Author Archive: aenriquez

Factors and Different Treatments for the Dreaded Scoliosis

Scoliosis is a condition that causes the spine to curve forming a “C” or “S” shape. The curved spine can irritate and stretch nerves, strain joints comprised of two bones, affect the posture, and make muscles fatigued. It causes pressure on the disks between the spinal vertebrae making them inefficient shock absorbers and causes strain with pressure on facet joints of the spine. The cause is unknown and there is no cure. Managing symptoms associated with the condition is the main course of treatment.

 

The single worst symptom is pain. The condition impacts quality of life and is a long-term disability. The curve is not usually painful but when changes cause it to become painful, it is debilitating. For some patients, over-the-counter medication helps them cope with the pain and discomfort, while others require stronger pain relievers that are taken several times a day. Pain is individualized and each person perceives it differently. Pain medications are not a long-term solution because they have no impact on the source of the pain.

 

There are several factors that affect how well the nerves work to decrease pain. These factors are:

  • Genes
  • Environment
  • Medication
  • Personal beliefs or perception

Surgical intervention is generally recommended when the curve is greater than 40-degrees

The most common pain is due to muscle strain as the individual tries to compensate for the curve while completing activities of daily living. (getting dressed, taking a bath, cleaning…)

The basic treatments for muscle strain include over-the-counter pain relievers, hot packs, cold compresses for inflammation, and rest. Often a brace is worn but can be uncomfortable and burdensome. Surgical intervention depends on the progression of the condition.

 

Finding appropriate treatment(s) begin with:

  • Talking to your healthcare provider
  • Participating in alternative therapies
  • Wearing a brace for support, if able to tolerate
  • Possible surgical intervention

 

Physical Therapy can help with pain management by incorporating exercises to improve back strength and flexibility. Stretching often is recommended. If an activity causes increased pain, stop doing it and rest. Other recommended therapies and programs include Pilates and Yoga to promote balance, develop deep and superficial muscles, and relax the mind.

 

Other treatments and therapies that can help alleviate pain and improve coping skills include:

  • Chiropractics
  • Massage Therapy
  • Acupuncture
  • Hydrotherapy
  • Steroid or Anesthetic Injections
  • Counseling
  • Surgical spinal fusion

Counseling can include Cognitive Behavioral Therapy (CBT). Cognitive Behavioral Therapy allows a counselor and patient to identify ways to manage and cope with pain and limitations. It can help the individual to overcome beliefs or behaviors that aggravate or cause more spinal damage and leads to the identifying techniques, like meditation, that help with mental ability to deal with pain (coping skills).

 

Surgical intervention is generally recommended when the curve is greater than 40-degrees. It is done to ensure the curving stops. Without surgery, the spinal curve would continue to increase by 1-2 degrees annually. But surgery has risks, so alternative therapies are recommended first.

The Causes and Treatment of Severe Obesity

Obesity is on the rise in the United States. It is caused by an increase in size and number of fat cells. A scale called Body Mass Index (BMI) is used as a measure to calculate obesity. A normal BMI is 20 or less but a BMI greater than 30 indicates obesity. Obesity is a serious condition with several causes and health complications.

 

Causes of obesity include:

  • lack of sleep
  • unhealthy diet
  • genetics
  • sedentary lifestyle and inactivity
  • age
  • changes in hormones within the body
  • sometimes, hypothyroidism or polycystic ovary syndrome.

 

There are different types of fat in different areas of the body. Three types of fat are brown, white and beige. The body uses these stores of fat to fuel the body, regulate body temperature, and store energy for later use. Fat builds up when there are more calories coming into the body than what is being used for energy. Brown fat builds up in the belly area in and around organs. Belly fat is more dangerous than the other two.  It interferes with the endocrine and immune systems and promotes chronic inflammation and obesity-related complications.

