About 80 percent of people all across the globe experience lower back pain at some stage in their lives. It is one of the most common reasons why people miss their work and appoint a physiotherapist. But lower back pain is an ailment that can be avoided with proper knowledge and some back exercises. In case your lower back pain is not under control and you have been neglecting it, you are susceptible to acute pain, sciatica, nerve pain and pain in other regions caused from a pinched nerve. Long-term pain in the back portion can lead to permanent ailments like degenerative disc disease or spinal stenosis.

Probable causes of lower back pain
Severe pain in the lower back region can be caused due to a herniated disc, back muscle pain, ligament strain or any other non-specific pain. An individual may also suffer from lower back pain due to systemic conditions like rheumatoid arthritis, fibromyalgia or ankylosing spondylitis. Though these causes are very common in most people suffering from lower-back pain, the diagnosis varies from person to person and to ensure the best care to alleviate the pain, you must consult a responsive musculoskeletal physiotherapist.

Stages for assessing and treating lower back pain
Managing the back pain is the primary objective of physiotherapy. In reality, back pain is the final symptom that is developed and the first thing that must be addressed.

Stage I
Back pain relief: The physiotherapist is going to use different types of tools and items to help the pain subside along with the inflammation. These include electrotherapy, acupuncture, ice application, soft-tissue massage and deloading taping techniques. Sometimes the physiotherapist may also recommend an anti-inflammatory drug if the pain is intolerable.

Stage II
Restoring normal strength: With the settling of pain and inflammation, you are more susceptible to injury because though your pain has subsided, your ligaments and muscles are weak. Your doctor will aim at restoring normal motion of lumbar spine, muscle endurance and strength, proprioception, balance and walking abilities.

Stage III
Restoring full body function: Depending on your daily chores and activity, your physiotherapist will aim at restoring the function of your back portion to keep you safe while performing the chosen activities. For some, it may be taking a slow walk around the park while for others it may mean taking part in some sports activity.

Stage IV
Preventing recurrence: Your physiotherapist will rehabilitate you to prevent further occurrence of this excruciating pain by suggesting proper postures, exercise and core muscle workout.

Each of these stages are important to help you get rid of severe back pain and with daily exercise, you can regulate your body and spare yourself from recurrence of this lower back pain.

Treating Chronic Lower Back Pain

One of the most common diseases that afflict a large section of the population is arthritis. It is common among people who are above 40 years of age. Acute joint pain, difficulties in movement and weakened bones are among the most common symptoms of arthritis. Given the fact that it is a condition that has permeated into modern life so deeply is what makes arthritis one of the most feared illnesses of this time. Although there are multiple forms of arthritis, there are primarily two types, which are:

Osteoarthritis: This is characterized by a breakdown of the cartilage between the bones. It is mostly known to affect a person s joints.
Rheumatoid Arthritis: This is a form of auto immune disease that severely affects the lining within the joints of bones.
Causes
The causes of arthritis might vary from person to person. Some of them are discussed below:

Diet and nutrition habits: Some food items, especially red meat and products derived from animals can cause a rise in the level of uric acid thus, increasing the risks of arthritis as well as gout. Smoking also has been known to worsen this condition.
Genetic predisposition: Some people are more prone to develop arthritis as they are genetically predisposed to it.
Problem in the immune system: Rheumatoid arthritis is one condition which is caused by the attack of immune system on the lining of the joints within the body.
Risk factors for arthritis include:

Obesity: The joints are subject to excess stress because of the excess weight. This results in a higher risk of arthritis in obese people.
Age: The risk of arthritis increases with age.
Family history: It is possible for you to be vulnerable to this disorder if arthritis runs in the family.
Previous injury: People who have had a previous joint injury are more susceptible to arthritis.
Typical symptoms of both forms of arthritis are:

Redness in the affected areas
Stiffness in the joints
Pain in the joints of the body
Swelling in particular joints or most joints of the body
Decreased mobility either due to pain or stiffness

Can Poor Diet and Nutrition be a Cause of Arthritis?

