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Non-specific low back pan which persists for some time is a common presentation for various health care practitioners to deal with, representing a major reason for absence from work due to sickness. Research has moved ahead quickly over the last decade, making a scientific view of assessment and treatment recommendations possible which could lead to predictable benefits for patients with persistent low back pain. The National Institute for Clinical Excellence (NICE) has just released a new set of guidelines in May 2009.

The rotator cuff is a musculotendinous cuff which surrounds the humeral head and through which the shoulder stabilising and movement muscles exert their forces onto the shoulder. The cuff enables us to put our shoulder through a very large range of motion, the greatest range of any joint in the body, for the purpose of putting our hands in functional positions. The shoulder’s function is to allow our hands to be put in useful positions within our visual field so we can perform the intricate activities that define being human to a degree.

Plate types vary with different bones and different fracture locations. One of the common types is a dynamic compression plate or DCP. The screw holes in this kind of plate are angled away from the centre of the device so when they are tightened up the bone fragments are pulled towards the centre, providing compression. The smaller plates are only 1mm thick which permits bending to fit the bony area and is mostly used for fractures of the distal ulna and lateral malleolus. Plates have been designed to fit fractures which occur near joints, reducing the size of the devices and increasing the options for fixation.

Non-specific low back pan which persists for some time is a common presentation for various health care practitioners to deal with, representing a major reason for absence from work due to sickness. Research has moved ahead quickly over the last decade, making a scientific view of assessment and treatment recommendations possible which could lead to predictable benefits for patients with persistent low back pain. The National Institute for Clinical Excellence (NICE) has just released a new set of guidelines in May 2009.

Rehabilitation after a hip replacement is usually straightforward but it is important to be aware of the priorities at each stage of the operation and recovery for the best outcome. Because an osteoarthritic hip is painful this has a series of knock-on effects. A painful joint means the musculature which controls that joint cannot work properly so tends to lose some of its strength and support for the joint. The joint may also become tight as the natural movements are not performed and the person may adopt an abnormal gait which becomes an ingrained habit.

The rate of bone turnover can be increased by excess production of thyroid hormones and this can make the development of osteoporosis more likely, although treatment to maintain the normal range of thyroid hormone concentrations is straightforward. Five percent of men who suffer from this condition do so because of consumption of excessive alcohol and they have three times the risk of suffering a hip fracture compared to people who do not drink. The activity of bone producing cells called osteoblasts is suppressed by alcohol, with other side effects such as the reduced absorption of nutrients and calcium, all contributing to bone loss and the tendency to fall.