Tag Archives: low back pain

Accident Rehabilitation

Accident Rehabilitation

Accident Rehabilitation

What is Accident Rehabilitation?

Motor vehicle accidents happen everyday in Ontario.  As a result, they produce a lot of pain, disability and stress for those involved. The impact can be quite debilitating. Accident rehabilitation is treatment that is given after being involved in a motor vehicle accident. It is important to seek out Registered Physiotherapists who are experienced in Accident Rehabilitation to ensure proper recovery. At PhysioNow we offer high quality Registered Physiotherapy and Registered Massage therapy treatments to help you recover from your injuries.

Accident Rehabilitation

Registered Massage Therapy

Who is entitled to receive Accident Rehabilitation?

Any person who has been involved in a motor vehicle accident in Ontario is entitled to receive Accident Rehabilitation benefits . This would include if you were a pedestrian hit by a vehicle.  It would also include coverage for treatment if you were involved in an accident outside of Ontario, but reside in Ontario.  However, if you are  injured and do not have your own insurance, you can still apply for accident benefits. The circumstances of the accident will determine which insurance company will pay for the benefits. For instance, you may be covered by the person that hit you or the Motor Vehicle Accident Fund.

How much accident benefit coverage is available?

The amount of the benefits that you are entitled to depends on the severity of your injuries. There are two categories of benefits available:

  • Minor Injury Guideline (MIG)

    • This plan is for people who have minor injuries including whiplash and sprains and strains.
    • The majority of motor vehicle accident injuries fall within this category
    • The MIG plan is standardized across all of Ontario in terms of its entitlement to Treatment benefits no matter where you receive treatment.
    • If you are under a MIG, the maximum benefit under the MIG is $3500

 

  • Major Injury Guideline (non-MIG)

    • This plan is  for people who have suffered serious injuries from an accident
    • Examples include fractures, surgeries, major neurological trauma and concussions
    • The maximum entitlement under this plan will vary depending on your injuries, but could be up to $65,000.

What is the process of receiving accident benefits?

Once the accident is reported to the insurance company, the  adjuster will ask if there are any injuries from the accident.  The adjuster will send you a package of forms that you have to complete and send back. The adjuster will also likely put you in touch with an approved physiotherapy clinic in the area closest to you. The clinic will then contact you to schedule an initial assessment.

1st visits with a Physiotherapist can take place within 1 day of the accident.  You are also able to go directly to your Approved Physiotherapy Clinic to initiate a claim and get started on your treatment.  The Approved Clinic can get the paperwork started for you.

PhysioNow is an approved company for the purposes of Motor vehicle accidents in Ontario.  PhysioNow is allowed to directly bill your treatment to your Auto Insurance company. They can provide all of the forms that you need to get started.

 

Accident Rehabilitation

Whiplash Pain

What are the most common injuries from a Motor Vehicle Accident?

Most car accidents tend to be minor in nature. The most common types of injuries are:

  • Whiplash

    • Happens when the force of the impact pushes your neck back and forth really fast
    • This causes a sprain/strain of the your muscles and ligaments of the neck
    • Symptoms range from pain, stiffness, numbness/tingling into the arms and hands, headache and loss of motion
  • Thoracic & Lumbar strains

    • The impact causes the joints and muscles of the spine to be over-stretched
    • The mechanism is similar to whiplash
    • Symptoms include pain, limited movement, numbness/tingling into the arms and/or legs, weakness
  • Shoulder strains

    • It is common for the shoulder to get injured in a car accident, especially for the driver – this is because their arms are usually holding on to the steering wheel
  • Concussion

    • Concussions are a form of a traumatic brain injury and can vary from mild to severe
    • It is possible for Concussions to occur as a result of either direct or indirect trauma to the brain
    • The most common symptoms of a concussion are dizziness, nausea, sensitivity to light and sound, headache, fatigue, difficulty concentrating and fogginess
    • Accident Rehabilitation

      Concussion

What can I expect from my first visit at the physiotherapy appointment?

