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What is arthritis?

What is arthritis?

arthritis

The medical and rehabilitation world uses the term ‘arthritis’ all the time.  However, what exactly does it mean to have this condition?  Simply put, arthritis refers to painful joints or joint disease.  However, this is a very simplistic definition of the term.  More specifically, there are over 100 different types of this condition.  Arthritis affects millions of people around the world, including men and women and people of all ages and ethnicities.  Additionally, because it affects the joints of the body, it is a leading cause of disability and affects a lot of the most basic day to day tasks.  Individuals who have severe forms of the disease have a significant loss in their quality of life.

What are some important statistics?

A good resource for information on arthritis is the Arthritis Society website.  According to their website, about 6 million people across Canada have arthritis.  That works out to about 1 in 5 people.  The impact of this condition on a person’s life can be substantial:

  • Someone with arthritis is 4 times more likely to feel that their health is not good
  • Suffering with arthritis may make someone 2 times as likely to suffer from mental health concerns
  • 40% of those with arthritis have pain that affects their ability to participate in activities
  • Those with arthritis are 5 times more likely to struggle with their mobility
  • Having arthritis may make someone two times as likely to be out of work

What are the signs and symptoms of arthritis?

The symptoms of this condition will vary depending on the specific diagnosis.  However, in general they include:

  • Swelling
  • Pain
  • Stiffness
  • Decreased range of motion

Are there different categories of this condition?

There are so many different types of arthritis and arthritis-related conditions that it would be too hard to describe them all in a single blog.  However, there are two main types: Degenerative and Inflammatory

Degenerative Arthritis

Another term for Degenerative Arthritis is Osteoarthritis (OA).  Furthermore, according to the Arthritis Society of Canada, osteoarthritis is the most common type.  Consequently, it affects more people in Canada than all the other forms of the disease combined.

  • Osteoarthritis is commonly described using the term ‘wear-and-tear’
  • However, the Osteoarthritis Research Society International (OARSI) more recently defined it as the body’s inability to properly repair damaged joint tissues.
  • The damage to the joints can develop from changes related to aging or from injuries.
  • Osteoarthritis damages the cartilage covering the joint surfaces.
    • Cartilage is a tough elastic material that covers and protects the ends of bones.
    • Severe damage to the cartilage leads to exposure of the boney surfaces
    • This creates pain, stiffness and reduced range of motion.
  • The most commonly affected joints are the knees, hips, hands and spine

What are some risk factors for osteoarthritis?

There are some factors that contribute to the development of OA including:

    • Age
    • Obesity
    • Sex
    • Occupation
    • Participation in certain sports
    • History of joint injury or surgery
    • Genetics

Inflammatory Arthritis

  • Inflammatory arthritis includes every other form of arthritis except osteoarthritis.
  • This category of the condition is very different from osteoarthritis because the joint damage comes from the process of inflammation.
  • In most cases, the inflammation is caused by an autoimmune disease, which is when the immune system mistakenly attacks the normal tissues of the body.
  • More specifically for inflammatory arthritis, the immune system attacks the joint tissues.
  • The inflammation can result in pain, stiffness, restricted mobility, fatigue and damage to joints and other tissues.
  • Furthermore, the damage can change the shape of the joints and deformities can develop.
  • Some forms of inflammatory arthritis are considered systemic because they can affect the whole body.

What are some common types of inflammatory arthritis?

    • Rheumatoid arthritis
    • Ankylosing spondylitis
    • Psoriatic arthritis
    • Juvenile idiopathic arthritis
    • Lupus
    • Gout

How is this condition diagnosed?

  • The diagnosis of arthritis is made using symptom presentations and physical examinations
  • Some doctors may order an X-ray to visualize the potential damage of a joint
  • It is important to understand that quite often the symptoms of osteoarthritis do not always match what is shown on x-rays.
    • For example, the x-ray may show significant joint changes but the symptoms may not be severe
    • However, the reverse may also be true
  • A medical history and physical examinations are required to diagnose inflammatory arthritis
    • Unlike with osteoarthritis, inflammatory arthritis usually requires diagnostic tests such as blood tests and x-rays to confirm the diagnosis

What are the treatment options for osteoarthritis?

