GENERAL ADVICE

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STORTFORD GRANGE

Physiotherapy Centre

Jenkins Lane Hallingbury Road

Bishops Stortford Herts CM22 7QL

01279 654020

1. REFERRED PAIN - WHERE DOES IT COME FROM?

PAIN IS NEVER REFERRED UP - IT NEARLY ALWAYS GOES DOWN with very, very few exceptions

The commonest example of this is where you may develop pain in the shoulder or upper arm. The pain may then start going down the arm, even into the hand, BUT it may also be felt in the side of the neck and the muscles on the top of the shoulder. So what might be going on?

Problems with the main shoulder joint will give you pain that starts from the deltoid muscle insertion - about 1/3 of the way down the upper arm. The worse it gets, the further down the arm it goes - even as far as the hand - but the thumb side of the hand.

Problems with the joint between the shoulder blade and the collar bone - on the very top of the shoulder, will give you pain precisely there.

Problems with the neck however, can give you pain from the side of the neck, down into the shoulder, the arm and even down to the hand.

This situation happens because of the nerve supplies to these areas is the same ie from the middle of the neck.

So, if you get pain above the shoulder, it is almost certainly coming from your neck.

At the Centre we come across a number of common misconceptions.

This page is designed to offer simple advice to help patients understand certain principles concerning musculo-skeletal problems and pain.

2. “MOST SIMPLE LOW BACK PAIN IS CAUSED BY STRAINING A MUSCLE”

MUSCLES HAVE A VERY GOOD BLOOD SUPPLY. WHEN YOU TEAR MUSCLE FIBRES - THEY BLEED AND CAUSES BRUISING.

The problem with this idea is that there is never any bruising associated with low back pain, unless there has been a direct injury like a kick to the back in a rugby game.

Most simple low back pain is caused by problems with the various joints of the spine and/or the pelvis joints. This is why manipulation of these joints works. This is why restoring the correct movement of the joints works. The “muscle element” only comes in after correcting the biomechanics of the joints, to correct the weakness or the incorrect timing of the muscles that caused the load on the joints in the first place.

3. PHYSIOTHERAPY IS ONLY ABOUT PROVIDING “EXERCISES AND MAYBE A BIT OF HEAT”!

This is a perennial problem that physiotherapists have had since the late 1800’s when the profession first came into being!

Admittedly, the profession was founded in Massage and Remedial exercises developing along the way during the wars etc where rehabilitation became a more distinct requirement following serious injuries etc.

History of the Chartered Society of Physiotherapy

The Society was founded in 1894 by four young nurses: Lucy Marianne Robinson, Rosalind Paget, Elizabeth Anne Manley and Margaret Dora Palmer. They set up the Society of Trained Masseuses to protect their profession from falling into disrepute as a result of media stories warning young nurses and the public of unscrupulous people offering massage as a euphemism for other services.

By 1900, the Society acquired the legal and public status of a professional organisation and became the Incorpororated Society of Trained Masseuses. In 1920, the Society was granted a Royal Charter. It amalgamated with the Institute of Massage and Remedial Gymnastics. As the Chartered Society grew in strength, branches and local boards were established all over the country and in 1944 the Society adopted its present name, the Chartered Society of Physiotherapy (CSP), being more representative of the field of work it covered.

In 1968 and 1970 respectively, the Faculty of Physiotherapists and the Physiotherapists Association Ltd amalgamated with the CSP. In 1976, the Society was certified as an independent trade union. In the same year, the first degree course in physiotherapy was established.

In 1977, the Department of Health memorandum HC(77)33 instituted professional autonomy for physiotherapists. In 1978 a bye-law change in the Society's statutes finally allowed physiotherapists to treat patients without prior medical referral. The Society of Remedial Gymnastics and Recreational Therapy merged with the CSP in 1985.

In 1986 student physiotherapists were admitted as members in order to involve them more closely in the development of the Society. In 1992, the profession became an all graduate entry profession. In the same year, the Society affiliated to the Trade Union Congress.

In 1994, the Society allowed physiotherapy assistants to become associates

GENERAL ADVICE