Bob Bacci, Author at Bacci & Glinn Physical Therapy

Shoulder Impingement & Labral Tears – Do You Really Need Surgery?

Reference for image https://www.bmj.com/content/364/bmj.l294 .

Physical therapy should be your first choice for shoulder pain, regardless of what’s causing it because it’s conservative, there are little to no side effects, and recent research suggests surgery is no better.

The shoulder is an incredible joint. As a ball-and-socket joint, it allows for an extremely wide range of motion and is the only type of joint that can rotate in a full circle around its axis. But as a result of its design, it’s vulnerable to injury. The rotator cuff can be pinched between the ball and a bone above the ball called the acromion. Also since the shoulder ball is much bigger than the socket, it makes the cartilage labrum around the socket also vulnerable to injury.

The issue is that the ball of the joint (the end of the upper arm bone, or humerus) is much larger than the socket (a structure called the glenoid fossa). Due to the major difference in size, the shoulder is considered an unstable joint, and the ball can slip out of the socket to cause pain and dysfunction. The good news is the rotator cuff helps actively hold the ball and socket together. One other feature of the shoulder that helps prevent dislocation is the labrum, which is a band of cartilage around the edge of the socket that adds depth and keeps the humerus in place. But despite this added protection, shoulder injuries are still quite common.

Two Diagnoses that Might (Yes, We Said “Might”) Cause Pain

Shoulder impingement occurs when the rotator cuff tendons, primarily the supraspinatus tendon, is pinched between the humerus, subacromial bursa, and the acromion. See the above image to try to orient yourself. Imagine what could happen if the arm bone (the humerus) was raised overhead and pinched the rotator cuff and blue bursa that’s below the acromion bone. That’s what happens with shoulder impingement. It’s common but as indicated in the main image of this article at the top, recent research suggests that surgery isn’t better than conservative care.

While we agree that conservative care, especially provided by one of our professionally trained and licensed musculoskeletal experts, is the best thing to do first, we’ve also seen a number of patients that have had surgery and good outcomes as well. Bottom line, research often doesn’t adequately summarize all possible outcomes. Nevertheless, we agree with the research – you should first try conservative care before you have any surgical procedures.

Similar Research Suggests Conservative Care First for SLAP Lesions Too

A SLAP (superior labrum, anterior to posterior) tear is an injury to top of the labrum (or superior), from its front to back (anterior to posterior). SLAP tears can come about from a single incident, such as falling on an outstretched arm or shoulder, or from doing lots of overhead activities on a regular basis. Participation in overhead sports like baseball or tennis, or lifting heavy objects repeatedly can all increase the likelihood of experiencing a SLAP tear. In other cases, they result from the labrum gradually losing strength over time as a natural part of the aging process.

Typical symptoms of a SLAP tear include pain when moving the shoulder, a sensation of locking, popping, or catching, a decrease in shoulder strength and flexibility, and a feeling that the shoulder will suddenly “pop out.” If you’ve been experiencing these symptoms, a SLAP tear my be possible, and some medical professionals might recommend getting an MRI to confirm the diagnosis. While MRIs can be helpful, they should not be relied upon too heavily in these types of situations. Research has shown that the MRIs of many patients—particularly older individuals—with no shoulder pain will actually reveal the presence of a SLAP tear. For example, one study of 53 individuals between the ages of 45-60 concluded:

There is a high prevalence of superior labral tears diagnosed by MRI in the asymptomatic shoulders of middle-aged people. These findings suggest that superior labral tears noted by MRI may not be the cause of symptoms in this patient group with shoulder pain.

Regardless of whether a SLAP tear is responsible for your shoulder pain, physical therapy is the best first step to address it in nearly all situations. A physical therapist will work with you to identify the specific ways your condition is limiting you, and then create a personalized treatment program to address these impairments. Every program is different, but most will include the following:

Flexibility exercises to stretch the shoulder capsule that surrounds the joint
Strengthening exercises for the muscles that support your shoulder
Manual therapy from the physical therapist to increase shoulder range of motion
An analysis of your movement patterns and correction of any overhead faults
Heat, ice, and/or electrical stimulation

Before you get an MRI of your shoulder in order to find out exactly what’s wrong, see a physical therapist. While specific diagnoses are helpful in some cases, they can also be distracting and take away from time that can be better spent getting treated and working your way back to full strength.

To Learn More about How We can Help, Call Us at: (559) 733-2478

Rotator Cuff Tear Treatment in Visalia

When someone says you have a rotator cuff tear, you might automatically think that it should be repaired or fixed. While that might seem to be common sense, fact is you don’t need to rush into surgery for a rotator cuff tear.

