Tag Archives: back pain

Relieving Your Pinched Nerve: Physio 101

March 11,2024 Erin Mills Physiotherapy Leave a comment

A pinched nerve, also known as a radiculopathy, is caused by pressure on a nerve as it exits the spinal cord, potentially causing pain, discomfort, weakness, and/or changes in sensation. Unfortunately, it can have quite detrimental effects on your daily life, hobbies, and ability to work. In this blog, we will discuss the causes, symptoms, and most importantly, how physiotherapy can help you recover from this condition.

Why does it happen?

Model of the spine showing how the nerves (yellow) exit through spaces around the spinal column. The nerves may get pinched in these spaces.

A pinched nerve occurs when there is compression or pressure applied to a nerve, disrupting its normal function. This compression can happen in various areas of the body but is most common at the spine of the lower back or neck. Common causes include repetitive movements, sudden increases in activity (ex. heavy lifting), poor posture, herniated discs, and degenerative changes in the back such as stenosis or bony spurs.

It is separate from the diagnosis known as a peripheral neuropathy that involves damage to the nerve. For example, a carpal tunnel syndrome. However, many of the symptoms between the two may overlap. In fact, a pinched nerve may turn into a neuropathy if left untreated for too long.

How do I know if I have a pinched nerve?

Primarily, nerve type pains have very specific symptoms. These usually include one, multiple, or all of the following:

Pain: Sharp or dull pain that radiates along the nerve pathway. The pain is usually quite variable and may change quickly in intensity from one day to the next, or throughout the day.
Sensation changes: This may be unusual sensations like pins and needles, losses of sensation, or even complete numbness in the affected areas.
Muscle weakness: Since our nerves are responsible for stimulating our muscles, you may experience reduced strength and control in the muscles connected to the affected nerve.
Radiating pain: Discomfort that extends beyond the initial site of compression. In the neck, it may go down into the shoulder blade or down the arms into the fingertips. In the lower back, it may radiate down into the glutes or further down to the legs or feet.

Why does physiotherapy help?

Manual therapy is one of the treatment techniques used by physiotherapists to relieve pain and increase mobility

Physiotherapy is the first line of treatment for a pinched nerve. It is non-invasive and has shown to be an effective approach for managing pain and dysfunction from a pinched nerve. A skilled physiotherapist can create a tailored treatment plan to address the specific needs of each individual. A treatment plan may include some or all of the following:

Manual Therapy: Hands-on techniques such as joint mobilization and soft tissue manipulation can help alleviate pressure on affected nerve. These techniques can help stiff areas, subsequently improving mobility and reducing pain.
Exercise Prescription: Targeted exercises may include stretches or postures to help relieve pain and other symptoms. Once the pain has been controlled, strengthening the muscles near the area of the affected nerve will help minimize the risk of future reoccurrences.
Posture Correction: Addressing poor posture is crucial in preventing and managing pinched nerves. Oftentimes, a certain position can be aggravating for the neck or back. A physiotherapist can assess which positions are helpful or harmful to you, and provide guidance on how to incorporate these changes into your daily life.
Education: Understanding the factors contributing to pinched nerves is essential for long-term management. Your physiotherapists will help you understand the do’s and dont’s during your treatment, and the predicted timeline of your recovery.
Modalities: Therapeutic modalities such as ultrasound, electrical stimulation, or heat and cold therapy may be helpful in reduce inflammation and reducing pain.

Need help? Look for PhysioNow!

Lumbar disc herniation resulting in a pinched nerve can be quite common, but may be treated with physiotherapy.

Pinched nerves may sound intimidating but with the right approach, they can be effectively managed. Physiotherapy offers personalized care to enhance mobility, alleviate pain, and improve overall quality of life. If you suspect a pinched nerve or have low back pain, PhysioNow is here to help! Consult with our expert team of physiotherapists with locations across the GTA. Book with PhysioNow today for your first assessment and treatment.

General Category

Could Your Back Pain Be Facet Joint Syndrome?

