Tag Archives: physiotherapy

Carpal Tunnel Syndrome, Hand Pain Treatment

Carpal Tunnel Syndrome: Physio 101

December 4,2023 Erin Mills Physiotherapy Leave a comment

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a common neurological disorder. It occurs when the median nerve, which runs from your forearm into the palm of the hand, becomes compressed or squeezed at the wrist.

Importantly, the median nerve provides feeling to the thumb, index, and middle finger, and part of the ring finger (but not the little finger). Also, it controls some small muscles at the base of the thumb. Sometimes, thickening from the lining of irritated tendons or other swelling narrows the tunnel and compresses the median nerve. For example, a common sign is that you might wake up and feel you need to “shake out” your hand or wrist.

What are the symptoms of carpal tunnel syndrome?

Usually, carpal tunnel syndrome symptoms start gradually and includes:

Tingling or numbness – You may notice tingling and numbness in the fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not the little finger. You might feel a
sensation like an electric shock in these fingers. The sensation may travel from the wrist up the arm. The numb feeling may become constant over time.
Symptoms often occur while holding a steering wheel, phone or newspaper, or may wake you from sleep.
Feeling the need to “shake out” their hands to try to relieve their symptoms.
Weakness – You may experience weakness in the hand and are more likely to drop objects.

What is the cause of carpal tunnel syndrome?

Anterior view of wrist comparing a healthy carpal tunnel with a compressed median nerve in the carpal tunnel
SOURCE: ortho_carp-tun-rel-endo_anat.ai

As a reminder, carpal tunnel syndrome is caused by pressure on the median nerve. Firstly, the median nerve runs from the forearm through a passageway in the wrist (carpal tunnel) up to the hand. Consequently, anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. For example, a wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation caused by conditions like rheumatoid arthritis.

What are the risk factors?

Trauma or injury to the wrist that causes swelling, such as a sprain or fracture
Imbalance of either the pituitary gland or the thyroid gland
Rheumatoid arthritis or other arthritic diseases
Mechanical problems in the wrist joint
Repetitive use of tools or wrist movements
Fluid retention during pregnancy or menopause
Development of a cyst or tumor in the canal
Sex—women are three times more likely than men to develop CTS
Diabetes or other metabolic disorders – can directly affect the nerves and make them more susceptible to compression
Sleeping positions ex. with a bent wrist
Increasing age—CTS usually occurs only in adults.

How is it diagnosed?

This condition can be diagnosed by:

Physical exam
Routine laboratory tests
X-rays
Specific wrist tests may produce the symptoms of CTS ex. Phalen’s test
Electrodiagnostic tests such as nerve conduction study and
electromyography
Diagnostic imaging such as ultrasound imaging and magnetic resonance imaging (MRI).

Phalen’s Test for carpal tunnel syndrome

How is carpal tunnel syndrome treated?

Splinting – Initial treatment is usually a splint worn at night

An example of a night time splint for carpal tunnel syndrome, from https://www.orthomed.ca/

Activity modification – Avoiding daytime activities that may provoke symptoms, take frequent breaks from tasks to rest the hand
Medication – In special circumstances, various medications can ease the pain and swelling associated with carpal tunnel syndrome. For example, nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, may provide some short-term relief from discomfort. However, they haven’t been shown to fully treat CTS
Exercise – Ask a physiotherapist at PhysioNow about hand exercises that might help with pain and improve grip strength among those with CTS. Alternatively, therapies such as acupuncture and chiropractic care have benefited some people with CTS. However, their overall effectiveness remains controversial in the research
Vocational or occupational therapy – You may need to learn new ways to perform certain tasks or job skills so as not to aggravate or worsen your CTS

Our team of qualified physiotherapists at PhysioNow will help and guide you through the treatment and exercises that will help you reduce pain and improve your quality of life. Book your first appointment with PhysioNow today!

Falls Prevention, General Category, Pelvic Health, Physiotherapy, TMJ Syndrome, Vestibular Rehabilitation

Physiotherapy: Did You Know It Can Help With These Conditions?

November 7,2023 Erin Mills Physiotherapy Leave a comment

When most people think about physiotherapy, they usually think about getting treated for a muscle pain, or other strain or sprain. However, the benefits of physiotherapy extend beyond just the musculoskeletal tissues of the body. In this blog post, we discuss through some of the lesser known conditions or symptoms that can improve with physiotherapy

Pelvic health physiotherapy for pelvic pain or dysfunction

Firstly, pelvic health physiotherapy may be right for you if you experience pain or dysfunction in the pelvic area. This may include but is not limited to pain during intercourse, and pain or abnormal control over urination and bowel movements (urgency, incontinence, retention) and prenatal and post-natal care. Both men and women may benefit from pelvic health physiotherapy.

