Physiotherapy for back pain and low back pain

 Does your back hurt and does that pain affect you in your day-to-day life? You probably think that the time has come to visit a physical therapy professional. In this article we are going to tell you about the benefits of physiotherapy to relieve back pain.

Pain in the lower back can be associated with various causes, from age and diet to aspects related to lifestyle, such as a sedentary lifestyle.

However, most back pain is caused by poor posture habits, but it can also be due to sudden changes in temperature or insufficient hydration. More rarely, behind low back pain there may be a more severe pathology that requires immediate attention, such as vertebral prolapse, herniated discs or fractures. That said, in most cases its origin is unknown (idiopathic).

Back pain is one of the most frequent musculoskeletal pathologies and is the first chronic health problem in India. In fact, it is the one that causes a greater number of primary care consultations within disorders of the musculoskeletal system. It is estimated that between 60% and 80% of the population will suffer from low back pain at some point in their lives.

SYMPTOMS OF BACK PAIN

Back pain can be localized in one area, spread throughout the lower back or radiate down the leg, and in terms of intensity, it can be deep, superficial or resemble a burning, cramp or prick.

Pelvic pain, on the other hand, generates high degrees of disability, usually related to gait disturbances and the transition from sitting to standing.

Some of the most common symptoms of back pain and low back pain are:

• Severe back pain, especially when bending over.
• Morning stiffness in the lower back after sitting.
• Sensation of pins or needles in the buttocks, legs or feet.
• Pain radiating down the back or front of the leg.

Other more infrequent symptoms, such as back pain accompanied by unexplained weight loss and fever or difficulty controlling the bladder or bowels or numbness in any area, require an urgent visit to the urologist in Delhi.

WHY SHOULD YOU GO TO THE PHYSIOTHERAPIST IN DELHI IF YOUR BACK HURTS?

If your back pain is giving you a lot of trouble or isn’t getting better after a few weeks, you should see a physiotherapist in Dwarka.

Physiotherapy in Dwarka can be very useful in the following cases of back pain:

• Nonspecific back pain, such as an injury, infection, or herniated disc.
• Sciatic pain: it is a pain that extends from the back to the legs and can even reach the foot.
• Back pain caused by the wear of the vertebral discs, very common as we age.
• Lumbar spinal stenosis – when spaces in the spine narrow and put pressure on the spinal cord and spinal nerve roots.

BENEFITS OF PHYSIOTHERAPY IN THE TREATMENT OF BACK PAIN

• Reduces pain, improving quality of life.
• It helps to improve the mobility of the back, so that the patient can resume their daily routine normally and minimizing discomfort.
• It effectively contributes to strengthening the back muscles, toning and reducing the risk of having painful episodes again.
• It favors the stability and function of the spine, reduces the risk of injury to the intervertebral disc and improves mobility, avoiding poor posture that can cause chronic back pain.
• Increases the vascularization of the area, favoring the de-inflammation of the region and a better recovery.

TREATMENTS FOR BACK PAIN

Immobilization and absolute rest as a method of dealing with back pain is an obsolete concept. The effectiveness of individualized exercises and training guidelines for each patient based on factors such as their muscular condition, the characteristics of their spine or the condition they suffer from has been demonstrated.

To find out the possible origin of the pain, the physiotherapist in Dwarka will perform a physical examination. Once you know the origin of the pain and the underlying pathology, you will determine the type of physiotherapy treatment to follow.

Physiotherapy for back pain offers a response adapted to each patient. Depending on the causes, the best physiotherapist in Dwarka specialized in traumatology will provide a treatment that combines different therapies in each session.

Some of the most used techniques are:

• Active therapy (rehabilitation). They are exercises and movements that you do yourself to improve flexibility, mobility and strength in the lower back. It includes proprioception exercises and muscle strengthening for lasting relief from discomfort.
• Manual therapy (mobilizations, massage therapy, manipulations). It is intended to reduce pain and improve joint mobility. Typically, manual therapy is combined with an exercise program.
• Osteopathic Manual Therapy. Massages and spinal manipulations are useful to mitigate pain and possible associated symptoms.
• Invasive therapy (dry needling, percutaneous electrolysis). Only when back pain is caused by high-grade muscle contractures.
• Means or physical agents (electrotherapy, ultrasound, short wave, bandages), which can help in certain pathologies.
• Diathermy. The application of heat to damaged tissues improves the vascularization of the area and speeds up recovery from injuries. Generally, this therapy is combined with others to create a more effective overall treatment.

