What is osteoarthritis?

Osteoarthritis (OA) is the most common chronic (long-lasting) joint condition. A joint is where two bones come together. The ends of these bones are covered with protective tissue called cartilage. With OA, this cartilage breaks down, causing the bones within the joint to rub together. This can cause pain, stiffness, and other symptoms. OA occurs most often in older people, although it can occur in adults of any age. OA is also called degenerative joint disease, degenerative arthritis, and wear-and-tear arthritis. A leading cause of disability, OA affects more than 30 million men and womenTrusted Source in the United States. Here’s everything you need to know about OA, from treatment to prevention and more.

Osteoarthritis Causes
OA is caused by joint damage. This damage can accumulate over time, which is why age is one of the main causes of the joint damage leading to osteoarthritis. The older you are, the more wear and tear you’ve had on your joints.

Other causes of joint damage include past injury, such as:

• torn cartilage
• dislocated joints
• ligament injuries

They also include joint malformation, obesity, and poor posture. Certain risk factors, such as family history and gender, increase your risk of osteoarthritis. Check out the most common causes of OA.

Osteoarthritis and cartilage
Cartilage is a tough, rubbery substance that’s flexible and softer than bone. Its job is to protect the ends of bones within a joint and allow them to move easily against each other.

When cartilage breaks down, these bone surfaces become pitted and rough. This can cause pain within the joint, and irritation in surrounding tissues. Damaged cartilage can’t repair itself. This is because cartilage doesn’t contain any blood vessels.

When cartilage wears away completely, the cushioning buffer that it provides disappears, allowing for bone-on-bone contact. This can cause intense pain and other symptoms associated with OA. Here’s what else you need to know about cartilage, joints, and osteoarthritis.

Osteoarthritis Treatment:

• Goal of therapy for patients with osteoarthritis is to control the pain, swelling, and improve quality of life.
• Non-pharmacological therapy includes: exercise programs, weight loss counseling, and education. Physical therapy can be beneficial because it is important to maintain muscle strength and to help identify factors that are contributing to an increase in the rate of this wear and tear. Swimming is an ideal exercise because there is minimal pressure on joints.
• Pharmacological Treatment:
  • Initial treatment of non-inflammatory OA should be with acetaminophen on an as needed basis, and can be used 3-4x daily (1000mg every six hours).Acetaminophen effects the liver, so car must be taken when ingested with other products that also are processed similarly, like alcohol.
  • If inflammatory OA is present or acetaminophen is not helping – use NSAIDS. Start on low dose on as needed basis. Side effects include: rash, abdominal pain, kidney or liver worsening, interference with aspirin.
  • If patients cannot tolerate medications by mouth, or are at increased risk from side effects with use (age >75), body cream composites with NSAIDS or capsaicin are used as alternative.
  • If NSAIDS and Tylenol do not help, use of joint injections with glucocorticoid (steroids) are useful.Patients may have 3 months of pain relief with each injection.
• Surgery is considered for patients with serious disability.
  • Total joint replacement can be performed if patients fail conservative therapy. Refer to Dr. Chahal’s video on total joint replacement for further information by clicking here.

Prognosis:

Prognosis for patients with OA depends on the joint involved. Patients who have bilateral knee OA have faster rate of deterioration than patients who have fewer joints involved. Patients who have multiple medical conditions (heart and lung) are at greater risk of developing lower extremity disability than those with knee arthritis alone. Medication does not prevent progression of OA but can help the patient’s quality of life by controlling the pain. Physiotherapy can help identify and modify the activities that hard on joints and can reduce the symptoms associated with osteoarthritis.

What Is Neck Pain & Physiotherapy Treatment ?

Neck pain also referred to as cervical pain, is the general sense of discomfort and pain in the vertebrae area. Neck pain can be due to several reasons, the most common being incorrect posture, other than that there can be some medical reasons behind neck pain or it can also be due to some structural disorders in the neck, the cervical vertebrae and inter – vertebral discs, muscles, esophagus, larynx, trachea, blood vessels, lymphatic organs, nerves, thyroid gland and parathyroid glands.

Minor neck pain can be treated with the help of some at – home neck pain remedies like, massages, rest and ice packs, while severe forms of neck pain need medical attention.

