Physical Activity for Depression

Even Small Amounts Of Physical Activity Can Significantly Improve Mental Health

Our modern world can be a stressful one. For many people, dealing with more than two years of fear, anxiety, and debate revolving around the coronavirus pandemic has had a harsh impact effect on the state of one’s mental health.

As a result, rates of depression—which were already high even before the pandemic—have been steadily increasing over the past two years, with no signs of slowing down. Major depressive disorder affects about 15 million American adults (or 6% of the adult population), and some research has suggested that the prevalence of depression symptoms has more than tripled during the pandemic. Depression is also the leading cause of mental health-related disease burden and is associated with a host of negative health effects, including an increased risk for chronic conditions and premature death.

Exercise – an Often Overlooked Treatment Option

Effectively treating and preventing depression often requires a multifaceted approach, and most health experts recommend talk therapy as a central intervention for those suffering from depression symptoms. But another strategy that’s being increasingly recognized as a powerful and vital tool against depression is regular physical activity. Ample research has shown that physical activity can prevent future depression, but no study is yet to describe the strength or shape of this association according to on a dose-response relationship.

Researchers Analyze the Findings of 15 Studies

Therefore, a study called a systematic review and meta-analysis was conducted to explore the impact of physical activity on the risk of depression. Researchers performed a search of four medical databases for studies with at least 3,000 participants that reported on the relationship between physical activity and the estimated risk for depression. All measurements of physical activity in these studies were then converted to a weekly duration and an activity volume, which was based on whether the activity was light, moderate, or vigorous. For reference, the World Health Organization recommends 150–300 minutes of moderate-intensity activity or 75–150 minutes of vigorous-intensity activity per week.

This search led to 15 studies being accepted, which included data on more than 191,000 participants. Results indicated that most participants were not meeting the recommended levels of weekly physical activity, and those with higher rates of depression symptoms were generally less active.

Just Doing Modest Amounts of Exercise is Helpful According to this Review

Physical activity was found to be associated with significant benefits, as participants who completed half the recommended volume of weekly physical activity had an 18% lower risk of depression, and those who met the full recommended volume—about 2.5 hours of brisk walking per week—had a 25% reduced risk. Further analysis revealed that the benefits of physical therapy were most notable when comparing individuals who progressed from no physical activity to at least some activity.

These findings suggest that even small amounts of physical activity may lead to major mental health benefits, as approximately 1 in 9 cases of depression could potentially be prevented if everyone meets the recommended weekly level of physical activity. At

Mental Health is as Important as Physical Health!

Bacci & Glinn Physical Therapy, we believe it’s extremely important to address not only physical conditions but mental health issues as well. While physical therapists primarily see patients with physical movement problems, this is another example where the appropriate exercise program can also help with mental health as well.

Have a Movement Disorder?  We Can Help

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) for more information or schedule an appointment today.

Basketball Injury Prevention Program

Basketball Injuries Are Extremely Common, But A Warm-Up Program May Help Mitigate This Risk

Basketball is one of the most popular sports in the country, and its popularity continues to grow as athletes are drawn to its fast pace and evolving nature. Unfortunately, one downside of this increased participation in basketball is that it also comes with a higher rate of injuries in a sport that’s already known to be high-risk.

Basketball Results in A Lot of Stress on the Knees & Ankles

To play basketball competitively, players must move at fast speeds and display great agility and coordination on the court. Though every position requires a different set of skills, each player needs to run, jump, make quick changes in direction, and accelerate and decelerate with and without the ball. Though these rapid movements are integral to the game, they also put competitive players at risk for injury.

Basketball Injuries are Common – Ankle & Knee Problems Happen the Most

Injuries can occur in several regions of the body, but the ankle is by far the area injured most. Ankle sprains account for about 25% of all injuries in basketball, which makes them a major concern for basketball players of all ages. Ankle sprains occur any time the foot twists or rolls beyond its normal range of motion, which is usually from a player landing on another player’s foot wrong or twisting the ankle when making a cut. The knees are another problem area in basketball players due to the running, jumping, and cutting motions involved. Jumper’s knee and injuries to the meniscus and ligaments—including the ACL—are all very common in all age groups of basketball players. Ankle sprains, ACL tears, and other injuries can all cause basketball players to be sidelined for an extended period, and in some cases, to miss an entire season.

