The Benefits Of Physiotherapy for chronic pain management

Introduction;

Chronic pain is a persistent pain that lasts for more than three months. It can affect people of all ages and can have a significant impact on their daily life, including their ability to work, socialize, and perform everyday tasks. Physiotherapy is a non-invasive treatment option that can help manage chronic pain and improve the quality of life for those who suffer from it.

Understanding the causes and types of chronic pain is crucial in seeking professional help for its management. Physiotherapists use various techniques such as manual therapy, acupuncture, and electrical stimulation to reduce pain and improve function. They also recommend exercises tailored to the patient’s needs to help them manage their pain effectively.

Physiotherapy can treat various

types of chronic pain, including back pain, neck pain, joint pain, and fibromyalgia. The benefits of physiotherapy for chronic pain management are numerous, including reduced pain intensity, improved mobility, and increased flexibility.

In conclusion, if you are suffering from chronic pain, seeking professional help from a physiotherapist can significantly improve your quality of life. Physiotherapy offers a non-invasive treatment option that can help manage pain and improve function, allowing you to live a more fulfilling life.

How physiotherapy can help reduce pain and improve function?

Physiotherapy can help reduce pain and improve function in several ways. Here are some of the ways physiotherapy can help:

1. Manual therapy: Physiotherapists use hands-on techniques such as massage, joint mobilization, and manipulation to reduce pain and stiffness in muscles and joints.

2. Acupuncture: Physiotherapists may use acupuncture to stimulate specific points on the body to reduce pain and promote healing.

3. Electrical stimulation: Physiotherapists may use electrical stimulation to reduce pain by blocking pain signals from reaching the brain.

4. Exercise: Physiotherapists prescribe exercises tailored to the patient’s needs to help improve strength, flexibility, and mobility. Exercise also helps release endorphins, which are natural painkillers.

5. Education: Physiotherapists educate patients on proper posture, body mechanics, and ergonomics to prevent further injury and manage pain.

Overall, physiotherapy is a non-invasive treatment option that can help manage chronic pain and improve function. By using a combination of manual therapy, acupuncture, electrical stimulation, exercise, and education, physiotherapists can help patients reduce pain, improve mobility, and live a more fulfilling life.

Types of chronic pain treated by physiotherapist

Physiotherapists can treat various types of chronic pain, including:

1. Low back pain: This is one of the most common types of chronic pain that physiotherapists treat. They use a combination of manual therapy, exercise, and education to reduce pain and improve function.

2. Neck pain: Physiotherapists use techniques such as massage, mobilization, and exercise to reduce pain and stiffness in the neck.

3. Arthritis: Physiotherapy can help manage the pain and stiffness associated with arthritis through exercise, manual therapy, and education.

4. Fibromyalgia: Physiotherapists use a combination of exercise, education, and manual therapy to reduce pain and improve function in patients with fibromyalgia.

5. Chronic headaches: Physiotherapists can help manage chronic headaches through techniques such as massage, acupuncture, and exercise.

6. Chronic pelvic pain: Physiotherapists can use techniques such as pelvic floor muscle training, manual therapy, and education to reduce pain and improve function in patients with chronic pelvic pain.

Overall, physiotherapy can help manage a wide range of chronic pain conditions by using a combination of techniques tailored to the patient's specific needs.

The role of exercise in managing chronic pain

Exercise is an important component in managing chronic pain. Physiotherapists can design exercise programs that are specific to the patient’s needs and condition. These exercises can help improve flexibility, strength, and endurance, which can help reduce pain and improve function.

Regular exercise can also help release endorphins, which are natural painkillers produced by the body. Endorphins can help reduce pain and improve mood, which can have a positive impact on the patient’s overall quality of life.

In addition to exercise, physiotherapists may also use other techniques such as manual therapy, acupuncture, and education to help manage chronic pain. These techniques can be used in combination with exercise to provide a comprehensive approach to pain management.

Overall, exercise plays a crucial role in managing chronic pain, and physiotherapists can design exercise programs that are safe and effective for patients with chronic pain conditions.

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Cardiac Cycle

The cardiac cycle consists of two interrelated phases: systole, the contraction phase, and diastole, the filling phase. During diastole, the ventricles fill with blood from the atria via open atrioventricular valves. he 526 SECTION II Intervention Strategies for Rehabilitation Coronary circulation. (A) left main (LM); (B) left anterior descending (LAD); (C) left circumlex (CX); (D) right coronary (RCA); (E) posterior descending (PDA).

