diabetesjain.com 

                Physiotherapy modern

Home
Patient Education
Organization
Consultations
Diabetes
Hypertension
Lipid disorder
Thyroid
Arthritis
Fever
Weight Reduction
Asthma over view
Jaundice Hepatitis A
Sleep disorders
Cardiac markers
CT MRI Xray
Discounts Lab tests
Free camps
For Patients
For Doctors
Pharma companies
For students
For schools
Life Insurance
Alerts
Visitor page
Donate
About us
Disclaimer
Feed back

[Up] [Anatomy joints] [Types of arthritis] [Spondylosis] [Investigations] [Management  arthritis] [Physiotherapy modern] [Joint strengthening] [Exercises 1] [Exercises 2] [Newer medicines] [Questions answered]

Physiotherapy  modern approach

                                                      

 

 

 What is physiotherapy?

bullet

Physiotherapy, also called physical therapy, is the treatment of disorders with physical agents and methods.

bullet

Some types are: massage, moving muscles and bones, exercises, cold, heat, and light therapy. 

bullet

They are done to assist in treating patients and in bringing back normal function after an illness or injury.

 

 

Short wave diathermy equipment

 

 

 What is Short wave diathermy?

bullet

Short wave diathermy is the production of heat in body tissues by short waves, generated by Short wave diathermy equipment, to treat certain disorders. This heat results from high-frequency electric currents.

bullet

The currents are not intense enough to destroy tissues or to damage function. 

bullet

Diathermy is used to treat arthritis, bursitis, fractures, gynecological diseases, and swelling of the sinuses (sinusitis).

bullet

The penetration of short waves is up to bony structures ,unlike superficial heat applied by conventional hot water fomentation. It helps in the following ways.

 

 Benefits of Short wave diathermy.

bullet

Reduces pain rapidly .

bullet

Decreases inflammation and swelling in joints and surrounding tissues, including muscles.

bullet

Relieves spasm of surrounding structures ,especially of muscles, thereby relieving distress associated with arthritis.

bullet

Increases circulation to joint structures thereby providing better oxygenation, nutrition; removing toxins and pain causing chemical mediators; alleviating swelling and inflammation.

bullet

Improves secretion and circulation of joint fluid and reduces inflammation of joint lining (synovial membrane), there by resulting in better lubrication of joints.

bullet

Reduces nerve compression by reducing inflammation and swelling in tissues. e.g. 'sciatic nerve' is compressed in a condition known as 'sciatica' due to arthritis in lower spine.

bullet

By reducing pain, inflammation, swelling, and nerve compression and improving lubrication of joint, it helps the patient to recover quickly ,and can be back to active exercises .

 

             

     Ultrasonic physiotherapy    

 

           

Ultrasonic equipment for physiotherapy

 

bullet

Ultrasound is a therapeutic method of aiding the healing process.

bullet

The ultrasonic waves massage the injured area, promoting blood flow and reducing swelling. Because swelling can be a significant source of pain, the reduction in swelling as a result of ultrasound treatments also relieves pain.

bullet

Ultrasound relieves pain by treating the cause of the pain.

 

 

 What is the role of Exercises in physiotherapy ?

bullet

Mainstay of physiotherapy is, strengthening of muscles around an arthritic joint, so as to take away weight from bony structures of a joint. 

bullet

The muscles so strengthened will move the joint without actually straining an already ageing arthritic joint.

bullet

Strengthening of muscles require controlled and gentle regular exercises under medical supervision. The nature and extent of exercises is determined by age, weight of patient, nature of arthritic problem and associated complications.

bullet

Over enthusiastic exercises, without medical advise can not only make things worse, but can precipitate severe pain, swelling, inflammation, and even paralysis due to nerve compression (e.g. paralysis of lower limbs due to intervertebral disc prolapse, thereby causing spinal cord compression). Ligament tears and muscle rupture may occur due to faulty methods of exercise.

 

 

 What are the ways of exercise ?

  1. Active Exercises.( Exercises 1, Exercises 2 )

 

                                                                                          

 

bullet

Means, active exercises done by the patient himself. 

bullet

Achieving active movement of muscles around a joint, and thereby preserving joint function is the ultimate goal of physiotherapy. 

bullet

Initially, during severe pain, inflammation and swelling in an arthritic joint; and more so if nerve compression is an associated complication; the active exercises are not possible, and may be even detrimental. 

bullet

During this period, when the patient is bed ridden and unable to undertake any active exercises, passive exercises are a must.

 

  1. Passive Exercises.

 

 

                                                                                

 

bullet

As the name suggests, it is a passive way of exercises of muscles done by an attendant without any effort on part of patient.

bullet

Latest techniques have been developed to strengthen muscles around a joint by muscle contractions, induced by signals given by equipments from outside.

 

    

  Why passive exercises are important?

bullet

The muscles atrophy (degenerates) rapidly if not used regularly .

bullet

This is known as 'Disuse atrophy' . Examples are atrophy of limb muscles in polio patients, and in severe incapacitating 'rheumatoid arthritic' patients.

bullet

Passive exercises help to maintain joint function, lubrication, prevents muscle spasms and preserves power of muscles.

