Posts Tagged ‘Sciatica’

Ankylosing Spondylitis and Physiotherapy

Ankylosing spondylitis is an inflammatory arthritic disease or spondyloarthropathy, classified with reactive arthritis, bowel disease arthritis and psoriatic arthritis. The underlying relationships between these diseases are complex but they are connected by enthesitis (inflammation of the ligament/bone junctions) and by possession of the HLA B27 gene on white blood cells. The enthesitis process at the joint edges can cause fibrosis and then ossification of the area (bone formation).

AS is the commonest of the spondyloarthropathies and its occurrence varies with the occurrence of the HLA B27 gene in the population, AS being less common in the tropics and more common in northern European countries. 0.1 to 1.0% of people are affected but this varies with latitude and is more common in white people. About 1-2% of people with the HLA B27 gene actually develop AS but this becomes 15-20% likelihood if they have a first degree relative with the disease.

Three males to every one female is the ratio of patients with Ankylosing spondylitis, as female patients may have much less obvious symptoms and so be missed from the diagnosis. Young men are the commonest presenting group with most consulting a doctor before they are 40 and up to 20% before they are sixteen years old. 25 years is the average age that someone goes down with the symptoms and is uncommon to find a diagnosis of AS in a person over fifty. It is easily overlooked as it can look like mechanical back pain if care is not taken. On questioning how they are in the morning, a typical answer is very stiff.

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Be the first to comment - What do you think?  Posted by admin - October 13, 2017 at 4:29 pm

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Physiotherapy and Back Exercises

The cost of low back pain to society is very great, with high financial costs in terms of lost income, lost production and time off work and the costs of medical and physiotherapy and other treatments. This is apart from the personal consequences of the loss of one’s work or job role, loss of the ability to do normal activities and the pain itself. Many back pain treatments have been developed, most of which do not have high levels of effectiveness, and much is down to self management. An exercise programme has been shown to be an important aspect of this and this includes stability work, gym or aerobic exercise and lumbar and pelvic ranges of movement.

Joint ranges of movement are not obvious to most of us but are vital to our ability to perform day to day activities. The shoulder is an important example of a highly functional joint which allows us to place our hands in front of our vision so we can perform precise actions. To do this it has a very large range of movement, allowing us to put our arms behind the back, behind the neck and right above the head. A joint can change due to Read more…

Be the first to comment - What do you think?  Posted by admin - October 11, 2017 at 4:34 am

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Treating Lumbar Spinal Pain by Physiotherapy

Low back pain is very common and most people have some experience of a back pain episode at some time of life. Attendances at physiotherapy clinics for low back pain are very high so physios have a variety of assessment and treatment techniques to manage spinal pain and improve patients’ function.

A serious medical condition such as cancer or infection is a very uncommon cause of back pain, but several medical problems can present this way and physiotherapists need to be aware of this so they can refer the patient on to the appropriate doctor. The physio will ask about past medical history (cancer, arthritis, diabetes, epilepsy), any loss of weight or appetite, bladder and bowel control, feeling unwell, sleep disturbance and worse pain when lying down to sleep.

The physio is looking for the patient to react as if they have mechanical spinal pain, a condition where normal physical stresses such as sitting or walking have a worsening or easing affect on the pain. The examination starts by observing the posture and movement of the patient during the questioning and the physio follows this by examining the spinal posture and ranges of movement. Abnormalities of posture are common and not always important, with leg length differences, a reduction or increase in the back curves and a scoliosis being common findings.

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Be the first to comment - What do you think?  Posted by admin - at 3:35 am

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Physiotherapy of Your Shoulder

The function of the human arm is to allow placement of the hand in useful positions so the hands can perform activities where the eyes can see them. Because of the huge range of positions required the shoulder is very flexible with a large motion range, but this is at the expense of some reduced strength and greatly reduced stability. A “soft tissue joint” is often a description of the shoulder, indicating it is the tendons, muscles and ligaments which are important to the joint’s function. Shoulder treatment and rehabilitation is a core physiotherapy skill.

The shoulder joint is constructed from the socket of the scapula and the humeral head, the ball at the top of the upper arm bone. The head of the upper arm is a large ball and important tendons insert onto it to move and stabilise the shoulder, but the shoulder socket, the glenoid, is small in comparison and very shallow. A cartilage rim, the labrum of the glenoid, deepens the socket and adds to stability. The acromio-clavicular joint lies above the shoulder joint proper and provides dynamic stability during arm movements, being made up from part of the scapula and the outer end of the clavicle.

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Be the first to comment - What do you think?  Posted by admin - October 6, 2017 at 4:46 pm

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Physiotherapy – Pain Syndromes

The gleno-humeral joint, known in lay terms as the shoulder, is a vital part of the links in the upper limb and responsible for our ability to place our hands where we can see them to perform activities. Because flexibility is a prime requirement the shoulder is a less stable joint with moderate muscle power and a large range of motion. It is described as a “soft tissue joint”, implying that the joint’s functional ability is dependent on its soft and not its hard components. Physiotherapists are closely involved in treating and rehabilitating the shoulder, dealing with the muscles, ligaments and tendons.

The shoulder joint is constructed from the socket of the scapula and the humeral head, the ball at the top of the upper arm bone. The head of the upper arm is a large ball and important tendons insert onto it to move and stabilise the shoulder, but the shoulder socket, the glenoid, is small in comparison and very shallow. A cartilage rim, the labrum of the glenoid, deepens the socket and adds to stability. The acromio-clavicular joint lies above the shoulder joint proper and provides dynamic stability during arm movements, being made up from part of the scapula and the outer end of the clavicle.