During the initial visit, you will have to complete some forms.  These forms are essential to submitting a successful claim. The experienced administrators at PhysioNow can help you to fill them out to make the process easier for you. The good thing about the  paperwork is that you only need to complete it once! After the initial paperwork, you can focus just on your recovery.

What can I expect from my Initial Assessment with the Registered Physiotherapist at PhysioNow?

Your Registered Physiotherapist will meet with you.  We will start by asking some questions to get an understanding of your injuries. For example, some sample questions can include:

  • How did the accident happen?
  •  Questions that will screen you for more serious injuries that could require further medical attention
  • Locating all the painful areas and injuries that have occurred
  • Details about past medical and injury history

Once this information has been collected, your Registered Physiotherapist will do a full assessment. We will check all of your  affected areas for movement and strength. This will start to give us an idea of the severity of your symptoms. We will then use this information to decide whether you will be classified as either MIG or non-MIG.

After this, we will then  fill out the required treatment plan for you.  In conclusion, we will go over what the plan will look like with you. Lastly, they will discuss treatment timelines and treatment goals. At PhysioNow, there will also be  time allocated  to start some light treatment to give you pain relief.

What kind of treatment will be provided for Accident Rehabilitation?

The types of treatment provided after vehicle accidents  will depend on the nature of your injuries.  It will also depend on  what your Physiotherapist feels is most appropriate for  you, taking into account all of your injuries. As a result, your treatment plan may include a variety of different treatments such as:

  • Treatment will start slowly at first and focus first on pain control,
  • Modalities – Ultrasound, Laser, Interferential Current
  • TherapyManual therapy – gentle soft tissue work, mobilizations, assisted stretching
  • Exercises – range of motion, postural and strengthening exercises
  • Concussion Treatment if needed
  • Education – explanations of the injuries and do’s and don’ts to help the recovery process
  • After that, this will be followed by recovery of movement, and then strength.
  • Lastly, we will work on helping you get back to all of your normal activities both at home and work
  • Neck Pain Treatment

    Accident Rehabilitation

How long will the treatment  take to complete for Accident Rehabiliation?

The length of the treatment plan depends on whether you are on a MIG or non-MIG pathway.

  • MIG (Minor Injury Guidleline)
    • 2 phases
      • 1st phase: 12 weeks in length
      • 2nd phase (if required): additional 4-8 weeks
    • Non-MIG ( Non- Minor Injury Guideline)
      • Timeline is at the discretion of your physiotherapist and will vary depending on your injuries
      • For post-surgical cases or individuals with multiple serious injuries, the timeline can be well over 1 year

As a result, it is very important to seek out Accident Rehabilitation as soon as possible when you have been involved in a car accident. The pain and limitations that you experience after an accident can really affect your quality of life. Therefore, scar tissue from injuries starts to form quickly after an injury.

At PhysioNow we want to help you get back on your feet and back to doing things that are important to you!  Give us a call at 289-724-0448 to get started today!

Sciatica

Sciatica Treatment Mississauga

Sciatica

Sciatica

Sciatica is a term that gets used quite frequently in the physiotherapy world. This refers to pain, tingling and/or numbness that goes down the back, hip or entire leg.

Who can get Sciatica?

  • It can happen to both younger and older adults for a variety of reasons.
  • For some, it starts after a traumatic event like a slip and fall or after a motor vehicle accident.
  • It can seem like pain develops out of nowhere for others.
  • Pain can start gradually then suddenly increase in severity.
  • The majority of the time, sciatica is a condition that starts with some mechanical changes in the low back that build up gradually over a period of time.

What is Sciatica?

  • The term sciatica itself refers to irritation of the sciatic nerve
  • It is the largest nerve in our body
  • This nerve has its roots at the lower levels of the lumbar spine
  • It  runs through the buttock area, and down the back of the thigh
  • Around the level of the knee, the sciatic nerve splits up into several smaller nerves that run down to supply the muscles of the lower leg, ankle and foot

What are the symptoms of Sciatica?

