पीठ दर्द के लिए फिजियोथेरेपी उपचार

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पीठ  की ऐंठन हमेशा लम्बर स्पॉन्डिलाइटिस या स्पॉन्डिलोसिस नहीं होती  है।
ज्यादातर समय आपको एक्सरे या एमआरआई करने की आवश्यकता नहीं है।

मांसपेशियों में ऐंठन और सूजन को आसानी से विशिष्ट मैनुअल परीक्षणों के साथ निदान किया जा सकता है।
यदि कोई तंत्रिका या डिस्क  संपीड़न मौजूद होता है तो भी मैनुअल परीक्षणों में दिखाई दे सकता है। केवल डिस्क / नर्व के मामले में सटीक परीक्ष्ण की द्रष्टि से  आपको एमआरआई  के लिए भेजा जा सकता है। सही
फिजियोथेरेपी उपचार सबसे उपयुक्त तरीके से इन समस्याओं को हल करने में सहायक होता है।

पीठ दर्द के लिए  फिजियोथेरेपी उपचार में विभिन्न  तकनीकों को शामिल किया जाता है, जो न केवल दर्द को कम करते हैं बल्कि दर्द के यांत्रिक कारणों का पूरी तरह से इलाज करते हैं।

एक दवा मुक्त उपचार होने के नाते, फिजियोथेरेपी अस्थायी रूप से दर्द को कम नहीं करता , बल्कि पूरी तरह से कारण को समाप्त करता है। कई मामलों में एक अत्यंत जटिल  IVDP या स्लिप डिस्क हो सकता है जहां अकेले फिजियोथेरेपी सहायक नहीं हो सकता, ऐसे मामलों में एक बहु आयामी दृष्टिकोण आवश्यकता होगी।

फिजियो उपचार अन्य उपचारों के साथ भी जारी रखा जा सकता है, भले ही कोई अन्य उपचार जैसे कि आयुर्वेद, होम्योपैथी, यूनानी, एलोपैथी या अन्य भी चल रहे  हों ।

आप को अपने फिजियो से दवा की उम्मीद नहीं करनी चाहिए, वास्तव में फिजियो उपचार आपको दवा से दूर रहने में मदद कर सकता है।

सर्जिकल हस्तक्षेप की बहुत कुछ मामलों में जरुरत होती है लेकिन इसका निर्णय मेडिकल टीम में रेफरल और चर्चा के आधार पर किया जा सकता है। अगर सर्जिकल हस्तक्षेप दर्द को कम करने में विफल रहता है, तो इसे "फेल्ड बैक सिंड्रोम" कहा जाता है और रोगी को फिजियोथेरेपी उपचार पर वापस आना पड़  सकता है । यदि आप सर्जरी के बाद भी पीड़ा से पीड़ित हैं, तो आपको तुरंत फिजियो उपचार लेना चाहिए।

