Tag Archives: low back pain

Back Pain, Health and Wellness, Low back Pain, Physiotherapy

Low Back Pain: 5 Tips for Prevention!

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Low back pain is one of the most common reasons people visit a Physiotherapist. It can happen to anyone, at any age, and it often shows up without warning. However, the good news is that there are ways to relieve your pain and minimize the chances of it coming back. In this blog, we will explore what causes this type of pain, how to treat it, and how to keep it from becoming a regular problem.

What causes low back pain?

Minimizing risk of lower back pain
Infographic demonstrating a proper and improper lifting position for the back

There are many reasons why you might have pain in your lower back. For example, some of the most common causes include:

  1. Poor Posture: Sitting or standing with poor posture can put a lot of strain on the muscles and joints in your back. Consequently, over time, this can lead to pain and discomfort.
  2. Muscle Strain: Lifting something heavy, twisting awkwardly, or overdoing it during exercise can strain the muscles in your lower back. This can cause pain that may last for a few days or weeks.
  3. Inactivity: If you spend too much time sitting or lying down, your back muscles can become weaker. Weak muscles are more likely to get tired and painful, especially when you try to do something active again.
  4. Injuries: Falls, accidents, or sudden movements can injure the structures in your back, including the muscles, ligaments, and discs. Furthermore, these types of injuries can lead to long-lasting pain if not treated properly.
  5. Age-Related Changes: As we get older, our spine changes. Namely, the discs between our vertebrae can wear down, and arthritis can develop. This is called degenerative disc disease or osteoarthritis, and it can lead to low back pain.

Tips for Preventing Low Back Pain

Here are some simple steps you can take to minimize the risk and chances of having low back pain:

  1. Stay active: Regular physical activity keeps your muscles strong and flexible. For example, walking, swimming, and yoga are all great low impact ways to keep your back healthy.
  2. Lift safely: When lifting heavy objects, bend your knees and keep the object close to your body. Additionally, avoid twisting while lifting, as this puts further strain on your back in an already vulnerable position.
  3. Take breaks from sitting: If you work at a desk or sit for long periods of time, make sure to stand up and stretch every 30 minutes. Importantly, this helps reduce the pressure on your lower back. Alternatively, you may choose to have a standing desk so that you can switch between both positions.
  4. Sleep in a comfortable position: Sleeping on your side with a pillow between your knees can help keep your spine in a comfortable position. Additionally, make sure your mattress provides enough support for your back.
  5. Maintain a healthy weight: Extra weight, especially around your belly, can put more stress on your lower back. As a result, eating a balanced diet and staying active can help you maintain a healthy weight.

How can physiotherapy help?

Manual therapy is one of the potential treatment techniques used by physiotherapists to manage lower back pain

Despite your best efforts to prevent it, if you are struggling with Low Back Pain, Physiotherapy is one of the most effective ways to manage a stubborn pain. A physiotherapist can help in the following ways:

  1. Pain relief techniques: Physiotherapists use various methods to help relieve pain, such as heat or ice
    therapy, massage and manual therapy techniques, or electrical stimulation. These treatments can help reduce your pain and make you feel more comfortable.
  2. Exercises to strengthen your back: Specific exercises can help strengthen the muscles in your back,
    core, and legs. Strong muscles support your spine better and reduce the risk of future pain. Your
    physiotherapist will show you exercises that are safe and effective for you.
  3. Stretching: Next, tight muscles can contribute to back pain. Your physiotherapist will guide you through stretches that help improve flexibility in your back, hips, and legs, which can ease the pain and improve your overall movement.
  4. Posture correction: Importantly, learning how to stand, sit, and move correctly can make a big difference. A physiotherapist can teach you how to maintain good posture and reduce the strain on your back during everyday activities.
  5. Education: Sometimes, understanding what is causing your injury or condition can help reduce your worries about it. Accordingly, your physiotherapist will explain what’s happening in your back, what that means for you, and how you can manage the pain.

When should you see a physiotherapist for low back pain?

If your lower back doesn’t get better within a couple days to weeks, or if it continues to worsen, it’s a good idea to see a physiotherapist. Also, you should also seek help if you have other symptoms, such as pain going down your leg, numbness, or weakness. Fortunately, a physiotherapist can assess your condition and create a treatment plan that’s right for you. With the right treatment, education, and some simple lifestyle changes, you can manage the pain and get back to doing the things you love. If you’re struggling with low back pain, look for PhysioNow! Book with us today for your first assessment and treatment!

Back Pain, Physiotherapy

I Have a Herniated Disk: Physio 101

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Herniated discs may also be referred to as slipped discs, or disc bulges. They can be a source of pain and fear for many people.  To understand a herniated disc, a quick anatomy lesson is needed, we have included a picture below to help.

What is a Herniated Disc?

Between each of our vertebrae in our spine, there is a disc with a soft inner core (nucleus pulposus, and tougher outside (annulus fibrosus). The herniation refers to the soft layer protruding out, and may vary in size. In larger protrusions, it may put pressure against other structures in the area like the nerves, causing a variety of symptoms in the areas the nerve root gives sensation and motor function to. Herniated discs can occur anywhere along the spine but are are most common in the lower back (lumbar) region.

What are the causes of a herniated disc?

  1. Firstly, age-related degeneration. With age, the intervertebral discs get stiffer which makes them more susceptible to injury when exposed to even minor strains.
  2. Secondly, trauma or injury. For example, a fall or heavy lifting with a twist are strong external forces which can cause a herniation.
  3. Additionally, repetitive strain. Jobs or activities with repetitive bending, twisting and lifting expose the disc to lots of pressure, increasing the risk of herniation

Do I need an x-ray/MRI?

Notably, many people have no symptoms from herniated discs, and are usually unaware they even have one. Oftentimes, many people will receive imaging reports that show varying level of degeneration and even disc herniations in the back, which may seem alarming.  It is important to note that this is actually a normal part of life, many people will have “positive” findings. In other words, even though these things appear on imaging tests, they are not necessarily a problem or correlated with pain. Therefore, it is crucial not to put too much stock in imaging and let the symptoms guide your back pain management instead.   Choosing Wisely Canada has a great article about why imaging may not always be included in the treatment plan.

What are the symptoms?