December 11,2023 Erin Mills Physiotherapy Leave a comment

What is a facet joint?

Image of 2 vertebrae showing the body, spinous processes, and transverse processes

Facet joints are located in the spine and are part of the vertebrae. The vertebra has two basic parts. Firstly, the body and secondly, the spinous process which is the bony part you can feel on your back that runs from the neck to just above the buttocks.

The joint from one inferior facet (transverse process) of the top vertebrae to superior facet of the bottom vertebrae is called the facet joint. As a result, they are called the connection joint from one vertebrae to another.

Facet joints are present on both sides of vertebrae. Facet joints increase in joint space when doing forward bending movements, and compression while moving backward. Similarly, facet joints also help in twisting and rotation movements of the spine. Finally, they also prevent these movements from happening over their normal physiological limits.

What is facet joint syndrome or pain?

Facet joint pain can be due to a condition like osteoarthritis or due to other spinal conditions like spondylolisthesis or stenosis. Alternatively, other causes involve obesity-linked arthritis, aging, heavy and repetitive work duties or secondary to other trauma.

Facet joint pain can occur anywhere along the course of your spine the cervical, thoracic or lumbar areas. Usually, facet joint pain or syndromes present as pain on the back which is localized or radiating. In the lumbar spine, it could radiate down to your buttocks or leg. Additionally, if it’s in the neck, it could be localized or radiating down to the hands.

Overall, the symptoms vary depending on the severity and level of joint involvement.

Other symptoms:

Stiffness
Painful bending/ rotation
Depending of the area involved it has difficulty like sit to stand, standing up straight

How is it diagnosed?

Facet joint pain/ syndrome may be investigated by an x-ray/ MRI but this is not enough to confirm diagnosis. Instead, the gold standard for diagnosis is the use of a diagnostic injection of a joint block into the area. Then, it is considered positive if the patient experiences immediate relief of their pain and symptoms.

From a physiotherapy point of view, it can be diagnosed by using a special test called quadrant test to confirm involvement of facet joint.

In addition, physiotherapists perform other tests which involves looking for flexibility, range of motion, strength, palpation of tender areas, and a sensory examination to check nerve root involvement.

Treatment:

From a medical perspective, facet joint pain can be treated by using anti-inflammatory injections or cortisone injections by healthcare provider.

For example, a physiotherapy treatment may involve:

Education
Manual therapy
Electrotherapy
Hot and cold therapy
Exercises mainly focusing on core and lower back strengthening
Traction machine

Core exercise that may be part of treatment for facet joint syndrome

Image by Freepik

Overall, the patient can be treated with a combination of the above treatment protocols. Importantly, treatment will be individualized based on your specific symptoms and presentation. You will be guided by the expertise of a physiotherapist throughout your journey.

In conclusion, if you are experiencing back pain or are experiencing any of the above symptoms, PhysioNow can you help you out. We have many experienced physiotherapists that can help you with your facet joint pain. Book with PhysioNow today for your first assessment and treatment!

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Motor Vehicle Accident: Injuries and Insurance

July 26,2023 Erin Mills Physiotherapy Leave a comment

Motor Vehicle Accidents / MVA and physiotherapy.

Motor Vehicle Accident

Injuries sustained from a motor vehicle accident affect your normal function in life differently. It depends on the extent of the impact. Thus, it is very important to address any pertaining issues from the accident to your doctor. Additionally, to start rehabilitation at the earliest to decrease the impact of injury and its effects.

MVA injuries can be as minor as sprains or strains or it can be extensive that might include concussion, fractures, neurological involvement, other musculoskeletal involvements, etc.

Once you are involved in an accident and you are discharged from your preliminary care, you would contact your auto insurance company for guidance on starting physiotherapy sessions.

Physiotherapy sessions for a motor vehicle accident:

Once you decide to attend a physiotherapy clinic, these are the few things to do and to expect on your first visit.

