I am writing it today because I think not only in my practise but all medical practises, we come across various patients who are stressed and they are told your pain is only in head and there's nothing wrong with you... stress leads to pain and pain leas to stress there seems no end to your vicious cycle of pain.
The more people you meet more advices you have professional and otherwise. Definitely some of them are useful and other frustrating.
This article reflects at what a person feels who has been struggling for days , months and years with pain, so I am trying to peep out of the window from the side of somebody who is suffering with pain and not as a physical therapist
"I think if you sit around thinking about your pain too much. Just get out of that house more and it may just heal itself." "If you really wanted to get well, you'd get serious about taking that juice I recommended. I don't understand why you won't at least try it."
Advices advices and here comes something more:-
MANAGING THE PAIN
[1] Release people from the expectations you have of them. This will likely be a life-long process, but without taking this step, you will consistently find that people will always disappoint you.Your illness is significant in your life. And even though people do care, they still will have significant things going on in their own lives. Don't expect them to always be at your call.
[2] Find supportive friends. Is there someone in your circle of friendships who is constantly belittling you or suspicious about your illness? Is he is beyond listening and instead spreading gossip about how he saw you last week and you looked perfectly fine? This should be a relationship to let go of or, if it's a relative, distance your self as much as possible. Illness can help us easily prioritize our friendships and that way we can spend our limited energies with those that mean the most to us.
[3] Find joy in your blessings. Rather than thinking about how badly you feel, find ways to bring more joy into your life. Appreciate the little things.
[4] Use your talents and skills for things you have a personal interest in. Don't allow yourself to feel like the skills you learned in a workplace are no longer valuable. Rather than focusing on what others aren't doing to comfort you, follow your dreams and give that gift to yourself. May be you always wanted to paint or sing ,this what my patient Sujata did , followed her dream , fought her battle of pain and is now an artist from being a computer engineer.
[5] Be a role model for someone else with an illness. You know how hard it is to live with pain and to feel like that no one understands what you are experiencing, so take time to be with someone else who is going through this. Make someones and your own journey easy.
You owe it to yourself to find joy despite your pain , and by focusing on how you can change your circumstances, instead of change other people, you'll be much more personally rewarded. And at the conclusion i would use the words of my friend and patient Azra give the best to yourself as you are worth it.
Friday, October 9, 2009
Tuesday, August 18, 2009
Neck and Back
Neck & back What is causing my spinal pain?
Spinal pain is something that many people experience at some stage during their life. It brings with it it distress and interruption to our work and social pursuits.
Fortunately serious or permanent damage is uncommon. Your spine is a solid structure of great strength. It is made of bony blocks (vertebrae) which are connected by discs and bands of tough tissue (ligaments) which give it strength, flexibility and shock absorbency. It is reinforced by strong supportive muscles. All these structures have an abundance of nerve endings. If they are under stress or injured they will let you know!
Most simple back strains do not cause any lasting damage. The pain experienced is your body telling you to do something about it!
Physiotherapy and Pain relief:
To bring relief of pain i may utilise any of the following: mobilisation, manipulation, exercises, and electrotherapy.
Spinal pain is something that many people experience at some stage during their life. It brings with it it distress and interruption to our work and social pursuits.
Fortunately serious or permanent damage is uncommon. Your spine is a solid structure of great strength. It is made of bony blocks (vertebrae) which are connected by discs and bands of tough tissue (ligaments) which give it strength, flexibility and shock absorbency. It is reinforced by strong supportive muscles. All these structures have an abundance of nerve endings. If they are under stress or injured they will let you know!
Most simple back strains do not cause any lasting damage. The pain experienced is your body telling you to do something about it!
Physiotherapy and Pain relief:
To bring relief of pain i may utilise any of the following: mobilisation, manipulation, exercises, and electrotherapy.
Tuesday, August 4, 2009
computer related injuries
If your job requires working long hours on the computer, there is a good chance that you have experienced some back, neck, shoulder, or arm pain at the end of your long working days. These are some of the common computer-related injuries caused by bad posture while using a computer and poor work station design. Sitting is not really a strenuous activity but since it requires your muscles and joints to remain in the same position for a long period, it can cause stiffness and fatigue. Some simple changes in your work habits can prevent computer related injuries.
Posture related injuries:
Back and neck pain, headaches, and shoulder and arm pain are common computer-related injuries. Such muscle and joint problems can be caused or made worse by poor workstation design, bad posture and sitting for extended periods of time due to reduction in circulation to the muscles, bones, tendons and ligaments and can result in stiffness and pain.