  1. Firstly, back or neck pain is usually the first sign. It can be mild or severe, stay in one spot or travel down the legs. Usually, the pain is more on one side.
  2. Secondly, numbness and tingling down the arms or legs is a sure sign of nerve involvement. In a disc herniation, the bulge may be putting pressure on the spinal nerves.
  3. Next, muscle weakness may be present due to nerve compression as above.
  4. Additionally, changes in reflexes where they are either exaggerated or reduced. For example, the common example of the reflex is when your doctor hits the reflex hammer beneath the knee on the patellar tendon and your knee automatically kicks out straight.
  5. Finally, pain is dependent on activities and is commonly worsened by certain positions. Usually prolonged sitting, bending, lifting, coughing, and sneezing.

The symptoms of a herniated disc will vary depending on location and severity. Not everyone will experience every symptom, many disc herniations occur with nerve involvement as they do without nerve involvement.

Can a herniated disc be treated?

Physiotherapy Treatment for Low back pain

Back pain from a herniated disc can be treated safely through physiotherapy treatment. Common treatments may include education about how to avoid aggravating your condition, movements or positions that may give you relief, electrotherapy, heat or cold therapy, manual therapy, stretch and strengthening exercises. The specific treatment plan is unique to the individual and the direction of the herniation and will be modified appropriately by your physiotherapist as you get better. Eventually, once your pain has been managed, your physiotherapist will work with you to get you back to normal function and doing the activities you love while remaining pain free. In some cases, they may not respond to physiotherapy in which case further medical management may be required.

If you are experiencing low back pain PhysioNow has many experienced physiotherapists to help you find relief. Book with PhysioNow today for your first assessment and treatment!

 

 

 

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Scoliosis: Types, Symptoms and Treatments

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Scoliosis

Scoliosis

A side deviation or curvature in your spine is scoliosis. It could be in your neck, mid back and lower back. It can present in more than one area.

The most common area where it develops is mid-back. Cervical and lumber spine are very common  when it comes to two curvatures.

Type of scoliosis:

  • C-shape: This is most common type, there is only one-sided curve. The most common area for C shape to develop is in the thoracic spine and also lumber spine.  In this type, scoliosis side leg could be short compared to non-scoliotic side. Sometimes, there are  changes in the scapular level. Scoliotic side scapula will be lower than non-scoliotic side.
  • S- shape: In this type, two curvatures are present in the spine. One curvature is the primary scoliosis and the other curvature develops in compensation of the primary curvature. In this type, the scoliotic sided leg is short and the scapular level is higher than the non-scoliotic side. S-shape will bring other complications such as respiratory issues, cardiovascular issues, etc.

'S' Shaped curve and 'C' Shaped Curve

‘S’ Shaped curve and ‘C’ Shaped Curve

Causes of scoliosis:

Usually, the cause of scoliosis is unknown. However, following are a few possible causes mentioned:

  1. Poor Posture habits: People who have habits of not following ergonomics pattern of posture are at risk. One who has the habit of leaning and sitting mostly on their right or left, are also at risk.
  2. Carrying heavy stuff on back: People who have to deal with the delivery of heavy packets and lifting heavy objects are at risk.
  3. Family history: Sometimes, scoliosis runs in family. There are higher chances in these cases.
  4. Congenital limb length discrepancy: Congenital limb length discrepancy needs immediate correction otherwise; it will lead to scoliosis.
  5. Neurological disorder: Neurological disorders like cerebral palsy, multiple sclerosis, Down Syndrome which are progressive diseases have muscular imbalance.

 

Signs and symptoms:

  • Limb length discrepancy
  • Visible deviation of spine to one direction
  • Uneven shoulder and pelvis height
  • In anterior view, one sided rib is popping out.
  • Chronic neck and also lower back pain
  • Breathing difficulties in severe cases
  • Recurrent lung conditions like pneumonia, atelectasis, etc.
  • Pain and numbness
  • Fatigue due to muscle imbalance

 

Assessment of scoliosis:

Imaging: X-ray is the gold standard or MRI.

Physiotherapy Assessment:  assess in posterior view which means back view with open back.

  • Therapist will look for visible prominent border of scapula.
  • with bending forward the scapular border will be seen as well as deviation .
  • When leaning backward , a visible S shape or C shape will be seen.

 

Risk factors of scoliosis:

Scoliosis is bony disorientation which is irreversible. The best management is prevention. However, if it not managed well enough , it can lead to many complications.

  1. Lung disorders: Specially, thoracic spine scoliosis has a chance to affect the respiratory system as it disturbs the alignment of the rib cage. Deep breathing becomes limited or difficult and that is why the lower portion of the lungs get less air. As a result of this,  atelectasis develops in some areas of the lung.
  2. Limb length discrepancy: Lumber scoliosis has a major effect on pelvis alignment. As scoliosis is irreversible, it leads to permanent muscular imbalance. Thus, there is limb length discrepancy.
  3. Scapular winging: Thoracic scoliosis has drastic effect on scapular orientation.  The scapula takes part in shoulder movement. Indirectly, mid back, scapula and the shoulder joint are all affected because of spinal curvature.
  4. Herniated disc in spine: Lumber spine scoliosis has a higher chance to develop a herniated disc. Therefore, you may develop pain in the lower back and down the leg  into the thigh, knee or ankle. Please seek immediate attention in this case.

 

Management of scoliosis:

 Scoliosis is a irreversible bony deformity.

  1. Posture: Contact your physiotherapist for a better understanding for well maintained posture at work and home.  Correction in pelvis alignment will help in preventing it from getting worse.
  2. Deep breathing exercise: Deep breathing exercise will help in maintaining lung function. Additionally, with breathing exercises, chest mobility exercises will help in maintaining flexibility in the spine and avoid lung conditions like pneumonia, atelectasis, etc.
  3. Spinal mobility exercises: Contact your physiotherapist for proper exercises. Your Physiotherapist can better assess scoliosis and based on that provide spinal mobility exercises to stop it from getting worse.
  4. Orthotics: orthotics adjust leg length discrepancy from scoliosis.
  5. Education: Finally, a physician or physiotherapist can help you to better assess and understand this condition.

 

Need some help?

Your concerns are best managed by a health care professional. Here at PhysioNow, we have many highly knowledgeable physiotherapists that can assist you with your issue. If you think you may have scoliosis or are diagnosed with it, book with PhysioNow today for your first assessment and treatment!

