The top physical symptoms are:
- Reduced Physical Ability
- Breathing Problems
- Tension Stress
90% of people who book in for a consultation have pain.
In fact pain is a very big topic. Pain, is complicated, distressing and upsetting. Pain gets in the way. When pain is really bad it stops people from sleeping, working. Basically it stops people from just being able to function day to day. Sometimes pain can be so bad that the person has pain constantly.
We can divide pain up into new pain, which is pain from an area where you haven’t had pain before. Old pain, which is a recurrence of an old familiar symptoms. Or persisting pain, which is pain which never really seems to go away but hangs around inside your system. Sometimes in a somewhat controlled manner and at other times like an unpredictable adolescent seemingly triggered off by nothing in particular apart from maybe a change in the weather.
The list of medical problems that include the symptom of pain, is huge. Almost all the ‘itis’ and ‘ology’ conditions have pain as a symptom. In fact just about anything which goes wrong with the body can cause people to feel pain.
What’s worse, is that pain can even be magnified by emotion, stress, worry and fear.
The list of places people can get pain is big. From head to toe no place is exempt. From headaches and migraine, facial pain, jaw pain, pain from what can seem like anywhere in the spine, all joint areas, inside joints, next to joints, in muscle and soft tissue. Pain when you stand, when you don’t stand, when you walk or sit or run or hop or bend or twist a joint. Basically anyone can feel pain from anywhere, inside, on the surface and in the case of phantom limb pain, even outside their body.
In some extreme pain problems, the sensation can just be everywhere. In every joint, every soft tissue area of the body on even the slightest movement. Just breathing can cause pain. Sometimes skin can become so sensitive that even the lightest touch can feel like excruciating pain.
So it would be fair to say that after 37 years of working in clinic, Jill has a lot of experience and is very good at treating and advising on the best management of all kinds of pain.
When you book in for advice and treatment a big part of your assessment will focus on discovering more about your pain. At the first consultation what’s very important is to exclude any other symptoms that seem to link with the pain. Jill looks out for ‘flags’, signs that the pain could be a part of a bigger more worrying pathology. Fortunately that’s not very common in clinic because GP’s are very good at spotting ‘flags’. However it’s always wise to check to be sure, just to make certain nothing has been missed which needs more in depth medical exploration.
Because pain is such an interesting and big topic I will write more about how it can be divided up and how different kinds of pain can be not only treated by also how risks of developing persisting pain can be reduced.
- Reduced Physical Ability
This is at number 2, but perhaps it should be right up there at number 1, level with pain.
That’s because not being able to ‘do’ things, physically, is very impairing. People bring all manner of physical problems to clinic, because this is a critical part of Physio, Physical, therapy.
Physical therapy is a profession that enables people to be able to do what they want to in their lived physical experiencing of the world.
Physical activity is in every aspect of life. Imagine a life without any ability to do anything physically. That includes breathing, speaking, moving eyes, eating. Physiotherapy addresses the way that an individual uses their body to do everything in life that they want to. All day, even when we are asleep, we are moving.
We move at every age, from baby to senior citizen. So people can come along with every form of movement problem. That can include poor movement control, habits of movement, weakness, poor balance. It can include movement related problems from neurological conditions like Parkinson’s or MS or peripheral neuropathy or brain injury and stroke.
At the clinic Jill can not only work with the physical aspect of moving, but she also advises interphases, aids and appliances. That can include advice on adaptations and aids for work. Mobility aids to improve ability to walk and get around in a wheelchair. She can advise on splints, help amputees with their prosthetics and increasingly advise on tech gadgets to support fitness training.
At the clinic it’s not just people with disability who benefit, because training can extend to athletes. How an athlete stands when they go to perform a lift. How they walk and run and throw and how to make the actions they make, optimal, is Physio work
There are so many problems people bring to clinic and more on this topic in another blog to come.
This is another very common symptom because tissue damage causes tissue fluid to be released. Swelling can be local to the site of an injury, so someone with a classic recent ‘sprained ankle’ which is where the soft tissues have been damaged to varying degrees, will have swelling. In the early days it’s a kind of soft spongy, springy to the touch swelling. Lots of injuries cause the body to produce this extra fluid as part of the healing process. So swelling near soft tissue trauma is common.
But swelling can also show up around joints where the joint surfaces are getting slightly worn. So maybe if the worn joint is over strained, or stressed some swelling can appear later. Say if someone has been on their feet all day then their worn ankle joint might seem to get a bit swollen late in the day so shoes feel tight.
If there is a little tear or damage to soft inside a joint, say a meniscal (cartilage) tear or ligament problem then swelling can be a sign that something is not right.
