Physio and Acupuncture Talk

Name:
Location: Brampton, Ontario, Canada

We have worked in healthcare for over 15 years and have learned a great deal about the business of healthcare during this time. We enjoy dealing with all types of people and our passion is to help out in the improvement of their lives. Our interests include Physical Therapy, Acupuncture, Herbs, Mila - the world's healthiest wholefood, marketing, networking, internet, writing, coaching, food, sports and travel.

Friday, April 28, 2006

Understanding Upper Back Pain

Upper Back Pain can be just as troublesome as the pain in the lower back or the neck. It can be caused by a variety of factors, ranging from poor posture to improper lifting, especially overhead lifting.

Muscular irritation and joint malfunction have been found to be the most common causes of upper back pain. This can be a result of injury or poor posture. It has been found that people sitting in one position for a long time (for example working in front of the computer) are more prone to suffer from this type of back pain. This occurs especially if the workstation is not set up ergonomically.

Lack of activity or poor strength of our muscles is also a very common cause of upper back pain and can be treated through acupuncture, massage, physical therapy and various types of stretching and strengthening exercises.

Many people will experience upper back pain for years without doing anything about it. Adopting good posture and starting regular strengthening exercises are a must for avoiding the pain in the upper back. Poor posture can lead to weak muscles and a strain in our joints and ligaments and thus cause upper back pain. Osteoporosis, a disease which makes ones bones fragile and weak, a rupture in the spinal disk or any other form of injury can also result in back pain.

Poor posture eliminates the natural, weight-supporting S curve in our back and weakens all the back muscles. In contrast, correct posture - chest out, stomach in, and buttocks tucked under - helps one to restore the S curve in our back. Proper exercises can enable one to rectify one's posture.

A few tips to help you with prevention of upper back pain include: standing with your back to the wall perodically and pushing your shoulders back, tucking your chin in and holding for 10 seconds. Also, make sure that your working chair supports you well as you sit and start exercising your shoulder blade muscles by doing the appropriate arm exercises with free weights. Consult your physical therapist today to start improving your upper back!

Monday, April 24, 2006

What is Frozen Shoulder?

Also known as ‘Adhesive Capsulitis’, Frozen Shoulder is a condition affecting people generally aged between 40 and 60. Essentially, it is a “painful and stiff” shoulder. It is more common in people suffering from Diabetes Mellitus. Investigations such as certain blood tests and X-rays are normal.

This condition usually lasts between 6 months to 2 years, and can even last longer if not treated.

There are 3 Phases to Frozen Shoulder, each lasting several months:

Freezing: There is increasing pain and stiffness. The patient first complains of a painful shoulder, that ‘feels like a toothache’. This affects the sleep adversely especially when lying on the affected side.Graduallly, it gets more difficult to raise the arm sideway and to touch behind one’s head until it becomes impossible.


Frozen: The pain gradually subsides but the stiffness persists.


Thawing: The movements gradually return. However, many patients do not regain their full range of movement even after many years.

How would I get it?

The cause is uncertain, but there seems to be multiple inter-related causes. Some patients may recall a minor trauma to the shoulder before the onset of Frozen Shoulder. There may be “autoimmune” response by the body’s immune system to attack the injured shoulder tissues. There are also studies that showed that identical twins are more likely to get it if the other twin-sibling has it, suggesting a genetic predisposition. Diabetics are 4-5 x more likely to get it.

Can it be cured?

The condition is self-limiting. Treatment will improve on the range of movement and pain while the body heals itself.

How is it treated?

General Advice: There should be sufficient rest for both the patient and the affected shoulder. Resting the affected arm on a “Collar and Cuff” sling for short periods may help to relieve pain.


Physiotherapy: Heat, and often, Ice Packs will help in pain relief. Exercise that works through the range of shoulder movement will help, if it is conducted regularly and gently. However, this should be done after the acutely painful stage has subsided. One particular exercise is the “pendulum” exercise, whereby the patient leans forward at the hip, hanging the arm down and move it in a stirring movement. Acupuncture can often help relieve the pain and facilitate ROM exercises.


Medications: Oral painkillers such as Paracetamol and Diclofenac will help relieve the pain. Oral steroids are effective too. Occasionally, injection of steroids into the shoulder joint may be indicated.


Surgery: Manipulation Under Anaesthsia, whereby the Orthopaedic Surgeon manipulates the affected shoulder through certain movements while the patient is under anaesthesia. The result is significant pain relief and a possible shortened course of the disease process.
Surgical Release can be done either through an open surgery or an arthroscope.

When should I see a doctor?

There are many causes to shoulder pain and Frozen Shoulder is but one of them. Some of these are potentially serious: Ischaemic Heart Disease, Arthritis, TB, Gallstones among others. It is important to see a doctor if in doubt as to diagnosis of the shoulder pain.