NECK PAIN ON THE LEFT SIDE

Neck pain on the left side is mainly the result of bad postures. People suffering from some medical conditions may also experience neck pain on the left side. Other possible severe neck pain reason can be trauma, inflammation, or abnormal growths on the left side of the neck. People having neck pain on the left side may also experience a general sense of weakness or numbness in the neck, shoulder or the arm.

Treatment for neck pain on the left side involves the usual rest and exercise and physiotherapy for neck pain unless there is some other medical condition that requires surgery, to have neck pain relief. Back of Neck Pain: Often neck pain transpires into the surrounding region affecting the muscles and nerves connected to the head leading to back of neck pain. Back of neck pain are also responsible for tension headaches.

Neck Pain Symptoms

There are several symptoms of neck pain; one of the most common neck pain symptoms is a dull pain in the neck. Some of the neck pain symptoms for underlying medical issues are as follows;

• Numbness
• Tingling
• Tenderness
• Sharp shooting pain
• Difficulty swallowing
• Pulsations
• Swishing sounds in the head
• Dizziness or lightheadedness
• Lymph Node Swelling
• Arthritis
• Wryneck
• Tumour Severe neck pain due to pinched nerve shows the following symptoms;
• Headache
• Facial pain,
• Shoulder pain,
• Arm numbness or Tingling (upper extremity paresthesias)

Apart from the above symptoms, in several medical conditions neck pain can also be accompanied by upper and lower back pain.

Neck Pain Diagnosis

In cases of severe neck pain, a doctor makes a diagnosis only after reviewing the history of the symptoms along with the site of neck pain, the intensity of the pain, duration, and radiation of the pain. Some of points noted by a doctor before making any diagnosis are – Is the pain getting worse or improved with some movement of the head, any injury to the neck in the past and the treatments received. Doctors also examine the patient’s nervous system to determine the involvement of any nerve behind the neck pain.

Some of the tests that can be administered by the doctor for making appropriate diagnosis include

• X-ray
• CT scan,
• Bone scan,
• MRI scan
• Myelogram
• Electromyography (EMG)
• Nerve conduction velocity test (NCV).

Causes of Neck Pain

There are as many neck pain causes as there are types of neck pain. From the common culprit like bad posture to more serious health conditions like tuberculosis of the neck are some of the few reasons behind neck pain. Some of the common neck pain causes are as follows;

• Degenerative disc disease
• Neck strain
• Neck injury – whiplash, herniated disc or a pinched nerve
• Neck pain due to throat virus infection causing swelling of the lymph node and neck pain
• Tuberculosis of the neck
• Infection of the spine bones in the neck (osteomyelitis and septic discitis)
• Meningitis, accompanied with neck stiffness
• Fibromyalgia
• Polymyalgia
• Rheumatica

Neck Pain Remedies

Neck pain remedies do not need to be restricted to massages and medication, there are now plenty of other forms of fun activities that can bring neck pain relief like Jacuzzi treatment, or specifically designed neck pillows for sleep besides the regular neck pain relief exercises and stretches.

Physiotherapy For Neck Pain

Physiotherapy for neck pain goes a long way in bringing neck pain relief in some cases, by means of Stretch, strengthen and straighten
Massage and specific neck pain exercises

• Ultrasound – helps in eliminating muscle and joint pain
• Transcutaneous electrical nerve stimulation or TENS – is a therapy that uses mild electrical currents to treat pain
• Mobilization – It is a manual treatment that improves joint function along with stretching tight muscles and ligaments through neck pain exercises.
• Traction – This therapy involves creating a sustained pull on the neck to bring neck pain relief in neck pain due to nerve root irritation or muscle spasms. 

How Can We Help?

Neck pain comes across as a very innocent type of pain but, who suffer from the severe neck pain understands the true nature of this pain.

Neck pain can be aggravated by simple activities like walking or sudden movements and as such these people require the help of health care professionals to get treated at the comfort of their home.

Portea is widely renowned for offering quality healthcare at home. Our physiotherapists are not only highly trained and well experienced; they follow a patient-centric approach, meaning they modify their services as per the need and condition of the patient.

We also train and help the patients in performing neck pain exercises as part of physiotherapy for neck pain. So if you need neck pain treatment at home or physiotherapy for neck pain just get in touch with us and allows us to rapidly bring you back to good health.

Neck Pain Treatment

What is the Best Treatment for Neck Pain?

