Punitha Chennai Pain Clinic

Joints form the connections between bones. They provide support and help you move. Any damage to the joints from disease or injury can interfere with your movement and cause a lot of pain. 
 

Many different conditions can lead to painful joints, including 
- Osteoarthritis 
- Rheumatoid arthritis 
- Bursitis 
- Gout 
-  Strains, sprains and other injuries of joints and around joints. 
-  Inflammation in and around joints 
- CFS (Chronic Fatigue Syndrome) 
- Fibromyalgia 
- Bursitis 
- Ankylosing Spondylitis(A.S.) 
- Tendon Sheath Inflammation (Tenosynovitis) etc. 

Joint pain is extremely common. In one national survey, about one-third of adults reported having joint pain within the past 30 days. 
Knee pain was the most common complaint, followed by shoulder and hip pain, but joint pain can affect any part of your body, from your ankles and feet to your shoulders and hands. As you get older, painful joints become increasingly more common. 
 

Physiotherapy treatment: 
For joint pain treatment we can use following techniques: 
-Taping 
-Modalities 
-Exercises 
-Corrective devices if needed (orthotics) 
-Manual therapy etc. depending upon the case. 

 

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.

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.