Study Monitors Players on 31 Basketball Teams for Two Seasons

To help mitigate this risk, many basketball teams have now incorporated injury-prevention programs into their routine, often with successful outcomes. This is exemplified in a recently published study, which highlights the type of impact a program like this can have on young basketball players.

For the study, players on 31 high school or club basketball teams—307 male and female players aged 11 to 18 years—were monitored for two seasons. During the first season, players only participated in a standard of practice warm-up. During the second season, all players participated in a training warm-up program called the Surveillance in High school and community sport to Reduce (SHRed) Injuries Basketball, which was designed to reduce ankle and knee injuries in youth basketball players. The SHRed Injuries Basketball program lasted 10 minutes and consisted of 13 exercises, which were intended to improve aerobics, agility, strength, and balance. A log was then kept of all injuries that occurred during these two seasons and comparisons were made between them to tease out any notable differences.

Study Results Demonstrate that Ankle Sprains & Knee Injuries Can be Significantly Reduced

Results showed that the SHRed Injuries Basketball program was protective of both knee and ankle injuries, as the rate of injuries was 36% lower in season 2 than season 1. This type of program can easily be incorporated into a warm-up routine, and based on these findings, it may yield dividends and keep young basketball players on the court injury-free for longer.

We’re Here to Help

At Bacci & Glinn Physical Therapy, we can provide assistance with an injury-prevention program for your basketball team, or if an injury does occur, we can guide players through a comprehensive rehabilitation program that will get them back on the court as quickly and safely as possible.

If You’ve Already Suffered a Sports Injury – We Can Help You Get Back in the Game

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) for more information or schedule an appointment today.

Osteoarthritis Treatment in Hanford – Physical Therapy Wins Again

Exercise Therapy Found To Be Better Than Pain Medications For Knee Osteoarthritis

If you are searching for osteoarthritis treatment in Hanford, we wrote this research summary for you. Before you dig into the summary, please understand that arthritis treatment in Hanford is not the only location we provide care.  We also provide conservative, natural care for those looking for osteoarthritis treatment in Visalia as well.

Arthritis – A Major Issue that Millions Deal With

Knee osteoarthritis is a bothersome condition that disables millions of Americans each year. In a normal knee, the ends of each bone are covered by cartilage, a smooth substance that protects the bones from one another and absorbs shock during impact. In knee osteoarthritis, this cartilage becomes stiff and loses its elasticity, which makes it more vulnerable to damage. Cartilage may begin to wear away over time, which greatly reduces its ability to absorb shock and increases the chances that bones will touch one another.

Typical Signs & Symptoms of Knee Osteoarthritis

Knee osteoarthritis typically leads to pain within and around the knee that tends to get worse with activities like walking, ascending/descending stairs, or sitting/standing. Other symptoms include swelling, tenderness, stiffness, and a popping, cracking, crunching sensation. The risk for knee osteoarthritis increases with age, and it represents the most common cause of knee pain in older adults. Overall, about 45% of the population will experience knee osteoarthritis at some point in their lifetime.

Hundreds of Osteoarthritis Treatment Options for Hanford Residents – Which One Should You Pick?

Numerous interventions may be followed to address knee osteoarthritis, including over the counter and prescription medications, lifestyle changes like exercise and diet, physical therapy, and surgery, which is typically only reserved as a last resort for cases that don’t improve with other interventions. Opioids are not usually recommended for patients with knee osteoarthritis due to the risk for overuse and abuse, but some patients—especially those with severe, long-lasting pain—may still be prescribed these medications. Non-steroidal anti-inflammatory drugs (NSAIDs) are among the more commonly used interventions to may provide mild pain relief, but long-term use of these drugs is discouraged. Exercise therapy, on the other hand, is considered a safe and effective way to manage knee osteoarthritis by helping patients move better through stretching, strengthening, and other exercises.