Book an appointment in a clinic which you decide to proceed with.
Once you arrive expect to fill a few Auto insurance forms and clinic specific forms to start your assessment at the clinic.
You would be seeing a physiotherapist who could be your primary care provider.
The therapist would do a detailed assessment on your situation and would also go over your treatment plan pertaining to your injury.
Your treatment session would be patient specific and progressive to get back to your normal functionality.

Facts about your treatment plan and coverage:

Once you are in a motor vehicle accident, you are mostly covered by the auto insurance company for treatment sessions.

Your treatment coverage depends on the category that you fall into.

Minor injury guideline/ MIG, where your injury falls into the category of sprains and strains and would need a shorter duration of recovery and treatment sessions. Your treatment sessions could extent up to 4 months or as needed. Reassessments are done as needed to see your progress and to plan further with your sessions.
Out of Minor injury guideline, where your injury is more extensive or catastrophic. Where the duration of recovery is longer and so the treatment allotment is longer when compared to MIG.
Any multidisciplinary approach needed would be advised and would be recommended to your insurance company for further proceedings.

Commonly seen injuries after a motor vehicle accident:

Motor Vehicle Accident Whiplash

Whiplash injury to the neck: which can include one or more of the symptoms ; pain, stiffness, swelling, muscle spasm, headaches, tingling /numbness into the hands, weakness, difficulty sleeping.
Low back Sprain/ strain or disc related symptoms which includes, pain, stiffness, tingling and numbness into the leg, disturbed sleep.
Shoulder, elbow, wrist, hip, knee, ankle sprain/ strain.
Seatbelt or airbag related pains in the chest area and abdominal area.
Fractures.
Concussion symptoms which might include dizziness, headaches, light and noise sensitivity, blurred vision, nausea, issues with concentration, imbalance, weakness, slurred speech, anxiety, depression, etc.
Vestibular symptoms with symptoms such as dizziness, nausea, vomiting, difficulty with positional changes, sense of imbalance, etc.

Treatment sessions:

These are patient specific.

Electrical modalities such as IFC, TENS, Ultrasound, LASER, heat or cold packs for pain relief and decreasing muscle spasm, and to improve circulation to the area.
Manual therapy which includes soft tissue techniques, joint mobilization, joint traction. Muscle energy techniques to reduce pain, improve function in the joint.
Exercises for improving mobility, strength, and also function.
Braces and splints for immobilization as needed.
Post concussion therapy focusing on your symptoms and additionally presentation, which is provided by a physiotherapist trained in concussion therapy.
Vestibular rehabilitation services provided by a physiotherapist specifically trained in vestibular rehab.

Need some help?

Your assessment session would ideally be an hour and treatment sessions would be 45 min to an hour in our clinic. Here at PhysioNow, we have many highly knowledgeable physiotherapists that can assist you with your injuries. If you think physiotherapy may help with an injury from an MVA, book with PhysioNow today for your first assessment and treatment!

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Scoliosis: Types, Symptoms and Treatments

July 24,2023 Erin Mills Physiotherapy Leave a comment

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

Causes of scoliosis:

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

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.
Carrying heavy stuff on back: People who have to deal with the delivery of heavy packets and lifting heavy objects are at risk.
Family history: Sometimes, scoliosis runs in family. There are higher chances in these cases.
Congenital limb length discrepancy: Congenital limb length discrepancy needs immediate correction otherwise; it will lead to scoliosis.
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.

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.
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.
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.
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.

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.
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.
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.
Orthotics: orthotics adjust leg length discrepancy from scoliosis.
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

November 28,2022 Erin Mills Physiotherapy Leave a comment

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 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: –

Calf pain – pain that stretches down the lower leg and back of the knee.
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.
A pain in your butt or leg that worsens while prolonged sitting.
Numbness in your leg or foot.
Tingling sensation in your extremity (lower body).
Persistent pain on one side of your butt.
Muscle weakness in the distressful leg or foot.
Shooting pain down the leg which makes it tough to stand up or extend the knee.
Pain in one part of the leg while numbness in another part.
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:

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!