Treatment depends on the cause and severity of the obesity

Risks associated with obesity are as follows:

  • osteoarthritis in hips, back, and knees
  • gallbladder disease due to excess cholesterol
  • sleep apnea, fatigue, and other breathing problems
  • heart disease and stroke
  • elevated cholesterol
  • cancer due to abnormal cell growth
  • elevated blood pressure due to damage to arteries leading to other health problems
  • Diabetes
  • Fatty Liver disease
  • low quality of life
  • mental illness – clinical depression, anxiety and other mental disorders
  • body pain and difficult physical functioning
  • pregnancy problems like gestational diabetes and pre-eclampsia

 

Treatment depends on the cause and severity of the obesity. Communication with your healthcare provider can help with making a weight loss plan. Lifestyle changes are at the top of the list and include :

 

  • eating a heart-healthy diet
  • increasing physical activity as tolerated
  • an FDA approved weight loss medication
  • surgical intervention (gastric bypass or gastric sleeve for example)

 

Healthcare providers have dieticians on staff that can provide guidelines for a low-calorie healthy diet plan. Weight-loss is dependent on setting individual goals and being compliant with the agreed upon plan. Weight loss can decrease the effects of obesity on hips, back, and joints. Exercise programs will improve breathing issues, decrease high blood pressure, decrease diabetes symptoms and in some cases, the need for certain medications.

According to the U.S. Surgeon General, 35 percent of women and 31 percent of men are seriously overweight, and 15 percent of children between the ages of six and nineteen are overweight. Public health officials are warning consumers that inactivity and poor diet are catching up to tobacco as a significant health threat.

Closed Fracture Treatment and Infection Prevention

A closed fracture is a broken bone that does not break through the skin. There are four commonly seen closed fractures. These fractures include wrist fractures, hip fractures, ankle fractures and spinal compression fractures. Hip fractures and spinal compression are often seen in the elderly. Fractures require emergency treatment. If neck, back or hip injury is suspected or if there is exposed bone do not move the person.

 

Diagnosis of fractures can generally be made through physical examination and x-rays. A compression fracture or a wrist fracture may not show on an x-ray. In this case, a CT or MRI can be used to locate the fracture. Often, the fracture will only be immobilized and a repeat x-ray done in 10-14 days when the healing makes the fracture more visible. With a skull fracture, a CT may be done, rather than an x-ray, to determine if there is brain injury secondary to the fracture.

 

Factors that predispose bones to fractures are:

  • Osteoporosis
  • Advanced age
  • Endocrine and GI issues
  • prolonged use of steroids
  • inactivity
  • smoking and alcohol

 

Treatment of these fractures is dependent on the severity and can include the following:

 

  • Reduction
  • Cast, sling or walking boot for immobilization
  • External fixation – intervention used with traumatic soft tissue injury and open fracture
  • Internal fixation – Surgical intervention with placement of pins, screws, plates, or rods.

 

Additional treatment includes medications for pain and to prevent infection.

 

A cast or other form of immobilization is meant to hold the bones in proper alignment and to provide protection from additional injury. Reduction is when the bone is set back in place to heal. Some fractures are realigned and held in place through internal fixation or external fixation. External fixation is a way to hold fragments of fractured bone together using metal pins with a compression device attached on the surface of the skin.

The treatment of closed fractures is highly dependent on age, patient preference and surgeon preference

External fixation is used when:

  • there is an open fracture with soft tissue damage
  • fractures with deficient bone (osteoporosis)
  • Infection

 

Rehabilitation begins right away because long-term immobilization causes muscles to become stiff. It takes 4 to 6 weeks to heal depending on the severity of the fracture and surrounding damage. Physical Therapy begins rehabilitation and has several goals.

 

The goals of Physical Therapy include:

  • promoting circulation
  • preventing clots
  • enhances the healing process
  • Once the cast is removed, exercise in a pool is beneficial and promotes mobility. The water also relaxes muscles making movement easier.

 

Treatment of closed fractures is highly dependent on age, patient preference and surgeon preference.

Causes of Abdominal Pain and How to Avoid Them

Generalized abdominal pain is felt in more than half of the belly between the chest and the groin. There are three types of abdominal pain including:

 

  • Localized pain – which is felt in only one area of the stomach
  • Cramp-like – that results from gas and bloating and usually is not serious
  • Colicky – which comes in waves and begins and ends suddenly. Pain is often severe.

 

Typically, abdominal pain is caused by viruses, indigestion or gas. If the pain is more severe it may be caused by other illnesses. The abdomen is full of organs including the small and large intestines, female organs, spleen, gallbladder, spleen, kidneys, and stomach.

