The Difference between Chiropractors and Medical Doctors

People have many misconceptions when it comes to chiropractic care and treatment. Some people believe visiting a chiropractor is only necessary when they experience a back injury or severe back pain. Other people fail to understand the extent of training chiropractors must complete and believe treatment options are limited. Most people are actually surprised to discover chiropractors have to complete rather complex medical training and most complete similar courses, training, and education as medical doctors.

One of the differences between medical doctors and chiropractors is how they approach diagnosing and treating aliments. Medical doctors tend to treat the symptoms rather than the underlying causes. Chiropractors, on the other hand, look at the symptoms, but also identify the underlying causes and develop treatments for those, too.

Another difference is chiropractors use drug-free and surgery-free treatment methods. Their overall goal is to help restore the body to proper functioning while promoting natural healing. To help achieve this, they focus on two primary systems within the body: The skeletal system and the nervous system.

Why the Skeletal and Nervous Systems Are Related

The nervous system is responsible for controlling every organ, cell, and body function. The skeletal system provides pathways for nerves to send feed back to the brain. When the skeletal system is out of alignment, it can place pressure on nerves and other trigger points within the body, which causes a disruption to the nervous system. One way our body responds is by alerting us to the problem through the use of pain, such as a headache, joint pain, lower back pain, and so on.

There are all sorts of underlying reasons the skeletal system can become misaligned. One of the more frequent ones is due to poor posture. We lean over our desks, tilt our heads to talk on the phone, and do not use the correct sitting postures to keep the spine straight.

Did you know that there have been studies on posture? From these, it was discovered there is about an extra ten pounds of stress placed on the neck and spine for every one inch your head is away from its natural center of gravity.

The added stress can cause muscles to tighten, stiffen, and place even more pressure on the spine, causing the vertebra to shift out of alignment. Once this happens there can be a wide array of side effects including:

  • Neck Pain
  • Increased Blood Pressure
  • Headaches
  • Back Pain
  • Ear Infections
  • Increase Arthritic Discomfort

Regular chiropractic care helps maintain the alignment of the spine and proper nervous system functioning. Treatments are designed to address current issues and concerns, like lower back pain. Once the primary complaint has been resolved, ongoing care serves as a preventative form of treatment. Chiropractic care has been used to successfully treat conditions such as:

  • Joint Pain
  • Arthritis
  • Asthma
  • Stress
  • Back, Neck, and Shoulder Pain
  • Scoliosis
  • Migraine and Tension Headaches
  • Muscle Tension

Keep in mind this is just a few of the conditions treated by a chiropractor. To learn more about chiropractic care and treatment, or to schedule an initial consultation appointment, please call P&C Rehabilitation Services at 416-652-6223 today!

Injured at Work: What You Need to Know

According to the Government of Canada’s Labour Program, on average, one out of fifteen people are involved in an accident at work, which results in personal injuries. Employers do their best to help provide healthy and safe working environments. Unfortunately, it is impossible to plan for every type of situation that could result in an accident. The best employers can do is to educate their employees on safe working practices as a means to help reduce on-the-job injuries.

Steps to Take if Injured at Work

Employees have specific responsibilities should they experience an injury at work. It is in your best interests to review your workplace practices and policies on a regular basis to ensure you fully understand the processes and procedures for filing a claim to receive benefits under WSIB.

Step 1 Notify Your Supervisor

It is your responsibility to report the accident to your immediate supervisor. If they are unavailable, notify either their manager or your human resource department. Your employer will need to obtain details about what occurred and how you were injured. In addition, they will provide you with vital information for seeking medical treatment. However, in the case of a serious injury, seek medical care first, then worry about filing a report afterwards.

Step 2 Seek Medical Treatment

After sustaining an injury, the most important thing is to have the injury treated. Sometimes this might involve receiving first aid to bandage a wound and other times, it could require visiting a doctor or hospital for more serious injuries. Failing to seek medical treatment could result in issues with being able to file a claim through your employer.

Step 3 Choose a Healthcare Provider

Canadian law allows for employees to choose their own doctor for treatment of their injuries, like our physiotherapy clinic in North York. It is essential to select the most appropriate doctor or healthcare provider. If you want to change providers, you will have to submit justification and wait for the WSIB board to approve your request.

Step 4 Complete All Required Care and Treatment

Some types of injuries could require rehabilitation before you are fully healed and released from care. Even if you are feeling better, you need to follow the recommendations of your doctor including any work restrictions they might impose. Never resume your full work duties until your doctor has determined it is safe to do so.

Do I Have to Report Minor Injuries?

In certain situations, you might experience a minor injury you may not deem worth reporting as a workplace injury. However, failing to report even minor injuries could have long term consequences and could become more serious, so it is always in your best interests to still report minor injuries.

For more information about our care and treatment services for workplace injuries, please feel free to call P&C Rehabilitation Services at 416-652-6223 to schedule a consultation appointment today!

WSIB Approved Drug-Free Treatment Program

Being injured, while on the job, is not often a pleasant experience. While most people might think injuries in the workplace only occur in construction, manufacturing, and other such labour intensive industries, they are mistaken. Even for people, who work in office, retail, restaurants, and other industries, they can be injured on the job, too.

