Unlocking Relief: How Physical Therapy Reduces the Need for Injections and Surgery for Neck and Back Pain

/in

Neck and back pain can disrupt daily life, making simple tasks feel insurmountable. Traditionally, many people have turned to injections or surgery for relief. However, physical therapy (PT) remains a leader in non-invasive, cost-effective solution that addresses pain at its root, often reducing or eliminating the need for these more aggressive treatments.

Understanding the Cause of Pain

Neck and back pain can arise from various factors, such as poor posture, muscle imbalances, herniated discs, or degenerative conditions. While injections and surgeries aim to manage symptoms or correct structural issues, they often do not address underlying dysfunctions that cause or perpetuate pain. Physical therapy focuses on improving mobility, strength, and alignment, offering a more holistic and sustainable solution.

How Physical Therapy Works

  1. Pain Reduction and Management

Physical therapists use techniques like manual therapy, soft tissue mobilization, and targeted exercises to reduce inflammation and alleviate pain. Modalities such as heat, ice, ultrasound, and electrical stimulation provide additional relief without the side effects of medications or injections.

  1. Improving Mobility

Many people with neck and back pain struggle with stiffness that limits movement. Physical therapy employs stretching routines, joint mobilizations, and posture training to restore range of motion and flexibility.

  1. Strengthening the Core and Stabilizing Muscles

Weak muscles can exacerbate pain by failing to support the spine adequately. A tailored physical therapy program strengthens the core and other stabilizing muscles, reducing strain on the neck and back.

  1. Education and Prevention

One of the most empowering aspects of PT is learning how to prevent future issues. Therapists teach patients proper posture, body mechanics, and exercises to maintain spinal health long after treatment ends.

Why Choose PT Over Injections or Surgery?

  1. Non-Invasive

Unlike injections or surgery, PT does not require needles, incisions, or downtime. It allows patients to recover naturally and gradually, without the risks associated with invasive procedures.

  1. Long-Term Results

Injections may provide temporary pain relief, but they do not fix the underlying problem. Similarly, while surgery can correct structural issues, it often requires extensive recovery and carries risks like infection or nerve damage. PT focuses on long-term improvement by addressing the root causes of pain.

  1. Cost-Effective

Medical procedures like surgery or a series of injections can be costly, even with insurance. Physical therapy is a more affordable option that delivers lasting benefits.

  1. Customizable to Individual Needs

Physical therapy programs are highly personalized. Whether someone is dealing with a herniated disc, muscle strain, or chronic tension, therapists tailor exercises and treatments to the individual’s condition and goals.

What the Statistics Say

Lower Risk of Surgery

Studies indicate that physical therapy can reduce the likelihood of spinal surgery by up to 50% to 70% when initiated early after the onset of back pain, particularly in cases of conditions like lumbar disc herniation or degenerative disc disease. Early PT interventions focus on pain relief, restoring function, and correcting biomechanics, which can mitigate the need for surgical correction.

Reduced Need for Injections

Physical therapy can decrease the reliance on spinal injections (e.g., epidural steroid injections) by approximately 40% to 60%, according to some research. This is because PT targets the underlying causes of pain—such as muscle weakness or poor posture—rather than temporarily masking symptoms with medication.

Cortisone Injections Vs Physical Therapy In Injury Recovery

/in

Two options that are commonly recommended to treat injuries and chronic joint issues. These are PT and Steroid Injections (Cortisone, etc). 

Cortisone Injections are an anti-inflammatory medication injected directly into the joint or tendon to reduce pain. Physical Therapy provides a patient specific plan including, manual therapy techniques, modalities (moist heat, ice, electrical stimulation), therapeutic exercise, and functional training to minimize discomfort, prevent reinjury, and return to normal activity participation.

PT may be for you!!!

Multiple studies have been completed on commonly injured joints indicating the benefits of PT vs cortisone injections. It is important to note that cortisone injections in these studies did show significant improvement in recovery from pain and can be even more effective in conjunction with PT. However, that does not consider some of the side effects that can come with injections such as increased blood sugar, high blood pressure, and osteoporosis (with long term use).