The symptoms produced by sciatica follow the pathway of the nerve and can reach all the way down to the toes. The symptoms can range from:

  • pain
  •  pins and needles
  • numbness
  • weakness in the leg or all of the above

ACUTE Sciatica

  • Sciatica can be very debilitating when it is in the acute stage.
  • Pain can be quite sharp and severe.
  • As a result, sciatica can limit your movement and function completely.
  • A lot of patients at this stage will rate their pain intensity at a 9 or 10 out of 10.
  • Any position or movement may be pain producing.
  • Anything you try, including over the counter medication, may not help with the intensity of pain.
  • You may feel very helpless and scared at this stage.
  • The sudden onset of intense pain may make you wonder if there is something seriously wrong.
  • You may even feel that you need to go to the emergency room because the pain is so severe.

Should you go to the Hospital for Sciatica?

  • It is not necessary to go to the Hospital for Sciatica.
  • Typically, most people with Sciatica can recover quickly with the help of a trained Registered Physiotherapist!
  •   PhysioNow has trained professionals standing ready to help you Now!
  • We do not need a doctors referral to see you at PhysioNow.
  • However, you may  require a doctor’s note for your insurance plan to cover your treatment.
  • Our Physiotherapists will screen for any serious issues and send you to a doctor if they find any ‘red flags’ with your Sciatica.
  • We will direct bill to your Extended Health Plan if your plan allows us to do so.

However, if you feel more comfortable seeing a doctor first, head to the Hospital or your family doctor.

At the hospital, the standard procedure will be to rule out anything potentially serious. Some of the more serious causes of severe low back pain can include:

Fracture
o History of significant trauma
o If there is osteoporosis present, then minor traumas are risk factors
o Loss of function with all movements making pain worse

• Cancer
o 55 years of age or older
o Previous history of cancer
o unexplained weight loss
o Increasing levels of pain that are not relieved by rest

• Infection
o Fever
o Malaise
o Constant pain
o All movements make the pain worse

Cauda Equina Syndrome
o Severe low back pain
o Pain, numbness or weakness in one or both legs
o Saddle anesthesia – loss of or altered sensations in your legs, buttocks, inner thighs, backs of your legs, or feet
o  Sexual dysfunction
o Sudden changes in bowel or bladder functions – difficulty with relieving yourself or difficulty with holding it in

The role for Physiotherapy in Sciatica

  • Any of the above-mentioned conditions would require emergency treatment, which the hospital would provide.
  • Thankfully, for most patients, their sciatica is not from anything  serious.
  • Most incidences of sciatica are mechanical in nature and can be treated with Physiotherapy.
  • Once the hospital has ruled out anything serious, they will likely prescribe some medication for pain management and provide a referral for physiotherapy.
  • For most people, sciatica can be treated with conservative treatment such as physiotherapy.
  • The important thing about treating sciatica effectively is to determine the correct source of the pain and address those specific areas.

What is causing the Pain from Sciatica?

  • With most sciatica patients, the pain is coming from pressure on one or more of the roots of the sciatic nerve.
  • The pressure on the nerve affects the proper function of the nerve and causes the symptoms to go down the leg.

What about if I have Tingling and Numbness? Is that more serious?

  • The tingling, numbness and weakness that a patient may experience is not something that will be permanent in most cases.
  • A good analogy for this process is like when someone is stepping on a water hose.
  • The pressure from the foot stops the water from passing through the hose.
  • However, once that foot comes off the hose, the water will flow through without any issues.
  • Similarly, the symptoms along the leg will get better once the pressure is removed off the nerve. Physiotherapy will help with this!
  • This pressure on the nerve may be caused by an injury to the disc or bony changes in the area.
  • An experienced physiotherapist will be able to perform a thorough assessment that will determine the potential cause of the sciatica.

Physiotherapy Treatment

  • Once the cause of your sciatica is established, the Physiotherapist will be able to provide the most appropriate treatment to take the pressure off the nerve.
  • Lots of research out there has shown that passive treatments such as heat, ice, and electrical modalities, like IFC and ultrasound, do not provide long term solutions.
  • These types of modalities may be useful in the acute phase to help with the management of pain.
  • They can be combined with other treatments as part of the overall treatment plan for sciatica.
  • However, on their own, they are unlikely to make any significant and long-lasting changes.
  • Specific movements are usually the most effective at shutting off your Sciatica Pain!
  • Your Trained Physiotherapist will determine the best movement for you to shut off your Pain!

