Physical Medicine and MSK
PHYSICAL MEDICINE IS WHAT WE DO. This includes the diagnosis and treatment of conditions that can affect any part of the skeleton – the joints, nerves, muscles, tendons and ligaments etc. In short, our aim is to find out what is stopping you from moving freely and without pain and then put together a Treatment Plan that is specific to your needs, which includes a full rehabilitation programme and how not to do it again.
These problems are usually called Musculo-Skeletal conditions (MSK) and include back and neck pain; sports injuries; sprains and strains etc etc and are commonly treated with exercises and massage. We don’t.
What makes the difference is the diagnosis. We can do “simple” injuries and all the way up to complex movement pathologies, neural dynamics and chronic pain.
Our treatment “toolbox” is extensive. We can, and do, manipulate necks and backs, but we also have a whole range of other manual therapy techniques running alongside acupuncture, Interferential Therapy and tailor-made rehabilitation programmes. And now we have the Alter G Anti-gravity treadmill!
What moves us into Physical Medicine is that we also treat asthma, IBS, headaches and migraines, eczema, hay-fever, dysmenorrhoea (painful periods), wounds and some circulatory disorders.
Yes, we are Physiotherapists – but not as you know it! – and we believe that the service we provide is second to none.
Musculoskeletal medicine (MSK)
MSK is the examination, diagnosis and treatment of non-surgical problems of the musculoskeletal system including disorders of joints, ligaments, muscles and tendons.
Orthopaedic Medicine, as a distinct speciality, was the culmination of more than 50 years work by Dr James Cyriax who founded the speciality at St Thomas’ Hospital, London. He developed a logical system of assessment, aiming to identify MSK disorders accurately and quickly.
The important point here is that Dr Cyriax developed this entire system of examination for structures and conditions that don’t show on X rays. This includes the discs between the vertebrae in the spine, as well as all the muscles, ligaments and tendons.
With the advent of MRI, we can now actually see these structures. What is not always appreciated is that although damage to a particular structure can now be seen on an MRI, it still doesn’t tell you which structure is actually causing the pain and problem. It is movement, or loading of these structures that is far more accurate in diagnosing the problem.
Dynamic MRI has been developed to try and overcome this problem, but they are very expensive and few and far between as yet.
Another useful tool is the dynamic ultrasound scanner. These are considerably cheaper than MRI and don’t need specially designed rooms etc, but again the most accurate diagnostic tool is a detailed clinical examination. X rays and scans are there to identify any really serious pathology. Within our clinical examination are tests that will indicate serious pathology if present, but not give the precise detail. If we have any concerns then patients are referred to their GP for further medical tests.
In 2016, we started our own research projects to provide even more evidence of the benefits and value of the treatments we now offer.