Article - anrc-uk.com

19 Apr

Heel Pain (Plantar fasciitis)

Heel Pain (Plantar Fasciitis) Introduction Heel pain is a very common problem that may be attributed to several etiologies, including heel spurs, plantar fascia irritation (acute or chronic), and bursitis. Plantar fasciitis is thought to result from microtears in the fascia due to repeated biomechanical stress on the arch of the foot on weight-bearing. Plantar fasciitis is an inflammation of the plantar fascia & the perifascial structures. Chronic stress to the origin of this fascia on the calcaneus may cause calcium to deposit, forming a spur (plantar calcaneal spur). Plantar Fascia is a Dense, broad band of connective tissue attaching proximal and medially to the calcaneus and fans out over the plantar aspect of the foot and works in maintaining the stability of the foot and bracing the longitudinal arch. The pain is maximal when the patient first stands in the morning and tends to decrease with walking. Ten percent of people may experience pain under the heel (plantar heel pain) at some time during their life. Cause Plantar fasciitis is the most common cause of heel pain in the adult population with an incidence of around 10%. It affects adults across the age spectrum with an incidence in women twice that of men. Ethnicity does not influence incidence. There is a higher preponderance in those who play sport either recreationally or professionally. Increased body weight and an increased body mass index (BMI) have also been shown to be significant risk factors for developing plantar fasciitis. Pregnancy, flat feet, high arched feet, poorly fitting or worn footwear, Calf muscle tightness, gait abnormalities, prolonged standing, running, jumping and walking are additional contributory factors. Excessive lumbar lordosis—a condition in which an increased forward tilt of the pelvis produces an unfavourable angle of foot strike when there is a considerable force exerted on the ball of the foot—can also contribute to this problem. Running on soft surfaces are also potential causes of plantar fasciitis. Clinical features Assessment Looking for Swelling, Arches, Deformity, Gait, posture, tenderness, Tight Structures etc & History Summary For the treatment of heel pain or plantar fasciitis, research has not indicated any consensus on a specific treatment regimen that has proven to resolve heel pain with any statistical significance. However nonsurgical treatment is ultimately effective in approximately 90% of patients. It is equally important to correct the problems that place individuals at risk for plantar fasciitis, such as the increased amount of weight-bearing activity, increased intensity of activity, hard walking/running surfaces and worn shoes. Early recognition and treatment usually lead to a shorter course of treatment as well as an increased probability of success with conservative treatment measures S.M.A.R.T. approach to prevent plantar fasciitis The Canadian Physiotherapy Association (CPA) Calf and Achilles stretching is achieved by performing asymmetrical stretching exercises ANRC Phases of Rehabilitation Phase 1- Pain Relief (Trigger Point Therapy, Myofascial Release, Sports massage, Taping, Electrotherapy modalities, Postural Correction, Basic Home exercises etc) Phase 2- Restoration of Range of movement and muscle length (Stretches, Exercises for the small muscles of the foot, Postural training, Basic Strength Training, Orthotics if needed) Phase 3- Maintenance Phase & Improve the activity of daily living (Intensive Strength Training, Ergonomic Modifications in Sports & Daily Activities Reference

