Myofascial Pain Syndrome

I am pretty sure all of you felt body pain at some point of your life,Maybe even now you might be feeling it. You might have gone to see the doctors and they x-rayed you pain part and said everything is fine and prescribe you pain medication. You follow the doctors order and eat the medication and you feel the pain relieve temporarily, only to return back after several hours. This might be an indication that you are suffering from Myofascial Pain Syndrome.

Myofascial Pain Syndrome

Myofascial pain syndrome is a chronic pain disorder. In myofascial pain syndrome, pressure on sensitive points in your muscles (trigger points) causes pain in seemingly unrelated parts of your body. This is called referred pain.

Myofascial pain syndrome typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension.

While nearly everyone has experienced muscle tension pain, the discomfort associated with myofascial pain syndrome persists or worsens. Treatment options for myofascial pain syndrome include physical therapy and trigger point injections. Pain medications and relaxation techniques also can help.

Symptoms

Signs and symptoms of myofascial pain syndrome may include:

• Deep, aching pain in a muscle
• Pain that persists or worsens
• A tender knot in a muscle
• Difficulty sleeping due to pain

Factors

Myofascial pain syndrome is caused by a stimulus, such as pressure, that sets off trigger points in your muscles. Factors that may increase your risk of muscle trigger points include:

• Muscle injury. An acute muscle injury or continual muscle stress may lead to the development of trigger points. For example, a spot within or near a strained muscle may become a trigger point. Repetitive motions and poor posture also may increase your risk.
• Stress and anxiety. People who frequently experience stress and anxiety may be more likely to develop trigger points in their muscles. One theory holds that these people may be more likely to clench their muscles, a form of repeated strain that leaves muscles susceptible to trigger points

Treatment

A physical therapist can devise a plan to help relieve your pain based on your signs and symptoms. Physical therapy to relieve myofascial pain syndrome may involve:
• Stretching. A physical therapist may lead you through gentle stretching exercises to help ease the pain in your affected muscle. If you feel trigger point pain when stretching, the physical therapist may spray a numbing solution on your skin.
• Massage. A physical therapist may massage your affected muscle to help relieve your pain. The physical therapist may use long hand strokes along your muscle or place pressure on specific areas of your muscle to release tension.
• Heat. Applying heat, via a hot pack or a hot shower, can help relieve muscle tension and reduce pain.
• Ultrasound. This type of therapy uses sound waves to increase blood circulation and warmth, which may promote healing in muscles affected by myofascial pain syndrome.

Usual points that can cause excessive pain

Can you relate to the points above? You might be suffering from myofascial pain syndrome.

we might be able to help you ease your pain. call us at 017-2348730 to make appointment.

Enlightenment from a 72 year old aunty

Today i was given the task of medical ward rounds.There I saw an old 72 year old asthmatic patient. She has severe shortness of breath until she could not speak in full sentence. After relaxing her by teaching her some relaxation exercises,i was able to reduce her shortness of breath. After she relaxed, she started talking about her social history, as we physiotherapist are required to check on their social history to correct her external factor.

Her story

She said she lived in a village house built by her husband in the 60's. Unfortunately her husband passed away last year. I asked her how long she has been having asthmatic problem. She said she has it for 50 years already. She continued telling that it was not severe in her early years. In her 30's, she only had one asthma attack every 6 to 7 years. And it would stop after taking a single tablet( obviously she could not remember what medicine it was). And she claimed last three years, she has been having attacks like once every 2 weeks, And i also took note of her address and her village house is nearby some new housing development by a famous company. And her house is also next to a North-South highway and the train tracks. Before i was going  to tell why she is having frequent attacks, she started explaining that it all because of the dust from the new housing development. But she cannott move away from there because that is her only house. She also said "pity all you youngsters going to suffer sooner than me". I am only exposed to this dust in my old age,but you all are exposed now itself.

I was actually abit awestruck by her last statement. Not being able to say a word, i just told her to wear a mask at least and learn the correct technique of using the inhaler. And told her that she should follow the breathing exercises taught. She thanked me for my time. (infact i should be thanking her in a way because eventhough a short conversation,it was an eye opener)

What i learned today:

1) Any greedy actions will affect someones  life. (the developer was thinking he was developing the place and getting money out of it, think about how many people life was affected by a corporate greed)

2) Do not underestimate the knowledge of elders. We think we live in a modern world and we know everything, but elders learned same knowledge we learn from internet by experiencing it

What Is Osteoarthritis?