One of the more common workplace injuries are neck, shoulder, and back injuries. These types of injuries are normally caused by not maintaining the proper posture while moving, bending, lifting, turning, and so on. All it takes to strain, sprain, or pull a muscle, or pinch a nerve ending is twisting or turning slightly irregular, or placing excessive strain on one muscle group, and the next thing you know, you are in pain.

Another common type of workplace injury as those caused from slips, trips, and falling down. Each of these particular accidents cause the body to move in various directions, often out of our control. In addition, some people naturally and instinctively tense up their muscles while slipping, tripping, or falling down, or attempt to break the fall using their arms, legs, or other parts of the body. This typically results in injuries to the muscle, nerves, and occasionally the bones.

Recovering from workplace injuries requires treatment and rehabilitation. There are several different treatment and rehab options to choose from, and more and more people are opting for drug-free treatment programs available at our physiotherapy clinic in North York. Our treatment program are tailored to the specific needs and based upon the actual injuries of the patient. Our goal is to help our patients recover from their injuries, not simply mask the pain, while waiting on the body to heal at its own pace.

Rather, our programs are designed to promote and stimulate the healing process to help restore your body much faster. Our WSIB approved drug-free treatments utilize evidence-based methods, including, but not limited to:

  • Self-management and pain strategies.
  • Patient education.
  • Customized treatment program which could involve exercises, physiotherapy, chiropractic treatment, massage,
  • spinal manipulation, mobilization, and other such effective treatments.
  • Addressing pain and learning how to manage it in steps.
  • Eventual transition and return to work.

Initially, the primary focus of rehab is to help strengthen damaged tissues and muscles through exercise. As the muscles and tissues start to heal and become stronger, the next step is to extend the range of motion and restore it. Throughout these processes, we instruct and educate our patients on effective pain management techniques they can use at home or at work, and not have to rely upon prescription pain medications.

For more information about our WSIB approved drug-free treatments, call P&C Rehabilitation Services today at 416-652-6223 to schedule a consultation appointment at our physiotherapy center in North York.

Are There Drug-Free Rehab Options After a Car Accident?

Being involved in a car accident can be a rather traumatic event. Afterwards, the road to recovery is not always as clear and concise for every person. Some people only suffer minor pain and discomfort from the accident, while others could have experienced more severe injuries, some of which may have required surgery to address.

In many cases, treating accident victims where there is ongoing and/or severe pain, typically involves prescribing some form of prescription-strength pain relievers. Granted, there are times where these drugs can be beneficial, like immediately following surgery. However, the best road to recovery does not have to rely upon taking pain medications to restore your mobility, increase your strength, and improve your overall well-being and health.

Developing an effective treatment and rehabilitation program, which either eliminates or limits the amount of pain medications used, is possible with physiotherapy in North York. The main purpose of physiotherapy is to identify the types of injuries sustained during the car accident, review the frequency, severity, and location of pain and discomfort, and use this information to create a customized rehabilitation program specific to each patient.

Initially, the rehab focuses on strengthening damaged muscles and tissues through exercise. Once strength has returned to the affected area, the next step is to start to work on restoring the range of motion and mobility functions. In addition, the patient is taught effective pain management skills and techniques for them to use at home or at work without having to rely upon prescription pain killers.

As rehabilitation treatment continues, regular examinations are conducted to ensure short term objectives are being met. Further, the exams allow your experienced and knowledgeable North York physiotherapist to make modifications to your treatment program, such as increasing the amount of resistance and types of exercises, to make them more challenging and continue to promote healing and restoration to the damaged area of your body.

What If I Only Experience Minor Pain After a Car Accident?

Minor pain, soreness, and swelling are common after less serious car accidents. It is not uncommon for some people to not experience any sort of pain or discomfort immediately following the accident because some injuries may not present themselves until a day or two after the accident. The body is still in shock and some people’s adrenaline levels are heightened, masking pain and discomfort.

Since car accident injuries are not always noticeable, it is still in your best interests to seek medical treatment and consider both physiotherapy and chiropractic treatments as viable options for diagnosing and treating minor injuries. Chiropractors focus on healing neuromusculoskeletal damage caused from the car accident by using a variety of treatment methods, as well as working alongside skilled physiotherapists to promote faster healing, all without the use of prescription medications.

If you or a loved one is looking for a drug-free alternative for rehabilitative services after a car accident, please feel free to contact PC Rehab Services at 416-652-6223 to schedule an initial consultation appointment at our North York physiotherapy center today.

Drug-Free Pain Management with North York Chiropractic Treatments

Chiropractic treatments in North York, by a licensed chiropractor offer a drug-free, natural approach to managing pain, as well as improving the overall health and well-being of patients. Treatments are well-suited for both chronic pain and short-term pain caused from accidents and injuries. Chiropractors focus on the nervous system and proper alignment of the spine. By addressing these two areas of the body, the body has the ability to naturally heal itself, in most cases, under the proper conditions. A chiropractor’s purpose is to help facilitate the body’s ability to heal itself without the use of drugs.