 

Less serious causes may include:

  • Constipation
  • Irritable Bowel Syndrome
  • Allergies or Lactose intolerance
  • food poisoning
  • stomach flu

 

Other, more serious causes include:

  • bowel blockage
  • gallbladder issues
  • kidney stones
  • GERD
  • Pancreatitis
  • Ulcers and Crohn’s Disease

Seek medical attention if the pain is so severe that you cannot sit still

Sometimes pain is due to a problem elsewhere in the abdomen such as, menstrual cramps, endometriosis, urinary infection, and even muscle strain. If the pain lasts more than a week or longer, and does not improve within 24 – 48 hours, medical treatment with your healthcare provider should be sought. When more serious symptoms are present then 911 should be called.

 

Serious symptoms include (but not limited to):

  • constipation and vomiting
  • vomiting blood or having bloody stools
  • chest, neck and shoulder pain
  • tenderness in the abdomen
  • abdomen is rigid and hard to touch
  • recent abdominal injury
  • difficulty breathing
  • severe pain
  • fever
  • yellowish tint to skin
  • weight loss

 

Seek medical attention if the pain is so severe that you cannot sit still, movement increases the pain, and you can’t find a comfortable position to rest. Avoid over – the – counter medicines like Advil because they can cause additional irritation.

 

Diagnosis, whether done by your provider or other emergency personnel, begins with a history and a physical. These are done so the doctor can develop a plan for treatment and determine what the possible cause might be and if the pain is injury related.

 

The doctor will ask about the characteristics of the pain if there were any recent injuries, and when the onset of pain began. Depending on the cause a variety of tests may be used to help diagnose the cause of the abdominal pain.

 

Diagnostic testing may include:

  • An ultrasound to check for fluid and need for a paracentesis
  • stool sample to check for Dif. Or parasitic infection
  • bloodwork like CBC and WBC to determine if there is anemia or an infection
  • CT scan with contrast to see the internal organs
  • Colonoscopy to check for bowel blockage

 

Lifestyle changes and prevention are important to avoid future events of abdominal pain. This includes nutritious meals, plenty of water, and taking medications as prescribed.  Don’t hesitate to seek medical attention. The sooner treatment starts the better the chances of avoiding long-term damage or the need for surgery.

Spinal Manipulation Could Help Headache Sufferers

A headache is something we have all experienced at one point in our lives. But for many these headaches stay for days and days. In many, they are chronic and significantly affect a person’s functioning. This might be at work or at home – either way, it affects who you are as a person and stops you from putting your best foot forward. For those suffering cervicogenic headaches there may be a new treatment on the horizon. For years many of your colleagues or friends may have recommended spinal manipulation – the chiropractic technique – but now research is mounting that spinal manipulation is effective for this condition.

What is a cervicogenic headache?

A detailed run through of cervicogenic headaches can be found at physiopedia but as an overview, a cervicogenic headache is a chronic headache that arises in the neck and at the back of the hand and moves round to the front of the head. Patients experience:

  • A one-sided headache
  • A headache is worsened when they move their neck
  • The top 3 points in the neck are painful to touch
  • There may also be neck pain
  • They have tightness in the upper shoulder muscles or back.

What is spinal manipulation?

Spinal manipulation is one of the man treatments used by chiropractors. There are a number of variants of spinal manipulation but generally, the practitioner will move the spine with his or her hands. They will move the spine in a way that is beyond its usual range of motion – this force can be applied slowly or with great speed.

Spinal manipulation techniques have been gathering evidence for the past 10 years for a whole range of conditions

Does spinal manipulation work for cervicogenic headaches?

Spinal manipulation techniques have been gathering evidence for the past 10 years for a whole range of conditions. However, a recent paper to be published in The Spinal Journal shows that move spinal manipulation therapy sessions is associated with a decreased frequency of having cervicogenic headaches. The trial looked at visits of spinal manipulation therapy versus the number of days with a headache per month. The individuals received 0 6 12 or 18 sessions. There were 256 patients included in the trial. The authors found that:

They found that 6 extraspinal manipulation sessions were equal to a reduction of 1 day with a headache a month

  • In a patient who had 18 sessions of spinal manipulation the average number of headaches per month fell from 16 to 8 days.

The authors end by concluding that

“For the highest and most effective dose of 18 SMT visits, CGH days were reduced by half and about 3 more days per month than for the light-massage control.”