Osteoarthritis is a joint disease that mostly affects cartilage. Cartilage is the
slippery tissue that covers the ends of bones in a joint. Healthy cartilage allows
bones to glide over each other. It also helps absorb the shock of movement. In
osteoarthritis, the top layer of cartilage breaks down and wears away. This allows
bones under the cartilage to rub together. The rubbing causes pain, swelling, and
loss of motion of the joint. Over time, the joint may lose its normal shape. Also,
bone spurs may grow on the edges of the joint. Bits of bone or cartilage can break
off and float inside the joint space, which causes more pain and damage.

Who Gets Osteoarthritis?

Osteoarthritis occurs most often in older people. Younger people sometimes get

osteoarthritis, primarily from joint injuries.

What Causes Osteoarthritis?

Osteoarthritis usually happens gradually over time. Some risk factors that might

lead to it include:

 Being overweight.

 Getting older.

 Joint injury.

 Joints that are not properly formed.

 A genetic defect in joint cartilage.

 Stresses on the joints from certain jobs and playing sports.

How Is Osteoarthritis Diagnosed?

Osteoarthritis can occur in any joint. It occurs most often in the hands, knees, hips,

and spine.

Warning signs of osteoarthritis are:

 Stiffness in a joint after getting out of bed or sitting for a long time.

 Swelling or tenderness in one or more joints.

 A crunching feeling or the sound of bone rubbing on bone.

No single test can diagnose osteoarthritis. Most doctors use several methods to diagnose the

disease and rule out other problems:

 Medical history.

 Physical exam.

 X rays.

 Other tests such as blood tests or exams of the fluid in the joints.

How Is Osteoarthritis Treated?

Doctors often combine treatments to fit a patient's needs, lifestyle, and health. Osteoarthritis

treatment has four main goals:

 Improve joint function.

 Keep a healthy body weight.

 Control pain.

 Achieve a healthy lifestyle.

Osteoarthritis treatment plans can involve:

 Exercise.

 Weight control.

 Rest and joint care.

 Nondrug pain relief techniques to control pain.

 Medicines.

 Complementary and alternative therapies.

 Surgery.

What Is Stroke?

A stroke or "brain attack" occurs when a blood clot blocks an artery (a blood vessel that carries blood from the heart to the body) or a blood vessel (a tube through which the blood moves through the body) breaks, interrupting blood flow to an area of the brain. When either of these things happen, brain cells begin to die and brain damage occurs.

When brain cells die during a stroke, abilities controlled by that area of the brain are lost. These abilities include speech, movement and memory. How a stroke patient is affected depends on where the stroke occurs in the brain and how much the brain is damaged.

For example, someone who has a small stroke may experience only minor problems such as weakness of an arm or leg. People who have larger strokes may be paralyzed on one side or lose their ability to speak. Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability. Source

Types of Stroke

there are two main types of stroke which is:-

Ischemic Stroke

In everyday life, blood clotting is beneficial. When you are bleeding from a wound, blood clots work to slow and eventually stop the bleeding. In the case of stroke, however, blood clots are dangerous because they can block arteries and cut off blood flow, a process called ischemia.Absense of blood flow causes death of brain cells,eventually causing paralysis.

Hemorrhagic Stroke

Strokes caused by the breakage or "blowout" of a blood vessel in the brain are called hemorrhagic strokes. The medical word for this type of breakage is hemorrhage. Hemorrhages can be caused by a number of disorders which affect the blood vessels, including long-standing high blood pressure and cerebral aneurysms. An aneurysm is a weak or thin spot on a blood vessel wall. These weak spots are usually present at birth. Aneurysms develop over a number of years and usually don't cause detectable problems until they break. There are two types of hemorrhagic stroke: subarachnoid and intracerebral.

In an intracerebral hemorrhage, bleeding occurs from vessels within the brain itself. Hypertension (high blood pressure) is the primary cause of this type of hemorrhage.

In a subarachnoid hemorrhage, an aneurysm bursts in a large artery on or near the thin, delicate membrane surrounding the brain. Blood spills into the area around the brain, which is filled with a protective fluid, causing the brain to be surrounded by blood-contaminated fluid.

Stroke Prevention

Talk to a healthcare professional and follow these guidelines.

Know blood pressure (hypertension)

High blood pressure is a major stroke risk factor if left untreated. Have blood pressure checked yearly by a doctor or at health fairs, a local pharmacy or supermarket or with an automatic blood pressure machine.

Identify atrial fibrillation (Afib)

Afib is an abnormal heartbeat that can increase stroke risk by 500%. Afib can cause blood to pool in the heart and may form a clot and cause a stroke. A doctor must diagnose and treat Afib.

