Physiotherapy for Ankylosing Spondylitis
December 20, 2008 | Leave a Comment
Ankylosing spondylitis belongs to a group of disorders called the spondyloarthropathies, a group which also includes psoriatic arthritis, reactive arthritis and arthritis related to inflammatory bowel disease. All these conditions are linked by the genetics of a gene on white blood cells called HLA B27 and by the presence of enthesitis, inflammation at the points where ligaments and tendons insert into bone. This can lead to fibrosis at these sites and then bone formation, causing joint fusion (ankylosis) in some cases.
The commonest spondyloarthropathy is Ankylosing spondylitis, which occurs as a reflection of the occurrence of the HLA B27 gene in the population. The gene occurs much less commonly near the equator and much more commonly in northern latitudes, and this is also the pattern with the development of AS. White race people are more commonly affected with around 0.1 to 1.0 percent overall, varying with latitude. Only 1 or 2 people of a hundred with the HLA B27 gene actually develop AS, but if they have a close relative who has the condition the likelihood rises to 15 to 20%.
Only one female is diagnosed with AS for every three males, and female patients’ symptoms are often much milder and some may be missed as a diagnosis of AS. The most typical presenting group is young men under 40 years old, with under sixteen year olds making up to twenty percent of this group. The symptoms appear on average at twenty-five years of age and the diagnosis is rarely made above fifty years old. AS can look like mechanical back pain if sufficient attention to detail is not made. Strong and persistent stiffness is often an answer to the question of how they are in the morning.
Low back pain is the major diagnostic alternative but AS patients are generally younger and the inflammatory process leads to different symptoms:
Morning stiffness in the lumbar spine, lasting at least 30 minutes or longer Exercise improves the back pain and stiffness Rest worsens the pain and stiffness Pain is usually worse in the second half of the night, after a time of rest Peripheral joints are affected in 30 to 50% of patients Tiredness is common AS has systemic affects from its inflammatory nature which can include feeling unwell, fever and loss of weight.
Physiotherapy examination of the spine in an AS patient usually uncovers significantly reduced ranges of spinal movement from normal, with perhaps a reduced lumbar lordosis and an increased thoracic curve. Neck movements may also be limited in later stages and a reduction in chest expansion noted due to rib joint involvement. Peripheral symptoms occur in around a third of patients and the physio will palpate the tender areas, searching for evidence of enthesitis in the insertions of the Achilles tendon and plantar ligament of the foot. These are areas of high mechanical stress and commonly affected.
Postural analysis of the AS patient is the first thing a physiotherapist notes after the subjective examination, recording spinal abnormalities, flexed knees, rounded shoulders or poking head posture. The ranges of movement of the cervical, thoracic and lumbar spine are measured and a battery of standard measures taken which allows assessment of the disease progression. The hips or other peripheral joints may be affected and these need to be measured also, with the physio likely testing out sites where the enthesis is likely to be painful and inflamed. If the disease is active then the patient may also have joint effusions and may appear unwell, be sweating and not have slept well.
Physiotherapists will concentrate on treating the inflamed areas first such as the areas where the ligaments insert into the bone, using insoles, cold, ultrasound and stretching techniques. Routine spinal range of motion exercises are taught to patients with an emphasis on getting to end ranges, concentrating initially on the anti-gravity muscles such as thoracic and lumbar extensors. Neck rotation and retractions and thoracic rotations are also important functional movements not to lose. Patients should rest themselves in good postures such as prone or supine with only one pillow, to avoid accentuating the typical spinal deformities. Treatment for AS in a hydrotherapy pool is beneficial and soothing and patient education important so they keep up their programme.
The Pain of Sacroiliac Joint Inflammation
December 15, 2008 | Leave a Comment
Have you been experiencing stabbing pains in your lower back? Is bending over, turning round, or rolling over into your bed even difficult for you? If this is the case, you might have a sacroiliac joint inflammation, and that is one pain in the back you would gladly do your Christmas holidays without.
Now, you might be wondering what the sacroiliac joints even are. They are two ‘L-shaped’ joints are situated at the lower back, between the pelvic ilium and the sacrum (the small wedge-shaped bone at the bottom of your spine), and are held in place by various muscles and ligaments. Their function is to enable you to move your pelvis - sacroiliac joints get pulled and twisted along the pelvic girdle whenever you move your lower back.
