Could Physical Therapy Provide Fibromyalgia Relief

If you have fibromyalgia, simple movement may be the last thing you want to do. But simple movements through physical therapy may be just the right treatment for you. How does physical therapy provide fibromyalgia relief? The answer: With a hands-on approach to reduce fatigue, pain, stiffness and loss of strength that accompanies fibromyalgia.

Fibromyalgia is a syndrome estimated to affect 5 million Americans (mostly women) with widespread aches and pains, fatigue, sleep difficulties, anxiety, and depression. Doctors don't know what causes fibromyalgia and there's currently no known cure. There are a variety of treatment options however that relieve patients' symptoms. Standard treatments include painkillers, antidepressants, cognitive-behavioral therapy, exercise and physical therapy.

Physical therapy and exercise address the physical problems caused by fibromyalgia such as pain, fatigue, de-conditioning, muscle weakness, and sleep disturbances. Patrice Winter PTMS, physical therapist and spokesperson for the American Physical Therapy Association says, "Fibromyalgia syndrome (FMS) can be very debilitating. The fatigue associated with it varies from mild to overwhelming. Some patients can't get even out of bed. By the time many patients come to a physical therapist, they're often severely de-conditioned from lack of activity due and this compounds their fatigue."

How can physical therapy relieve fibromyalgia? Physical therapists design individual treatment plans that use a variety of passive and active treatments.

Passive treatments may include:

• Deep tissue massage to relieve muscle tension and spasms and improve muscular and joint range of motion.
• Soft Tissue Mobilization to treat muscle spasms, trigger points and improve range of motion.
• Heat Therapy to relax muscles, improve circulation to affected areas, and improve the body's natural healing processes.
• Ice Therapy to reduce inflammation.
• Hydrotherapy (hot baths and whirlpools) to relax muscles, improve circulation and allow for gentle no-stress exercise.
• Electric Muscle Stimulation (don't worry, it's painless) to reduce pain by increasing endorphins.
• Ultrasound therapy (sound waves) to create heat, improve range of motion, relax muscles and improve circulation

Active Treatment may include a variety of exercises to strengthen core (abdominal), back, arm and leg muscles and increase flexibility.

Winter says, "Our best results come from addressing individual patients at the physical state they present in and working very gradually. We've seen a lot of success with developmental sequencing work, similar to the process a baby goes through in normal development.... rolling, crawling, balancing, sitting, standing. This helps reorganize the neurologic system to return it to more normal function. We address body pain and trigger points with soft tissue mobilization and manual stretching."

Once patients have improved their overall physical condition, therapists help them keep their fitness plan in motion. They might recommend yoga, Pilates, cardiovascular and strength training options. They'll also work on fundamental body issues like posture, work-related body mechanics and sleep positions to help fibromyalgia patients function at their best.

Does it Work?

In the face of a potentially disabling condition, physical therapists may get fibromyalgia patients back on their feet and moving in the right direction.

Studies show many patients report improvement in their symptoms and sense of well-being.

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Sources:

Physical therapy in the treatment of fibromyalgia.
Offenbächer M, Stucki G.
Department of Physical Medicine and Rehabilitation, University of Munich, Germany.
http://www.ncbi.nlm.nih.gov/pubmed/11028838

Move Forward - the website of the American Physical Therapy Association
Fibromyalgia
http://www.moveforwardpt.com/find-your-condition/fibromyalgia/

Spine Universe
Physical Therapy for Fibromyalgia, author Kelly Rehan (3/09) for Spine Universe
http://www.spineuniverse.com/conditions/fibromyalgia/physical-therapy-fibromyalgia

Understanding Breast Cancer - Symptoms

What Are the Symptoms of Breast Cancer?

In its early stages, breast cancer usually has no symptoms. As a tumor develops, you may note the following signs:

• A lump in the breast or underarm that persists after your menstrual cycle; often the first apparent symptom of breast cancer, breast lumps are painless, although some may cause a prickly sensation. Lumps are usually visible on a mammogram long before they can be seen or felt.
• Swelling in the armpit.
• Although lumps are usually painless, pain or tenderness in the breast can be a sign of breast cancer.
• A noticeable flattening or indentation on the breast, which may indicate a tumor that cannot be seen or felt.
• Any change in the size, contour, texture, or temperature of the breast; a reddish, pitted surface like the skin of an orange could be a sign of advanced breast cancer.
• A change in the nipple, such as an indrawn or dimpled look, itching or burning sensation, or ulceration; scaling of the nipple is symptomatic of Paget's disease, a localized cancer.
• Unusual discharge from the nipple that may be clear, bloody, or another color. It's usually caused by benign conditions but could be due to cancer in some cases.
• A marble-like area under the skin.
• An area that is distinctly different from any other area on either breast.