The best treatment for your neck pain is determined entirely by the specific reasons for WHY you are suffering neck pain. Everyone is different, but there are some common similarities.

Your physiotherapist is highly skilled at the diagnosis and treatment of mechanical neck pain and headache. Posture correction is important but it does depend upon the availability of enough joint and muscle flexibility to attain a good posture, plus muscle strength and endurance to maintain your good posture. Any deficit will need to be addressed.

We understand that your neck pain may not be solely about stiff or wobbly joints or tight/weak neck muscles. There is a whole gamut of information that your physiotherapist will analyse during your diagnostic consultation and then commence the correction of your individual problems. They’ll also consider other systemic conditions that can cause neck pain eg cancer, and direct you towards the appropriate healthcare practitioner if appropriate.

Fortunately, the vast majority of neck pain does come from your neck joints and muscles. Pleasingly, researchers have shown that a combination of neck joint and muscle treatment performed by your physiotherapist and some specific strengthening exercises are an effective way to eliminate your neck pain, stiffness and headaches.

For advice specific to the diagnosis and management of your neck pain, please contact your trusted healthcare practitioner.

 What Is Back Pain?

Back pain is by far the most common health problem affecting millions of people globally. It is also the most casually dealt health problem by people, as we casually disregard back pain as an unavoidable physical discomfort; we fail to realize that the very basic back pain can be a symptom for a potentially serious decease. People usually reach out for over the counter pain killers or pain relief sprays instead of seeking proper back pain treatment.

Depending upon the region of the back that is affected, back pain can be categorized into three different types – cervical or neck pain, thoracic or middle back pain and Lumbar/ Coccydynia (tailbone or sacral pain) or lower back pain.

• Lower Back Pain – Lower back is also medically referred to as lumbar or Coccydynia (tailbone or sacral pain). It affects the lumbar region spine and surrounding areas like the buttocks, upper thigh and the groin areas. Lower back pain is also the most common type of back pain affecting people.
• Middle Back Pain – It affects the area between the cervical and lumbar region. It is also medically referred to as thoracic pain and is a less common form of back pain.
• Upper Back Pain – Upper back pain affects the cervical region i.e. the spine and neck. It causes stiffness and discomfort in the neck and shoulder area. Slouching, sleeping posture are some of the chief causes of cervical back pain.

 Why Is Back Pain A Common Problem?

Back pain is by far the most common debilitating health problem for people caused mainly due to incorrect posture and bad lifestyle. Back pain is common in older people. Women, especially pregnant women, are more prone to backaches than men. Back pain is by far the most common debilitating health problem for people caused mainly due to incorrect posture and bad lifestyle. Back pain is common in older people.

Women, especially pregnant women, are more prone to backaches than men. Often ignorance of the severity of the problem and lack of proper back pain treatment aggravates the pain and resulting in a chronic problem. So don’t further aggravate your back pain and seek treatment at home. You can simply go online and type back pain relief near me or back pain treatment near me to find good back pain treatment offered  by Portea Medical at the comfort of your home.

 Common Causes Of Back Pain

There are numerous causes of back pain; nearly 98% of all back pains have no serious medical pathology, while a little less than 2% of all back pains are caused due to serious infections and metastatic cancer. And a little less than 1% is caused due to epidural abscesses. There are innumerable causes of back pain, some of which are as follows;

Strain

Strained muscles and ligaments, muscle spasms, muscle tension and injuries related to falls are the root cause for a majority of back pain complaints. Back muscles are mostly strained due to heavy lifting, lifting stuff improperly and sudden awkward movements. But you have more control on this form of backaches than you believe. With the availability of back pain treatment at home, you needn’t have to live with the pain. We offer the best back pain physiotherapy treatment at home.

Back Structural Problems

Ruptured discs, bulging discs, abnormal curvature of the spine, sciatica, arthritis, osteoporosis and kidney infections or stones can also lead to excruciatingly painful backaches restricting one to bed. In this scenario a patient’s movement is massively affected and they are best advised to seek back pain treatment at home, so as to not to further aggravate the problem with travelling.

 Movement and Posture

A majority of all back pains today are caused due to bad postures, sudden jerks, standing or sitting for long periods, driving for a long period without breaks. These are just some of the few examples of movement and posture related back pains. Physiotherapy for back pain can be safely said to be the best form of treatment for this type of back pain.