6 Apr

Myofascial Pain Syndrome

Musculoskeletal disorders are the main cause of disability in the working-age population and are among the leading causes of disability in other age groups. Myofascial pain syndrome is a common painful muscle disorder caused by myofascial trigger points. Pain and limited function of the locomotor (or musculoskeletal) system are two of the most common reasons for consulting a doctor or therapist. The fascia & muscles have a key role in this, because of their anatomical and functional properties. The importance of the muscles is frequently underestimated in practice, however, although muscular imbalances, muscle tension and painful disorders of muscle function play a large part in both acute and chronic locomotor system symptoms, according to current knowledge. The clinical correlate is the myofascial trigger point (mTrP). We rely for the most part on the guidelines of the pioneers in the field of trigger point research, Janet Travell and David Simons (Travell, Simons 2002). Simons et al. (1999) have claimed that myofascial trigger points (TrPs) from neck and shoulder muscles might play an important role in the genesis of mechanical neck pain. There are epidemiological studies suggesting that TrPs represent an important source of musculoskeletal disorder (Chaiamnuay et al., 1998). We understand the mTrP to be a site or band that is hypersensitive and palpably tense compared to the surrounding area in a muscle that is often shortened, and which demonstrates changes in tone and consistency (‘taut band’). It is painful when palpated and from it pain and autonomic disorders may be caused in an area that cannot usually be attributed to a particular segment (‘referred pain’). We describe the resulting muscle pain as myofascial pain syndrome (MPS). The formation of TrPs may result from a variety of factors, such as severe trauma, overuse, mechanical overload or psychological stress (Simons et al., 1999). Recent studies have hypothesized that the pathogenesis of TrPs results from injured or overloaded muscle fibres. This leads to involuntary shortening, loss of oxygen supply, loss of nutrient supply and increased metabolic demand on local tissues (Mense et al., 2000). Diagnostic criteria are: A localised, dull, pressing, dragging, occasionally burning spontaneous pain associated with acute or chronic muscular strain The pain is often described as spreading or radiating. Referred pain is an important characteristic of a trigger point Tenderness with typical pain reproduction within a palpable ‘taut band’ of muscle, A pain that predominantly radiates in a distal direction after mechanical stimulation, Painful limitation of movement, Muscular weakness without atrophy. As these are not ‘hard’, evidence-based criteria but subjective information and findings, an appropriate finding oriented medical differential diagnosis is an indispensable prerequisite for making the diagnosis of ‘myofascial pain’ with or without limitation of movement In the head and neck region, myofascial pain syndrome with trigger points can manifest as tension headache, tinnitus, temporomandibular joint pain, eye symptoms, and torticollis. Upper limb pain is often referred and pain in the shoulders may resemble visceral pain or mimic tendonitis and bursitis. In the lower extremities, trigger points may involve pain in the quadriceps and calf muscles and may lead to a limited range of motion in the knee and ankle. The muscular fascial network suggests the following applications in relation to trigger points: pain sensations caused by trigger points supposedly originate mostly from fascial receptors which have undergone sensitisation. A possible treatment plan is a therapeutic stimulation and proprioceptive sensitisation of other fascial receptors (preferably in the area belonging to the same cortical area). Fascial changes supposedly also play a key role in changed muscle stiffness in the area around a trigger point as well. Principles of Treatment: PHYSIOTHERAPIST –PATIENT RELATIONSHIP: The key influential factor for the success of treatment is a ‘healing’ physiotherapist–patient relationship. In patients with chronic myofascial pain, in particular, psychosocial stress factors must also be evaluated and included early on in the consultation. The treatment plan for myofascial trigger point therapy (MANUAL TECHNIQUES AND DRY NEEDLING) – Ischaemic compression of the mTrP, Manual stretching of the mTrP region Fascia stretching technique, Manual stretching of the superficial and intramuscular fascia etc Functional training, ergonomics, Physiological weight-bearing and exercise support the regeneration process and make the muscles more resilient Ergonomics reduces incorrect strain on the muscles Summary The aim of trigger point therapy is to provide a permanent cure for myofascially caused pain and functional disorders. Otherwise, recurrences inevitable This requires: finding the relevant active trigger point, deactivating the relevant trigger point using manual techniques and/or dry needling, providing thorough manual treatment of the connective tissue changes which occur as a reaction, especially with chronic symptoms, recognising the factors which cause the problem to persist and including them in the treatment process Predisposing and perpetuating factors must be recognised and included in the treatment strategy in the form of ergonomics and functional training of the muscles ANRC Phases of Rehabilitation Deactivation of trigger points and Pain Relief ( Trigger Point Therapy, Myofascial Release, Taping, Electrotherapy modalities, relaxation Training etc) Restoration of Range of movement – Stretches, Postural training, Basic Strength Training Maintenance Phase & Improve the activity of daily living – Intensive Strength Training, Ergonomic Training etc Reference Myofascial Trigger Points Comprehensive diagnosis and treatment; Edited by Priv. Doz. Dr. med. Dominik Irnich: Toronto 2013 First edition published in English © 2013, Elsevier Limited. All rights reserved. Trigger Points: Diagnosis and Management DAVID J. ALVAREZ, D.O., and PAMELA G. ROCKWELL, D.O., University of Michigan Medical School, Ann Arbor, Michigan. Myofascial trigger points in subjects presenting with mechanical neck pain: A blinded, controlled study C. Ferna´ ndez-de-las-Pen˜ as_, C. Alonso-Blanco, J.C. Miangolarra Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorco´n, Spain Received 12 November 2004; received in revised form 4 January 2006; accepted 3 February 2006

6 Apr

What is iliotibial band syndrome and how is it treated?

