• Matthew Anstey MCSP HCPC

Case study of Mrs Y – Sciatica, pain and symptoms not always being as they seem.


Mrs Y was a keen runner, running several times a week to when she developed pain in the back of the leg which started to restrict the running she so enjoyed, it was a huge problem affecting her quality of life. After having various visits to orthopaedic consultants, physiotherapists, chiropractors and osteopaths, Mrs Y had all but given up hope of ever being able to run again. She came to me initially for another issue, but mentioned in passing the diagnosis of sciatica in her leg. She explained how they had tried so many different types of treatment to get the sciatic pain under control, including spinal injections (an invasive, risky and incredibly unpleasant treatment) but nothing had worked.


I offered to take a look at the pain down the back of the leg. Within minutes I had distinguished between the supposed sciatic nerve irritation, and pain in the hamstring muscle at its proximal attachments (up into the buttocks). My diagnosis was proximal hamstring tendinopathy (breakdown of the tendon) and I gave Mrs Y a simple programme to follow to start rebuilding the tendon (a process that is difficult to do without specific instruction). I checked up on Mrs Y a few weeks later – symptoms were already improving. With an additional 2-3 appointments, I was able to progress the exercises enough to help Mrs Y back to running.

Mrs Y is now back to running pain free for the first time in years. It took 4 appointments to get her there (with some homework in-between). It shows how important an accurate diagnosis is, and how easy it is for a misdiagnosis to lead to much more pain and suffering than is necessary.

Our Physiotherapists are experts in diagnosing musculoskeletal disorders, and using evidence based treatments maximizes cost efficiency for our patients. We only book appointments for and therefore only pay for the sessions you need. If and injury or pain problem will be better helped at home doing exercises, that is the approach we will take. Filling appointments with treatments that are not evidence based will mean the total number of appointments required is much higher, and the total cost of treatment is much higher. Acupuncture, ultrasound therapies and other such treatments are good examples of treatments that often are not required.

Our philosophy is different, we educate to minimize your dependence on us as your Physiotherapist, and maximize the efficiency of your recovery.


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