Pregnancy

Back pain is a pretty common phenomenon both during and post pregnancy owing to hormonal changes, weight gain and epidural injections. Since seeking medications during pregnancy for such a pain is not advisable, physiotherapy for back pain can be said to be the safest bet to get rid of back aches in these times.

Obesity or Overweight

Obesity is another leading factor of back pain. A lot many of us are more or less overweight and this excess weight puts a lot of strain on our body leading to all sort of body pain. To counter this, it is best recommended to indulge in healthy eating and some form of exercise to lose the extra weight and for the back pain you can seek back pain therapy or physiotherapy for back pain.

Medical Condition

 We do not realize something as basic as a back pain can be a symptom of various diseases like Cauda Equina Syndrome, Cancer of the Spine, Infection of the Spine, Pelvic Inflammatory disease, Kidney infections, Sleep Disorders and Shingles among others. When your back pain does not subside in a few days, it is highly recommended to seek medical attention to get to the root cause of the pain and thereby seek proper medication and back pain therapy as recommended by the doctor.

 How To Prevent Back Pain

Some of the steps we can undertake to lower the risk of back pain are as follows;

• Make exercise a part of your daily routine; even a 15 minute exercise will go a long way in strengthening the back muscles and adding flexibility. However, don’t practice exercises that include heavy lifting without due supervision.
• Indulge in a healthy diet that includes enough calcium and Vitamin D, for good bone health. A proper diet will also help in losing extra body weight.
• Mind your posture while sitting and standing. Don’t slouch and don’t sit or stand for long hours at a stretch.
• Be careful while heavy lifting. Always bend your knees when lifting anything.
• Do not lift heavy objects and twist at the same time.
• Also wear proper footwear; ladies who wear high heels for long period of time are more susceptible to back aches.
• Don’t drive continuously for long hours; take proper breaks to stretch yourself.
• Invest in a good mattress that provides proper support to your body.

 The Best Treatment for Lower Back Pain?

The best treatment for lower back pain obviously relies upon an accurate diagnosis to direct the primary treatment direction. Once the specific spinal pathologies have been excluded or the patient referred to the relevant specialist we are dealing mostly with radicular syndromes and non-specific lower back pain (NSLBP).  

With accurate assessment and early treatment, most NSLBP and radicular pain syndromes will respond extremely quickly to physiotherapy, allowing you to quickly resume pain-free and normal activities of daily living.  Please ask your physiotherapist for their professional treatment advice. They can also advise you when a back brace is suitable or if you are better advised to perform some specific back exercises. 

Real-time ultrasound has been used by back pain research in recent years to assist the diagnosis and successful treatment of lower back pain. Real-time ultrasound is now available at leading physiotherapy clinics to assist you and your back pain relief and prevention.

While lower back pain treatment will vary depending on your specific diagnosis, your physiotherapist will have the following aims. 

 PHASE I – Back Pain Relief & Protection

Managing your back pain is the main reason that you seek treatment for lower back pain. In truth, it was actually the final symptom that you developed and should be the first symptom to improve.

Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include ice, electrotherapy, acupuncture, de-loading taping techniques, soft tissue massage. A course of non-steroidal anti-inflammatory drugs such as ibuprofen may also help in this phase.

Osteoporosis Physiotherapy

Osteoporosis is a common disease that causes a thinning and weakening of the bones (the bones becomes thinner and more porous, which makes it mechanically weaker as well).  It can affect people of any age. Women have the greatest risk of developing the disease, although it also occurs in men. Osteoporosis affects 55% of Americans aged 50 or older; one-half of women and a quarter of men will fracture a bone as a result of low bone density (osteopenia) or osteoporosis.

Thin bones are the cause of 1.5 million fractures per year in the United States; just hip fractures alone result in 300,000 hospitalizations. It is important to diagnosis low bone density or osteoporosis early so that steps can be taken to rebuild bone strength and lessen the risk of fracture.

FIRST OF ALL, WHAT IS OSTEOPOROSIS?
Osteoporosis is a bone disease characterized by

• low bone density (thickness of the bone)
• decreased bone strength
• and a change in the bone structure

– which can lead to an increased risk of fracture.

The normal bone structure becomes thinned out and porous with poor nutrition, aging, or when osteoporosis develops, lessening the ability of the bone to withstand the typical forces that are applied in everyday living. Fractures from low bone density and osteoporosis can be serious, causing pain and affecting quality of life.