Want to keep the weight off? Get on your bike...

WASHINGTON (Reuters) - Just five minutes of riding a bicycle each day can help a younger woman keep the pounds off, U.S. researchers reported on Monday in a study offering one potentially easy way to help Americans slim down.

"Small daily increments in bicycling helped women control their weight. But the more time women spent bicycling, the better," said Rania Mekary, of the Harvard School of Public Health in Boston, who worked on the study.

"Women with excess weight appeared to benefit the most. This is encouraging for women with weight problems because they could substitute bicycling for slow walking or car driving."

The research could help public policymakers trying to find ways to slow the U.S. obesity epidemic, the researchers wrote in the Archives of Internal Medicine.

Two-thirds of U.S. adults are overweight or obese and 16 percent of children and adolescents are overweight.

The accompanying disease burden costs billions and President Barack Obama has assigned his wife Michelle Obama and cabinet secretaries to find ways to counter this trend.

Their plan includes changes to neighborhoods and cities to make it easier for Americans to exercise.
Mekary and colleagues studied 18,414 healthy women who had not yet gone through menopause taking part in the Brigham and Women's Hospital-based Nurses' Health Study, an ongoing study of women's health over time.

On average, the nurses gained about 20 pounds (9.3 kilograms) over the 16-year period.

The women who did not bicycle in 1989 who had started by 2005 were a quarter less likely to have gained weight, even if they rode for just five minutes a day, the researchers found.

Comparatively, women who started out exercising on bikes for more than 15 minutes day in 1989 but who slacked off over time gained weight.

Overweight and obese women who were bicycling just two or three hours a week were 56 percent less likely to gain weight.

Brisk walking, but not slower strolling, was also helpful in keeping weight off, the study found. Actually, "if women walked slowly, not only did they not control weight, they gained weight," Harvard's Dr. Anne Lusk, who was involved in the study, told Reuters Health.

This finding, Lusk said, contradicts the conventional wisdom that has driven physician recommendations for decades that any kind of walking is better than no walking at all.

SOURCE: http://link.reuters.com/qec84m Archives of Internal Medicine, June 28, 2010.

Why you should use exercise balls

By Jeanne Faulkner
Reviewed by QualityHealth's Medical Advisory Board

In the past few years, exercise balls have become all the rage as they've encouraged us to get fit in fun, new ways. Here, the top five reasons to bring balls into your workout routine.
1. Balancing Act. Balls are unstable, and sitting on one requires more balance than you'd expect. It contracts the small muscles in your abdomen, back, and spine into the most physically correct alignment. Exercising on the ball means you get a double whammy from your work out-the muscles the exercise intends to target plus the ones that keep you from falling off. Over time, you'll find your balance and your posture will improve.
2. Core Work. According to the American Council on Exercise, think of your core as a strong column that links the upper and lower body together. Having a solid core creates a foundation for all activities, and is especially important when you add a heavy load, such as weights to your workout. Exercising with stability balls helps to develop and strengthen those muscles. Try doing crunches "on the ball," and feel the difference between those on the ground and those done while trying to balance. It's a whole different ball game.
3. Office Equipment. Using your exercise ball as your office chair provides an all day workout with proper spinal alignment during what would otherwise be "sitting around time." Every movement, like turning to answer the phone, requires subtle adjustments using your core muscles. Traditional office chairs are hard on the butt and back and can impede circulation between the upper and lower body. Exercise balls, however, require low-level exertion that improves circulation.
Updated: August 24, 2009

Sciatica: What a Pain in the Behind!

Hip Arthritis: There's Nothing Hip About It

Hip arthritis generally results from osteoarthritis, or “wear-and-tear” arthritis. In a nutshell, osteoarthritis progressively wears away the cartilage of the joint it affects. Without cartilage in the joint to make movements smoother, the hip bones begin to grind and cause pain. Hip arthritis is typically found in individuals who are:

· Over 50 years old

· Overweight – in fact, weight loss has a tendency to lessen the symptoms of hip arthritis.

· Genetics - if the condition runs in your family, your chances of developing it are much greater.

· Trauma – injuries to the hip, including fractures, can increase risk.