Powerful literature analysis supports the effectiveness of exercise therapy

A recently published study  compared these three commonly utilized interventions for knee osteoarthritis through a systematic review and network meta-analysis, which identifies and analyzes all available literature on the topic to determine which was best.

To conduct the study, researchers performed a literature search of three medical databases for high-quality studies that compared exercise therapy, NSAIDs, and opioids for knee osteoarthritis pain. This search led to 13 studies being included, which featured data on nearly 1,400 patients. A total of 101 supplemental studies were also included.

Exercise Therapy Wins – This is Exactly What Physical Therapists are Trained to Provide

Results showed that exercise therapy ranked as the best intervention overall in the network meta-analysis, followed by NSAIDs, opioids, and placebo.

These findings suggest that exercise therapy is an effective intervention for knee osteoarthritis. Considering the risks associated with opioids and long-term use of NSAIDs, exercise therapy presents a far better option for patients with knee osteoarthritis.

Therefore, if you’re currently dealing with symptoms that sound like knee osteoarthritis, we strongly encourage you to contact Bacci & Glinn Physical Therapy.  You can learn more about our orthopedic physical therapy services by clicking here.

Contact Us Today – Take the First Step to Getting Rid of Your Pain

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Preventing ACL Injuries in Female Athletes

In-School Prevention Programs May Be A Viable Solution To Reduce The Risk For ACL Injuries

Injuries to the anterior cruciate ligament (ACL) are one of the biggest problems in sports. Approximately 100,000–200,000 ACL tears occur each year in the U.S., and one of the most at-risk populations is adolescents, particularly females. ACL injuries account for about 21% of knee injuries in young athletes, and young females have a two to eight times higher risk for these injuries compared to their male counterparts.

Differences in Development & Behaviors May Lead to Increased Injury Risk

There are several reasons for this disparity, including differences in the structure of the knee joint—which is looser and more flexible in females—landing patterns in sports, genetics, and hormonal and neuromuscular differences between males and females. Strength also develops at different times during puberty for females compared to males, which is believed to be another important contributing factor.

To make matters worse, ACL injuries are often not isolated incidents, as they may damage surrounding tissue and increase the likelihood of chronic knee problems like secondary injuries and early osteoarthritis in the future. But the good news is that research suggests many of these injuries can be prevented because about 70% of ACL tears occur without contact.

For this reason, numerous prevention programs have been established to reduce the rate of ACL injuries in high-risk populations, including adolescent female athletes. ACL prevention programs incorporate interventions like balance training, stretching, strength training, and plyometrics (jumping exercises) into a comprehensive framework that’s performed regularly, and research has shown that these programs are beneficial.

Recent study shows why these programs are frequently recommended

For example, one recently published study investigated the effectiveness of a strength-based prevention program for reducing the risk of ACL injury in adolescent females. For the study, a team of researchers identified 30 healthy female middle school students between grades 6 to 8 and matched them with another group of 30 healthy females of similar age, height, and weight. The first group served as the strength-training group and the second group served as the control group.

Individuals in the first group underwent a six-month strength training program administered through a gym class curriculum that targeted the muscles of the hips and knees, with the intention of improving hip extension and knee extension and flexion. The control group did not undergo any specific interventions. All patients were evaluated before and after the six-month period for various measures of strength and range of motion (ROM).

Study Results – Improve Strength & Agility

Results showed that females in the strength training group had greater strength values in hip extension, hip abduction, and knee flexion compared to the control group. The strength training program also led to significantly lower scores compared to the control group in a test called the Landing Error Scoring System (LESS), which is used to the risk of non-contact injuries during jumping and landing movements. These findings show that a strength training program for middle school females leads to several improvements that are associated with a reduced risk for ACL injuries. This program is also easy to implement since it was performed during gym class and could therefore represent a practical option for addressing the issue of frequent ACL injuries in youth sports.

Contact Us Today for Help

If you’re currently dealing with symptoms suggestive of knee osteoarthritis, Bacci & Glinn Physical Therapy can help.