Unfortunately, osteoarthritis creates irreversible joint changes.  However, the good news is that the symptoms can be relieved or significantly improved with several management strategies.  Specifically, the main goal of any treatment is to manage pain and improve function instead of curing the condition.

 Medications

    • Medication is usually required on an as-needed basis when symptoms come and go
    • For people who have more severe or constant symptoms, medications may have to be used daily to manage the symptoms, especially for inflammatory conditions

Physiotherapy

  • Physiotherapy is a form of rehabilitation that helps to decrease pain, increase range of motion and improve strength and function
  • The Registered Physiotherapists at PhysioNow will use a wide range of treatment techniques to help improve a patient’s condition
  • More specifically, physiotherapy treatment at PhysioNow may include the following types of treatments:
    • Modalities to help manage pain and inflammation
      • Examples may include interferential current (IFC), ultrasound, laser and acupuncture
    • Manual techniques to reduce tissue and joint stiffness
      • At PhysioNow, the physiotherapists have expertise in soft tissue work, joint mobilizations and stretching techniques that will help alleviate pain and stiffness
    • Exercises that will help improve flexibility and overall strength of the affected areas
      • The exercises prescribed by our therapists will help our patients regain their strength and function and get back to doing the important things in life
      • A lot of elderly patients with arthritis conditions may stop being active and lose their strength and overall function
      • This will place them at increased risk of falling, which can cause serious injury
      • The physiotherapists at PhysioNow can implement a Falls Prevention Program that will help rebuild strength, endurance and reduce the risk of falls
    • Education to help the patient manage their symptoms at home and continue with their activity

 

Surgery

  • The most common types of surgical procedures are total joint replacements, especially for the hip and knee
  • More specifically, joint replacement surgery involves removing the damaged joint and replacing it with a prosthesis.
  • However, the first line of defense should always be conservative treatments such as medication and physiotherapy
  • Surgery is considered when there is no response to conservative treatments

What are the treatment options for inflammatory arthritis?

  • Medications are a large part of the treatment for inflammatory arthritis as well
  • The medications are dependent on the specific diagnosis, but their overall aim is to control the inflammation that is causing the joint damage
  • The different classes of medications available for treatment of the various conditions include:
    • Biologic
    • Disease-Modifying Anti-Rheumatic Drug (DMARD)
    • Corticosteroids
  • Additionally, inflammatory arthritis also results in pain, joint stiffness and loss of function
  • Similar to osteoarthritis, a Registered Physiotherapist can help develop a treatment plan that will help address these issues and improve patients’ quality of life
  • More specifically, movement and exercise is an important part of managing inflammatory arthritis

To sum up, leaving arthritis untreated can have debilitating effects on your quality of life.  More specifically, people will live their life with pain, limited strength and mobility as a result.  Therefore, to prevent the loss of your quality of life, it is important to get help with management as soon as possible.  Start your recovery with the experts at PhysioNow.  Call PhysioNow today to book your appointment with a Registered Physiotherapist!

 

Fibromyalgia

FIBROMYALGIA

Fibromyalgia is a chronic condition. It is often associated with widespread symptoms including fatigue, pain and sleep disturbances.

 

Causes and Risk Factors

It is unclear as to what causes fibromyalgia. However, there are some causes which might be increasing your risk of getting fibromyalgia:


Genetics-

You could be ay a higher risk for fibromyalgia if it runs in your family

Stress-

Emotional or physical stresses have been known to aggravate or cause this condition

Age-

Women have been found to be at a higher risk


Symptoms of Fibromyalgia:


The symptoms may vary from individual to individual but, following are some of the commonest symptoms-

Fatigue-

One of the commonest symptom is fatigue

Pain-

Pain that lasts > 3 months and widespread pain at several sites in the body

Sleep disturbances-

 You could have sleep disturbances or non restorative sleep (sleeping for long but not feeling rested)

Reduced exercise tolerance and morning stiffness.


Other symptoms include trouble with concentration/memory. It is also called ‘fibro fog’ or ‘brain fog’. Headaches and depression are also common. It is common to have fluctuations in the symptoms. You may experience pain that may range from a mild discomfort/ache to an unbearable pain.

