Physical Therapy for Low Back Pain Relief Patients suffering from most types of low back pain are often referred for physical therapy for four weeks as an initial conservative (nonsurgical) treatment option before considering other more aggressive treatments, including back surgery. The goals of physical therapy are to decrease back pain, increase function, and teach the patient a maintenance program to prevent future back problems.

Common forms of physical therapy include:

1. Passive physical therapy (modalities), which includes things done to the patient, such as heat application, ice packs and electrical stimulation. For example, a heating pad may be applied to warm up the muscles prior to doing exercising and stretching, and an ice pack may be used afterward to sooth the muscles and soft tissues.

2. Active physical therapy, which focuses on specific exercises and stretching. For most low back pain treatments, active exercise is the focus of the physical therapy program.

3. Exercise is one of the most significant ways we can increase our longevity, improve our health, and decrease our pain and suffering. Proper exercise can improve flexibility, increase strength, and even reduce back pain. Knowing the best exercises to improve your health or decrease your pain is essential to a workout plan or a pain management program.

Osteoarthritis (OA) or degenerative joint disease affects a large number of the population and can be well managed by maintenance physiotherapy and a prescribed exercise program.

Research indicates that 90% of people will have some type of osteoarthritic changes occurring in their weight bearing joints by the time they are 40 years of age. While not all of these are symptomatic, osteoarthritic patients present regularly in large numbers to their doctors or health professionals with joint pain and inflammation. These damaged joints can be irritated at work, during sport or in a home related trauma. Different joints are affected depending on posture, injury, past history and a range of hereditary factors. The most commonly-affected joints are spinal and weight-bearing joints such as the hip and knee.

Medication is often prescribed including pain relief and non-steroidal anti-inflammatories (NSAIDs). Whilst these can assist with initial management they may have long term side effects. Patients often seek more natural options to manage their condition or to use in conjunction with medication. Generalised exercise programs given to these clients with insufficient education, instruction and warnings in place have the ability to increase pain and aggravate inflammation. It is therefore important that these clients see a trained physiotherapist who has knowledge and understanding of OA.

Intermittent flare-ups in arthritic joints are most common because the normal range and function of the joint are disrupted due to damage. This is tolerated until function is significantly affected. It is often at this point that patients will make an appointment to see their doctor or health professional.

Physiotherapy treatment provides conservative but effective results with even severely damaged arthritic joints. A thorough assessment is vital for treatment prescription.

A range of modalities include but are not limited to:

• joint mobilisation
• exercise prescription
• electrotherapy modalities
• acupuncture
• hydrotherapy
• supports/aids and education.

Tennis elbow or lateral epicondylitis is a condition in which the outer part of the elbow becomes sore and tender. Tennis elbow is an acute or chronic inflammation of the tendons that join the forearm muscles on the outside of the elbow (lateral epicondyle). The forearm muscles and tendons become damaged from overuse — repeating the same strenous motions again and again. This leads to inflammation, pain and tenderness on the outside of the elbow.<>

Any activity, including playing tennis, which involves the repetitive use of the extensor muscles of the forearm can cause acute or chronic tendonitis of the tendinous insertion of these muscles at the lateral epicondyle of the elbow. The condition is common in carpenters and other laborers who swing a hammer or other tool with the forearm.

Runge is usually credited for the first description of the condition, in 1873.[2] The term tennis elbow first appeared in an 1883 paper by Major called Lawn-tennis elbow. Signs and symptoms

• Pain on the outer part of the elbow (lateral epicondyle)
• Point tenderness over the lateral epicondyle—a prominent part of the bone on the outside of the elbow
• Pain from gripping and movements of the wrist, especially wrist extension[citation needed] and lifting movements
• Pain from activities that use the muscles that extend[citation needed] the wrist (e.g. pouring a container of liquid, lifting with the palm down, sweeping, especially where wrist movement is required)
• Morning stiffness

Frozen shoulder

It is also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years. Your risk of developing frozen shoulder increases if you're recovering from a medical condition or procedure that prevents you from moving your arm — such as a stroke or a mastectomy.

