Physiotherapy can help arthritic ‘wear and tear’ aches and pains. There is a common misconception that you have to ‘live with arthritic pain’. However, unless x-rays reveal severe signs of wear and tear (degeneration) then these problems can respond very well to physiotherapy because the pain is coming from soft tissues not the joint as is commonly thought.

The following areas of pain fall into the ‘arthritis’ category and can respond to physiotherapy treatment:

  • Back pain
  • Knee pain
  • Shoulder / Rotator
  • Cuff pain
  • Neck pain
  • Hip pain
  • Thumb pain

Back & Neck Pain

Aches and pains in the back and neck are frequently recurring problems. However, physiotherapy can help you successfully managed them so they are no longer an intrusive and restricting part of your life.

Recurrent bouts of back or neck pain can lead to loss of joint mobility, muscle flexibility and muscle strength and, in particular, weakness of the core stabilising muscles.

Factors such as lifting injuries, poor sitting postures, repetitive activity especially involving bending, lack of exercise as well as emotional stress and anxiety can lead to back and neck pain or discomfort.

Common symptoms:

  • Pain working at the computer or sitting
  • Pain and/or stiffness getting up from sitting
  • Pain on half bending e.g. cleaning your teeth, mowing the lawn
  • Difficulty getting comfortable at night or turning over in bed
  • Waking up with pain or stiffness which eases during the day
  • Pain and/or stiffness after sport or activity e.g. gardening
  • Pain looking over your shoulder .e.g. when driving or looking up
  • ‘Heavy’ head feeling
  • Recurrent episodes of pain which are slowly becoming more intense, more frequent and more persistent
  • Ache and/or pins and needles into the buttock, leg or arm

Referred Arm or Leg Pain (Including Sciatica)

Referred pain can be mistaken for a muscle strain but it is a nerve pain which can originate in the neck or lower back even though pain is not felt in these areas.

Common symptoms:

  • Pain in the back or front of the leg or arm
  • Pain/ache is deep and poorly localised
  • Nerve pain tends to be more intense than muscle pain
  • Pain or ache can be intermittent or constant
  • Sudden intense pain on movement which takes time to subside
  • Pins and needles or numbness in feet or hands


Physiotherapy can help headaches caused by muscle tension or referred pain from the neck or upper back. These types of headaches can be caused by feeling stressed, poor posture driving, sitting at the computer, certain sleeping positions or after a whiplash injury.

Common symptoms:

  • Aching at the base of the skull
  • Dull, persistent tight feeling or band like pain across the head
  • Headaches come on gradually and may last for hours or several days
  • Symptoms become worse in certain positions or with certain movements

Whiplash Injuries

Whiplash injuries are injuries caused by a violent force most commonly as a result of a road traffic accident but also from falls when horse riding or skiing for example. These injuries can cause a great deal of soft tissue damage because of the forces involved, even at slow speeds.

Physiotherapy initially settles pain and promotes healing and movement. If untreated, whiplash injuries can cause pain and stiffness months or even years after the injury. However, even at this late stage physiotherapy can help to restore mobility and muscle strength.

Common symptoms:

  • Neck and/or back pain either intermittent or a constant ache
  • Arm or leg pain General stiffness and loss of flexibility
  • Headaches
  • Pins and needles in the hands or feet
  • Muscle tension and reduced tolerance to sport / daily activity

Tennis & Golfers Elbow

Tennis elbow is pain at the tendon insertion on the outside of the elbow and golfers elbow is pain at the tendon insertion on the inside of the elbow. These elbow pains used to be attributed to inflammation of the tendon. However, modern scan technology is showing this is not always the case. This is why these conditions do not always respond to cortisone injections. It is essential that our evaluation determines the underlying cause of elbow pain, for example an overstrain of the tendon as in repetitive strain injury or referred pain from the neck.

Common symptoms:

  • Niggling elbow pain gradually becoming more intense or more frequent over weeks or months
  • Pain lifting saucepans, carrying shopping or unscrewing jar tops
  • Pain during or after your sport
  • Pain using the mouse
  • History of neck pain

Shoulder Pain and Stiffness

The shoulder is a very mobile joint due to the number of ways in which we need to move our arms.

There are a group of four muscles called the ‘rotator cuff’ which contribute to the shoulder staying in the correct alignment throughout these movements. If there are any changes, no matter how small, within the shoulder joint, such as inflammation, swelling, muscle spasm, or muscle weakness then this shoulder alignment will be altered. This in turn causes pain in the shoulder, and aching into the upper arm. The pain can be constant or intermittent and related to certain movements only.

If you stop doing these painful movements or your body compensates in some way to avoid pain your shoulder joint will begin to stiffen up. Physiotherapy will assess why this alignment has been altered and give appropriate advice, treatment and exercise to resolve the problem.


Hip Pain & Groin Strains

Hip Pain

A hip replacement is one of the most common operations due to severe arthritis in the joint. One contributory factor to arthritis of the hip is restricted hip movement. If you are experiencing niggly groin pains then this may be causing your hip to stiffen up. Hip degeneration can also refer pain to the knee without any hip pain. Physiotherapy helps restore hip mobility and muscle strength to relieve pain and help prevent further degeneration of the joint.

Groin Strains

Groin pain is usually a result of a problem with the muscles that move the hip. The muscle which flexes the hip is also attached to the spine so back problems are often associated with hip pain (even if you do not have back pain).

Common symptoms of both hip pain and groin strains:

  • Pain bending over or flexing your leg up to put shoes or socks on
  • Pain walking up or down hills
  • Pain turning over in bed and stiffness in the mornings
  • Pain getting up from sitting
  • Pain during or after sport or activity e.g. gardening

Knee Pains

Ligament and cartilage injuries are common knee problems from sudden twisting movements playing sport. These types of traumatic injuries will generally swell up and cause pain immediately. However, we often see knee problems which come on gradually and become more painful over time. These are the type of problems which are often labelled as ‘arthritis’.

However, the pain may actually be coming from a variety of sources such as scar tissue and chronic swelling which are all soft tissue NOT joint problems and will respond to physiotherapy. Swelling, pain and scar tissue lead to muscle weakness and restricted movement leading to a cycle of persistent pain on certain activities or positions.

Common symptoms:

  • Pain around the front of the knee or inside of the knee
  • Pain on squatting
  • Pain going up or down stairs or hills
  • Pain getting out of a chair
  • Pain lying on your side at night
  • ‘Catching’ pain on twisting


These are usually acute injuries where you ‘go over’ on your ankle and tear the ligaments. If it is only mild then it may not require treatment but an ankle with significant swelling and pain needs rehabilitation. If not individuals may be left with residual pain and muscle weakness which a few simple exercises could correct.

Common symptoms:

  • A history of ‘going over’ on your ankle either since childhood or a previous ankle sprain
  • Pain, stiffness or swelling after activity
  • Pain walking over rough ground
  • Fatigues quickly with activity

Achilles Tendonitis / Tendonosis

Achilles tendon pain often recurs over many weeks or months. Swelling at the back of the heel or ankle indicates inflammation of the tendon (Achilles tendonitis). Pain but no swelling indicates tendonosis where the tendon may be may be overloaded because of poor alignment of the foot and leg or because of a muscle imbalance. It is essential to identify why the Achilles tendon is overloaded so appropriate physiotherapy can stop the pain/inflammation recurring.

Common symptoms:

  • Gradual onset, may be only niggling for weeks
  • Pain on walking or running or the day after activity
  • Stiffness in the morning (you cannot put your heel to the floor, & limp the first few steps)
  • Pain & limp on the first few steps after sitting