Stop smoking

Smoking doubles the risk of stroke. It damages blood vessel walls, speeds up artery clogging, raises blood pressure and makes the heart work harder.

Control alcohol use

Alcohol use has been linked to stroke in many studies. Most doctors recommend not drinking or drinking only in moderation - no more than two drinks each day.

Know cholesterol levels

Cholesterol is a fatty substance in blood that is made by the body. It also comes in food. High cholesterol levels can clog arteries and cause a stroke. See a doctor if your total cholesterol level is more than 200.

Control diabetes

Many people with diabetes have health problems that are also stroke risk factors. A doctor and dietician can help manage diabetes.

Manage exercise/diet

Excess weight strains the circulatory system. Exercise five times a week. Maintain a diet low in calories, salt, saturated and trans fats and cholesterol. Eat five servings of fruits and vegetables daily.

Treat circulation problems

Fatty deposits can block arteries carrying blood to the brain and lead to a stroke. Other problems such as sickle cell disease or severe anemia should be treated.

Transient Ischemic Attack (TIA)

A TIA is a temporary episode of stroke-like symptoms that can last a few minutes to 24 hours but usually causes no permanent damage or disability. TIA and stroke symptoms are the same. Recognizing and treating a TIA can reduce stroke risk. Up to 40 percent of people who experience a TIA may have a stroke.

How To Identify Stroke Before It Happens

Stroke symptoms include:

• SUDDEN numbness or weakness of face, arm or leg - especially on one side of the body.
• SUDDEN confusion, trouble speaking or understanding.
• SUDDEN trouble seeing in one or both eyes.
• SUDDEN trouble walking, dizziness, loss of balance or coordination.
• SUDDEN severe headache with no known cause.

If any of the stroke symptoms is identified, the person should be sent to the hospital as soon as possible. Medications can be given to reverse the effect of stroke if it is not to late, where the brain tissue has not died yet.

Stroke can be prevented if the sign and symptoms can be detected earlier. Therefore each and every good samaritan should be aware on how to detect these signs and symptoms. Being in the know helps. So be safe and also watch out for others.Thank you.

Electrotherapy

What Is Electrotherapy?

Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term electrotherapy can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological disease. The term has also been applied specifically to the use of electric current to speed wound healing. Additionally, the term "electrotherapy" or "electromagnetic therapy" has also been applied to a range of alternative medical devices and treatments.(Source)

Electrotherapy in Physiotherapy

In physiotherapy, we do use some effective electrotherapy modalities to treat range of conditions such as muscle pain,soft tissue injury, muscle weakness, nerve damage and so on. The modalities we use has been clinically proven to be effective to treat such conditions. Common Modalities used in Malaysian hospitals include:-

1. Hotpack,coldpack- (yes,they are included in electrotherapy because the machines which manipulates temperature,which is knows as the freezer and hydrocollator,uses electricity to function)
2. Ultrasound therapy machine(abbreaviated as US)
3. IFT (interferential therapy) machine
4. SWD (shortwave diathermy) machine
5. TENS (transcutaneous electrical nerve stimulation)
6. Infrared therapy
7. UV therapy
8. Traction machine
9. Laser therapy

So lets learn more about the modalities:-




Hotpack
-its basically a pack made out of thick cloth filled with wheat,flaxseed,buckwheat or any other material which can absorb heat and release it slowly over a period of time. The pack is dropped in a machine called hydrocollator which is filled with water and a heating element heats up the water. Over a period of time,the hotpack is heated up. To apply on a patient, the pack is lifted from the machine,wrapped in certain layer of towels and placed on the problem area. The hot pack gives moist heat to the area applied.


Hotpacks are helpful in reducing muscle and soft tissue pain,relaxing muscles and help in soft tissue healing.Conditions which can benefit from hotpack include


-joint pain
-muscle tightness
-back pain

-chronic cases of pain
-muscle and ligament injury

the light brown pack is known as the hotpack.
And a typical apperance of patient having hotpack
 for the back

Coldpack
-An ice pack or cold pack is a plastic sac of ice, refrigerant gel or liquid. The refrigerant, usually non-toxic, can absorb a considerable amount of heat. It is commonly used as a cold compress to alleviate the pain of minor injuries. The packs are simply placed in a freezer. To use,its wrapped in a wet towel and placed on the problem area.


Coldpacks is used to treat mostly fresh sport injuries. The cold helps by shrinking your blood vessels and slowing blood flow to the area and stopping the formation of swelling and internal bleeding. And cold also helps hide the sensation of pain from reaching the human brain,effectively relieving pain.