Treatment for frozen shoulder involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint capsule. In a small percentage of cases, arthroscopic surgery may be indicated to loosen the joint capsule so that it can move more freely. It's unusual for frozen shoulder to recur in the same shoulder, but some people can develop it in the opposite shoulder. Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months. Symptoms

• Freezing stage. Any movement of your shoulder causes pain, and your shoulder's range of motion starts to become limited.
• Frozen stage. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and using it becomes more difficult.
• Thawing stage. The range of motion in your shoulder begins to improve.
For some people, the pain worsens at night, sometimes disrupting sleep.

Causes

The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. Doctors aren't sure why this happens to some people, although it's more likely to occur in people who have diabetes or those who recently had to immobilize their shoulder for a long period, such as after surgery or an arm fracture

Tests:-

During the physical exam, your doctor may ask you to move in certain ways to check for pain and evaluate your range of motion (active range of motion). Your doctor might then ask you to relax your muscles while he or she moves your arm (passive range of motion). Frozen shoulder affects both active and passive range of motion. In some cases, your doctor might inject your shoulder with a numbing medicine (anesthetic) to determine your passive and active range of motion. Frozen shoulder can usually be diagnosed from signs and symptoms & limited ROM of shoulder mainly abduction and internal rotation is affected.

Physiotherapy :-

frozen shoulder treatment involves controlling shoulder pain

preserving as much range of motion in the shoulder as possible. A physical therapist can teach you range-of-motion exercises to help recover as much mobility in your shoulder as possible. Your commitment to doing these exercises is important to optimize recovery of your mobility & electrotherapy modalities helps to decrease pain at shoulder joint.

Prevention

One of the most common causes of frozen shoulder is the immobility that may result during recovery from a shoulder injury, broken arm or a stroke.

If you've had an injury that makes it difficult to move your shoulder, talk to your doctor about exercises you can do to maintain the range of motion in your shoulder join

Bell's palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve) causing an inability to control facial muscles on the affected side. Often the eye in the affected side cannot be closed. The eye must be protected from drying up, or the cornea Corticosteroids have been found to improve outcomes, when used early, while anti-viral drugs have not Many show signs of improvement as early as 10 days after the onset, even without

treatment. Bell's palsy is the most common acute disease involving a single nerve and is the most common cause of acute facial nerve paralysis (>80%). It is named after Scottish anatomist and Edinburgh graduate Charles Bell (1774–1842), who first described it. It is more common in adults than children. Physiotherapy

Physiotherapy can be beneficial to some individuals with Bell’s palsy as it helps
1) To maintain muscle tone of the affected facial muscles
2) stimulate the facial nerve.
3) It is important that muscle re-education exercises and soft tissue techniques be implemented prior to recovery in order to help prevent permanent contractures of the paralyzed facial muscles.
4) To reduce pain, heat can be applied to the affected side of the face.
5) There is no high quality evidence to support the role of electrical stimulation for Bell's palsy.

May be permanently damaged resulting in impaired vision. In some cases denture wearers experience some discomfort. The common presentation of this condition is a rapid onset of partial or complete paralysis that often occurs overnight. In rare cases , it can occur on both sides resulting in total facial paralysis.

Usually it gets better on its own with most people achieving normal or near-normal function. With all these therapies, spinal cord injury patients can sometimes restore themselves to earlier functioning. Other times, they can simply keep their bodies from deteriorating as they wait for a cure.

Manual therapy can be defined differently (according to the profession describing it for legal purposes) to state what is permitted within a practitioners scope of practice. Within the physical therapy profession, manual therapy is defined as a clinical approach utilizing skilled, specific hands-on techniques, including but not limited to manipulation/mobilization, used by the physical therapist to diagnose and treat soft tissues and joint structures for the purpose of modulating pain; increasing range of motion (ROM); reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function.

Manual therapy, or manipulative therapy, is a physical treatment primarily used by massage therapists, physiotherapists, occupational therapists, chiropractors, osteopaths, and osteopathic physicians to treat musculoskeletal pain and disability; it most commonly includes kneading and manipulation of muscles, joint.

As we know that few people may not be able to cover the distance for clinic, yet in the meantime require treatment and care of a certified and experienced physiotherapist. People take advantage of this service of physiotherapy at home for a lot of reasons; people are often too sick or injured and due to their hectic schedule, to leave the house, while in various cases, people normally prefer to get physiotherapy treatment at home where they feel more comfortable.

Dr. sumit does a lot of conferences and workshops in various institutions and MNC’S. he has vast clinical experience in the field of orthopaedic problems like low back pain and cervical spondylosis and knee osteoarthritis.

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