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Sciatica? 10 warning signs

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What is Sciatica?

Sciatica is a pain in the back, neck, or buttock that radiates to the leg or arm. Sciatica is also quite common and affects almost 40% of adults. It travels through the sciatic nerve, which starts in your lower back and extends to run down your leg.  A proper diagnosis that confirms and best sciatica treatment is all that you need to lead a pain-free life.

Sciatica

Sciatica pain

10 signs which confirm the diagnosis

Before knowing about sciatica treatment, one needs to understand the nature of pain. The symptoms of sciatica are as follows: –
  1. Calf pain – pain that stretches down the lower leg and back of the knee.
  2. Lower back pain running down the leg.  A pull sensation from your lower back to buttocks and thigh, that further extends from calf to the foot.
  3. A pain in your butt or leg that worsens while prolonged sitting.
  4. Numbness in your leg or foot.
  5. Tingling sensation in your extremity (lower body).
  6. Persistent pain on one side of your butt.
  7. Muscle weakness in the distressful leg or foot.
  8. Shooting pain down the leg which makes it tough to stand up or extend the knee.
  9. Pain in one part of the leg while numbness in another part.
  10.  Lastly, a sensation of pins and needles only in the toes or feet

Early Symptoms Of Sciatica

 Apart from the 10 signs above, sciatica pain often starts in the back. However, occasionally, pain may start at the hip or knee; which may not look like sciatica. Although, you may feel isolated symptoms like feet numbness, knee pain, buttock pain, tingling, etc.

What contributes to Sciatica?

There are many factors that can lead to sciatic pain but the most common ones are listed below,
 • Strain and Occupational Stress: People in more physically demanding jobs as a result affect your nerve.
 • Obesity and genetic factors: The excess weight in the body put prolonged pressure on the backbone, leading to a slipped disc.
 • Accidents and Injuries: Unexpected physical damage from accidents can crack the vertebrae and irritate the nerve.
 • Gender: Studies have shown that men are more prone to slipped discs than women.
Treatment options available
Moreover, depending on the severity of the case, sciatica pain can be treated in the following ways:
 • First, medication and pain management: Pain can be controlled with various pain relief treatments including medication.
 • Second, surgery: In rare cases, the pain doesn’t subside for a prolonged period (6 weeks or more), and surgery can help relieve the pressure on the sciatic nerve endings caused by Sciatica.

 • Third, spine rehabilitation:

Sciatica

Effective exercises for Sciatica

There are multiple approaches to physical therapy in spine care and they can stabilize the spine and help patients with disability or restricted physical movement. This helps improve the mechanical functioning of the spine, manages pain, promotes regeneration of the affected tissue and disc, and with functional training, improves strength and flexibility.

 • Lastly, even in the case of surgery, follow-up rehabilitation helps sustain and improve the results.
If you are experiencing any such symptoms, our team of qualified physiotherapists at Physio Now will help you diagnose and guide you through your treatment. Book your appointment now!
General Category

What is Sciatica?

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What is sciatica?

Sciatica is a term that gets used quite frequently in the physiotherapy world.  It refers to pain, tingling and/or numbness that goes down the back, hip or entire leg.  It can happen to both younger and older adults for many reasons.  For some, it starts after a traumatic event like a slip and fall or after a motor vehicle accident.  For others, however, it starts gradually then suddenly increases in intensity over time.  Despite the exact cause, sciatica can be a very difficult condition to go through.

Where does the term sciatica come from?

The term sciatica refers to irritation of the sciatic nerve, which is the largest nerve in our body.  This nerve has its roots at the lower levels of the lumbar spine and runs through the gluteal area down the back of the thigh.  Around the the knee, the sciatic nerve splits up into several smaller nerves that run down to supply the muscles of the lower leg, ankle and foot.  The pathway of the sciatic nerve is important because the symptoms of sciatica can travel anywhere along the nerve.

What are the most common signs and symptoms of sciatica?

Symptoms of sciatica can affect one or both legs.  The most signs and symptoms of sciatica include:

  • Pain in the low back, hips and leg(s)
  • Loss of range of motion through the low back
  • Pins and needles going down the leg(s)
  • Numbness or loss of sensation down the leg(s)
  • Weakness in different muscles in the leg(s)
  • Shifted postural alignment
    • Some people are bent sideways
    • Other people are stuck in a bent forward position

How can sciatica affect your day to day activities?

The exact ways that sciatica can affect a person will vary from person to person.  However, most people with sciatica do have similarities in what they experience.  For example:

  • Pain with sitting for long periods of time
    • For example, while working or driving
  • Difficulty with getting up from prolonged sitting
  • Cannot tolerate standing in one spot for prolonged periods of time
  • Pain or inability to bend forward
    • For instance such picking something off the floor or putting on socks
  • Disturbed sleep
    • It may be difficult to find a comfortable position
    • Changing positions during sleep may cause intense pain
  • Inability to walk for long periods of time

How severe can the symptoms get?

Sciatica can be very debilitating when it is in the acute stage.  Pain can be quite sharp and severe, limiting mobility and function completely.  A lot of patients at this stage will rate their pain intensity at a 9 or 10 out of 10.  Any position or movement may be pain producing and anything they try, including over the counter medication, may not help with the intensity of pain.  A lot of patients feel very helpless and scared at this stage.  The sudden onset of intense pain makes these patients wonder if there is something seriously wrong.  A lot of people go to the emergency room because the pain is so severe.  At the hospital, the standard procedure will be to rule out anything potentially serious first.

What are some of the more serious causes of severe low back pain?

  • Fracture
    • History of significant trauma
    • If there is osteoporosis present, then minor traumas are risk factors
    • Loss of function with all movements making pain worse
  • Cancer
    • Risk factors for cancer can include:
      • 55 years of age or older
      • Previous history of cancer
      • Unexplained weight loss
      • Increasing pain that is constant and not relieved by rest
  • Infection
    • Signs and symptoms of an infection include:
      • Fever
      • Malaise
      • Constant pain
      • All movements make pain worse
  • Cauda Equina Syndrome
    • Severe low back pain
    • Pain, numbness or weakness in one or both legs
    • Saddle anesthesia
      • Loss of or altered sensations in your legs, buttocks, inner thighs, backs of your legs, or feet
    • Sudden sexual dysfunction
    • Sudden changes in bowel or bladder functions
      • Difficulty with relieving yourself or difficulty with holding it in

Any of the above-mentioned conditions would require emergency medical treatment, which the hospital would provide.  However, for most patients, their sciatica is not from anything potentially serious.  Most incidences of sciatica are mechanical in nature and can be treated.  Once the hospital has ruled out anything serious, they will likely prescribe medication for pain management and provide a referral for physiotherapy.

