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Sciatica? 10 warning signs

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What is Sciatica?

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

Sciatica

Sciatica pain

10 signs which confirm the diagnosis

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

Early Symptoms Of Sciatica

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

What contributes to Sciatica?

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

 • Third, spine rehabilitation:

Sciatica

Effective exercises for Sciatica

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

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

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Why do you need a walking aid?

Quality of life

Elderly man independent in walking

Restricted and reduced ability to walk and perform your daily chores can impact your quality of life. Walking aids are devices designed to help people walk and can be used by individuals of any age. As a result, this improves your quality of life by making you independent and confident. Here are some reasons that will indicate you need walking aids.

  1. difficulties walking whether it’s due to pain.
  2. frequent falls or fear of falling.
  3. tiring quickly.
  4. decreased balance.
  5. difficulty putting weight on a body part, post-surgery, or any other reason.

What types of walking aids are available?

The categories of walking aids include crutches, canes, and walkers, and has their own pros and cons. Below are general overviews of the most common types of walking aids.

  1. crutches, often prescribed to individuals following an injury or surgery to the lower body. They are usually used on both sides of the body but can be used on just one side. The benefits of crutches include complete non-weight bearing on the injured leg, can be used on stairs, and lastly near to normal walking speed can be achieved.  However, it needs good upper body strength, cannot use for longer distances and must have a higher level of balance.

    Walking Aids

    Different types of crutches

  2. Canes are used on a single side. Helpful for individuals with minor balance issues or weakness in the legs or body. You can either get a single-point cane or 4 points which provides additional stability. But, on another side, it gives an unstable base of support.

    Types of Canes

  3. Walkers are the most stable type of walking aid. The most common are 2-wheeled walkers and rollator or 4-wheeled walkers. They are good for longer distances and more stable but cannot be used on stairs or smaller occupancies. 
  4.  

    Types of Walkers 

How to choose a walking aid?

If you think you need a walking aid but are unsure which one is best for you, a physiotherapist can help assess your needs and recommend the right one. An unfitted walking aid or improper use of one can be a safety hazard and increase the risk of a fall.

At PhysioNow, we are a qualified team of Physiotherapists that would love to help you! We do a full assessment which will include your balance, strength, and the way you walk to determine whether need of a gait aid and which one is suitable. Also, provide resources on how to acquire one. Lastly, we will also teach you how to use it in your everyday life including sitting and standing up, walking, and navigating stairs and obstacles with your aid.

Book with us today for an initial assessment and treatment at PhysioNow! Improve your Quality of Life.

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What is a chronic low back pain?

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What is a Chronic low back pain?

Although commonly used word for being in pain for a long time is ‘Chronic’, I would like to call it ‘Persistent Pain’. Because, the word Chronic seems to have a very negative connotation to it. Also,  It is a general belief that if you have ‘Chronic Pain’, you will have to live with pain forever! If you wish to get more knowledge about persistent pain, please visit this link. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Living-with-persistent-pain

Chronic pain, persistent pain, low back

Chronic pain speedometer

Case review of chronic low back pain

Let us take an example here of a person who has had low back pain, for many years. They have had an X-ray and an MRI done which shows some minor degenerative changes. There is no major nerve compression. However, there may be some minor disc bulges which their family doctor mentioned is normal for the age.  As a result, they were advised to go for physiotherapy, which was done for several weeks with minor relief.

Chronic and persistent low back pain

Chronic lower back pain

Also, Chiropractic and Massage therapy was then tried, again with some temporary benefits. Through this Chronic Pain, the family doctor then referred them to see an Orthopedic Surgeon who again advised them to continue physiotherapy and painkillers. This person then went to a pain clinic after hearing about this from a friend, and now goes for Pain injections every 6 weeks.

What is a pain assessment

We see many such patients coming to our clinic – PhysioNow on frequent basis. You might question what different are we going to do from what has been previously done. As a result, what I do know is that appropriate assessment and treatment has not been provided else.

A thorough assessment is first needed to guide any treatment process, and in our clinic we look at the spine segment by segment, to identify the restrictions/ pain generating areas. These restrictions may be in the joint, or even along the pathway of the nerves which as associated with these joints.

Planning the right treatment

Manual therapy is then incorporated to treat the areas of restricted mobility that may be in turn forcing many other areas of your low back (including joints and muscles) to produce compensatory pain. Also, there may be some areas which have more mobility than expected (hypermobile) and need to be stabilized by strengthening the muscles which support these structures.

In conclusion

Overall, manual therapy and exercises (stretch and strengthen as needed) are at the heart of the treatment for our person in question preceded by a meticulous lumbar spine segmental and nerve mobility assessment.