Chiropractic treatments can be used to treat a wide variety of conditions and pain, including:

  • Lower, Middle, and Upper Back Pain
  • Shoulder Pain
  • Neck Pain
  • Hip Pain
  • Tension and Stress Relief
  • Headaches
  • Joint and Extremity Pain
  • Arthritis
  • Improving Organ Function
  • High Blood Pressure
  • Ear Infections
  • Scoliosis and Other Spinal Conditions

When there are blockages and pressure on nerves, it prevents the nerves from communicating and sending signals to the brain and the other systems and organs within the body. As a result, the body is not able to heal what ails it, naturally, without drugs. By using a hands-on approach and manipulation, a chiropractor realigns the spine and restores proper nervous system functions.

Another benefit of chiropractic treatments is to help patients remain healthy and avoid future injuries. General health and well-being treatments combine several aspects of chiropractic care and other methods, such as nutrition education, strength training, and exercise. Many chiropractors complete nutritional, strength, and exercise related educational and development courses as part of their requirements when earning a chiropractic degree. Some of these courses are advanced, PHD level coursework.

To further help patients, chiropractic treatments are able to be combined with other forms of drug-free services, like massage therapy and physiotherapy in North York. Massage therapy helps improve blood flow to affected areas of the body, work out tension and stress, and alleviates pain and discomfort. Massage therapy further stimulates the body’s natural healing response when used with chiropractic care.

Physiotherapy (a.k.a. physical therapy) is used to help restore functioning to affected extremities and limbs, while improving mobility and reducing pain. Physiotherapy also helps to restore, maintain, and improve patients’ overall health and fitness. Treatments typically involve exercises designed to strengthen the body, improve range of motion, restore coordination and balance, muscle response, and posture. Combined with chiropractic care, both treatments further improve a person’s overall well-being, with a reduction in pain and discomfort, while decreasing the risks of future injuries.

Keep in mind treatments are customized to fit the needs of each patient, depending upon their medical diagnosis, overall health and fitness level, age, and other related medical conditions. Prior to starting any treatment program, the chiropractor and physiotherapist will review your medical history and conduct several tests to develop the most appropriate treatment plan for you. To learn more about the benefits of chiropractic and physiotherapy treatments, or to schedule an initial consultation appointment to discover what drug-free treatment options are available, contact P&C Rehabilitation Services today at 416-652-6223.

Sciatica

The sciatic nerve is the largest nerve of the body that is composed of individual nerve roots which start by branching out from the spine in the lower back and combine to form the “sciatic nerve.” The sciatic nerve runs from the lower back, through the buttocks, and down the back of each leg. Sciatica refers to the pain that radiates through the course of the nerve. Typically, sciatica affects only one side of the body.

Causes

Sciatica is a symptom caused by the irritation of the nerve. The nerve may be compressed either in the spinal canal or peripherally throughout its course. The following are the leading cause for its compression:

  • Intervertebral disc herniation or a slipped disc – this is the most common cause of sciatica.
  • Spinal stenosis- is a narrowing of the spinal canal which can eventually compress the nerve roots of the sciatic nerve within the spinal canal.
  • Spondylolisthesis- is a forward displacement of a vertebra. The abnormal position of the vertebra can put pressure on the emerging nerve roots of the sciatic nerve.
  • Spondylosis- is a degenerative arthritis of the spine with associated bone spurs which can impinge the sciatic nerve.
  • Piriformis syndrome- the piriformis is a small muscle of the buttocks. When it becomes tight, it can put pressure on the sciatic nerve.
  • Sacroiliac joint dysfunction- the sacroiliac joint is composed of the sacrum and the pelvis, specifically the ilium. Improper functioning of SI joint may produce sciatic-like symptoms.
  • Miscellaneous – tumors within the spinal canal or along the path of the sciatic nerve, fracture of the hip bone , systemic conditions like diabetes can also contribute to sciatica.

Symptoms

  • Pain- shooting pain often commencing in the low back and/or buttocks, radiating down to the back of the thigh, lower leg or toes. Typically, one side of the leg is affected. Pain might increase with sneezing and/or coughing.
  • Tingling and numbness in the legs – pins and needle sensation may be felt along the back of the thigh and leg as sensory fibers of the never can be compressed.
  • Weakness of the lower extremities – resulting from nerve root or peripheral nerve compression.

Diagnosis

Sciatica is typically diagnosed with a subjective history and physical examination consisting of a neurological screen, movement patterns and orthopaedic tests. A positive straight leg raise test is indicative of sciatica.

Following diagnostic tests are performed to confirm the cause of sciatica:

  • X Ray – degenerative changes in spine, bone spurs and decreased intervertebral joint space can be displayed on lateral and anteroposterior views of the lumbar spine.
  • MRI- has the ability to detect soft tissue abnormalities such as tumors, disc bulges, nerve root compression.
  • CT scan- detailed cross section images of the spinal tissue.

