Common Painful Conditions That Physical Therapy Can Treat

No matter where it hurts, physical therapy can deliver effective relief and help you move more easily

Aches and pains can develop just about anywhere in the body. Sometimes pain greets you the first thing in the morning and then dissipates by the time lunch rolls around, while in other cases it becomes a daily visitor that seems to overstay its welcome. But regardless of how long it lasts, pain can always interfere with your ability to get through the day and degrade your quality of life in the process.

When pain arises, the natural reaction for most people is to hope that it goes away on its own. While this outcome is a reasonable possibility, it’s certainly not the best strategy, especially when pain continues to rear its head. For these cases and for pain that just won’t seem to dissipate, additional interventions are needed.

Physical therapy represents one of the safest and most effective treatment options available for all types of pain. Whether it’s short-lived (acute) or long-term (chronic) and no matter where it is in the body, there is an appropriate physical therapy plan that will address your pain with a variety of tactics and techniques.

Below, we offer a brief overview of what physical therapy strategies are typically used to treat some of the most common types of pain:

Searching for Back Pain Treatment in Visalia?
The back is far and away the most common location for pain in the body. At any given time, about 25% of Americans report experiencing low back pain at least once within the past three months, and at least 75% of people will experience at some point in their lifetime. Symptoms vary significantly, as pain could be dull, burning, or sharp, and it may be concentrated or spread over a broad area.

Physical therapy for low back pain also varies depending on the type and severity, but certain interventions are likely to be used in most cases. These include manual (hands-on) therapy techniques like spinal manipulation to improve the mobility of joints and soft tissues, strengthening and flexibility exercises, patient education about how better care for your back, pain-relieving modalities, and training on how to properly lift, bend, and sit to avoid further aggravation.

Need an Expert for Neck Pain Treatment in Visalia?
Neck pain is the third most common cause of chronic pain and it affects about 30% of adults each year, particularly those in the 30-50 age range. It usually manifests as a sharp, stabbing or dull, aching pain and tends to make it difficult to turn one’s neck and perform activities like working, driving, or playing sports.

Physical therapists will first identify the source of each patient’s pain and then target symptoms with a variety of interventions. This may include stretching exercises to improve the range of motion of the neck, strengthening exercises for the arms and upper back, massage and other manual therapy techniques, and posture training if posture is believed to be a contributing factor.

Looking for Shoulder Pain Treatment in Visalia?
Most shoulder problems that lead to pain result from a tear or inflammation of a tendon, instability, arthritis, or a fracture. People who perform lots of overhead activities on a regular basis like painters, carpenters, swimmers, and baseball players are all at an increased risk for developing shoulder pain, and bad posture can contribute as well. It usually manifests as pain and discomfort that occurs when moving the arm overhead and a restriction in shoulder motion.

A typical treatment program for shoulder pain will include both active and passive interventions. Stretching and strengthening exercises are often needed to improve flexibility and build back strength, while manual techniques like soft-tissue massage and shoulder stretches will help to improve range of motion. Heat, ice, and other modalities are often used to reduce pain levels, while patient education and functional training may also be needed.

Trouble Finding Knee Pain Specialist in Visalia?
Knee pain is also extremely common and represents the biggest cause of disability in people aged 65 and older. It may develop from a traumatic event or a chronic condition like osteoarthritis, and the resulting pain could range from mild to severe.

Treatment depends on the specific condition present, but usually involves stretching exercises to decrease tension and help restore the normal motion of your joints, strengthening exercises to address any muscle weakness or imbalances, manual therapy techniques to guide your joints into a less stressful movement pattern, and functional training. Braces and other assistive devices may also be prescribed for some types of knee pain.

How Physical Therapy Can Help If You’re Looking for Hip Pain Relief in Visalia
In most cases, hip pain is the result of a chronic condition like osteoarthritis or rheumatoid arthritis, but it can also be caused by injures like fall-related fractures. Symptomatic hip osteoarthritis will affect about 25% of the population at some point, which typically leads to a sharp, shooting or full, achy pain, along with stiffness, weakness, and difficulty performing daily activities.

Physical therapy can be used to help you avoid surgery, or in the cases when surgery is required, to help you recover. A physical therapy will prescribe interventions to reduce your pain, boost your strength and flexibility in the leg, hip, and back, and improve your balance and walking ability. Active and passive exercises, as well as guidance on how to return to activities will form the basis of your program.