As we have seen, through physiotherapy we can treat different back injuries, both at the lumbar, dorsal and cervical levels. Depending on your diagnosis, physiotherapist in Najafgarh will apply the physiotherapy treatment that best suits you to achieve a better recovery and avoid relapses.

If you suffer from back pain and seek relief from your symptoms through physiotherapy, at Dr Sarwar Physiotherapy Centre, we are the best physiotherapy clinic in Dwarka, with more than 10 years of experience. You can visit us or ask us your questions.

What are trigger points and how are they treated?

 

Today musculoskeletal disorders are one of the main causes of consultation with our physiotherapist in Dwarka. There are many soft tissue problems: trauma or blows, inflammation, loss of strength… and Myofascial Pain and Dysfunction Syndrome, which mainly affects the muscles and is caused by the Myofascial Trigger Point.

What is a myofascial trigger point?

A Myofascial Trigger Point is a palpable nodule within a taut band of skeletal muscle, the most significant feature of which is pain.

It is called the trigger point, alluding to the trigger of a firearm, since when we press the trigger, the impact of the bullet occurs at a distance. Thus, in a trigger point the pain produced is radiated.

This phenomenon explains why in many patients a muscular problem, such as hypertonus or contraction of the sternocleidomastoid, causes referred or distant pain in the area of ​​the head in the occiput or in the orbicular area (around the eye). We would speak in this case of a tension-type headache.

The presence of trigger points is quite common in the posterior muscles of the neck and back. This is due to the fact that, due to their morphology, biomechanics, and function, they are muscle groups that are very prone to fatigue and hypertonia.

What symptoms do trigger points cause?

To find out if it is a trigger point that is causing your injury, in addition to intense pain, you will be able to perceive:

• Contractures.
• Rigidity.
• Muscle weakness.
• Muscular fatigue.
• Imbalances.
• dizziness
• dizziness
• Chronic headaches.
• and many other symptoms depending on each individual.

When a patient has trigger points, the band where the trigger point is lodged feels tense. Sometimes a nodule will be visible and sometimes not.

Myofascial Pain caused by Trigger Points is different in each muscle. The severity and extent of the pain pattern will depend on the degree of trigger point irritability and not on the size of the muscle. On the other hand, their irritability can vary according to the time or day and the stress threshold.

What causes or factors cause the appearance of a trigger point?

Muscles are made up of many muscle fibers and these fibers in turn are filled with sarcomeres which are what allow contraction. When a muscle is in permanent contraction due to muscular overload, a trigger point is activated in the area.

Trigger points thus reflect points where sarcomeres become overactive.

Possible triggers:

• Physical factors:

• • Postural fatigue due to maintained postures (the muscles of the back are usually fatigued).
  • Direct or repetitive trauma.
  • Acute overload.
  • Joint alterations
  • Fatigue due to overexertion in muscles subject to excessively sustained or repeated contractions.
  • By action of other trigger points of muscles that are in the area of ​​referred pain.

• Emotional factors: stress, anxiety…
• Visceral factors: Stomach or liver problems from poor diet or stress can activate upper back trigger points.

Treatment of myofascial trigger points

The treatment of myofascial trigger points can be done using different methods, since they can be conservative or invasive.

Among conservatives, physiotherapy techniques based on manual therapy can be performed, such as digital pressure on trigger points, decontracting massage therapy, stretching and cryotherapy (application of ice). Regarding its invasive treatment, dry needling in Dwarka is postulated as one of the most effective techniques in the approach of myofascial pain syndrome.

There are also other invasive physiotherapy techniques such as intratissue percutaneous electrolysis, neuromodulation, which help the physiotherapist in Dwarka in dealing with pain.

The benefits of invasive techniques are that, although they are more aggressive, they help speed up recovery periods.