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Physical Therapy for a Frozen Shoulder in Visalia and Hanford

Are you searching for a specialist that treats frozen shoulder treatment in Visalia or Hanford?  You may not know, but our physical therapy treatment for frozen shoulders is some of the best you’ll find in the area.

Understanding a frozen shoulder/adhesive capsulitis diagnosis is important, so we wrote this article below to help those in need.

Comprehensive Review Finds That Several Types Of Exercise
Lead To Improvements For Patients With Frozen Shoulder

Adhesive capsulitis, or frozen shoulder, occurs when scar tissue forms within the shoulder. This causes the shoulder capsule to thicken and tighten around the shoulder joint, which means there is less room to move the shoulder normally. Although frozen shoulder affects up to 5% of the population, the reasons why it develops have not yet been clearly established. It is generally believed that not moving the shoulder normally for long periods is a leading factor, as most people who get frozen shoulder have kept their shoulder immobilized due to a recent injury, surgery, or pain. People between the ages of 40–60, women, and patients with arthritis, diabetes, cardiovascular disease, and other health conditions are also more likely to develop frozen shoulder.

Frozen shoulder usually develops slowly and gets progressively worse over time with more pain and loss of motion. It is typically divided into the following four stages:

  • Stage 1: consists of the onset of symptoms, which gradually get worse over 1–3 months
  • Stage 2: the “freezing” stage, which generally occurs 3–9 months after symptoms begin and is very painful
  • Stage 3: the “frozen” stage, which involves the shoulder becoming even more stiff and difficult to move
  • Stage 4: the “thawing” stage, which occurs within 12–15 months and involves pain decreasing significantly and range of motion starting to improve

Adhesive Capsulitis Treatment in Visalia & Hanford – Clinical Research Supports Physical Therapy

Physical therapy is commonly used and often recommended for frozen shoulder because it’s effective for addressing symptoms at every stage; however, there are some questions about the exercises used in physical therapy that have not yet been clearly answered. Therefore, a comprehensive study called a systematic review and meta-analysis was conducted to 1) compare the effectiveness of exercises alone and exercises in combination with other interventions and no exercises and 2) determine what kind of exercises are most effective for frozen shoulder.

Researchers review 33 studies on exercise therapy for frozen shoulder

To conduct the study, researchers performed a search of three medical databases for relevant studies about exercise therapy for frozen shoulder. This led to 33 studies being accepted into the review, which saw patients treated with a variety of exercises, some prescribed individually, and others prescribed as part of a comprehensive treatment program. The findings of all included studies were then reviewed and compared to one another with the goal of answering the two main research questions.

Results showed that exercises—both on their own and as part of a program—improved range of motion (ROM), function, disability, and pain, and the type of exercise performed had little to no impact on these improvements. Also, adding physical modalities to exercises did not provide any benefits to treatment outcomes, and programs that included exercises resulted in larger active ROM gains than programs that did not.

Frozen Shoulder Physical Therapy Visalia & Hanford – Physical Rehab is the Key

These findings support the effectiveness of physical therapy for frozen shoulder and suggest that the type of exercises performed and whether they are completed alone or combined with other interventions may not be important, so long as they are featured in a rehabilitation program.

Therefore, if you’re currently dealing with symptoms that may suggest the presence of frozen shoulder, Bacci & Glinn Physical Therapy can help.

Call us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

PT vs Surgery for SIS – Research Says Try Conservative First

 

Are you searching for a specialist that treats shoulder impingement in Visalia or Hanford? You may not know, but our physical therapy care for shoulder impingement is some of the best you’ll find in the area.

Understanding rotator cuff problems and shoulder impingement is important, so we wrote this article below to help those in need.

Physical Therapy Is Just As Effective As Surgery In The Long Term For A Common Shoulder Condition

Most shoulder conditions—about 85%—involve the rotator cuff, which is a group of muscles and tendons that keeps the shoulder stable. Among these common shoulder conditions is shoulder impingement syndrome (SIS), in which rotator cuff tendons become compressed—or “impinged”—as they pass through a small bone on top off the shoulder blade called the acromion. Over time, this causes the tendons to become irritated and inflamed, and will lead to bothersome symptoms like swelling and tenderness, loss of strength, restricted movement, and pain.