Treatment

  • Physiotherapy/Chiropractic – a form of conservative management for sciatica. The physiotherapists or chiropractor will formulate specific treatment plans consisting of core muscle strengthening, stretching exercises, postural correction and provide educational material to avoid aggravating activities. Mechanical lumbar traction is also a useful modality to decompress the sciatic nerve.
  • Pharmaceutical medicine-  such as ibuprofen , naproxen , narcotics  and anti-inflammatories are taken to control and/or alleviate symptoms.
  • Steroid injection- injected locally in the affected nerve roots. Steroids suppress the symptoms by reducing the inflammation of the nerve roots and surrounding structures.
  • Steroid injection- injected locally in the affected nerve roots. Steroids suppress the symptoms by reducing the inflammation of the nerve roots and surrounding structures.

The health professionals at P&C Rehabilitation Services have a lot of experience treating sciatica. If you are suffering from this condition or have any questions contact us today and book your free consultation with the physiotherapist or chiropractor.

Piriformis Syndrome

Piriformis is a small butt muscle that contributes to external rotation of hip. It enables us to walk, shift weight from one foot to another and maintain balance. Piriformis Syndrome occurs when this muscle compresses the sciatic nerve (the nerve that originates from spine and passes through the buttocks and down the back of thighs and legs). Piriformis Syndrome is also known as pseudo sciatica, wallet sciatica or hip socket neuropathy.

Causes

  • Piriformis muscle either irritates or compress the proximal part of sciatic nerve due to spasm or contracture.
  • Fibrosis due to trauma.
  • Prolong sitting .
  • Keeping wallet/cellphone in the rear pocket of jeans.
  • Vigorous physical activity.
  • Total hip arthroplasty.
  • Myositis ossificans.
  • Leg length discrepancy.
  • Bleeding or hematoma near piriformis muscle.

Symptoms

  • A dull ache in buttocks .
  • Pain down the back of thigh, leg and foot .
  • Tingling and numbness in leg and foot .
  • Pain on walking uphill or climbing stairs.
  • Increased pain on prolong sitting .
  • Reduced range of motion of hip .
  • Pain worsens on prolong walking and running and one feels better lying down on the back.

Diagnosis

Diagnosis is based on patient’s medical history and physical examination. In physical examination, attempt is made to stretch an irritated piriformis muscle and provoke sciatic nerve compression. FABER (Flexion, Abduction, External rotation of hip) and FAIR (Flexion, adduction, Internal rotation of hip) maneuvers are done to provoke sciatic nerve compression. Other diagnostic modalities like X ray, MRI, CT scan, Ultrasound and EMG are done to rule out other conditions.

Treatment

  • Non-steroidal anti-inflammatory and muscle relaxants help in relieving pain.
  • Physical Therapy- Stretching and strengthening exercises of muscles surrounding the hip joint. Hip joint mobilization, massage, myofascial release techniques, hot/ice application, TENS are therapeutic approaches to treat piriformis syndrome.
  • Piriformis injection- Local injection of corticosteroid or anesthetic agent directly over piriformis muscle to reduce swelling, spasm and pain. The goal of injection is to relax the muscle and help reduce pressure on sciatic nerve.

If you are suffering from piriformis syndrome or have any questions regarding this condition don’t hesitate to contact us. All the health professionals at P&C Rehabilitation Services have experience treating this condition.

BPPV

Benign Paroxysmal Positional Vertigo is a disorder of the vestibular system in the inner ear. The condition is characterized by a sensation of dizziness and spinning with change in head positions. It occurs when calcium crystals called otoconia are dislodged from their normal location from the top of the utricle (sensory organ of inner ear). These free floating crystals travel in the fluid contained within the semicircular canals of the inner ear. It is the movement of these crystals that can trigger the sensory receptors within the inner ear resulting in disorientation and disequilibrium.

Causes

  • Old age.
  • Head trauma.
  • Meniere’s disease.
  • Vestibular migraines.
  • Vestibular neuritis.
  • Maintaining static positions of the head such as in a dentist chair and prolonged bed rest.
  • Ototoxicity (inner ear infection).

Symptoms

  • Vertigo
  • Dizziness
  • Lightheadedness
  • Nausea/vomiting
  • Imbalance
  • Difficulty concentrating
  • Nystagmus (involuntary eye movements)

Symptoms are triggered by the change in head position like getting up from the bed, tilting head in shower, reaching for upper shelf.

Diagnosis

BPPV is diagnosed by taking a medical history, a physical examination and vestibular and auditory tests. MRI may be recommended to rule out other conditions such as a stroke.

Dix Hallpike maneuver – This is a vestibular test: the physiotherapist or chiropractor will instruct you to sit on treatment table. You will be asked to lie back quickly while your head is held stationary in a certain position. These set of movements will usually trigger an episode of intense dizziness (vertigo) in patients with BPPV.

Treatment

  • Epley maneuver- This treatment involves a series of movements.  First, while sitting up, the patients head is turned about 45 degrees to the side that normally provokes the vertigo. Then the patient is quickly laid down backwards with their head just over the edge of the examining table. This position usually provokes strong vertigo. The head is kept in this position for about 30 seconds and then turned 90 degrees to the opposite side. After another 30 seconds, the head and the body are turned together in the same direction so that the body is pointing towards the side, and the head is pointing down toward the ground at a 45 degree angle. After 30 seconds in this position, the patient is brought upright again. This is repeated as many as five or six times until neither vertigo or nystagmus are elicited when the head is brought into the previously aggravating position.
  • A hand held vibrator is applied to the bone behind the affected ear to help dislodge the crystals that may have become stuck on the walls of the semicircular canal.
  • Anti-nausea or antiemetic medicine is prescribed if vomiting sensation is severe.