Dry needling

It consists of the percutaneous application of acupuncture needles to the myofascial trigger point area with the aim of breaking the adhesions of the nodule.

Dry needling in Dwarka is a very effective technique since after 24-48 hours the pain has disappeared and the muscle has managed to relax, recovering its normal state.

Is dry needling the same as acupuncture?

Due to their similarities in the therapeutic approach, many patients confuse acupuncture with dry needling since both are performed with needles.

The main difference between the two is the mechanism of action: As we have mentioned before, dry needling seeks to break the muscle contraction mechanism that is generating the pain. However, acupuncture is based on the principles of traditional Chinese medicine and seeks to release and normalize the energy flow of the body through the energy meridians.

If you report muscle pain, it is best to see a qualified physiotherapist in Delhi for evaluation. In order for a physiotherapist to perform the dry needling technique, they must be trained and accredited to perform this invasive technique.

PHYSIOTHERAPY TREATMENT FOR ADHESIVE CAPSULITIS

 

Adhesive capsulitis, also known as “frozen shoulder”, is a painful syndrome of the shoulder, which causes a progressive reduction in the range of motion of the shoulder, being one of the main causes of functional disability of the shoulder. 

One of the structures that make up the shoulder complex is the joint capsule. This collagen-based, elastic and flexible structure contributes to the stability and function of this joint.

Adhesive capsulitis is an inflammatory condition of the joint capsule that courses with contracture, pain and stiffness and promotes significant restriction of active and passive movement of the shoulder.

In many cases the cause is unknown, but it is known that it is more common in women (40 to 60 years old), it can also be related to diabetes mellitus, thyroid disorders, previous trauma and almost always with reports of a previous episode in the other shoulder.

Adhesive capsulitis is a pathology that has a beginning, middle and end cycle. This cycle is divided into 4 phases:

==>> Inflammatory phase: usually in the first 3 months. In this phase, the patient presents acute pain on active or passive movement and limitation for flexion, abduction and rotations.

==>> Freezing phase: occurs between the third and ninth month of the disease and the patient has chronic pain on movement, in addition to significant limitation of movement.

==>> Frozen shoulder: at this time, which usually occurs between the ninth and fifteenth month of the disease, the pain is minimal, but the limitation of movement (especially rotations) is quite significant.

==>> Thawing phase: last phase of the disease, the patient already has a considerable improvement in range of motion and the pain is almost zero.

The treatment of Adhesive Capsulitis is basically conservative, and the most important thing is to respect the patient’s symptoms in decision making. In the initial phase, the patient usually seeks a medical service and performs serial blocks of the subscapular nerve.

When arriving at physiotherapy, if the patient has a lot of pain and inflammatory signs, it is worth investing in resources such as combined therapy, laser, US and analgesic currents. The range of motion must be maintained and manual therapies with the aim of recovering them will be introduced after the blockade, as well as the gain in muscle and sensorimotor strength.

Physical Therapy in Adhesive Capsulitis

The goal of physical therapy in adhesive capsulitis is to eliminate discomfort and restore shoulder mobility and function. Considering the pathophysiology of adhesive capsulitis of the shoulder, there are several modalities of Physiotherapy in Dwarka. Each procedure is an integral part of the physiotherapy program and must be in accordance with the clinical aspects and the stage of the condition.

At first, cryotherapy is performed for 30 minutes two to three times a day, then transcutaneous electrical neurostimulation (TENS), with the aim of reducing pain and mobilization with pendular exercises and gentle passive mobilization of the shoulder, which can and should be repeated at home by the patient.

Although heat applications help to reduce pain, they are not necessarily the most indicated, due to some factors, passive or active mobilization is the most effective measure, as they significantly help to increase the range of motion.

Kinesiotherapy

Initially, inflammation control is sought in the treatment, for this it is necessary to eliminate any activity that may worsen the condition.

The use of analgesics and non-hormonal anti-inflammatory drugs can help with recovery, and intra-articular corticoid infiltration is a very indicated measure to reduce pain and consequently improve mobility.

Another treatment option is manipulation of the glenohumeral joint under anesthesia, aiming to reduce the period of joint stiffness, being a technique that favors the early restoration of movements and accelerates the return of function in the primary form.

