BSc MSc Grad Dip Phys MCSP MSOM DipInjTher
We treat an enormous range of patients with a huge array of conditions, but in all cases we are committed to delivering effective treatment. Unique amongst physiotherapy clinics in this country, we have audit figures going back 27 years, so we are able to constantly review our treatment success rates. In addition, Tony Wilson’s ongoing commitment to research and teaching means he is always fully up-to-date with the latest advances in musculoskeletal medicine. However, if we do not think physiotherapy is appropriate for you or is not the most effective treatment available, we have extensive knowledge of and good contact with other specialist clinicians in the South of England and we will be able to refer you to the most appropriate surgeon, physician, podiatrist etc for your particular condition.
Treatments available at the clinic include:
Physiotherapy involves the use of specialised manipulation, mobilisation and rehabilitation techniques to decrease pain and restore function in musculoskeletal conditions. It has been shown to be effective, either on its own or in conjunction with the treatment interventions below, in the vast majority of common soft tissue problems, including back pain, neck pain, sciatica, and most types of muscle, tendon, joint and ligament injuries and conditions.
This is a technique used in 2 main ways:
To treat myofascial pain in painful, tense or shortened muscles. It involves inserting needles in to trigger points to de-sensitise these local painful foci, and so reduce spasm and discomfort. It is particularly effective in muscular back and neck pain. This technique is sometimes called intra muscular stimulation.
To treat chronically inflamed tendons. It involves repeatedly inserting a small hypodermic needle in the affected area 5-10 times to produce a minor acute inflammatory reaction. This brings reparative cells to the area and re-starts the healing process, which is then appropriately managed to produce full resolution. In this way it is thought to mimic one of the main mechanisms for surgical success in these conditions.
This refers to the use of a specialised biofeedback machine, which is applied to a muscle or group of muscles when performing a particular movement or activity. It provides both visual and aural feedback to the patient as to the strength of contraction of the specified muscle(s). It is of great use in re-training weakened or inhibited muscles post surgery or trauma.
Several types of different injection interventions are available at the clinic:
Steroids are potent anti-inflammatory agents and are the most common injectable intervention used in musculoskeletal medicine. When injected accurately, often in combination with a local anaesthetic, they have been shown to be effective in a huge variety of joint and soft-tissue conditions. They are particularly useful in the treatment of frozen shoulder, rotator cuff/impingement syndrome, osteoarthritis, post-traumatic joint inflammation, wrist/hand tendon sheath conditions, bursitis and certain ligament injuries.
Viscosupplementation (Sodium hyaluronate/hyaluronic acid)
The majority of joints in the body, certainly the ones involved in musculoskeletal conditions, are synovial joints. These joints contain synovial fluid, which bathes the articular cartilage that covers the ends of each bone. The destruction of this articular cartilage is the process that leads to arthritis. An essential component of synovial fluid is sodium hyaluronate, which enables the synovial fluid to act as both a lubricant and a shock absorber, and so protects the articular cartilage from damage. In viscosupplementation, sodium hyaluronate is injected in to the affected joint and works by restoring the normal balance between the natural breakdown and production of sodium hyaluronate. It has been shown to be effective long term in decreasing the pain and stiffness associated with osteoarthritis.
Local anaesthetics/nerve blocks
This involves the injection of local anaesthetic +/- a steroid around a nerve to reduce symptoms associated with compression of that nerve. It is most often used in the treatment of carpal tunnel syndrome, a very common condition resulting in pain and/or numbness/tingling in the hand. It is also used around the shoulder in chronic, unresolving shoulder pain, and around the ankle in tarsal tunnel syndrome.
The Western approach to acupuncture is practised at the clinic. Following an appropriate diagnosis, very fine needles are inserted in to the skin to stimulate sensory nerves. This has the effect of relaxing muscles, decreasing spasm and reducing pain. The precise mechanism of pain relief is not known, but it is thought to derive from both the local desensitisation of trigger points and the release of endorphins. It is particularly effective in muscular back and neck pain, tension-type headaches and osteoarthritis of the knee.