Cancer rehabilitation

Secondly, physiotherapy can help manage the many side effects of cancer treatment after surgery, radiation, and chemotherapy. Addressing these side effects can help you increase the quality of your life and get you back into your normal routine. Physiotherapy can help you with scar management, weakness, loss of range of motion, fatigue, pain, swelling, and nerve disorders after cancer treatment.

TMJ/jaw pain

Additionally, the temporomandibular joint (TMJ) can be a source of pain and dysfunction in individuals. Many people clench or grind their teeth without conscious thought. You may experience clicking, locking and tightness through the jaw. While most people think of the dentist when they have pain around their mouth, physiotherapists are experts in treating the TMJ. The TMJ is just like any other joint in the body. Treatment may include manual therapy, relaxation and posture exercises, correcting the jaw movements and more.

Vestibular physiotherapy for dizziness and vertigo

Image by cookie_studio on Freepik

Dizziness and vertigo are often symptoms that arise when there is a problem in the vestibular system of our body. Our vestibular system is in the inner ear system and is responsible for coordinating balance, head and eye movements. Vestibular rehabilitation is mostly performed by physiotherapists and a comprehensive assessment will be done to determine the correct treatment plan for your specific vestibular disorder. Treatment may include repositioning maneuvers, eye and head exercises, and exercises to retrain balance and decrease motion sensitivity

Fall prevention

If you have had a previous fall or are concerned about your balance, then physiotherapy can help you. Your physiotherapist will work with you to determine where your risk is coming from, whether it’s dizziness, weakness, or something else. They will give you advice on how to set up your environment to minimize your risk of falling and may prescribe you a walking aid like a cane or walker. They will also give you a home exercise program to work on your balance and strengthen your muscles.

Osteoporosis

Osteoporosis is characterized by low bone mass, leading to an increase in bone fragility and risk of fractures. This can be scary and discourage people from their normal activities and exercises out of fear. However, with supervision from a professional like a physiotherapist, exercise therapy is one of the best treatments to minimize bone loss and restore strength. Your physiotherapist will show you how to safely perform exercises in the clinic, and give you a home exercise program to ensure that you are still able to live the life you want.

If any of these above symptoms or conditions match what you’re feeling, find us at PhysioNow. We have many expert physiotherapists who would love to help you out. Book with PhysioNow today for your first assessment and treatment!

Bursitis, Hip Pain, Physiotherapy

Understanding Hip Bursitis: Physio 101

October 16,2023 Erin Mills Physiotherapy Leave a comment

Hip bursitis is a common yet painful condition that affects many individuals. This condition often leads to discomfort, limited mobility, and decreased quality of life. Fortunately, physiotherapy can be an effective approach to alleviate pain, improve mobility, and enhance strength. In this blog, we will explore what hip bursitis is, its symptoms, and how physiotherapy can help in managing and treating this condition.

Understanding Hip Bursitis

Hip bursitis is the inflammation of one or more bursae in the hip joint. Bursae are small, fluid-filled sacs that cushion and reduce friction between bones, tendons, and muscles around joints. In the hip, two bursae commonly become inflamed: the trochanteric bursa on the outside of the hip and the iliopsoas bursa on the inside.

Diagram showing greater trochanteric bursitis

Causes of Hip Bursitis

Repetitive Overuse: Firstly, continuous activities that involve repetitive hip movements, such as running, cycling, or climbing stairs, can lead to bursitis.
Trauma or Injury: Additionally, a fall or direct impact on the hip can cause inflammation of the bursae.
Muscle Imbalances: Similarly, weak or tight hip muscles can disrupt the biomechanics of the hip joint, increasing the risk of bursitis.
Certain Medical Conditions: Unfortunately, conditions like rheumatoid arthritis or gout can contribute to bursitis.
Bone Spurs: Also, abnormal bone growth around the hip joint can irritate the bursae and trigger inflammation.

Symptoms of Hip Bursitis

The symptoms can be quite distressing and may include:

Pain on the outside of the hip, which can radiate down the thigh.
Pain that worsens with activities such as walking, climbing stairs, or standing for prolonged periods.
Swelling and tenderness over the affected bursa.
Reduced range of motion and stiffness in the hip joint.
Discomfort while lying on the affected hip.

