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Thursday 24 May 2012

Manual Physical Therapy for Pain Relief




Many patients arrive at their first physical therapy appointment expecting to receive hot packs, ultrasound and instructions on how to complete a series of exercises. These modalities are warranted in many instances and most therapists would agree that exercise is needed to help restore muscle imbalances. However, many therapists now approach the restoration of function from a different perspective. These therapists are interested in why a muscle isn’t functioning properly and view back exercise not as the driving mode of recovery but as a complement to manual therapy. They may, for instance, look to restore proper sacroiliac or lumbar joint function to treat piriformis syndrome rather then directly manipulate the piriformis muscle through exercise.
Manual physical therapy is a specialized form of physical therapy delivered with the hands as opposed to a device or machine. In manual therapy, practitioners use their hands to put pressure on muscle tissue and manipulate joints in an attempt to decrease back pain caused by muscle spasm, muscle tension and joint dysfunction.

Manual Physical Therapy can Offer Pain Relief for Acute and Chronic Back Pain

Manual therapy can be helpful for the treatment of joints that lack adequate mobility and range of motion in certain musculo-skeletal conditions. This limitation can cause discomfort, pain, and an alteration in function, posture, and movement. Manual physical therapy involves restoring mobility to stiff joints and reducing muscle tension in order to return the patient to more natural movement without pain. Thus, manual physical therapy may provide back pain relief both for patients with chronic back pain involving joint problems, such as sacroiliac joint dysfunction , and acute back pain from soft tissue injuries such as a back muscle strain or a pulled back ligament. Although extensive clinical studies have yet to be performed on all areas of manual therapy, limited clinical data and patient reports support the assertion that manual physical therapy can be effective in relieving back pain for certain patients.
As a group, manual physical therapy techniques are aimed at relaxing tense back muscles and restricted joints in order to decrease back pain and increase flexibility. In general, manual physical therapy techniques employ the following types of movement:

    Soft tissue work, including massage, which applies pressure to the soft tissues of the body such as the muscles. This pressure can help relax muscles, increase circulation, break up scar tissue, and ease pain in the soft tissues.

    Mobilization/manipulation, which uses measured movements of varying speed (slow to fast), force (gentle to forceful), and distances (called ‘amplitude’) to twist, pull, or push bones and joints into position. This can help loosen tight tissues around a joint, reduce pain in a joint and surrounding tissue, and help with flexibility and alignment.

The following page covers the specific manual physical therapy techniques that are designed to alleviate low back pain related to muscle spasm, muscle tension and joint problems.

Monday 21 May 2012

Can you lend a helping hand?

It looks like our "Physiotherapy and Back Pain" is one of our most popular post so far. Twenty seven views and counting. We've even been +1. It's all very exciting.
There is nothing better then knowing that a blog you manage is helping others get the knowledge they are searching for.
Now its time for us to ask you for your help, we want to know what you would like to know about physiotherapy. Whether it be about Physiotherapy, about our physiotherapist we have here at Therapyworks or about our company itself.
We want to hear from you. You are the most important people to us here at Therapyworks and we strive to make sure you are 100% happy with the information we provide.
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Wednesday 16 May 2012

Hydrotherapy


Hydrotherapy

Hydrotherapy, formerly called hydropathy, involves the use of water for pain-relief and treating illness. The term hydrotherapy itself is synonymous with the term water cure as it was originally marketed by practitioners and promoters in the 19th century. A hydrotherapist therefore, is someone who practices hydrotherapy.
Water cure has since come to have two opposing definitions, which can cause confusion.
(a) Water cure therapy  – a course of medical treatment by hydrotherapy
(b) water cure torture  – a form of torture in which a person is forced to drink large quantities of water.[1]
The sense used in this article is the first one, synonymous with the term hydrotherapy, and which precedes recorded use of the second sense.[a]
Hydrotherapy in general encompases a range of approaches and their definitions. These range from approaches and definitions which are either naturally distinct, or made so for marketing purposes, to approaches and definitions which overlap significantly, and which can be difficult to disentangle.
One such overlap pertains to spas. According to the International SPA Association (ISPA), hydrotherapy has long been a staple in European spas. It is the generic term for water therapies using jets, underwater massage and mineral baths (e.g. balneotherapy, Iodine-Grine therapy, Kneipp treatments, Scotch hose, Swiss shower, thalassotherapy) and others. It also can mean a whirlpool bath, hot Roman bath, hot tub, Jacuzzi, cold plunge and mineral bath. These treatments use physical water properties, such as temperature and pressure, for therapeutic purposes, to stimulate blood circulation and treat the symptoms of certain diseases.[