The branches of the LAD are known as diagonals; the branches of the CX are known as marginals. atrioventricular valves lie between the atria and the ventricles and include the tricuspid valve on the right and mitral valve on the left. he first two-thirds of ventricular filling is passive; during the last one-third the atria contract and push the blood into the ventricles. his contraction is known as the atrial kick. After the atrial kick, diastole ends and the atrioventricular valves close. Systole begins with both the atrioventricular and semilunar valves closed. An initial isovolumetric contraction, similar to an isometric contraction of striated muscle, increases the pressure within the ventricles, and the semilunar valve opens. he LV then undergoes a concentric contraction, causing a volume to be ejected, termed the stroke volume (SV). After the SV is ejected, the aortic valve closes and systole is complete. he cardiac cycle is defined by the presence of normal heart sounds, S1 and S2. Heart sounds are associated with valvular closings; S1 is associated with atrioventricular valve closure, and S2 is associated with semilunar valve closure. Systole occurs between S1 and S2, and diastole occurs between S2 and S1

EPIDEMIOLOGY AND ETIOLOGY OF STROKE

Stroke is the fourth leading cause of death and the leading cause of long-term disability among adults in the United States. An estimated 7,000,000 Americans older than 20 years of age have experienced a stroke. Each year approximately 795,000 individuals experience a stroke; approximately 610,000 are first attacks and 185,000 are recurrent strokes.

Women have a lower age-adjusted stroke incidence than men. However, this is reversed in older ages; women over 85 years of age have an elevated risk compared to men. Compared to whites, African Americans have twice the risk of first-ever stroke; rates are also higher in Mexican Americans, American Indians, and Alaska Natives. he incidence of stroke increases dramatically with age, doubling in the decade after 65 years of age. Twenty-eight percent of strokes occur in individuals younger than 65 years of age. Between 5% and 14% of persons who survive an initial stroke will experience another one within 1 year; within 5 years stroke will recur in 24% of women and 42% of men. Current data reveal that stroke incidence has been declining in recent years in a largely white adult cohort. he incidence of stroke deaths is greater than 143,000 annually, and strokes account for 1 of every 18 deaths in the United States. he type of stroke is significant in determining survival. Of patients with stroke, hemorrhagic stroke accounts for the largest number of deaths, with mortality rates of 37% to 38% at 1 month, whereas ischemic strokes have a mortality rate of only 8% to 12% at 1 month. Survival rates are dramatically lessened by increased age, hypertension, heart disease, and diabetes. Loss of consciousness at stroke onset, lesion size, persistent severe hemiplegia, multiple neurological deficits, and history of previous stroke are also important predictors of mortality.1,2 Stroke is the leading cause of long-term disability in the United States. Of ischemic stroke survivors 65 or older, incidences of disabilities observed at 6 months include hemiparesis (50%), unable to walk without assistance (30%), dependent in activities of daily living (ADL) (26%), aphasia (19%), and depression (35%). Stroke survivors represent the largest group admitted to rehabilitation hospitals and about a third of patients receive outpatient rehabilitation services. Another indicator of disability is the fact that approximately 26% of patients with stroke are institutionalized in a long-term care facility. Direct and indirect costs of stroke are in the billions. Atherosclerosis is a major contributory factor in cerebrovascular disease. It is characterized by plaque formation with an accumulation of lipids, fibrin, complex carbohydrates, and calcium deposits on arterial walls that leads to progressive narrowing of blood vessels. Interruption of blood flow by atherosclerotic plaques occurs at certain sites of predilection. hese generally include bifurcations, constrictions, dilations, or angulations of arteries. he most common sites for lesions to occur are at the origin of the common carotid artery or at its transition into the middle cerebral artery, at the main bifurcation of the middle cerebral artery, and at the junction of the vertebral arteries with the basilar artery

Ischemic strokes are the result of a thrombus, embolism, or conditions that produce low systemic

perfusion pressures. The resulting lack of cerebral blood flow (CBF) deprives the brain of needed oxygen and glucose, disrupts cellular metabolism, and leads to injury and death of tissues. A thrombus

results from platelet adhesion and aggregation on plaques. Cerebral thrombosis refers to the formation

or development of a blood clot within the cerebral arteries or their branches. It should be noted that