If you or somebody you know suffers with chronic headache – it might cervicogenic in nature. Get in contact with a specialist chiropractic centre today to discuss spinal manipulation therapy further.

Top Athletes Are Turning To PRP Therapy To Heal Injuries

How do top athletes come back so fast from seemingly career-ending injuries? In the NBA, NFL it’s common to hear of athletes coming back from ACL injuries to play their best seasons in just a matter of months. But what is their secret? What technologies and new and innovative therapies are they trying? One of these is known as platelet-rich plasma therapy, and the list of All-American athletes that have used it is grown. It now includes names like Troy Polamalu, Tiger Woods, Kobe Bryant and Danny Salazar.

What is platelet rich plasma therapy?

Platelet-rich plasma therapy is a new and exciting treatment that can be used for a whole host of injuries suffered by sports stars and amateur athletes alike. It works by enhancing the body’s own natural healing mechanisms. The procedure is performed in a number of steps:

  • A sample of the patient or athletes own blood is taken
  • This sample is spun at high speed (centrifuged), which acts to separate out the different components of the blood.
  • The platelets and plasma are removed from the centrifuge, leaving behind the red blood cells
  • The platelets and plasma are injected back into the individual into the area of injury that requires healing.

When these platelets are injected back into the injured site current theories suggest they work to stimulate the bodies healing process and speed up recovery time.

Platelet rich plasma therapy is a new and exciting treatment that can be used for a whole host of injuries

Russell Westbrook Joins growing list of top athletes trialing PRP

In late 2017 Russell Westbrook, star of the Oklahoma City Thunder,  was reported to have a PRP injection in his left patellar tendon. The injection wasn’t for any previously reported injury and Westbrook was it wasn’t for anything serious – he just had a minor injury was needed to get on top of it fast so that it wouldn’t trouble him in the regular season. General Manager Sam Presti said

“I think he really wanted to make sure he took care of that in advance, so it wasn’t something that lingered through the year,” Presti said. “We’ll work him back in, I think, as we get through camp and see how he’s doing.”

Many athletes are following Westbrooks lead, using PRP to get on top of small injuries as well as last ligament tears. PRPs power to improve the body’s own natural healing process is perfect for this.

Another athlete who recently turned to PRP injections to get back to their best was Tampa Bay Buccaneers quarterback Jameis Winston. He received the injection for an AC joint sprain in his throwing shoulder. Jameis ended up being able to finish the NFL season because of conservative treatment like PRP therapy.

If you or somebody you know has suffered a sporting injury and you think you might be benefited by platelet-rich plasma therapy, get in contact with a specialist clinic that specializes in the procedure today.

Ultrasound Therapy Found To Be Effective For Osteoarthritis Pain

Osteoarthritis is often referred to as “wear and tear” arthritis or “degenerative arthritis”. It is a condition that occurs with aging and can cause significant pain. One might find as they grow older than their joints begin to creak and ache – some of this may be due to osteoarthritis. Some statistics estimate that around 10% of men and 13% of woman over the age of 60 have symptomatic osteoarthritis. This pain is often constant and significantly debilitating – coming to dominate the lives of millions of Americans each and every year. There are a number of different treatment out there – but many don’t work for patients and there’s a need to identify new and exciting therapies that could treat this chronic condition. Luckily a physical therapy technique known as ultrasound therapy has recently been shown to be effective for those suffering from osteoarthritis!

What is osteoarthritis?

Osteoarthritis can occur in any joint but typically affects the knee or the hip. There is a protective layer in each and every joint known as the cartilage which acts as a shock absorber and stops bones rubbing up against each other and causing significant pain. In individuals with osteoarthritis the cartilage wears down and bone on bone contact results in pain.

therapy has been found to be effective in reducing pain and improving physical function

What is ultrasound therapy for osteoarthritis?

In a therapeutic ultrasound session sound waves from an ultrasound probe is used to relieve pain in a joint. This is usually done by a trained physiotherapist or doctor. In some specialized physiotherapy programmes the ultrasound treatment may be used before exercise therapy to relieve pain and allow the patient to undertake physiotherapies they wouldn’t be able to engage in with the pain.

So what’s the verdict – does ultrasound therapy work?