How Physiotherapy Can Help:

Physiotherapy plays a crucial role in managing and treating hip bursitis. Here are some ways in which it can help:

Pain Relief: Physiotherapists use hands-on techniques to reduce pain and inflammation in the hip joint. Additionally, they use modalities like heat, ice, laser therapy to alleviate pain and promote healing.
Exercise Prescription: Specific stretches can improve hip flexibility and reduce muscle tightness. Similarly, targeted exercises enhance the strength of the hip muscles, helping to stabilize the joint. Finally, exercises that improve balance can reduce the risk of falls and further injury.
Gait Training: Physiotherapists can analyze your walking pattern and provide guidance to reduce stress on the affected hip.
Education and Lifestyle Modification: Educating patients about proper body mechanics and ergonomics can prevent further aggravation of the condition. Also, recommendations for activity modification may be provided to reduce strain on the hip.
Assistive Devices: Depending on your condition, a physiotherapist might recommend assistive devices such as crutches or braces to aid mobility.

What can I do about my hip pain?

Hip bursitis can be a painful and debilitating condition, but with the right approach, you can manage and alleviate its symptoms. Physiotherapy offers a holistic solution by addressing pain, mobility issues, and muscle imbalances. If you suspect you have this condition or are experiencing hip pain, consult a physiotherapist for a personalized treatment plan to help you regain your mobility and improve your quality of life. Remember, early intervention and a dedicated physiotherapy program can make a significant difference in your recovery journey.

acupuncture, Dry Needling, Physiotherapy

Trigger Point Dry Needling: A Physiotherapy Tool

October 2,2023 Erin Mills Physiotherapy Leave a comment

Image by wavebreakmedia_micro on Freepik

Trigger Point Dry Needling (TDN) is a therapeutic technique that has gained popularity for its potential to relieve muscle pain and discomfort. Often compared to acupuncture, dry needling is a distinct approach to addressing muscle knots and trigger points in the body. In this blog, we’ll explore what trigger point dry needling is, how it differs from acupuncture, how it works, its potential pain level, and what to expect during and after the treatment.

What Is Trigger Point Dry Needling?

TDN is a therapeutic procedure that involves the insertion of fine, sterile needles into specific points in the muscles known as trigger points. Trigger points are tight knots of muscle fibers that can cause pain, limited range of motion, and discomfort. Consequently, this technique aims to release these knots, providing relief to the patient.

How Is Trigger Point Dry Needling Different from Acupuncture?

While both TDN and acupuncture involve the use of needles, they are fundamentally different in terms of their principles, goals, and techniques.

1. Theory and Philosophy

Firstly, acupuncture is a traditional Chinese medicine practice. It based on the belief that the body has a network of energy channels, or meridians. Thus, the needles are used to balance the flow of energy (qi) within these channels.

On the other hand, TDN is rooted in Western medicine. Specifically, it targets muscle knots or trigger points believed to cause pain, muscle dysfunction, and other symptoms.

2. Needle Placement

Primarily, Acupuncture needles are often inserted along the meridians, which may be quite distant from the pain site.

On the contrary, TDN needles are inserted directly into the trigger points or tight muscle bands responsible for pain or discomfort.

3. Goals:

Overall, acupuncture aims to address a wide range of health issues, not just musculoskeletal problems.

Conversely, TDN primarily focuses on musculoskeletal issues, targeting trigger points and relieving muscle tension.

How Does it Work?

Image by tonodiaz on Freepik

TDN works through several mechanisms:

1. Stimulation and Relaxation: Essentially, the insertion of needles into trigger points stimulates the muscle fibers, causing them to twitch and relax. This helps reduce muscle tension and improve blood flow.

2. Pain Reduction: Additionally, this technique can trigger the release of endorphins, the body’s natural painkillers. Consequently, this may provide immediate pain relief.

3. Improved Range of Motion: Furthermore, by releasing tight muscle knots, TDN can enhance joint flexibility and range of motion. As a result, it is a valuable therapy for athletes and those with mobility issues.

Is it Painful?

The level of discomfort experienced during TDN can vary from person to person. Some individuals may feel minimal discomfort, while others may experience a temporary, sharp sensation when the needle is inserted into a trigger point. However, this discomfort is typically short-lived and subsides once the muscle relaxes. It’s important to communicate your comfort level with your therapist during the treatment to ensure adjustments can be made if necessary.