PT has been shown to provide effective recovery and decreases in pain, during and immediately following a consistent bout of participation, but the benefits don’t stop there!!  Studies have shown that compared to cortisone injections, PT has required less one year returns to the doctor for related issues, and less pain and functional disabilities after a full year following completion compared to cortisone injections.

Not only is PT effective in the present but it’s been shown to be more effective in the long term without the side effects or repeated need for injections in the future. Your body is an investment worth making, and if you have any ailments, PT is a decision worth investing in!

Physical Therapy and Constipation

/in

Physical Therapy and Constipation

 

Did you know physical therapy can help with Constipation?

 

It can! Constipation is defined as infrequent, irregular, or difficult evacuation of bowels. Pelvic floor training, manual therapy and biofeedback can help with your constipation.

 

Exercises that will assist with defecation:

 

  • Deep squat: Stand with hips shoulder width apart and squat down to the ground to help relax the pelvic floor muscles.
  • Pelvic Tilts: Laying on your back, draw your belly button in and flatten your back to the mat/bed. Hold position for 5 seconds.
  • Diaphragmatic breathing
  •  Double knee to Chest – laying on your back bring both knees into your chest and hold for 30 seconds.

 

“ILU” Massage will help stimulate bowel movements. It is performed in circular movements in forms of letters I, L and U,  along the colon and small intestine.

  •  Circular abdominal massage movements are performed in the form of letters I, L, U, and O towards the bowel movements of colon and small intestine.

“Squatty Potty” or a foot step stool, will help with proper positioning on the toilet to encourage bowel movements. When on the toilet, prop up your feet on  a step stool right in front of the toilet.

Of course, drinking the proper amount of water, and proper diet are also essential parts of the puzzle to battling constipation.

 

Orthobiologics and Regenerative Medicine

/in

I recently viewed this course on Medbridge for my continuing education, Orthobiologics and Regenerative Medicine: Rehabilitation Implications. I found it to be beneficial and wanted to share. The instructor is John O’Halloran, PT, DPT, OCS, ATC (retired), CSCS (retired), cert MDT, Certified SCTM-1 Practitioner. 

 

As he stated, 560 million people are affected by osteoarthritis (OA) and the number one leading cause of disability worldwide. He decided to do this course due to the rapid emergence of regenerative medicine to treat OA non-operatively and feels PTs today should be highly informed and provide patients with the best evidence available. 

 

Here is what I took from the course:

 

Platelet-rich plasma (PRP) – blood is drawn, placed in a centrifuge, separate white and red blood cells, left with the platelets. Platelets are the number one factor for healing. 

 

Stem cells – taking from bone marrow or adipose, huge chondral potential to regrow cartilage. 

 

In this course, he presented a Systematic Review and Meta-analysis of PRP clinically compared to other therapies in the Treatment of Knee OA. Comparing PRP to viscosupplementation, cortisone injection, and placebo injection. At 6 months, PRP is as effective, in some studies,  more effective for pain, function, and stiffness. 

 

PRP is used to delay the process of the breakdown of the OA. There is a difference on how it is provided. Landmark-based provider vs. ultrasound guided.

 

Things for the patient to consider when finding their provider: Preparation of the platelets (how many cc’s injected) and how experienced is the provider (sports fellowship trained in ultrasound guided vs. regenerative medicine non-fellowship trained or ultrasound guided trained)

 

Stem cells from adipose tissue from 2022 study for treatment of knee OA. 2 year follow-up on pain and function at 6 months showed overall improvement, and at 24 months, pain and function plateaued. Mild OA patients did better than severe. Bone marrow – 19 studies, bone marrow group was more effective. Helps you go through the stages of healing to put a stop to the bouts of inflammation and buy some time. 

 

Research so far has not shown that the treatment can rebuild damaged joints in patients with prolonged OA or advanced OA.