SIS is most common in individuals that regularly perform lots of overhead activities like golfers, swimmers, and baseball and tennis players, as well as painters and construction workers. The condition can also result from an injury that compresses the structures of the shoulder—like a fall—or from frequently sleeping on your side. Sleeping in this position regularly can strain the shoulder and cause impingement over time.

SIS is closely related to rotator cuff tendinitis and subacromial pain, and in some cases, the terms may be used interchangeably. When any of these conditions develop, the best course of action is a comprehensive physical therapy program, which helps patients work through their pain to regain strength, flexibility, and physical function; however, many patients undergo a surgical procedure called arthroscopic subacromial decompression (ASD) to treat their shoulder pain. An abundance of research has shown that this procedure does not lead to any significant benefits, but it remains one of the most frequently performed procedures in the world, and some professionals still advocate for it. Therefore, a study was conducted to compare the return-to-work rates for patients with subacromial pain who underwent different interventions.

More than 200 patients are monitored periodically for 5 years in this research study

A total of 210 patients with subacromial pain for more than 3 months were enrolled in the study and randomly assigned to one of three treatment groups: exercise therapy, diagnostic arthroscopy, or ASD.

Patients in the exercise therapy group underwent a supervised, individually designed physical therapy program that included daily home exercises and 15 visits to the physical therapy clinic. Patients in the diagnostic arthroscopy group underwent a “sham” procedure in which an examination of the shoulder was performed with a small camera inserted surgically, but no repairs were made to the shoulder. Patients in the ASD group were treated surgically with the ASD procedure, which involved the careful removal of some portions of bone and a structure called the bursa. Patients in the diagnostic arthroscopy and ASD groups also participated in a postoperative physical therapy program. All patients were assessed at the beginning of the study and then again 2 years and 5 years later.

Two years after the interventions, 78% of patients in the exercise group, 80% of patients in the diagnostic arthroscopy group, and 82% of patients in the ASD group were actively working.

Five years after the intervention, these figures were 66% for the exercise group, 69% for the diagnostic arthroscopy group, and 67% for the ASD group.

These results show that there were NOT significant differences between the three groups 2 years and 5 years after the intervention. Therefore, based on these findings, physical therapy can be considered just as effective as ASD for helping patients with subacromial pain recover and maintain their improvements in the long term.

Subacromial Impingement Pain Treatment is Something We Specialize In…

At Bacci & Glinn Physical Therapy, we frequently see patients with subacromial pain and related shoulder conditions and help them regain their abilities in a safe and cost-effective manner.

Therefore, if you’re currently dealing with any type of shoulder pain, we recommend giving us a call.

You can reach us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Physical Therapy for Pinched Nerves in Visalia & Hanford

Physical Therapy Leads To Significant Benefits For Radiating Neck Pain

The spine contains nerves that send messages to and from the brain and all other parts of the body. For this reason, any time one of these nerves is affected, it can lead to problems not only in the spine, but in other body parts as well. One condition that involves spinal nerves is called cervical radiculopathy, in which pain and other symptoms radiate out from the neck to other areas of the body.

A Brief Anatomy Review

The spine is made up of 24 bones called vertebrae that are stacked on top of one another. Together, these bones connect to create a canal that protects the spinal cord from damage. The uppermost portion of the spine that begins at the base of the skull is called the cervical spine. It contains nerves that carry messages between the brain and muscles in the shoulders, arms, and hands. This is achieved through nerve roots that travel through the spinal canal and branch out through openings in the vertebrae called foramen.

Pinched Nerves Cause Radiating Pain

Cervical radiculopathy, which is also referred to as a pinched nerve, occurs any time one of the nerve roots in the neck is compressed or pinched when it branches away from the spinal cord. This is caused by any condition that injures or irritates nerves in the cervical region, including a herniated disc, spinal stenosis, or degenerative disc disease. In most cases, patients with cervical radiculopathy experience a burning pain that starts in the neck and travels down the arm. This pain can get worse from turning or straining the neck. Other symptoms include tingling, as well as weakness or loss of sensation in the shoulders, arms, or hands.