Ankle Pain Expert in Visalia – Try PT First
The most likely cause of pain in the ankle is a sprain. Ankle sprains are the most common injury in the athletic population, accounting for 45% of all sports injuries. They are most frequent in sports such as basketball, football and soccer, but can occur during any sport or activity when the ankle moves beyond its normal range of motion.

Physical therapy for ankle pain from a sprain will first involve a period of RICE (rest, ice, compression, and elevation), followed by a structured rehabilitation program. This program usually involves range of motion exercises to restore ankle movement, strengthening exercises to help you regain your strength and prevent any long-term ankle disability, balance training to improve your stability, and functional training that will help you complete activities you might have difficulty with like walking, running, or jumping.

The Role of Physical Therapy

As you can see, physical therapists know how to approach any type of pain in any region of the body with a specific and customized treatment approach. So if you’re currently dealing with pain of any sort, contact us to get started on a treatment program today.

Contact Us at (559) 733-2478 for more information.

Physical Therapy After Back Surgery in Visalia or Hanford

A recovery from back surgery can only be completed with physical therapy

Back pain is a class of its own. As the most common painful disorder, about 85% of Americans will experience low back pain at least once in their lives. So if you’ve never dealt with bothersome pain or stiffness in your spine, you are technically part of the minority.

Anyone can get low back pain and it can develop for a variety of reasons, but there are certain factors that increase one’s chances of getting it. These include older age, poor physical fitness, a sedentary lifestyle, being overweight, other diseases like arthritis and cancer, risky occupations that may strain the back, smoking, depression, and anxiety.

Though it can be a bothersome condition that may interfere with your daily life, fortunately, most cases of low back pain will improve over time and with non-surgical, or conservative treatment. Conservative care is strongly recommended in nearly all cases of acute low back pain, and physical therapy is typically regarded as a fundamental component of this approach. Physical therapists implement a variety of interventions that are designed to decrease pain, increase function, and prevent further recurrence, and the majority of patients will notice these benefits as they progress through their program.

But a small percentage of patients don’t respond to physical therapy and continue to experience cumbersome back-related issues. These non-responders may be considered good candidates for surgery because conservative methods have failed to produce satisfactory improvements. Surgery may also be recommended for patients with persistent and disabling pain that’s due to certain conditions, including herniated discs, bone spurs, spinal stenosis, broken bones, or more serious problems like spinal infection and spinal tumors.

Explaining the necessity of physical therapy after surgery
If you fall into one of these groups and come to decide that surgery is the best path forward, your surgeon will explain what to expect before, during, and after your procedure. In particular, your surgeon will tell you that while the surgery itself will correct the anatomical problem that is responsible for your symptoms, it doesn’t guarantee a positive outcome in and of itself. Physical therapy begins as soon as the day after surgery and is regarded as an integral part of the recovery process that strongly increases the chances of success. Post-surgery physical therapy programs vary depending on the procedure and patient, but some of the most common interventions you’re likely to see include the following:

  • Pain-relieving modalities: ice, heat, electrical stimulation, and other passive modalities will be administered in the immediate days after surgery to reduce your pain levels
  • Stretching exercises: in the first week after surgery, your therapist will teach you gentle stretching exercises for the hamstrings and quadriceps muscles of the thigh; as you continue to heal, you will progress to stretching the back and abdominal muscles as well
  • Strengthening exercises: starting in week 2 of your recovery, you will begin basic strengthening exercises to build back the core muscles of your lower back and abdomen; these exercises will also increase in intensity as you progress, with elastic bands, exercise balls, and yoga stretches being incorporated staring around week 6
  • Manual therapy: your therapist will probably perform several manual—or hands-on—therapy techniques to increase mobility and alleviate pain, such as massage around the surgical incision, mobilization, and manipulation
  • Aerobic exercise: starting around week 9 after surgery, you should be ready to begin engaging in low-impact aerobic exercises, such as brisk walking, swimming, bike riding, and stair climbing; your therapist will guide teach you to perform these activities in the safest possible manner that keeps your risk for reinjury low

While surgery can generally be avoided for most cases of low back pain, as we’ve shown, there are certain circumstances when it may become a necessity. If you decide to have back surgery and want to get back to your pre-injury levels as safely and quickly as possible, physical therapy is the best way to get there, and we can help. Contact us today to learn more or schedule an appointment.