भारतीय संदर्भ में स्वास्थ्य विज्ञान

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 भारत में न केवल एक महान सांस्कृतिक और भौगोलिक विविधता है अपितु हम उन कुछ देशों में से हैं, जहां कई स्वास्थ्य विज्ञान लंबे समय से सह-अस्तित्व में  हैं ।
 एलोपैथी या पश्चिमी चिकित्सा इस देश के स्वास्थ्य परिदृश्य के लिए सबसे नवीनतम विज्ञान है (सापेक्ष दृष्टि से)। होम्योपैथी भी आयुर्वेद या चिकित्सा के अन्य प्राचीन रूपों की अवधारणा के रूप में पुरानी नहीं है, तो उपचार की एक पारंपरिक तरीका नहीं है। शब्द एलोपैथी, हालांकि आमतौर पर आधुनिक चिकित्सा के लिए इस्तेमाल एक व्यापक अर्थ है।यह सबसे संगठित और शायद प्रभावशीलता में तेज है, इसलिए यह लोकप्रियता के मामले में सबसे आगे है । इस तरह पूर्व कुछ  दशकों में  स्वास्थ्य देखभाल और पश्चिमी चिकित्सा पर्याय बन गए हैं। एलोपैथी विकसित स्वास्थ्य विज्ञान है ऐसी लोकप्रिय धारणा है। यह एक विशाल सार्वभौमिक एवं अनुसंधान और साक्ष्य आधारित अभ्यास है जिसे  अंतरराष्ट्रीय संगठनों की मान्यता प्राप्त है । एलोपैथी अध्ययन की भी हर विज्ञान की तरह अपनी कुछ सीमाएं हैं और समय-समय पर अपने आप ही चुनौतियों का सामना करता एक निरंतर विकसित होता क्षेत्र है। जैसे  हाल के वर्षों में "दवा प्रतिरोध" एक चुनोती के रूप में उभरा है।
  हर मरीज को समझ लेना चाहिए कि एलोपैथिक अभ्यास विशेषज्ञता का एक क्षेत्र है और स्वास्थ्य के किसी भी पदानुक्रम का हिस्सा नहीं है।  ऐसा कोई  श्रेणीबद्ध पैटर्न मौजूद नहीं है।  अन्य चिकित्सक जैसे आयुर्वेद या होम्योपैथी चिकित्सक अपनी पद्धत्ति में निपुण हैं तथा स्वतंत्र तौर पर इलाज  के लिए अधिकृत हैं। एक एलोपैथ से यह पूछना कि हम किसी और चिकित्सक से परामर्श करें या नहीं ठीक वैसा है जैसा फुटबॉल कोच से क्रिकेट की जानकारी मांगना।
  विभिन्न स्वास्थ्य विज्ञान हैं जो समय की कसौटी पर खरी उतरी है और उन्हें  अभी भी प्रभावी होने के लिए जाना जाता है। प्राकृतिक चिकित्सा, एक्यूप्रेशर, एक्यूपंक्चर, पंचकर्म, योग थेरेपी (चिकित्सकीय योग) और सिद्धा जैसे अन्य विज्ञान भारतीय लोगों को ज्ञात हैं। आमतौर पर पुरानी बिमारियों के वैकल्पिक उपचार की चर्चा में आयुर्वेद, होम्योपैथी, पारंपरिक चीनी चिकित्सा और यूनानी जैसे शब्द सुनने को मिल जाते हैं।
  फिजियोथेरेपी का विज्ञान चुपचाप पश्चिमी चिकित्सा की छाया से बाहर विकसित हो रहा है और अपनी विश्वसनीयता बना  रहा है एक स्वतंत्र  क्षेत्र के रूप में है।  यह  पद्धति मानव एनाटॉमी, फिजियोलॉजी, बायोमैकेनिक्स, पैथोलॉजी आदि के ज्ञान का एक होनहार समामेलन है।इसमें आधुनिक चिकित्सा और योग, टीसीएम आदि का ज्ञान इस्तेमाल करते हुए चुंबकीय, इलेक्ट्रो, एक्सरसाइस, मैन्युअल टेक्निक्स चिकित्सा से उपचार किया जाता है।यह एक संपूर्ण विज्ञान है जिसमे समकालीन स्वास्थ्य समस्यायों का विभिन्न पद्धतियों से उपचार होता है।
  फिजियोथेरेपी  पाठ्यक्रम अनुसन्धान पर आधारित है और इसमें काम आने वाले उपकरण पूरी तरह सुरक्षित हैं। मैनुअल फिजियो उपचार में इस्तेमाल वैद्य तकनीक या आयुर्वेद की मालिश की तरह कुछ अन्य स्वास्थ्य पेशेवरों द्वारा इस्तेमाल की तकनीक के साथ तुलना आकर्षित कर सकता है, लेकिन वास्तव में तकनीक अलग़  हैं। एक फिजियोथेरेपिस्ट द्वारा भौतिक पुनर्वास के दौरान "व्यायाम" शारीरिक स्वास्थ्य के मुद्दों के लिए इलाज का सबसे विकसित तरीका है और अच्छी तरह से तैयार रूपों में से एक है और यह  हृदय (कार्डियक रिहैब ) जैसे अन्य स्वास्थ्य संबंधी समस्याओं पर लागू किया जा सकता है। फिजियोथेरेपी की जड़े कई चिकित्सा पद्धतियों से प्रेरित हो कर विकसित हुई हैं। आधुनिक तकनीकों का उपयोग जिसमें विशेष तौर पर बायोमैकेनिक्स का ज्ञान निश्चित रूप से स्वास्थ्य देखभाल के भविष्य के लिए एक वरदान है।
  अभी भी लोगों के बीच फिजियोथेरेपी के बारे में थोड़ा अविश्वास है। श्रेणीबद्ध विचारधारा से बाहर विश्वसनीयता के शिखर तक जाने के लिए एक लंबा रास्ता तय करना है। एक बात तय है कि पदानुक्रम बनाने का कोई औचित्य नहीं हर पद्धति की अपनी विशेषता है और अपनी सीमायें हैं।  

                                  Dr. Shailendra Kumar Saxena PT 

                                  Senior Consultant Physiotherapist 

                                  

