Relive Physiotherapy & Wellness Clinic

Most of us suffer from lower back pain at some point in our lives; be it from a sedentary lifestyle, spending hours at the office desk or from strenuous physical exercises. In most cases, a little bit of rest does the trick. However, if the lower back pain persists for 3-6 weeks, physiotherapy is recommended.

How does physiotherapy help?
The main purpose of physiotherapy is reducing lower back pain and increasing muscle and bone function so that such instances are avoided in the future. Physiotherapy is the first line of the defence against lower back pain. More drastic measures such as surgery are undertaken once physiotherapy fails to do is the job.

Physiotherapy is often recommended when the back pain is caused due to lifestyle factors, a minor injury like a fall or other moderate factors. For more severe back injuries, doctors recommend surgery straight away when there is no scope for performing physiotherapy.

Low-intensity back pain can be cured using a combination of heat packs, ultrasound wave therapy and Iontophoresis (using a localized current source to introduce medical ionic compounds to the body).
 

A physical therapy program for back pain usually has two components:

1. Passive physical therapy to help reduce the patient's pain to a more manageable level
2. Active exercises

Passive Physical Therapy - Modalities

The physical therapist may focus on decreasing pain with passive physical therapy (modalities). These therapies are considered passive because they are done to the patient. Examples include:

• Heat/ice packs
• TENS units
• Lontophoresis
• Ultrasound

Active Physical Therapy - Back Pain Exercises
In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine. Here are some of the common exercises for back pain:

1. Back Stretch: Put your hands underneath your head while lying back. Bend your knees but put your feet on the ground. Roll your legs to one side and hold them there for 10 seconds. Repeat three times for each side.
2. Deep Lunge: For this, you need to kneel on one knee with the other foot pointed towards the front. Lift the back knee up and hold it there for five seconds and then bring it down. Repeat this exercise three times for each side.
3. One Leg Stand: This is the simplest of exercises. Hold on to a wall for support while standing and face towards it. Then slowly hold one leg and bend it behind you. Hold in the same position for five seconds before bringing it down. Repeat the process three times for each leg in five second gaps. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

Lower back pains may underline a host of diseases, some of the most distinctive being the degeneration of lumbar disc and strain of back muscles. If left unattended, these acute durations of severe pain can lead to further complications, beyond the scope of both active and passive physical treatment regimes. Hence, it is always recommended to attend to these minuscule symptoms as soon as they are detected.

How physiotherapy works wonders in lower back pains:

1. Physiotherapy is recommended when lower back pains are frequent, or stretch for days at a time. Most medical literatures, which shower their unanimous support in favour of physiotherapy for back pain, make note that physiotherapy relieves pain, as well as improves the functions, which are most likely to be affected by this disorder.
2. Pain emanating, following a surgery, is recognized as one of the most significant aspects where benefits of physiotherapy are more visible. Generally, patients are advised to undergo physiotherapy sessions after surgical procedures irrespective of age and gender, unless the move is contraindicated in specific cases.
3. Muscular spasms and muscle shrinking is a highly familiar phenomenon observed in individuals who are relatively less active. Muscle shrinking can often be attributed to very low usage of certain muscles, while muscle spasm can occur when neurons at the affected muscles are irritated. Physiotherapy is observed as both the first line as well as the second line of treatment regimen in such occurrences; a routine for gradual and slow stretching is recommended by physiotherapists involving the muscles of legs, hips, abdomen and lower back, based on their intensity of pain.
4. Advanced stages of a physiotherapy treatment regime upgrade the simple stretching exercises to more rigorous ones like specific stabilizing drills, exercises involving balancing machines and/or exercise balls. This aspect of physiotherapy caters to the secondary spine muscles of the human body.
5. The area of the body considered to be the core of lower back pain (lower back muscles and muscles of abdomen) requires more than just stretching or exercises involving machines. Workout focused on these core areas are based on a complex set of exercises, which may have to be improvised such that the aforementioned muscles absorb the maximum shock.
6. In addition to these conventional exercises, which are based on applications of gravity, some centres offer a different environment for individuals who are unable to perform activities in normal conditions. The concept of aquatic pools addresses the issue, and makes exercising quite an easy feat for the physically challenged individuals.