What to Expect During and After Treatment

During the Treatment:

Initially, you will be asked to lie down, and the therapist will locate the trigger points through physical examination
Next, sterile needles will be inserted into these points, and you may feel a mild discomfort or twitching sensation
The therapist may gently manipulate the needles to stimulate the trigger points
Overall, he entire session can last from a few minutes to around 30 minutes, depending on the number of trigger points being treated

After the Treatment:

Some people experience immediate relief from pain and improved mobility
You may also experience temporary soreness or bruising at the needle insertion sites. Usually, it resolves within a day or two
Later, i’s recommended to stay hydrated, rest, and avoid strenuous activities on the day of treatment to allow your body to recover

In conclusion, Trigger Point Dry Needling is a Western-based therapeutic technique that focuses on addressing musculoskeletal issues by targeting trigger points in the muscles. While it involves the use of needles like acupuncture, the two practices differ significantly in their philosophies and goals. TDN can be an effective way to alleviate muscle pain and improve mobility, with the level of discomfort during treatment varying from person to person. If you’re considering TDN, consult with a qualified physiotherapist to discuss your specific needs and expectations.

Manual Therapy, Physiotherapy

IASTM: A Physiotherapy Tool

September 26,2023 Erin Mills Physiotherapy Leave a comment

IASTM, or Instrument-Assisted Soft Tissue Mobilization, is a manual therapy technique used by physical therapists, chiropractors, and other healthcare professionals. It is used to diagnose and treat various musculoskeletal conditions. In this blog, we’ll explore what IASTM is, how it works, and the conditions in which it can be beneficial.

What is IASTM?

The hawk tool is a type of IASTM instrument that we frequently use at PhysioNow

IASTM involves the use of specially designed instruments, like above, often made of stainless steel or plastic, to assess and treat soft tissue abnormalities. These instruments have various shapes and edges that allow the practitioner to detect and treat adhesions, fascial restrictions, and other soft tissue abnormalities. Additionally, IASTM practices have been further refined into methodologies to be followed by clinicians, an example of which is called the Graston Technique.

How does it work?

The process typically involves the following steps:

1. Assessment: Firstly, the practitioner assesses the patient’s musculoskeletal condition. For example, they use the instruments to scan the skin and underlying tissues and identify areas of restricted mobility or dysfunction.

2. Treatment: Secondly, once problem areas are identified, the practitioner applies controlled pressure with the instrument over these areas. As a result of this pressure, it helps to break down adhesions and fascial restrictions, promoting better tissue function and blood flow.

3. Stretching and Range of Motion: Next, after treating the affected areas, the practitioner may incorporate stretching and range of motion exercises to further improve mobility and flexibility.

4. Reassessment: Finally, the practitioner reassesses the patient to determine the effectiveness of the treatment and to make any necessary adjustments to the treatment plan.

Conditions IASTM Can Help With:

IASTM can be beneficial for a wide range of musculoskeletal conditions and injuries, including:

1. Soft Tissue Injuries: Firstly, it is effective in treating conditions like muscle strains, ligament sprains, and tendonitis. It breaks down fascial adhesions and promotes tissue healing.

2. Chronic Pain: Secondly, patients with chronic pain conditions such as fibromyalgia or myofascial pain syndrome. Patients may find relief through IASTM treatments that target trigger points and muscle tightness.

3. Post-Surgical Rehabilitation: Thirdly, this technique can be incorporated into post-surgical rehabilitation programs. It will improve tissue healing, reduce pain, and enhance mobility.

4. Sports Injuries: Additionally, athletes often use this technique to address sports-related injuries like shin splints, tennis elbow, or rotator cuff injuries. Incorporation of this technique can expedite recovery and reduce pain.

5. Joint Dysfunction: Alternatively, this technique can also be used to address joint dysfunction by improving the mobility of surrounding soft tissues. Furthermore, this improvement can positively contribute to joint stability and function.

6. Neck, Hip and Back Pain: In addition, individuals suffering from chronic neck, hip or back pain may benefit from IASTM treatments to alleviate muscle tightness and improve posture.

How can I receive IASTM?

Overall, it’s important to note that IASTM should be administered by trained healthcare professionals who are knowledgeable about the technique. The intensity and duration of treatment can vary depending on the specific condition and the patient’s individual needs.

In conclusion, IASTM is a valuable manual therapy technique used to diagnose and treat various musculoskeletal conditions. It addresses soft tissue abnormalities by breaking down fascial restrictions, improving blood flow, and enhancing tissue mobility. Thus, it makes it a versatile and effective approach for many individuals seeking relief from musculoskeletal pain and dysfunction.

If you’re considering IASTM as a treatment option, consult with a qualified healthcare provider like a physiotherapist to determine if it’s appropriate for your specific condition. Book with PhysioNow today for your first assessment and treatment with a Registered Physiotherapist!