Typical Icepack. needs to be frozen in the freezer before use

Ultrasound Therapy machine

-Ultrasound is applied using a transducer or applicator that is in direct contact with the patient's skin. Gel is used on all surfaces of the head to reduce friction and assist transmission of the ultrasonic waves. Therapeutic ultrasound in physical therapy is alternating compression and rarefaction of sound waves with a frequency of >20,000 cycles/second.


Ultrasound therapy benefits by speeding up of the healing process from the increase in blood flow in the treated area. The second is the decrease in pain from the reduction of swelling and edema. The third is the gentle massage of muscles tendons and/ or ligaments in the treated area because no strain is added and any scar tissue is softened.


Conditions which ultrasound may be used for treatment include the follow examples: Ligament Sprains, Muscle Strains, Tendonitis, Joint Inflammation, Plantar fasciitis, Metatarsalgia, Facet Irritation, Impingement syndrome, Bursitis, Rheumatoid arthritis, Osteoarthritis, and Scar Tissue Adhesion.

Ultrasound therapy

IFT (interferential therapy) machine

-uses a mid-frequency electrical signal to treat muscular spasms and strains. The current produces a massaging effect over the affected area at periodic intervals, and this stimulates the secretion of endorphins, the body's natural pain relievers, thus relaxing strained muscles and promoting soft-tissue healing. Its use is contraindicated if the affected area has wounds, cuts or infections. It helps relieve pain,stimulate muscles,increase local blood flow, and reduce edema.

Interferential Therapy machine

SWD machine

Short wave diathermy machines utilize two condenser plates that are placed on either side of the body part to be treated. Another mode of application is by induction coils that are pliable and can be molded to fit the part of the body under treatment. As the high-frequency waves travel through the body tissues between the condensers or the coils, they are converted into heat. The degree of heat and depth of penetration depend in part on the absorptive and resistance properties of the tissues that the waves encounter.

Useful for ,Inflammation of Shoulder Joint,Inflammation of Elbow Joint (Tennis Elbow),Degeneration of Joints of Neck (Cervical Spondylosis),Degeneration of Joints like knee and Hip (Osteoarthritis),Ligament Sprains in knee Joint,Low Back Ache,Plantar Fascitis (Heel Pain).

But currently its being phased out in foreign countries due to risk of side effects of the wave.

Shortwave diathermy machine

Patient with TENS fixed on the
 upper back

TENS (transcutaneous electrical nerve stimulation)

the use of electric current produced by a device to stimulate the nerves for therapeutic purposes. TENS by definition covers the complete range of transcutaneously applied currents used for nerve excitation although the term is often used with a more restrictive intent, namely to describe the kind of pulses produced by portable stimulators used to treat pain. The unit is usually connected to the skin using two or more electrodes. A typical battery-operated TENS unit is able to modulate pulse width, frequency and intensity. It can be set either to stimulate muscle contraction, or to give pain relieve.The machine's compact size makes it ideal to be brought along with the patient.

Infrared therapy

Infrared radiation is a convenient system to heat parts of our body. It has the advantage over direct contact in that radiation can heat directly the area where the blood capillaries and neuron terminals are. When heat comes from a direct contact source it has to heat the external layer of the skin, and heat is transferred to the deeper layer by conduction. Since heat conduction needs a temperature gradient to proceed, and there is a maximum temperature that can be safely used (around 42°C), this means lower temperature where warming is needed.It is an alternative to hotpacks.

infrared light

Mechanical Traction

Mechanical traction are tables that the patient lies down on, either on their back or face down, depending on which therapy the doctor decides would be most beneficial for their condition. There are a few different types of traction tables.

For patients suffering from low back pain, there is Lumbar Traction, which is designed to specifically target the lumbar curve(lower spine), restoring your lumbar spine to it's appropriate degree of curvature. Cervical Traction is designed for the cervical curve (neck spine), helping to reduce neck tension and is especially beneficial for headache sufferers. Each of these machines has rollers that are brought up under your back, helping to reduce tension, break up scar tissue, hydrate discs, and bring new blood and fluids to the area, helping your body to heal faster.

patient undergoing lower back traction

Well,that ends this post. Maybe this article was too technical to understand. But its enough if you can know the names of the machines. You might come across similar looking machines if you visit physiotherapy centre. At least you will recognise the machine and have some idea about it. Technical wise, just leave it to the professional. See you againYatta!!

What is Stretching?

Today let's learn about stretching. First of all,the definition of stretching is as follows:-

Stretching is a form of physical exercise in which a specific muscle or tendon (or muscle group) is deliberately flexed or stretched in order to improve the muscle's felt elasticity and achieve comfortable muscle tone. The result is a feeling of increased muscle control, flexibility and range of motion(more available movement).( as stated here).

