Comprehensive Physical Therapy
A type of treatment you may need when health problems make it hard to move around and do everyday tasks. It helps you move better and may relieve pain. It also helps improve or restore your physical function and your fitness level.
The goal of physical therapy is to make daily tasks and activities easier. For example, it may help with walking, going up stairs, or getting in and out of bed.
Physical therapy can help with recovery after some surgeries. Your doctor may suggest physical therapy for injuries or long-term health problems such as arthritis or chronic obstructive pulmonary disease (COPD).
Physical therapy may be used alone or with other treatments.
Trigger Point Injections (TPI)
This treatment may be an option for treating pain in some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.
In the TPI procedure, a health care professional inserts a small needle into the patient’s trigger point. The injection contains a local anesthetic or saline, and may include a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections are given in a doctor’s office and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain drug, a dry-needle technique (involving no medications) can be used.
This treatment is suggested when the tissues around a tendon are painful, swollen or difficult to move. Tendon sheath injections on their own are unlikely to offer a cure, but can be helpful alongside other treatments such as physiotherapy, splinting and other longer term medicines.
A tendon is a cord of strong fibrous tissue that connects muscle to bone. It is what allows the muscle to bend and straighten a joint when it contracts. Most tendons are surrounded by a sheath or sleeve of synovial tissue. This tissue produces tiny quantities of fluid that lubricate the tendon and allow it to slide smoothly over the joint and work effectively.
In some inflammatory conditions, the synovial tissue becomes thickened and irritable, so that it produces too much fluid and causes pain. Injecting steroid medicine into the fluid within the tendon sheath can treat the inflammation, decreasing the pain and increasing the range of movement in that area.
Your doctor will suggest tendon sheath injections based on your child’s current symptoms, the underlying cause of these symptoms and recent imaging studies.
If they are having the tendon sheath injections under general anaesthetic, it is very important that your child’s stomach is as empty as possible on the day of the procedure, as this reduces the risk of vomiting during and after the anaesthetic.
From: Great Ormond Street Hospital for Children
Platelet-Rich Plasma (PRP)
Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.
PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.
To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.
More information can be found by visiting: stemcellnyc.org/
Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.
To speed healing, the injury site is treated with the PRP preparation. This can be done in one of two ways:
- PRP can be carefully injected into the injured area. For example, in Achilles tendonitis, a condition commonly seen in runners and tennis players, the heel cord can become swollen, inflamed, and painful. A mixture of PRP and local anesthetic can be injected directly into this inflamed tissue. Afterwards, the pain at the area of injection may actually increase for the first week or two, and it may be several weeks before the patient feels a beneficial effect.
- PRP may also be used to improve healing after surgery for some injuries. For example, an athlete with a completely torn heel cord may require surgery to repair the tendon. Healing of the torn tendon can possibly be improved by treating the injured area with PRP during surgery. This is done by preparing the PRP in a special way that allows it to actually be stitched into torn tissues.