Sciatica Treatment

Positions and Movements that can Help with Sciatica Pain

  • More importantly, there has to be an evaluation of what positions and/or movements are pain producing and which are pain relieving.
  • A physiotherapist who has lots of experience working with low back issues will be able to help make this discovery.
  • Therefore, the results of the movement assessment will allow for the prescription of the appropriate exercise to help take the pressure off the nerve roots.
  • For example, if you feel less leg symptoms when you arch your back backwards, then that means your nerve is less irritated with that movement.
  • As a result, your treatment plan will then include exercises that involve various forms of backwards movements that continue to improve your leg symptoms.
  • Possible Sciatica Treatment

What Does Centralization of the Pain mean?

  • As the pressure on the sciatic nerve improves, the pain will move upward towards the low back in a process called centralization.
  • In general, these changes may happen quickly for most patients.
  • However, with more complex cases, it can take longer to ease the pain and regain function.
  • As a result, any movements that  produce centralizing symptoms are going to be beneficial in reducing pain.
  • In the majority of cases, pain can be resolved completely, and you can return to your normal level of activities quickly.

What do I need to know to keep the pain away?

  • It is important that the physiotherapist provides proper education.
  • They should give you  a good home exercise program for the continued maintenance of your sciatica condition.
  • As a result of the pain, some patients will continue to avoid certain activities or movements because of their experience with sciatic pain.
  • Therefore, it is important that your physiotherapist  work with you to regain full function and confidence with your mobility.

PhysioNow has highly trained Registered Phyiotherapists ready to help you with Sciatica.  We have same day emergency appointments available.  Call today to help with the Sciatica Pain! 289-724-0448.

Fracture Rehabilitation

Fracture Treatments Mississauga & Etobicoke _ PhysioNow

Fracture types

Fracture Rehabilitation


Fractures are common injuries .  They can happen to people of all ages, from the very young to the very old.  The majority of fractures occur with trauma to the bone.  It could be  either from a fall or a blunt force.  Most people can readily feel that they have a broken bone. This is because the signs and symptoms can be very obvious.

Some of these indicators of Fracture are:

  • Swelling or bruising over a bone
  • Deformity of an arm or leg
  • Pain that gets worse with any movement or added pressure
  • Inability to put any weight through the injured area
  • Protruding bone through the skin (in the case of open fractures)

In some cases, however, fractures can be less obvious.  Some ankle fractures may look a lot like ankle sprains. You may not even know that it was a fracture until it shows up on an X-ray.

Spine Fractures

Fractures through the spine may feel a lot like back pain initially.  This is due to the  make-up of the spine.  Bony injuries to the back do not produce any of the obvious signs and symptoms .  However, one of the key components of a spinal fracture is that it occurs after some sort of trauma. This is most commonly a fall.  Therefore, if there is a traumatic event reported, the physiotherapist  will rule out any potential spinal fracture. They will  do a thorough assessment.  If the   Physiotherapist suspects a potential fracture, we will refer you back to your doctor to get X-rays done.

Fragility Fractures

In people with osteoporosis, fractures can happen with very minor stumbles or movements.  Osteoporosis is a condition where the bones become fragile or brittle from loss of bone.   Fractures associated with osteoporosis are called fragility fractures.  They occur due to the weakness of the bone itself.

If you have Osteoporosis, your bones can be injured with small traumas that would not normally affect the average person.  If you have  back pain and you have had trauma, the Physiotherapist will ask whether you have osteoporosis. This is to rule out potential fragility fractures.

Diagnostic tests for a Fracture

In any incident where there is a suspicion of a fracture, X-rays are necessary.  This will confirm the presence of the fracture, its exact location and severity.  However, in some cases, an X-ray may not be sensitive enough to show the fracture.   In these situations, if a fracture is still suspected, more sensitive tests like a CT, MRI or bone scan may need to be completed.