Hydrotherapeutic mechanisms and modern medicine
Modern medicine's successes, particularly with drug therapy, removed or replaced many water-related therapies during the mid-20th century. Nowadays, water therapy may be restricted to use in physical therapy, and as a cleansing agent. However, it is also used as a medium for delivery of heat and cold to the body, which has long been the basis for its application.
Hydrotherapy involves a range of methods and techniques, many of which use water as a medium to facilitate thermoregulatory reactions for therapeutic benefit. While the physiological mechanisms were initially poorly understood, the therapeutic benefits have long been recognised, even if the reason for the therapeutic benefit was in dispute. For example, in November 1881, the British Medical Journal noted that hydropathy was a specific instance, or "particular case", of general principles of thermodynamics. That is, "the application of heat and cold in general", as it applies to physiology, mediated by hydropathy. In 1883, another writer stated "Not, be it observed, that hydropathy is a water treatment after all, but that water is the medium for the application of heat and cold to the body". Thus, the "active agents in the treatment (are) heat and cold", of which water is little more than the vehicle, and not the only one".
With improved knowledge of physiological mechanisms, practitioners wrote specifically of the use of hot and cold applications to produce "profound reflex effects", including vasodilation and vasoconstriction. These cause changes in blood flow and associated metabolic functions, via physiological mechanisms, including those of thermoregulation, that are these days fairly well understood, and which underpin the contemporary use of hydrotherapy. Although standard anatomy and physiology textbooks make only passing reference, if any, to hydrotherapy, some of the best descriptions of the underlying physiology upon which hydrotherapy relies, are to be found in such textbooks. For example, one of the best succinct descriptions of blood redistribution (which is fundamental to the above-mentioned reflex reaction), quoted below, is from a standard textbook.
...by constricting or dilating arterioles in specific areas of the body, such as skeletal muscles, the skin, and the abdominal region, it is possible not only to regulate the blood pressure but also to alter the distribution of blood in various parts of the body.
British and other hydrotherapy establishments are discussed from another standpoint in a recent history of psychiatry.

Monday 14 May 2012

Acupuncture treatment good for shoulder-hand syndrome


Abstract
OBJECTIVE:
To assess the effectiveness of acupuncture therapy for shoulder-hand syndrome.
METHODS:
According to the requirements of evidence-based medicine, papers of randomized controlled clinical trials for shoulder-hand syndrome published in China from 2005 to 2010 collected by databases VIP, Wanfang, CNKI, collections of papers of academic conferences, etc. were retrieved by using key words of shoulder-hand syndrome, reflex sympathetic dystrophy, acupuncture, moxibustion. Then the collected documents were given with Jaded score, and analyzed by using software Manager 5. 0 Review Cochrane.
RESULTS:
A total of 100 papers were retrieved. Among them, 29 papers that met our inclusion criteria were given with Jaded scores (2 points for 2 papers, 1 point for the rest 27 papers, being low in quality). Twenty-one papers were brought into Meta analysis. These papers contain 1 768 cases of patients who were divided into three sets of groups according to the used intervention measures. Meta-analysis showed that simple acupuncture therapy is significantly superior to acupoint block therapy for relieving shoulder-hand syndrome [odds ratio (OR, 95% CI) 4.80 (2.02 to 11.41), P < 0.05]; electroacupuncture therapy is markedly more effective than simple acupuncture therapy [OR (95% CI) 4.60 (2.08 to 10. 17), P < 0.05]; and acu-moxibustion combined with other therapies is significantly more effective than simple acupuncture therapy [OR (95% CI) 3.31 (2. 30 to 4.77), P < 0.05]. The other 8 papers were not brought into Meta-analysis due to being different to the 21 papers in the intervention measures.
CONCLUSION:
Acupuncture can effectively relieve shoulder-hand syndrome in pain, wrist- and shoulder-joint motor, etc. But, larger size of samples and high quality randomized clinical trials are needed for providing more reliable conclusive evidence.