Prevention of muscle and joint injuries:
Use an adjustable desk designed for use with computers
•Position the monitor so that it is either at eye level or slightly lower
•Position your keyboard at a height that allows your elbows to rest comfortably at your side
•Forearms should be roughly parallel with the floor and level with your keyboard
•Adjust your chair so that your feet rest flat on the floor
•Use a footstool if your feet do not rest on the floor
•Switch to an ergonomic chair, which helps your spine to naturally hold its curve while sitting
•Use an ergonomic keyboard to offer your hands and wrists a more natural holding position
•Take frequent short breaks and go for a walk or perform stretching exercises at your desk or Stand often.
Prevention of upper limb related injuries:
Muscles and tendons can become painful with repetitive movements and awkward postures and symptoms of overuse injuries in the upper limbs include pain, swelling, and stiffness of the joints, weakness and numbness
•Keep your mouse at the same height as your correctly positioned keyboard
•Position the mouse as close as possible to the side of the keyboard
•Use your whole arm, not just your wrist, when using the mouse
•Type lightly and gently
•Mix your tasks to avoid long, uninterrupted stretches of typing
•Remove the hands from the keyboard when not actively typing, to allow the arms to relax.
Posture related injuries:
Back and neck pain, headaches, and shoulder and arm pain are common computer-related injuries. Such muscle and joint problems can be caused or made worse by poor workstation design, bad posture and sitting for extended periods of time due to reduction in circulation to the muscles, bones, tendons and ligaments and can result in stiffness and pain.
Prevention of muscle and joint injuries:
Use an adjustable desk designed for use with computers
•Position the monitor so that it is either at eye level or slightly lower
•Position your keyboard at a height that allows your elbows to rest comfortably at your side
•Forearms should be roughly parallel with the floor and level with your keyboard
•Adjust your chair so that your feet rest flat on the floor
•Use a footstool if your feet do not rest on the floor
•Switch to an ergonomic chair, which helps your spine to naturally hold its curve while sitting
•Use an ergonomic keyboard to offer your hands and wrists a more natural holding position
•Take frequent short breaks and go for a walk or perform stretching exercises at your desk or Stand often.
Prevention of upper limb related injuries:
Muscles and tendons can become painful with repetitive movements and awkward postures and symptoms of overuse injuries in the upper limbs include pain, swelling, and stiffness of the joints, weakness and numbness
•Keep your mouse at the same height as your correctly positioned keyboard
•Position the mouse as close as possible to the side of the keyboard
•Use your whole arm, not just your wrist, when using the mouse
•Type lightly and gently
•Mix your tasks to avoid long, uninterrupted stretches of typing
•Remove the hands from the keyboard when not actively typing, to allow the arms to relax.
Monday, July 27, 2009
Back Pain & Posture
For many people back pain is directly related to poor posture, in both standing and sitting. The majority of people will have at least one, usually more, postural abnormalities. Afterall, if you go back a few evolutionary steps, we walked on all fours! Evolving to walk on two legs has placed a large amount of stress on our spines.
How does poor posture contribute to back pain?
1. Poor posture places additional strain on the muscles, ligaments and discs of the back
2. Over time this additional strain can lead to structural changes to the discs, muscles and ligaments surrounding the spine
3. These structural changes are usually what causes mild to moderate back pain
4. Pain most often comes from strain to muscles and as a result of muscle imbalances
5. Poor posture is sometimes due to inherent factors. A leg length discrepancy can mean one hip is higher than the other. This can cause lower back pain due to some muscles having to work harder to compensate. This can be corrected by wearing a heel wedge.
6. Biomechanical factors such as over-pronation of the feet can also cause back pain. Over-pronation causes the shin to roll inwards, followed by the thigh, which in turn alters the position of the pelvis.
What are muscle imbalances?
All muscles have an optimum length and tension. When your posture is good the muscles surrounding and supporting your back are at this optimum length. When your posture is poor some muscles will be shortened and tight, others (usually the antagonist) will be lengthened and weak.
For example, those who spend all day hunched over a desk often develop shortened, tight chest muscles and weak, lengthened back muscles.
Similarly, in those with a lumbar lordosis (excessive curvature of the lower back) The hip flexors (rectus femoris, iliopsoas) and lower back become tight and short and the glutes (bum muscles) and abdominals become loose and weak.
What is good posture?
A good back posture does not involve a perfectly straight spine. The spine has natural curves which help it to transmit forces and so the key to good posture is maintaining what is known as a "neutral spine". The following is a list of the key points for a neutral spine in standing, from head to toe:
1. The head should be held up straight, with the chin tucked in. Earlobes are level so you know you are not tilting the head to the side.
2. Lift the sternum (breast bone). Imagine a piece of string attached to the sternum, pulling it towards the ceiling. As you do this you should notice your shoulders move back and down.