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Be the first to comment - What do you think?  Posted by admin - at 4:32 am

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Try Physiotherapy for Golfer’s Elbow

Golfer’s elbow (medial epicondylitis) is not confined to golfers, but occurs in many sportsmen and women, with racquet sports the most common causes. Other sports where golfer’s elbow occurs are in bowlers in cricket, archers and weightlifters. This and the more common tennis elbow are tendinopathies, overuse syndromes where there is no significant inflammation but a pathological alteration in the body of the tendon at the painful site.

The medial epicondyle is the bone prominence on the inside of the elbow where the forearm and rotatory muscle originate from. The muscles become tendinous near the bone and the tendon inserts into the bone to anchor the muscles. This area is where the pain occurs but no inflammatory process, rather a degenerative one. As the elbow is stresses by forces which would tend to push the elbow out into “knock elbow”, the tendon takes a lot of stress and changes occur.

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Be the first to comment - What do you think?  Posted by admin - October 5, 2017 at 4:34 pm

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Physiotherapy and Gait Analysis

Travelling short or medium distances for us is easily accomplished by walking, which is convenient and easy but needs our muscles and joints to be in good condition and to be pain free. Having enough muscle power and sufficient joint range of movement in the legs is necessary for efficient walking. As walking progresses one leg gives the body support while the other swings through to be placed forward and in its turn to take weight. The swing and stance phases are the easiest way of understanding where either leg is at a particular point.

Achieving all the phases of gait so that you get back onto the same foot you started on is referred to as the gait cycle. The duration of both feet remaining on the ground at the same time is about 10 percent and one leg is standing on the ground for about 40 percent of the time. The rest consists of the swing part of the cycle as the non-weightbearing leg is taken through to a position where it can again bear weight. As our walking speeds increase the duration of the gait cycle phases  reduces until there is no double support phase where both feet are weight bearing at the same time, a condition known as running.

The leg joints follow a specific and repeatable series of actions during the swing and stance phases with stance made up of five sections in the order of initial contact, loading response, mid stance, terminal stance and preswing. Heel strike is the common name given to initial contact but some people do not heel strike at all or transfer weight to the heel later in the phase. Heel strike allows the leg which is about to weight bear to take the weight but not compromise speed, stability or shock protection.

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Be the first to comment - What do you think?  Posted by admin - September 30, 2017 at 4:32 pm

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Physiotherapy Can Help Cervical Nerve Root Neck Pain

Cervical radiculopathy is a pain syndrome involving one of the cervical nerve roots, with the C7 root (60%) and the C6 root (25%) being the most commonly involved. In younger persons this is due a direct injury which compromises the nerve exit or due to an acute disc prolapse. In older age groups this syndrome can also occur, but in this case is due to narrowing of the nerve exit by arthritic joints and ligament enlargement, disc bulging and bony outgrowths. Cervical nerve root pain referred to physiotherapists for the management of neck pain and arm pain.

The regular lifting of weights over 12 kilograms (25 pounds), operating or driving machinery which vibrates and cigarette smoking are all risk factors for cervical radiculopathy. This kind of neck and arm pain is much less common than the lumbar syndrome of back and leg pain (sciatica). The discs between the cervical vertebrae allow loads to be transmitted down the spine and damp down unwanted shocks. The joint, disc, bone and ligamentous structures form exit spaces for the nerves on the sides of the vertebrae, with up to a third of their space taken up by the nerve. This space can be compromised if degenerative changes occur nearby, leading to nerve compression symptoms.

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Be the first to comment - What do you think?  Posted by admin - September 15, 2017 at 4:28 pm

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Shoulder Rotator Cuff Disease

The rotator cuff is a musculotendinous cuff which surrounds the humeral head and through which the shoulder stabilising and movement muscles exert their forces onto the shoulder. The cuff enables us to put our shoulder through a very large range of motion, the greatest range of any joint in the body, for the purpose of putting our hands in functional positions. The shoulder’s function is to allow our hands to be put in useful positions within our visual field so we can perform the intricate activities that define being human to a degree.

As the muscles approach their insertions on the humeral head they become more and more fibrous until they become wholly tendinous. Many bodily tendons are cylindrical and long but the shoulder tendons are flatter structures which coalesce over the top of the humeral head. The rotator cuff has a relatively poor blood supply and little or no ability to heal and with time and physical stresses tears appear which are often painful but not always so. Rotator cuff tears are a major part of a shoulder surgeon’s work and rotator cuff surgery is common, complex and demands detailed physiotherapy follow up for successful outcomes.

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Be the first to comment - What do you think?  Posted by admin - September 10, 2017 at 4:27 am

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Physiotherapy and Stretching

The limitations in flexibility which people exhibit are of interest to a large group of professions from medicine to physiotherapy, osteopathy and chiropractic. Yoga and other eastern traditions have employed stretching techniques called asanas for thousands of years although this was not their primary purpose. The eastern martial arts, such as karate, judo and taekwondo, also emphasise flexibility in the performance of these comprehensive martial ways of living. Flexibility is not precisely defined but in anatomical terms it mostly refers to the ability of joints to go through a particular range of motion.

Ballistic versus Static Stretching

Stretching, when you get down to details, has a lot of controversial and uncertain matters which are unresolved. The pros and cons of static and ballistic stretching is one discussion point. Static stretching is Read more…

Be the first to comment - What do you think?  Posted by admin - September 8, 2017 at 4:39 am

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