Physiotherapy
in orthopedics
Health is wealth. It is
the greatest of human blessings.
The aim of
Physiotherapy is to identify and maximize human movement potential
within the sphere of promotion, prevention, treatment and
rehabilitation. Physiotherapy is providing service to people to
develop, maintain and restore maximum movement and functional ability
throughout lifespan. Physiotherapy helps where movement and function
are threatened by process of ageing, disease or injury. One of the
symptoms of injury is pain.
Pain is defined as an
unpleasant sensory and emotional experience that is associated with
actual or potential tissue damage. It is the alarm system of the
body, which alters the individual to make an appropriate response to
prevent further injury.
Types
of pain:
Acute
pain: Pain of short duration .i.e. following sprains, strain,
trauma etc. Shoulders, wrist, ankle, knees are the commonest sites.
Chronic
pain: It is pain of long duration i.e. month to year. e.g.
Osteoarthritis of the knee, low back pain (Lumbar spondylosis), calf
muscle pain, cervical spondylosis, Periarthritis of shoulder.
Referred
pain: It is pain felt at a site in the body elsewhere from source
of disease or injury. E.g. Tingling sensation in the hand may be due
to cervical spondylosis. Sciatic pain in the leg can be due to lumbar
pain.
Neurogenic pain:
It is due to some form of neural damage. It is mostly burning type of
sensation.
Psychological pain:
pain is influenced by Psychological factors.
Physiotherapy plays a
very important role in the treatment of various pains like joint
pain, muscular pain, tendinitis, bursitis etc. Selection of
appropriate modalities is very important to achieve result. Following
are the modalities which help in relieving pain.
Treatment modalities
for pain relief
Shortwave diathermy:
It is electromagnetic waves that are made to pass in the body by
means of placing pads on the body. It increases the blood
circulation, and thus fastens the healing process.
Ultrasound: These
are sound waves. This is given for localized pain. Eg.
Tennis elbow, Golfers elbow, Supraspinitis, Calcarium Spur. It can
also be given over healed scar to loosen the scar tissue.
dig 1 : ultrasound
TENS:
This is the safest modality for pain relief. It works on simple
theory of closing the gate. The pain sensation reaching to the brain
can be blocked at the spinal cord level. It is used for chronic back
pain, neck pain with radiating (referred) to upper limb & lower
limb simultaneously.
Contraindication:
pace maker.
IFT
(Interferential
therapy): It is very effective in referred
pain. It is medium frequency current which penetrates more than low
frequency current. It works on the same principle of “Closing the
gate”.
Dig 2 :
IFT (Interferential therapy)
Ice Pack: It is
used mainly in acute condition for reducing pain. It helps in
condition like ankle sprain, muscle cramp (hamstrings, Quadriceps).
Hot Packs: Used
in chronic cases. Hot packs should not be very hot. (myth: very hot
relieve pain faster – is wrong.)
Along with the above
mentioned modalities Exercise, Traction, Manipulation, Mobilization
and Taping is given to achieve best results.
Exercise:
Exercises are used in pain conditions like Cervical and Lumbar
spondylosis, listhesis, OA knee etc and post operative conditions
like fractures of upper limb, lower limb & spine.
- Deep breathing exercise improves vital capacity of lungs and to be able to get ride of the post anesthetic secretions.
- Strong sustained isometric contrations to improve strength and endurance.
- Guidance on ROM and strengthening exercise to avoid stiffness and incordinations.
- Resistive exercise for weight bearing muscle group to facilitate early ambulation with walking aid in case of lower limb fracture.
- Proper limb positioning is also taught.
- Appropriate techniques of transfer to avoid undue strain on the operated leg.
The
benefits of exercises depend on how an individual does exercise at
proper intensity in scientific manner under supervision of qualified
therapist.
