Physiotherapy for pain and injury in London
Many people with persisting and chronic pain elect to have an intervention for pain relief. This can include steroid injections, facet joint injections, nerve root blocks, epidurals, denervations and sympathetic blocks to name but a few. These procedures are usually administered by a pain consultant (a doctor who specialises in pain management), an orthopaedic surgeon, […]
The rehabilitation journey following an injury must be traveled with full commitment and completed. Usually when we talk about rehabilitation, it is the exercises that are focused upon: the movement, the task, the goal and how much to do. Nothing wrong with this of course as the training parameters are important to understand the effects […]
I see a number of cases of cervical dystonia (spasmodic torticollis) that features awkward posturing and movement of the head and neck. This can be painful and have consequences for normal activities. We rely upon being able to orientate ourselves to our environment by controlling our head and gaze direction and then responding appropriately. Primary dystonia has no […]
Sustaining an injury is commonplace in sport. What happens in the first few minutes, hours and days can play a big part in how well we recover. The injury needs to be diagnosed and understood, for example an ankle twisting beyond the normal range of movement that results in a sprained ligament. As important is […]
Understanding pain mechanisms is the key to effective treatment. The mechanisms that have been studied, written about in science journals and discussed with patients include nociceptive pain, inflammatory pain, neuropathic pain and central sensitisation. Elucidating which are playing a role in the patient’s experience allows the doctor to prescribe the right medication and the modern […]
As a physiotherapist I frequently use my hands to treat the joints and tissues. It comes with the territory, everyone expects hands-on therapy and it does helps to reduce tension and pain. Most likely, the pain relief from joint mobilisation is due to descending mechanisms that include those that are powered by serotonin and noradrenaline […]
Chronic pain is a real problem in the sporting world. The effects of not being able to participate are far reaching, especially when sport is your profession. There are a huge numbers of clinics offering treatments to deal with pain and injury and in many cases the problem improves. However, there are those who do […]
To the skier, the thought of watching friends and family clumping off in their boots towards the lift whilst sitting with a leg up, packed with ice and the daily paper, is intensely frustrating. Injuries happen. In many cases with the right early treatment, perhaps surgery and definitely a thorough rehabilitation programme, the symptoms resolve […]
Clifford Woolf recently said this about central sensitisation: Nociceptor inputs can trigger a prolonged but reversible increase in the excitability and synaptic efficacy of neurons in central nociceptive pathways, the phenomenon of central sensitization. Central sensitization manifests as pain hypersensitivity, particularly dynamic tactile allodynia, secondary punctate or pressure hyperalgesia, aftersensations, and enhanced temporal summation. It […]
Feeling numb can mean that the self has lost its physical presence, or in an emotional sense, feelings have become blunted. These are both different constructs of loss for which we are compelled to seek an answer, often causing great angst. To step out of the normal sense of self is profound, difficult to define […]
The ‘Living with Dystonia’ Day, organised by the Dystonia Society, was held in London in November. This was an opportunity to talk to neck dystonia sufferers and their carers about the sensorimotor training programme that I am using in conjunction with botox treatment — see here. We have an understanding of how the brain plans and […]
Thich Nhat Hanh, a Vietnamese Buddhist monk who has written and spoken about compassion and mindfulness for many years, talks to Oprah Winfrey. There is a great deal that we can learn from him, in particular the potency of breathing and awareness of the breath that anchors us to the present moment, the only ‘real’ […]