 

More effective: Stem cells or PRP: Bone Marrow Aspirate Concentrate is equivalent to PRP for the Treatment of Knee OA at 2 years: A Prospective Randomized Trial. Both are equally effective according to clinical trials up to 24 months. PRP costs much less. 

 

Protocol for PRP/Stem Cells: comes down to stages of healing.

Week 1: lie low

Weeks 2-6: light stretching and low level exercises, ROM

After 6 weeks: start stressing the tissues

 

Supplements – Glucosamine and Chondroitin

Limited studies. Things to consider: purity of the product, it is not going to rebuild cartilage or prevent breakdown of articular cartilage, 30% placebo effect. 

 

Viscosupplementation – indication to improve quality of synovial fluid. Systematic Review and Meta-Analysis in British Medical Journal stated that viscosupplementation in the majority is no better than placebo. 

 

Role of Practitioners for treatment of OA: Individualized programs 

  1. Avoid impact loading
  2. Kinetic chain evaluation
  3. Unloading braces
  4. Aquatics
  5. Avoiding processed foods
  6. Dropping weight

 

Lastly, Journal of Orthopedic and Sports Physical Therapy: revealed evidence that pre-hab before TKA, one will have better effects in a positive way after surgery.

 

Sarah Falvey, PT

April is National Move More Month

/in

April is National Move More Month and April 3rd, 2024, is National Walking Day! Join Red Canyon Physical Therapy and the community as we move more this entire month of April.

 

National Move More Month was created by the American Heart Association (AHA) with the aim of improving the health of Americans and those all around us.

 

The American College of Sports Medicine (ACSM) recommends at least 150 minutes of moderate aerobic exercise per week. We know this may sound difficult, but sessions can be broken up into shorter periods of time throughout the week.

Example: walking 30 minutes a day, 5 days a week would reach this goal.

 

Walking is a great way to implement physical activity and achieve the associated health benefits. Walking is simple enough that all ages and fitness levels can participate. Walking requires no special skill, equipment, or gym membership to perform.

 

Research shows that walking can:

  • Help you sleep better
  • Increase energy and endurance
  • Improve blood pressure, blood sugar, and cholesterol levels in the blood
  • Supports health immune system and boosts metabolism
  • Improve overall mental and emotional well-being
  • Improve bone strength and prevent against the risk of osteoporosis
  • Prevent weight gain and maintain a healthy weight
  • Alleviate joint pain
  • Lower your risk of mortality

 

Add walking as a part of your daily routine and feel better. Every step counts so get up and move!

Sources

Physical Therapy for Reducing Fall Risk

/in

Are you or a loved one afraid of falling? Has a doctor ever told you you’re at risk for falls? As we age, our fall risk tends to increase – up to one third of community dwelling people over 65 fall every year. Those under 65 with certain underlying medical conditions can also be at an increased risk of falling. Many people also experience fear and anxiety around the possibility of falling. But there’s good news too – Physical Therapy can help.

How would you know whether someone is at risk of falling? There are many factors which can increase one’s risk for falls, such as:

  • Advanced age
  • Deconditioning and weakness
  • Peripheral neuropathy
  • Neuromuscular conditions such as Parkinson’s disease, Multiple Sclerosis
  • Vestibular system dysfunction, such as Vertigo
  • Cognitive decline

There are 3 systems of balance your body employs. These systems all provide valuable information to your brain to help keep your body upright.

  • Vision
  • Proprioception – senses muscle tension, joint position, and the feeling you get through your feet
  • Vestibular system of your inner ear- senses motion of the head

By challenging each of these 3 systems of balance in a safe environment, Physical Therapy can improve overall balance to reduce fall risk in the community.

Research shows that general physical activity helps to reduce fall risk. A multifaceted exercise program has shown to be most effective, vs. only one type of training (ex – resistance training only). Physical Therapy typically employs several strategies to reduce fall risk.