Some patients with cervical radiculopathy will get better on their own over time, while others will continue to be affected by symptoms for extended periods. For patients that fail to improve, conservative treatments—particularly physical therapy—are typically recommended as the first step. A standard physical therapy program for cervical radiculopathy will include a variety of stretching and strengthening exercises, as well as a manual therapy component. Manual therapy involves numerous hands-on mobilization and manipulation techniques that are intended to alleviate pain and improve mobility and function.

Big study conducted to better define effects of physical therapy

To assess the effectiveness of this intervention, a high-quality type of study called a randomized-controlled trial was conducted on patients who had cervical radiculopathy for at least three months, which was defined as neck pain that radiated to only one upper extremity with ≥1 level of root involvement. A total of 28 patients who fit the necessary criteria were randomly assigned to either the experimental group or the comparison group.

All patients participated in a verbal education session about pain and a unique program designed by a physical therapist that took place during 6 treatment sessions over 3–5 weeks. Patients in both groups also completed strengthening exercises that targeted the deep flexor muscles of the neck, but the manual therapy component of these programs differed. Patients in the experimental group were treated with a cervical mobilization technique in which the physical therapist applied pressure to various painful areas of the spine for several minutes at a time. For patients in the comparison group, the therapist only applied a minimal amount of pressure to one location of the spine and did not perform the actual cervical mobilization technique used in the experimental group.

Patients with Pinched Nerves in the Neck Did Better

Results showed that patients in the experimental group experienced greater improvements than the comparison group in pain intensity, neck function, and neck range of motion, as well as local pressure hypersensitivity, which means they were less sensitive to stimuli. Based on these findings, it appears that a manual therapy technique frequently used by physical therapists can lead to short-term benefits for this patient population. When combined with the other interventions typically featured in a physical therapy treatment program, the gains are likely even greater for patients.

Contact Us Today for Help with a Pinched Nerve in the Neck

Therefore, if you’re currently bothered by radiating neck pain, it may be time to see a physical therapist, and we can help.

Contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

PT for Breast Cancer Patients

Physical Therapist-Led Exercise Boosts Function
And Improves Quality Of Life In Breast Cancer Patients

Breast cancer is the second most common type of cancer in women, as about 1 in 8 women will be diagnosed with it at some point in their lives. Each year, about 240,000 new cases of breast cancer are detected, and about 40,000 women lose their lives to the disease. Over the past 10 years, the number of women diagnosed with breast cancer has remained stable, while the associated death rate has declined slightly. Still, breast cancer remains a major health concern for women today.

Many women diagnosed with breast cancer will undergo a surgical procedure at some point, such as a breast biopsy, lymph node biopsy or removal, lumpectomy, mastectomy, or breast reconstruction. Frequently, this is in addition to other common cancer interventions like radiation and/or chemotherapy. After completing these treatments, a sizable percentage of women go to experience various side effects, such as pain and stiffness in the chest, shoulder, and back muscles, or nerve irritation that can cause numbness, pain, and tingling.

Each patient’s recovery differs depending on the severity of the cancer and what treatments were used, but side effects often reduce flexibility and range of motion, which can prevent women from returning to their normal daily activities. In addition, many women that undergo various treatments and hospitalizations become deconditioned due to lack of physical activity, which can have further repercussions on their health.

Lack of research prompts new study on exercise for breast cancer patients

Therefore, general exercise and physical therapy are strongly recommended for women recovering from breast cancer treatment. A carefully designed physical therapy program will focus on improving qualities like strength, range of motion, and endurance to allow these women to reestablish their previous level of activity; however, research is lacking on structured exercise for breast cancer patients and if there are any safety concerns in high-risk patients. In response, a robust type of study called a randomized-controlled trial was conducted to evaluate the effectiveness of a physical therapist led exercise program for women at high risk for disability after breast cancer treatment.