Although it may mimic more like an arthritis/ bone related pain, it actually comes from the soft tissues. Fibromyalgia can start at any age. However, mostly it is by early to middle adulthood that people start feeling it.


Diagnosis:


Your doctor will take a detailed history to understand all of your symptoms. There is no definitive test to diagnose this condition. However, the doctors may prescribe you to do other tests like blood work or X-rays to rule out other conditions that show similar symptoms.


How do you treat it?

Drugs-

The treatment is usually focused on relieving the symptoms. For instance, your doctor may prescribe muscle relaxants, pain killers, anti-depressants or sleep medications,

Acupuncture-

To help relieve pain

Acupuncture: Neck pain

Fibromyalgia. Acupuncture

Cognitive Behavior Therapy-

Cognitive Behavior Therapy can help to reduce stress. Can be individual or group therapy.

Nutrition-

A healthy balanced diet is good because it helps to keep your body healthy and keep the energy levels high. 

Massage therapy-

Helps in relaxing the muscles and relieve pain

Activity pacing-

There may be good and bad days in this condition. Thus, it is important to make sure you prioritize your activities for the day. This is helpful in order to reduce excessive fatigue.

Physiotherapy-

Physiotherapy can help to firstly, reduce your pain. Secondly, they can give guidance on modifying activities and finally, prescribe exercises. In addition, aerobic fitness and strengthening exercises  help in this condition.

Physiotherapy Treatment for Low back pain

Physiotherapy for fibromyalgia


How can we help?

Our physiotherapists will take a detailed history followed by a thorough evaluation of all your symptoms and problem areas. Then, they will formulate and discuss a treatment plan for you. Also, we have massage therapists and therapists who do acupuncture. Thus, if you are having fibromyalgia or know anyone who needs help with the same, contact us today at PhysioNow!

Neck related dizziness

Neck related dizziness

Neck related or cervicogenic dizziness is one of the common causes of dizziness and affects 45-80% population. However, while treating the symptoms of being dizzy/light-headed, this diagnosis is commonly missed.

How can it come from the neck?

Nerves from the upper part of the neck connect with the vestibular system(area of the brain responsible for balance). As a result, any injury or impairment in the upper neck like car accident (whiplash), abnormal posture or any inflammatory condition could eventually lead to disturbance in the vestibular system. This, in turn, leads to dizziness.

How to know if your dizziness is related to your neck?

  • If you are experiencing lightheadedness, unsteadiness, feeling imbalanced and above all, feeling like your external environment is spinning
  • Moreover, if your symptoms comes with moving the head quickly in any direction, during sitting or standing up
  • Further, if you are experiencing headache and neck pain
  • In addition, you have a history of neck injury due to a car accident or neck pain due to abnormal posture

Diagnosis:

There is no specific test with good evidence for cervicogenic dizziness. However,  there are tests that will help you rule out other causes of dizziness. This, in turn will help in concluding that cervical spine is the cause for your symptoms.

How could physiotherapy help you with dizziness?

First of all, there will be a comprehensive assessment of your symptoms. Then, the physiotherapist designs a treatment plan incorporating manual therapy , exercises, education and other modalities like acupuncture. Consequently, it will help treat the neck as well as the vestibular system.

Physiotherapy Treatment Etobicoke

Neck related dizziness

Prognosis:

Cervicogenic dizziness usually has good prognosis. It usually resolves with the treatment of neck and the vestibular system. About 75% of patients have reported significant improvement in their symptoms.

Are you experiencing any of these symptoms? Our Vestibular physiotherapists specialize in treating this. Book an appointment today at one of our clinics! We will do an assessment and help you get better.

Physiotherapy Mississauga

Physiotherapy Mississauga

Why choose PhysioNow for Physiotherapy Mississauga?

• Over 16 years of providing top rated Physiotherapy Mississauga
There are 4 convenient locations- Erin Mills, Applewood, Lorne Park and Long Branch

• Awards/nominations? PhysioNow: nominated for a Top Choice Award in 2020.

• A team of highly qualified physiotherapists and massage therapists

All of our physiotherapists and massage therapists have several years of experience in their field and are registered in good standing with the College of Physiotherapy and Massage Therapy.

