Physiotherapy
Injection Therapy
Acupuncture

Physiotherapy

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Physiotherapy

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Specialties within Physiotherapy

Here at Bramhall Park Physiotherapy, we have an excellent track record in helping people in and around Stockport, Cheadle Hulme, Hazel Grove and Bramhall with all their physiotherapy needs.

Our physiotherapy services will help you get back to normal as fast as possible.

  • Neck and back pain including whiplash

  • Joint and muscle aches, pains and injury

  • Arthritis

  • Injury rehabilitation

  • Headache and migraine headache treatment

  • Adolescent musculo-skeletal physiotherapy

  • Rehabilitation at home for older people

  • Sports related and running injuries

Our Treatment Philosophy

Our treatment philosophy aims to empower people to take an active role in their treatment and rehabilitation. We listen carefully to your concerns and aspirations and prepare an individual programme to address your needs.

Our therapists aim to assess, diagnose and effectively treat your injury, abolish your pain, restore normal movement and prevent the problem reoccurring.

Injection Therapy

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Injection Therapy

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Injection Therapy

At Bramhall Park Physiotherapy Clinic, we provide an expert Injection Therapy service. Injection Therapy is an effective way to abolish or reduce pain and restore function by providing a ‘window of opportunity’ that allows your physiotherapist to integrate conventional physiotherapy treatment. By effectively treating the underlying cause of your pain your physiotherapist can help you achieve the best possible outcome.

Our clinic offers both Corticosteroid injection and Hyaluronic Acid injection (Ostenil injection). Both injections have their own use and therapeutic benefits. The choice depends on your presenting symptoms/condition, as well as your personal preferences. Your management plan will be tailored to your individual needs.

Types of Injection

Corticosteroid injection has been frequently used in clinical practice for many years. It is a powerful anti-inflammatory medicine which has a significant effect in reducing pain and improving function in the short-term. It can be useful when pain is severe and irritable, or where there is low-grade persistent pain, for which anti-inflammatory and analgesics may be required locally at the site of the preesnting symptom. However, Corticosteroid injections can cause side-effects, particularly with repeated use and when injecting on certain joints or some soft tissue conditions.

Hyaluronic Acid (HA) is a naturally occurring substance found in normal joints and tissues, and is therefore free of harmful side effects. HA injection has been shown to reduce pain and stiffness, with a particularly high success rate on mild-moderate Osteoarthritis (OA) knee joints, shoulder joints and small joints such as hand and feet. HA injection has been widely used in private practice, sports medicine and elite sports such as Premiership football and cricket. It is also very popular amongst the older active population who wish to keep active and control symptoms, without the risk of negative side-effects.

Why Choose Bramhall Park?

Injection Therapy falls within the Advanced Scope of Practice of a Chartered Physiotherapist. The governance and post-graduate training of Injection Therapy is very robust in the UK. As a result, very few private physiotherapy clinics throughout the UK offer this service.

At Bramhall Park Physiotherapy Clinic, injection therapy is performed by Dr. Sharon Braddock, who is an experienced injection therapist (performing over 200 injections each year).  Dr. Braddock is also a Teaching Fellow of the Society of Musculoskeletal Medicine (SOMM), training post-graduate doctors and physiotherapists in Injection Therapy.  Dr. Braddock’s extensive expertise in both teaching and practising injections enables her to provide a high quality service for her patients.

Your Treatment

Prior to any treatment, patients are given a thorough examination to confirm the diagnosis and to assess if it is appropriate and beneficial to receive injection therapy. Treatment options and the type of injection therapy will be discussed accordingly. Injection is performed under a strict aseptic technique and is delivered to the targeted area. You will be asked to take it easy following the injection, yet comfortable active movement is encouraged. You will be re-assessed 2-3 weeks following the injection, at this point pain and associated symptoms should be improved, and your physiotherapy rehabilitation can be re-commenced in line with your goals.

Corticosteroid is an anti-inflammatory medication, which is used to reduce inflammation, pain and swelling of irritable joints and soft tissue conditions. It is widely used in a variety of musculoskeletal conditions in clinical practice. Research evidence suggests that corticosteroid injection is effective in reducing pain and symptoms, and improving function in the short-term (1-3-months).

Corticosteroid injection reduces inflammation and pain by inhibiting both chemical and cell-mediated aspects of inflammatory responses to disease and injury. This results in reduction in inflammation and discomfort. The effects of cortisone part of the injection can take few days to few weeks to take effect. Some of this difference may depend on the nature, duration and severity of the presenting condition.

When pain becomes a barrier to your normal function and physiotherapy treatment, the short-term effectiveness of a Corticosteroid injection provides a ‘window of opportunity’, allowing your physiotherapist to treat the underlying cause of your pain and problem, and facilitate your return to normal function quicker.

  • Osteoarthritis of shoulder, elbow, thumb, finger, knee, ankle and big toe joint
  • Frozen shoulder
  • Subacromial impingement syndrome- rotator cuff tendinopathy and/ or subacromial bursitis
  • Tennis elbow and golfer’s elbow
  • De-Quervain’s tenosynovitis
  • Trigger finger
  • Greater trochanteric pain syndrome
  • Plantar fasciitis

Yes, Corticosteroid is a very safe and effective treatment when it is used appropriately. The injection is performed using a strict aseptic technique, which delivers the injection accurately to the target area.

We take our patients’ condition and safety very seriously. You will be given a thorough examination including the understanding of your current/past medical history, current medications, and known allergies prior to injection. There are certain conditions that may be contraindicated to the use of Corticosteroid injection (such as any systematic/local infection), which may increase the risk of side-effects (such as diabetes, and patients on anti-coagulants). These will be discussed prior to injection to reduce any risk.