Monday, April 17, 2006

Basic Facts on Whiplash

Most of the time, whiplash affects the soft tissue in a person's body. Soft tissue consists of:

Muscles
Tendons
Ligaments.

In the days following an impact your neck or back muscles may feel stiff and sore. This may subside within a few days, or may persist.

Injury beyond Soft Tissue

Soft tissues generally heal completely within about 3 months. (Some experts say 3-6 months.) If pain persists beyond this timeframe, the whiplash injury may also be affecting any or all of these structures:


Intervertebral joints
Facet joints
Nerve roots
Interveterbral disks.

Diagnosis

If pain does persist beyond the normal amount of healing time for whiplash (3-6 months), a diagnosis is often made by a doctor as to the exact location and nature of the problem.

Diagnostic tools the doctor might use include: MRI, X-Rays and Injections.

Recovery from Whiplash

Generally, whiplash injuries take no longer than 6 months to heal. There are conflicting views as to how many whiplash patients end up with chronic pain - this varies between 5 and 20 percent.

Most of the time, exercise, patient education (on body mechanics), and physical therapy are enough to cause significant improvements, allowing patients to return to their normal activities of daily living.

Treating Dysmenorrhea

Dysmenorrhea refers to lower abdominal pain which is experienced premenstrual, during menstration or before menstruation. It occurs most typically in young women two to three years after the onset of menstruation. In severe cases , lower abdominal pain is also accompanied with nausea, vomiting, headaches, dizziness, lower back pain or a pulling sensation in the inner thighs. This is a common health problem for women all over the world.
This health problem is often related to stagnation of qi and blood in the uterus, retention of cold-damp, damp heat in the liver channel or liver qi stagnation and deficiency of qi and blood. The first three are dysmenorrhea of excess type and the last one is dysmenorrhea of deficiency type.

CASE STUDY
Female patient, 28 years of age came to the clinic seeking help from her dysmenorrhea that she has been suffering with most of her adult life but the past three year have been unbearable. This condition has affected her life dramatically. She has taken time off work because of the pain and more importantly it has affected her relationship with her family. Over the years she has tried all kinds of prescription pain killers and over-the counter pain relievers. Finally, a friend of hers recommended that she see a Chinese Medicine Practitioner. She was extremely hesitant at the beginning, but she came to see me on one of her "bad" days. The patient presented with lower abdominal pain, irritability, purplish red flow with clots, alleviation of pain with discharge of clots, restlessness, painful breasts, purplish hue on border of the tongue, and a wiry pulse. This individuals Chinese Pattern was stagnation of qi and blood. Treatment consisted of acupuncture and chinese herbs. Points selected were Li4, Liv 3, CV3, ST29, SP8, and Sp6. The patent medicines Tongjing Wan and Xiao Yao were also prescribed. The patient achieved immediate results after the acupucture treatment. I recommended that she have two treatments every month before her menstruation. After three months her menstral pain has disappeared and she is now living a happy productive life.

Sunday, April 09, 2006

Do you have a Painful Knee? - It could be Patellofemoral Syndrome

Patellofemoral syndrome is a common overuse injury of the knee that often results from exercises involving repetitive movements using a higher degree of knee angle than most other exercises.

This condition occurs via two mechanisms, either when the extensor mechanism of the knee is malaligned or as a result of repetitive microtrauma from overuse. Basically, overuse can cause irritation on the articulation between the patella bone and the femoral condyles, the rounded projections on the femur (commonly called the thigh bone). To make this clear let us take a look at the anatomy of the knee. The patella is a small, round bone, commonly called the knee cap. It is situated within the lower end of the quadriceps tendon and the upper end of the patellar tendon (or ligament). There are two projections at the lower end of the femur that hold the patella in place. Patellofemoral syndrome affects the tracking of the patella within this region. People who exercise excessively may develop this condition by causing microtrauma in the area of patellofemoral joint, which means that through external stresses tracking is compromised.

The pain associated with this condition is probably due to the strain placed on the retinaculum, the structure that holds the patella, often times to the lateral side of the knee, causing inflammation. Inflammation of the soft tissues surrounding the area, along with the irritated, yet highly enervated patella, causes pain. The patellofemoral syndrome is recognized by a dull, aching pain behind or above the knee. Inflicted exercisers often have pain while sitting for any length of time with a flexed knee position. Sharp pain may be observed upon activities that require squatting and climbing or descending stairs. Another common symptom is cracking noises that come from the knee during bending and stretching, called crepitus. Often these symptoms do not appear at one instance but develop gradually, which is characteristic of an overuse injury.