Physical Therapy After Neck Surgery in Hanford or Visalia

Bouncing back from neck surgery
requires the individualized care of a physical therapist

Neck pain is the third most common cause of chronic pain in the country, placing only behind back pain and headaches in this ranking. Figures vary, but it’s been reported that up to 50% of the population will experience an episode of neck pain each year, and up to 70% will encounter it at some point in their lifetime.

Most cases of neck pain are due to strains and sprains of the muscles, tendons, and ligaments that support the bones of the spine and keep our heads upright. Some of the most common causes of neck pain include sleeping on your neck wrong, sitting or standing for prolonged periods with bad posture—especially from leaning over too much—spending too much time performing repetitive movements, and regularly carrying a heavy backpack, purse, or briefcase. Neck pain can also develop from conditions like osteoarthritis, a herniated disc or spinal stenosis, or from sudden injuries that may cause whiplash or other problems in the neck.

When neck pain does occur, most experts strongly recommend seeking out conservative (non-surgical) treatments like physical therapy, which is intended to safely alleviate painful symptoms and improve functional abilities. Physical therapy will lead to notable improvements in the majority of patients with neck pain, but not everyone responds to treatment to an adequate degree. For these individuals and anyone with neck instability, a pinched nerve in the neck that’s getting worse, compression on the spinal cord, and other more serious issues, surgery may become necessary. In these rare cases, discectomy, fusion, and cervical disc replacement are some of the most common procedures that will be performed.

Physical therapy steps in after surgery to help patients regain their abilities
Surgery has the potential to help patients improve significantly, but positive outcomes are only possible if the patient also completes a structured physical therapy program. Physical therapists work with patients as early as the day after surgery to begin regaining their strength, flexibility, and other abilities, setting these individuals on a path to a full recovery. Your personalized treatment program will depend on the type of surgery performed and your individual goals, but some or all of the following elements are likely to be included:

  • Stretching exercises: your therapist will slowly help you regain your flexibility and range of motion through gentle exercises that will gradually increase in intensity
  • Strengthening exercises: one of the primary ways to avoid future neck pain is by building back the strength of neck muscles that may have been lost through injury and surgery
  • Manual therapy: once the incision wounds have healed, your therapist will begin performing a series of hands-on techniques such as massage, mobilization, and manipulation to increase mobility levels and alleviate any lingering symptoms
  • Functional education and training: your therapist will also teach you the best ways to move your body in tasks that involve the neck—like lifting objects—which will help you to move more efficiently and avoid future neck pain

Neck surgery is only needed in rare circumstances when conservative methods have failed or the patient is at risk for more serious complications, but in the event that it is needed, physical therapy will play a crucial role in the rehabilitation process. So if you have neck pain and are either looking for an effective treatment or considering surgery, we can help. Contact us today to learn more or schedule an appointment.

Physical Therapy After Shoulder Surgery in Visalia or Hanford

Searching for physical therapy after shoulder surgery in Visalia or Hanford?  We can help – read more below.

If you decide to have shoulder surgery, physical therapy is an integral part of the recovery process

The shoulder is an incredible joint. As the only joint in the body that can rotate a full 360°, the shoulder is the most mobile and flexible joint in the body, and this wide range of motion is the reason you can move your arm in so many directions. There is, however, one downside to all this mobility: it makes the shoulder particularly vulnerable to injury.

The Shoulder Joint is Complex – Therefore, There are All Kinds of Potential Problems

Although the shoulder is typically referred to as a single joint, it is technically more complex and consists of four joints, with the acromioclavicular and glenohumeral joints being the most important for movement. Bones of the shoulders are connected by several ligaments, while muscles connect to bones through various tendons. Other important structures of the shoulder include the rotator cuff, a group of four muscles that form a “cuff” around the upper arm bone, a ring of protective cartilage (the labrum), a fluid-filled sac that provides cushioning (the bursa), and the joint capsule, which encloses all the components of the shoulder.

Any of these structures can become damaged and lead to shoulder-related disability. The rotator cuff is one of the most commonly injured areas of the shoulder, with a condition called rotator cuff tendinitis being the most prevalent cause of shoulder pain. Tears of the rotator cuff also occur frequently, and these injuries can occur either traumatically from a single incident, or gradually over time, which is usually the case in older patients.