Our bones are living tissue.

Normally, one type of cell removes bone and another type of cell adds bone in a balanced, ongoing process. However in the case of osteoporosis, bones weaken when not enough new bone is formed and/or too much bone is lost. This imbalance commonly begins in women during the first 5 years of menopause. That being said, it can also occur in men and in children, often due to diseases that affect bone development, such as

• celiac disease
• inflammatory bowel disease
• rheumatoid arthritis
• spina bifida
• cystic fibrosis
• kidney disease

Some medicines, such as steroids, may increase the risk of developing osteoporosis. Athletes who are underweight during the time of peak bone development are also susceptible. There are many factors that can cause a person to be at risk for developing osteoporosis. It is important to know your risks so that you can be diagnosed and proactive in your treatment.

Risk Factors for Osteoporosis

Noncontrollable risks

• Female gender
• Small frame
• Advanced age
• Hormone levels
• Genetics
• Predisposing medical conditions

Controllable risks

• Cigarette smoking
• Excessive alcohol intake
• Inactive lifestyle
• Excessive caffeine intake
• Lack of weight-bearing exercise
• Drugs (eg, steroids, heparin)
• Poor health
• Low weight
• Calcium-poor diet
• Low vitamin D levels

How does osteoporosis feel like?

Osteoporosis is a disease that can be “silent” i.e., the patient can be totally unaware of it. There may be no outward symptoms until a fracture occurs. If you are middle-aged or older, you may notice a loss of height or the appearance of a humpback. You may also begin to experience pain between your shoulder blades or above the crest of the pelvis.

People with low bone density may experience fractures in everyday situations that would not occur in persons with healthy bones, such as breaking a hip or a breaking their wrist with a fall from a standing height, breaking a rib when opening a window or when receiving a hug, or breaking an ankle after stepping off a curb.

These are called fragility fractures and are a red flag for bone disease.

Spinal compression fractures, particularly those in the upper back or thoracic spine (area between the neck and the lower back), are the most common fractures, followed by hip and wrist fractures.

HOW IS IT DIAGNOSED?

If you see our senior physiotherapists for back pain or other rehabilitation issues (or if you have wrist fractures, you may see our senior hand therapists), we will review your

• medical
• family
• medication
• exercise
• dietary
• hormonal history
• conduct a complete physical examination

and determine your risk factors for osteoporosis. The assessment may lead us to recommend further testing. Osteoporosis is best diagnosed through a quick and painless specialized X-ray called the DXA, which measures bone density. The results are reported using T-scores and Z-scores.

• The T-score compares your score to that of healthy 30-year-old adults. If you have a T-score of -1 or less, you have a greater risk of having a fracture.
• If the T-score is -2.5 or less you will receive the diagnosis of osteoporosis.

The Z-score compares your bone mineral density to those of the same sex, weight, and age. It is used for those whose bone mass has not yet peaked, premenopausal women, and men older than 50.s

Fibromyagia Physiotherapy

Fibromyalgia is a chronic condition that is often difficult to diagnose and unfortunately affects almost 5 million people in the United States, where 80% to 90% are women. Fibromyalgia usually is diagnosed in adults between the ages of 30 and 50, but the symptoms—such as widespread chronic pain and fatigue—can show up earlier. Although there is no definitive cure at this time, there are treatments that can help. Our senior physiotherapist can help you:

• Understand and manage your pain
• Reduce your fatigue
• Improve your function and quality of life
  

WHAT IS FIBROMYALGIA?
The cause of fibromyalgia is unknown, but it’s thought to be due to changes in how our nervous system experiences, understands and interprets pain. It might be triggered by

• trauma
• surgery
• infection
• arthritis
• or major emotional stress
• or it may develop gradually over time

Also, individuals who have health conditions such as rheumatoid arthritis, systemic lupus erythematosis, or ankylosing spondylitis are more likely to develop fibromyalgia.