Spondylitis includes swelling of the vertebra. It happens because of wear and tear of the ligament and bones found in your cervical spine, which is in your neck. While it is to a great extent because of age, it can be brought on by other reasons too. Side effects incorporate pain and stiffness starting from the neck to the lower back. The spine's bones (vertebrae) get fused, bringing about an unbending spine. These changes might be mellow or extreme, and may prompt a stooped-over posture. Some of the non-surgical methods to treat spondylitis are as follows-

Exercise based recovery/physiotherapy: Your specialist may send you to a physiotherapist for treatment. Non-intrusive treatment helps you extend your neck and shoulder muscles. This makes them more grounded and at last, relieves pain. You may neck traction, which includes using weights to build the space between the cervical joints and decreasing pressure on the cervical disc and nerve roots.
Medications: Your specialist may prescribe you certain medicines if over-the-counter medications do not work. These include:
Muscle relaxants, for example, cyclobenzaprine, to treat muscle fits
Opiates, for example, hydrocodone, for pain relief
Epileptic medications, for example, gabapentin, to ease pain created by nerve damage
Steroid infusions, for example, prednisone, to decrease tissue irritation and diminish pain
Home treatment: In case your condition is less severe, you can attempt a couple of things at home to treat it:
Take an over-the-counter pain reliever, for example, acetaminophen or a calming medication, for example, Advil or Aleve.
Use a warming cushion or an ice pack on your neck to give pain alleviation to sore muscles.
Exercise routinely to help you recover quickly.
Wear a delicate neck prop or neckline to get transitory help. In any case, you shouldn't wear a neck brace for temporary pain relief.
Acupuncture: Acupuncture is a highly effective treatment used to mitigate back and neck pain. Little needles, about the extent of a human hair, are embedded into particular points on the back. Every needle might be whirled electrically or warmed to improve the impact of the treatment. Acupuncture works by prompting the body to deliver chemicals that decrease pain.
Bed Rest: Severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (DVT, blood clots in the legs).
Support/brace use: Temporary bracing (1 week) may help get rid of the symptoms, however, long-term use is not encouraged. Supports worn for a long time weaken the spinal muscles and can increase pain if not continually worn. Exercise based recovery is more beneficial as it reinforces the muscles.
Lifestyle: Losing weight and eating nutritious food with consistent workouts can help. Quitting smoking is essential healthy habits to help the spine function properly at any age.

Spondylitis - Can Non Surgical Methods Help You?

Knee is a hinge joint where the lower leg bone tibia meets the thigh bone femur. During osteoarthritis, cartilage or ligament defects and degenerative arthritis, knee replacement surgery is recommended world-wide to get relief from extreme pain. Knee replacement surgery, also known as knee arthroscopy, is a surgical procedure, in which the affected knee joint is replaced with synthetic material. The most likely candidates for total knee replacement are the patients with severe destruction of the knee joint coupled with progressive pain and impaired function.

Modern technological advances have made computer assisted knee replacement surgery extremely popular around the globe. In this surgery, the surgeon is assisted by a computer to remove the optimum amount and angle of the bone, which otherwise is done by inspecting manually. This is an excellent example of surgery through small incision and it eliminates the chances of human error. A perfect alignment and balance is achieved and hence longevity is also increased to 20 - 30 years. Knee replacement surgery is also specific to gender as the anatomy of male and female patients is different.

There are many types of knee replacements, most common being the total knee replacement or Total Knee Arthroplasty. In addition, there is partial knee replacement, bilateral knee replacement, revision knee replacement and knee arthroscopy.

In knee replacement surgery, the worn out surfaces of joints of knee are replaced with artificial implant of plastic and metal. The lower end of the femur bone is removed and replaced with a metal shell. The upper end of the lower leg bone (tibia) is also removed and replaced with a channelled plastic implant with a metal stem. A plastic ball is also added under the kneecap depending on its condition. These artificial components are commonly referred as prosthesis. The design of these highly flexible implants replicate knee, with the rotating knee replacement implants assist in backward and forward swing of the legs.

Patients whose knee joints have been damaged by either trauma or progressive arthritis should consider total knee replacement surgery. Post-surgical hospital stay after knee joint replacement is usually three to five days. The surgery has a very high success rate and shows dramatic improvement after a month. This improvement is most notable one month or more after surgery. The pain caused by the damaged joint is reduced significantly when the new gliding surface is constructed during surgery. Initially, patient will walk with the help of a walking aid until the knee is able to support full body weight. After six weeks, patient can walk comfortably with minimal assistance. Patients with artificial joints are prescribed to take antibiotics during the course of any elective invasive procedures including dental work. Physiotherapy is an essential part of rehabilitation and it will increase the muscle strength and patient can enjoy most activities, except running and jumping.

Knee Replacement

You must have often heard about sports person, especially those associated with tennis or baseball (that involves continuous arm movement) suffer from rotator cuff injury. But what exactly is this injury? To understand the condition better, you need to know what is a rotator cuff. A rotator cuff is a group of tendons and muscles that keep the shoulder joints stable enabling a person to rotate or lift their shoulders freely.