For the study, 392 women newly diagnosed with breast cancer who were scheduled to have surgery and considered to be at high risk for upper limb disability served as the primary study group. These women were randomly and evenly assigned to either exercise plus usual care or usual care alone. Women in the usual care alone group received information leaflets recommending exercise and general advice for after surgery, and no further interventions were performed. Women in the exercise plus usual care group underwent a structured exercise program supervised by a physical therapist. The program consisted of various upper extremity exercises targeting the shoulder and was intended to restore range of motion of the shoulder, improve strength, and increase physical activity levels. All patients were assessed before and after completing these programs with various outcome measures.

Patients in the Exercise Group had a Better Outcome

Twelve months later, patients who underwent the exercise program reported significantly better scores on a questionnaire that measured disability of the shoulder, arm, and hand. These patients also reported less pain intensity and fewer activity limitations, participation restrictions, and impairments than the usual care alone group, and the intervention did not lead to any increase in complications or lymphedema symptoms. Finally, the exercise program, which only cost an average of $178 per patient, was found to be significantly more cost effective than usual care.

Call Us to Schedule Your Appointment

This study shows that physical therapy can lead to improved upper limb function, postoperative pain, arm symptoms, and physical quality of life at 12 months compared with usual care alone in women at high risk of upper limb disability after breast cancer treatment. So if you’re affected by breast cancer and scheduled to have surgery, we strongly encourage you to reach out to us to get set up for your postoperative program.

Contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Patients and HCP Perceptions about LBP

Patients’ And Healthcare Providers’ Perceptions On Back Pain Do Not Always Align

Low back pain is jarringly common. About one-half of all working Americans will experience related symptoms at least once every year, and roughly 31 million are affected by it at any given point in time. In essence, low back pain is just “one of those things” that we will all probably face in the eventual future if we haven’t already faced.

Dealing with low back pain can be troublesome and place a strain on everyday life. Typical movements like bending over to pick something off the ground or twisting your torso when looking to the side might suddenly give you pause and make you less mobile. This regular reminder naturally leads to frustration and often creates a shift in focus to one question: “what’s causing my pain?”

As a result, many patients with low back pain start to place a particularly strong—sometimes unhealthy—emphasis on obtaining a diagnosis. This desire may be explained by several factors, such as the assumption that the diagnosis will provide a clear explanation of what is causing the pain and what treatments will improve it, even though this is rarely true. Nonetheless, not receiving a diagnosis can lead to anger and frustration in patients who feel that they are not being heard or understood. Some healthcare providers may also experience frustration with low back pain patients who expect their problem to be “fixed” by certain interventions, regardless of how realistic these expectations are.

Healthcare providers underestimate the importance of an explanation for pain

A study was therefore conducted to evaluate the expectations of patients with low back pain and compare these expectations to the assumptions of the healthcare providers who treat them. This was a survey-based study, which administered one survey to 419 patients who were visiting a doctor for low back pain for the first time. In addition to questions about demographics and pain characteristics, this survey included 8 variables frequently related to the medical care of low back pain (eg, improvement in pain/function, explanation of what is causing the pain, diagnostic testing, medication, physical therapy, and surgery), which patients were asked to rank in terms of personal importance on a 5-point scale. A similar survey was given to 198 healthcare providers, who were asked to rank the same 8 variables in terms of their importance to patients.

Patients considered an explanation for what is causing their pain to be far more important

Results showed that both patients and healthcare providers attributed similar—and high—levels of importance to the improvement of pain and the improvement of function; however, there were also several key differences in the assessment of expectations. Patients considered an explanation for what is causing their pain to be far more important than healthcare providers believed, while patients attributed much less importance to diagnostic tests, medications, and surgery compared to healthcare providers. This suggests that healthcare providers are more driven to act by ordering tests and administering treatments for their patients, while patients appear to be more interested in receiving a diagnosis.

Unfortunately, a clear diagnosis for low back pain is not always possible, or helpful.