                                    https://g.co/kgs/H6DSBS

Indian Idea Of Health Sciences

 India not only has a great cultural and geographic diversity but is one of the few countries where many healthcare sciences have co-existed for ages.
 Allopathy or Western Medicine is the most recent addition to the health scenario of this country (recent only in relative terms). Homeopathy is also not as old as the concept of Ayurveda or other ancient forms of medicine, so is not a traditional way of treatment. The word Allopathy though commonly used for Modern Medicine has a broader meaning. Being the most organized and probably the quickest in effectiveness, it has taken over most other health care sciences in terms of popularity. Such is the notion developed over the decades that health care and Western Medicine have become synonymous. It commands the authority with a vast back up of research and evidence-based practice which is regulated by international organizations thus making it most universal medical science. Allopathy is a constantly evolving field of study where there is little scope for error.This science as any other has its limitations and faces its own challenges from time to time. One of the most talked about and worrying challenge in recent years is "Drug Resistance".
 Every patient must understand that allopathic practice is one field of expertise and is not a part of any hierarchy of health sciences.No such hierarchical pattern exists so other health care professionals like Ayurveda or Homeopathy practitioners are independent in their own rights, to diagnose and treat. Asking an Allopathic practitioner on whether to go for any other consultation, is like a cricketer asking a football coach about which batting position is most suitable for him.
Various Health Sciences that have stood the test of time and are still known to be effective include Ayurveda, Homeopathy,Traditional Chinese Medicine and Unani among others.Many common terms like Naturopathy, Acupressure, Acupuncture, Panchakarma,Yoga Therapy (therapeutic Yoga) and Siddha usually make their way during discussions when patients are trying to find alternative ways of treating their health issues, particularly chronic conditions.
 Physiotherapy or Physical Therapy is a field of healthcare which is quietly evolving out of the shadow of Western Medicine and finding its own ground as a methodology of treatment.It is a promising amalgamation of the knowledge of Human Anatomy, Physiology, Biomechanics, Pathology etc. from Modern Medicine and the application of treatment which finds its derivation from concepts based on Yoga,TCM etc. and of course evidence-based research back up.Electro Magnetic or Electro Therapy treatment uses some of the most sophisticated equipment available for treatment in any form of treatment. Manual Techniques used in physio treatment may draw comparisons with techniques used by few other health professionals like Chiropractic techniques or Ayurveda massages but are actually not the same. Exercise prescription during Physical Rehabilitation by a Physiotherapist is one of the most evolved and well-formulated forms of treatment for physical health issues and may also be implemented on other health related problems like cardiac conditions.This is a branch of science which has its roots in the best of the past but is surely a boon for the future of Health Care. It is still a long way to go before the old  misplaced thoughts about Physical Therapy among people may be taken over by the complete faith in the effectiveness. One thing is for sure that there is no point drawing comparisons or creating a hierarchy amongst health care sciences  as each one has a way of its own and a role to play depending on many factors that rule your health.

Ankle Twist: Ligament Injury

When it comes to ankle injuries, it is just not enough to check if it is a fracture or not? Fractures are serious injuries, no doubt; but soft tissue injuries, particularly ligament injuries may be as difficult to treat in case of the ankle joint. Lateral (outer side) three ligaments are very vulnerable to sustain injuries during ankle twist and it is possible that patient may feel a pop during a severe tear. Many ankle twists may also hurt muscle tendons like the Tendo Achilles or involve more than one ligament group. Though initial physical assessment is sufficient for diagnosis in most cases; some cases may need X Ray or even MRI to do a precise differential diagnosis. On field injuries are usually first seen by the team Physio who may have seen the fall happening. Seeing the mechanism of injury makes it easier for on field Physios to immediately conclude about the area and extent of injury. Early referral to nearest hospital for further examination should be done if Physio feels the necessity because continuing to play with a minor soft tissue injury may only worsen the injury.

 

Initial immobilization using ankle support/ strap/ brace/ plaster/ taping may be useful. Physio prescribed exercises like the isometrics for surrounding muscles must be started early to avoid unnecessary weakness and stiffness from setting in. Established Physical Rehabilitation Protocols may help as a guidance during recovery but your of Physio must help to modify the protocols and help in achieving better results.

Most of the soft tissue injury patients get back to normal life within few weeks.This is mainly done by progression through various stages of mobility and strengthening of the associated joint structures. Athletes and dancers should take special care. Getting back to regular sport or dancing routine must be closely monitored because at various stages of recovery, proper Bio Mechanical and Balance analysis is essential. Choice of rehabilitation exercise largely depends on the form of activity that you are supposed to take up after recovery. Dancers, Cricketers, Runners or Football  players may all need different variations of sport specific training during recovery. As you progress, you can gradually add exercises involving body weight and later start some weight training too.