Fibromyalgia is a condition characterised by chronic widespread body pains and increased responsiveness to pressure. Women are at a higher risk of suffering from this disorder than men. Fibromyalgia can be treated with physiotherapy, pharmacotherapy and combined efforts of physician and the patient.

Some of the symptoms that characterize this disorder are:

1. Pain: Fibromyalgia is characterized by pain that has no apparent reason. It can affect different parts of the body and presents itself in different ways. Some people may experience a stabbing pain while others complain of a persistent dull ache. This pain may be affected by climate changes or stressful situations. There is reduced threshold to pain, because of certain chemical ( neurotransmitters) abnormalities in brain. Pain is generalized, felt above and below the waist, right and left-side of body, arms, legs, neck and back. 
2. Abnormal Sensitivity: Fibromyalgia patients are extremely sensitive to environmental changes that involve sight, sound and smell. For example, cigarette smoke can make a fibromyalgia patient extremely nauseous while loud music can give the person an instant headache. Lights that are brighter than normal can also make such a person feel uncomfortable. Patients have an abnormal sensitivity to pain, which leads to generalized aching of the body and tender points. 
3. Muscle & Joint Stiffness: Fibromyalgia patients often experience stiff muscles and joints without any form of strenuous activity or other reason. This may be localised to one group of muscles or affect the whole body. For some patients, this pain is worse in the morning or when sitting for extended periods of time. However, moving around does not provide any significant relief.
4. Chronic fatigue and exhaustion: There are two main reasons for a fibromyalgia patient to complain of tiredness. Firstly, the condition itself drains a person of energy even without overexerting themselves. Secondly, the pain and joint stiffness can hamper a person’s sleep and lead to sleep deprivation. Over time, this can become a vicious cycle of tiredness and insomnia. Chronic fatigue also affects a person’s immune system causing his or her energy levels to drop.
5. Cognitive impairments: Fibromyalgia patients also complain of a compromised short term memory. They often face difficulties recalling names of people they have recently met or other newly acquired information. These people may also have trouble concentrating on tasks for extended periods of time and experience mental sluggishness also known as fibro-fog.
6. Irritable bowel syndrome: Bowel disturbance is another common symptom of this disease. Passing stool may become difficult due to a combination of pain and muscle stiffness. With time, this problem can worsen unless addressed with laxatives. However, an over-dependence on laxatives can lead to further problems.
7. Somatic Symptoms: Apart from pain, patient experiences unrefreshing sleep and fatigue throughout the day. Other associated features can be depression, abdominal cramps, chest pain, tingling.
8. Lab Tests: Fibromyalgia is a clinical diagnosis. There are no definite laboratory tests. In fact, most conducted tests will turn out to be normal. 

Treatment: Foremost important is an education of patient and caregivers, regarding nature of the disease. The patient needs to indulge in recreational activities and undergo supervised physiotherapy. There are potent medicines to correct the chemical imbalance in the body thereby increasing the pain threshold and leading to better quality of life.

As soon as it doesn’t hurt too much to put pressure on the ball of your foot, start stretching your ankle using the towel stretch. When this stretch is easy, try the other exercises. Towel stretch: sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel toward your body keeping your leg straight. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. Standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep your injured leg back with your heel on the floor. Keep the other leg forward with the knee bent. Turn your back foot slightly inward (as if you were pigeon-toed)

 Slowly lean into the wall until you feel a stretch in the back of your calf. Hold the stretch for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Do this exercise several times each day. Standing soleus stretch: stand facing a wall with your hands on the wall at about chest height. Keep your injured leg back with your heel on the floor. Keep the other leg forward with the knee bent. Turn your back foot slightly inward (as if you were pigeon-toed). Bend your back knee slightly and gently lean into the wall until you feel a stretch in the lower calf of your injured leg. Hold the stretch for 15 to 30 seconds. Return to the starting position. Repeat 3 times.

Ankle range of motion: sit or lie down with your legs straight and your knees pointing toward the ceiling. Point your toes on your injured side toward your nose, then away from your body. Point your toes in toward your other foot and then out away from your other foot. Finally, move the top of your foot in circles. Move only your foot and ankle. Don't move your leg. Repeat 10 times in each direction. Push hard in all directions.