Interventions for fall prevention may include…

  • Narrow base of support/Single leg training
  • Balance training on uneven surfaces
  • Dynamic balance training
  • Stair and curb training, obstacle navigation
  • Muscle strengthening
  • Functional activity training
  • Gait training
  • Assistive device training (cane, walker)
  • Fall prevention education and assessment of environment
  • Cardiovascular exercise or walking program

In summary, balance training as part of a well-rounded exercise regimen has been proven to reduce fall risk. Your physical therapist will guide you through testing designed to determine your fall risk level. Then, based on that information they will design a customized plan of care to help improve your balance. A home exercise program (HEP) is usually given to help maximize the benefits of therapy. These exercises can be done at home safely with the use of a sturdy countertop, table, or chair. Your therapist will also help educate you about how you can reduce your risk of falling, and help you regain confidence to go through your daily activities with less fear of falling.

Sources:

https://www.physio-pedia.com/Balance_Training?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635278/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518387/

https://www.kansashealthsystem.com/news-room/blog/0001/01/the-balance-system#:~:text=Three%20systems%20in%20the%20body,proprioceptive%20(sensory%20nerves)%20system.

Why A Reverse Shoulder Replacement?

/in

Why did my surgeon recommend a reverse shoulder replacement?

Maybe you’re asking why, and the answer is simpler than you think.

Here are some possible reasons why your surgeon would recommend a reverse shoulder replacement over a normal shoulder replacement.

 

– torn rotator cuff that surgery can’t repair

– You had a previous shoulder replacement procedure that hasn’t resolved your issue(s)

-a complex fracture of the shoulder join

– d have chronic shoulder dislocation

– If you have a tumor of the shoulder joint

 

Your new shoulder pieces will fit together like your natural shoulder, with the ball in the socket. However, their positions are reversed. The metal ball is attached to your shoulder bone. The plastic socket cup goes on your upper arm bone, and shoulder muscles replace the rotator cuff to stabilize the joint.

 

When a surgeon performs a reverse total shoulder surgery, he/she is changing the leverage of your shoulder to allow muscles other than the rotator cuff to perform the actions.

You should have “normal” range of motion. There may be some loss of mobility mostly with internal rotation such as washing your back or putting on a bra behind your back.

 

Strength can be gained with time and Physical therapy but due to no longer using the rotator muscles, strength likely hood would be in the 50-75% range of your previous shoulder strength.

 

So to recap:

Some of the possible limitations for a reverse total shoulder are:

-Lack of reaching behind your back

-Restricting lifting over 25# overhead

 

While positives are:

Pain free motion

ability to bathe and dress

Rehabilitation could take about 4-8 months with Physical therapy and determination

 

Always ask questions when determining if a shoulder replacement is right for you like:

– Are there certain activities that you are currently able to perform that you are unwilling to give up?

– ask if there are specific activities that put you at higher risk of developing a complication such as fracture or dislocation.

– ask if there are specific activities that put you at higher risk of causing premature failure of the replacement?

 

Sources

  • www.umms.org
  • coloradosportsdoctor.com

3 Ideas to Improving Physical Health in 2024

/in

2024 is here and individuals are always trying to make all types of New Year’s resolutions. Make your physical health a priority throughout 2024 by following these three activities highlighted below.

 

Stretching Routine

Make stretching a priority going into 2024. Performing stretches everyday has many effects to improve physical health. Stretching is beneficial to prevent injury, improve flexibility, and improve posture. Finding 5-6 stretches that you can perform throughout your day focusing on muscles you find tighter than others will give you the most benefit. Be sure to hold the stretches for 30-60 seconds and stop if you experience increased pain as you might do more harm than good. One easy way to make stretching a habit is to perform them once in the morning and before you go to bed.

New Sport or Hobby

Finding a new hobby or sport is a great way to stay active throughout 2024.It is important to find an activity that you are interested in and can keep up with. Whether it is pickleball, swimming, running, walking, hiking or other activities they are all great to improve strength, flexibility, and endurance. Finding friends or family and setting goals are great ways to make it fun and  stay engaged.

