Thursday, November 29, 2012

What is Stenosis?



What is Spinal Stenosis?

Spinal stenosis

Spinal stenosis is a narrowing of the spinal canal and foramen, which results in “choking” of the spinal cord and/or nerve roots.

Stenosis usually involves the narrowing of:
  1. The spinal canal in the centre of the column of bones (spinal column) through which your spinal cord and nerve roots pass.
  2. The spinal foramen openings between your spinal vertebrae through which nerves leave the spine and go to other parts of the body. 

What Causes a Spinal Stenosis?

What is stenosis?Spinal stenosis most often results from a gradual, degenerative ageing process of your spine.

As you age, the ligaments of your spine may thicken and calcify, and start to compromise the adjacent tunnels.

Your bones and joints also tend to enlarge due to increased bone stress and cause bone spurs, which encroach in the spine’s space.

Your spinal discs, between the vertebrae, become dehydrated with age and lose their height. This disc narrowing can deteriorate quicker with injury eg disc bulges or degenerative disc disease. 

Osteoarthritis of your spine is the most common form of arthritis and is more likely to occur in middle-aged and older people. It is a chronic, degenerative process. It is the result of everyday wear and tear of the spine joints, and is often accompanied by overgrowth of bone, formation of bone spurs, which can cause spinal stenosis.

Spinal stenosis is most common in men and women over 50 years of age and is related to degenerative changes in the spine. However, it may occur in younger people who are born with a narrowing of the spinal canal or who suffer an injury to the spine.


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What are the Symptoms of Spinal Stenosis?

Most commonly, spinal stenosis sufferers experience numbness, muscle weakness, diminished reflexes cramping or general pain in the arms or legs. 

The exact symptoms depend upon which part of your spine is stenotic.

The most common stenosis regions of your spine are your lumbar spine (low back) and your cervical spine (neck), but any spinal region can suffer stenosis.

In lumbar spinal stenosis, the spinal nerve roots in the lower back are compressed and this can produce symptoms of pain, tingling, weakness or numbness that radiates from the low back and into the buttocks and legs, especially with activity.

Cervical stenosis may cause similar symptoms affecting your arms and potentially your legs too!

If the narrowed space within the spine is pushing on a nerve root, you may feel pain radiating down the nerve eg sciatica. However, unlike patients who have sciatica due to slipped disc, this sciatica is relieved by sitting down in stenotic patients.

Classically, in stenosis patients, sitting or bending forward to flex the spine should relieve your symptoms. The flexed position “opens up” the spinal column and therefore enlarges the spaces between the vertebrae. Because keeping the lower back ‘flexed' (bent forward) relieves their symptoms, patients will often walk with a slight stoop forward or look downwards.
Stenosis treatment
With this adaptive posture, the lower back is often stiff and tightness develops in the hip flexor muscles at the front of the hips.

Standing, walking or bending backwards often makes stenosis-related symptoms worse because this position causes narrowing of the space surrounding the nerves.

Walking up a hill may be fine because leaning forwards opens up the space around the nerves.

The space in the spine may narrow without actually producing any symptoms of stenosis. It is only when the narrowing causes the compression of the spinal cord, nerves and nerve roots, that there may be an onset of stenosis symptoms.

Your neck or back may not even be painful. In severe spinal stenosis, you may experience with constant or worsening back pain; numbness or pins and needles in the genital region; weakness in both legs; and or disturbances in bladder or bowel function.

If this is the case, you require urgent medical attention!

How is Spinal Stenosis Diagnosed?

Your physiotherapist or doctor may diagnose you with spinal stenosis based on your symptom behaviour alone.

However, the extent of your stenosis is best determined via a CT-scan, MRI or myelography.

stenosis MRI
MRI Spinal Stenosis


Spinal Stenosis Treatment

PHASE I - Pain Relief & Protection

Managing your pain is usually the main reason that you seek treatment for stenosis. In truth, it was actually the final symptom that you developed and should be the first symptom to improve.

Managing your inflammation. Inflammation is the main short-term reason for why you have suddenly developed stenosis symptoms. It best reduced via ice therapy and techniques or exercises that deload the inflammed structures.

Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, deloading taping techniques, soft tissue massage and temporary use of a back brace.

Your doctor may recommend a course of non-steroidal anti-inflammatory drugs such as ibuprofen.

PHASE II - Restoring Normal ROM, Strength

As your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal joint alignment and range of motion, muscle length and resting tension, muscle strength and endurance. 

Your physiotherapist will commence you on a lower abdominal and core stability program to facilitate your important muscles that dynamically control and stabilise your spine.

