Welcome to our continuation of common disorders treated by Physical Therapy!
Treatment by a physical therapist may be prescribed by the referring physician and/or a plan the PT develops following a comprehensive assessment of the patient’s condition. Therapies are described as passive or active. Passive therapies do not require the patient’s participation, active therapies do.
The goals of physical therapy include reducing inflammation, muscle spasm, pain, and increasing flexibility (range of motion), strength, and mobility. Postural correction, ergonomics (proper body mechanics), and prevention are key to all physical therapy programs.
Passive Therapies: It includes heat and ice, joint mobilization, manipulation, massage, myofascial release, spinal traction, transcutaneous electrical stimulation (TENS), and ultrasound.
Active Therapies: It includes stretching, strengthening, and aerobic (cardiovascular) training. Therapeutic exercise may be performed in a swimming pool (anti-gravity environment) to make stretching and strength building easier for patients who find weight-bearing exercise difficult.
Your doctor may refer you to a physical therapist to help you relieve your sciatica and restore movement. Physical therapy includes both passive and active treatments. Passive treatments help to relax you and your body. They also prepare your body for therapeutic exercise, which is the active part of physical therapy.
Your physical therapist may give you passive treatments such as:
- Deep Tissue Massage: This technique targets chronic muscle tension that could be pressing on your or related nerve roots. The therapist uses direct pressure and friction to try to release the tension in your soft tissues (ligaments, tendons, muscles).
- Hot And Cold Therapies: By using heat, the physical therapist seeks to get more blood to the target area because an increased blood flow brings more oxygen and nutrients to that area. For example, a heat pack placed on your piriformis muscle may help to reduce muscle spasms that could be causing your sciatica. Cold therapy slows circulation, helping to reduce inflammation, muscle spasms, and pain. Your physical therapist will alternate between hot and cold therapies.
- TENS (Transcutaneous Electrical Nerve Stimulation): You could even use this at home, if your therapist thinks it’s necessary. A machine stimulates your muscles through variable (but safe) intensities of electrical current. TENS helps reduce muscle spasms, and it may increase your body’s production of endorphins, your natural painkillers. The TENS equipment your physical therapist uses is larger than the “at-home” use machine. However, whether large or small, a TENS unit can be a helpful therapy.
- Ultrasound: Ultrasound sends sound waves deep into your muscle tissues and creates a gentle heat that enhances circulation and helps to speed healing. Increased circulation helps to reduce muscle spasms, cramping, swelling, stiffness, and pain.
In the active part of physical therapy, your therapist will teach you various exercises. Your physical therapy program is individualized, taking into consideration your health and history. It may include aerobic conditioning, strengthening exercises, and movements to increase flexibility and range of motion.
If needed, you will learn how to correct your posture and incorporate ergonomic principles into your daily activities.
Physical therapy often takes a hands-on approach, which may make you cringe if you’re experiencing pain from multiple hypersensitive tender points. However, physical therapy uses methods that are gentle, effective, and will most likely play a major role in managing your fibromyalgia symptoms.
There are a variety of physical therapy techniques. Passive treatments relax your body and include deep tissue massage, heat therapy, hydrotherapy, electric muscle stimulation, and ultrasound.
Your physical therapy program will usually begin with passive treatments. When you feel ready, you will start active treatments that strengthen your body and prevent further fibromyalgia pain. Your physical therapist will work with you to develop a plan that best suits you.
- Deep Tissue Massage: Unless you’re in an extreme amount of pain, deep tissue massage is an ideal fibromyalgia treatment because it uses a great deal of pressure to relieve deep muscle tension and spasms. Spasms prevent muscle motion at the affected level, which is one of the reasons people with fibromyalgia experience a decreased range of motion. Physical therapy techniques, including deep tissue massage, will help you use your muscles more effectively. This treatment may be combined with heat or cold therapies to boost the benefits.
- Heat Therapy: Heat therapy is one of the most preferred methods of reducing chronic aches and pains associated with fibromyalgia. Heat triggers the body’s natural healing process by relaxing your muscles and speeding up blood flow to the affected area. Extra blood delivers extra oxygen and nutrients. Blood also removes waste byproducts from muscle spasms.Heat may not completely eliminate the source of your pain, but it can effectively reduce your pain. This therapy is used in a couple of ways—through dry heat (a heating pad or a dry, hot towel) or moist heat (steam heat or a moist, warm cloth).When using heat therapy on your own after physical therapy ends, never overheat painful areas. If you’re using a heating pad, set it to low or medium. When using a hot towel, touch it first to make sure it’s not too hot. Excessive heat may not only exacerbate your fibromyalgia pain but also potentially cause burns.
- Hydrotherapy: As the name suggests, hydrotherapy involves water. As a passive treatment, hydrotherapy may simply involve sitting in a whirlpool bath to relieve pain, relax muscles, and condition your body without adding unnecessary stress.
- Electric Muscle Stimulation: Electric muscle stimulation sounds intense, but it really isn’t painful. This technique reduces muscle spasms and is generally believed to trigger the release of endorphins, which are your body’s natural pain killers.
- Ultrasound: This therapy uses sound waves to create a gentle heat that increases blood circulation to your deep tissues. Ultrasound helps reduce muscle spasms, inflammation, stiffness, and pain and is most effective in relieving range of motion limitations in chronic pain sufferers,as opposed to those with acute inflammatory conditions.
Active treatments help address core stability, flexibility, strength, and joint movement. An exercise program may also be prescribed to achieve optimal results. This will not only curb recurrent pain but will also benefit your overall health. Your physical therapist will work with you to develop a program based on your specific symptoms and health history.
Active treatments include:
- Core Stability: Your core (abdominal) muscles have a greater impact on your overall health than you may think. Strong core muscles serve as good allies to your back muscles in supporting your spine. It’s called the core because it’s the central powerhouse of your body. Naturally, a healthy core provides your body with a strong, stable center point.
- Muscle Flexibility And Strengthening: Your range of motion will likely be restricted if you’re experiencing fibromyalgia pain. Using customized stretching and strengthening exercises, your physical therapist will help you lengthen and strengthen your muscles, and improve joint movement. Strong, lean muscles better handle pain.
- Hydrotherapy: Water-based exercises may be recommended to provide gentle aerobic conditioning.
Your physical therapist will teach you self-care principles so you understand how to best treat your symptoms. The ultimate goal is for you to develop the knowledge to help control your symptoms. It’s essential that you learn the exercises and continue them after the formal therapy ends. If you fail to keep with a fitness regimen, you won’t enjoy long-term results from your physical therapy. By taking care of your back on your own, you’ll reduce further fibromyalgia pain.