Pain, Injury and Treatment

Detailed below are some of the most common types of pain and injuries.

Back Pain

This is the most common condition that we treat and contributes to the highest number of days absence from work. The pain can be acute or chronic. It may travel into your leg [sciatica] or cause pins and needles or numbness in your leg.

The most common causes of back pain are:

  • Often referred to as a ’slipped disc’. This can occur suddenly eg bending down and your back ’goes’. Or a gradual increase in pain over a number of days. The discs are the shock absorbers that sit between each vertebrae. They should be shaped like a disc but if they bulge out to one side of the spine they can then press on the nerve which causes pain. As the nerves travel down your leg this can give you sciatica. Most disc protusions respond very well to physiotherapy, but a small number require either an injection or in more severe cases, surgery. If this becomes necessary we can help to organise a scan if this is necessary and refer you to the right specialist.

  • If you Xray anyone’s spine from their 40s onwards there will be evidence of some ‘wear and tear’ or arthritis. As we age our discs become less hydrated. This is the normal ageing process and for most people they are symptom free. However some people’s spines degenerate more than others. This can cause pain and stiffness. Although you cannot get rid of the wear and tear, the symptoms can be fully alleviated using manual therapy, acupuncture and exercises working on flexibility, strength, stability and efficient movement.

  • This is when you have back pain but there is no structural damage to the spine. So if you had an xray or scan it would be normal. However the joints and muscles are not working as they should be. This can be due to a sudden awkward movement eg twisting while playing football or because your work station is not set up as it should be so your spine is in an awkward position on a day to day basis, which eventually results in pain. Once we get the joints and muscles moving freely again the pain goes.

Neck and Shoulder Pain

When you have pain in the shoulder area it maybe originating from the shoulder itself or it can be referred from the neck. The neck can give you pain, pins and needles or numbness down your arm and into your hand. It can also give you headaches. With a thorough assessment we can work out where the pain is actually coming from and then target treatment accordingly.

 The most common causes of pain in the neck are:

  • This is age related ‘wear and tear’. Between each vertebra we have a disc. As we age the discs lose fluid which causes them to become stiff therefore causing pain and lack of movement. A combination of joint mobilisations, soft tissue release, exercises for mobility and strength and acupuncture are all very effective. We also teach you how to manage the symptoms as effectively as possible.

  • This is very similar to the lumbar disc protrusion but gives neck and potentially arm pain rather than back and leg pain or sciatica. You can develop a cervical disc protrusion due to sudden injury, ongoing overload for example if your computer screen is not positioned quite as it should be, or as part of the wear and tear process.

  • This most commonly happens as a result of a road traffic accident but can happen with a fall or collision, such as when playing rugby. It is when the head gets thrown rapidly forwards and backwards due to the impact. All the structures, so the muscles, joints and nerves get over stretched. In response they tighten up, therefore restricting movement and causing pain. Like all other spinal problems they generally respond well with the right treatment.

Shoulder Pain

The most common causes of shoulder pain relate either to impingement of the rotator cuff tendons or other tissues around the joint or to instability of the joint. The former results in pain, primarily when lifting your arm over head, reaching or moving your hand up your back. The pain generally responds well to manual therapy, acupuncture and taping to release the muscles that are tight. This alleviates the pain but then exercises to correct the mechanics provide a long term solution and address the underlying cause.

Shoulder Instability responds well to a progressive exercise programme to improve the biomechanics of the shoulder and therefore take the pressure off the joint and relieve the pain.

Frozen Shoulder or Capsulitis

This can occur following an injury or for no reason whatsoever. Initially pain is the main thing that limits movement, but in later stages movement is simply limited by stiffness. Frozen shoulder generally resolves with time and although physiotherapy can’t eliminate the problem it can hugely relieve the symptoms that are associated with it.

Knee Pain

Knee pain broadly speaking occurs for one of three reasons; sudden injury, repetitive strain or age related degeneration.