Wednesday 9 May 2012

Acupuncture in Physiotherapy


Background
Acupuncture may be offered to you as part of your rehabilitation and pain management programme. Acupuncture is one of a number of different types of treatment that the physiotherapist can offer and there is good evidence for its effectiveness. Often a physiotherapist will use acupuncture alongside treatments such as exercise, joint manipulation/mobilisation and general rehabilitation.
Acupuncture is viewed by physiotherapists as a complementary rather than an alternative therapy

What is Acupuncture?
Traditional Chinese Medicine (TCM) acupuncture (which can be traced back as far as 1000BC) developed out of a concept of using needles inserted into the body as a means of balancing the movement and level of 'Qi' (energy life force) within the body – an imbalance of Qi leading to disease, pain or disability.
Recent research is now supporting the effectiveness of acupuncture, particularly in the management of pain, suggesting that it is effective in the treatment of low back pain, neck pain, and knee/hip osteoarthritis.
Acupuncture combined with physiotherapy is now widely accepted within the NHS and private practice.
When Should it Not Be Used?
There are certain circumstances where acupuncture should not be used.

  If you have a known metal allergy, specifically stainless steel

  If you have a needle phobia

  If you have a known infection in the area to be needled


When Should it Be Used With Caution?
You should also inform your physiotherapist if you:

  Have haemophilia

  You are pregnant or trying to conceive

  Suffer from epilepsy

  Have a deficient/weakened immune system

  Have a heart pace maker

  Are taking anticoagulation (blood thinning medication)

  Are Diabetic

These conditions do not exclude you from having acupuncture but they will influence its application. Your Physiotherapists needs to know.
Does Acupuncture Work?
Yes, but it does not work for all. Success can depend on a number of factors, which include:

  General health

  The severity and duration of the condition

  How the condition has been managed in the past

No two people are the same and it is one of the strengths of acupuncture that we treat people individually to get better results. If you know someone who has experienced acupuncture you may find it helpful to discuss the process before deciding on treatment.
What does Acupuncture Treatment Involve?
Your Physiotherapist will use sterile, single use needles. The needles are fine (a lot finer than an injection needle) and they are inserted quickly through the skin and into the tissues. Acupuncture needling should not be painful although some people do report experience a pinprick or scratch like sensation.
Once the needles are in place you may feel a mild ache, numbness, warm or heavy sensation at and around the needle. This should not be unpleasant. This is referred to as 'De Qi' and is a sign that the body’s inbuilt pain relieving mechanisms are being stimulated.
How Many Needles Will Be Used?
Most commonly a treatment will involve the insertion of between 2-16 needles.
Needle Stimulation?
Once the needles are in place your physiotherapist may gently stimulate the needle until you experience the De Qi. This may be repeated again throughout the treatment.
Needles can also be stimulated using electrical impulses. This is called electro- acupuncture. Here needles are coupled to a battery-operated machine. This causes a tingling sensation to be felt at the site of the needle. Low Frequency impulses can help reduce longstanding chronic pain whilst higher frequency impulses can be more helpful in managing acute pain and muscle spasm.
How Long are The Needles In For?
Needles can be in place for as little as a few seconds or 1-2 minutes. More commonly needles will be in place for between 10-30 minutes.
Where Will The Needles Be Placed?
Needles may be inserted:

  Around the painful area

  Away from it (hands or feet)

  On the opposite side of the body

Recent research suggests that needling away from an area of pain is effective. This can be particularly useful if you feel the painful area is too sensitive.
How Many Treatments Are Needed?
Research suggests that for a longstanding condition such as low back pain, a course of 6 – 10 treatments is required to achieve the best results. If after further assessment/ treatments your symptoms remain the same, it is unlikely that acupuncture will help you. If you do respond positively to acupuncture the period of symptom ease is varied and uncertain. Some people experience lasting relief of symptoms especially when used to manage a recent acute problem. Your physiotherapist will discuss your individual management plan. Acupuncture treatments may vary dependent on the condition being treated and how you respond to treatment. Each treatment should be tailor-made to you and your condition.
Is It Safe?
Members of the Acupuncture Association of Chartered Physiotherapists (AACP) are required to train to a minimum standard and are bound by professional codes of conduct through the Chartered Society of Physiotherapy (CSP) and Health Professions Council (HPC). 
Acupuncture is safer than many of the drug treatments used. However, any procedure that involves inserting needles into the body has some potential problems, but these remain minimal. Acupuncture has been known to produce some ‘side effects’ in certain people.
Minor Side Effects:


  Some discomfort at needle site

  Drowsiness and sleepiness following treatment

  Bruising at the needle site

  Temporary pain increase

  Fainting

  Feeling faint