Iliotibial (IT) band syndrome is often caused by repetitively bending the knee during physical activities, such as running, cycling, swimming, and climbing. The IT band is a group of fibers that run the length of the upper leg, from the hip to the top of the shin.The best treatment is often to stop doing the activity that is causing the pain. In more severe cases, surgical options may need to be considered. Symptoms 1) Pain when running or doing other activities involving the outside of the knee2) A clicking sensation where the band rubs against the knee3) Lingering pain after exercise4) The knee is tender to touch5) Tenderness in buttocks6) Redness and warmth around the knee, especially the outer aspect Treatment IT band syndrome is often relatively easy to treat. There are two main types of treatment for the condition: 1) Reducing pain and swelling2) Stretching and preventing further injury Some of the most common ways to treat IT band syndrome include: 1) Resting and avoiding activities that aggravate the IT band2) Applying ice to the IT band3) Massage4) Anti-inflammatory medications, which are often available overthe counter5) Ultrasounds and electrotherapies to reduce tension (News from medical news today) Us our contact form or call today our ANRC Physiotherapy clinics in Horsham, East Grinstead, West Sussex or Lingfield, Surrey which Physiotherapy or Sports injury treatments.

4 Apr

What is a Muscle Knot and How we can treat it?

The medical term for muscle knots is myofascial trigger points. These are occur when muscle fibers or the bands of tissue called fascia underneath them tense and tighten. Symptoms: These knots can develop almost anywhere on the body where muscle or fascia is present. The knots feel as if they are small, hard lumps or nodules. A person may have to press deep into their connective issue to feel the knots or trigger points. These knots commonly occur calf muscles, lower back, neck, shins, shoulders. Causes: Common causes of muscle knots include: Stress and tension, injuries related to lifting and repetitive motion, poor posture, prolonged bed rest or sitting without stretching. A person who spends a significant amount of time sitting at work may develop muscle knots due to staying in the same position for prolonged periods. sedentary lifestyle. People who play sports or work with their hands may also be at risk because they engage in repetitive activities. Repeatedly, doing the same motion can cause tension and knots over time. How to treat at home? People may want to try home remedies, which are often the first line of treatment for muscle knots. The individual should begin by evaluating why their muscle knots might have occurred. If someone’s muscle knots are due to prolonged sitting or a prior muscle injury, engaging in regular stretching breaks may help reduce muscle tension. People can also try: Applying a cloth-covered heat pad or ice pack to the affected area. Aerobic exercise, such as swimming, jumping jacks, and cycling to loosen tight muscles. Taking anti-inflammatory medications, such as ibuprofen to reduce muscle pain. If stress is the cause of someone’s muscle knots, they can take steps to reduce it, including: Taking short stretching and deep breathing breaks during the day Exercising for 30 minutes a day Reading a book or listening to music Getting more sleep at night Spending at least 15 to 30 minutes a day on relaxation techniques, such as meditation or gentle yoga

3 Apr

Rocker bottom shoes

Rocker bottom shoes help strengthen back muscles, reduce low back pain Sports Physiotherapy- Researchers of the Sports Physiotherapy master’s degree at Valencia’s CEU Cardenal Herrera University have confirmed, in a new study of their research work into back pain, that unstable shoes improve the strength of back muscles in order to maintain balance and stability when walking. Forefoot Rocker Sole: A rocker placed just behind the metatarsal heads is much effective at reducing pressure under the ball of the foot and reducing motion in the toe joints. Thus we use it for treating hallux limit us (big toe arthritis) and ball-of-foot pain. Physiotherapy Horsham, Physiotherapy East Grinstead. Heel to Toe Rocker Sole: This type of rocker sole has the thickest point farther back on the shoe. This type of rocker shoe can be effective for limiting ankle and midfoot movements. Thus, it is helpful when a patient has ankle arthritis or midfoot arthritis. It also can reduce pressure on the heel at heel strike, as the foot rolls faster off of the heel. To contact our Physiotherapy clinic in Horsham or Physiotherapy in East Grinstead please contact us on info@anrc-uk.com, www.anrc-uk.com ANRC Physiotherapy clinic deals with Sports physiotherapy, MSK physiotherapy, and domiciliary physiotherapy How to self-manage foot pain and swelling Try these things for a week: If you can, avoid standing on it-put as little weight as possible on the foot Apply an ice pack (or a bag of frozen peas in a towel) on the foot for up to 20 minutes every 2 to 3 hours Wear comfortable shoes – for example, avoid shoes with heels Take paracetamol