Physical Therapy After Rotator Cuff Surgery – We Can Help Both Visalia and Hanford Residents

In the event of shoulder pain from injury to the rotator cuff or any other structure of the shoulder, the patient will decide with a doctor whether surgery is needed or a conservative (non-surgical) approach—which primarily involves physical therapy—can be taken. Most shoulder injuries can be effectively treated with a conservative plan, but if this approach fails to produce significant improvements or the patient has suffered a severe injury like a high-grade, sudden rotator cuff tear, surgery may be needed. Surgery is also more likely to be selected by active athletes involved in overhead sports.  If you’d like additional resources, the American Physical Therapy Association also has some details – click here.

Physical therapy also essential after surgery

If you have a shoulder injury and decide to have surgery, physical therapy will still serve as a fundamental component of the recovery process. Through a movement-based, individualized strategy, physical therapy will help to bring you back to full strength and function with targeted exercises and other interventions. A typical treatment program for patients recovering from shoulder surgery will likely include the following:

  • Stretching and strengthening exercises: weakness and reduced flexibility/mobility are two major consequences of surgery, so the bulk of rehabilitation will aim to address these impairments; key exercises include:
    • External rotation: using a resistance band or dumbbell, keep your elbow bent at a 90° angle and slowly move your hand out from the body
    • Internal rotation: same as external rotation, but move your hand towards your body
    • Forward flexion shoulder raise: holding a dumbbell, keep your arm straight and lift it directly in front of you until it’s at eye level
    • Pendulum exercises: holding a dumbbell, let your arm hang loose and swing it around in a circle; then try swinging it back and forth
    • Scapular squeezes: lie on your stomach with arms at your sides, draw your shoulder blades together and down back as far as possible; ease about halfway off from position and hold it
  • Passive treatments: ice, heat, ultrasound, and other interventions will likely be utilized to alleviate shoulder pain
  • Activity modification: your therapist will teach you how to avoid positions and movements that can aggravate pain and make the condition worse, like sleeping on your side and carrying heavy loads

Contact Us Today if You are in Need of Physical Therapy After Shoulder Surgery

Remember that you always have options after a shoulder injury of any sort, and surgery is not necessary for many patients. But if you do opt to go the surgical route, keep in mind that physical therapy will play a major role in your recovery, and that better adherence to your treatment will lead to improved outcomes. Contact us to learn more about how we manage patients recovering from shoulder surgery or to schedule an appointment today.

Call Us in Visalia at (559) 733-2478 or Hanford at (559) 582-1027 for More Information

Physical Therapy After Knee Surgery in Visalia & Hanford

Committing to physical therapy after knee surgery will boost your outcomes

The knees are built for durability, but they also take on a fairly constant array of strain throughout the course of a normal day. When structures within the knee joint are pushed past their limits, they can become damaged through various injuries. And due to the frequency that the knees are used, knee pain of any type ranks as the second most common disorder affecting the body’s movement, behind only back pain.

The Knee Sometimes Requires Surgery and Physical Therapy Afterward

The knee is a hinge joint that’s responsible for bearing weight and allowing the leg to extend and bend back and forth with minimal side-to-side motion. It primarily joins the thigh bone (femur) to the shinbone (tibia), but also includes the kneecap (patella) and other lower leg bone (fibula). Other important structures of the knee joint include the meniscus, which acts as a cushion and shock absorber, a thin layer of protective articular cartilage that helps bones to move smoothly, plus several muscles, tendons, and ligaments—including the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)—which connect bones and stabilize them by preventing too much motion in any direction.

Any of these structures can become damaged, either through a traumatic incident, due to sustained wear and tear over time, or from a combination of both factors. Knee osteoarthritis—in which articular cartilage gradually wears away and leaves bones more vulnerable—is by far the most prevalent knee condition, particularly later in life.

Common Knee Injuries that Respond to Physical Therapy

Strains, sprains, and tears of knee ligaments and the meniscus are particularly common in athletes and active individuals, as are runner’s knee, jumper’s knee, and iliotibial band syndrome.

If you happen to experience a knee injury of any sort, it’s important to understand that you have options. Many knee-related conditions can be managed effectively with (conservative) non-surgical interventions like physical therapy, and this approach is generally recommended for most patients.

However, if conservative treatments don’t lead to notable improvements or in the event more serious injuries like a severe ACL tear or advanced knee osteoarthritis, surgery may be needed. ACL tears are typically treated with a surgical procedure called ACL reconstruction, while advanced knee osteoarthritis is most often managed with a total knee replacement.