 

You may need to stay in touch with Physio for few months to get time to time guidance for a complete recovery. A good follow up leads to a perfect recovery, otherwise chances of the pain troubling you later in life are very high. Ligaments and soft tissues are such important structures that their injuries may lead to early arthritic changes, if not treated well at the right time.

Physiotherapy - Physical and Electromagnetic means of treatment.

The only way in which Physiotherapy can reach new heights in India is by gaining popularity. Consistent good results are building people's faith. Depending on authorities to change anything has wasted many careers, but not much has changed in the past few decades. Professionals from other medical sciences still seem to be catching up with the idea of "physical and electromagnetic means of treatment". Though mostly not necessary, many practitioners like to mention 7 days of IFT, UST, SWD in their prescription sheets instead of simply referring the case to Physiotherapist.Manual techniques and exercises are still not being taken seriously as treatment methodology .
Physiotherapy is a medicine free science, so few cases may need to undergo medicine and physio treatment at the same time.Patient needs to understand that in such instances, two different forms of treatment are coming together to work faster and it is not one single treatment.So decisions can be taken individually by each practitioner regarding their treatment or with a mutual discussion between both teams.
Physiotherapy follows a progress dependent Physical Rehabilitation;so fixing the number of days of treatment like fixed dosage of antibiotics generally does not apply well here.Physical Therapy needs improvisation at every step during treatment so it depends a lot on knowledge, experience and work style of your Physiotherapist. 
We appreciate the effort of those Physiotherapists who have consistently worked to improve the standards of this profession in India. Some others who have prioritized monetary benefits over the faithfulness towards profession,may learn their lessons with time.

Thank you! for being "ON TIME"

In Physio practice, we see various types of cases. Most of the cases are a learning experience in a way or the other. We like to treat everyone, whatever the person or the personality. Most of the people are interesting to interact with, some of them are enlightening. Patients are mostly humble, but few seem arrogant. We understand that every person has a different way of looking at problems so we try to give our best to all of them. People who make us unhappy are those who do not respect time. Coming late is a personality trait which comes so naturally to some. Those who reach late must understand that they are disturbing the next patients' schedule. Appointment delays dilute our energy levels with which we would like to treat patients. Thank You, for being ''On Time."

My Shoulder Hurts !

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You feel pain in your shoulder after a sudden stretch, during some activity. You decide to wait and watch if the pain subsides on its own. You try hot pack, ice pack, diclofenac application and  muscle relaxant tablets randomly to reduce pain. Pain remains mildly, but you feel better within 4-5 days. Slowly getting back to activity, you realise that pain increases while performing certain movements only. 

After another 15 days, on a holiday; you decide it is still bothering so let me see a doctor. Knowing that you are insurance covered, you find the best-known shoulder surgeon in the city (if it was possible, you may have tried the most known surgeon in the world) through Internet. The surgeon who is just about to enter the OT for some important surgery takes out some time to consult you. Knowing that the  problem is probably not meant to be handled by a surgical intervention he explains you the exact situation. 

Now that you have met him, instead of sending you empty handed, back to a local physician he prescribes you pain killers and/or recommends physical therapy. He mentions if condition persists he may need a scan or think of surgery. You were anyways always sure even if he had recommended an immediate surgery you would have anyways not taken his word as it is. Now, ask yourself if you want gardening to be done, do you call a farmer all the way from a farm or hire a gardener within your locality. 

If your plan A was to not do a surgery, why did you waste the time of someone who may have used it for some more crucial cases.Your family physician is capable enough to give you painkillers as and when required, he/she also knows best when to refer you to some super speciality consultation.

Continuing from where we left, you decide to take the medicine first because physiotherapy needs daily treatment and you are too busy with office work these days. Ten days of prescribed painkillers, you see pain comes back only once or twice a day. Improving but not convinced you (or on medical advice, looking at your chronic pain) decide to take an MRI. Reports show degenerative changes with some muscular problem which you are exactly not able to understand.

Now from family to friends to your medical advisers, everyone pushes you to do "SOME" PHYSIOTHERAPY. The first question you ask  your physio is how many days?

After all this when he wants you to start with exercise you feel it may aggravate the injury. Again ask yourself, under the effect of pain killers when you drove around and played with your child, don't you think you may have actually aggravated the injury unknowingly already.

Be sure well prescribed Exercise/ Electro-therapy will not do any harm, but yes it may have taken only a week to recover if you had taken up this in the initial stages.Now you need 45-50 days to recover. 