Researchers have discovered the importance of your back and abdominal core muscle recruitment patterns. A normal order of: deep, then intermediate and finally superficial muscle firing patterns is normally required for pain-free backs. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs.

Your physiotherapist may recommend a stretching program or a remedial massage to address your tight or shortened muscles.

Please ask your physio for their advice.

PHASE III - Restoring Full Function

As your back’s dynamic control improves, your physiotherapist will turn their attention to restoring your normal pelvic and spine alignment and its range of motion during more stressful body positions and postures. They’ll also work on your outer core and leg muscle power.

Depending on your chosen work, sport or activities of daily living, your physiotherapist will aim to restore your function to safely allow you to return to your desired activities. 

Everyone has different demands for their body that will determine what specific treatment goals you need to achieve. For some it be simply to walk around the block. Others may wish to run a marathon. 

Your physiotherapist will tailor your back rehabilitation to help you achieve your own functional goals.

PHASE IV - Preventing a Recurrence

Back pain does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation. In particular, poor compliance with deep abdominal and core muscle exercises. You should continue a version of these exercises routinely a few times per week. Your physiotherapist will assist you in identifying the best exercises for you to continue indefinitely.

In addition to your muscle control, your physiotherapist will assess your spine and pelvis biomechanics and correct any defects. It may be as simple as providing you with adjacent muscle exercises or some foot orthotics to address any biomechanical faults in the legs or feet. 

General exercise is an important component to successfully preventing a recurrence. Your physiotherapist may recommend pilates, yoga, swimming, walking, hydrotherapy or a gym program to assist you in the long-term.

Fine tuning and maintenance of your back stability and function is best achieved by addressing any deficits and learning self-management techniques. Your physiotherapist will guide you.

What is Your Prognosis for Spinal Stenosis?

The success of treatment for stenosis is reasonably good in the short-term due to the symptom onset mainly being related to recent inflammation.

With each repeat episode, it is more difficult to control your symptoms because your pathology has deteriorated.

Other Treatment Options

Epidural Injections

spinal canal stenosisIf your stenosis symptoms persist, you could consider an epidural corticosteroid injection. 

While these injections can seldom be considered curative, they can alleviate the pain in about 50% of cases. 

Epidural injections should not be used alone but in conjunction with an active rehab program designed by your physiotherapist.

There are a number of complications and risks and therefore options should be discussed with your doctor.

Contact PhysioWorks or Book Online

Spinal Stenosis Surgery

Surgery may be considered in patients where conservative treatment has been unable to prevent worsening symptoms (over 50% of cases). 

Surgery is usually only considered when the patient has severe constant pain that is making everyday tasks impossible and cannot be managed conservatively. 

The results of surgery are mixed and there tends to be a poor outcome in patients who have diabetes, hip pain or pain that is predominantly in the back. Surgery is more effective in those people who have leg pain from spinal stenosis. 

Surgery will also be considered immediately if you experience numbness or pins and needles in the genital region; weakness in both legs; and or disturbances in bladder or bowel function. 

The type of surgical intervention will be based on your specific pathology. 

Results of surgical intervention is variable however most studies describe good-to-excellent overall outcomes.
The most common surgical procedure is a laminectomy, where a section of your vertebrae is removed to open the stenotic bone tunnel.

For more information please contact your physiotherapist or doctor.


Common Treatments for Spinal Stenosis





FAQs about Spinal Stenosis





Helpful Products for Spinal Stenosis

Spinal Stenosis

Related Conditions





Spinal Stenosis Link

Tuesday, November 27, 2012

What is Acupuncture? How does it help you?


What is Acupuncture?

Acupuncture

Acupuncture
 is a Chinese art of medicine dating back to thousands of years in China and other parts of east Asia.


Chinese medicine states that an illness is due to an imbalance in the body’s energy. This energy is known as Qi. 

Qi runs throughout the body by way of channels and meridians that run both superficially & deep.
Acupuncture promotes the free flow of the body's Qi (energy) to bring the body into it's natural balance.

How Can Acupuncture Help You?

Acupuncture is for almost everyone. The great thing is, you don’t even necessarily need to be unwell to benefit from acupuncture. Acupuncture can be effective in preventing the severity of colds and flues, muscle tension, cramping & other minor problems associated with everyday life.

Acupuncture can also treat specific disorders to relieve symptoms and reduce recurrence. It can also be used for maintenance treatments of a long-term condition.

For more specific information regarding how acupuncture can help you please ask one of our acupuncturists or staff.


Do Acupuncture Needles Hurt?