Reap all the benefits of surgery through personalized physical therapy after knee surgery in Visalia

While surgery can lead to significant improvements, the buck does not end there. In order to experience the best possible outcome, you will also need to complete a course of physical therapy after surgery. Your physical therapy program will be personalized based on your needs and abilities, will help you work towards your goals, whether that’s getting back on the playing field or being able to play with your grandkids again. Knee surgery rehabilitation programs will vary depending on the surgery performed, but several components are likely to be involved:

  • Strengthening exercises to build back up the weakened muscles of the leg
  • Stretching and range of motion exercises to increase flexibility and regain normal mobility that may have been lost
  • Plyometrics, or jump training, for patients recovering from ACL tears
  • Recommendations on how to modify your activities in order to minimize the risk for future injuries
  • Exercises to improve body awareness, balance and neuromuscular control, which is the body’s ability to stay strong and stable during all movements
  • Activity-specific training for athletes and active individuals

Be sure to consider all treatment options available and evaluate the risks and benefits of each before determining if surgery is right for you. And remember that if you opt for surgery, adhering to your physical therapy plan afterwards can significantly increase the chances of a positive outcome.

Contact us if you’re interested in learning more about how we manage patients recovering from knee surgery or to schedule an appointment today.

Call Us in Visalia at (559) 733-2478 or Hanford at (559) 582-1027 for More Information

 

Benefits of PT Over Other Interventions for Pain

Seeing a physical therapist first will save you time and money while helping you avoid unnecessary tests and interventions

Every October, physical therapists around the country come together to celebrate National Physical Therapy Month. The purpose of this annual campaign is to highlight the many ways that physical therapy can benefit individuals of all ages and ability levels with an individualized approach to treatment. In honor of these efforts, we’d like to discuss a few of the key reasons why seeing a physical therapist first for any sort of pain is always the best treatment decision that you can make.

For anyone that encounters pain or gets injured, relief often becomes the number one priority. There are many treatment options available to address painful issues, and it may be difficult to determine which approach is best for you. But regardless of your condition or its severity, one universal truth applies: trying physical therapy first is a smart move that will usually help you avoid other unnecessary tests and treatments down the road.

Physical therapy is not a magical cure-all that will immediately fix any physical problem, but it does have an incredibly wide range of applications and is appropriate for the vast majority of painful conditions. Every physical therapy treatment program is individually tailored with each patient’s abilities and goals in mind, and by carefully guiding them with exercises and movement-based techniques, significant improvements can usually during treatment and upon discharge.

Physical therapy vs. surgery, injections, and opioids

Other commonly used treatment options for pain include surgery, injections, and prescription medications like opioids, but research continuously shows that physical therapy is a superior option that will save patients money and time while leading to similar—if not superior—outcomes.

For example, one study showed that physical therapy was just as effective as surgery in the midterm and long term for reducing pain and improving function and flexibility in patients with various tendon disorders. Similarly, another study found only minimal differences after five years between patients treated surgically compared to those who had physical therapy for ACL tears. Surgery has great value that can often lead to positive outcomes, and it may be necessary in certain situations, but it does come with some potential downsides as well. These include high costs, long recovery times, and risks associated with the procedure. Physical therapy, on the other hand, is universally regarded as an affordable, safe intervention with minimal to no associated risks.

Physical therapy can also help patients avoid taking prescription drugs like opioids, which are a significant problem in the country today due to alarmingly high rates of addiction, overdose, and death. One study of 454 patients with low back pain found that those who participated in physical therapy had a lower chance of being prescribed opioids in the following year, while another found that those who saw a physical therapist early were 33% less likely to use narcotic analgesics like opioids and 50% less likely to receive non-surgical invasive procedures than patients who did not.

Do Not Wait if You Have Pain – It’s Likely to Cost You Money

The earlier a patient sees a physical therapist, the more likely they will be to experience positive outcomes with lower overall healthcare costs. This is exemplified in other research, in which 308 patients with neck pain were divided into different groups depending on when they consulted a physical therapist: early (within 14 days), delayed (15-90 days), or late (91-364 days). Results showed that early physical therapy was associated with an average savings of $2,172 on healthcare costs over one year compared to late physical therapy, as well as a lower risk for patients being prescribed opioids, having a spinal injection, or undergoing an imaging test.

