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 behind 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 defence against lower back pain. More drastic measures such as surgery are undertaken once physiotherapy fails to do is 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 of 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:

Passive physical therapy to help reduce the patient's pain to a more manageable level

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

Iontophoresis

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:

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.

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.

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.

Physiotherapy for Back Pain

Pelvic pain is generally referred to as the pain in the lower abdominal region. Pelvic pain might be acute, sudden, or chronic, recurrent, cyclical in nature. It may present as central or lateralized pain and might spread to the thighs and buttocks. Pelvic pain might be an indication that something is wrong with the internal reproductive organs located in the pelvic region such as ovaries, fallopian tube, uterus and vagina in which case occurrence of pain may be related to particular time in menstrual cycle.

Pelvic pain can be indicative of a pelvic infection or related to the pelvic bones/spine problems.

Also it may indicate that there is something wrong with the digestive system or urinary system.

Causes-

The causes are as follows:

Pelvic pain occurs commonly in disorders of the internal reproductive organs such as ovarian cysts or pelvic inflammatory disease (where in sexually transmitted bacteria spread through the reproductive organs and cause infection) or pain during ovulation.

Pelvic pain might also occur due to endometriosis (a form of disorder where the endometrial tissues that are located inside the uterus tend to grow outside the uterus resulting in severe pain), adenomyosis (a disorder wherein the endometrial tissues which line the wall of the uterus tend to grow within the uterus), , pelvic adhesions or ectopic pregnancy (when the fertilized egg gets inserted somewhere else other than the main uterine cavity),

Pelvic pain can occur due to bladder disorders, kidney stones, infection in the urinary tract, constipation, flatulence,inflammatory bowel disease, irritable bowel syndrome and chronic hernia.

It can also be a symptom in some cancers such as ovarian cancer, colonic cancer, advanced ovarian , endometrial and cervical cancer.

The following symptoms might occur along with pelvic pain:

Sustained pain in the hips and the groin

Sudden fever

Severe pain while urinating , passing stools or during sexual intercourse (dysparuenia)

Vaginal bleeding or vaginal discharge .

Blood in stool

Severe menstrual pain ( dysmenorrhoea)

Repeated instances of constipation or diarrhoea

Increase In pain with stress and physical movements

Investigations-

The Gynaecologist will do physical examination including bimanual internal examination. Also, complete blood count, urine for microscopy, vaginal swabs if discharge, stool examination. Ultrasound examination of the pelvis is an important investigation.

Treatment-

If the pain is gynaecological and depending on the cause doctors might suggest different therapies. In cases where pain is due to an ovarian cyst or endometriosis, doctors may prescribe birth-control pills. In cases of suspected pelvic infection, antibiotics are prescribed. Also, laparoscopic surgery might be advised in cases of acute pain due to cyst, endometriosis, or pelvic adhesions: for confirmation of diagnosis and excision or removal of cysts and endometriotic implants and division of adhesions respectively. In some cases of chronic pain, the gynaecologist may manage the case with inputs from gastroenterologist and pain consultant.

Causes and Symptoms of Pelvic Pain

The knee is the largest joint in the human body and is a complex structure formed of bone, muscle and cartilage. Development of pain in the knees can be caused by numerous factors such as aging, injuries, diseases, dietary deficiencies, etc.

Arthritis is the most common cause of knee pain and usually affects the elderly and aged. It occurs due to an inflammation of the joint and causes pain, swelling, redness and inflexibility of the knees.

What are the factors that determine treatment method?

Diagnosis for knee pain varies from patient to patient as each case is different and must be approached differently. Some of the factors that determine the treatment method are as follows:

- Cause of the problem
- Nature and intensity of pain
- Age of the patient
- Medical history of the patient
- Diet and lifestyle of the patient

There are a number of different types of arthritis which can affect the knees in different ways and, consequently, require different types of treatment methods.

What are the various treatment methods for knee pain?

1. Conventional Remedies - These are used in case of conditions that are not too severe or chronic. It includes keeping on bed rest, using an ice pack, taking a painkiller and anti-inflammatory medicines, wearing knee braces, etc.

2. Physical Therapy - There are many stretching and strengthening exercise routines that help alleviate knee pain and treat the condition. Recovery is achieved by making the muscles around the knees stronger and increasing stability and flexibility.

3. Injections to the Knees - A number of anti-inflammatory substances and supplements, as well as lubricants, can be injected into the knee joint which helps reduce pain and makes the joint more supple.

4. Stem Cell Therapy - This involves drawing platelets from the patient's blood and injecting it into the knee joint for repairing damage caused to ligaments, tendons or cartilage.

5. Surgery - Surgical procedures for treating knee pain include partial or complete knee replacements.



What kind of treatment does your knee pain require?

Neck pain is fairly common among adults. It results from the soft tissues such as ligaments, muscles and tendons. It can result from spasms and muscle strain from neck problems such as disc degeneration and spinal stenosis. Be it a chronic pain or a sudden one, addressing it is important to get on with the daily office life. 