There’s no way to tell for sure who will develop hip arthritis, but there are a few measures you can take to avoid this debilitating condition:

• Lose weight. More weight = more compression on all joints. Weight loss can dramatically decrease symptoms.Seek the help of your physical therapist or exercise professional. We can teach you exercises to better distribute the pressure on your joints from everyday movements.
• Modify your activities. Limit activities that are painful. Continue with ones that are not. Aquatic exercise is a great option to perform exercises without increasing joint compression. Use walking aids. We can show you the right way to use a cane/crutch to help alleviate your pain.
• Ask your doctor about trying anti-inflammatory medications.
• In severe cases, you may need to talk to your doctor about hip replacement surgery.

· As soon as you start feeling the symptoms of hip arthritis, including limited range of motion, joint stiffness, and pain in the hip area, see your doctor. If you receive a diagnosis of hip arthritis, following the steps outlined above. The goal is to avoid a hip replacement surgery, which should always be your last resort. Our well trained staff will help you make the most of your condition so you can carry out your day to day activities with less pain.

Becoming a Couch Potato Won’t Save Your Hip

It's a common misconception that less activity (being sedentary) will “save” your hip from further decay. On the contrary, medical experts recommend that you remain as active as your comfort level will allow. You certainly don’t want to force activities that will result in more pain down the road.

If you or a loved one have any hip discomfort, it is IMPERATIVE that you consult our staff right away for recommendations on exercises and activities that will be right for your condition.

The Importance of Heat and Stretching

Before exercising, use heat to loosen the muscles in preparation for stretching exercises. The best method is a warm shower or bath for 10-15 minutes. You can also use a heating pad or a towel warmed in the microwave, but remember, warm heat gets into the joint better than dry heat! Then, STRETCH daily!. Some common stretching we recommend include:

• Knee-to-chest pulls. Start in a comfortable position lying on your back with knees bent and feet flat on the floor. Bring one knee to your chest and hold it with your hands for 10 seconds. Do not bounce. Lower your leg and repeat the process with the other leg. Repeat the sequence 5 times.

• Hamstring stretch. Lie on your back in a doorway, with one leg through the open door. Slide your leg up the wall to straighten your knee. You should feel a gentle stretch down the back of your leg. Hold it for 10 seconds. Be careful to not arch your back, or bend either knee. Remember to keep one heel touching the floor and the other heel touching the wall. Do not point your toes. Repeat with your other leg.
• .

Physical therapy is a critical step in the management of pain associated with hip arthritis. We will work with you to create a treatment plan that includes exercise and other specialized techniques to relieve your pain.

Exercising with Osteoarthritis

Exercise is considered the most effective non-drug treatment for reducing pain and improving movement in osteoarthritis.

Joints and muscles need exercise to prevent stiffness and weakness. Exercise also makes you feel better and helps you maintain a healthy weight. Excess body weight places extra force and pressure on arthritic joints, causes osteoarthritis to progress more rapidly, and is a risk factor for the development and progression of osteoarthritis.

For each pound of weight you gain, your knees gain three pounds of added stress and your hips have six times the pressure on the joints. However, shedding extras pounds can reduce the pain in osteoarthritic joints, which in turn will make you feel better. When introducing exercise into your daily routine, some doctors may suggest that you take a supplement of either Glucosamine or Chondrotin. These are two nutritional supplements that have been reported to help arthritis.

Preliminary reports indicate that glucosamine may indeed relieve the pain and stiffness associated with osteoarthritis, especially when combined with exercise, weight loss, physical therapy, and other measures.

Stretching exercises help prevent stiffness and injury. Stretching correctly provides an easy method of reducing arthritis pain that takes only minutes each day. Done properly, these stretching regimens serve to enhance and speed the healing process by reducing pain and increasing mobility.

Strengthening exercises help strengthen the muscles and ligaments surrounding a joint, which helps protect and reduce stress on the joint.

By building muscle, strength training helps you stay strong and get around better. Strong muscles absorb shocks andreduce the strain on joints, which helps protect your joints from injury. In addition, strength training helps build strong bones as well as improves physical functioning.

Several studies have shown the benefits of exercise for people with osteoarthritis. Exercising can help by:

• Aerobic exercises help to condition your body, thus reducing fatigue so you have stamina throughout the day.

• Aerobic activity also helps you sleep better and improves your mood.

• Improved posture and balance in older adults, and helps to reduce the chances of falling.

• Improved hip and knee joint function and movement.

• Improved function in individuals with knee osteoarthritis, and it may delay or prevent the need for surgery.

Exercising will not wear out a damaged joint; however, not exercising will progress the affects of osteoarthritis.

Please be careful and plan well before starting any exercise program. Feel free to consult with one of our therapists to learn what exercises are best for you.