With time, certain activities may cause a wear and tear of the rotator cuff injuring them. The injury sustained can result from a partial or a complete tear.
A partial tear of the rotator cuff may damage the tendons, but it will remain attached to the bones. However, in the case of a complete tear, the injury is more severe that penetrates deep within detaching the tendons off the bone (humerus).

Who can suffer from a Rotator Cuff Injury?
While the condition can affect anyone, people under the following situations stand a greater chance of injuring their rotator cuff.

People in their old age may suffer from the Rotator Cuff injury as with age the tendons and muscles may undergo a degeneration.
The injury may also be genetically linked.
The problem is found to be common among tennis and baseball players.
Painters, as well as carpenters who need to move their arms and shoulders continuously in a particular direction, stand at a risk of injuring the rotator cuff.
Symptoms associated with a Rotator Cuff Injury
People with a Rotator Cuff Injury may exhibit the following symptoms and associated discomfort.

The rotator cuff ensures the free and comfortable rotation of the arm and the shoulder. An injury will limit this rotation. As a result, a person may experience great difficulty and pain in lifting and moving the arm.
Lying on the affected shoulder can be a painful experience.
There is instability of the shoulder joints followed by weakness.
A person finds it difficult to carry out the basic activities such as bringing a glass of water close to the mouth or combing the hair.
Treatment

Anti-inflammatory drugs and painkillers (Acetaminophen) may be used to reduce the pain and swelling associated with the injury.
Physiotherapy and various strengthening exercise can go a long way to deal with shoulder weakness, stiffness, and restricted movement. However, one needs to have patience as the treatment may take time to produce the desired results.
In extreme cases, the doctor may opt for a surgery.
Arthroscopic surgery: The procedure is simple and involves a small incision on the affected shoulder to place an arthroscope (that comes fitted with a camera and the surgical instruments) to treat the condition.
The doctor may also carry out an open surgery or a mini-open surgery (an amalgamation of open and arthroscopic surgery) to fix the tear.

Rotator Cuff Injury - Symptoms Associated With It!

Physiotherapy can greatly help a patient of paralysis by making him/her independent to the maximum extent. Physiotherapy also plays an important role in negating potential complications after a paralysis. Although the process of rehabilitation can take time, it produces significantly encouraging result for a patient to continue with it until full recovery. The recovery depends on the type of paralysis a person has undergone. Notably, there are four types of paralysis:

Hemiplegia

Quadriplegia

Paraplegia

Monoplegia

Role of Physiotherapy-

The process of physiotherapy should resume as soon as the patient is stabilized. It not only helps in relaxing muscles, but also helps in smooth blood circulation. Long-term therapy can ensure muscle tone and overall well-being of an individual.

In the case of an external injury related to the brain, physiotherapy can speed up the recovery and reduce swelling to a significant extent. Some of the benefits are-

Physiotherapy can help a person regain the highest possible mobility.

Physiotherapy can increase the respiratory function of a person.

It helps the person in bringing down blood pressure and contracture.

A physiotherapist also focuses on unaffected area and works on them to ensure that the unaffected part of the body, in no way, loses mobility and retains the natural strength.

Physiotherapy also helps to manage a paralyzed bladder.

A physiotherapist suggests proper wheelchair, splint, braces, orthosis etc. These help a person to reintegrate quickly after the paralysis.

Physiotherapy lifts the morale and motivation of a patient by addressing post-traumatic experiences such as denial, anxiety, hostility, depression and anger.

It also serves as a perfect guide for the family of the patient.

Exercises that a Physiotherapist Suggests-

Aerobic Exercise: This is a set of physical exercises that lets the muscle tissues exchange oxygen at a rapid rate. The goal is to enhance the function of the motor neuron and the aerobic capacity of a patient. Support straps and gain belts might be required for a patient to stand on feet. A handrail helps to walk during this phase.

Physical Conditioning: Balance, stability, and coordination is the motive of any physical program for a paralyzed individual. Passive or active motion exercises help an individual to regain function of the limbs. Passive exercise also helps to regain strength. A physiotherapist rotates the thumb of a patient in such a way that the back of his hand faces forward.

Leg Rotations: One common exercise that is tried by a physiotherapist is to make the patient lie down on a mat with his/her legs straightened. Supporting the knee joint and the ankle, the right leg is moved outward and pulled backward. This is again repeated with the other leg.

Physiotherapy For Paralysis

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