The technique has been used for a number of years – but evidence for its use has been slowly mounting. A Cochrane review suggested that it might be useful for knee osteoarthritis in 2010 but more research was needed. A recent 2017 study published in the journal “Ultrasound in Medicine and Biology” assessed its effectiveness in patients with osteoarthritis. The study included 62 patients 31 of which had the treatment 31 of which had a placebo treatment. They found that:

● In a patient receiving real ultrasound therapy, there was a significant improvement in pain compared to the sham group immediately after treatment
● At 1 month after treatment, there was no statistically significant improvement in the real group versus the sham group.

The authors conclude that

“In conclusion, US therapy has been found to be effective in reducing pain and improving physical function in the short term, but this positive effect was not persistent in the long term. However, we believe that the results of our study may contribute to ongoing research for the treatment of patients with knee OA, and further systematic investigation on larger patient populations may delineate the role of US in knee OA treatment.”

In fact, its use as a short-term treatment before another physiotherapy at some centers is potentially the best use for the experimental therapy.

For Patients with Lymphoedema – Decongestive Lymphatic Therapy Could be Key

What is Lymphoedema?

Lymphoedema is a chronic disorder characterized by swelling tissue (usually a lump) with fluid rich in proteins. It can either be a developmental problem (meaning there is no cause per se) or secondary and associated with some sort of precipitating event. These secondary causes include:

● Surgical causes:
○ Sometimes removal of lymph nodes – such as in breast cancer surgery – can result in lymphoma
● Radiation treatment for certain cancers can scar the nodes and vessels.
● Cancer. Certain types of cancer can invade the lymphatic vessels and this can result in lymphoedema
● Infection often invades the lymph nodes and causes them to swell.

If you have lymphoedema you might suffer from a number of symptoms including:

● Swelling of a limb. This can occur in part of the leg or arm or the entire limb.
● The affected limb will typically cause heaviness and tightness
● The limb will have restricted movement
● There may be aching or discomfort
● There may be recurrent infections of the surrounding skin (cellulitis)
● There might be a hardening of the skin.

What is decongestive lymphatic therapy?

A decongestive lymphatic drainage is a specialized form of physical therapy offered at a number of specialist centers across the country. The decongestive lymphatic therapy consists of four distinct components:

● Compression bandages are applied to complement the exercises in the therapy to move fluid out of the limb.
● Skincare is undertaken to reduce the chances of skin breakdown (which is a big infection risk in these patients)
● Exercises will be undertaken with a physiotherapist to improve the lymph drainage in the affected limb
● The therapist will also undertake specialist massage techniques known as manual lymphatic drainage that stimulated the flow of fluid through the system and reduces the swelling.

The treatment is intensive and can be every day for a number of weeks. After this initial phase patients typically move to the maintenance phase whereby they maintain good lymph flow with exercise and home self-massage techniques.

Does decongestive lymphatic therapy work?

There is a growing body of literature that suggests decongestive lymphatic therapy is a safe and effective treatment for patients with lymphedema that resulted following breast cancer surgery (eg a mastectomy with axillary clearance). A study conducted at the University of Texas looked to see whether the therapy worked on this patient group even if they had had the therapy before. They found that in both patients who had had the therapy before and naive patients, there was a statistically significant reduction in the mean size of the limb. This is great news for sufferers!

If you our somebody you know is suffering from lymphoedema, either following a surgical procedure or for development reasons – contact a specialist physiotherapy center who and provide one to one support and a personalized treatment plan to help reduce the swelling and get you back on your feet.

Dizziness Found to be Significantly Reduced in Patients Undergoing Vestibular Rehabilitation Therapy

Dizziness is one of the most common complaints a family practitioner will deal with day to day and some estimates suggest that 1 in 3 of us will have vestibular dysfunction (causing dizziness) at some point over a 3 year period.

Patients who have dizziness because of a peripheral cause (aka the balance system outside of the brain) report symptoms that include:

● Dizziness
● Imbalance
● Some visual disturbance

There are a number of causes of unilateral peripheral vestibular dysfunction, some rarer than others. These include:

● Meniere’s disease
● Vestibular neuritis (often caused by a viral infection)
● Benign paroxysmal positional vertigo (known as BPPV)

What is vestibular rehabilitation therapy?

For patients that are having trouble with balance, there are a number of medication available. However, these can be used to more effect in combination with physiotherapy from specialist centers across the united states. Vestibular rehabilitation therapy is done a trained and specialized physiotherapist who will assess your needs and recommend a personalized blend of different exercises and retraining regimes to help your particular balance problems.