lesions of extracranial vessels (carotid or vertebral arteries) can also produce symptoms of stroke. Thrombi lead to ischemia, or occlusion of an artery with resulting cerebral infarction or tissue death (atherothrombotic brain infarction [ABI]). Thrombi can also become dislodged and travel to a more distal site in the form of an intra-artery embolus. Cerebral embolus (CE) is composed of bits of matter (blood clot, plaque) formed elsewhere and released into the bloodstream, traveling to the cerebral arteries where they lodge in a vessel, producing occlusion and infarction. The most common source of CE is disease of the cardiovascular system. Occasionally systemic disorders may produce septic, fat, or air emboli that affect the cerebral circulation. Ischemic strokes may also result from low systemic perfusion, the result of cardiac failure or significant blood loss with resulting systemic hypotension. The neurological deficits produced with systemic failure are global in nature with bilateral neurological deficits. Hemorrhagic strokes, with abnormal bleeding into the extravascular areas of the brain, are the result of rupture of a cerebral vessel or trauma. Hemorrhage results in increased intracranial pressures with injury to brain tissues and restriction of distal blood flow. Intracerebral hemorrhage (IH) is caused by rupture of a cerebral vessel with subsequent bleeding into the brain. Primary cerebral hemorrhage (nontraumatic spontaneous hemorrhage) typically occurs in small blood vessels weakened by atherosclerosis producing an aneurysm. Subarachnoid hemorrhage (SH) occurs from bleeding into the subarachnoid space typically from a saccular or berry aneurysm affecting primarily large blood vessels. Congenital defects that produce weakness in the blood vessel wall are major contributing factors to the formation of an aneurysm. Hemorrhage is closely linked to chronic hypertension. Arteriovenous malformation (AVM) is another congenital defect that can result in stroke. AVM is characterized by a tortuous tangle of arteries and veins with agenesis of an interposing capillary system. he abnormal vessels undergo progressive dilation with age and eventually bleed in about 50% of cases. Sudden and severe cerebral bleeding can result in death within hours, because intracranial pressures rise rapidly and adjacent cortical tissues are compressed or displaced as in brainstem herniation.

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WHAT IS STROKE ?

Stroke (cerebrovascular accident [CVA]) is the sudden loss of neurological function caused by an interruption of the blood flow to the brain. Ischemic stroke is the most common type, affecting about 80% of individuals with stroke, and results when a clot blocks or impairs blood flow, depriving the brain of essential oxygen and nutrients.

Hemorrhagic stroke occurs when blood vessels rupture, causing leakage of blood in or around the brain. Clinically, a variety of focal deficits are possible, including changes in the level of consciousness and impairments of sensory, motor, cognitive, perceptual, and language functions. To be classified as stroke, neurological deficits must persist for at least 24 hours. Motor deficits are characterized by paralysis (hemiplegia) or weakness (hemiparesis), typically on the side of the body opposite the side of the lesion. he term hemiplegia is often used generically to refer to the wide variety of motor problems that result from stroke. he location and extent of brain injury, the amount of collateral blood flow, and early acute care management determine the severity of neurological deficits in an individual patient. Impairments may resolve spontaneously as brain swelling subsides (reversible ischemic neurological deficit), generally within 3 weeks. Residual neurological impairments are those that persist longer than 3 weeks and may lead to lasting disability. Strokes are classified by etiological categories (thrombosis, embolus, or hemorrhage), specific vascular territory (anterior cerebral artery syndrome, middle cerebral artery syndrome, and so forth), and management categories (transient ischemic attack, minor stroke, major stroke, deteriorating stroke, young stroke)

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Heart Valves

HEART DISEASE

CARDIAC ANATOMY AND PHYSIOLOGY OF HEART

HEART TISSUE

CORONARY ARTERIES

Heart Valves ;

Four heart valves ensure one-way blood flow through the heart. Two atrioventricular valves are located between the atria and ventricle. The atrioventricular valve, positioned between the RA and RV, is termed the tricuspid valve; the left atrioventricular valve is the mitral valve (also known as the bicuspid valve), located between the left atrium and ventricle. he semilunar valves lie between the ventricles and arteries and are named based on their corresponding vessels (i.e., pulmonic valve on the right in association with the pulmonary artery, and aortic valve on the left relating to the aorta).

Flaps of tissue called leaflets or cusps guard the heart valve openings. he right atrioventricular valve has three cusps and is therefore termed tricuspid, whereas the left atrioventricular valve has only two cusps and hence is termed bicuspid. These leaflets are attached to the papillary muscles of the myocardium by chordae tendineae. the primary function of the atrioventricular valves is to prevent backflow of blood into the atria during ventricular contraction or systole, while the semilunar valves prevent backflow of blood from the aorta and pulmonary artery into the ventricles during diastole. Opening and closing of each valve depends on pressure gradient changes within the heart created during each cardiac cycle.