When these joints get infected, they can cause stabbing pains in the lower back, the buttocks, and even the thighs on occasion. This inflammation can occur when one half of the pelvis is constantly driven backwards and forwards, or at times when the joints get stuck.
While small infections of the sacroiliac joints and associated ligaments are quite common, the more sever forms of sacroiliitis tend to occur more frequently with aging. The main causes of sacroiliitis are degenerative arthritis (also known as osteoarthritis of the spine) which leads to the deterioration of the sacroiliac joints; pregnancy, as it forces the pelvis to stretch to accommodate childbirth; or some form of sudden impact or traumatic injury to the spine or pelvic region. But do not worry: sacroiliitis is treatable, as long as you are sure to visit osteopath as soon as you notice any of its defining symptoms.
The most noticeable symptoms of sacroiliac joint inflammation include: - Restricted hip movement (having difficulty turning around or rolling over in bed) - Stiffness in the lower back after long periods of immobility (such after long car journeys) or when waking up in the morning - Difficulty bending down - Pain during sexual intercourse - Sharp pain the thighs when swinging your legs out of bed or out of the car
If you recognize any of these symptoms in your own situation, be sure to visit someone with an in-depth knowledge about the sacroiliac joint, such as an osteopath. To minimize your discomfort temporarily, you are advised to: - Wrap a damp tea towel around an icepack and place it on the painful area for 10-minute intervals, over the course of a half hour, for up to three times a day. - Sleep on your side at night (not your back or stomach) - Place a pillow between your knees while you are in a sedentary position or when lying down. This should take some of the pressure off your pelvis.
While sacroiliac joint inflammation can be a real pain in the back, osteopaths can help cure the problem effectively through a combination of physical therapeutic techniques and anti-inflammatory medication. So as long as you visit your osteopath and nurture your body, you should be fit and healthy for the upcoming holiday season.
Massage Chair Recliners Are an Effective Back Pain Treatment
December 9, 2008 | Leave a Comment
Back pain at some point will rear its ugly head with most of it. It may be lower back, shoulders or maybe the neck. Either it is the result of injury or it is the more gradual progression. If it is more gradual, then do not wait until it is a problem to get it looked at. If you are injured you go immediately, but when back pain just creeps up, then we do nothing. There are treatment options available. Preventative options are better. Check with your health care professional on a course of action for you. Most likely, massage therapy will be part of the healing process. Professional massage therapy is preferred, but not always convenient. Massage chairs are another alternative with many benefits
There are two major causes of back pain. Either it just happens, like an accident, which is most unfortunate. Or it creeps up gradually on us as we go about our routines. A traumatic injury is usually a sharp pain which needs immediate attention. The more subtle, gradual pain build up may from our sitting, posture, pregnancy or even from stress. This more subtle pain is nonetheless painful. We need to think prevention and start to seek treatment while it is in its early stages.
An ounce of prevention is worth a pound of cure. This is certainly true with back pain. If you suffer from back pain, it is not going to go away on its own. Seek professional help. Your doctor can find out what is wrong and develop a plan with you to get healthy again. Remember other than injury, back pain occurs gradually. This means that habits need to be changed to reverse the causes of the pain.
Many of us have built up habits that are now causing the back pain we experience. I know as my stress builds, my shoulders and neck areas get stiff. This starts to cause considerable discomfort as my shoulders and neck start to ache. After speaking with my doctor, I started to realize how I carried my stress and we found some ways to start to reduce the stress by changing my reaction to certain situations. My shoulders and neck would really ache. I have started to change some habits which have started my healing.
Tension, aches, pains, anxiety and soreness are all symptoms of back pain. Although we start to change our habits, these symptoms may not go away immediately. We may need relief from some of these symptoms. Massage therapy is an effective modulator of these symptoms. Most people think of going to a therapist to get a massage. However, massage chairs have advanced with the ages and provide some amazing full body massages. Massages range from deep tissue to Shiatsu to Hawaiian. Nothing like having a massage therapy machine at your disposal 24/7.
Consult with your doctor or chiropractor and find the best course of action for your particular condition. Do not just continue to live with the pain. Find relief for your back pain. There are many options available today. You owe it to yourself and your family to get the healing process going. Relieving your discomfort can go a long way to changing your outlook on life. Do not wait find out how you can get relief today.