These can involve a whole host of different techniques but a few are listed below:

● The Epley maneuver: This is highly effective for those patients suffering from benign paroxysmal positional vertigo (BPPV).
● Gait drills: these can help you with walking
● Balance retraining guidance: these exercises help hone your balance so that dizziness and vertigo don’t take you off guard.
● Strength training: training groups of muscles can help the body respond to imbalance. Don’t worry – this isn’t bodybuilding! It just gets your core muscles to a point where they can react appropriately to instability.
● There are also other therapies that include symptom management (accepting you have balance issues and psychologically getting over this) and relaxation therapies

Does vestibular rehabilitation therapy?

Evidence-based medicine counts for a lot in this 21st century. Treatments that don’t have a good evidence base quickly fall by the wayside. Thankfully vestibular rehabilitation therapy has a large and growing body of research suggesting how beneficial it is. Many doctors consider a Cochrane review to be the highest form of evidence. Vestibular rehabilitation had a Cochrane review undertaken in 2015. A Cochrane review is a systematic review that looks at all the previous research published across the world and amalgamates it see if overall the treatment is working. The researchers pooled 39 scientific studies including more than 2440 patients and conclude

“ There is moderate to strong evidence that vestibular rehabilitation is a safe, effective management for unilateral peripheral vestibular dysfunction, based on a number of high-quality randomized controlled trials. There is moderate evidence that vestibular rehabilitation resolves symptoms and improves functioning in the medium term”

This is great news for anybody struggling with balance problems. If you or somebody you know has problems with dizziness and vertigo and thinks they might benefit from vestibular rehabilitation therapy – get in contact with a specialist physiotherapy clinic today.

Stories of Trigeminal Neuralgia

Trigeminal Neuralgia“When an attack actually happens, it feels like you’ve been placed into an electric chair for about five minutes. It feels like your face is being scraped off, acid being thrown on it, and it’s a burning, searing sensation that will travel on my whole right side,”

These are the words of Tim Haynes – who recently talked to Daily-Journal.com about his struggles with the severe facial pain disease Trigeminal Neuralgia.

“You can’t see it. You can’t tell it’s there until you live with it,” Haynes said. “It’s a life-changing, debilitating disease, and you wouldn’t want your worst of the worst enemies to have it. … And I don’t have it nearly as bad as a lot of people that have it.”

Amy Cook is another young sufferer of the disease. At just 21 she is also plagued by the sharp stabbing pains. She talked to the Daily Mail saying

“It has almost taken over my life in a sense because when it’s really bad I cannot function.”

From Johannesburg in South Africa, Amy said

“I have decided to raise awareness of it. It made me happy to know that I was not alone in this rare condition.”

What is Trigeminal neuralgia?

Trigeminal neuralgia is a disease whereby the trigeminal nerve that supplies the sensation to the face comes into contact with blood vessels in the brain. When this happens, the nerve is stimulated and it shoots signals off to the brain that tell the central nervous system there is severe injury happening to the face. As such patients feel a shooting electric intense pain for just a few seconds. This happens periodically as the blood vessel touches up against the nerve.

How can trigeminal Neuralgia be treated

Is there any hope for Amy, Tim and the others afflicted with this rare disease? In fact, there is. Treatments are currently available and recent reports suggest new drugs are on the horizon. However, people need specialist help to get the treatment they desperately need. Treatments can include:

● Avoiding triggers. This seems simple but specialists can often provide invaluable tips and tricks to avoid the shooting pains. Knowing what triggers the pain, like a scarf touching your chin or the blowing of the wind can help patients avoid these situations
● Epilepsy drugs are the major treatment options. Anticonvulsants, as they are often called, were not originally intended to treat pain but they calm activity in the nerves and as such work well in conditions like trigeminal neuralgia. The most commonly used is Carbamazepine – which is effective in lots of patients. Others, however, are available such as pregabalin and baclofen.

If you or somebody you know are suffering from sharpshooting facial pains then consider getting in contact with a specialist clinic to help relieve their condition. Often family doctors are ill-equipped to deal with this rare and debilitating disorder and specialist help can often make all the difference.

JOIN OUR E-MAIL LIST!