If you are suffering from BPPV or have any questions regarding this condition don’t hesitate to contact us and book your free consultation. All the health professionals at P&C Rehabilitation Services have experience treating this condition. We have been providing chiropractic and physiotherapy to the Jane and Finch Community for 6 years. We take pride in providing excellent health care services to the North York community.

Whiplash

Whiplash neck injury is often just called a neck strain. Even though whiplash is often associated with car accidents, any impact or blow that causes your head to jerk forward or backward can cause neck strain.

Causes

A whiplash neck injury occurs when the head is suddenly jolted backwards and forwards or forwards then backwards in a whip-like movement, or when suddenly rotated. The sudden force stretches and tears your neck muscles and tendons. Sometimes the blow is strong enough to damage the vertebrae, intervertebral disc, nerves and other tissues of neck. The following are major factors for whiplash.

  • Car accident- Rear end collision is the most common cause of whiplash. But, front and side collision can also lead to whiplash neck strain.
  • Contact sports – Sports like football, rugby and others.
  • Physical abuse – Whiplash can occur in physical assault incidents like being punched and shaken baby syndrome.

Symptoms

It may take several days for symptoms to appear after an injury.

  • Pain in the neck. Pain may radiate to the cervical area, shoulder and down the arms.
  • Neck stiffness
  • Headache. Most common at the base of skull, which radiates to the forehead.
  • Symptoms of concussion. Dizziness, blurred vision, pain on swallowing, unusual sensation over fascial skin. These symptoms require for immediate doctor consultation.
  • Feeling of tiredness, irritation, difficulty to concentrate, excessive sleepy and unconsciousness.

Diagnosis

  • History and physical examination – The physiotherapist or chiropractor will usually be able to diagnose a whiplash neck injury from the description of the accident, the typical symptoms and by examining you. Examination includes checking the neck and shoulder range of motion, palpation of facet joints in the neck, muscle strength, sensation over face and limbs, and reflexes.
  • X-ray of skull and neck- Fracture of any cervical vertebra or skull can be ruled out with x-rays in the anterior-posterior and lateral views.
  • CT scan and MRI – These tests help to diagnose soft tissue injury or any brain/spinal cord damage.

Treatment

Treatment of Whiplash injury is simple and often resolves completely.

  • Physiotherapy- Physical therapy plays a vital role in treating whiplash injury. Posture correction, flexibility and strengthening exercises for specific muscle group helps for a speedy recovery. Massage therapy over para spinal cervical muscles helps in relaxing the muscles of the neck. Transcutaneous Electronic Nerve Stimulation (TENS) may help reduce pain.
  • Chiropractic therapy – Chiropractic treatment has been shown to be very successful in treating whiplash injuries. The chiropractor will use techniques such as cervical mobilizations, manipulation, traction, and soft tissue techniques to relieve the neck pain.
  • Cryotherapy – Application of ice for at least 20 minutes twice or three times a day in an acute stage i.e. first 2-3 days helps in pain relief.
  • Hot pack- Once acute stage subsides, application of hot packs or moist heat helps in reducing muscle spasms and relax the muscles and soft tissues.
  • Collar- Foam collar are given to keep the neck stable. However, they must be worn for only 10-15 days after the injury otherwise they may weaken the muscles if worn for prolong periods.
  • Over the counter pain medications- Non-steroidal anti inflammation drugs like aspirin, naproxen helps to alleviate pain and swelling.

If you have suffered a whiplash injury from a car accident don’t hesitate to contact P&C Rehabilitation Services for your free assessment. If you have been involved in a car accident you are entitled to receive physical therapy whether the accident was your fault or not. The insurance company covers the cost of therapy. All the health professionals at P&C Rehabilitation Services have vast experience treating whiplash injuries. We have been serving the community of Jane and Finch and North York for 6 years. Call today and get rid of your neck pain.

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) is a condition characterized by discomfort and pain in the knee due to contact of the patella (knee cap) and the femur (Femur bone). PFPS is sometimes also referred as “runner’s knee”, “housemaid’s knee” or “secretary’s knee”.

Causes

Abnormal gliding of the patella over the femur with knee movements  can cause increase pressure and friction in the Patellofemoral joint. Several factors for mal mechanism are:

  • Mal alignment of the patella as in knock knees, flat feet or unusual shaped patella.
  • Over activities like running, jumping, climbing or descending stairs.
  • Prolonged sitting with knees in a moderately bent position (the so-called “theater sign” of pain upon arising from a desk or theater seat).
  • Quadriceps muscle imbalance or tight hamstring/weak quadriceps.
  • Excess weight/obese.

Symptoms

  • Knee pain; especially dull aching pain in the knee. Pain is mainly noticed while walking up and down stairs, squatting or getting up after prolong sitting.
  • Crepitus on knee movements
  • Knee buckling; the loss of quadriceps strength may cause the leg to “give out.”
  • Stiffness in knee.
  • Limited knee range of movement.
  • Decreased quadriceps strength.