Side effects of Corticosteroid injection are very rare (for instance, incidence of infection is estimated to be approximately 1: 40,000 risk), and often very minor. The therapeutic benefits often outweigh the possible side-effects which may include; post-injection flare-up for 1-2 days, facial flushing, small area of fat loss or change of colour of skin, slight vaginal bleeding, temporary increase of blood sugar if you are diabetic, skin bruising if you are on blood-thinning drugs.

Anaphylactic reaction is extremely rare. It happens because your body has an extreme allergic reaction. Please let us know if you have had any adverse drug reaction to a local anaesthetic in the past. We take patients’ safety very seriously. You will be thoroughly examined prior to injection to ensure it is appropriate and safe for you; an aseptic technique is performed; our clinic is well-equipped with emergency care; you will also be asked to wait in the clinic for 25 minutes following the injection to monitor any adverse effect.

Injection of Corticosteroid and local anaesthetic are often used together for diagnostic and therapeutic use. If local anaesthetic is used, you should experience pain relief within minutes. Corticosteroid usually starts working within 24-48 hours but may take longer, and it usually continues to work for 3-6 weeks, providing short-term pain relief. The duration of effect varies from person to person, depending on their individual conditions, degenerative changes, and presenting symptoms.

This depends on the presenting symptoms and the condition being treated. In most cases, one injection is sufficient to reduce pain to a manageable level. For some chronic conditions such as a frozen shoulder and greater trochanteric pain syndrome, a second injection may be offered to relieve severe pain, if the first injection provides only partial or short-term relief. It must be noted that Corticosteroid injection has its side effects with repeated use, particularly in weight-bearing joints. It is recommended to have no more than three injections in one area within a year. If repeated injection remains unsuccessful, alternative treatment options or further diagnostic investigation will be discussed with you.

In order to maximise the benefit from your injection and lower the risk of any potential side-effects, you will be asked to ‘relatively’ rest the injected area for 2-3 weeks. Relative rest does not mean complete rest, it means rest from aggravated activities and movements. If your job is likely to aggravate the symptoms, you may consider taking leave or reducing your duties for a few weeks. You can take your normal pain medications following injection if required. An after-care advice sheet and appropriate exercise will also be provided following the injection. You will be provided with a review appointment 2-3 weeks following the injection.

Corticosteroid and local anaesthetics are prescribed medication, so a prescription is required. Dr Sharon Braddock is a qualified independent prescriber, so can provide a private prescription for both Corticosteroid and local anaesthetic on the day of your injection appointment, alleviating the necessity to return to your GP. Pain medication can also be prescribed where necessary.

If you would like to receive further information about Corticosteroid injection, please contact us at [email protected] or call 07976 028171.

Acupuncture

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Julie Davidson – Acupuncture

Julie, Sharon & Clodagh are qualified in the use of Acupuncture and are members of the Acupuncture Association of the Chartered Physiotherapists (A.A.C.P.)

Acupuncture is one of the skills many physiotherapists use as part of our approach to the management of pain and inflammation. Physiotherapists base their treatments on scientific research and clinical evidence that Acupuncture can reduce pain by stimulating the brain and spinal cord to produce natural pain-relieving chemicals such as endorphins, melatonin (which promotes sleep) and serotonin (to promote well-being), to name but a few. These chemicals assist the body’s healing processes and offer pain relief as a precursor to other treatments such as manual therapy or exercise in order to aid recovery.

AACP members combine Traditional Chinese Medicine (TCM) principles with scientific evidence as a means of reducing pain and promoting healing, always with the aim of enhancing physiotherapy treatments such as exercise and rehabilitation to promote recovery and improve quality of life.

There are several techniques for applying acupuncture and these are described below:

Conventional acupuncture involves the use of single-use, pre-sterilised disposable needles of varying widths, lengths and materials that pierce the skin at the acupuncture points. The physiotherapist will determine the locations of these points on the basis of an assessment of the cause of the imbalance. A number of needles may be used during each treatment, and these are typically left in position for between 20 and 30 minutes before being removed.

Trigger point acupuncture may also be used to facilitate relaxation in specific muscles following traumas, for longer-term unresolved muscle pain, or as a means of increasing muscle length in order to aid stretch and rehabilitation. In the latter case, the needle is inserted into the affected muscle until the tissue is felt to relax under the needle, which is then removed. Trigger point needling often produces an effect much more quickly, and therefore, does not require the 20–30-minute treatment time.

The use of acupuncture needling for the treatment of pain is supported by an ever-growing body of scientific evidence.

Scientific research has examined the effectiveness of acupuncture for various conditions. In recent years large studies have begun to emerge which have helped to support the benefits of acupuncture treatment. For example it is accepted that acupuncture can help tension-type headaches and pain of osteoarthritis, for example osteoarthritis of the knee, especially when it is used in conjunction with other treatments such as physiotherapy.

Acupuncture combined with physiotherapy is widely accepted within both the National Health Service (NHS) and private practice. This is evident in the recommendation by the National Institute for Health and Clinical Excellence (NICE) that acupuncture should be available as a cost-effective short-term treatment for persistent non-specific low back pain

NICE, 2009

Members of the AACP are required to keep up with a stated minimum number of hours of continuing professional development each year in order to remain on the register.

Julie, Sharon & Clodagh are in a unique position to combine acupuncture with other treatment methods, such as:

  • Exercise

  • Manipulation

  • Muscle re-education

  • Joint mobilisation

  • Relaxation

  • Electrotherapy

  • Sports rehabilitation

Helping you be yourself again.

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