Takeaway Message

If this case study sounds similar to your story, come and speak with us. Let us help you get rid of this Persisting (Not Chronic) Low back Pain. You can book your appointment visiting the link below.

General Category, Registered Physiotherapist Mississauga, Registered Physiotherapy Mississauga

Cancer Rehabilitation

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Cancer Rehabilitation

What is Cancer?

Cancer rehabilitation is an important part of a patient’s cancer recovery journey.  But it is important to understand what it mean to have cancer.

Firstly, the normal, healthy cells of our body go through stages of development, maturity, and death.  Importantly, cell death is part of the normal life cycle of tissues.  In short, this process allows for the removal of older and damaged or abnormal cells from the body and the addition of new healthy cells.  However, with cancer, the old, damaged, or abnormal cells do not go through the process of death.  That is to say, they continue to accumulate and grow, spreading into surrounding normal tissues.  Moreover, these abnormal cells are capable of surviving and can do a lot of damage to the body.  Consequently, cancer cells can:

  • Invade surrounding healthy tissues
  • Develop their own blood supply
  • Eat away at bone
  • Add extra bone where none is needed
  • Use the blood vessels and lymph channels to spread across the body

What are the Stages of Cancer?

There are so many different types of cancer diagnoses.  Therefore, there is a classification system in place to help describe the overall severity of the disease.  In short, cancer is classified by how much cancer is in the body and where it is when it is first diagnosed.

  • 0 – abnormal cells are present but have not spread to nearby tissues
  •  1 –  cancer has spread to other tissues in a small area
  • 2 –the tumour is between 20-50mm and some lymph nodes are involved or a tumour larger than 50mm with no lymph nodes involved
  • 3 – the tumour is larger than 50mm with more lymph nodes involved across a wider region
  • 4 – cancer has spread beyond where it started to other parts of the body

 

What are the different types of cancers?

Cancer is such a variable disease and can affect so many different organs and tissues.  In other words, cancer is not really one disease.  For example, according to the Canadian Cancer Society, there are more than 200 different types of cancers.  Some of the most diagnosed cancers include:

  • Breast
  • Colorectal
  • Liver
  • Lung
  • Melanoma
  • Pancreatic
  • Prostate
  • Metastatic

 

What causes cancer?

Most cancers do not have one single cause.  Cancers usually develop from a combination of different risk factors.  However, it is possible that some people develop cancer without having any risk factors.  There are some risk factors that can either increase the risk of starting cancer or helping it grow.  These include:

  • Increased age
  • Smoking
  • Increased sun exposure
  • Genetic changes
  • Increased weight or obesity
  • Poor diet
  • Sedentary lifestyle
  • Increased alcohol consumption
  • Exposure to harmful chemicals
  • Having certain types of infections

 

What are the statistics on cancer?

The Canadian Cancer Society has a wealth of information on cancer statistics.  Some of the most notable are:

  • In Canada, an estimated 225,800 new cancers would have been diagnosed in 2020
  • Lung, colorectal, breast and prostate cancers will make up about half of all the cancer diagnoses in 2020
  • Approximately 1 in 2 Canadians will develop cancer in their lifetime

These statistics make it very clear that there are thousands of people who have undergone cancer diagnoses and treatments.  The good news is that research has come a long way and the survival rates for some of these cancers have improved greatly.  For example:

  • 2012-2014 data reveals that 63% of Canadians diagnosed with cancer are expected to survive for 5 years or more after their diagnosis
    • This is increased from 1992-1994 data, which had the survival rate at 55%
  • The 5-year net survival rate for colorectal cancer is about 65%
  • The 5- year net survival rate for prostate cancer is 93%
  • The survival rate for breast cancer in 2019 is estimated to be 95%

 

What factors have contributed to this increased survival rate?

  • Ongoing research in the field of cancer
  • Early detection through screening
  • Genetic surveillance for specific genes
  • Better treatment options

What are some of the treatment options for cancer?

There are a variety of medical treatment options available for cancer.  However, the exact nature of the treatment will depend on the specific type and stage of cancer that is diagnosed.  The most common forms of treatments available include:

  • Surgery
  • Chemotherapy
    • Treatment that addresses the potential spread of cancer cells away from the origin
    • Usually given through an IV
    • The length of treatment is determined by the nature of the cancer
  • Radiation Therapy
    • Treatment that is used to reduce the risk of local cancer recurrence
  • Hormone Therapy
    • Medication that slows the growth of cancers like breast, prostate and uterine cancer that use sex hormones, such as estrogen, progesterone and testosterone to grow

Is there a role for physiotherapy in the treatment of cancer?