Approximately 70–80% of all low back pain cases do not have a specific identifiable cause and are classified instead as “non-specific back pain,” which patients could contribute to patients’ frustration because it does not explain their pain. It’s also worth noting that some apparent back pain diagnoses—like a herniated disc—may not truly be responsible for the patient’s pain, which can lead to unnecessary and unhelpful treatments being undertaken.

Nonetheless, this study shows that it is essential for healthcare providers to clearly communicate with patients and educate them on the nature of low back pain, particularly by explaining that not all pain is dangerous or a reflection of injury.

As physical therapists, we incorporate these methods into our practice, and explain to each of our patients with low back pain that a diagnosis is usually less important than they might think. Instead, we start patients on a comprehensive treatment program right away that will address their pain and functional limitations without the need for other diagnostic tests that could possibly do more harm than good.

Contact Us Today for Help

So, if you’re dealing with low back pain, we invite you to contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment today.

Postoperative Opioid Use After Spinal Fusion

Opioid Use Persists In Many Patients After Common Spine Surgery

The prevalence of pain is far greater in the spine than anywhere else in the body. In fact, back pain ranks only behind skin disorders and osteoarthritis/joint disorders in top reasons to visit a doctor. Up to 80% of the general population will experience at least one episode of back pain in their lives, and about 65 million Americans report dealing with a back-related issue recently. So, if your back is bothering you right now, you’re far from alone.

Most cases of back pain will resolve on their own over time, and studies consistently show that patients with persistent or chronic back pain can improve from conservative interventions like physical therapy. But research has also shown that opioids represent one of the most prescribed treatments for back pain, either along with other conservative interventions or independently. The high risk for abuse and addiction with opioids is well documented by now, and these drugs also fail to truly resolve patients’ pain by only masking the sensation and tricking the brain that it has dissipated.

Surgical procedures like lumbar spinal fusion—which joins together two moveable bones in the lower back—is typically regarded as a last resort for chronic back pain, but rates of this surgery have been steadily increasing over the past few decades.

In addition, up to 70% of patients who decide to have surgery have already begun taking opioids by this point, with nearly 20% being dependent on opioids prior to their procedure. The use of opioids may affect outcomes, and most patients would prefer to not take opioids for an extended period after their procedure. But statistics show that continual use is somewhat common, both in patients taking opioids before surgery and in those who do not.

More than one in three patients are taking opioids six months after surgery

Therefore, a study was conducted to determine how many patients who undergo lumbar spinal fusion continue to take opioids in the long term. This type of study was called a systematic review, in which researchers performed a comprehensive search of four major medical databases to identify relevant studies that tracked the use of opioids in patients for at least six months after a lumbar spinal fusion procedure. A total of 329 studies were identified in the search that met all inclusion criteria. Of these, only 32 (9.7%) included data on the use of opioids, and only 21 (6.4% of all included studies) tracked the use of opioids for at least six months.

Analysis of this data revealed that the long-term use of opioids after surgery varied greatly from 6% to 86%. The average across all studies was 35%, with an average follow-up of 34 months. This suggests that more than one in three patients were taking opioids for at least six months after undergoing lumbar spinal fusion. The percentage of patients who were on opioids before the procedure also varied substantially, from 23% to 76%.

Based on these findings, it appears that many patients who have spine surgery continue to rely on opioids for pain relief for six months or more after their procedure. This contradicts with most patients’ expectations, as it is a common conception that surgery will automatically alleviate pain and eliminate the need for continual pain medication.

This information is particularly valuable for patients with chronic low back pain who are weighing the pros and cons of surgery.

While surgeries like lumbar spinal fusion may be appropriate and beneficial for certain patients, this study shows that it may not always lead to the outcomes that most patients expect, and it could maintain or create a reliance on opioids in the long term. For these reasons, we believe physical therapy is a much safer and more effective option for most cases of low back pain, since it can often produce long-term relief without the need for opioids.

Experiencing Lower Back Pain? Give Physical Therapy a Try

If you’re dealing with low back pain, we invite you to contact Bacci & Glinn Physical Therapy at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or to schedule an appointment today.

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