No. When using proper placement techniques, you should not feel any pain. You may feel a slight tingling or heaviness after they are inserted. This is a very common and encouraged sign. 

Acupuncture needles are extremely thin and solid unlike injection needles, which are hollow. The main reason that a drug injection needle hurts is not due to the needle, but rather the pressure of the liquid drug entering your body.

At PhysioWorks, we only use single use, individually wrapped and sterilized needles that we discard immediately after use.

Can Children Have Acupuncture Treatment?

Yes. Older children are usually comfortable with acupuncture. However for small children or patients who fear needles, needle acupuncture is not recommended. Laser acupuncture is an alternative for these patients.

Laser acupuncture therapy is the use of a high frequency laser light to stimulate acupuncture points. Children respond well to both acupuncture and laser therapy as their energy is close to the surface and responds rapidly to treatment.

How Much Acupuncture Treatment Will You Need?

The response to acupuncture treatment varies from person to person. Generally for recent injuries or current conditions, only a few acupuncture treatments are needed in a short space of time.

Chronic conditions involving severe pain, or conditions that have been drawn out, may require some intense initial treatment followed by ongoing treatment on a monthly or six-weekly cycle may to simply maintain your improvement.

There are also additional methods that can be used for long term suffers such as “tense”. This is the use of a small electric current used in conjunction with the needle for stronger results.

Obviously, your treatment schedule will vary depending on your condition. For more specific discussion, you are best consulting your acupuncture practitioner.


Can Acupuncture Be Used in Combination with Modern Medicine?

Yes, acupuncture does not interfere with existing drug therapy. People seeking physiotherapy, massage and other modalities often combine their treatments with acupuncture for greater recovery time and better mobility.

What Conditions Does Acupuncture Help?

Acupuncture is now officially recognised as an effective treatment for pain.

The main reason behind its success appears to be related to chronic pain patterns. The establishment of chronic pain patterns occurs within a few months of an injury.

Once established, these pain patterns are difficult to reverse by other conservative treatment techniques. Acupuncture is often very useful in breaking this pain cycle. 

In particular, acupuncture is useful when other forms of traditional western treatments have failed to fully eliminate your pain. In our experience, acupuncture is very useful in the relief of:


For more advice please ask your acupuncture practitioner.



Most Private health funds offer rebates on acupuncture treatments.



More info about: PhysioWorks Acupuncture in Brisbane

Monday, November 26, 2012

Congratulations to Zoe for Finishing her Dual Masters degrees.

Congratulations to Zoe who has recently completed her dual Masters in Sports Physiotherapy and Musculoskeletal Physiotherapy.

Finally, you can enjoy a weekend off!


More info about Zoe...

Zoe Russell graduated with a dual Bachelor degrees in Physiotherapy and Exercise Science from Griffith University. She return to the study books a few  years ago to complete her Masters in Sports Physiotherapy and Masters in Musculoskeletal Physiotherapy in 2012.

Zoe is a friendly, caring Physiotherapist and has experience in treating musculoskeletal, orthopaedic, sports and womens health conditions, while working at Greenslopes and Ipswich Hospitals, prior to joining PhysioWorks in 2007.

Zoe focuses her injury management by combining her Physiotherapy and Exercise Science knowledge to provide a caring, multifaceted approach to treating musculoskeletal and orthopaedic problems.

Her experience and knowledge of sporting biomechanics and the demands of various sports, allows her to diagnose, treat and help you recover more quickly!

Sports Injury Management

Zoe is currently the Head Physiotherapist to Brisbane City Football Club, and is also Physiotherapist to Queensland’s Indoor Netball State Teams.

Zoe has previously been Physiotherapist to numerous teams including South African Indoor Netball, Northside Wizards Basketball, and QAS Rugby League teams.

Zoe enjoys an active lifestyle, and is a current member of the Queensland Open Mixed Indoor Netball team, and has represented Australia in Indoor Netball. She continues to compete competitively in Netball in addition to Triathlons, water polo, swimming and indoor soccer.

Zoe is a Member of the Australian Physiotherapy Association. She also holds Musculoskeletal Acupuncture and Dry Needling and PIM qualifications.

As a registered physiotherapist, 
private health insurance rebates apply.


How to Book Your Appointment with Zoe

CLAYFIELD - Phone 3862 4544 or Book Online

SANDGATE - Phone 3269 1122 or Book Online


Zoe's Special Interests


Zoe is a Registered Physiotherapy Provider with:

  • All Private Health Insurance Funds
  • Workcover
  • InjuryNet
  • Medicare
  • Department of Veterans' Affairs
  • CTP & Sports Insurers


How to Book Your Appointment with Zoe

CLAYFIELD - Phone 3862 4544 or Book Online

SANDGATE - Phone 3269 1122 or Book Online



Zoe Russell - Brisbane Sports Physiotherapist



More info about: Zoe Russell

Sunday, November 25, 2012

What is the PainEze Plus TENS Machine?