Here is a list of some quick solutions, which when followed can give considerable relief from the pain:

Computer should be at eye level: While sitting at it you must ensure that the middle of the computer screen is parallel to the eye. If it is required that you bend your neck to view the screen, then you should adjust the screen, without bending your neck. This happens most often while working with a laptop. The chair length can be adjusted to fix this problem.
Refrain from neck straining while typing: If typing requires straining the neck, it should be ensured that the same doesn t happen. This is the case while texting in a mobile. A better solution is to fix this is to take the mobile at a level which does not require the neck bend down. It will ensure that the joints and discs of the neck are not stressed.
Use headset: If the work demands longer time on the phone, instead of bending the neck it makes sense to use a headset. Practicing the chin tuck exercise can help in this case. This exercise can strengthen the soft muscles of the neck. It also maintains the alignment of the head and the shoulder.
Stay hydrated: Enough hydration is necessary to ensure spinal alignment and disc height. Hydration also takes a eases the spine and relaxes the soft muscles. A practice of adequate hydration throughout the day can help stop the degeneration of the cervical disc. While drinking water is a matter of practice, keeping a water bottle serves as a constant reminder to drink it throughout the day. Keeping an alarm after 2 hours also serves as a constant reminder to drink water.
Carrying weight: One common mistake committed by most people is to carry weight with one hand. Since the load doesn t distribute evenly, it strains the neck muscles causing pain. It should be ensured that the office briefcase or the heavy purse is carried with equal stress on both the shoulders. This will ensure a painless day at the office.
Maintaining a good posture: Poor sitting or walking posture is often the cause of neck pain. While sitting it should be ensured that the back is straight and rests in the chair once in awhile. The neck and head should fall in a line while working.

Neck Pain at Work - 6 Tips to Help You Prevent it

Arachnoiditis is a sort of inflammation of the defensive layers of the spinal canal. You can envisage it as the scar tissues that enlarge in the arachnoid lining. Also the lining can turn out to be inflamed due to the recurrent intervention on the spine, a lot of surgeries can lead to the scarring, for instance. It can also expand due to definite type of the spinal infections as well as due to the chemicals of epidural steroid injections, particularly if these kinds of chemicals get into the spinal fluid.

As the disease increases day by day, the symptoms also become bigger in magnitude. A lot of people who are suffering from this type of problems are incapable of working. Further due to Arachnoiditis the following symptoms are likely to happen

Grounds of the nerve roots to plod together
The nerve pain
The numbness
The tingling
Radio Frequency rhizotomy is primarily effectual on the joint pain. Patients who are good candidates for the RF have the pain whilst they're doing activities that increase the stress of the spine. Also the RF blocks all the nerves around the joint from sending the pain signals to the brain, as well as that pain free period normally lasts around one year. In that time, patients have to learn regarding the postural correction as well as the good body mechanics. RF presents the patients an option to get back their mobility as well as provide training regarding the movements of their daily lives with the less pain.

The details of information about drugs which might help arachnoiditis:
There are lots of pain management treatments available. Further patients might try the medications to find out the pain relief. A number of options are:

The NSAIDs ( one kind of the anti-inflammatory drugs)
The corticosteroids kind of drugs
The anti-spasm type of the drugs
Also an anti-convulsant drugs as well as
The narcotic type of the pain relievers
A number of these types of medications might be given with a spinal pump. That is the little device which is entrenched under the skin and it then distributes the medication straightly to the inflamed area.
Also the patients might also take the spinal cord stimulation. On the other hand, the natural type of the treatments can assist, also, as well as it can often be utilized in conjunction with the prescribed type of the medication. You can also consult with your doctor about your options regarding your treatments.

Arachnoiditis - Pain Management Techniques For It!

Knee pain or injuries are very common and have numerous causes. Knee pain can emerge from delicate tissue wounds like ligament sprains and muscle strains. Bone conditions like knee joint pain, Osgood Schlatters, and biomechanical dysfunction can also cause knee pain. Treatment can include basic knee mobilization techniques, taping, massages or knee strengthening exercises completely through a careful recovery method after knee replacement or reconstruction.

Physiotherapy can help you overcome the pain and increase your strength and flexibility. A physiotherapist can suggest you a number of treatments and also help you understand your issue and get you back to your everyday routine. Physiotherapists are said to be successful in getting rid of the source of the knee pain by diagnosing a cause. This includes tightness around the knee and treating it with stretching and exercises.

Following are some of the exercises a physiotherapist might generally recommend for knee pain:

Hamstring stretch: Stretching keeps you flexible and increases your scope of movement, or how far you can move your joints in different directions. It additionally helps you reduce your chances of injuries and pain. Continuously warm up with a five minute walk first. Lie down when you are prepared to stretch your hamstring. Circle a bed sheet around your right foot, use the sheet to pull the leg up and hold for twenty seconds and then lower the leg. Repeat twice and switch legs.
Calf stretch: Use a chair for balance. Bend your left leg. Step back with your right leg and gradually straighten it behind you. Press your left heel toward the floor. You should feel the stretch in the calf of your back leg. Hold for 20 seconds. Repeat twice and then switch legs.
Straight leg raise: It helps build muscle strength to give support to the weak joints. Lie on the floor. Twist your left knee, foot on the floor. Keep the right leg straight, toes pointed up. Tighten your thigh muscles and raise your right leg.
Quad set: With these, you don't raise your leg. Just tighten the thigh muscles, also called the quadriceps, of one leg at once. Begin by lying on the floor. Keep both legs on the ground, loose. Flex and hold the left leg tense for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Cushion squeeze: This move strengthens your legs from the inside so that they can support the knees. Lie on your back, both knees facing inwards. Place a cushion or a pillow between the knees. Press your knees together, squishing the cushion between them. Hold for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Heel raise: Stand tall and hold the back of a seat for support. Lift your heels off the ground and rise on the toes of both feet. Hold for three seconds. Gradually lower both heels to the ground. Do three sets of ten repetitions. 

Knee Pain - How Physiotherapy Can Heal Knee Pain?

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