Tag Archives: physiotherapy

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.

TMJ syndrome

TMJ syndrome

TMJ syndrome is broadly classified into 2 syndromes.
The temporo- mandibular joint (TMJ) is the synovial joint that connects the jaw to the skull. These joints are located just in front of each ear.

TMJ syndrome

Classification of TMJ syndrome

TMD is broadly classified into 2 syndromes:
• Muscle-related TMD (myogenous TMD), sometimes called TMD secondary to myofascial pain and dysfunction
• Joint-related TMD, or TMD secondary to true articular disease

Causes of TMJ syndrome

• trauma
• disease,
• wear and tear due to aging
• oral habits, such as chewing gum, tobacco, candy or ice

  • grinding your teeth or clenching your jaw

 

Signs and Symptoms of TMJ syndrome

• Pain in the jaw
• Clicking and popping sound in the ear
• Pain while chewing the food
• Stiff and sore jaw muscles
• headaches

Treatment for TMJ syndrome

general

  • • including heat to the joint,
    • nonsteroidal anti-inflammatory drugs (NSAIDs)
    • avoiding chewing gum, candy, ice, or tobacco
    • stress reduction.

    • wear a mouth guard at night
    • avoid activities that require you to keep your mouth open such as fellatio
    • avoid eating food that is hard to chew such as steak

If you are interested in knowing a bit more about this syndrome, check out this link .

 

Physical therapy techniques for TMJ syndrome may include:

• Jaw exercises to strengthen muscles and improve flexibility and range of motion.
• Heat therapy to improve blood circulation in the jaw.
• Ice therapy to reduce swelling and relieve pain.
• Massage to relieve overall muscle tension.
• Transcutaneous electrical nerve stimulation (TENS),
• Movement of the temporomandibular (TM) joint to release scar tissue that restricts muscle movement and to improve range of motion.
• Ultrasound therapy- to reduce pain and swelling and improve circulation.

If you have any further queries please call PhysioNow. Our experienced Registered Physiotherapists would be happy to help you recover from TMJ syndrome.  There are Registered Physiotherapists at each of our locations that are trained specifically to assess and treat this injury.  Assessment takes about 40-50 minutes and each treatment typically takes about 30-40 mins.  Resolution of TMJ syndrome can be quite rapid with some patients only requiring a few visits for the pain the stop.

Call today!

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!

Labyrinthitis

Labyrinthitis is an inner ear disorder. The two vestibular nerves in your inner ear send your brain information about your spatial navigation and balance control. When one of these nerves becomes inflamed, it creates a condition known as labyrinthitis.

Labyrinthitis
Symptoms:

  • dizziness
  • vertigo
  • loss of balance
  • nausea and vomiting
  • tinnitus, which is characterized by a ringing or buzzing in your ear
  • loss of hearing in the high-frequency range in one ear
  • difficulty focusing your eyes

Causes

  • respiratory illnesses, such as bronchitis
  • viral infections of the inner ear
  • stomach viruses
  • herpes viruses
  • bacterial infections, including bacterial middle ear infections
  • infectious organisms, such as the organism that causes Lyme disease

If you would like to learn more about Labyrinthitis, please check out this link.

Diagnosis
Tests to check for the condition may include:

  • hearing tests
  • blood tests
  • a CT or MRI scan of your head to record images of your cranial structures
  • electroencephalogram (EEG), which is a brain wave test
  • electronystagmography (ENG), which is an eye movement test

Treatment

Most of the time, labyrinthitis and vestibular neuritis go away on their own. This normally takes several weeks. If the cause is a bacterial infection, your doctor will give you antibiotics. But most cases are caused by viral infections, which can’t be cured with antibiotics. In those situations, your doctor may prescribe steroid medicines, which may help you get better sooner.

  • Avoid television, computer screens, and bright or flashing lights during a vertigo attack.
  • If vertigo occurs while you’re in bed, try sitting up in a chair and keeping your head still.

Low lighting is better for your symptoms than darkness or bright lights.

If your vertigo continues for a long time, physical therapists can teach you exercises to help improve your symptoms

If you have any further queries please call PhysioNow. Our experienced physiotherapists would be happy to clear your doubts.

Concussion

Concussion

The topic of concussion has been in the media quite frequently in the last several years. Top athletes, like Sidney Crosby, have definitely put concussion in the spotlight.

Crosby was unable to return to his game for almost a whole year because of persistent symptoms related to concussion. Furthermore, research has shown that 96% of deceased ex-NFL players have a form of brain damage called Chronic Traumatic Encephelaphathy (CTE), which may be related to repeated head traumas like concussions.