This procedure, although indicated, should be done with caution as it can cause aggravation in patients with osteopenia in the humerus, osteoporosis and diabetes, in addition to other complications.

Analgesia makes it possible to perform Codmann pendular exercises for decoaptation, relaxation of muscle spasm, bringing pain relief and maintenance of minimum joint amplitude.

Stretching

Stretching is used to increase the length of the soft tissue structures that were affected by the problem and consequently shortened, which causes mobility deficit. This procedure makes it possible to increase the range of motion.

There are several stretching techniques that can be used, and they are determined by the specialist Physiotherapist in Dwarka based on the assessment of the patient’s condition and needs. We can cite as examples the posterior capsular stretching and stretching with the hands behind the back.

It is recommended that these exercises be practiced with the individual standing with the lumbar spine flexed at 90º. Movements are performed clockwise, counterclockwise, latero-lateral and anteroposterior.

It is important that, at the time of execution, the patient has the scapular muscles relaxed as much as possible, this allows the movements to extend as far as possible.

The professional physiotherapist in Dwarka can also guide the patient to reproduce the exercises at home with the help of a specific object and in an appropriate way. In general, a stick is used for this.

Stretching seeks to increase the length of shortened tissue structures thereby increasing range of motion. There are several stretching techniques that can be applied, which will be indicated by the professional according to the patient’s need.

Stretching exercises, whether active or passive, aim to restore movement in the affected limb, improving not only symptoms such as pain, but also your activities of daily living.

Cryotherapy

Cryotherapy is a treatment that uses cold for therapeutic treatment, very common for problems related to the musculoskeletal system, especially in the acute phases of inflammatory processes.

The cold applied to the affected limb helps to reduce the inflammatory process and helps to reduce edema, relieving pain. The explanation for this reaction is the effect of cold on nerve fibers, since it slows down impulse conduction, decreasing sensitivity.

Ultrasound

Ultrasound as a therapeutic method has been used due to its deep heating effects, which causes an increase in blood flow, and increases the speed of tissue repair and consequent improvement of the lesion. 

When ultrasound penetrates the body, it can have an effect on cells and tissues through two physical thermal and athermal mechanisms, in thermal effects the ultrasound travels through the tissues, where a part of it is absorbed, and this leads to generation of heat within the tissue, where they lead to pain relief, decreased joint stiffness and increased blood flow, being of fundamental importance in the acute phase.

In athermic effects, stimulation of tissue regeneration, soft tissue repair, increased blood flow in chronically ischemic tissues, protein synthesis and bone repair can be observed. It is assumed that one or more of the following physical mechanisms are involved in the production of these athermal effects, such as cavitation, acoustic currents and standing waves.

TENS

Tens or electrotherapy is a treatment that uses electrical current to improve injuries, promoting pain relief, as it normalizes circulation in the affected region, while activating the system that inhibits pain.

TENS (Transcutaneous Electrical Nerve Stimulation) is an analgesic current where peripheral nerves are stimulated through electrodes attached to the skin for therapeutic purposes.

The intensity of the current will depend on the parameters used during the treatment, according to what was directed by the physical therapist.

Regardless of the associated measure, Physiotherapy in Dwarka is an indispensable treatment in these cases, and should be started as soon as possible It is important to understand that treatment done properly and as soon as possible allows for a faster improvement and reduces the chances of a possible functional limitation of the member.

If you identify any of the symptoms listed above, look for a doctor immediately, he will certainly, in addition to requesting appropriate tests and prescribing pain relief medication, refer you to a Physiotherapist in Delhi for adequate treatment of the problem.

The procedures listed above must be performed by a specialized professional Physiotherapist in Delhi, and in the case of the use of anesthetics, follow-up by an anesthetic team.

Physiotherapy sessions in Dwarka for the treatment of Adhesive Capsulitis are usually prolonged and performed daily. For this reason, the understanding and cooperation of the patient in relation to the exercises is also a predominant and essential factor for the improvement and recovery of the patient.

Also remember to be careful when doing exercises and other activities that can cause injury to the muscles and joints of the body. Always seek the follow-up of a professional in the case of gyms for example.