Tuesday, January 13, 2009
Know your Back Pain
You Can Be Me -- A Career in Physical Therapy (APTA)
Considering a career in health care? This American Physical Therapy Association (APTA) video shows what you might do as a physical therapist (PT) or physical therapist assistant (PTA). Learn more at www.beapt.org.
Saturday, March 29, 2008
Internet Sites for Physical Therapy and Medical Research
Physical Therapy information and consumer health links
Physical Therapists Online http://physicaltherapist.com/
Includes a good list of physical therapy related links and jobs some for PTAs
Physiotherapy Evidence Database http://www.pedro.fhs.usyd.edu.au/
Cochrane http://www.cochrane.org/reviews/index.htm
Evidence-based health information; abstracts only
About Physical Therapy http://physicaltherapy.about.com/mbody.htm
A wide variety of information on a range of subjects from anatomy to foot pain.
National Library of Medicine Topic–Rehabilitation http://www.nlm.nih.gov/medlineplus/rehabilitation.html
Medweb at Emory University http://www.medweb.emory.edu/MedWeb/
Sunday, March 2, 2008
Stroke Risk Factors
Stroke Risk Factors
Some stroke risk factors are hereditary. Others are a function of natural processes. Still others result from a person's lifestyle. You can't change factors related to heredity or natural processes, but those resulting from lifestyle or environment can be modified with the help of a healthcare professional.
Uncontrollable risk factors:
Age
The chance of having a stroke approximately after age 55.Stroke is more common in people over 60.
Sex
Stroke is more common in men than in women. In most age groups, more men than women will have a stroke in a given year.
Heredity and Race
Your stroke risk is greater if a parent, grandparent, sister or brother has had a stroke.African-Americans and Hispanic Americans are at higher risk than white Americans.This is partly because they have higher risks of high blood pressure, diabetes and obesity.
Prior stroke, TIA or heart attack
The risk of stroke for someone who has already had one is many times that of a person who has not. Transient ischemic attacks (TIAs) are "warning strokes" that produce stroke-like symptoms but no lasting damage. TIAs are strong predictors of stroke.
Controllable risk factors & life style choices:
High blood pressure.
High blood pressure is the most important controllable risk factor for stroke.Many people believe the effective treatment of high blood pressure is a key reason for the accelerated decline in the death rates for stroke.
Diabetes mellitus.
Diabetes is an independent risk factor for stroke. Many people with diabetes also have high blood pressure, high blood cholesterol and are overweight. This increases their risk even more. While diabetes is treatable, the presence of the disease still increases your risk of stroke.
Cigarette smoking.
In recent years, studies have shown cigarette smoking to be an important risk factor for stroke. The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system in many ways. The use of oral contraceptives combined with cigarette smoking greatly increases stroke risk.
Heart disease.
Particularly heart beat irregularities (atrial fibrillation), disease of the heart valves, congestive heart failure or recent heart attack. If you have one of these conditions, your physician may prescribe medications to thin your blood and/or reduce your cholesterol level.
Obesity, elevated cholesterol, and elevated lipids.
Reducing your dietary intake of saturated fats and cholesterol may help reduce your risk of a stroke.
Physical inactivity.
A sedentary lifestyle void of regular exercise can contribute to heart disease which may lead to stroke.
Alcohol abuse
Alcohol abuse can lead to multiple medical complications, including stroke. For those who consume alcohol, a recommendation of no more than two drinks per day for men and no more than one drink per day for nonpregnant women best reflects the state of the science for alcohol and stroke risk.
Drug abuse
Drug addiction is often a chronic relapsing disorder associated with a number of societal and health-related problems. Drugs that are abused, including cocaine, amphetamines and heroin, have been associated with an increased risk of stroke
STROKE
Stroke
Stroke is a medical emergency. A stroke or "brain attack" occurs when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain. When either of these things happen, brain cells begin to die and brain damage occurs.When brain cells die during a stroke, abilities controlled by that area of the brain are lost.These abilities include speech, movement and memory.
For example, someone who has a small stroke may experience only minor problems such as weakness of an arm or leg. People who have larger strokes may be paralyzed on one side or lose their ability to speak. Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability
Types of Stroke:
There are two kinds of stroke. The more common kind, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain. "Mini-strokes" or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly interrupted.
Symptoms of Stroke:
If you think someone may be having a stroke, act F.A.S.T. and do this simple test:
Act F.A.S.T.
FACE Ask the person to smile.
Does one side of the face droop?
ARMS Ask the person to raise both arms.
Does one arm drift downward?
SPEECH Ask the person to repeat a simple sentence.
Are the words slurred? Can he/she repeat the sentence correctly?
TIME If the person shows any of these symptoms, time is important.
Symptoms of stroke are
Sudden numbness or weakness of the face, arm or leg (especially on one side of the body)
Sudden confusion, trouble speaking or understanding speech
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden severe headache with no known cause
If you have any of these symptoms, you must get to a hospital quickly to begin treatment.
Saturday, March 1, 2008
Physical therapy benefits of low back pain
Physical therapy Benefits of low back pain:
After an episode of low back pain has lasted between two and six weeks, or if there are frequent recurrences of low back pain, it is reasonable to consider back pain exercises and physical therapy for back treatment. (Some spine specialists consider back exercise and physical therapy sooner, particularly if the pain is severe.) In general, the goals of back pain exercises and physical therapy are to decrease back pain, increase function, and provide education on a maintenance program to prevent further recurrences.