• Services we offer

Services are provided for all ages and for a variety of conditions. For instance,  our therapists are specialized in several areas including manual therapy, acupuncture, vestibular rehabilitation, concussion , sports injuries, pelvic health and soft tissue techniques.

Physiotherapy Mississauga

Lower Back Pain Treatments

Physiotherapy Mississauga

Donjoy Defiance ACL Repair Brace

Physiotherapy Mississauga

Return To Sport After ACL Ligament Repair

In addition, we  do custom orthotics and braces.  For your convenience, we are currently also offering our physiotherapy services virtually .

• Direct billing available

In addition, Direct billing is available to most of the insurance companies so it is convenient for you.  For instance, we also deal with third party insurers like MVA and WSIB.

• Flexible hours and free parking available

Above all, we are open for extended hours ( ) to help you at a time that is best for you.

What to expect at Physiotherapy Mississauga?

First, you have an assessment with our physiotherapist.  They will do a full check up of the problem area .

Next, the physiotherapist will then prescribe a treatment plan especially for you.

Further, they can also help you understand more about your condition.

We will answer your questions .

Lastly, changes may be made  in your daily routine.

As a result, this will  help you to get better faster.

COVID considerations: We take excellent precautions!

 

• Providing a face mask and use of 70% alcohol hand sanitizer for each patient upon arrival into the clinic

• Installation of sneeze guards at the front desk

• In addition, Sanitization of treatment beds after before each patient use

• Disinfecting commonly touched surfaces between every patient

• Switching out pillowcases with each patient use

• All staff will wear a gown and mask and wash hands between each patient contact

  • Social distancing throughout the clinic.
  • Lastly, no visitors are sitting in reception

If you are in need of Physiotherapy or Massage Therapy, Contact PhysioNow today.

Kevin Durant

Kevin Durant

What happened to Kevin Durant?

Kevin Durant originally injured his calf in early May during the second round of playoff games.  The injury had been labeled a ‘calf injury’ and Durant has not been able to play for over 30 days.  After doing a shoot around with the team, the Warriors made the decision to allow Durant to play for Game 5.  Durant came out strong, scoring 11 points in 12 minutes of play. But things changed as he tried to do a crossover move and had to fall to the floor on the sidelines.  He was grabbing onto his lower right calf, more towards his Achilles tendon. In conclusion, from the replays, it looked like he may have torn his Achilles tendon.

What is the difference between a calf strain and an Achilles tendon tear?

Calf Strain : Did Kevin Durant have this injury?

It is possible that Kevin Durant had a calf strain to start.

The bulk of the calf is made up of 9 different muscles.  Three muscles work together to produce a downward movement of the foot. These 3 muscles attach themselves into the heel bone:

  • Gastrocnemius
  • Soleus
  • Plantaris

Other Muscles of the calf/ foot

The other 6 muscles cause knee, toe and foot movements in different directions.  These muscles are located deeper in the calf area. However, these muscles travel around the sides of the ankle and attach to different parts of the foot and toes.  These muscles are:

  • Popliteus
  • Flexor digitorum longus
  • Flexor hallucis longus
  • Tibialis posterior
  • Peroneal longus
  • Peroneal brevis

Sometimes injuries are labelled incorrectly.  Pain in the calf region is attributed to the first three muscles.  However, a calf strain could involve any one of the 9 muscles mentioned above.  As a result, it is up to the health professional to correctly identify which of the muscles are involved in the strain.

Severity of Calf Strain: What Grade did Kevin Durant have?

In general, a calf strain is caused by overstretching or tearing of the calf muscles.  This type of injury can occur suddenly or over time. The severity of the strain is graded by the amount of muscle damage that has occurred:

  • Grade 1
    • Mild or partial stretch or tearing of a few muscle fibres
    • The muscle may be tender and painful
    • Strength and function are maintained
  • Grade 2
    • Moderate stretching or tearing of a greater percentage of muscle fibres
    • A snapping or pulling sensation may be felt at the time of the injury
    • More tenderness and pain
    • There may be some visible bruising
    • Loss of strength and function
  • Lastly, Grade 3
    • Severe tear of the muscle fibres, commonly a complete rupture
    • A ‘popping’ sound may be heard of felt at the time of the injury
    • There is definite bruising and sometimes there is a visible ‘dent’ in the muscle
    • Severe loss of strength and function

Signs and Symptoms of a Calf Strain

  • A snap, pull or “pop” felt or heard at the time of injury
  • Pain and weakness in the calf area
  • Swelling in the calf area
  • Tightness
  • Bruising
  • Weakness in the calf when doing any weight bearing activities
  • Limping when walking

What is the usual Physiotherapy treatment for a calf strain?