Safety Of Athletes Involved In Contact Sports

Concussion

This calls into question the safety of athletes involved in contact sports. In contact sports, there seems to be a higher incidence of these injuries.

However, concussions do not just happen to the famous pro-athlete. They can happen to athletes playing at any level or any age. They can do more than take away playing time.

Rowan Stringer, a high school rugby player, sadly made headlines in the media in 2013 after she lost her life to Second Impact Syndrome (SIS). This occurs when multiple concussions occur in rapid succession. SIS specifically affects the peadiatric and adolescent populations.

Concussions can also happen to anyone who is involved in an accident involving some form of head trauma. This includes falls and motor vehicle accidents. It is important to understand, that concussion is a serious injury.

If not managed appropriately, it can lead to persistent symptoms. Concussion can prevent you from returning to your beloved sport and/or regular life activities including work and family.

What Exactly Is Concussion?

So, what exactly is concussion and why does it have such a major impact? The changes that happen with concussion happen at a deep cellular level of the brain.

The injury starts with some form of trauma to the head, which creates stretching of the cells in the brain. These changes are microscopic and most often not picked up on imaging exams. As a result, concussion is often labelled as an invisible injury process.

Symptoms of Concussion

These chemical processes produce symptoms such as headache, nausea, dizziness and fogginess that are classic to concussion injuries.

Another major hallmark symptom of concussion is fatigue. This feeling of persistent tiredness is due to the energy crisis in the brain that results from the initial cellular stretching. These symptoms can wreak havoc on a person’s life and take them out of their sport or work.

How long do Concussion symptoms last?

Although the chemical reactions from the initial trauma take about 7 to 10 days to stabilize, the symptoms that are experienced by the patient can last for several weeks and months or even years. The lasting symptoms happen as a result of the changes that have been made to the different processing systems of the brain.

These changes produce an inability to make sense of either the visual or vestibular information in our environment. This overwhelms the brain and further aggravates the symptoms. It is vitally important, that appropriate management strategies have to be in place to treat these symptoms in an effective and timely manner so that an individual can return to their life.

How Do You Treat Concussion?

So how do you treat concussion if it is an invisible injury? The mechanism may be invisible but the symptoms are definitely not. Therefore, it is important to do a thorough assessment. This helps to understand what the exact symptoms are and which brain systems are at fault.

imPACT Testing

During the initial assessment, the patient will most likely be starting the appointment with a computerized test called imPACT, which is a heavily researched and validated neurocognitive test. This test looks at a variety of categories including verbal memory, visual memory, speed and reaction time. At completion it provides important information on a patient’s performance.

The test can be repeated over time and it can be used to check if there has been any meaningful change in performance. Once the imPACT test is completed, the patient will be assessed by the physiotherapist.

The Physiotherapist will go through a detailed history of the injury and symptoms to get an understanding of what the patient is going through and which brain systems are affected. The Physiotherapist will then go through a series of physical tests that test the visual and vestibular systems.

The therapist will be looking at how the patient is performing on the test and what symptoms are produced with the tests. If there are any other injuries present, such as neck pain, the physiotherapist will assess these issues as well.

Concussion Treatment

With the information gained from the assessment, the therapist will start providing the appropriate treatment to start reducing the symptoms of concussion. The treatment provided will vary from person to person because each case of concussion is unique.

Therefore, there cannot be a cookie-cutter approach to treating this complex injury. A large component of the initial treatment plan will involve education to rest and reset the brain and modify work/home/sport activities to allow for appropriate healing.

FOLLOW UP VISITS

On follow up visits, the therapist will prescribe specific exercises to start healing the affected systems in the brain. These exercises are important to be continued at home. Consistent and regular practice of these exercises will ensure improvement in the symptoms. It is important to understand that these exercises will produce some of the symptoms of concussion but they are meant to do so.

It is in this manner, that the visual and/or vestibular systems are retrained. Once the exercises are mastered at one level, the physiotherapist will continue to progress them to be more and more challenging until the patient is able to perform them without any symptoms. It is through these progressions that the therapist will be able to help the patient return to work and/or play and just life in general.

SUMMARY

Concussion symptoms can be very debilitating and can go on for a long time. It is important to seek out a qualified Physiotherapist trained in concussion management as soon as possible so that these symptoms are not affecting a person’s quality of life and taking them away from the things that they love.

At PhysioNow, we have highly trained Registered Physiotherapists ready to assess and treat Concussions.  Call today to get started on your recovery!