What is causing the sciatica symptoms?

For most people, sciatica can be treated with conservative treatment such as physiotherapy.  The important thing about treating sciatica is to determine the correct source of the pain and address those specific areas.  With most sciatica patients, the pain is coming from pressure on one or more of the roots of the sciatic nerve.  These nerve roots are found in the lower back.  The pressure on the nerve affects the proper function of the nerve and causes the symptoms going down the leg.

Are the symptoms permanent?

It is important to note that, in most cases, the tingling, numbness and weakness in the leg is not something that will be permanent.  A good analogy for this process is like when someone is stepping on a water hose.  The pressure from the foot stops the water from passing through the hose.  However, once that foot comes off the hose, the water will flow through without any issues.  Similarly, the symptoms along the leg will get better once the pressure is removed off the nerve.  Specifically with sciatica, the pressure on the nerve is usually caused by intervertebral discs or bony changes in the area.

Can physiotherapy help with sciatica?

Physiotherapy can definitely help with sciatica!  An experienced physiotherapist will be able to perform a thorough assessment that will determine the potential cause of the sciatica.  Once this cause is understood, the physiotherapist will be able to provide the most appropriate treatment to take the pressure off the nerve.

What does physiotherapy treatment involve?

Physiotherapy treatment for sciatica usually consists of multiple components.  Lots of research out there has shown that passive treatments such as heat, ice, and electrical modalities, like IFC and ultrasound, do not provide long term solutions.  However, these types of modalities may be useful in the acute phase to help with the management of pain.   They can be combined with other treatments, including exercises and manual therapy, as part of the overall treatment plan for sciatica.  However, on their own, they are unlikely to make any significant and long-lasting changes.

More importantly, there has to be an evaluation of what positions and/or movements are pain producing and which are pain relieving.  A physiotherapist who has lots of experience working with low back issues will be able to help make this discovery.  The results of the movement assessment will allow for the prescription of the appropriate exercises to help take the pressure off the nerve roots.  The movement assessment will also help to determine which manual treatment techniques are most appropriate for the patient.

For example, if the patient feels less leg pain when they arch their back backwards, then that means their nerve is less irritated with that movement.  Their treatment plan will therefore include exercises that involve various forms of back extensions that continue to improve their symptoms.  The manual treatment provided will also help to improve this movement pattern and increase flexibility in general.

How long does it take for sciatica symptoms to improve?

As the pressure on the sciatic nerve improves, the pain will move upward towards the low back in a process called centralization.  These changes may happen quickly for some patients.  However, with more complex cases, it usually takes several weeks to ease the pain and regain function.  Any exercises that are producing centralizing symptoms are going to be beneficial in creating lasting changes.  Once the leg pain is better, strengthening for the back, hips, and lower limbs is important to prevent future episodes of sciatica.

In majority of cases, pain can be resolved completely, and the individual can return to their normal level of function.  It is important that the physiotherapist provides education and a good home exercise program for the continued maintenance of the condition.  Some patients will continue to avoid certain activities or movements because of their experience with sciatic pain.  It is important for the physiotherapist to work with the patient to regain full function and confidence with their mobility.

If you have been experiencing sciatica, do not let the pain limit what you can do.  Call and book your appointment with an experienced physiotherapist at PhysioNow today!

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Fibromyalgia

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FIBROMYALGIA

Fibromyalgia is a chronic condition. It is often associated with widespread symptoms including fatigue, pain and sleep disturbances.

 

Causes and Risk Factors

It is unclear as to what causes fibromyalgia. However, there are some causes which might be increasing your risk of getting fibromyalgia:


Genetics-

You could be ay a higher risk for fibromyalgia if it runs in your family

Stress-

Emotional or physical stresses have been known to aggravate or cause this condition

Age-

Women have been found to be at a higher risk


Symptoms of Fibromyalgia:


The symptoms may vary from individual to individual but, following are some of the commonest symptoms-

Fatigue-

One of the commonest symptom is fatigue

Pain-

Pain that lasts > 3 months and widespread pain at several sites in the body

Sleep disturbances-

 You could have sleep disturbances or non restorative sleep (sleeping for long but not feeling rested)

Reduced exercise tolerance and morning stiffness.


Other symptoms include trouble with concentration/memory. It is also called ‘fibro fog’ or ‘brain fog’. Headaches and depression are also common. It is common to have fluctuations in the symptoms. You may experience pain that may range from a mild discomfort/ache to an unbearable pain.

Although it may mimic more like an arthritis/ bone related pain, it actually comes from the soft tissues. Fibromyalgia can start at any age. However, mostly it is by early to middle adulthood that people start feeling it.


Diagnosis:


Your doctor will take a detailed history to understand all of your symptoms. There is no definitive test to diagnose this condition. However, the doctors may prescribe you to do other tests like blood work or X-rays to rule out other conditions that show similar symptoms.


How do you treat it?

Drugs-

The treatment is usually focused on relieving the symptoms. For instance, your doctor may prescribe muscle relaxants, pain killers, anti-depressants or sleep medications,

Acupuncture-

To help relieve pain

Acupuncture: Neck pain

Fibromyalgia. Acupuncture

Cognitive Behavior Therapy-

Cognitive Behavior Therapy can help to reduce stress. Can be individual or group therapy.

Nutrition-

A healthy balanced diet is good because it helps to keep your body healthy and keep the energy levels high. 

Massage therapy-

Helps in relaxing the muscles and relieve pain

Activity pacing-

There may be good and bad days in this condition. Thus, it is important to make sure you prioritize your activities for the day. This is helpful in order to reduce excessive fatigue.

Physiotherapy-

Physiotherapy can help to firstly, reduce your pain. Secondly, they can give guidance on modifying activities and finally, prescribe exercises. In addition, aerobic fitness and strengthening exercises  help in this condition.

Physiotherapy Treatment for Low back pain

Physiotherapy for fibromyalgia


How can we help?

