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Back Pain

Sixty percent of adults suffer from back pain every year, and half become chronic sufferers. Back pain is most often the result of poor posture, an injury or overuse, but there are other causes of back pain such as inflammation, and rarer, more serious problems such as progressive diseases affecting bones and joints. Our Physiotherapists are trained to diagnose problems in the joints and soft tissues of the body, and will carry out a comprehensive assessment and treatment plan for your particular problem. Physiotherapy for back pain provides a wide range of treatments to relieve pain, promote relaxation and restore movement. They include manipulation, mobilisation and massage. Exercise may also be used to increase general fitness or to strengthen muscles which support the spine. If you are prone to back pain, we can also offer preventive advice.

What is physiotherapy?

Physiotherapy is a health care profession concerned with human function and movement and maximising potential:

  • It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking account of variations in health status.
  • It is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery.
  • The exercise of clinical judgement and informed interpretation is at its core.
  • The above definition is taken from the CSP curriculum framework (January 2002). Physiotherapists work in a wide variety of health settings such as intensive care, mental illness, stroke recovery, occupational health, and care of the elderly. To build a better picture of the range of conditions that we can treat, see our A-Z of physiotherapy:


    TA fracture is a break in the bone, which is either complete or partial. Most fractures are caused by a sudden injury that puts more pressure on the bone than it can withstand Areas of the body where fractures most often occur include the hand, wrist, ankle, collarbone and the neck of the femur of the hip, which can be the result of a fall. Physiotherapy is used once the bone has been realigned and splinted, usually by encasing it in plaster of paris. We offer advice about positioning of the limb as well as teaching exercises to avoid muscles wasting and to prevent stiff joints. We will also help the person to get used to crutches and other appliances After the plaster is removed, We plans a rehabilitation programme taking into account the person's needs and lifestyle. Using techniques including specific exercises and general fitness programmes, the aim is to reduce any swelling, regain full muscle power and joint movement and to bring back full function.


    Gait, or walking pattern, is a complex activity involving most parts of the body. Our gait varies according to our individual anatomy, our age and whether the walking is fast or slow Physiotherapy is used to help a person learn how to walk again following a disease or injury, or to keep them mobile if they have irreversible problems affecting their walking pattern. Pain, muscle weakness, joint stiffness and nervous system diseases can result in abnormal gait patterns. Wet also work with children with walking difficulties. After assessing a person's gait, We plan an individually tailored rehabilitation programme which may include activities to strengthen muscles, increase range of movement and relieve pain as well as providing walking re-education. We also show the person how to use appropriate walking aids such as crutches and walking frames.

    Knee Replacement

    A knee replacement operation is carried out when the knee is badly damaged by arthritis causing severe pain and impaired motion. Most artificial knees are metal or plastic implants that cover the worn cartilage. After the operation, physiotherapy is essential for getting the best result from the new joint. Using a range of exercises, We will help you to regain muscle strength and movement so that you can walk normally as soon as possible. We 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, we will continue to physiotherapy until you have optimum function from the new joint.

    Repetitive strain injury (RSI)

    RSI is caused by repetitive movement leading to muscular pains or problems with nerves, ligaments and joints to the upper limbs. Usually work related, the incidence of RSI has risen dramatically with the use of word processors and other automated equipment, which need only a limited range of movement. Many groups of working people can be affected, including computer operators, typists, musicians, shop staff and factory workers. We are trained and experienced in treating muscle, nerve, joint and ligament complaints. After assessing the affected person's posture, workplace, lifestyle and work patterns, they will devise a treatment programme This may include stretching exercises, mobilisation and electrotherapy, such as ultrasound, to speed up the healing process. If treatment is delayed, RSI can take longer to clear up. Physiotherapists can also give preventive advice.


    Osteoarthritis is probably the most common form of arthritis. It occurs when the cartilage covering the end of bones becomes thin and worn, making the joints stiff and painful to move. Osteoarthritis develops gradually over years, most often affecting knees, hips, feet, hands, and sometimes the neck and lower back. Physiotherapy plays an important role in treating this painful condition. After assessing your mobility and range of movement, we will devise a treatment programme. A range of techniques are used to relieve pain and stiffness, and to improve mobility, co-ordination and posture. Manipulation and tailored exercises help to ease pain, build stamina and mobilise joints, while hydrotherapy is used to strengthen and relax muscles Other treatments used for pain relief include hot and cold treatments, TENS, acupuncture and relaxation techniques . We also give practical advice on doing everyday household tasks. If surgery is needed to replace your hip or knee, we will help you to regain muscle strength and muscle strength and movement.

    Your Health

    With our detailed knowledge of human anatomy and movement, we can help you to solve all kinds of problems during and after illness or injury, as well as offering preventative advice We work in a wide variety of settings, including hospitals, health centres, GP practices, pay hospitals, workplaces, schools and peoples' own homes. There are 3 main treatment routes if you are resident in the United Kingdom and wish to see a physiotherapist: via the NHS, via private practitioners or via the independent sector.