Signs and symptoms

Fibromyalgia isn’t “just” a condition; it’s really a complicated and complex syndrome involving many different signs and symptoms. Patients may experience:

• Widespread pain, often a dull achiness, on both sides of the body above and below the waist  
• Spots on your head, neck, chest, shoulders, elbows, hips, or knees that are tender to a firm touch; these “tender points” may move around or come and go
• Muscle stiffness, especially in the morning
• Headache
• Thinking and memory problems
• Fatigue (sometimes misdiagnosed or even has chronic fatigue syndrome as well)
• Depression
• Anxiety
• Pain or cramps in the abdomen or pelvis
• Irritable bowel syndrome
• Irritable bladder syndrome
• Difficulty sleeping or getting back into sleep; waking unrefreshed
• Temporomandibular (jaw joint) pain
• Numbness or tingling

Often, stress can aggravate symptoms too.

HOW IS IT DIAGNOSED?

Because there are no blood tests, x-rays, or muscle biopsies that can be used to diagnose fibromyalgia, you’ll need to work closely with your doctors to obtain an accurate diagnosis. The reason is because there are really many health conditions that can cause pain and fatigue, so it’s important to have a thorough medical examination to rule out conditions other than fibromyalgia, such as

• rheumatologic diseases
• infectious diseases
• Lyme disease
• hypothyroidism
• metabolic disease
• or side effects due to medication

• Once other conditions have been ruled out, a diagnosis is made based on key symptoms—extreme fatigue, pain in multiple “tender points” (points that are tender to touch and that move around), trouble sleeping, anxiety, and memory problems.
• Our senior physiotherapist can identify fibromyalgia while performing a routine examination and taking your health history. We will pay close attention to the pattern of your symptoms.
• For instance, there are 18 possible tender points, and the more tender points you have, the more likely you have fibromyalgia. We may refer you to a rheumatologist, a physician who specializes in arthritis, for medical care that includes medications.
• HOW OUR SENIOR PHYSIOTHERAPISTS CAN HELP

Living with fibromyalgia can be very challenging.

Your pain and other symptoms might take different forms from day-to-day. If you avoid activity because of pain, your overall physical fitness might  decrease and that comes with a different set of health problems. Extensive research supports the use of education, aerobic exercise, and strengthening exercise to help improve fibromyalgia. Usually (and naturally) the fear of pain often keeps people from beginning an exercise program.

We will teach you how to interpret pain signals—and how to manage and decrease your symptoms—through a customized exercise program.

Help You Take Control Through Information

Research shows that people who are knowledgeable about their health condition

• have more confidence
• can cope better with their condition
• and are more likely to get “back in the swing”

We can explain how fibromyalgia affects the way your body perceives and responds to pain and how you can start to take control of the pain, rather than the pain controlling you. We also have evidence to support that knowledge is power, as it pertains to managing pain. We also can provide information on local support groups, exercise programs, and self-help programs. 

Manage Your Symptoms Through Exercise

Regular, moderate exercise is an important part of managing fibromyalgia. Reducing body mass index (weight loss) can actually reduce the risk of developing fibromyalgia. Research has shown that the following treatments can decrease pain and improve function, general health, and sleep in people with fibromyalgia:

• Aerobic conditioning
• Aquatic exercise
• Stretching
• Strengthening exercise
• Yoga
• Tai chi
• Deep breathing
• Recreational activities
• Manual therapy

We will design an exercise program that’s right for you. To ensure your success, the therapist will show you how to:

• Start slow.
• Pace yourself.
• Set realistic goals for exercise and physical activity.
• Modify your program in times of stress.

We can help you improve not only your fitness, but your quality of life by designing a program of aerobic exercise, which trains your heart and lungs as well as your muscles. Aerobic exercises include walking briskly (you can talk but you need to take deep breaths), bicycling, swimming, and using a stair-climbing or elliptical device.

If you have severe symptoms, we will work with you to gradually increase your overall activity level and your tolerance for exercise, starting you off with exercises that you are able to perform for short periods (eg, 10 minutes), and then gradually building up your tolerance for longer exercise. Even short, 10-minute exercise sessions done 2 or 3 times per day can improve your strength and increase your endurance. If you have milder symptoms, we might focus on strengthening your muscles or increasing your cardiovascular fitness. We might recommend aquatic exercise in a pool to help reduce stiffness and pain while you exercise.

Even if you start out slowly, you are likely to have more pain as a result of increasing your activity. We will prepare you by teaching you techniques that you can use at home, such as relaxation techniques and stretching exercises.

You might have other conditions in addition to fibromyalgia, such as

• tendinitis
• arthritis
• or heart disease

These conditions can make exercise more difficult for you.