Our physiotherapists will take a detailed history followed by a thorough evaluation of all your symptoms and problem areas. Then, they will formulate and discuss a treatment plan for you. Also, we have massage therapists and therapists who do acupuncture. Thus, if you are having fibromyalgia or know anyone who needs help with the same, contact us today at PhysioNow!

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Posture

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IS POOR POSTURE THE CAUSE OF YOUR PAIN?

Did you know that current research suggests 80% individuals will experience back pain at some time in their lives? There are several causes that can lead to back pain-degenerative changes, herniated discs, poor posture, pulled/torn muscle /ligament around the spine, kidney stones or many other pathological causes. Of all these various causes, there is one thing that can be controlled and taken care of by you-POSTURE!

 

WHAT EXACTLY IS A POOR POSTURE?

Any position that places our spine in unnatural curves (most often a C shape) instead of the normal S shape curve is a poor posture (see picture below). S shaped curve allows for equal weight distribution as well as flexibility of the spine. Poor posture is known to affect not just the spine but also the surrounding ligaments and muscles. Prolonged poor postures lead to a lot of pressure on these surrounding tissues thus increasing the damage and pain.

Posture. Physiotherapy Mississauga

Good-Posture-vs-Poor-Posture

FACTORS CONTRIBUTING TO POOR POSTURE:

Improper workstation design :

Could be a wrong chair, monitor height or distance of yourself and the monitor. Lack of enough breaks specially in a desk job also contribute to poor posture in the long run.

Repetitive movements/postures as a part of work/occupation:

Bending repeatedly and working.

Lifestyle:

Current technology has made people to bend down and look into their electronic devices for several hours every day. High heels, sitting with the wallet in the back pocket and heavy bags/purses also lead to malalignment of the spine.

Muscle imbalance:

Due to certain sports that we play or our basic posture leading to weakness in some groups and tightness in others thus affecting the curve.

Poor core stability and strength

Age:

As age advances, it leads to lesser flexibility and strength. If we keep thinking that doing exercises will cause more discomfort than what we currently have, the muscles become weaker and weaker and without enough muscle strength, the spine cannot stand erect

Habit:

The habit of poor posture is very difficult to change like sitting slouched on a couch for several hours or just slouch sitting or standing in day to day activities. Sure, everyone loves to sit in a relaxed position but, if you do not make the effort of trying to change it, it will keep creating more and more problems for the body.

 

EFFECTS OF BAD POSTURE:

Since childhood we have been asked to sit straight or stand tall and not slouch. Mostly everyone did that as a compulsion and rather grudgingly. However, it has many important reasons instead of it just being better for our appearance!

Back pain:

That is the most obvious one! Poor posture leads to stretching of the muscles of the back and the surrounding structures thus making them weak which in turn reduces the support it gives to the spine – taking us back to poor posture! As it becomes more of a chronic habit, you then have to take care of your posture and make your muscles stronger as well.

Neck pain, headaches and jaw pain:

Sometimes when there is no trauma or injury to your jaw and it starts clicking, popping, paining or going into spasm. There is a possibility it might be coming due to malalignment of the neck. A forward head posture has been known to cause jaw pain and headaches.

Hip, knee and foot pain:

Yes, the body is a closely connected structure. Any malalignment or change at one point like the foot or knee does affect the spine and leads to pain and vice versa.

Gastrointestinal system problems:

A slouched position/poor posture may compress the internal organs of the abdomen. It also affects the movement of the intestines thus leading to numerous gastrointestinal troubles like acid reflux or constipation. Over time it can also affect the metabolism and the way food is processed in the body.

Psychosocial impact:

In general, a person with a good upright posture seems more approachable and confident compared to the one who is slouching. This in turn leads to less motivation or mood issues in social situations. It has also been known to cause more fatigue and sleep problems as the body has to work harder and spend more energy to maintain itself when it is clearly not aligned well.

 

WHAT CAN YOU DO TO FIX A BAD POSTURE?

  • Avoid prolonged sustained positions. Make sure you take frequent breaks, if possible, try getting up from your chair after every 30-45 minutes .
  • Get into the habit of sitting well- always sit with your buttocks touching the back of the chair. This, in turn, will promote an erect posture and your back will get enough support
  • While you are standing try to distribute your weight evenly on both legs and do not lean on one side.
  • Use a backpack instead of a one sided bag if it is heavy so there is equal weight distribution on the shoulders. While sitting remove the wallet from the back pocket
  • Do a chin tuck- if you have a poking chin and rounded shoulders, straighten your upper back and do a chin tuck and repeat it 10 times. You should also stretch your chest muscles if you have rounded shoulders
  • If you have to use the phone for a long time, try holding it with your hand. You can also use a hands-free device instead of cradling it with your shoulder

 

HOW DOES PHYSIOTHERAPY HELP TO SOLVE POSTURE RELATED PROBLEMS?

Physiotherapists can help you by assessing exactly where your problem begins and then helping you to understand and modify habits that lead to bad posture. There are also various other treatments like manual therapy, taping and exercises that are aimed at stretching the tight muscles and strengthening the weaker muscles around the spine. They can also advice you regarding your work station modifications, if required.

 

PhysioNow

If you or anyone you know has posture related aches and pains or wants to get an assessment done to find out more about how you can improve your posture, call us today for an appointment!

 

 

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Accident Rehabilitation

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Accident Rehabilitation

Accident Rehabilitation

What is Accident Rehabilitation?

Motor vehicle accidents happen everyday in Ontario.  As a result, they produce a lot of pain, disability and stress for those involved. The impact can be quite debilitating. Accident rehabilitation is treatment that is given after being involved in a motor vehicle accident. It is important to seek out Registered Physiotherapists who are experienced in Accident Rehabilitation to ensure proper recovery. At PhysioNow we offer high quality Registered Physiotherapy and Registered Massage therapy treatments to help you recover from your injuries.

Accident Rehabilitation

Registered Massage Therapy

Who is entitled to receive Accident Rehabilitation?

Any person who has been involved in a motor vehicle accident in Ontario is entitled to receive Accident Rehabilitation benefits . This would include if you were a pedestrian hit by a vehicle.  It would also include coverage for treatment if you were involved in an accident outside of Ontario, but reside in Ontario.  However, if you are  injured and do not have your own insurance, you can still apply for accident benefits. The circumstances of the accident will determine which insurance company will pay for the benefits. For instance, you may be covered by the person that hit you or the Motor Vehicle Accident Fund.