Diagnosis

  • Physical examination – The physiotherapist or chiropractor will conduct a medical history with orthopaedic testing to make a diagnosis
  • X ray – These are usually not helpful in diagnosing this condition but can be used to rule out other conditions
  • Magnetic Resonance Imaging – MRI is a diagnostic tool which is used to see whether the pain is due to bone, cartilage or muscle problems.
  • Arthroscopy – The internal structure and state of joint is visualized by inserting a camera through your knee joint.

Treatment

Around 80-90 percent of people suffering from patellofemoral pain recover fully and are able to resume their previous activities. Most active people respond to non-surgical treatments. Following is the line of management.

  • Rice- Rest, Ice, Compression and elevation is the first line of treatment in acute and early stage of patellofemoral syndrome. RICE helps to alleviate pain and swelling.
  • Physiotherapy or chiropractic care- Specific exercises for strengthening quadriceps, hamstrings and calf muscles. Stretching exercises for hamstrings and iliotibial band. Usually, six weeks to six months of supervised physical therapy and rehabilitation program is recommended depending on each case.
  • Orthotics- If the underlining cause is flat feet then being fitted for orthotics can be beneficial in the management of this condition.
  • Knee support- Wearing a patella tracking knee brace helps in proper knee mechanics and preventing further damage along with reducing pain by controlling knee movements. Patellofemoral taping techniques can help reduce pain by altering the track of the patella.
  • Medications- Over the counter non-steroidal anti-inflammatory drugs like ibuprofen, naproxen help to reduce pain, swelling and stiffness.
  • Surgery- In chronic and severe cases where conservative treatment fails to treat the symptoms, surgery is recommended. The Surgeon may have to perform reconstructive surgery depending on the cause.

If you are suffering from patellofemoral pain syndrome or have any questions don’t hesitate to contact us for your free consultation. The physiotherapist and chiropractor have vast experience in treating this condition. Lets end your knee pain today!

Cervical Spondylosis

Cervical spondylosis is a degenerative condition of the bones, joints and discs of the neck due to general wear and tear of aging. There may be abnormal growths or spur formation on the cervical vertebrae. These are called osteophytes. With age, fluid content of the disc is reduced and as a result it becomes stiffer, harder and eventually breaks. In some people, the nearby muscles, ligaments or nerves may become irritated or compressed by the degenerative changes.

Causes

Following are the major risk factors for the development of cervical spondylosis:

  • Age – Cervical Spondylosis is a normal aging process. It usually occurs in middle age and elderly people.
  • Occupation – Certain jobs may place the neck and neck muscles under stress. Such jobs include repetitive neck motions, awkward positioning or lot of overhead work. Computer users, gymnasts and athletes are at high risk.
  • Neck and whiplash injuries- Previous injuries on the neck can increase the chance of cervical spondylosis.
  • Genetic- Degenerative changes run more in some families while less in others.

Symptoms

  • Neck pain
  • Neck stiffness
  • Pain may radiate down the forearm and arm
  • Tingling and numbness in fingers if nerve roots immerging between the vertebrae are compressed.
  • Headache that may originate from the neck.
  • Vertigo and dizziness
  • Very rarely cervical spondylosis results in pressure on spinal cord. Such symptoms include:
  • Tingling, numbness and weakness in the arms, hands, legs and feet.
  • Lack of co-ordination
  • Difficulty in walking
  • Change in muscle tone and muscle weakness
  • Loss of bladder and bowel control

Diagnosis

  • Physical exam- Your physician ask you to bend your head forward and to each side while putting slight downward pressure on the top of your head. Increased pain or numbness during this test is usually a sign that there is a pressure on a nerve in your spine.
  • X ray spine- Anterior, posterior and lateral X ray views of the cervical spine is taken to investigate decrease joint space and degenerative changes in vertebrae.
  • Magnetic Resonance Imaging (MRI) – This will give in depth imaging about changes in intervertebral disc, nerve root impingement and spinal cord compression.
  • EMG (Electromyography) and NCV (Nerve Conduction Velocity) – These tests are done to examine nerve root function.
  • Myelogram- This test involves generating images using X-rays or CT scans after dye is injected into the spinal canal. The dye makes areas of your spine more visible.

Treatment

  • Physiotherapy/Chiropractic- A physiotherapist or chiropractor will teach you stretching exercises for your neck muscles. Strengthening exercises are incorporated in the program for the neck and shoulder which will help in limiting pain and to prevent further damage. Hot or cold packs are recommended to ease the pain. Many  people benefit from the use of cervical traction which can help in providing more space within the spine if nerve roots are impinged.
  • Drugs and medications- Over the counter drugs like Aspirin or ibuprofen are helpful in reducing pain. If over the counter pain relievers don’t help, your doctor may prescribe you muscle relaxants, narcotics or steroids to help reduce the symptoms.
  • Surgery- If aforementioned conservative methods fail in treating the symptoms, surgery is recommended. Surgery involves removing of herniated disc or bone spur, laminectomy (removal of part of vertebra) or fusion of vertebrae.