17 Dec

Ayurveda Massage Therapy

Have you ever felt that you could benefit from a deep, all-the-way-to-your-core cleanse? Or perhaps you feel so depleted and fatigued that you sense a need for deep rejuvenation and nourishment? Is your mind so cluttered that you have a hard time finding the calm within? If so, consider giving yourself the gift of panchakarma/Massage therapy or any of the other healing therapies offered at ANRC Physiotherapy Clinic – massage therapy- Horsham and East Grinstead. This could be the best gift you ever give yourself; the gift of health, and a return to your own true nature. The Ayurvedic Spa at ANRC Physiotherapy Clinic is a place to relax and be nurtured. Using traditional Ayurveda massages, our intention is to restore your sense of balance and well-being, returning you to the level of energy you desire. The nourishing treatments build up the health of the immune and nervous systems and provide you with a fresh start as you complete each three-day programme. Ayurvedic Massage / massage therapy brings instant benefits on physical, psychological and energetic levels, among them: Reduces muscle tension and stress Improves mobility Realigns body posture Improves breathing capacity Increases the circulation of body fluids Balance the proprioceptive sensitivity Reconstitutes energy reserve indication The massage therapy contributes to the alleviation and recovery of injuries and diseases, such as: Joint and muscle related aches Breathing difficulties General problems related to stiffness from lack of exercise Disorders of intestinal/digestive organs Stress, anxiety, depression Headaches Sleep disorders For more information contact as info@anrc-uk.com, www.anrc-uk.com. Physiotherapy Horsham, Physiotherapy East Grinstead

18 Oct

The Whiplash Injuries/ Neck Pain

The Whiplash Injuries/ Neck Pain – Physiotherapy near to me Motor vehicle accidents result in many patients with chronic head and neck pain, some of which meet the criteria for a (The whiplash Injuries)“whiplash syndrome.” The cervical zygapophysial joint synovium, muscular, and ligamentous strains and other anatomical sites are often implicated in the pathophysiology of these cases. Some patients have a characteristic constellation of vague neurological symptoms, often including a headache, posterior neck discomfort, dizziness, nausea, and sometimes visual changes. The pain that results from whiplash injury may come from injury to the muscles in the neck and Shoulder region, or from injury to the spinal joints or intervertebral discs. Either muscle injury or spine injury can reduce the ability to turn the neck. Limited movement of the neck is an important sign of ongoing muscle or joint problems. Physiotherapy Horsham and East Grinstead Early mobilization of the neck to maintain movement is an important principle of treatment; early treatment is therefore directed toward relieving pain and restoring full motion to the neck. In summary, persistent symptoms after whiplash injury should be evaluated to identify the causes, because they can frequently be treated and corrected. This is true when symptoms have been present only for a short time, but it is also true when symptoms have been presented for months and even years. Contact physio Horsham mailto:info@anrc-uk.com The Physio East Grinstead and Physio Horsham offer detailed assessment and physiotherapy management of Whiplash injuries. Late Whiplash Symptoms- Physiotherapy East Grinstead Chronic cervicogenic headaches may be associated with reduced cervical ROM (especially extension), dizziness, and ipsilateral shoulder Payne Late Whiplash Syndrome Cervicogenic vertigo has only recently been recognized in the clinical and scientific domain as a pathological condition that may result because of whiplash. Symptoms of dizziness and impaired balance may occur soon after the neck injury. Local Cervical Syndrome is a disorder that involves local neck complaints, such as neck pain and stiffness. The primary pain generator may be associated with a disc-related or joint-related disorder. In the case of Late Whiplash Syndrome, the symptoms may arise because of a combination of these etiologies. Cervico–Brachial syndrome involves complaints in the local cervical area and one or both upper extreme. Physiotherapy for Whiplash injuries/ Neck pain – physio near Horsham. Most whiplash patients will start to feel better within a few weeks of the injury. Your physiotherapy treatment will aim to: Reduce neck pain, headaches, and inflammation. Normalise joint range of motion. Strengthen your neck muscles. Strengthen your upper back muscles. Improve your neck posture. Normalise your muscle lengths and resting muscle tension. Resolve any deficit in neural tissue extensibility. Improve your neck proprioception, fine motor control, and balance Improve your ability to cope with everyday activities, plus more stressful ones such as lifting. Minimise your chance of future neck pain or disability. We strongly suggest that you discuss your specific whiplash injury after a thorough examination from a physiotherapist who specializes in whiplash associated disorder. Physio near to me- Sit up straight- Postural syndrome is essentially repetitive stress to the neck and thoracic spine, or the 12 vertebrae of the mid-back and chest area, from the so-called flex-forward position. Doctors and physical therapists say that the injury commonly targets the fourth, fifth and sixth discs in the thoracic spine, leading to muscle tenderness, stiffness or, in some cases, nerve irritation. Sure, most office workers and their ergonomic specialists are familiar with the dangers of repetitive motions with a mouse and keyboard at the PC all day, resulting in weakened wrists, tennis elbow or, worse, carpal tunnel syndrome. But some physical therapists say that such injuries lately are taking a backseat to patient complaints of pains in the mid- to upper back and neck. “We call it the flex-forward posture, where your head’s jetting forward, the abdominals shut down and the majority of the pressure comes to the mid-back,” said Caroline Palmer, a physical therapist at the Stone Clinic, based in San Francisco. “Your spine is going to have to give somehow.” Physiotherapy Horsham and East Grinstead A prolonged slouch over many years causes the disc space to narrow, which in turn can cause nerve irritation that spreads underneath the shoulder blades, down the arms, and down the back. If you’re reading this article with hunched shoulders and a craned neck, your “computer slump” could one day give way to what some physical therapists call “postural syndrome.” contact us Info@anrc-uk.comMedical Tourism