To Heel or to Heal: The Great Stiletto Debate
December 6, 2008 | Leave a Comment
There has been much debate in recent years over the negative impacts that high heels can have on your body. Doctors shake their heads in dismay when women come to them with back problems, osteopaths tut, and the local newspaper’s health section goes into a frenzy about the evils of stilettos. But are they really that bad? All right, after you wear them, your feet can be a little painful and your calves might twinge a bit for a couple of days, but once worn on a regular basis, your body does get accustomed to high heels - and your calves and feet will be tougher for it.
It is high time someone tackled these myths head-on. Some already have: earlier this year the BBC published an article which argued that wearing high heels can actually be beneficial. We shall therefore challenge three common myths about the stiletto, and then examine the ways in which heels might have a positive influence on the body.
Myth #1: High heels are a source of back problems. Senior osteopaths say this is not necessarily the case. Only those with a pre-disposition for back injuries are likely to get one - but that doesn’t mean all of us will suffer as a result of wearing heels. While it is true that walking on 8-inch stilettos for days on end can result in too much pressure being put on the front of the ankles (which leads to postural problems) if you wear your heels wisely, this should not be a problem. Instead of walking to work in high heels, for instance, keep the stilettos at the office and commute to work in your trainers.
Myth #2 : Stilettos cause the lower back and neck to become stiff. Not exactly. Stiffness, osteopaths claim, has less to do with the fact that you’re wearing heels, and more to do with how you wear them. If you are already experiencing postural problems even without wearing shoes (such as tilting your back), then of course stilettos will problem make that problem worse as they add pressure to the lower back. If you make sure you are standing straight and assume the right posture before you slip on the heels, however, you avoid any future problems. If fact, high heels often have the tendency to correct a woman’s posture, as they help them balance their weight. Stiffness is therefore no a direct result of wearing stilettos.
Myth #3: Heels have a negative effect on your muscles. Again, not true. While some might have sore muscles due to wearing stilettos too often, you can steer clear of this easily, as proposed for Myth #1. A recent study has uncovered that women who wear stilettos do, in fact, have stronger leg and pelvic muscles then those who don’t. As long as you vary your footwear every day, there should be no reason for you to overexert these muscles.
Another interesting discovery about the advantages of the stiletto was uncovered by Italian Urologist Dr. Cerruto, as mentioned in the BBC article. Because the foot is being forced into a certain angle by the shape of the heel, Cerruto explains, the pelvic muscles get a work out. As a woman pelvic floor functions are key to sexual performance, the idea that this performance might be improved simply by wearing heels is certainly not unwelcome.
Despite the many myths that float around regarding stilettos, there is always a solution for your individual needs. As long as you pay attention to the cues your body gives off, and you wear high heels in moderation, there should be no reason for you to sacrifice those sexy stilettos.
Useful Tips On Back Pain
December 4, 2008 | Leave a Comment
Those who are suffering from back ache for a prolonged period, can rely on Yoga to improve their condition- its been acknowledged by many professionals. In Yoga, people learn to sit in the right position and learn to breathe right, thus allowing the lungs to get enough fresh air and stabilized the body.
The stretching of the parts of the body, that Yoga actually does to the practicing person has a great impact on relieving pain. This is why we shouldn’t ignore doing some exercises daily that will stretch our body. On the other hand Yoga also tells us what’s the wrong way to sit. Sitting on a chair bending the back or standing for a long time without rest may also cause back pain. We should avoid these.
However, researches have been going on by National Institute of Health on the topic of pain succor, which reveals that acupuncture is effective in backache management. And this Chinese method is now increasingly popular throughout the world. You can contact any Yoga specialist anytime if you are convinced by the amazing outcome of Yoga. Actually, Yoga fights back pain by enabling people to sit in the right posture.
Another good treatment for backache can be undergoing regular exercise. Science has proved that exercise improves pain complications because of the body’s releasing of endorphins. So we all should think about it again, if we will choose to do some physical exercises everyday like the formers used to do.
Sometimes pregnant women have backache, which is quite common after an age of 45-50. its due to the increased weight of the body and the swelling that causes back pain not only by putting extra stress on the back bone but also by changing the center of gravity. Exercises that involve extending of the body can comfort in these case to some extent.
Alongside with the body extending exercises, which consistently stretch and relax your muscles you can also seek refuge to massages. In acute back ache the pressure applied should be less, but if the severity of pain isn’t that much more pressure could be applied during massages.
To tell in one sentence, undergoing some exercises regularly that stretches the body, sitting in right postures are the simplest ways that give succor to pain.