Physical therapy and back pain part 2

When does physical therapy start?

After the acute back pain has subsided with bed rest and use of pain medications, most individuals are encouraged to enter a physical therapy program. Because of ongoing pain, the initial physical therapy is limited to improving mobility and there is little weight training. The majority of physical therapy centers offer excellent therapists who understand the problem and know what is required to get the individual back on their feet.

Rest assured, you will not be immersed into intense physical therapy the first day you arrive. In all cases, the therapist will assess and physically examine you to ensure that you are fit for physical therapy. The therapist will assess your degree of pain threshold, mobility, flexibility, and limitations and then prescribe an exercise program to fit your condition.

There is a lot of evidence that shows physical therapy is better able to treat individuals with mild or moderate back pain. Evidence now indicates that when regularly performed, both passive and active therapy can relieve back pain. Passive physical therapy programs consist of application of heat or ice packs, use of TENS unit and application of ultrasound. Passive modalities of physical therapy treatment work well in the early phase of back pain. Also included in physical therapy are massages, heat, diathermy, and hydrotherapy.

Once the individual has a decrease in back pain, active physical therapy is undertaken. This involves muscle stretching, improving range of motion exercises, gradual muscle strengthening, pain relieving movements and aerobic conditioning. Over time, many cases of back pain can be significantly improved with strengthening of back muscles.

For residual back pain, one may also undergo various spinal decompression treatments including use of traction devices.

If the pain continues, one can wear a brace or corset, which can be worn both during exercises and at rest. These braces help support the back, improve posture and assist with mobility. Braces can be bought from any medical supply store.

Physical therapy for back pain gives different results for different patients. No two individuals obtain the same response. Because each individual has a distinct body shape, anatomy, build, and physique, the benefits also vary. After a program of 2-4 months, most individual with back pain should see some improvement. Following this, one can be taught to undertake physical therapy exercises at home. These exercises can help improve posture and prevent back pain from coming back.

The major problem with physical therapy is that most people seem to think it is a bunch of useless exercises. Sure, physical therapy is not a magic bullet, nor does it work in everyone- but it is perhaps the best treatment for back pain- bar none. No available treatment for back pain can match the outcomes of physical therapy

Physical therapy is not a one shot deal and needs motivation, patience, and dedication. One may start off once a week and progress from that point. Physical therapy is also not a quick fix to back pain and requires time- perhaps 3-6 months. Nevertheless, in the long run, this therapy is safer, cheaper, and more effective than surgery or any other decompression treatment.

Once back pain has resolved, it is vital to maintain a decent weight, continue with exercises, and remain active.

for back pain braces and traction devices, visit www.medexsupply.com

post herpetic neuralgia part 3

Anti depressants are widely used to treat post herpetic neuralgia. These drugs are quite effective in decreasing the pan sensation in at least 40% of individuals. The doses of the anti depressant selected are much lower than the actual dose used to treat depression. To date, all classes of antidepressant have been shown to have some benefit in relieving the pain of post herpetic neuralgia but the tricyclic anti depressants seem to work the best.

Anti convulsants. Some drugs used to treat seizures have also been found be useful in the treatment of post herpetic neuralgia. The classic anti convulsant is Gabapentin or neurontin today. Another related drug is called lyrica and it is also useful in the treatment of post herpetic neuralgia. These drugs do relieve pain in close to 30-40 percent of individuals but the duration of pain relief is not long lasting. In some cases, the drug does work initially but fails to work in the long run.

Some physicians have tried to inject corticosteroids around the spinal cord. The results of corticosteroid are not always reproducible but when it works the pain relief is long term. However, less than 5% of patients respond to these injections. Steroid injections are never first choice treatment for this disorder. Only individuals who fail the above drug therapies should receive steroidal injections.

Narcotics. Over the counter pain pills are useless for Post herpetic neuralgia. Narcotics like oxycontin, hydrocodone, and percocet do work but long-term use of these narcotics has been associated with physical dependence and addiction. With many cases of overdose, many physician s have become hesitant about writing prescriptions for such medications.

Transcutaneous electrical nerve stimulation involves insertion of tiny electrodes into the painful skin areas; the electrodes are then stimulated to deliver painless electrical impulses to the nerves. It is believed that these impulses can block the pain fibers or stimulate the nerves to release pain-relieving chemicals. While the treatment is effective, it does not work in everyone. Some individuals combine TENS with drug therapy to get the maximal benefit.

Spinal cord or peripheral nerve stimulation. Devices similar to TENS are now being placed underneath the skin for long-term use. These devices can be turned off or on as needed to control the pain. At the time of implantation, the doctor will test the device to see if it works. The electrodes are placed in the vicinity of the spinal cord and the small stimulator is placed in the upper buttock area but can be placed in the chest or abdomen. This method of pain control is quite expensive and does require a minor surgical procedure.

Lidocaine patches are small bandage like patches that do relieve only the mild pain. The patches are available with a prescription and can be applied on to the skin. They do not always work and are not recommended for moderate or severe pain.

As far as pain relief is concerned, no method provides complete relief. Some people do have little relief but many obtain no relief. The majority of patients live with the pain for many years. Luckily, in most cases, the pain of post herpetic neuralgia disappears within 3-6 months. In some unlucky individual, the pain may last a few years

For more on TENS, please visit www.medexsupply.com