  • Normally a twisting force which can cause an anterior cruciate ligament injury, damage to other ligaments or a meniscus tear. An anterior cruciate ligament tear can often cause the knee to ‘give way’ or feel unstable. This can be treated with physiotherapy involving a progressive rehabilitation programme, but sometimes surgery is necessary. If this is the case comprehensive rehabilitation is vital to ensure a successful outcome.

  • Is when there is excessive force put through the knee over a period of time which eventually results in pain. This includes conditions such as patella femoral pain syndrome, patella tendinopathy and iliotibial band syndrome. While treatments such as soft tissue release, taping and acupuncture are helpful for settling the pain, it is important that the biomechanics are dealt with so the underlying cause is addressed.

  • Once you mention arthritis people often think that they need to have a knee replacement. This is only the case with severe arthritis. Many people never get to this point and their pain can be very well managed with a strengthening exercise programme which relieves the pressure on the joint. Acupuncture is also very good for pain relief, along with joint mobilisations and soft tissue release.

  • This is a very common injury. It occurs when you roll onto the outside of your foot, often when walking or running on uneven ground. The ligaments on the outside of the ankle are stretched or torn. Physiotherapy will help alleviate the initial pain and give you lots of advice as to how best to manage the acute injury. If you get this right it can make a huge difference to your recovery. However the most important thing is to rehabilitate the ankle, so as to try to avoid re injury which is very common.

  • This is common in running and jumping sports. It is when the Achilles tendon becomes stiff and painful, particularly first thing in the morning, when you start to walk after being sat down for a while or when running. It is because the tendon isn’t coping with the load that is going through it. This often happens if the load is increased [for example if a runner increases their training too quickly in preparation for a half marathon] or if the load changes, or using inappropriate foot wear. It can also become overloaded if your biomechanics are putting undue pressure on the Achilles. Achilles tendons can be slow to recover but the most critical form of treatment is a progressive loading programme to increase its resilience.

  • The plantar fascia is a band of tissue that runs across the sole of your foot and supports the arch in your foot. Like the Achilles if it becomes over loaded it can become painful. Once we have worked out why it is being overloaded we can address the problem. In the short term to give some pain relief taping, and soft tissue release to the plantar fascia and surrounding soft tissues can be really helpful.

Foot and Ankle Pain

The most common foot and ankle problems are:

Sports Injuries

Georgina is an avid sports person herself and spent a number of years working with top athletes in a variety of sports.

G Taft Physiotherapy sees people from a huge range of sports including hockey, netball, rugby, triathlon and running, swimming, skiing and the gym. She sees children who are in the infancy of their sporting lives through to the ageing veteran desperate to eek out a few more years in their chosen sport. Injuries can be acute, such as accelerating for a ball and tearing a hamstring muscle or chronic, such as Achilles tendinopathy, occurring as a result of a too rapid an increase in running or altered biomechanics.

Georgina will work out the underlying cause, address it and get you back to playing sport as soon as is feasibly possible.

Paediatrics

Children and adolescents are not simply mini adults. Adult bone is significantly stronger than childrens’, so whereas the ‘weak point’ in adults is generally ligaments or tendons, in children it is the bones. For example if an adult rugby player falls onto the side of their shoulder they are most likely to injury the joint  between the collar bone and the shoulder, whereas children are likely to break their collar bone.

 There are also a number of joint conditions that only occur in children, largely because they have growth plates at the end of their bones, whereas in adults the growth plates have fused. It is really important not to miss these types of injuries in children as they can cause permanent problems if a prompt diagnosis is not made.

However youngsters heal considerably quicker than adults so you can normally get children back on the sports field pretty quickly.

Acupuncture

Is extremely effective for treating pain, inflammation and tight muscles. Some patients are often sceptical as to how effective it is but it is backed up by vast amounts of clinical research which not only proves it is effective, but also shows how it works. It has its effect by:

  • Encouraging the release of the brain’s natural pain killers such as endorphins therefore helping to reduce pain.

  • It increases circulation locally so it helps with the healing response.

  • If a  muscle is tight and you put a needle into the muscle it allows the muscle to release. You can often get deeper into a muscle with a needle than you can with soft tissue release with your hands.

It can sometimes be a bit uncomfortable but is not painful and sometimes you don’t feel anything at all.