Our muscles have four very important properties which makes muscles behave like...,(yes you guessed it) like muscles. The properties are:-

• extensibilty(can be lengthened)
• elasticity(can return to its original shape after lengthened or shortened)
• excitability(can be made to move by electrical impulses made sent by the brain through the nerves)
• contractility(can be shortened)

As we age and use less of our movement, our muscles tend shorten and lose their certain amount of elasticity. As time goes by,they start to restrict your movement. In simple words, a muscle which should act like a rubber band,starts to act like a tight rope,tying down your joint from moving. All of us experience tightness. You might have realized that when you were young, you can bend down and touch the floor with your hands while keeping your knees straight like a flag pole. Now, when you drop your keys on the floor, you have to sit down to pick it up, or bend your knees and pick it up. Its harder to keep your knees straight because the muscles at the back of your legs are tight and not allowing your to bend forward. Imagine being tied down with a rope from the back of your neck to the floor. You can only bend forward if you bend your knees right? This is tightness and you have to do regular stretching to maintain your flexibility of your body.

How Stretching Helps Tightness?

When we stretch,we hold our muscle at the most lengthened position.Since muscle has the elastic properties, they start to lengthen a little by little. Other than that,when we stretch, small micro tear happens in the muscles fibers  The torn gap in the muscle fibre is filled with new muscle cell. As time goes by, the fiber starts to elongate.

Benefits of Stretching

benefits of stretching include

• Reduced muscle tension
• Increased range of movement in the joints
• Enhanced muscular coordination
• Increased circulation of the blood to various parts of the body
• Increased energy levels (resulting from increased circulation)
• Less risk of muscle injury during rigorous activity

Some Easy Basic Stretching

There are a list of stretching listed here with clear instruction and diagrams.Click on the blue link. Feel free to browse.

List of Stretching exercises

How Much Stretching Should You Do? 

Frequency: Number of stretching sessions per week?
The more frequently you stretch, the more quickly you will gain flexibility. It is recommended to stretch all of the major muscle groups daily—or at the very least, each time you exercise (a minimum of 3-4 times per week).

Intensity: How deeply to stretch?
Each stretch should be done in a slow and controlled manner, without bouncing or forcing, which can cause your muscles to tighten, increasing your risk of injury. Stretch in a slow, steady motion to the point of “mild discomfort.” If you are stretching to the point of pain, you have stretched too far.


Time: How long you should stretch
Ideally, most experts recommend that people stretch for 10-15 minutes per day. Hold each stretch for 15-30 seconds, repeating one or two more times, depending on how you feel.

Get the Most Out of Your Stretching Routine
Stretching can be highly beneficial if done properly. If done improperly, it can cause serious damage. Here are some helpful tips to ensure you are stretching safely and preventing injury:

• Always warm up before stretching. Stretching a cold muscle increases the risk of pulls or tears. Think of your muscles like you would a rubber band. It’s easy to stretch a warm rubber band, but if you try to stretch a cold one, you risk cracking or breaking it. Don’t treat your muscles like a cold rubber band! Your best bet is to stretch after warming up or at the end of your workout.
• Do not lock your joints when you stretch. Keep joints like the elbows and knees slightly bent to avoid unnecessary stress on the joints.
• Never hold your breath while stretching. Try to breathe normally, in through the nose and out through the mouth. This will make your stretching a more relaxing experience.
• Take your time. The long-sustained, mild stretch reduces unwanted muscle tension and tightness.
• Do not compare yourself with others. Everyone has different degrees of flexibility. Comparisons may lead to overstretching.
• If you have had a hip replacement, do not cross your legs or bend your hips past a 90-degree angle during any of your stretching exercises.
• Avoid ballistic stretching and other high-force, short-duration stretches that use rapid bouncing motions or momentum. You have far less control during this type of stretch and therefore a greater potential risk of injury. It does not allow your muscles to adjust to, and relax in, the stretched position. It may instead cause them to tighten up by repeatedly activating the stretch reflex.
• Never stretch to the point of pain. If it hurts, stop.
• Talk to your doctor about any current or former musculoskeletal injuries or problems that might affect your ability to stretch safely and effectively.

Hope this article helped you understand the importance of stretching and some basic stretching technique. It is also advisable for you to approach a trained professional for more better specific tailor made stretching techniques, especially  if you have any medical problems before. Please get a second opinion before engaging in any stretching techniques. BE SAFE AND BE HEALTHY. And just for your info,you do not have to reach this level of flexibility  This is abnormal.

something worth sharing

credits to the original creator.just sharing