17 Oct

Upper Back Pain Management at Physio Horsham

Upper Back Pain at Physio Horsham Medically the area requiring upper back pain physiotherapy is known as the thoracic spine, which consists of a series of vertebrae, discs, muscles, and ligaments as well as rib articulations coming off the side of each of these thoracic vertebrae. Upper back pain can be as a result of stress or injury to any of these structures causing pain anywhere from the base of your neck to your rib cage. Although perhaps not as common as low back pain or neck pain, complaints requiring upper back pain physiotherapy are still relatively common. In physiotherapy, ANRC Physiotherapy locations patients complaining of upper back pain is a regular occurrence because sedentary postures at the desk are a common cause of stiffness or tightness in thoracic structures. Common Upper Back Pain Complaints Seen In Physiotherapy ANRC Physio Clinics Prolonged repetitive, forceful or awkward hand movements “Static loading” or holding a posture Poor conditioning of the heart and lungs, and poor muscle endurance Direct mechanical pressure on tissues Cold work environment Poorly fitting furniture Basic inadequacies of workstation design Work organizational and psychosocial issues Similar to low back pain the thoracic spine can suffer from bulging and degenerative discs, pinched nerves, facet joint pain, muscle pain but as well as these other conditions requiring upper back pain physiotherapy can include: Ankylosing spondylitis: Ankylosing spondylitis is a disease causing inflammation and pain in the spine and other joints such as the shoulder, hips, knees, ankles and between your sternum and ribs. Scheuermann’s Disease: Scheuermann’s Disease is a developmental disorder of the spine causing the abnormal growth of the thoracic vertebrae. Thoracic Spondylosis: Thoracic Spondylosis a common form of arthritis in the spine and is one of the most common causes of upper back pain and stiffness once aged over fifty. Side Strain: Side strains also commonly cause thoracic region pain and are strongly related to fast bowlers in cricket, specifically related to bowling speed with the fastest bowlers much more likely to suffer this type of injury. High-Risk Groups Computer users Checkout clerks Musicians Hairdressers Health professionals: surgeons, dentists Nurses Butchers Massage therapists Sportspersons Laboratory workers Children Teachers Housewives Manual labourers Assembly line workers Assistants Management Of Upper Back Pain Upper back pain management at physiotherapy physio East Grinstead practices key aim is to restore normal function and improve any required strength and mobility in the thoracic spine and related areas. Upper back pain physiotherapy following assessment and diagnosis will use a combination of techniques to achieve the above goals. As previously stated upper back pain isn’t as common as low back pain and neck pain however at ANRC Physiotherapy Clinic each year we see a substantial number of patients complaining of upper back pain as a result of a variety of triggers including overuse, poor posture, unaccustomed activity or injury, caught early upper back pain physiotherapy can be a very successful way to manage thoracic complaints of musculoskeletal origin. The trademarked Skilled Hands-on Approach for Release of Myofascia, Articular, Neural and Soft-tissue mobilization (SHARAN) rehabilitation protocol management is followed. There are four interlinked phases here. Phase 1 – Severe discomfort in the initial stage: Management – Myotherapy soft tissue mobilisation, neural mobilisation, rib mobilisation, clavicular mobilisation, scapula thoracic mobilisation and physiotherapeutic modalities like IFT, US. These are followed by assisted stretches. Phase 2 – Moderate discomfort in the upper limb and neck region: Management – It is a follow up to Phase 1 which includes more self-stretching exercises, a range of motion exercises and relaxation techniques like breathing exercises, Alexander techniques and yoga therapy. Phase 3 – Mild discomfort: Management: In this phase, continue with self-stretching exercises, free exercises and begin progressive strengthening exercises followed by relaxation techniques. Phase 4 – Maintenance phase: Management – This consists of postural maintenance, generalized whole body stretching and strengthening exercises in order to maintain the length and strength of muscle. Physio Horsham and physio East Grinstead advice -Adequate micro and macro breaks should be taken in between work: Do the stretches and strengthening exercise at least thrice a week. If there is any flare-up of symptoms in phase 4, stop all the exercises and immediately consult a physiotherapist for further clarification. Find out physio near to me