Fracture Classifications

There are 4 main classifications of fractures:

  • Displaced – the bone snaps into 2 or more parts and moves so that the two ends are not lined up straight.
  • Non-displaced – the bone breaks partly or all the way through, but the ends remain lined up
  • Closed – the bone breaks but there is no puncture wound in the skin
  • Open –the  bone breaks through the skin

Types of Fractures

There are also 7 different types of fractures to describe the specific nature of the break line:

  • Greenstick – incomplete fracture, where the broken bone is not completely separated
  • Transverse – the break is in a straight line across the bone
  • Spiral – the break spirals around the bone, common in a twisting injury
  • Oblique – the break is in a diagonal line across the bone
  • Compression – the bone is crushed, causing the broken bone to be wider or flatter in appearance
  • Comminuted – the break is in three or more pieces
  • Segmental – the same bone is fractured in two places, so there is a ‘floating’ segment of bone

Fracture Treatment

In terms of management of fractures, the treatment depends on the type of fracture.  The fractured ends of the bone must be set in their proper place and held there for the bone to heal properly.  This process is called reduction.

Fracture Repositioning

Most fractures are repositioned without the need for surgery. This  is called closed reduction.  Once the bones are positioned properly, the joint is casted .  The length of casting is usually 6 weeks.  This is how long it typically takes the fractured bones to heal.  There are circumstances where the period of casting may be either shorter or longer. This depends on the nature of the fracture.  If it is an ankle or foot fracture, the doctor may also recommend that you wear an aircast boot to stop your foot from moving.

PhysioNow carries a full supply of these aircast boots if you need one.

Open Reduction (Surgery) after Fracture

Open reduction (surgery)  is done for fractures that are more complicated. The repositioning of the bones wil be done with surgery in this case.   The surgeon will use screws and or plates to keep the bone fragments in proper position. This  allows for proper healing.   Following open reduction, you will have a period of immobilization .  The length of time for a fracture thathas required surgery will depend on the bone that was fractured. It also depends on  the severity of the fracture.  Also, depending on the fracture and the needs of the patient, the hardware may either be left in permanently or taken out with another surgery.  If removal of the hardware is necessary, it will happen once the fractured bone has completely healed.

Spinal and Rib Fractures

There are however some fractures that cannot be effectively immobilized such as spinal and rib fractures.  For these types of fractures, the affected area is protected with avoiding certain activities or postures.

Healing times for Fractures

In terms of healing times, most uncomplicated fractures take approximately 6 weeks for the bones to fuse.  Although medically, the fracture would have healed,  there may still be a lot of limitations. For fractures that are more complicated and required surgery, the healing times may be a little longer due the surgery.

Delayed Healing of Fractures

There are also some people who will heal at a slower rate because of various health conditions or medication use.  So, if you have diabetes, osteoporosis or are a long time user of prednisone, you may fall into this category.  Scaphoid Fractures also may have delayed healing because there is a poor blood supply to the bone.

Registered Physiotherapy after Fractures

Once the fracture itself is healed, there may still be some remaining problems from the injury.  Since the fracture would have been immobilized for several weeks, there will be a significant loss of movement and strength around the broken bone.

It is important to follow up with Physiotherapy for Fracture Rehabilitaton.  This helps to ensure that there can be a safe return to all previous activities.  A Registered Physiotherapist will be able to assess the limitations.  They will prescribe the necessary range of motion and  strengthening exercises and  then you can get back  to  all of your normal activities quickly!

PhysioNow Etobicoke and Mississauga

PhysioNow has highly trained Registered Physiotherapists on staff to help you after a Fracture.  We are open evenings and weekends to help meet your needs.  We also do direct billing to your insurance plan if you have one and if they allow us to do so on your behalf.

Call today to get started on your Fracture Rehabilitation!

Heat therapy

Heat and Cold therapy

How it works

When we apply Heat therapy, it improves circulation and blood flow to  that area due to increased temperature. Heat therapy can relax and soothe muscles and heal damaged tissue.

Heat therapy

Types

  • Dry Heat therapy includes sources like heating pads, dry heating packs, and even saunas. This heat is easy to apply.
  • Moist Heat therapy includes sources like steamed towels, moist heating packs, Theratherm heating pads that take moisture from the air, or hot baths. Moist heat may be slightly more effective as well as require less application time for the same results.

