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Soft Tissue Technique Or Massage In Pain Management

February 27, 2010 by 1 Comment

Massage has been used for centuries as a form of stimulation technique aimed at muscle relaxation and improvement in local blood flow. This indirectly gives pain relief. Massage is a part of manipulation therapy which consists of

  • Soft tissue technique (massage)
  • Passive mobilization of joints
  • Passive stretching of soft tissues
  • Autostretching of soft tissues

The term ‘massage’ has been replaced by “soft tissue technique” terminology in view of bad publicity given to massage in late 70s. This therapy involves stroking, kneading picking up, skin rolling etc., of soft tissues (muscles with their fascial sheaths, ligaments, tendons and skin). [Read more...]

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Spinal Traction

July 23, 2009 by Leave a Comment

Note: This article on traction relates to traction used in physiotherapy. For traction for acute problems, please refer to other article.

This is a stretching force applied in a longitudinal direction of the spine.  Traction is supposed to separate vertebral bodies, stretches fibrous tissue, improve movements of facet joints,  better drainage of fluid around the nerve roots, and improves circulation.

Traction is of two types – sustained and oscillatory. While sustained hold is used for injuries, root compression and muscle spasm, oscillatory  is used for degenerative changes. [Read more...]

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Transcutaneous electrical nerve stimulation-TENS

June 18, 2009 by 1 Comment
TENS Unit - Credit Wikipedia

TENS Unit - Credit Wikipedia

Transcutaneous electrical nerve stimulation (TENS) is in essence application of electric current for control of pain. It involves a principle wherein the sensory myelinated fibres are stimulated without discomfort to the patient and without muscle contraction. TENS is a non-invasive, very safe method to reduce pain, both acute and chronic. While ther eare conflicting views on its efficacy, its effectiveness for postoperative pain, osteoarthritis, and chronic musculoskeletal pain has been confirmed by systemic reviews.

How Does TENS Act?

The  stimulation activates local inhibitory circuits within the dorsal horn of spinal cord. These inhibitory circuits reduce the transmission of painful impulse through the spinal cord.

This stimulation is done by a frequency of 70 Hz, patients feel comfortable at this level of stimulation. TENS equipment has a frequency of 1 to 100 Hz. When stimulated at high frequency of 70 Hz, the pain relief is shorter and of fast onset. [Read more...]

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Passive And Auto Stretching of Soft Tissue of Manipulative Therapy in Pain Management

April 13, 2009 by 1 Comment

Passive stretching of soft tissues

In soft tissues after any injury immediate repair takes place by formation of fibrous tissue (scar). This scar has an inherent property of contracture and tends to bind tissues together. When this scar tissue forms in fascia, muscles and ligaments it limits the function of tissue because of its lower elasticity.

It hurts when the scar tissue is stretched beyond a limit. Early ambulation is essential after injury to ensure that scar tissue is laid down in the correct plane of movement. Despite all these precautions, nerve entrapment happens in scar tissue.

Passive stretching of soft tissues is most often done for frozen shoulder, early osteoarthritis, sprain and other conditions. [Read more...]

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Conditioning Exercises For Back Pain Relief

April 6, 2009 by Leave a Comment

Pelvic tilt:

The pelvic tilt is a posture that  reduces stress on the lower back caused due to sitting or standing.

Lie on your back with your knees bent and your head comfortably supported.

You would notice a space between your lower back and the surface on which you are lying. (You can find this by inserting yourfingers underneath your back.)

Squeeze your buttocks together, tighten your abdominal muscles, and raise your buttocks slightly off the floor until the small of back is pressing flat against the surface. This is the pelvic tilt position.

Hold this position for 10 seconds. Then relax completely.

The pelvic tilt rotates your pelvic bone and decreases the curve in the lower part of your spine. [Read more...]

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Passive Mobilization Of Joints – Manipulative Therapy In Pain Management

April 3, 2009 by 4 Comments

Mobility of joints might get restricted because of degenerative changes, trauma, chronic pain. The restricting factors may be pain, muscle spasm, oedema, fibrous contracture of fascia, ligament or capsule.

Restoration of normal function of joints is very important.

Pain itself may be relieved by restoring normal movements. The relief could be because of direct effect of passive joints movements by the stimulation of mechanoreceptors, which in turn inhibits the transmission of pain impulses from the periphery through the spinal cord to the brain. [Read more...]

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Pool Hydrotherapy in Musculoskeletal Pain Management

March 22, 2009 by 1 Comment

In hydrotherapy, water is used as a therapeutic measure. Already ice water therapy has been discussed. The pool therapy is one wherein patients are mobilized to do activities in warm swimming pool.

This warmth of water reduces pain and relaxes muscle spasm. Water with its buoyancy counteracts gravity, provides support and relieves weight bearing in degenerated joints or unstable joints.

Pool therapy is indicated in

Indications

  • Degenerative arthritis
  • Neurological disorders-hemiplegia, paraplegia

Contraindications

  • Infection
  • Haemodynamically unstable patients
  • Major systemic illness
  • Tracheostomy
  • Vertigo, epilepsy
  • Others
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Physical Exercise For Back Pain Relief-Hamstring Stretch Exercise

February 15, 2009 by Leave a Comment

This exercise stretches the muscles in the back of your thighs.

Straighten your left leg in front of you with the back of your knee firmly on the floor and your toes pointed straight up. Bend your right leg so that the sole of the foot is touching the inside of the left knee.

Hold for 15 seconds.

Slowly bend forward from the hips, reaching with both hands toward your left foot until you feel a good stretch in the back of your thigh. Bend as far as you can without pain.

Hold this position for 15 seconds

Slowly return to the upright position and relax. Then switch and stretch the other thigh.

Put your right leg straight ahead with your knee flat on the floor and toes pointed up. Bend the left leg so that the sole of that foot is against the right knee. Hold for 15 seconds.

Then bend forward from the hips as far as you can without pain. Hold that stretch for 15 seconds. Then return to the resting position.

Repeat once more time on each side.

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Heat Therapy in Pain Management

January 22, 2009 by Leave a Comment

Local application of heat can provide pain relief and reduce muscle spasm. Most chronic pain patients are aware of superficial heat applied locally in the form of a hot water bottle, or generally in the form of a hot bath or shower.

There are different ways by which heat therapy can be provided. They are broadly classified as:

Superficial heat therapy

  • Paraffin wax
  • Infrared radiation
  • Heat pad
  • Hot moist packs

Deep heat therapy

  • High frequency currents
  • Medium frequency currents
  • Low frequency currents

The superficial heat can reach up to 1 to 2 cm depth, while deep heat has the reach beyond this.

This superficial heat produces different response including changes in neuromuscular activity, blood flow, capillary permeability, enzymatic activity and pain.

The deep heat  delivers energy directly to deeper tissue, which improves muscular function, blood flow and local reflexes by suppressing sympathetic over-activity.

[Read more...]

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Exercise For Back Pain Relief-Extension Exercises

January 12, 2009 by Leave a Comment

Extension exercises are the exercises which cause the spine to extend. Before going further, it is important to understand the concept of flexion extension movements.

Flexion of the spine brings you torso towards your foot on the anterior aspect. When you bend yourself to touch your feet, it is the flexion that is responsible.

Extension is opposite to the flexion. If you lie on your stomach and lift your head and shoulders off the ground, this would cause extension of the spine.

These exercises may help some people with back pain. However, certain medical conditions that cause back pain can be aggravated by these exercises, so they must be done with caution and under supervision, at least for an initial period. [Read more...]

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