Saturday, April 01, 2006

Dealing with Back Pain

Many people try to ignore their back pain when they first start experiencing it. Often, the pain gradually escalates to a severe level, radiating down the leg and limiting most activities. Many can barely walk. They can't shop for groceries, go to family outings, exercise or even work.

This is the collateral damage of pain. Pain is a noxious stimuli that affects all parts of our lives. When we get stopped in our tracks because of the pain we have, we become 'de-conditioned' both physically and emotionally. It becomes a vicious cycle and a downward spiral.

We all get back aches. That's universal. But most pain, even the most severe pain, goes away in a few days. If the pain lingers -- shooting down your legs, arms getting electrical 'zingers' -- you should tell your doctor or physiotherapist and get it examined.

Years ago, doctors recommendeded that patients go to bed and stay there in order to heal. That's absolutely not the recommendation today. In fact, not moving at all could be the worst medicine.

In order for the joints to clean out toxins, feed themselves and regenerate, they need movement to get nutritious fluids in and out of them. So movement as soon as possible, is very important in helping to reduce back pain.

Poften tend to overdo it, or "underdo" it. People exercise too much and stress their bodies even more. Or they don't move at all. The key is to engage in modest, persistent activity. That may mean just walking a little bit every hour while you're having a back-pain episode, just making sure you're not sitting in a chair or lying down for long periods of time.

The first step toward making movement tolerable is taking over-the-counter medications such as aspirin or ibuprofen. These medications work by diluting the power of the nerve pathway to the brain. For most patients, a couple of days of medication and movement makes the pain goes away.

But for chronic pain sufferers, there can be difficulties sifting through appropriate medications. Most people have a view that drugs, since they are over-the-counter, are nontoxic, with no side effects. That's not the case! These drugs come with a whole range of side effects, particularly if taken in greater than recommended doses or taken for long periods of time.

For example, aspirin and ibuprofen can cause stomach ulcers, increase bleeding and damage kidneys. This can be especially problematic for patients on blood-thinning medications. Tylenol can adversely affect the liver. This, too, can be problematic for patients on other medications that affect the liver, as well as patients who drink large amounts of alcohol.

Morphine-like prescription drugs may be an option for some patients. Vicodin, percocet and oxycontin are all morphine-derived medications. They are the "gold standard" of pain relief, because they're potent and effective.

There are alternatives for those who don't like the idea of being on medication every day. Great examples include Acupuncture and Physiotherapy. Patients can also learn psychological techniques, much like those used by athletes. These powerful psychological tools are not new; Buddhists have relied on them for centuries.
Patients can harness their brainpower to get "really robust effects on their pain and general health that are lasting and can be used most of their lives and may even mean they rarely have to go to the hospital or see the doctor.

Stress does not cause pain, but it can exacerbate it and make it worse. Much of chronic pain is 'remembered' pain. It's the constant firing of brain cells leading to a memory of pain that lasts, even though the bodily symptoms causing the pain are no longer there. The pain is residing because of the neurological connections in the brain itself.

One helpful technique is the 'relaxation response' to change the brain's perceptions of what it is experiencing, and help erase the memory of pain. In order to do this, a person has to break the train of everyday thought.

To do that, two steps are necessary. First is repetition. Patients repeat a word, sound, prayer, phrase or movement, such as yoga or tai chi. Most patients use a prayer they are comfortable with and believe in, such as "The Lord is My Shepherd." Other patients choose general words, such as "peace" "love" or "gentle."

The patient then does a combination of the following: sit up, close their eyes, relax all their muscles, loosen their clothing, shrug their shoulders and roll their head and neck around. Then, they focus on breathing. With each outgoing breath, patients repeat their special word or phrase silently to themselves, letting it drain out with each breathe. They should repeat this for ten to twenty minutes every day.

Often, practicing this relaxation technique regularly will deliver the intended results. Long-term bodily changes occur. Pain becomes less bothersome, and if stress is exacerbating the pain, then this approach can work in the long term and can relieve the pain entirely.

This is often true with tension headaches, and sometimes with back pain.
Scores of techniques can evoke the relaxation response -- meditation, repetitive prayer, yoga, Tai Chi and Chi Gong.

The relaxation response is a physiologic state characterized by decreased metabolism, decreased heart rate, decreased rate of breathing, lower blood pressure and specific changes in brain waves, including the liberation of a substance called nitric oxide, a chemical that relaxes blood vessels. This is a discrete physiologic package that's opposite of the "stress" package called the "fight or flight" response.

Often the pain is still there, but relaxation-response techniques help patients live with the pain and return to normal activities. In some cases, the pain disappears completely.

For more information, please visit one of our clinics, www.albionhillsphysio.com in Bolton and www.queenwestphysio.ca in Brampton.