16 Oct

Suffering from Low back pain ? Physio Horsham and East Grinstead.

The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet. Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain. There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of low back pain helps determine the cause. Range of Lower Back Pain Symptoms- Physio Horsham and East Grinstead Low back pain can incorporate a wide variety of symptoms. It can be mild and merely annoying or it can be severe and debilitating. Low back pain may start suddenly, or it could start slowly possibly coming and going and gradually get worse over time. Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example: Pain that is dull or achy, contained to the low back Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet; can include numbness or tingling (sciatica) Muscle spasms and tightness in the low back, pelvis, and hips Pain that worsens after prolonged sitting or standing Difficulty standing up straight, walking, or going from standing to sitting. Physiotherapy for low back pain- Physio near to me For many patients, it is best to follow a stretching routine that has been individually designed for them by a physical therapist or a spine physician. As a general rule, low back pain patients should focus on stretching the lower back muscles, abdominal muscles, hips, and legs. When to see a physio If your back pain is not settling with simple self-care options it can be helpful to make an appointment to see a physio. Your physio can provide treatment to relieve the pain and they can also teach you how to look after your back and prevent future episodes. If you have a long-term back problem the physio can design a suitable exercise program for you. Find a physiotherapist near you. Other indications that it is time to call your physio include: Back pain following trauma Back pain accompanied by pain, numbness, pins, and needles in your leg(s), and weakness or balance problems. If your back pain is accompanied by fever/feeling unwell or bladder/bowel disturbance, you should see a doctor immediately. Physio Horsham and East Grinstead may prescribe a tailored series of exercises to prevent and manage injury and help optimise your health. As you can see while lower back pain is common, the diagnosis of the cause of your back pain is specific to you and therefore the treatment or investigation pathway does vary from case to case. A spinal health care professional can assist you a prompt diagnosis, early referral, acute and chronic back pain relief, plus long-term self-management or back pain prevention strategies specific to your back pain. You should feel confident that your practitioner has screened you for specific pathologies that require urgent medical attention. Plus they should also assess you for any neurological deficits such as loss of bowel or bladder function, leg muscle weakness, loss of sensation, diminished reflexes and day-to-day function to determine whether you have a radiculopathy or stenosis, which may require different treatment options to nonspecific low back pain or radicular pain. Read what is our patients telling us: I visited Praveen having been referred by BUPA. I was suffering from lower back and referred pain around the ribs. He quickly established what was causing the problem and following 7 sessions, over a period of time where a number of different techniques were employed, I was able to resume exercising in the Gym. He further diagnosed that the problem would be improved if I visited a podiatrist. As a result, I am now without pain. Praveen takes a holistic approach, has a range of techniques to solve problems, and is flexible with his appointments and I recommend him highly. Regards, Peter Jones. For specific guidance regarding your condition, please seek the individual assessment from a health practitioner with a special interest in back pain, such as a musculoskeletal physiotherapist. If you have any questions, physio near to me, please contact physio Horsham and physio East Grinstead at info@anrc-uk.com Medical tourism packages are available- please ask to www.anrc-uk.com

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