Conditions Treated

Osteoarthritis (OA)

Osteoarthritis (from the Greek words for bone, joint and inflammation) is the most common form of arthritis and is defined as a degenerative joint condition characterised by the destruction of the articular cartilage.

Risk factors for developing osteoarthritis include family history of OA, trauma to or around the joint (e.g. fracture), and age. Females are more affected by OA than males.

OA affects almost 7 million Australians.

Although osteoarthritis effects most commonly the weight bearing joints of the hip, knee and ankle, it can occur in any joint.

Dr Dwyer provides advice in all non-surgical management options for your osteoarthritis.

Tendinopathies

Tendinopathy is defined as a degeneration of the tendon’s collagen in response to chronic overuse. Basically, tendinosis occurs when the tendons’ injury rate exceeds the repair rate. It is not an inflammatory process.

The commonly affected tendons are at the elbow (Golfers and Tennis elbow), the knee, ankle, hip and shoulder.

Tendinopathy responds to various non-surgical treatments and Dr Dwyer will guide you through this.

Back Pain

Lower back pain is extremely common. 80% of Australians will have an episode of lower back pain in their lifetime. Most of these episodes resolve spontaneously over a period of a few days to six weeks. For approximately 10 percent of people, an episode of acute back pain persists and turns into chronic pain.

It is important to distinguish between back pain alone (axial pain) and those cases of back pain with leg pain (radicular pain).

Axial pain can be caused by injury to the muscles, joints, tendons, muscles, or discs in the back.
Radicular pain is due to a nerve (usually one part of the sciatic nerve) becoming irritated or compressed in the lower back. This usually occurs due to a disc protrusion but can be from arthritic joints in the spine.

There are a multitude of treatments proposed for both acute and chronic LBP. Dr Dwyer provides you with evidence-based treatment tailored to your specific condition. This includes exercise therapy, medications, cortisone injections, prolotherapy injections, platelet rich plasma injections and coordination of guided injections with local radiology and pain medicine specialists.

Neck Pain

Is not quite as common as back pain but can be thought about in similar terms. Like the lower back, it is important to delineate neck pain from neck pain with referred pain to the arm. The treatments are very different. Thorough examination and review of your imaging will help determine the correct treatments.

Dr Dwyer will develop an individualised treatment plan for your neck pain problem.

Headache

There are over 100 different types of headache. Common headache diagnoses are migraine, tension headache, cervicogenic headache (a headache referred from the neck), cluster headache, chronic daily headache and allergy headache.

These all have slightly different features and underlying causes and therefore require different treatment. IF you have had more serious causes of headache ruled out with MRI and or neurologist review, treating the neck may well be beneficial.

Injection therapy can be very successful in treating cervicogenic headache.

Concussion

Concussion is defined as a traumatic brain injury induced by biomechanical forces.
The acute neurological symptoms reflect a functional disturbance, rather than neurostructural pathology, and as such standard imaging of the brain shows no abnormality.

Symptoms usually follow a steady path to resolution, though occasionally symptoms can be prolonged.

Assessment of concussion can be complex and the rehabilitation and return to sport programs are increasingly recognised as essential components of concussion management.
Each sporting body has slightly different rules with regards to return to play following a concussion.

Concussion in children is particularly serious and requires careful management.

Dr Dwyer has extensive experience in the diagnosis and management of concussion and works closely with neurologists, neurosurgeons, physiotherapists and neuropsychologists to ensure a safe return to sport.

Plantar Fasciosis

This is a new term to describe heel pain coming from the plantar fascia.
The fascia is a thick broad piece of connective tissue that runs from the plantar aspect of the heel spreading out to attach to the underside of the base of the toes. It functions to support the arch of the foot.

It can become inflamed with acute overuse but tends to become more degenerative with persistent overuse. It can tear.

Steroid injections are used to treat the inflammation component though there is at least theoretical risk that these medicines can lead to a tear.

Other injection treatments include platelet rich plasma and prolotherapy.
Nerve blocks and radiofrequency neurotomy can also be helpful in severe cases.

Surgery is very rarely required as it is a self-limiting condition, which means that eventually it goes away in the vast majority of cases.

Dr Dwyer will provide you with evidence based treatment advice for plantar fasciopathy.

Trochanteric Bursitis

This is a very common condition that causes lateral hip pain that is usually worse when walking and at when lying on the affected side in bed. It is more common in women than in mean. It is often treated with a cortisone injection but this variable success rates as the bursitis is often secondary to a nearby tendon injury that requires a more complex treatment plan. Platelet rich plasma injections can be very useful in treating this condition.

Sacroiliac Joint Dysfunction

The sacroiliac joint is at the base of the spine and is a less common cause of lower back and buttock pain. Occasionally it can cause pain further down the leg. It can be difficult to diagnose sacroiliac joint pain as imaging findings are often non-specific. Injections are sometimes used to diagnose and treat sacroiliac joint pain.

Sciatica

Medically speaking, sciatica is a term used to describe nerve pain referred to the leg from the back. Nerve pain is a tingling, or shooting pain with electricity-like sensations, often associated with numbness. This is the result of irritation of compression of a nerve root in the spine. Medically, we prefer the term radicular pain or radiculopathy.

Like lower back pain, exercise, injections and medications can help improve radicular pain.

Whiplash

Is a term used to describe a neck injury caused by a forceful, rapid back and forth movement of the head and neck. This commonly occurs in motor vehicle accidents but can also occur on the sporting field where it often co-exists with a concussion.

It results in neck pain and headache and that can in some cases be severe. Most cases resolve in a few months but a small number persists for a year or more.

Physiotherapy, exercise prescription, medication and injection therapy are all used to treat whiplash.