Physical therapy in hospitals associated with higher costs

Avoiding the hospital for elective reasons like surgery will further lower costs for patients, as receiving physical therapy in a hospital is typically lower than when it is received at a clinic or office. One study compared these costs, and results showed that the average prices were 41% higher for therapeutic exercises and 64% higher for manual (hands-on) therapy in a hospital than a community setting. A 15-minute session of manual therapy, for example, was an average of $58 in a hospital versus $35 in a clinic.

On top of all of this, you can see a physical therapist much sooner than your primary care doctor and many other healthcare professionals. While it could take several days, weeks, or longer to get an appointment with many healthcare professionals, many physical therapy practices can schedule in as soon as the next day. This yields further dividends, since the sooner you see a physical therapist, the better your outcome will be.

With this in mind, if you’re currently dealing with a painful condition of any sort, we strongly recommend seeing us before consulting with your primary care doctor. We can quickly identify the source of your problem and get you started on a tailor-made treatment program right away that factors in your needs, abilities, goals, and preferences.

Contact Us at (559) 733-2478 for more information.

Chronic Pain Treatment Visalia – Is Surgery a Good Idea?

Chronic Pain Treatment Visalia – Evidence to support surgery for chronic pain conditions is severely lacking

October is National Physical Therapy Month, an annual campaign intended to increase awareness of the countless and wide-reaching benefits of physical therapy. Among these is the fact that physical therapy is one of the best treatment options available for chronic pain, an extremely common issue in healthcare today. In honor of the month, we’d like to discuss why physical therapy is usually the most effective option for chronic pain treatment here in Visalia or Hanford, and why interventions like surgery fail to completely address all components of these complex issues.

But to understand why physical therapy is appropriate for chronic pain, we must first explain what it is and how it differs from acute pain.

Acute vs. Chronic Pain

Acute pain is fairly straightforward: it’s the type of pain we experience after an injury like a broken wrist, which is a normal sensation triggered in the nervous system to alert you that something is wrong with the body and it needs to be addressed. Chronic pain is much different: the pain signals that are sent out by the nervous system continue to fire and tell the body that something is wrong for weeks, months, or even years. It’s believed that this is due to the body incorrectly sensing pain due for reasons related to one’s psychological state and long-term perception of pain. While an injury or damage to the body may be responsible for the original pain message, for some patients there is no clear reason the body acts in this way, which often makes the condition even more difficult to treat.

One in Three Americans Suffer with Chronic Pain Include Those in Visalia and Hanford

Nearly 100 million Americans have chronic pain to some extent, which is more than the number of people with diabetes, heart disease, and cancer combined. We know this because a. we see this search – chronic pain treatment Visalia on our web analytics and we also care for patients with chronic pain. Chronic pain comes in many forms, and has been described as a throbbing, shooting, aching, burning, or freezing pain. There is also a wide array of conditions that can cause chronic pain, including headaches, low back pain, cancer pain, and arthritis pain.

Physical therapists are movement experts that understand the importance of managing chronic pain with a multifaceted approach that considers each patient’s psychological wellbeing as well as their physical state. Other interventions, like surgery, only focus on addressing the physical aspects of the patient’s condition. As a result, even if the anatomical damage believed to be responsible for the painful symptoms is corrected, it does not necessarily guarantee that the patient will experience relief from their chronic pain.

This uncertainty is one of the many reasons surgery is not typically recommended for chronic pain conditions. Others include the high costs of surgical procedures, the extensive recovery usually required afterwards, and the associated risks involved in performing any type of surgery. Nonetheless, chronic pain is among the most common indications for surgery, particularly for prevalent conditions like arthritis and back pain.

Widespread Use of Surgery without Supportive Evidence?

Despite the frequency by which surgery is used to treat chronic pain, it’s been questioned whether there is sufficient evidence to support this type approach. To explore this question, a study was conducted that collected and reviewed the number of high-quality trials—called randomized-controlled trials—in which common surgical procedures for chronic pain were compared to not performing the procedure. The study also measured the number of randomized-controlled trials (RCTs) that were supportive of surgery and the proportion that used patient blinding, which is an important component of any robust individual study.

This search identified a total of 6,734 RCTs, but only 64 of these (less than 1%) compared a surgical procedure to not performing the procedure. Furthermore, only 9 (14%) of these 64 RCTs were favorable to surgery, and when considering individual procedures, the majority of studies did not favor surgery. Lastly, 12 (19%) of the included RCTs used patient blinding, which is a rather low proportion.