People can also get swelling from inflamed joints, where there is some kind of arthritic issue. That kind of swelling can be hot to the touch and seem to be all round the joints
Another kind of swelling is thick solid oedema, this is the kind of swelling you can prod a finger in to and it leaves a dent when you take your finger away. This might be a sign of fluid retention or sometimes it can be present if someone has just come out of immobilization in a plaster cast or boot.
Usually when treatment progresses and as the body heals the swelling reduces. There are some kinds of treatment which can be carried out to help persisting swelling, there is a lot of self-management you can do. So more to follow on this topic as well.
Stiffness is a funny word, but it’s the one I chose because it’s the word people use. They say things like “My joints just feel stiff” or “I’ve noticed I’m not as flexible as I used to be” or” My posture is getting more bent over”
So maybe we could call this “limitation in movement ability”, but that’s quite long winded so I will stick to ‘stiffness’
So here we are talking about someone not being able to move their joints through a natural, average normal for them range of movement. They might have noticed that they just can bend down to touch their toes or perhaps when they stand up they seem to be getting shorter.
There are three age groups that bring this symptom. First the children brought by their parent, second there are those who sit, drive or spend hours curled up working and then finally the older age group usually with wear & tear.
Parents often notice if their child has a problem with posture when their offspring are in their teens. Developing a scoliosis is not very common, but it can happen. Sometimes the first sign a parent notices is that their youngster just doesn’t seem as flexible. As youngsters grow it can take time for their soft tissue to adapt to different bone length. So changes in flexibility around growth spurts can be natural, but can also be something parents want advice on.
For those who are no longer growing, but spend hours and hours in one posture, say over a keyboard. For this group stiffness is all about habits. Unfortunately a growing number of younger people are developing restrictions in their movement ability which can make their movement seem quite aged. However this can be helped with skilful support so this is another topic to go into in depth. A hint, doing the Feldenkrais Brighter Brain Better Movement lessons can help this group a lot.
Lastly in this ‘stiffness’ group are the older people with wear and tear. In this case if joint surfaces really have changed shape then the chance of restoring full natural movement is remote. However this group can be helped in many differing ways as I will describe in another blog
- Breathing Problems
Breathing is a natural physical process but people get problems, sometimes after an illness, chest infection, pneumonia or time in hospital. At times like this they need some lessons to retrain their natural breathing pattern.
Maybe there is a deeper more ongoing issue such as cystic fibrosis, asthma or an airway disorder and they needs treatment.
Athletes often want to discover how to use their breathing more effectively or a musician or theatre performer may want to sing or produce a voice more effectively.
Breathing is a physical process and Physio, Physical Therapists work with physical problems
- Tension Stress
It might sound odd. I have put this down at number 6, but nearly everyone who books in to clinic has some degree of emotional distress. Pain, being unable to do what you want to physically. Being impaired in your movement is very stressful. At the root of most of this is fear and having pain and not being able to do stuff is worrying.
When we are fearful and worry. We tend to ruminate and dwell on all the possible ways that this might affect us. That makes us fear even more about the future, which in turn causes more stress.
Some people get stressed in life and develop physical signs like neck, back and shoulder pain or even breathing issues.
That doesn’t necessarily mean there is anything wrong with the bones or joints or structures in their neck or shoulders. The issue may be that the problem is how they are coping with life. Some people are more prone to physical aches and pains and instead of getting mental health signs they may get physical health signs.
People coming to the clinic often have some emotional issues such as mild anxiety, low grade depression, PTSD. They might have IBS, or chronic fatigue or have suffered from a breakdown or burnout in the past. If they complete a lifestyle inventory they probably score very high on simple stressful life events and sometimes this can cause people to feel physical symptoms
Jill is part of a very small number of UK Physiotherapist’s who have trained in mental health care. She is trained in Stress Management, personal coaching and many positive psychological approaches. More of this in another blog when I will explain where the boundary between this work and that of a Psychotherapist.
Hopefully the outline above has provided a small overview of some of the problems people frequently bring to get help with.
If you want to know if your problem can be helped then just email or make a call.
Jill Wigmore-Welsh MSc GradDipPhys is a HCPC registered Physiotherapist with a MSc in Public Health / Health Promotion
She is additionally qualified as a Hypnotherapist, Life & Business Coach, a Stress Management Trainer, Trainer in Neurolinguistic Programming, Feldenkrais Method Teacher & Bones For Life Practitioner & Laughter Yoga Leader. Over the years she has completed a high level of training in Physiotherapy approaches including acupuncture, Cyriax & Maitland joint manipulation.
She has a clinic in West Reading, Berkshire UK established for 30 years and also works in London & Oxfordshire
She can be contacted via email: jill at wigmore-welsh.com