If you are suffering from cervical spondylosis or have any questions regarding this condition contact one of the health professionals at P&C Rehabilitation Services.

Carpal Tunnel Syndrome

The carpal tunnel is an anatomical compartment which is formed of ligaments and carpal bones. It is located at the base of the palm at the wrist. Finger flexor tendons and the median nerve pass through the carpal tunnel. Compression of the median nerve within this tunnel produces series of signs and symptoms which is called carpal tunnel syndrome. Carpal tunnel syndrome is the most common and widely known entrapment neuropathies in which the body’s peripheral nerves are compressed or traumatized.

Causes

Carpal tunnel syndrome is the result of factors that decrease space in the compartment; eventually compressing the median nerve. Factors contributing are as follows:

  • Congenital predisposition – Carpal tunnel is smaller in some subjects since birth.
  • Trauma or injury to wrist like fracture, sprain which causes swelling near the wrist.
  • Hormonal imbalance – Over activity of pituitary gland; hypothyroidism; diabetes.
  • Rheumatoid arthritis.
  • Mechanical problems in wrist like work stress; repeated use of vibrating hand tools.
  • Fluid retention in pregnancy and menopause.
  • Cyst or a tumor in the carpal tunnel.
  • Bursitis or tendonitis around the wrist.
  • Obesity.

Signs and symptoms

Symptoms appear gradually, without a specific injury. Most common symptoms are:

  • Tingling, numbness, pins-needle and burning sensation over thumb, index, middle and half of the ring finger.
  • Tingling, numbness and pain may move up to your arm.
  • Weakness in hand.
  • Dropping objects. i.e. decreased grip strength.
  • Difficulty handling fine objects like pin, pen, key, etc.
  • In severe carpal tunnel syndrome, there is muscular atrophy (loss of muscle mass) of thumb.
  • In severe and long standing cases, there is loss of sensation over palmar aspect of thumb, index, middle and ring finger.

Diagnosis

  • History and Physical examination – Carpal tunnel Syndrome is diagnosed mostly from history and symptoms. Examination of neck, shoulder, elbow, pulses and reflexes are performed to rule out other conditions. Tapping near the wrist can sometimes produce tingling and numbness. This is called positive Tinel’s sign. Phalen’s maneuver (bending of wrist) confirm the diagnosis.
  • Nerve conduction velocity test- This test measures the rate of speed of electrical impulses as they travel down the nerve. In carpal tunnel syndrome, impulses slow down as it passes through the median nerve at carpal tunnel.
  • Electromyography (EMG) – Test of muscles of extremity is sometimes carried out to exclude other muscular conditions that mimic carpal tunnel syndrome.
  • Miscellaneous- Blood test including thyroid hormone levels, complete blood counts, blood sugar and protein analysis may be performed to identify medical conditions associated with carpal tunnel syndrome. X-ray tests of the wrist and hand might also be helpful to identify abnormalities of the bones and joints of the wrist.

Treatment

Carpal tunnel Syndrome must be treated as early as possible. It can be treated non-surgically if symptoms are mild to moderate.

  • Rest and ice – Symptoms of mild carpal tunnel syndrome can be eased by taking more frequent breaks to rest the hand and avoid activities that stress the wrist. Application of ice packs will alleviate swelling and pain.
  • Wrist splint- Stabilizing the wrist in a splint will limit the wrist motion and hence reduce the symptoms. Nocturnal splinting is a good option to limit night time symptoms. This is a good option in pregnancy causing carpal tunnel syndrome.
  • Physiotherapy and occupational therapy- Stretching and strengthening exercises of wrist and finger muscles is a key to relieve the symptoms. The use of modalities by the physiotherapist can also relieve symptoms.
  • Medications- Non steroidal anti-inflammatory drugs like ibuprofen can relieve pain and swelling. In severe cases, corticosteroid is injected in the carpal tunnel to relieve the symptoms.
  • Surgery- If symptoms are not reduced with conservative methods then surgery is a preferred option. The goal of carpal tunnel surgery is to relieve pressure on the median nerve by cutting the ligament pressing on the nerve.

The health professionals at P&C Rehabilitation Services have extesive experience treating carpal tunnel syndrome. The physiotherapist, chiropractor, and massage therapist all provide treatment for this condition. If you are suffering from this condition call today and bok your free consultation.

Trigger Finger

Trigger finger is a painful condition in which a finger gets locked in a bent position. The similar condition in the thumb is called trigger thumb. The finger once bend gets straighten with a snap like a trigger being pulled and released. It occurs when the finger or thumb tendon gets inflamed. A tendon usually glides smoothly within its covering sheath, “synovium”. In trigger finger, the bending finger or thumb can pull the inflamed tendon through a narrowed tendon sheath, making it snap or pop.

Causes

Repeated and forceful movement of the finger or thumb can cause trigger finger. The following are the leading causes of trigger finger.

  • Rheumatoid arthritis.
  • Gout.
  • Diabetes.
  • Farmers, industrial workers, and musicians often get trigger finger since they repeat finger and thumb movements. Even smokers can get trigger thumb from repeated use of a lighter.
  • It is more common in women than men and tends to happen more between ages 40 to 60 years.