Based on these findings, researchers concluded that there have been very few studies comparing common surgical procedures for chronic pain to not performing the procedure, and most of the studies that did evaluate these procedures were not in favor of surgery. This highlights an imperative need for more high-quality research that assesses the effectiveness of surgery for chronic pain to support the use of this practice.

In the meantime, physical therapy remains a much safer and less expensive option for chronic pain that factors in the intricate nature of these conditions and addresses them with a multifaceted treatment approach.

Contact us to learn more about physical therapy for chronic pain treatment in Visalia or Hanford, or to schedule an appointment.

Physical Therapy to Treat Knee Osteoarthritis

Study shows that physical therapy produces
greater improvements than injections for knee arthritis

In our last blog, we discussed the prevalence of knee osteoarthritis and examined the role of imaging tests in the diagnosis and follow up of patients with this condition. We also explored why seeing physical therapist for knee pain first is always a smart choice because it will get you started on a movement-based program to regain your abilities from the start.

Should You Consider Steroid Injections?

But physical therapy is just one of many treatments available for knee osteoarthritis. Another popular option is the use of steroids that are injected into the affected knee to alleviate symptoms. Steroid injections are frequently used for patients with knee osteoarthritis, but there is conflicting evidence regarding their effectiveness and how long these benefits last. The guidelines regarding these injections also vary, and although rare, they have been associated with complications like infection and accelerated loss of articular cartilage.

Physical therapy has been recommended by some guidelines and was traditionally utilized frequently to treat knee osteoarthritis, but its use has been declining in recent years. According to one large study, four times as many patients with knee osteoarthritis received a steroid injection as physical therapy before undergoing knee surgery. It’s also been found that steroid injections don’t lead to any additional benefits to physical therapy for these patients.

For these reasons, a recent study was conducted to compare the effectiveness of steroid injections to physical therapy for patients with knee osteoarthritis. Researchers randomly assigned 156 participants with knee osteoarthritis to receive either ≤3 steroid injections over one year or ≤8 treatment sessions with a physical therapist over 4–6 weeks. In each session, the therapist would perform a series of hands-on, manual techniques to the knee and surrounding area that were intended to make it easier for the patient to perform various exercises and knee movements.

All patients were assessed before treatment began and then again one year later with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, which scores patients from 0 to 240, with higher scores indicating worse pain, function, and stiffness. Another outcome measure called the Global Rating of Change Scale was also used to assess patients’ symptoms, with higher values indicating greater improvements.

After one year, patients who received steroid injections reported WOMAC scores of 55.8, while those who received physical therapy reported scores of 37.0. In addition, scores on the Global Rating of Change scale were +4 (“moderately better”) in the steroid injection group and +5 (“quite a bit better”) in the physical therapy group.

Physical Therapy for Knee Arthritis is the Clear First Choice…But Some Still Need Surgery

Together, these findings show that physical therapy was more effective than steroid injections for patients with knee osteoarthritis, as they experienced greater improvements in pain, physical function, and stiffness one year after undergoing the intervention. Other studies have also identified a similar trend, with both injections and physical therapy producing similar outcome, but the benefits of therapy lasting for at least one year. Therefore, physical therapy appears to be the better option of the two since it outperformed steroid injections in the long term.

With this in mind, if your knee is bothering you and osteoarthritis may be responsible, we strongly recommend seeing a physical therapist first before considering other injections and other possible treatments.

Knee Arthritis Treatment in Hanford

For knee arthritis treatment in Hanford, we suggest you skip the imaging test and start physical therapy right away instead

If you are searching for options for knee arthritis treatment in Hanford, read on.  I’d like to share with you why our type of treatment is what you should try first.

Knee pain can be seriously detrimental to the flow of your life. Regardless of your activity level, you need your knees to function well in order to get around, and anything that gets in the way can slow you down and throw your days out of whack.

Such is the case with knee osteoarthritis, which is one of the most common causes of knee pain. Osteoarthritis describes several disorders in a joint that lead to inflammation-related symptoms due to the loss of cartilage and other changes to the structures within it. Any joint in the body can be affected by osteoarthritis, but it occurs most frequently in the knees, with knee osteoarthritis accounting for more than 80% of all cases.

Patients who develop knee osteoarthritis typically experience pain that gets worse with physical activity, swelling around the knee, a feeling of warmth in the joint, stiffness (especially in the morning or after sitting for a while), and sometimes a creaking sound that’s heard when the knee moves. These symptoms in turn lead to less mobility of the knee, which make it more difficult to walk and perform basic movements like getting in and out of a car and climbing stairs.