Please calculate the total time, cost and, of course, you can't calculate all the unnecessary suffering that too for such a minor injury. During the course, almost everyone you met actually gave you the best advice as per his field of specialisation. The question is, did you always enter the right place or just trying to gain a little too much, made a monster out of a simple injury.

Let us keep it simple, sometimes no one else but our own half knowledge leads us to situations where we never wanted to be. 

Does Physiotherapy really help ? YES IT DOES...

Physiotherapy is being widely used as a 10-day treatment, before concluding that spine surgery is a necessity. In many such cases, only Ultrasound Therapy and Interferential Therapy are administered for the entire treatment and then the patient is informed  "Physiotherapy did not help, so surgery is the only option".

It should be clear to patients that in cases of severe disc compression / spondylitis /nerve impingement / stenosis, just 10 days of Electrotherapy can not do wonders.

In all such spine related problems, physical approach to treatment just acts as a catalyst to natural recovery and must be followed for a long period of time. Mechanical changes of the spine can not be corrected unless mechanical re-alignment is done. Electrotherapy must be used along with or as an alternative to medication to reduce inflammation and pain but  not as a complete treatment.

 Many practitioners restrict physical activity completely during the acute phase of pain, this needs a debate because total inactivity leads to consequential muscle weakness. Limitation of activity and kind of activity to be performed should be decided by professionals like Physiotherapists , who may use their Biomechanical Analysing Skills.

The fact of the matter is that most spine related cases do not need surgical intervention or even a thought of it.  Although few cases which may have irreversible complications or possibility of further aggravation, need to be referred to Surgical Departments and then best left to the Surgeon's decision for further follow up.

What we want to convey is that half-hearted application of Physiotherapy (in these cases 

-Electrotherapy) is a waste of time and also it promotes the idea of Physiotherapy being ineffective in such cases. As a patient, one should be aware that Physio Therapy being a medicine-free treatment may need time for providing a relatively long term or permanent recovery as opposed to many quick temporary forms of treatments.

Pseudo Sciatica - Piriformis Syndrome

http://www.physicalhealthconsultants.com/the-physio-way.html

Everyone who has pain or numbness in leg, comes in with a self-diagnosed SCIATICA on mind.

Many patients even know the treatment to be done - Traction and Diathermy.

Sciatic pain is one which radiates from the origin of Sciatic Nerve in the Lumbar Spinal region and radiates down to the legs. Mostly it may radiate down on only one leg.

This sciatic pain is sometimes mimicked by another condition "Piriformis Syndrome". Piriformis is a small muscle in the upper gluteal region. This muscle may get over stressed and spasmodic due to sedentary jobs or may even have structural variations since birth. Sciatic nerve passing under / through the muscle gets compressed due to the above mentioned stress or structural variation. This leads to discomfort / tingling through the Sciatic Nerve route.

This condition is easy to treat once correctly diagnosed. Manual muscle release, Cryotherapy.

Stretches and treatment with Ultrasound therapy are very effective.

If this pain is because of permanent structural variation then minor surgical intervention may be required.

Infected muscle or direct impact on the nerve due to trauma may also lead to sciatic pain, so any such pain should not be ignored for too long. Early intervention shall avoid complications.

Online Physiotherapy Video Consultation

Link for THE PHYSICAL HEALTH CONSULTANTS Online Video Consultation form

physicalhealthconsultants

www.physicalhealthconsultants.com

Timing is not a hinderence for those calling from any time zones,  we consider late appointments after 10:00 pm IST also. 

The fee is minimal, so do not hesitate before contacting.  

 Patients who come for treatment at our clinic often tell us that their parents need consultation as well, but they are based in some other city.These are mostly chronic problems like arthritis, back-related problems or old injuries.  

 Few of these cases end up coming to us whenever they are here in Bangalore for a holiday. Follow-up treatment for such cases is generally done via phone or emails. Sometimes we refer them to follow up with physio clinics available near them.  

 This way we have treated many cases from across India and few cases from other countries as well. Particularly in Singapore, UAE, USA and Australia where some of our patients have moved permanently; they say getting a Physical Therapy appointment is a long and costly procedure there, so they find it easier to consult us online.  

 In India, our online consultations have become popular particularly in few cities where our patients mostly introduce us to their near and dear ones. We have never done any publicity for the same. Some of these cities where we are known include:

Kota
Jabalpur
Allahabad
Secunderabad
Raipur
Jaipur
Ratlam
Bhopal
Cuttack

Hyderabad 

Delhi

 The reason for writing this post today is that we are available at your service as and when you require. 

Make sure that your physical health continues to be maintained irrespective of your location.

Fill video consultation form on our website for  enquiries.