 

Limitations of passive exercises done by an attendant.

bullet

Less effective than active exercises in strengthening muscles.

bullet

May be painful, as movement at joint is required.

bullet

Time consuming and requires days or even months of therapy to have appreciable effect.

bullet

Requires help of a professional for desired results.

bullet

Patient may become ambulatory (able to walk) only after several days causing complications like: deterioration of diabetes due to lack of active movement, development of bed sores in bed ridden patients, clot formation in limbs, and loss of working hours.

 

Paraffin bath

bullet

also called wax bath. 

bullet

Placing heat on a surface of the body using paraffin. 

bullet

The part is quickly sunk in heated liquid wax and then taken out so that the wax surrounds it.

bullet

It is done several times, and then the whole surface is wrapped in a loose-fitting plastic bag or in paper towels.

bullet

It is effective for heating injured or swollen areas, especially the hands, feet, and wrists. 

bullet

It is used for patients with arthritis and rheumatism or any joint problem.

 

 Traction (in orthopedics)

 

 
bullet

Traction involves the use of a pulling force either directly or indirectly to bones. 

bullet

Traction can be used to prevent or reduce muscle spasms, keep a joint or other part of the body from moving, or restore a fractured bone to its normal position. 

bullet

The process of putting a limb, bone, or group of muscles under tension by means of weights and pulleys to align or to keep rigid the part or to relieve pressure on it. 

bullet

Kinds of traction include Bryant's traction, Buck's traction, Russell traction, skeletal traction, skin traction, and split Russell traction.

bullet

There are two main types of traction--skin and skeletal.

 

 Skin traction
bullet

Skin traction is applied to the skin surfaces, usually by a pelvic belt, head halter, traction boot, or moleskin straps covered with elastic wraps. 

bullet

It is attached to ropes and weights appropriate to the age and condition of the patient.

bullet

Skin traction uses lower amounts of weight because skin cannot tolerate the pull of large amounts of weight over long periods. 

bullet

Thus skin traction is sometimes used intermittently or for short periods while skeletal traction, once applied, is always continuous and is used for longer periods and with heavier weights.

bullet

Skin traction is used to treat muscle injuries, bone fractures, ruptured or herniated discs, muscle contractures, and arthritic conditions.

bullet

It can be applied to an arm, the head, a leg or the pelvis. 

bullet

Some types of skin traction, such as the head halter and Buck extension, can be used at home. 

 

 Considerations for use of skin traction at home include
bullet

Look over all areas of the skin where the traction is to be applied. 

bullet

The traction will pull on the skin and could cause additional injury to the already compromised skin. 

bullet

It should not be applied over open sores, rashes, bruises, marked swelling, or raised moles or warts.

bullet

Do not shave the skin under the areas where the traction is to be applied. Shaving could cause small cuts that could become inflamed under the traction.

bullet

Make sure the skin is clean and dry to prevent chafing or maceration caused by excess water on the skin.

bullet

Be sure you have an explanation of the traction equipment and how it is to be applied. 

bullet

Have the instructions in writing so there is no chance of forgetting a vital piece of information.

bullet

Also, have the phone number of the physician ordering the traction and the supplier of the equipment to clarify any concerns you may have before or after the traction is in use.

bullet

Find out if the weights can be removed at times--especially at night. The doctor may give an order that the patient can be in 2 hours, then out 2 hours, and off at night. Being in traction at night often prevents the patient from relaxing muscles to allow rest and sleep.

bullet

Usually the patient will receive relief of muscle spasms and pain from the effects of the traction. 

bullet

If the spasms or pain increase, however, be sure to notify the doctor. 

bullet

Adjustments in the amount of weights, positions, or time in traction may be needed for benefits to be achieved. At times, the use of traction may need to be stopped if there are adverse reactions.

bullet

Usually, you will be shown how to feel and count the arterial pulses in the extremities or area in traction, how to feel for temperature, color, and swelling. 

bullet

You will also be shown how to wrap the elastic bandages (if used) properly to prevent over tightness leading to more swelling, numbness or tingling, or throbbing under the bandages. 

bullet

Elastic bandages should be removed and reapplied more loosely if these symptoms occur after the traction has been applied.

bullet

If possible, an orthopedic technician, a nurse, or a physical therapist should check the traction while in use at home. Arrangements can be made with your doctor.

 

 

 Skeletal traction
bullet

When the injury is severe and demands longer periods of immobilization, skeletal traction is needed. 

bullet

Skeletal traction is applied directly to the bone by nails or pins inserted into the bone.

bullet

Because your bones can tolerate more pres- sure than your skin, up to 30 pounds of pull may be applied by means of weights, ropes, and pulleys.

bullet

Skeletal traction is done in a hospital. 

bullet

Your doctor and nurse will tell you on what you are allowed to do while in traction. Many times you can help with your own personal care. 

bullet

The one important thing to remember is not to disturb the traction apparatus or remove any weights. Skeletal traction must remain in continuous use until the doctor says it can be removed, usually when bone healing has occurred or when surgical repairs are done so healing can continue at home and out of traction.

 

                                       Site designed and maintained by JMWDC                 Medical Web designing for doctors contact