How much accident benefit coverage is available?

The amount of the benefits that you are entitled to depends on the severity of your injuries. There are two categories of benefits available:

  • Minor Injury Guideline (MIG)

    • This plan is for people who have minor injuries including whiplash and sprains and strains.
    • The majority of motor vehicle accident injuries fall within this category
    • The MIG plan is standardized across all of Ontario in terms of its entitlement to Treatment benefits no matter where you receive treatment.
    • If you are under a MIG, the maximum benefit under the MIG is $3500

 

  • Major Injury Guideline (non-MIG)

    • This plan is  for people who have suffered serious injuries from an accident
    • Examples include fractures, surgeries, major neurological trauma and concussions
    • The maximum entitlement under this plan will vary depending on your injuries, but could be up to $65,000.

What is the process of receiving accident benefits?

Once the accident is reported to the insurance company, the  adjuster will ask if there are any injuries from the accident.  The adjuster will send you a package of forms that you have to complete and send back. The adjuster will also likely put you in touch with an approved physiotherapy clinic in the area closest to you. The clinic will then contact you to schedule an initial assessment.

1st visits with a Physiotherapist can take place within 1 day of the accident.  You are also able to go directly to your Approved Physiotherapy Clinic to initiate a claim and get started on your treatment.  The Approved Clinic can get the paperwork started for you.

PhysioNow is an approved company for the purposes of Motor vehicle accidents in Ontario.  PhysioNow is allowed to directly bill your treatment to your Auto Insurance company. They can provide all of the forms that you need to get started.

 

Accident Rehabilitation

Whiplash Pain

What are the most common injuries from a Motor Vehicle Accident?

Most car accidents tend to be minor in nature. The most common types of injuries are:

  • Whiplash

    • Happens when the force of the impact pushes your neck back and forth really fast
    • This causes a sprain/strain of the your muscles and ligaments of the neck
    • Symptoms range from pain, stiffness, numbness/tingling into the arms and hands, headache and loss of motion

  • Thoracic & Lumbar strains

    • The impact causes the joints and muscles of the spine to be over-stretched
    • The mechanism is similar to whiplash
    • Symptoms include pain, limited movement, numbness/tingling into the arms and/or legs, weakness

  • Shoulder strains

    • It is common for the shoulder to get injured in a car accident, especially for the driver – this is because their arms are usually holding on to the steering wheel

  • Concussion

    • Concussions are a form of a traumatic brain injury and can vary from mild to severe
    • It is possible for Concussions to occur as a result of either direct or indirect trauma to the brain
    • The most common symptoms of a concussion are dizziness, nausea, sensitivity to light and sound, headache, fatigue, difficulty concentrating and fogginess

    • Accident Rehabilitation

      Concussion

What can I expect from my first visit at the physiotherapy appointment?

During the initial visit, you will have to complete some forms.  These forms are essential to submitting a successful claim. The experienced administrators at PhysioNow can help you to fill them out to make the process easier for you. The good thing about the  paperwork is that you only need to complete it once! After the initial paperwork, you can focus just on your recovery.

What can I expect from my Initial Assessment with the Registered Physiotherapist at PhysioNow?

Your Registered Physiotherapist will meet with you.  We will start by asking some questions to get an understanding of your injuries. For example, some sample questions can include:

  • How did the accident happen?
  •  Questions that will screen you for more serious injuries that could require further medical attention
  • Locating all the painful areas and injuries that have occurred
  • Details about past medical and injury history

Once this information has been collected, your Registered Physiotherapist will do a full assessment. We will check all of your  affected areas for movement and strength. This will start to give us an idea of the severity of your symptoms. We will then use this information to decide whether you will be classified as either MIG or non-MIG.

After this, we will then  fill out the required treatment plan for you.  In conclusion, we will go over what the plan will look like with you. Lastly, they will discuss treatment timelines and treatment goals. At PhysioNow, there will also be  time allocated  to start some light treatment to give you pain relief.

What kind of treatment will be provided for Accident Rehabilitation?

The types of treatment provided after vehicle accidents  will depend on the nature of your injuries.  It will also depend on  what your Physiotherapist feels is most appropriate for  you, taking into account all of your injuries. As a result, your treatment plan may include a variety of different treatments such as:

  • Treatment will start slowly at first and focus first on pain control,
  • Modalities – Ultrasound, Laser, Interferential Current
  • TherapyManual therapy – gentle soft tissue work, mobilizations, assisted stretching
  • Exercises – range of motion, postural and strengthening exercises
  • Concussion Treatment if needed
  • Education – explanations of the injuries and do’s and don’ts to help the recovery process
  • After that, this will be followed by recovery of movement, and then strength.
  • Lastly, we will work on helping you get back to all of your normal activities both at home and work

  • Neck Pain Treatment

    Accident Rehabilitation

How long will the treatment  take to complete for Accident Rehabiliation?

The length of the treatment plan depends on whether you are on a MIG or non-MIG pathway.

  • MIG (Minor Injury Guidleline)
    • 2 phases
      • 1st phase: 12 weeks in length
      • 2nd phase (if required): additional 4-8 weeks
    • Non-MIG ( Non- Minor Injury Guideline)
      • Timeline is at the discretion of your physiotherapist and will vary depending on your injuries
      • For post-surgical cases or individuals with multiple serious injuries, the timeline can be well over 1 year

As a result, it is very important to seek out Accident Rehabilitation as soon as possible when you have been involved in a car accident. The pain and limitations that you experience after an accident can really affect your quality of life. Therefore, scar tissue from injuries starts to form quickly after an injury.

At PhysioNow we want to help you get back on your feet and back to doing things that are important to you!  Give us a call at 289-724-0448 to get started today!

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Sciatica

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Sciatica Treatment Mississauga

Sciatica

Sciatica

Sciatica is a term that gets used quite frequently in the physiotherapy world. This refers to pain, tingling and/or numbness that goes down the back, hip or entire leg.

Who can get Sciatica?

  • It can happen to both younger and older adults for a variety of reasons.
  • For some, it starts after a traumatic event like a slip and fall or after a motor vehicle accident.
  • It can seem like pain develops out of nowhere for others.
  • Pain can start gradually then suddenly increase in severity.
  • The majority of the time, sciatica is a condition that starts with some mechanical changes in the low back that build up gradually over a period of time.