The Pictures Rarely Tell It All When It Comes to Knee Arthritis

Knee osteoarthritis is often diagnosed with a clinical evaluation—which includes a patient interview and thorough physical examination—and imaging tests like an X-ray and MRI. Many doctors use imaging tests to confirm the diagnosis and rule out other conditions, but the value of these tests and whether or not they are always needed has been called into question.

For example, one study investigated the connection between the loss of cartilage and pain in the knees of 600 patients with knee osteoarthritis. The reason is that when knee osteoarthritis is discussed, there is often an emphasis on depleted cartilage being the primary driver of pain, which leads some patients to request an MRI or focus too heavily on its findings. Results of this study showed that while there was some relationship between cartilage loss and knee pain, it was “modest at best.” A loss of 0.1 mm of cartilage over 24 months was only associated with <1 point of worsening on a pain scale from 0–20.

These findings suggest that imaging tests like MRIs and evaluating the thickness of cartilage may not always be necessary for patients with knee osteoarthritis. This holds true for the diagnosis, which can be reached many patients with a clinical evaluation alone—especially those who are aged ≥50 years—and as patients continue to be examined in the long term. Imaging tests are also expensive and frequently lead to unnecessary or invasive procedures to treat abnormal findings that may be unrelated to pain.

Physical therapy is a smart alternative

An alternative approach is to see a physical therapist before any other medical professional if you’re experiencing knee pain. Physical therapists perform a detailed clinical evaluation during the first visit and generally aim to avoid imaging tests unless they are completely necessary. Another advantage of physical therapy is that it begins right away during this first visit, with less of an emphasis on the diagnosis itself and more on addressing your limitations and impairments with a movement-based strategy. This allows you to work through your problems with guided assistance while developing activity-related habits that will translate into long-term improvements and avoidance of pain in the future.

In our next blog, we’ll look at why physical therapy is a better option that steroid injections for knee osteoarthritis.

Neck Pain Expert in Visalia for Pinched Nerves in the Neck

Pain radiating out from the neck is best treated with physical therapist directed care and if you are looking for a neck pain expert in Visalia, we can help.

When it comes to a search for a neck pain expert in Visalia, there are options. But, who should you choose?

A medical doctor may be hard to get in to see, may run expensive tests, and the treatment is usually drugs.

Some chiropractors will suggest you “realign your spine” with repeated treatment sessions.  You may end up thinking (or you are sold the idea that) the only way to treat the pain is with a chiropractic adjustment.

A Model of Treatment Based on Current Best Research and Common Sense

The physical therapists at Bacci & Glinn Physical Therapy approach, who are also neck pain experts in Visalia, identify the root causes of your pain – muscles, joints, poor posture/body mechanics, and additional factors that may make you more sensitive to pain (this is called a biopsychosocial approach to the treatment of pain).

We Treat the Cause Then Teach You How to Care for Yourself

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.

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.

A Specific Kind of Neck Pain – Cervical Radiculopathy AKA, a Pinched Nerve in the Neck

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 cases of cervical radiculopathy will get better on their own over the course of a days or weeks, but this not true for all patients. When the condition fails to improve, targeted interventions are needed. Physical therapy is a movement-based intervention that can effectively train patients to overcome their limitations by practicing specific exercises and changing the way they move in daily life. A typical physical therapy program for cervical radiculopathy will include the following:

  • Manual (hands-on) therapy
  • Cervical traction to reduce pressure on the nerve
  • Laser therapy for pain relief
  • Stretching exercises
  • Strengthening exercises
  • Posture education
  • Functional training

Physical therapy has been supported in the medical research as a beneficial treatment for cervical radiculopathy, with one study called a systematic review and meta-analysis identifying three powerful studies that evaluated the use a manual therapy technique (cervical spine manipulation) for this condition. Analysis of these studies led to the following conclusion:

There was evidence from three trials of moderate quality that supported cervical spine manipulation in treating people with degenerative cervical radiculopathy.

If You are Looking for a Neck Pain Expert Near Me, Click Here to Contact Us

Thus, if you are currently experiencing persistent pain or any other symptoms radiating down your arm that have not improved, it’s a good thing you searched for a neck pain expert in Visalia. We strongly recommend seeing one of our physical therapists soon to be evaluated. Following this approach will help you get started on an effective, personalized treatment plan and a path to less pain and better functioning right away.

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