    ICE-Cryotherapy, Swelling and Pain Relief

    Cryotherapy (which includes ice pack therapy that is used for the application of an ice pack - typically a plastic bag filled with ice) is commonly used to treat pain conditions. Most forms of cryotherapy (eg, ice, cold packs, cold whirlpool baths, cryotherapy-compression units, vapocoolant spray) used as passive physical modalities (these include cryotherapy, heat, and electrical stimulation) of the management and rehabilitation of both acute and persistent pain conditions, provide transfer of thermal energy by conduction, with the exception of vapocoolant sprays (evaporative cooling) and whirlpool baths (convective cooling). The physiologic effects of cold application include immediate vasoconstiction with reflexive vasodilation, decreased local metabolism and enzumatic activity, and decreased oxygen demand. Cold decreases muscle spindle fiber activity and slows nerve conduction velocity, therefore it is often used to decrease spasticity and muscle guarding.

    Ice is one of the most effective treatments used in physiotherapy.

    Why is ice bused as a treatment?

  • Alleviates pain
  • Reduces swelling
  • Reduces muscle spasm
  • When is it used?

  • Acute injuries- in the first 48 hrs it is most effective
  • Chronic pain
  • Inflammatory conditions i.r. RA
  • Precautions for using ice

  • People who have poor skin sensatoin i.e. diabetics
  • Poor/ reduced circulation i.e varicose veins, DVT or arterial disease
  • Recent heart attack - less than 6 weeks ago
  • What to use for ice treatment?

  • Theraflex
  • Frozen towel
  • Crushed ice in a plastic bag
  • Applying ice treatment

  • Check the precautions list to see whether using ice is suitable for you
  • Be aware that there is a risk of getting an ice burn if you are lint careful, therefore, always check the skin for excessive redness throughout the treatment
  • Get in a comfortable position - remember your posture- protect your spinal curves using pillows under your hips and neck
  • Wrap the ice pack in a plastic bag, then a damp towel and then place over the pain. put a pillow on top to secure in place
  • When using ice, the skin should be checked after 5 minutes, and the pack re- applied if no adverse reactions
  • Leave the ice on for a further 15 minutes to gain maximum benefits
  • Warning: be careful not to get an ice burn (blisters) Much of today's use of cryotherapy is in the acute injury stage and/or post-surgical. The common acronym R.I.C.E. is still the best rule of thumb when setting up a treatment program. Otherwise known as REST ICE COMPRESSION and ELEVATION.

    R.I.C.E is very effective in the initial treatment of soft tissue injuries such as sprains, strains, and contusions which we will hit upon in forthcoming posts. A great resource for injury information can be found at So why cold packs and not heat packs? We all know heat generally feels better on the surface but the use of cold therapy physiologically blocks pain. How? When a muscle is in its shortened state, it can program a repeating process to influence nerves in the area to continually spasm. These spasms can be painful but eventually broken with the use of cold therapy. We can get into the gate theory of pain here but we'll save that for a later discussion In a nutshell, the cold pack application is used to bring the muscle back to a more natural resting state without producing more pain. As for compression, this helps to control the swelling and edema over the area. The compression should be comfortable. There are fancy expensive machines ranging from $100 -$1000 that provide this method of treatment however an ActiveWrap Hot Cold System is designed to give targeted relief with comfortable compression over acute areas at a fraction of the cost. Visit for more details Elevation is another important factor to reduce swelling with the help of gravity and the above components. If we're dealing with ankles, legs, and arms these areas should be propped up well above the heart (ala more than one pillow). Gentle soft tissue massage will also help edema control.


    What is Heat?

    Heat can arise from many different sources. heat can be an open fire, sunlight, water bottle, blanket, hot towels and even generated by rubbing your skin!!

    There are ways of heating structures deep within the body, and heat treatments, which heat structures near to the surface of the skin. Heating deep structures involves using equipment such as ultrasound or SWD, which you may have experienced yourself when being treated by a physiotherapist. The treatments, which we are interested in , are the ones that heat the surface of the skin. Examples of these are heat packs, electrical blankets, warm towels, moist towels etc. all these are easily available and are cheap.

    What does it do?

  • Heat causes blood vessels near the skin to increase in size allowing more blood to flow to the effected area.
  • An increase in blood flow brings more oxygen and nutrients to the damaged site as well as removing nasty toxins.
  • Heat also speeds up chemical reactions within the tissues
  • Heat can also be sued for pain relief by stimulation nerves within the tissues which block pain near the spinal cord.
  • Heat decreases joint stiffness
  • All of these together help to promote faster healing of the damaged tissues.
  • Be Aware!

  • Check that you can feel hot and cold skin sensation
  • Check you have no circulatory problem i.e. varicose veins, DVT or arterial disease
  • Make sure you never apply heat packs to open wounds and infected wounds
  • NEVER apply heat packs to tumors or tuberculosis
  • Check that there is no gross swelling
  • Check list for applying heat treatment

  • Check the precautions list to see whether heat treatment is safe for you
  • Always be aware that there is a risk of a burn if the heat treatment you are using is too hot, so be aware of the temperature and make sure it is tolerable on the skin
  • Inspect the area to be treated for cuts, wounds etc. as heat may make these worse
  • If you are using a heat pack, blanket etc make sure it is SECURED! Use another towel to keep it in place if necessary.