For more articles from our April Newsletter, please click on the link below!

April Newsletter

Headaches

Headache is one of the most common maladies. There is scarcely anyone who has not had a headache at some point in their lives. For many, a headache is an occasional painful inconvenience easily controllable with an over-the-counter medication. But for others, the headache is frequent and can disable them and cause missed work or damage social and family aspects of life. There are about three hundred causes of headaches but only the most common ones will be discussed here.

The International Headache Society (IHS) broadly divides headache into two categories: primary and secondary headaches. Primary headaches are a constellation of clinical symptoms and not a result of another disorder.

Primary headaches include:

- Migraine headache and its variants
- Cluster headache
- Tension type headache

Secondary headaches are headaches caused by an underlying medical condition such as sinus disease, brain tumor, or stroke. There are numerous causes that could be listed for secondary headaches. A thorough evaluation by a trained professional is aimed at investigating causes for the headache.

Getting help - What to Expect

Getting help for frequent and severe headache starts with an expert who is experienced in the evaluation and treatment of headaches, especially if a clear diagnosis and/or effective treatment is not forthcoming.

A headache expert takes a thorough medical and dental history. Common questions include asking about diet, depression, anxiety, work, and family, as well as past evaluations and treatments. Of primary importance will be the nature, frequency and location of your headaches and any other symptoms that accompany them.

After taking the history, the doctor performs a thorough examination including examination of the cranial nerves in the head and neck, examination of the ears and eyes, and palpation of head, neck and jaw muscles.

Diagnostic tests may include magnetic resonance imaging (MRI) and computer assisted tomography (CT). Other tests, such as blood tests and urinalysis, may help to diagnose diseases that secondarily cause headaches.

After assembling all information, a diagnosis is made and treatment is planned. Simple treatment, such as identifying and eliminating causes of headache (such as eating certain foods), is tried first. Trials of one or more medications may be indicated. Other treatments, such as those performed by psychologists, physical therapists, chiropractors, and acupuncturists, may help as part of overall medical/dental treatment. Before initiating any of these treatments, the doctor explains the diagnosis and treatment plan as well as risks or side effects.

Common Forms of Headache and Their Treatment

Migraine Headache and its Variants

Migraine headache affects over 23 million Americans. Women are affected three times as often as men and there is a hereditary component in many migraine sufferers. Research has shown that migraine and other forms of headache result from neurochemical changes in the brain and are not the result of psychological problems. We know that anxiety and depression often accompany headache and comprehensive treatment should address these conditions. Understanding these scientific advances led researchers to discover better treatments than in the past.

Migraine with Aura

Migraine with aura is the "classical" migraine headache. This kind of migraine has four phases - the prodrome, the aura, the headache, and postdrome or after effect of the headache.

The prodrome occurs anywhere from 2 to 24 hours before the start of the headache and can include such symptoms as lightheadedness, funny smell, upset stomach, dizziness, and sometimes a general feeling of something not being quite right. The aura occurs several minutes to an hour before the headache starts and can include disturbances in vision, numbness, muscle weakness, speech disturbance, lightheadedness, and nausea. If the aura lasts more than one hour, the patient may be referred to a neurologist to rule out possibly dangerous problems that seem like migraine with aura, but aren't. During the headache phase, patients experience moderate to severe head, neck, facial or oral pain, often, but not always, accompanied by nausea and vomiting. The headache is usually one sided and may or may not have a pulsating quality that lasts from four hours to three days, sometimes longer. Most migraine sufferers complain that light and sound bothers them during the headache and they prefer to lie down in a dark, quiet, cool room.

Doctors sometimes divide migraine into categories related to the cause of the headache; for example, migraine occuring monthly in a woman relating to the menstrual cycle is referred to as "menstrual migraine", or a migraine that started after head injury might be called "traumatic migraine".

Subtypes of Migraine Headache

Many, if not most, migraine sufferers have headache without a prodrome and/or aura but still suffer with debilitating headaches associated with light and sound sensitivity and nausea and vomiting.

Migraine can occur anywhere in the head, neck, face, or mouth. Often, it is one sided and concentrates around one of the eyes.

In some patients, the migraine is started by specific stimuli. These stimuli may be poor sleep, increased stress, or diet. Specific foods that can trigger a migraine headache include those containing monosodium glutamate, citrus fruits and drinks, red wines, aged cheeses, and chocolate.

The treatment of migraine often falls into three categories - behavior modification, physical therapy and exercise, and medications. Commonly, several treatments are used in combination.