We are uniquely trained to individualize treatment for those conditions, taking into consideration the effect that they might have on your fibromyalgia symptoms and on your exercise ability.

You may be prescribed medications that target brain chemicals that are responsible for the way your body deals with pain. We also take into account the effects that medications may have on your movement and exercise ability.

Improve Your Range of Motion

Our senior physiotherapists may use manual therapy techniques to move your joints while you are relaxed to help improve your joint motion. These techniques are combined with exercise, stretching, and movements that you control.

Use Special Techniques

Research indicates that the best results are likely to come from combining a variety of treatments. Appropriate medications, exercise, and “mind-body techniques” can work together to help you manage your symptoms. Some techniques, such as meditation and cognitive behavioral therapy, can change your responses to pain and promote relaxation. We also are educated and experienced in how to recognize behaviors that may interfere with recovery of function, and often refer patients to other health care professionals who can help them overcome these barriers.

We might use biofeedback to help you control muscle tension and decrease pain, using a device that provides you with information about the amount of tension in your muscles. We place electrodes on your skin with a soft gel, and these electrodes record muscle tension while explaining how you can relieve that tension. We also can show you how to set a routine time for sleeping and waking to allow for good restorative sleep. We will discourage you from sleeping in the daytime, as that can throw off your sleep cycle.

Reduce Your Pain

To reduce your pain, we may select from a number of treatments:

• We may use pressure on specific areas of the muscle, followed by stretching or contracting your muscles, to relieve pain and make the muscles more flexible. We also might use manual therapy techniques to help relieve pain in your muscles and other connective tissues (the material between the cells of the body that support the organs and other tissues).
• We may use dry needling to relieve your pain by inserting very fine wire-like needles into the painful areas of the muscle.

What is the Temporomandibular Joint (TMJ)?

The TMJ is located directly in front of your inner ear, below your temple, and is a part of the body we use many times during the day when we talk, yawn, eat, drink or chew (see diagram). Usually, you are only aware of this joint when it becomes painful.

What causes TMJ Dysfunction?

The pain and tenderness of TMJ dysfunction can be caused by the disc in the joint moving out of place and causing pressure on sensitive structures around the joint. Other causes of TMJ Dysfunction include:

• Clenching or grinding of the teeth, both during the day and while sleeping at night
• Poor posture, leading to strains or overuse of muscles in the face and neck
• Inability to relax
• Poor diet
• Lack of restful sleep
• Arthritis
• Fractures
• Alignment or structural problems present since birth
• Injuries to the face, head or neck, such as concussions, facial blows, or motor vehicle accidents

Symptoms of TMJ Dysfunction

The pain of TMJ dysfunction can be sharp, searing and catching, or dull and constant. It can be extremely debilitating. Other symptoms include:

• Ear pain, or fullness of the ears
• Facial pain
• Sore, tight, tender jaw muscles
• Temple, cheek, tooth or jaw pain while swallowing, yawning, talking or chewing
• Jaw popping, clicking or locking upon opening or closing, or while chewing
• Reduced ability to fully open or close the mouth
• Frequent headaches or neck aches
• Muscle pain and spasms in the face, head and neck
• Ringing in the ears

Physiotherapy and TMJ Treatment

Are there treatment options?

Fortunately, a trained Physiotherapist can help by teaching you relaxation, stretching and strengthening exercises for the face, head and neck muscles. These exercises can also help to augment the effect of the appliance or mouth guard your dentist may have already provided to you. Your program may include one or more of the following:

• Stretching and strengthening exercises of the jaw, head and neck
• Postural correction, relaxation and breathing exercises
• Manual stretches and mobilizations of the jaw and neck joints
• Ultrasound and electrical stimulation to improve healing

What can you expect?

At Ortho Neuro Physiotherapy Clinic, you will work directly with a certified Physiotherapist, trained through post graduate course work, in the assessment and treatment of TMJ dysfunctions.

Your Physiotherapist will assess:

• Your unique jaw and neck movement disorder or alignment issues
• Muscle imbalances and tightness
• Any joint related problems

Following your assessment, your Physiotherapist will put you on a specific, individualized exercise program. You will continue to see your Physiotherapist to monitor and progress your program, and to provide you with the hands-on therapy you may require.

Your Physiotherapist will always be in contact with your dentist and/or specialist to coordinate your treatment with their recommendations.