3. Maintain a slight hollow at the lower back as this is a natural curve of the spine.
4. Hips should be level.
5. The neutral spine should be maintained when standing and sitting.
In addition, when standing:
1. Knees should be straight and feet at shoulder width, toes pointing straight forwards.
2. When standing sideways on, it should be possible to draw a line straight through the centre of your feet, knees, hips, shoulders and earlobes.
When sitting:
1. Keep both feet flat on the floor
2. Make sure your chair has good lumbar (lower back) support or use an additional lumbar support.
When lifting:
1. Ensure the object to be lifted is close to you so that you are more stable.
2. Have your feet at shoulder width to provide a solid base of support.
3. Activate your core muscles to help stabilise the spine.
4. Keeping the back straight throughout, use the legs to push yourself up.
How can i improve my posture?
Posture can be improved by following a rehabilitation program which should include:
1. Core strength exercises
2. Stretching tight muscle groups
3. Strengthening weak muscle groups
4. Altering your working position (If you work mostly at a desk)
5. Correcting any biomechanical abnormalities
Here are some simple exercises you can do at your desk to help improve your posture:
1. Sit comfortably in your chair, with both feet on the ground. Relax your shoulders and look straight ahead. Pull your chin in towards your head and hold for 10 seconds initially, increasing to 30 seconds. Repeat 3 times
2. Again, sitting in your chair, rest your hands on your thighs. Slowly squeeze your shoulder blades together. Hold for 10 seconds, increasing to 30 seconds. Repeat 3 times
3. Whilst sitting at your desk practise activating your core muscles.
How does poor posture contribute to back pain?
1. Poor posture places additional strain on the muscles, ligaments and discs of the back
2. Over time this additional strain can lead to structural changes to the discs, muscles and ligaments surrounding the spine
3. These structural changes are usually what causes mild to moderate back pain
4. Pain most often comes from strain to muscles and as a result of muscle imbalances
5. Poor posture is sometimes due to inherent factors. A leg length discrepancy can mean one hip is higher than the other. This can cause lower back pain due to some muscles having to work harder to compensate. This can be corrected by wearing a heel wedge.
6. Biomechanical factors such as over-pronation of the feet can also cause back pain. Over-pronation causes the shin to roll inwards, followed by the thigh, which in turn alters the position of the pelvis.
What are muscle imbalances?
All muscles have an optimum length and tension. When your posture is good the muscles surrounding and supporting your back are at this optimum length. When your posture is poor some muscles will be shortened and tight, others (usually the antagonist) will be lengthened and weak.
For example, those who spend all day hunched over a desk often develop shortened, tight chest muscles and weak, lengthened back muscles.
Similarly, in those with a lumbar lordosis (excessive curvature of the lower back) The hip flexors (rectus femoris, iliopsoas) and lower back become tight and short and the glutes (bum muscles) and abdominals become loose and weak.
What is good posture?
A good back posture does not involve a perfectly straight spine. The spine has natural curves which help it to transmit forces and so the key to good posture is maintaining what is known as a "neutral spine". The following is a list of the key points for a neutral spine in standing, from head to toe:
1. The head should be held up straight, with the chin tucked in. Earlobes are level so you know you are not tilting the head to the side.
2. Lift the sternum (breast bone). Imagine a piece of string attached to the sternum, pulling it towards the ceiling. As you do this you should notice your shoulders move back and down.
3. Maintain a slight hollow at the lower back as this is a natural curve of the spine.
4. Hips should be level.
5. The neutral spine should be maintained when standing and sitting.
In addition, when standing:
1. Knees should be straight and feet at shoulder width, toes pointing straight forwards.
2. When standing sideways on, it should be possible to draw a line straight through the centre of your feet, knees, hips, shoulders and earlobes.
When sitting:
1. Keep both feet flat on the floor
2. Make sure your chair has good lumbar (lower back) support or use an additional lumbar support.
When lifting:
1. Ensure the object to be lifted is close to you so that you are more stable.
2. Have your feet at shoulder width to provide a solid base of support.
3. Activate your core muscles to help stabilise the spine.
4. Keeping the back straight throughout, use the legs to push yourself up.
How can i improve my posture?
Posture can be improved by following a rehabilitation program which should include:
1. Core strength exercises
2. Stretching tight muscle groups
3. Strengthening weak muscle groups
4. Altering your working position (If you work mostly at a desk)
5. Correcting any biomechanical abnormalities
Here are some simple exercises you can do at your desk to help improve your posture:
1. Sit comfortably in your chair, with both feet on the ground. Relax your shoulders and look straight ahead. Pull your chin in towards your head and hold for 10 seconds initially, increasing to 30 seconds. Repeat 3 times
2. Again, sitting in your chair, rest your hands on your thighs. Slowly squeeze your shoulder blades together. Hold for 10 seconds, increasing to 30 seconds. Repeat 3 times
3. Whilst sitting at your desk practise activating your core muscles.
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