Behavior modification can include dietary avoidance, stress reduction techniques, and avoidance of headache triggers. Patients can learn to avoid stressful situations when possible and also learn simple relaxation exercises to "turn off" their anxiety. Erratic sleep schedules, smoking, altitude changes, and hormonal changes are other examples of triggers that can be changed.

Often times, the patient will note radiating pain into the muscles of the face and more often the neck. While this may represent a pain referral pattern from the area of the brain that causes the migraine, many patients experience at least partial relief from doctor prescribed stretching and other exercises aimed at alleviating muscle soreness in the head and neck. Patients can be taught to apply heat and cold and to massage these areas, giving them a tool to obtain some relief.

The most common way to control migraine headache is through the use of medication. The two most common approaches are those medications aimed at preventing the headache and those that stop or "abort" the headache once it has begun. These two approaches are often used in combination. New medications are being developed constantly and have vastly improved over the last several years.

Preventive medications are prescribed when the headaches are frequent, long lasting, and/or severe enough to change activities of daily living, family and social interactions, and ability to work. These preventive medications lower the frequency and intensity of headaches and, in some patients, may prevent them all together. Often a medication originally intended for another purpose, for example, lowering blood pressure, will be chosen to prevent headache. Other medications commonly used to prevent headache are anti-seizure and anti-depressant medication. Use of these medications does not indicate that your doctor believes you are depressed, but that research and experience have shown these are effective drugs.

Abortive medications include various forms of over-the-counter and prescription medications. The newest groups of abortive medications are taken orally, by nasal spray, or injected.

Whether using preventive or abortive medications, or a combination of both, the doctor tailors the doses and kinds of medication, taking into consideration the particular headache pattern, the patient's past experiences with medication, other medications being taken at the time, and other medical problems.

Pain anywhere in the trigeminal nerve's distribution, which includes the jaw joints (TMJ's), jaw muscles, neck muscles, teeth and other oral structures, can trigger headache. A thorough headache treatment regimen should include evaluation and treatment of any active or latent sources of stimulation within the trigeminal system to reduce the potential they will trigger a headache.

Cluster Headache

Cluster headache is extremely painful, most often affecting middle-age men. Patients may describe pain in or behind one eye and describe the feeling of the headache as an "ice pick" kind of pain. The headache may be accompanied by a runny nose and tearing of the eye. Cluster headache patients may be in so much pain that they need to pace around the room and are restless and agitated.

The headaches occur in clusters of one to seven days, last from 20 to 60 minutes and often awake the patient from sleep. While the medications used for cluster headache are similar to those used for migraine, the cluster sufferer will often get quick relief from inhaling 100% oxygen. A variant of cluster headache affecting mostly women is known by the complicated name "Chronic Paroxysmal Hemicrania" or CPH for short. These headaches are short, between 5 and 20 minutes, but can occur as many as 15 times in a single day. Fortunately, these headaches frequently respond to an anti-inflammatory drug called Indomethacin.

Tension Type Headache

Tension Type Headache (TTH) is the most common kind of headache. They usually affect both sides of the head and can range in location from the base of the neck to the temples, top of the head and to the eyes. The causes of TTH vary and are not always readily identifiable and may or may not be associated with stress. The cause of the headache may be as common as a stressful work environment or a difficult personal relationship. What are often described as "sinus headache" or "eye strain" can actually be TTH.

Tension Type Headache can be chronic, occurring over long periods of time, or they can be episodic. They may or may not be accompanied by muscle pain in the head and neck.

Orofacial pain specialists often see patients that clench or grind their teeth at night or during the day. Many of these patients complain of daily headache, sometimes accompanied by other symptoms such as tooth pain, ear pain, facial pain, jaw clicking or popping, pain around the eyes and even pain in the neck and shoulders. This is thought to be tension type headache.

The treatment for TTH can very but often includes anti-inflammatory medications, muscle relaxants, anti-depressants and pain medication to control the headache. A great deal of attention has to be paid to stress management and physical conditions that may bring on and/or maintain the headache and, therefore, relaxation training, counseling, and physical therapy are important treatments. It is necessary to stress that while the name of this headache contains that word "tension", it is not certain that psychological factors play a role in causing these headaches.

Chronic Migraine

Migraine patients who take prescription or over-the-counter medications for a long period of time may experience an increase in frequency and a change in the quality of their pain. What started as episodes of migraine can then change to a chronic daily headache. This phenomenon, although very common, often goes unrecognized and undiagnosed. Once diagnosed, there are treatments that can break the chain of daily medication-induced headache and make the residual headache amenable to treatment.