Strengthening program

A good strengthening program is another way to stay active going into and throughout 2024. Strengthening has many health benefits like improving muscle and bone health and improving ability to perform daily activities. Body weight exercises and using items like a gallon jug or can of corn are great ways to start a strengthening program without breaking the bank on a gym membership or equipment. Finding a routine of 3-4 days a week with rest days in between will be important to see good benefits. Setting goals to progress weight, sets, and reps with exercises when they are easy will allow you to continue to improve strength over time.

Home Office Workstations: Are Standing Desks the Bees Knees or Bad Business?

/in

Since COVID, many employees have chosen to work from home, leaving the cubical lifestyle in the past. This change has led to an increase in postural-related aches and pains due to poor home office ergonomics.

Physical therapy is a great way to manage these new physiological challenges in the workplace. One question physical therapists are often asked is, “What is the best home office set-up?”

Recently, sit-to-stand desks have been perceived as a great solution to posture-related pain due to the sedentary work environment. So the question is, “Are sit-to-stand desks really worth it?” The answer is not as easy as yes or no.

Standing desks have become increasingly common in office settings as the conversation about the health impacts of prolonged periods of sitting has ramped up. Studies have found that sitting for long periods can lead to higher mortality rates, obesity, postural abnormalities, and complications with circulation, regardless of personal physical activity level.

What we do know is in 2011, the Centers for Disease Control and Prevention (CDC) reported that standing desks reduced upper back and neck pain and improved overall mood vs sitting down. However, there is minimal research looking into the possible long-term risks of using a standing desk vs sitting for a workstation setup.

Whether you are sitting or standing, ask yourself: is my workstation set up correctly for my body?

You may be surprised to learn that it’s just as easy to increase your risk of musculoskeletal disorders (MSDs) while standing as it is while sitting if you’re not following proper ergonomic guidelines.

Reviewing the most common mistakes, physical therapists often must aid in simple adjustments to minimize musculoskeletal risk of injury or overloading. One such adjustment is addressing monitor height. The correct monitor height to reduce strain on the head and neck is to have the top of the monitor at the top of the forehead. This is important as you change from sitting to standing.

Additionally, one must provide support for your upper extremities (UEs) when standing or sitting to minimize the strain on the shoulder complex and cervical structures. No chair means no armrests. This can add to UE strain and poor posture over time. Proper mouse and keyboard height/alignment can also be overlooked when standing. Reaching outside of the recommended zone for extended periods can increase the risk of injury and increase your chances of pain and other negative side effects.

Now, reading all of this, you may assume the answer to the question is unequivocally “No, a standing desk is not better than a sitting desk.”

Well, you would be incorrect. It is recommended that anyone who sits longer than four hours a day should opt for a transitional desk to allow for intermittent change in position. However, this means when transitioning, you must follow correct guidelines for proper use.

 

Proper Guidelines for Standing Desk Setup

  • Back and neck straight, elbow around 90º
  • Wrist in a neutral position
  • Standing mat to reduce overall fatigue
  • a potentially a footrest to allow alternating offloading

Additionally, it is recommended that no position should be held for longer than 30-45 minutes at a time. Change is good for your body! Movement is even better, so as you take intermittent breaks, go for a little walk around your home, or even ger outside for some fresh air!

Maximizing your workstation setup will promote proper ergonomics and give you the best opportunity to work in a pain-free environment. Hopefully, this will give you an optimal environment to which you are excited to come back to every work day!

 

Maria Caccamise DPT, PT

Clinical Director

Knee Pain

/in

Knee Pain Unveiled: Exploring the Root Causes

 

Knee pain can be a perplexing and persistent problem for many individuals. It’s a common issue, but what you might not know is that the source of knee pain can often be found outside the knee joint itself. Knee pain is not always a straightforward matter. It can originate from various factors that extend beyond the knee joint. To help you understand this complexity, we’ll dive into these factors and their connection to knee pain.