Interestingly, the field of Cancer Rehabilitation is relatively new compared to other specialties of physiotherapy.  This means that not many patients who have undergone cancer treatments would have been referred to physiotherapy.  For example, a 2012 study demonstrated that 6 years after a breast cancer diagnosis, 63% of women had no physiotherapy or active cancer rehabilitation.

Why is this important? 

Medical cancer treatment options have provided an improved survival rate.  However, the same treatments can produce some very significant side effects and complications.  These can include:

  • Pain
  • Decreased range of motion
  • Reduced strength
  • Impaired mobility and function
  • Balance impairments
  • Fatigue
  • Lymphedema
  • Axillary web syndrome
  • Pelvic and sexual health problems

Consequently, these complications can be very debilitating for people going through recovery following a cancer diagnosis.   Specifically, they can severely affect a person’s ability to get through their day to day responsibilities.  For example, these side effects or complications can limit a person’s ability to complete their:

  • Self care activities, such as bathing and dressing
  • Work responsibilities
  • Caregiving for children or ageing parents
  • Recreational activities

 How can physiotherapy help with the complications from cancer treatment?

A registered physiotherapist who has training in cancer rehabilitation can help manage a lot of the treatment complications.  Just like with any other injury or pain problem, the physiotherapist will perform an assessment and determine the areas that need treatment.  They will assess:

  • Range of motion of the affected areas
  • Extent of any swelling
  • The nature of the surgical scars
  • Sensitivity of the surrounding skin
  • Presence or absence of Axillary Web Syndrome for breast cancer patients
  • Functional limitations

The treatment after cancer treatment can include a variety of techniques:

  • Manual therapy for the surgical scars and stiffened tissue
  • Manual therapy to reduce and manage swelling
  • Exercises to improve range of motion and strength
  • Education regarding pain, preventing/managing lymphedema, skin care and energy management

Going through a diagnosis and treatment of cancer can be a very traumatic and stressful experience.  Physiotherapy can help play an integral role with cancer management.  It is important for these patients to get the help they need to ensure that their quality of life remains positive.

Call PhysioNow today to book your appointment and let us help you get back to living your life!

Clavicle Fracture, Frozen Shoulder, General Category, Rotator Cuff tear, Shoulder Dislocation, Shoulder Injuries, Shoulder pain, Sports Injuries

Shoulder Pain and Treatment

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Shoulder Pain

Shoulder pain is a common problem for many people.  It can happen to people of all ages from children to the elderly.  The pain can be very severe and cause a lot of limitations with work and activity.  Shoulder pain is one of the top 5 reasons why people seek out physiotherapy and massage treatments.

What Causes Shoulder Pain?

There are several reasons why people suffer from shoulder pain.

Trauma

Any type of direct or indirect trauma can produce shoulder pain if the arm and/or shoulder is involved

Shoulder trauma

    • Motor vehicle accidents
    • Falls
    • Sports injuries
    • Violent incidents

Poor office ergonomics

Many people who work in offices spend majority of their time sitting  in front of a computer for long periods of time.  Additionally, many offices do not always provide optimal ergonomic setups for their staff.  Over time, as a result, this may lead to the development of pain and stiffness in the shoulder.

Examples of poor ergonomics include:

    • poor desk and screen height
    • poor positioning of the keyboard and mouse
    • inadequate chair height and support

Poor workplace ergonomics

Poor day to day posture

Shoulder pain related to posture usually develops over time with certain habits.  For the most part, some of these habits we just adopt over time.  For instance, examples include looking at our phones for long periods of time or spending hours playing video games.  In other words, shoulder pain can develop from poor posture if we do not make an effort to be more active during our day.

Repetitive activities

Many people perform tasks that are repetitive at work and/or home.  For instance,  overhead lifting, sorting on an assembly line and typing are examples of repetitive activities.  These repetitive activities can certainly take their toll if it has been going on for a long period of time.  Therefore, if the shoulder is not strong enough to support the work that it’s having to do, then injury may occur.

Repetitive lifting

Consequently, it is not uncommon for people who do a lot of repetitive manual labour to hurt their shoulder at work.  In Ontario, if workplaces are registered with the WSIB or the Workplace Safety & Insurance Board, they may qualify to get physiotherapy treatment.

Congenital or Developmental changes

Some people are born with a unique bone structure that may place them at increased risk of injury. For example, if the acromion of the shoulder blade has a hooked shape, there is more potential for a rotator cuff injury.  Similarly, your genetics may influence the shape of your bones in the shoulder.  This may lead to an increased risk of shoulder pain as a result.

