of the UK population experiencing back pain at some point in their lifetime. It affects approximately one third of the adult population each year with 20% of people consulting their GP. Neck pain is also extremely common, and can have a negative impact on an individual’s daily life.

There are a number of different guidelines for both low back pain and neck pain, with those proposed by the National Institute for Health and Care Excellence (NICE) being most commonly used in the UK. These provide clinical guidance regarding the most appropriate treatment methods and assessment tools. At Total Physiotherapy we follow such guidelines in order to provide evidence based treatments for back and neck pain.

At Total Physiotherapy the majority of patients we see suffer with lower back and neck problems. Low back pain is the most common cause of sickness in the workplace in the UK with up to 80% of the UK population experiencing back pain at some point in their lifetime. It affects approximately one third of the adult population each year with 20% of people consulting their GP. Neck pain is also extremely common, and can have a negative impact on an individual’s daily life.

There are a number of different guidelines for both low back pain and neck pain, with those proposed by the National Institute for Health and Care Excellence (NICE) being most commonly used in the UK. These provide clinical guidance regarding the most appropriate treatment methods and assessment tools. At Total Physiotherapy we follow such guidelines in order to provide evidence based treatments for back and neck pain.

What is the main cause of neck and low back pain?

The actually causes of neck back pain are poorly understood, however it is believed that symptoms develop due to multiple factors. Only 15% of cases are thought to have an identifiable cause, with the remains 85% of cases classed as non-specific.

 

Both neck and low back pain can be caused by genetics, a lack of fitness, muscle weakness, poor posture, muscle imbalance, damage to the vertebrae or intervertebral discs, repetitive movements, or medical conditions such as scoliosis.

 

An increase in sedentary lifestyles and static working conditions is thought by many to have increased the prevalence of neck and low back pain. This is often related to office based working conditions where the individual is sat in a static position with poor posture and ergonomics. Poor posture and ergonomics increase the risk of muscle imbalances developing, causing muscles to become overactive and painful. Lifting with an unstable lower back/trunk can also cause damage to the facet joints and intervertebral discs. If the vertebra or intervertebral discs are damaged (in the form of a disc prolapse) the muscles overlying the area will go into spasm causing pain and restricting the individual’s mobility.

 

Symptoms can typically persist for longer than 6 months, however it is important to speak with a physiotherapist early for advice on how to treat the neck pain. If following the road traffic accident you suffer from prolonged dizziness, fainting or problems with your speech, swallow or vision, you need to speak to a doctor as soon as possible.

How can Physiotherapy help my neck and back pain?

Physiotherapy is extremely beneficial for neck and low back pain with a large amount of research available which supports its effectiveness as a treatment method. There are a number of different treatment methods which can be used for low back pain which will depend on its presentation and severity. At Total Physiotherapy the physiotherapist will complete a thorough assessment, ruling out any sinister cases through asking specific questions. Once the physiotherapist has completed a thorough assessment, they will then be able to provide hands on treatment which again, will depend on the severity of the patient’s symptoms.

Treatment methods include soft tissue massage, acupuncture, exercise prescription, joint mobilisations, joint manipulations, stretching and trigger point release therapy. The physiotherapist’s at Total Physiotherapy use an evidence based approach and the above treatment methods have recommended in the NICE Guidelines for low back pain. We also have immediate access to MRI scans, if further investigation is deemed necessary. 

As well as providing treatment, the physiotherapist will be able to advise with your desk set up and lifting postures when at work. They may also be able to advise you with your activity levels at work, encouraging certain movements to reduce your pain levels. This may be as simple as standing to have a stretch every 10-20 minutes if you sit at a desk all day. This will reduce the strain your back is put under and allow the soft tissues to lengthen.

Red Flags

Red Flags is a term used by health care professionals to highlight signs and symptoms of a serious underlying pathology. If the individual is suffering with back pain and they experience any changes in their bladder or bowel symptoms, radiating pins and needles or numbness down their legs to the toes, or numbness around the groin region, they need to visit their local A+E department for an immediate MRI scan. If the individual is suffering with neck pain then they need to be aware of any dizziness, problems with swallowing or speaking, changes in their vision (double vision) and fainting episodes. If they do experience these symptoms then they need to seek medical attention.

 

If you would like to discuss your problem before booking an appointment please give our physiotherapy team a call, we will do our best to help.

Physiotherapy for Osteoarthritis:

It may be that as a consequence of osteoarthritis at the lumbar spine (also known as Spondylosis), the spine has become very stiff and the patient has developed low back pain. As a result of the joint stiffness the muscles and fascia around this area will have stiffened and restrict movement (bending forwards and side to side.) With deep tissue massage and joint mobilisations, the joints and soft tissue will become more mobile, improving the spines mobility and reducing pain. It is also important to complete specific exercises that the physiotherapist may have issued to improve the stability and mobility at the lumbar spine. The physiotherapist will also encourage general mobility to prevent the risk of losing range of movement in the joint. When treating arthritic conditions it is important for the patient to control their pain, this may be through pain relief prescribed by a pharmacist or doctor, or through electrotherapy in the form of a TENS machine. The NICE guidelines recommend the above treatments to be used in conjunction with one another, especially alongside an exercise routine designed to provide local joint strengthening and general aerobic fitness. At Total Physiotherapy we can also provide the patient with specific walking aids to help maintain mobility, as well as advice with specific aids in the home environment to help sustain independence with everyday tasks. If the osteoarthritis is too painful and the patient is struggling with exercise and mobility, it may be appropriate for the physiotherapist to refer the patient to an Orthopaedic doctor to consider intra-articular corticosteroid injections or surgery in the form of a joint replacement.

Physiotherapy for Rheumatoid Arthritis (RA):

Due to the nature of RA it is extremely important for the individual to maintain their function and find ways to manage their condition. At Total Physiotherapy we will complete a thorough assessment to determine where they may be struggling and aim to use manual treatment techniques, alongside exercise prescription and advice/education to improve the patients function. With inflammation at the joint capsule, the joints stability is compromised. It is therefore important to maintain muscle strength and stability at the affected joints to reduce the risk of further irritation and loss of function. Through simple exercises that the individual can complete at home, alongside further treatment options that may have been implemented by the Rheumatology medical team, the patient will be able to manage their condition and maintain their functional ability. It may be appropriate to provide the patient with specialist splints to support particular joints (wrists, knees, ankles, elbows) to help provide extra stability if the condition progresses. As mentioned above we can also provide the patient with specific walking aids to help maintain mobility, as well as advising with specific aids in the home environment to help maintain independence with specific everyday tasks.

Physiotherapy for Gout:

At Total Physiotherapy we treat a number of patients who suffer with gout, aiming to improve their mobility and reduce the irritation to the specific joint. As mentioned before, gout can be extremely painful. As a consequence the joint affected will lose its function which will impact on the patient’s ability to complete certain tasks. However, if the patient is advised with preventative measures and ways of managing the condition when it is in its acute form the pain can be reduced and physical ability maintained. Gentle exercises can be given to the patient to help maintain the joints mobility, as well as advising with ice as a treatment modality.

 

At Total Physiotherapy we have good links with the local GP’s and can therefore communicate with the patient’s doctor with regards to the most appropriate treatment methods and recommend referrals to any other health professionals if required.

 

If you would like to discuss your problem before booking an appointment please give our physiotherapy team a call, we will do our best to help.

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