Treatment for a calf strain is like that of any other muscle in the body.  The goals of the treatment include:

  • Reducing pain
  • Improving range of motion of the knee and ankle
  • Improving the strength
  • Speeding up recovery time
  • Returning to activities
  • Preventing re-injury

How long does it take to recover from a calf strain?

The length of time for recovery from a calf strain injury depends on the severity of the injury.  On average:

  • Grade 1: 10-12 days
  • Grade 2: 4-6 weeks
  • Lastly, Grade 3: 6 months after surgery

Achilles Tendon Rupture : Kevin Durant’s final injury

The gastrocnemius, soleus and plantaris muscles unite to form the Achilles tendon.  The tendon is a tough band of tissue that connects these three calf muscles to the heel bone.  When the calf muscles contract, the Achilles tendon is tightened and pulls the heel. As a result, the action allows the foot to be pointed down.  A complete tear of this tendon is called an Achilles tendon rupture.

Signs and symptoms of Achilles Tendon Rupture

  • Sudden and severe pain at the back of the ankle or calf
  • Sound of a loud pop or snap
  • Immediate swelling and weakness
  • Visible bruising and possible denting in the tendon

Treatment options for Kevin Durant’s Achilles Tendon Rupture

  • Non-surgical treatment
    • Rest
    • Crutches
    • Ice
    • Pain medication
    • Immobilisation for the first few weeks with a walking boot and heel wedges
    • Recovery may take longer but risks of surgery are avoided
  • Surgical Treatment

The choice between surgical or non-surgical treatment depends on different factors. A patient’s age, activity level and severity of the injury all play a factor.  In general, younger and more active people, especially athletes, choose surgical repair. In contrast, older and more sedentary individuals usually choose the non-surgical pathway.  In either option, rehabilitation is a lengthy and difficult process to make sure full function is returned.

So, what happened to Kevin Durant?

The Kevin Durant was out for over a month with an initial calf strain.  Due to the amount of time that he was out of the game, it’s likely that he had a grade II strain of his calf.  As a result, his return to the game resulted in a complete Achilles tendon rupture. In review, it makes you wonder whether he was physically able to return to play.  Did he have enough time for recovery from his initial injury to withstand the demands of the game?

Basketball is a sport that has a lot of pivoting, stop and go movements and bursts of high intensity activity.  In conclusion, it is possible to say that judging from how soon into the game the injury happened, that Kevin Durant was likely not fully recovered.

Professional Sports: Decisions for return to play. Should Kevin Durant have returned to play in Game 5?

However, in professional sports, there is a lot of pressure from all fronts to get a star player back in the game.  The team was down 3-1 and having Durant back in the game boosted their confidence and morale. As a result, the fans wanted the Warriors to win.  The organization wanted the team to hold on to their title again. In addition, Kevin Durant himself probably felt terrible that he wasn’t able to play and support his team.  As a result, all of these pressures likely led to the decision for him to play.

Unfortunately, our bodies are not always able to function like we want them to. In Durant’s case, his return to the game led to an even more serious injury, which required surgery.  In conclusion, after surgery he will have to endure a lengthy process of physical therapy and will likely be out for the entire next season.

Return to Play Decisions

This is an excellent example of the importance of return to play decisions.  Regardless of the sport and regardless of the injury, it is vital that the health and well being of the athlete is the top priority.  In conclusion, returning to play too soon isn’t worth risking a more serious injury. Lastly, a more serious injury can affect the athlete’s future participation in the sport.

Physiotherapy Treatment options for Achilles Rupture

If you or someone you know has experienced calf pain or an achilles rupture, our Physiotherapists at PhysioNow are here to help! We have treated many patients with exactly these injuries. Call today to get started on your treatment and get back in the game!