Symptoms

Signs and symptoms of trigger finger ranges from mild to severe and it includes:

  • Soreness at the base of the finger or thumb.
  • Finger stiffness, especially in the morning.
  • Popping and clicking sensation when you bend the finger.
  • Tenderness and a nodule in the palm at the base of affected finger.
  • Finger gets locked in a bent position and must be gently straightened with other hand. This catching sensation tends to get worse after resting the finger or thumb and loosens up with movement.

Diagnosis

Trigger finger is generally diagnosed from the medical history and physical examination. During physical examination, the physiotherapist will ask the patient to open and close fingers several times and check the painful area.  The physiotherapist will examine if there is a nodule at the base of finger and determine if there is locking of the finger. X-ray of the hand may be done to investigate arthritis. Blood test are prescribed to rule out under lying medical conditions like diabetes, gout, etc. causing trigger finger.

Treatment

Treatment depends on the severity of symptoms. The following is the main line of treatment and is started once the condition is diagnosed.

  • Rest- Avoid activities that require repeated gripping, grasping and prolong use of fingers for at least 4-6 weeks. A splint may be given to keep the affected finger in an extended position. Splint helps to rest the tendon and prevents finger curling. This will help to reduce swelling.
  • Ice or heat- Some people find relief by applying ice packs. However, others see more benefit with warm-water soaks in the morning. Contrast bath (alternate immersion in warm and cold water) is one of the best method to relieve pain in trigger finger.
  • Physiotherapy or chiropractic therapy – Flexibility and gentle strengthening exercises will be suggested by the physiotherapist or chiropractor to curb the symptoms and to prevent re-occurrence.
  • Medications- Non steroidal anti-inflammatory drugs like ibuprofen and naproxen to alleviate pain and swelling.
  • Steroid injection- Cortisone is injected near the tendon sheath to subside the symptoms. This is the most common and effective treatment if above conservative methods fail to treat trigger finger symptoms.
  • Surgery- Percutaneous release of tendon sheath is done under local anesthesia.

If you require treatment for this condition or have any questions contact one of the health professionals at P&C Rehabilitation Services and book your free consultation. The physiotherapist and chiropractor both have experience treating this condition.

 

Tennis Elbow

Tennis elbow is a painful condition over the lateral (outer) part of elbow due to inflammation of tendons of the forearm and hand muscles. Tennis elbow can occur in anyone who overuses the forearm and not just restricted to tennis players. Likewise, a painful inflammatory condition of the medial (inner) condyle of elbow is called Golfer’s elbow.

Causes

Certain repetitive movements of the wrist can strain the forearm and wrist muscles resulting in swelling and inflammation of  the tendons (origin of muscles) at the elbow joint. Tennis elbow occurs in people who are engaged in activities that demand excessive and frequent gripping, squeezing and screwing.

It is commonly seen in plumbers, lumber workers, and tennis players. In a game of tennis, certain strokes and actions that lead to tennis elbow (lateral condylitis) are one- handed backhand stroke, late forehand swing and full power serving.

Symptoms

The symptoms of tennis elbow develop gradually. There is usually no specific injury associated with the start of symptoms. Common signs and symptoms of tennis elbow are:

  • Pain over the outer side of elbow. Pain may extend to the muscle bulk of forearm.
  • Weak and painful grip.
  • Certain activities like holding a coffee cup, turning a door knob, wringing clothes, etc. become difficult.

Diagnosis

  • Physical examination – Generally, medical history and physical exam provide enough clues to diagnose tennis elbow. There is a tenderness on applying pressure on lateral condyle. Manual tests like Mills and Cozens test are done by the physiotherapist to confirm the tennis elbow.
  • X rays – This is done to rule out arthritis of elbow joint.
  • Magnetic Resonance Imaging (MRI) – If the doctor feels that the symptoms are related to the cervical spine, then they may suggest an MRI of the cervical spine to rule out a herniated intervertebral cervical disc.
  • Electromyography (EMG) – Doctor may order an EMG to rule out nerve compression. Many nerves pass around the elbow joint and symptoms of nerve compression are similar to tennis elbow.

Treatment

  • Rest- Avoid all activities that put forearm muscles under stress and strain. A supportive elbow brace is prescribed to control swelling and protect the forearm muscles.
  • Non-steroidal anti-inflammatory medicines like ibuprofen and aspirin are prescribed to relive pain and swelling. These drugs are generally taken when required depending on symptoms.
  • Physiotherapy – Physiotherapy has a vital role in treating tennis elbow. Ice, massage and ultra sound helps in healing the injured tendons. Once pain subsides, stretching and strengthening exercises are started to prevent recurrence.
  • Steroid injections – Injections of steroid like cortisol is given locally over the elbow to relieve the symptoms.
  • Surgery- If none of the above conservative and non- surgical methods are effective in terminating the symptoms, surgery is recommended. Surgery involves removing the damaged tendons/muscles and reattaching the healthier ones back to bone.

If you are suffering from tennis elbow or have any questions regarding this condition please don’t hesitate to contact one of the health professionals at P&C Rehabilitation Services. The physiotherapist and chiropractor are well trained in treating this condition. Call today to book your free consultation.