Some Basic Shoulder Anatomy

Having some knowledge of basic shoulder anatomy will help with understanding why shoulder pain develops.  The shoulder joint is quite complex.  Specifically, there are a lot of structures that attach to or present around the shoulder.  For example, these structures include tendons, ligaments, bursae, cartilage and the joint capsule. Furthermore, the shoulder joint is held together by mostly soft tissues without a lot of bony protection.  This setup specifically allows for a lot of movement.  However, as a result there is less stability through the area.

What structures makes up the shoulder joint?

The shoulder is made of 4 separate joints that work together to allow function:

  • Glenohumeral (GH) joint – this is a ball and socket joint and is where majority of our arm movement happens. The socket is made up by part of the shoulder blade and the ball is made up of the humerus, which is the long bone of the upper arm.
  • Acromioclavicular (AC) joint – joint between the acromion of the shoulder blade and the collar bone.
  • Sternoclavicular (SC) joint – joint between chest bone and the collar bone.
  • Scapulothoracic joint – the joint between the shoulder blade and the ribs at the back of the chest.

Why is the shoulder joint prone to pain?

The shoulder is held together by many soft tissues including ligaments, muscles and tendons.   Other important anatomical structures include the joint capsule surrounding the ball and socket joint and the subacromial and subdeltoid bursae.  The function of the joint capsule is to protect the joint and produce a lubricating fluid.  The bursae are small fluid-filled sacs that act as a cushion between the bone and other moving parts.

What are some of the injuries that can happen to the shoulder?

  • Sprains/Strains of any of the muscles, tendons and ligaments
  • Tears/Ruptures of any of the muscles, tendons and ligaments
  • Tendonitis/Tendinosis
  • Fractures
  • Bursitis
  • Dislocations
  • Adhesive Capsulitis or Frozen Shoulder
  • Osteoarthritis
  • Nerve entrapments/injuries

Signs and Symptoms of Shoulder Injuries

  • Pain
  • Swelling
  • Restricted range of motion
  • Weakness
  • Instability
  • Bony deformities

Healing Times for Shoulder Injuries

The healing time for shoulder injuries will vary depending on the injury.  Most simple sprains and strains will take anywhere from 6-8 weeks to get better.  On the other hand, other types of injuries may need more time to recover.  For example, muscle or tendon tears can take 6-12 months to improve.  And similarly, frozen shoulders can take well over 1 year to improve.  Therefore, the timeline for healing really depends on the nature of the injury.  Additionally, there are a lot of individual differences in healing time even for similar injuries.  Some of these factors include:

  • Age
  • Level of fitness and/or mobility
  • Commitment to treatment
  • Consistency of doing home exercise program
  • Ability to modify workplace or home environment to allow for optimal treatment response
  • Presence of other injuries
  • Amount of time that they injury/pain has been present

Treatment for Shoulder Pain

The treatment for shoulder pain will depend on the type of injury and the structure(s) that has been injured. Most importantly, it is important to understand that the shoulder is made up of 4 different joints.  Additionally, these 4 joints are all interconnected with each other.  Therefore, treatments needs to target the whole shoulder complex and not just the individual structures involved.  Consequently, this will allow the shoulder to return to its full potential and reduce the risk of re-injury.

The main goals of any shoulder pain treatment will be to:

  • Reduce pain
  • Regain full range of motion
  • Regain strength and stability
  • Return to pre-injury activities

What is the typical treatment for shoulder pain?

Treatment for shoulder pain usually has multiple components.  The Registered Physiotherapist will start with a thorough assessment.  Firstly, this allows them to identify the source of the shoulder pain.  Secondly, based on the assessment, the physiotherapist is able to provide the most appropriate treatment.  Specifically, examples of physiotherapy treatment can typically include:

  • Manual therapy
    • soft tissue work
    • mobilizations
    • assisted stretching of the shoulder and associated areas

  • Modalities – these are usually used in the acute phase for pain relief
    • Ultrasound
    • Laser
    • IFC or TENS
    • Acupuncture
    • Heat/Ice
  • Exercises
    • Range of motion and strengthening exercises that are specific to the injury
    • It is important that the patient completes the prescribed exercises on a regular basis at home.  Firstly, this allows the patient to make the necessary changes with movement and strength.  More importantly, however this allows the patient to be independent and provide self treatment on a daily basis.

  • Education
    • Explanation of the condition
    • Rationale for the treatment choices
    • Do’s and don’ts to help the injury along

In conclusion, shoulder pain can be quite debilitating for many people.  Therefore, it is important to seek out a registered physiotherapist for assessment and treatment sooner than later.  Similarly to most other injuries, the longer an injury is left untreated, the more chronic it becomes.  Consequently, this makes it more difficult to resolve in a timely manner.  Call PhysioNow today to get treatment for your shoulder injury.  Our experienced physiotherapists and massage therapists in Mississauga, Etobicoke and Oakville will help you recover!