Contraindications

  • diabetes
  • dermatitis
  • vascular diseases
  • deep vein thrombosis
  • multiple sclerosis (MS)

 Heat is useful for relieving:

  • osteoarthritis
  • strains and sprains
  • tendonitis, or chronic irritation and stiffness in the tendons
  • warming up stiff muscles or tissue before activity
  • relieving pain or spasms relating to neck or back injury, including the lower back

Cold therapy

How it works

Cold therapy is also known as cryotherapy. It works by Louis- hunting reaction theory. When we apply Ice to an injured site, it reduces the blood flow by vasoconstriction. After some time, it causes vasodilatation and increases the blood flow to the area. This process goes on continuously. This reduces inflammation and swelling that causes pain, especially around a joint or a tendon. It can temporarily reduce nerve activity, which can also relieve pain.

Types of Cold Therapy

There are a number of different ways to apply cold therapy to an affected area. Treatment options include:

  • ice packs or frozen gel packs
  • coolant sprays
  • ice massage
  • ice baths

Cold treatment can help in cases of:

  • osteoarthritis
  • a recent injury
  • gout
  • strains
  • tendinitis, or irritation in the tendons following activity

Contraindications

  • people with sensory disorders
  • uncontrolled diabetes
  • You should not use cold therapy on stiff muscles or joints.
  • Cold therapy should not be used if you have poor circulation.

Here’s a general guide that helps you to decide which to use heat or ice : https://www.healthline.com/health/chronic-pain/treating-pain-with-heat-and-cold#cold-therapy

In General,  use ice for the first few days after an injury.  Beyond that, heat usually does the trick.  There is some evidence that suggests that using ice beyond the first few days can actually slow down injury healing.  It pushes away the healing agents that help you to get better.

If you have been injured and need advice or treatment, please call PhysioNow today.  We are always happy to help!

Benefits of massage therapy 

Benefits of Massage Therapy

There are many Benefits of massage therapy.  Below you will find some of the injuries that benefit most from massage therapy.

  1. Whiplash Injury

    A common injury from a motor vehicle accident, whiplash is a neck sprain resulting from the sudden forces typical of a car crash.

    Symptoms

    • Neck stiffness
    • Headache
    • Dizziness
    • Paresthesia
    • Shoulder, back or arm pain

    Benefits of massage therapy

    Massage therapy can be used for the treatment of both acute and chronic conditions. RMTs can work with a wide variety of patients, of all ages, in the treatment of illness, injury rehabilitation and disability.

  2. Fibromyalgia

    Fibromyalgia is associated with widespread chronic pain, fatigue, memory problems and mood changes. It occurs more often in women than in men. It is not a disease, but rather a syndrome that can be managed.

    • Benefits of massage therapy
    • The first will be relaxation to improve sleep.
    • The second benefit is improved muscle tonicity
    • A fifth benefit is diminishing the effects of any anxiety or depression
  3. Low Back Pain.

    The low back is susceptible to strain because of its weight-bearing function. Connection in movements, such as twisting and bending can cause Low back pain. Muscle strain is caused when muscle fibers are over-stretched or torn. Inflammation is common at the site of injury.  This is usually accompanied by pain with movement.

    Causes

    • Facet joint disease
    • Osteoarthritis
    • Muscle strain
    • Mechanical pain
    • Degenerative disc disease

    Benefits of massage therapy

    Some benefits of Massage therapy for Low Back Pain include the following:

    • Reduced pain.
    • Improved joint mobility.
    • Improving circulation.
    • Improving lymphatic drainage.
    • Reducing muscular tension.
  4.  

  5. Pregnancy

    Massage Therapy performed during pregnancy can:

    • Reduce anxiety
    • decrease symptoms of depression,
    • relieve muscle aches and joint pains,
    • improve labor outcomes and newborn health.

If you or someone you know could benefit from Massage Therapy,  please call PhysioNow. Our highly experienced Massage Therapists would be happy to help you!