What is Sciatica?

  • The term sciatica itself refers to irritation of the sciatic nerve
  • It is the largest nerve in our body
  • This nerve has its roots at the lower levels of the lumbar spine
  • It  runs through the buttock area, and down the back of the thigh
  • Around the level of the knee, the sciatic nerve splits up into several smaller nerves that run down to supply the muscles of the lower leg, ankle and foot

What are the symptoms of Sciatica?

The symptoms produced by sciatica follow the pathway of the nerve and can reach all the way down to the toes. The symptoms can range from:

  • pain
  •  pins and needles
  • numbness
  • weakness in the leg or all of the above

ACUTE Sciatica

  • Sciatica can be very debilitating when it is in the acute stage.
  • Pain can be quite sharp and severe.
  • As a result, sciatica can limit your movement and function completely.
  • A lot of patients at this stage will rate their pain intensity at a 9 or 10 out of 10.
  • Any position or movement may be pain producing.
  • Anything you try, including over the counter medication, may not help with the intensity of pain.
  • You may feel very helpless and scared at this stage.
  • The sudden onset of intense pain may make you wonder if there is something seriously wrong.
  • You may even feel that you need to go to the emergency room because the pain is so severe.

Should you go to the Hospital for Sciatica?

  • It is not necessary to go to the Hospital for Sciatica.
  • Typically, most people with Sciatica can recover quickly with the help of a trained Registered Physiotherapist!
  •   PhysioNow has trained professionals standing ready to help you Now!
  • We do not need a doctors referral to see you at PhysioNow.
  • However, you may  require a doctor’s note for your insurance plan to cover your treatment.
  • Our Physiotherapists will screen for any serious issues and send you to a doctor if they find any ‘red flags’ with your Sciatica.
  • We will direct bill to your Extended Health Plan if your plan allows us to do so.

However, if you feel more comfortable seeing a doctor first, head to the Hospital or your family doctor.

At the hospital, the standard procedure will be to rule out anything potentially serious. Some of the more serious causes of severe low back pain can include:

• Fracture
o History of significant trauma
o If there is osteoporosis present, then minor traumas are risk factors
o Loss of function with all movements making pain worse

• Cancer
o 55 years of age or older
o Previous history of cancer
o unexplained weight loss
o Increasing levels of pain that are not relieved by rest

• Infection
o Fever
o Malaise
o Constant pain
o All movements make the pain worse

• Cauda Equina Syndrome
o Severe low back pain
o Pain, numbness or weakness in one or both legs
o Saddle anesthesia – loss of or altered sensations in your legs, buttocks, inner thighs, backs of your legs, or feet
o  Sexual dysfunction
o Sudden changes in bowel or bladder functions – difficulty with relieving yourself or difficulty with holding it in

The role for Physiotherapy in Sciatica

  • Any of the above-mentioned conditions would require emergency treatment, which the hospital would provide.
  • Thankfully, for most patients, their sciatica is not from anything  serious.
  • Most incidences of sciatica are mechanical in nature and can be treated with Physiotherapy.
  • Once the hospital has ruled out anything serious, they will likely prescribe some medication for pain management and provide a referral for physiotherapy.
  • For most people, sciatica can be treated with conservative treatment such as physiotherapy.
  • The important thing about treating sciatica effectively is to determine the correct source of the pain and address those specific areas.

What is causing the Pain from Sciatica?

  • With most sciatica patients, the pain is coming from pressure on one or more of the roots of the sciatic nerve.
  • The pressure on the nerve affects the proper function of the nerve and causes the symptoms to go down the leg.

What about if I have Tingling and Numbness? Is that more serious?

  • The tingling, numbness and weakness that a patient may experience is not something that will be permanent in most cases.
  • A good analogy for this process is like when someone is stepping on a water hose.
  • The pressure from the foot stops the water from passing through the hose.
  • However, once that foot comes off the hose, the water will flow through without any issues.
  • Similarly, the symptoms along the leg will get better once the pressure is removed off the nerve. Physiotherapy will help with this!
  • This pressure on the nerve may be caused by an injury to the disc or bony changes in the area.
  • An experienced physiotherapist will be able to perform a thorough assessment that will determine the potential cause of the sciatica.

Physiotherapy Treatment

  • Once the cause of your sciatica is established, the Physiotherapist will be able to provide the most appropriate treatment to take the pressure off the nerve.
  • Lots of research out there has shown that passive treatments such as heat, ice, and electrical modalities, like IFC and ultrasound, do not provide long term solutions.
  • These types of modalities may be useful in the acute phase to help with the management of pain.
  • They can be combined with other treatments as part of the overall treatment plan for sciatica.
  • However, on their own, they are unlikely to make any significant and long-lasting changes.
  • Specific movements are usually the most effective at shutting off your Sciatica Pain!
  • Your Trained Physiotherapist will determine the best movement for you to shut off your Pain!

Sciatica Treatment

Positions and Movements that can Help with Sciatica Pain

  • More importantly, there has to be an evaluation of what positions and/or movements are pain producing and which are pain relieving.
  • A physiotherapist who has lots of experience working with low back issues will be able to help make this discovery.
  • Therefore, the results of the movement assessment will allow for the prescription of the appropriate exercise to help take the pressure off the nerve roots.
  • For example, if you feel less leg symptoms when you arch your back backwards, then that means your nerve is less irritated with that movement.
  • As a result, your treatment plan will then include exercises that involve various forms of backwards movements that continue to improve your leg symptoms.

  • Possible Sciatica Treatment

What Does Centralization of the Pain mean?

  • As the pressure on the sciatic nerve improves, the pain will move upward towards the low back in a process called centralization.
  • In general, these changes may happen quickly for most patients.
  • However, with more complex cases, it can take longer to ease the pain and regain function.
  • As a result, any movements that  produce centralizing symptoms are going to be beneficial in reducing pain.
  • In the majority of cases, pain can be resolved completely, and you can return to your normal level of activities quickly.

What do I need to know to keep the pain away?