Pain Eze Plus TENS Machine

Pain Eze Plus TENS Machine

The Pain Eze Plus TENS machine is like nothing else available. Weighing only 17 grams the Pain Eze Plus TENS machine is an effective and economically priced pain relieving system.

Simple & Quick to Use

The Pain Eze Plus TENS machine has only two simple operating buttons.
  1. Turn it on and increase the stimulation intensity.
  2. Turn it off or reduce the stimulation intensity.

Is the Pain Eze Plus TENS Machine Powerful?

Yes it sure does! This is truly a miniature powerhouse tens machine attained through a unique computer chip in each tens unit.

The technology is so good that a single 3 Volt battery will last for up to 40 hours of tens machine use use. That's almost two days straight! 

What's Included?

PainEze Plus TENS Machine

  • Pain Eze Plus TENS machine
  • Ready to Use Battery (CR2032)
  • 2 self-stick "ready to use" TENS machine electrodes
  • TENS machine electrode leads
  • TENS machine instruction booklet
  • 3 -months manufacturer warranty

Pain Eze Plus TENS Machine Review 

tens machine review

Pain Eze Plus TENS Machine Client Reviews

"With the new Pain Eze Plus machine working most impressively, it has been most effective in coping with my back pain.  It was worth the money just for the relief it gave me last weekend."
M Trantern, Sandgate

Private Health Fund Rebates for TENS Machines

Private Health Fund Rebates are available from most insurers. Please contact your fund for specific information and requirements.

More info...

Money Back Guarantee

TENS Machine for Sale


PhysioWorks is so confident that this Pain Eze Plus TENS machine will work for you that if you are not completely satisfied we'll happily refund you the full price of the machine within 30 days of purchase. No questions asked!



TENS Machines


More info about the PainEze Plus TENS Machine

Monday, November 19, 2012

What's Your Body Fat Percentage?


What's Your Body Fat Percentage?

Body Fat Percentage


Calling all athletes! Or even non-athletes who want to keep a much closer track on your body fat percentage or your fat loss.

Not weight but FAT loss!


Commonly your doctor will use the Body Mass Index (BMI) scale approximate your fat percentage. Unfortunately, the BMI is a simple measure of comparing your weight and height and comparing it to the general public.  It doesn't take into account the different body shapes that we all have.

A far more accurate test of your actual body fat percentage is a skinfold test.

Using skinfold callipers, Rachel Haddow, our Sport’s Dietitian is able to take your exact Skin Fold Measurements to accurately determine your body fat percentage.

What’s the Benefit of a Skin Fold Test? 

Your skin fold test is a technique used to measure just fat loss and gain and is able to track exactly the areas where this fat-loss is happening. The technique requires a qualified Anthropometrist and is a very reliable measure of body fat.

In addition to determining your body fat percentage you can also determine if your weight-loss is due to fat loss or muscle wastage.

When you get on the scales and have gained 5kg wouldn’t you like to know if that’s muscle before you start panicking? Most people will assume that’s fat. It could very well be muscle.

By seeing our Sport’s Dietitian, you can kill two birds with one stone.

Interested in Your Body Fat Percentage?

If you want to find out more about this technique, make an appointment with our Rachel Haddow, our Sport Dietitian to find out exactly how skinfold testing could benefit you.

Clayfield 3862 4544
Sandgate 3269 1122

Contact PhysioWorks or Book Online Now!

Thursday, November 15, 2012

Need an Arm Sling for Your Shoulder Pain?

Arm Sling (Shoulder)

This arm sling is designed for shoulder pain and shoulder immobilisation.

This arm sling is suitable for:

This arm sling is a strong a cotton shoulder sling with adjustable velcro straps, and includes an extra strap to hold the arm against the body.




Wednesday, November 14, 2012

What are Common Causes of Foot Pain & Injury?


Foot  pain and injury are extremely common. With accurate assessment and early treatment most ankle and foot injuries respond extremely quickly to physiotherapy allowing you to quickly resume pain-free and normal activities of daily living.


Foot

Common Sources of Foot Pain & Injury



Common Foot Pain Treatments



Frequently Asked Questions about Foot Pain



Helpful Products for Foot Pain & Injury

Foot Injuries


Foot Pain & Injury