Passive physical therapy - modalities
There are many different forms of physical therapy. Acutely, the therapist may focus on decreasing pain with passive physical therapy (modalities). These are considered passive therapies because they are done to the patient. Examples of modalities include:
Heat/ice packs,TENS units,Ultrasound
Active physical therapy - back pain exercises
In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine. Generally, a patient’s back exercise program should encompass a combination of the following:
Stretching for back pain exercise
Strengthening for back pain exercise
Low-impact aerobic conditioning
Even patients with a very busy schedule should be able to maintain a moderate back pain exercise regimen that encompasses stretching, strengthening, and aerobic conditioning. These exercises suffice as physical therapy for back pain relief.
Stretching for back pain exercises. Almost every individual who has suffered from low back pain should stretch their hamstring muscles once or twice daily. Simple hamstring stretching does not take much time, although it can be difficult to remember, especially if there is little or no pain. Therefore, hamstring stretching exercises are best done at the same time every day so it becomes part of a person’s daily routine.
Strengthening for back pain exercise. To strengthen the back muscles, 15-20 minutes of dynamic lumbar stabilization or other prescribed exercises should be done every other day.
Low-impact aerobic conditioning. Low impact aerobics (such as walking, bicycling or swimming) should be done for 30-40 minutes three times weekly, on alternate days from the strengthening exercises.
Low back pain : Introduction,Causes and Treatment
Low back pain is extremely common. Almost every person will have at least one episode of low back pain at some time in his or her life. The pain can vary from severe and long term to mild and short lived. It will resolve within a few weeks for most people.Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region. It may also radiate from other areas like your mid or upper back, a hernia in the groin, or a problem in the testicles or ovaries.You may feel a variety of symptoms if you've hurt your back. You may have a tingling or burning sensation, a dull aching, or sharp pain. You also may experience weakness in your legs or feet.It won't necessarily be one event that actually causes your pain. You may have been doing many things improperly -- like standing, sitting, or lifting -- for a long time. Then suddenly, one simple movement, like reaching for something in the shower or bending from your waist, leads to the feeling of pain.
Low Back Pain - Cause
The most common causes of low back pain are:
Injury or overuse of muscles, ligaments, facet joints, and the sacroiliac joints.
Pressure on nerve roots in the spinal canal. Nerve root compression can be caused by:
A herniated disc, often brought on by repeated vibration or motion (as during machine use or sport activity, or when lifting improperly), or by a sudden heavy strain or increased pressure to the lower back.
Osteoarthritis (joint degeneration), which typically develops with age. When osteoarthritis affects the small facet joints in the spine, it can lead to back pain.
Spondylolysis and spondylolisthesis, vertebra defects that can allow a vertebra to slide over another when aggravated by certain activities.
Spinal stenosis, or narrowing of the spinal canal, which typically develops with age.
Fractures of the vertebrae caused by significant force, such as from an auto or bicycle accident, a direct blow to the spine, or compressing the spine by falling onto the buttocks or head.
Spinal deformities, including curvature problems such as severe scoliosis or kyphosis.
Compression fractures. Compression fractures are more common among postmenopausal women with osteoporosis, or in men or women after long-term corticosteroid use. In a person with osteoporosis, even a small amount of force put on the spine, as from a sneeze, may cause a compression fracture.
Your state of mind also has an effect on your level of pain and whether it becomes long-lasting (chronic). People who are depressed, under stress, unhappy in their work, or seeking money for an injury are more likely to have chronic back pain.
Treatments for low back pain are multiple and varied.
Counseling and Education:
At times, counseling and education about the problem to ease a person's anxiety is enough to make it tolerable until the episode resolves.
RestA few days of rest can often calm the pain down as well. Prolonged bed rest (more than 2 days to 3 days) is no longer generally recommended for people with low back pain.
Medication
Medications such as nonsteroidal anti inflammatory drugs (NSAIDS) or acetaminophen can be helpful. Occasionally, stronger medications such as muscle relaxants and narcotics are used for a short period.
Braces
Although there is minimal scientific evidence of their effectiveness in treating low back pain, back braces are commonly used. Most common is a corset type brace that can be wrapped around the back and abdomen. People who use corset type braces sometimes report feeling better supported and more comfortable.
Passive Modalities
Passive modalities include the application of heat or cold, massage, ultrasound, electrical stimulation, traction, and acupuncture. How long the benefit will last or what the chances are of receiving benefit from any of these treatments is not completely known.
Spinal Manipulation
Another form of passive treatment is spinal manipulation. There are many different practitioners of spinal manipulation, each with their own style of manipulation. This has also at times improved symptoms of low back pain.
Injections
The most commonly used injections are local anesthetic and/or steroids. They are usually given either in the area that is believed to be the source of the pain, such as into a muscle or facet joint, or around the nerves of the spine (an epidural or nerve root injection). Injections are occasionally placed into the disk, but this is done far less frequently.
Exercise and Stretching
Exercising to restore motion and strength to a painful lumbar spine can be very helpful in relieving pain. Although there is controversy as to which are the most effective spine exercises, it is generally agreed that exercise should be both aerobic (aimed at improving heart and lung function) and specific to the spine. Aerobic exercises include walking, jogging, swimming, and bicycling.
Proper Lifting Technique
Instruction in lifting techniques can be helpful as well. Improperly bending over to lift can cause a large increase in strain on the low back. Proper lifting keeps the back straight while you bend with the knees.