Resisted ankle dorsiflexion: tie a knot in one end of the elastic tubing and shut the knot in a door. Tie a loop in the other end of the tubing and put the foot on your injured side through the loop so that the tubing goes around the top of the foot. Sit facing the door with your injured leg straight out in front of you. Move away from the door until there is tension in the tubing. Keeping your leg straight, pull the top of your foot toward your body, stretching the tubing. Slowly return to the starting position. Do 2 sets of 15. Resisted ankle plantar flexion: sit with your injured leg stretched out in front of you. Loop the tubing around the ball of your foot. Hold the ends of the tubing with both hands. Gently press the ball of your foot down and point your toes, stretching the tubing.

Return to the starting position. Do 2 sets of 15. Resisted ankle inversion: sit with your legs stretched out in front of you. Cross the ankle of your uninjured leg over your other ankle. Wrap elastic tubing around the ball of the foot of your injured leg and then loop it around your other foot so that the tubing is anchored there at one end. Hold the other end of the tubing in your hand. Turn the foot of your injured leg inward and upward. This will stretch the tubing. Return to the starting position. Do 2 sets of 15.

Resisted ankle eversion: sit with both legs stretched out in front of you, with your feet about a shoulder's width apart. Tie a loop in one end of elastic tubing. Put the foot of your injured leg through the loop so that the tubing goes around the arch of that foot and wraps around the outside of the other foot. Hold onto the other end of the tubing with your hand to provide tension. Turn the foot of your injured leg up and out. Make sure you keep your other foot still so that it will allow the tubing to stretch as you move the foot of your injured leg. Return to the starting position. Do 2 sets of 15.

When a blow or a fall causes an injury, where the top of your arm bone pops out from your shoulder socket, it’s called shoulder dislocation. It is a very painful condition and you need to get this relocated to its position immediately. The tissues and bone related to that particular joint get damaged. 

If you ignore this situation or keep the shoulder like this, it will be more harmful and painful for you. There may appear a bump in front or at the back of your shoulder that hurts. 

What can lead to a dislocated shoulder injury? 

• Sharp or a very fast twist of your arm. 
• Falling down on a hard surface. 
• A sudden hurt or hit. 
• It may also happen when you fall down and try to save yourself using your hand. The force of the hit indirectly gets into the shoulder and your shoulder joint may slip from its place. 

In some of the outdoor games, there are high chances to get hurt in the shoulder. Hockey, football, rugby, rock climbing, volleyball etc. bring in high probabilities of injuring the shoulder, thereby resulting in a shoulder dislocation. 

What is the treatment or therapy of a dislocated shoulder? 

The dislocated shoulder should be very urgently treated. As this injury of the shoulder is very painful, you should go to a specialized orthopaedist as fast as possible to fix up the shoulder to its proper joint. As it is very painful and swollen, the faster the treatment, the better it is. When your doctor fixes your shoulder in its actual place or the bone of your arm comes back to the socket, most of your pain will go away and you get huge relief from pain. After the shoulder bone is relocated, you can use further conservative treatment to reduce the pain and swelling of that place. Dislocated shoulder may take 3 to 12 weeks to recover. But this is the approximate time and it depends on the seriousness of the injury. 

After the treatment, when all the symptoms are gone, the doctor will suggest some exercises for better results and normal shoulder movement and to prevent future shoulder injury. Ones the shoulder is dislocated, the chances of dislocation in future is further increased as the tissue supporting the head of humerus into its socket is torn. Such patients may land up with recurrent dislocation of shoulder wherein shoulder dislocates easily on specific movement and patients are afraid to do over-head activities. The problem is best diagnosed by MRI Scan. 

The best treatment for this is Arthroscopic (Key-Hole Surgery) Bankart's Repair. Following operation shoulder is kept at rest for 2 weeks then Physiotherapy is started. Day to day activities are started after 2 weeks and sports activity is started after 3 to 5 months.

Knock knee and bow legs is a condition in which your legs appear bowed out that means that your knees stay wide apart and your ankles are together and knock-knee is the condition in which the knees angle touch to one another, commonly called valgus and varus deformities. 

Causes of bow legs and knock-knee genetic are due to rickets and arthritis deficiency of vit D and other nutritions, abnormalities, muscle imbalances, which can cause these deformities which results in excessive hip-knee-ankles. These deformities can affect various joints of the body including the knee, ankle, hip and spine. We take different treatments to prevent this, like painkillers, knee brace, exercise splint and finally surgery. If you want to correct this deformity without any surgery with laser treatment and other specific exercises then you can contact us.