  • It is important that the physiotherapist provides proper education.
  • They should give you  a good home exercise program for the continued maintenance of your sciatica condition.
  • As a result of the pain, some patients will continue to avoid certain activities or movements because of their experience with sciatic pain.
  • Therefore, it is important that your physiotherapist  work with you to regain full function and confidence with your mobility.

PhysioNow has highly trained Registered Phyiotherapists ready to help you with Sciatica.  We have same day emergency appointments available.  Call today to help with the Sciatica Pain! 289-724-0448.

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Fracture Rehabilitation

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Fracture Treatments Mississauga, Etobicoke & Oakville _ PhysioNow

Fracture types

Fracture Rehabilitation


Fractures are common injuries .  They can happen to people of all ages, from the very young to the very old.  The majority of fractures occur with trauma to the bone.  It could be  either from a fall or a blunt force.  Most people can readily feel that they have a broken bone. This is because the signs and symptoms can be very obvious.

Some of these indicators of Fracture are:

  • Swelling or bruising over a bone
  • Deformity of an arm or leg
  • Pain that gets worse with any movement or added pressure
  • Inability to put any weight through the injured area
  • Protruding bone through the skin (in the case of open fractures)

In some cases, however, fractures can be less obvious.  Some ankle fractures may look a lot like ankle sprains. You may not even know that it was a fracture until it shows up on an X-ray.

Spine Fractures

Fractures through the spine may feel a lot like back pain initially.  This is due to the  make-up of the spine.  Bony injuries to the back do not produce any of the obvious signs and symptoms .  However, one of the key components of a spinal fracture is that it occurs after some sort of trauma. This is most commonly a fall.  Therefore, if there is a traumatic event reported, the physiotherapist  will rule out any potential spinal fracture. They will  do a thorough assessment.  If the   Physiotherapist suspects a potential fracture, we will refer you back to your doctor to get X-rays done.

Fragility Fractures

In people with osteoporosis, fractures can happen with very minor stumbles or movements.  Osteoporosis is a condition where the bones become fragile or brittle from loss of bone.   Fractures associated with osteoporosis are called fragility fractures.  They occur due to the weakness of the bone itself.

If you have Osteoporosis, your bones can be injured with small traumas that would not normally affect the average person.  If you have  back pain and you have had trauma, the Physiotherapist will ask whether you have osteoporosis. This is to rule out potential fragility fractures.

Diagnostic tests for a Fracture

In any incident where there is a suspicion of a fracture, X-rays are necessary.  This will confirm the presence of the fracture, its exact location and severity.  However, in some cases, an X-ray may not be sensitive enough to show the fracture.   In these situations, if a fracture is still suspected, more sensitive tests like a CT, MRI or bone scan may need to be completed.

Fracture Classifications

There are 4 main classifications of fractures:

  • Displaced – the bone snaps into 2 or more parts and moves so that the two ends are not lined up straight.
  • Non-displaced – the bone breaks partly or all the way through, but the ends remain lined up
  • Closed – the bone breaks but there is no puncture wound in the skin
  • Open –the  bone breaks through the skin

Types of Fractures

There are also 7 different types of fractures to describe the specific nature of the break line:

  • Greenstick – incomplete fracture, where the broken bone is not completely separated
  • Transverse – the break is in a straight line across the bone
  • Spiral – the break spirals around the bone, common in a twisting injury
  • Oblique – the break is in a diagonal line across the bone
  • Compression – the bone is crushed, causing the broken bone to be wider or flatter in appearance
  • Comminuted – the break is in three or more pieces
  • Segmental – the same bone is fractured in two places, so there is a ‘floating’ segment of bone

Fracture Treatment

In terms of management of fractures, the treatment depends on the type of fracture.  The fractured ends of the bone must be set in their proper place and held there for the bone to heal properly.  This process is called reduction.

Fracture Repositioning

Most fractures are repositioned without the need for surgery. This  is called closed reduction.  Once the bones are positioned properly, the joint is casted .  The length of casting is usually 6 weeks.  This is how long it typically takes the fractured bones to heal.  There are circumstances where the period of casting may be either shorter or longer. This depends on the nature of the fracture.  If it is an ankle or foot fracture, the doctor may also recommend that you wear an aircast boot to stop your foot from moving.

PhysioNow carries a full supply of these aircast boots if you need one.

Open Reduction (Surgery) after Fracture

Open reduction (surgery)  is done for fractures that are more complicated. The repositioning of the bones wil be done with surgery in this case.   The surgeon will use screws and or plates to keep the bone fragments in proper position. This  allows for proper healing.   Following open reduction, you will have a period of immobilization .  The length of time for a fracture thathas required surgery will depend on the bone that was fractured. It also depends on  the severity of the fracture.  Also, depending on the fracture and the needs of the patient, the hardware may either be left in permanently or taken out with another surgery.  If removal of the hardware is necessary, it will happen once the fractured bone has completely healed.

Spinal and Rib Fractures

There are however some fractures that cannot be effectively immobilized such as spinal and rib fractures.  For these types of fractures, the affected area is protected with avoiding certain activities or postures.

Healing times for Fractures

In terms of healing times, most uncomplicated fractures take approximately 6 weeks for the bones to fuse.  Although medically, the fracture would have healed,  there may still be a lot of limitations. For fractures that are more complicated and required surgery, the healing times may be a little longer due the surgery.

Delayed Healing of Fractures

There are also some people who will heal at a slower rate because of various health conditions or medication use.  So, if you have diabetes, osteoporosis or are a long time user of prednisone, you may fall into this category.  Scaphoid Fractures also may have delayed healing because there is a poor blood supply to the bone.

Registered Physiotherapy after Fractures

Once the fracture itself is healed, there may still be some remaining problems from the injury.  Since the fracture would have been immobilized for several weeks, there will be a significant loss of movement and strength around the broken bone.

It is important to follow up with Physiotherapy for Fracture Rehabilitaton.  This helps to ensure that there can be a safe return to all previous activities.  A Registered Physiotherapist will be able to assess the limitations.  They will prescribe the necessary range of motion and  strengthening exercises and  then you can get back  to  all of your normal activities quickly!

PhysioNow Etobicoke and Mississauga

PhysioNow has highly trained Registered Physiotherapists on staff to help you after a Fracture.  We are open evenings and weekends to help meet your needs.  We also do direct billing to your insurance plan if you have one and if they allow us to do so on your behalf.

Call today to get started on your Fracture Rehabilitation!