 

  1. Biomechanical Issues: Your knee is part of a larger kinetic chain that includes your hips and ankles. Problems in these neighboring joints, such as hip instability or ankle mobility deficits and misalignment, can lead to altered gait patterns and increased stress on the knee.

 

  1. Muscle Imbalances: The muscles around your knee play a crucial role in stability and function. Imbalances in strength or flexibility, particularly in the quadriceps, hamstrings, and calf muscles, can cause knee pain.

 

  1. Overuse and Repetitive Stress: Activities like running, jumping, or squatting can strain the knee joint over time. The source of this overuse isn’t necessarily the knee itself – it could be related to improper technique or muscle imbalances elsewhere.

 

  1. Nerve Compression or Irritation: Nerve issues in the lower back or thigh regions can lead to radiating knee pain. Conditions like herniated discs or sciatic symptoms may be the real culprits behind your knee pain.

 

  1. Inflammatory and Systemic Conditions: Conditions such as rheumatoid arthritis, osteoarthritis, or gout can cause inflammation in multiple joints, including the knee.

 

  1. Referred Pain: Pain can be referred from one area to another. Hip or lower back problems may send pain signals to your knee, making it seem like the knee is the primary source.

 

  1. Environmental Factors: Factors like prolonged sitting, poor ergonomics, and inappropriate footwear can contribute to knee discomfort. These environmental issues need consideration in your treatment plan.

 

Treatment plans for knee pain can vary depending on the underlying causes, severity of the pain, and individual patient needs. A well-rounded approach to treatment often combines multiple strategies to address the specific factors contributing to knee pain. Here are some examples of treatment components that may be included in a comprehensive knee pain treatment plan:

 

  1. Therapeutic Exercises: Physical therapy is a cornerstone of knee pain treatment. Therapists design exercise programs to improve muscle strength, flexibility, and joint stability. Specific exercises may target the quadriceps, hamstrings, calf muscles, and hip muscles to minimize deficits to support the knee joint.

 

  1. Manual Therapy: Hands-on techniques performed by physical therapists and assistants, such as joint mobilization and soft tissue manipulation, can help improve joint mobility and reduce pain.

 

  1. Biomechanical Assessments: Evaluating the patient’s gait and movement patterns can reveal any issues with posture, alignment, or movement that may contribute to knee pain. Custom orthotics or shoe recommendations may be provided to address these problems.

 

4.Pain Management: In some cases, pain management techniques may be necessary, such as the use of non-steroidal anti-inflammatory drugs (NSAIDs) or prescription medications to alleviate pain and reduce inflammation.

 

  1. Bracing or Taping: Depending on the nature of the knee pain, bracing or taping may be recommended to provide support, stability, and pain relief during physical activity.

 

  1. 6. Modalities: Physical therapists may use modalities like electrical stimulation, and/or hot/cold therapy to temporarily manage pain and inflammation.

 

  1. Education: Patients are educated in proper body mechanics, ergonomics, and activity modification to prevent further knee injury. This can include advice on posture, footwear, and exercise technique.

 

  1. Activity Modification: Patients may be advised to modify or temporarily avoid certain activities that exacerbate their knee pain.

 

  1. Home Exercise Programs: Physical therapists often provide patients with home exercise programs to continue their rehabilitation and maintain progress outside of clinic visits.

 

  1. Follow-up and Progress Monitoring: Regular follow-up appointments and progress assessments are crucial to adjusting the treatment plan as needed and ensuring the patient is achieving their goals.

 

Treatment plans are highly individualized, and the specific components and duration of treatment will vary based on the patient’s diagnosis and response to therapy. A collaborative approach involving the patient, physical therapist, and, if necessary, other healthcare professionals, is key to achieving the best outcomes in managing knee pain. Call Red Canyon Physical Therapy today to schedule your initial evaluation today!