Injury and Pain Clinic

05/10/2025

Infographic showing what happens with injury.

➡️ The tissue tolerance to load eg walking is reduced particularly in patients with chronic pain.

➡️ Chronic pain creates a hypersensitive nervous system which impacts on tissue tolerance.

➡️ Chronic pain causes part of the brain (amagdyla) to be on ‘alert’ and thereby protecting the limb/region causing normal movement and touch to the skin to be painful.

21/09/2025

Facts!

➡️ Your spine is robust and meant to bend so don’t avoid using it. You have to ‘bend to mend’!

➡️ Everyone is asymmetrical. If people tell you that you’re out of alignment, this is fear inducing language and simply not the case.

➡️ Steroid injections can work but remember they are not a quick fix to a problem.

➡️ Remember MOTION IS LOTION!

➡️ Manipulation is a good tool to use in appropriate circumstances. If people tell you that manipulation can realign and readjust they are telling you incorrect information. Manipulation does NOT realign anything!

➡️ Pelvic tilts, spinal curves and leg length discrepancies are normal. We all have variations within our body.

07/09/2025

Osteoarthritis - the facts!



Infographics courtesy of Middleton Physio

31/08/2025

Prolonged achilles pain/injury!

➡️ Chronic Achilles tendinopathy on both sides can be a sign of systemic disease.

➡️ Achilles tendinopthy on both sides can be a sign of: diabetes, being overweight, rheumatology conditions such as rheumatoid arthritis.

➡️ Treatment would be blood tests to rule out other conditions and then focusing on building up tendon tolerance to load.

➡️ Achilles injury can be due to a sudden increase in exercise/activity level.

➡️ Treatment approach for Achilles injury/tendinopathy is about a gradual increase in load and should also consist of an holistic approach to prevent re-occurrence.

28/08/2025

10/08/2025

Frozen shoulder and diabetes facts!

➡️Diabetics are 5x more likely to develop frozen shoulder

➡️ People with type 2 Diabetes were 4x more likely to to develop frozen shoulder.

➡️ The reason for diabetics being at more risk of developing frozen shoulder is due to an increase in systemic inflammation on top of an already heightened systemic response.

➡️ An increase in inflammation can cause fibrosis and contracture of the joint capsule.

➡️ Symptoms of diabetes can include:
- increased thirst
- increased urination
- unexplained fatigue
- weight loss
- blurred vision

➡️ Evidence shows that diabetics can have poorer outcomes regarding pain, motion and functional outcomes.

➡️ Steroid injections can help with pain from frozen shoulder but if your diabetes are poorly controlled then steroid injections might not be right for you due to the heightened risk of infection.

12/07/2025

What is Collagen and how does it repair after injury?

➡️ collagen is what our tendon, ligaments and muscles are made from.

➡️ If you injure the structure or have a chronic condition affecting these structures it can take time to heal.

➡️ Rehabilitation to strengthen the tendon, ligament or muscle is important so that the integrity is restored as much as possible to reduce re-injury and/or manage pain.

➡️ Chronic conditions affecting collagen include (to name but a few):
- hypermobility
- fibromyalgia
- rheumatoid arthritis
- lupus
- ankylosing spondylitis
- marfan syndrome
- ruptures to tendon, ligament or muscles (partial or full rupture)

From Dr Keith Barr ⬇️

25/06/2025

Graphics courtesy Cor Kinetic

19/06/2025

Will I have to give up my activities/sport after hip replacement?

Graphics courtesy Mehmet Gem

25/05/2025

Rheumatoid Arthritis - some important facts!

➡️ Rheumatoid arthritis is an autoimmune condition where the body starts to attack its own cells causing inflammation.

➡️ Rheumatoid arthritis can lead to osteoarthritis.

➡️ Because rheumatoid arthritis is an autoimmune condition , it can increase the risk of other conditions such as diabetes and interstitial lung disease.

➡️ It is estimated that around 10% of people with RA have interstitial lung disease. Interstitial lung disease is scarring on the lungs (fibrosis). It is also estimated that around 60% on RA patients have lung tissue changes.

➡️ There are medications available to help manage rheumatoid arthritis but most of these medications can have significant side affects.

➡️ A patient with suspected rheumatoid arthritis should be referred for blood tests.

➡️ If blood tests show raised markers for rheumatoid arthritis then a referral to rheumatology should be completed.

➡️ Management of rheumatoid arthritis should be under a multidisciplinary team so that a good outcome can be achieved.

➡️ Being overweight, smoking, excessive alcohol consumption all impact RA.

18/05/2025

Facts about gout!

➡️ Gout is a type of arthritis affecting the joints, more commonly affecting the toe.

➡️ A blood test may be needed to assess the uric acid levels.

➡️ Gout can be treated with prescribed anti-inflammatory medication. Recurrent episodes of gout may need treatment with allopurinol which can help to reduce uric acid levels.

➡️ Being overweight, diabetic and having a poor diet can increase your risk of getting gout.

➡️ A gradual increase in exercise is important.

➡️ If gout isn’t treated, it can lead to chronic gout which can result in further damage to joint(s) as well as increase risk of developing kidney stones.

➡️ Gout usually occurs suddenly. Sudden severe pain, redness and swelling to the joint is a common sign.

➡️ Once you’ve had one episode of gout you can be more predisposed to recurrent attacks of gout.

➡️ Gout commonly affects the big toe. It can feel like the toe is on fire. Light touch to the joint such as a bed sheet, can sometimes increase pain.

04/05/2025

What is complex regional pain syndrome (CRPS)?

➡️ There is no cure for CRPS. Management is a key part of treatment as well as medication.

➡️ CRPS can occur after an injury eg wrist fracture or in some cases occur without a cause.

➡️ CRPS requires a multidisciplinary treatment approach for a good outcome as it affects mental health as well as physical health.

➡️ CRPS is a neural related condition whereby the nerves are in a constant state of ‘wind up’.

➡️ Usually, CRPS affects 1 region however it can spread to other regions of the body.

➡️ CRPS is a severely debilitating and painful condition.

➡️ People with CRPS find that even a light touch such as a bed sheet causes severe pain.



Graphics: NOI