For tears of the rotator cuff, physical therapy may be just as effective as surgery according the the research, and we here at Bacci and Glinn Physical Therapy have treated many rotator cuff tears. If you are looking for rotator cuff tear treatment in Visalia, and you don’t want to go through all of the risks and challenges of surgery, you should consider trying natural and conservative care first.

More on the Rotator Cuff

The rotator cuff is a crucial component of the shoulder that allows it to function. It connects the upper arm bone (humerus) to the shoulder blade (scapula) with four muscles, each of which has a tendon that attaches to different parts of the scapula. These tendons form a “cuff” around the head of the humerus, and all the muscles work together to control and stabilize the shoulder.

As a ball-and-socket joint, the rotator cuff helps secure the “ball” portion of the joint—the humerus—as the arm moves and rotates within the “socket” (the scapula). It plays an extremely important role in keeping the shoulder stable when performing many overhead movements, such as reaching, throwing, and picking things up. Unfortunately, because these movements are so common and the rotator cuff is used so frequently, it’s also quite vulnerable to injury.

When any of the tendons of the rotator cuff becomes injured or torn, the tendon becomes detached from the head of the humerus, and the injury is called a rotator cuff tear. Some rotator cuff tears occur after sudden injuries like falling on an outstretched arm or lifting a heavy object, but most develop gradually over time after the tendon gradually loses its strength. Athletes involved in overhead sports like baseball, tennis, and weightlifting, and those who are older than 40 are at a greater risk for rotator cuff tears.

If you happen to experience a rotator cuff tear, it’s important to understand that surgery is not the only option available. For many patients, physical therapy can lead to similar results as surgery, but at a much lower cost and with far fewer risks for complications. Similar outcomes between surgery and conservative treatments have been found in a number of studies, one of which—published in 2017—concludes with the following:

There is limited evidence that surgery is not more effective in treating rotator cuff tear than conservative treatment alone. Thus, a conservative approach is advocated as the initial treatment modality (for these patients).

Whether or not surgery is needed depends on the seriousness of the injury, the age of the patients, and several other factors. If it is determined that physical therapy is appropriate, a typical treatment program will consist of:

Stretching exercises: intended to increase flexibility that has been lost
Strengthening exercises: intended to build back strength in the shoulder
Passive treatments: includes ice, heat, and ultrasound to alleviate pain
Activity modification: your therapist will teach you what positions and movements to avoid or modify to reduce aggravating your shoulder further

So if you’ve recently experienced a rotator cuff tear and are wondering what to do next, visit a physical therapist first before anything else. Taking this step will get you started on a treatment program and on your way to recovery right away, and will also help you reduce the chances of unnecessary tests or procedures down the line.

Tennis Elbow Treatment in Hanford

Looking for Tennis Elbow Treatment in Hanford? Try these things first to avoid the treatment altogether – read on…

Tennis is a great form of physical activity that works many parts of the body due to its demanding dynamics, but just like every other sport, it also comes with a risk for injury. The most common injury in the sport is called lateral epicondylitis or epicondylalgia, which is usually referred to as tennis elbow. Tennis elbow can be a truly bothersome injury, but there are several ways to prevent it from happening and address the symptoms if it does.

Tennis elbow is an overuse injury, meaning it results from performing the same movements repeatedly for a long period of time. Athletes who play tennis and other racquet sports therefore have a particularly high risk for developing tennis elbow, but it can occur in anyone who performs repeated movements that involve the elbow.

The lateral epicondyle is the bony bump on the outside of the elbow. When the arm is overworked, a muscle in this region gets weakened, which eventually leads to microscopic tears in the tendon that attaches to the lateral epicondyle. This results in inflammation of this tendon—called lateral epicondylitis—which leads to symptoms like pain, a burning sensation in the outer part of the elbow, and weakened grip strength.

The good news for patients with tennis elbow and looking for tennis elbow treatment in Hanford, it usually heals on its own with some basic remedies, as approximately 80-95% of patients will have a successful outcome and don’t need surgery. But there are also plenty of ways to prevent tennis elbow from occurring in the first place.

To reduce your risk for tennis elbow, follow these tips:

Learn to use your shoulder and upper arm muscles to take the strain off your elbow
Stick to the middle of your range of motion during strokes, and avoid bending or straightening your arm all the way
Make sure your racquet is right for you; lighter weight, larger grips, and softer strings may reduce the strain on your tendons
Take breaks from tennis to play other sports throughout the year to avoid overuse
Try to maintain adequate fitness and flexibility levels with conditioning exercises
Avoid repeating any one type of stroke, and practice a range of strokes instead

If symptoms of tennis elbow are noticed, however, patients should see a physical therapist first and fast. Therapists are experts at identifying the cause of the pain, and from here, can design a personalized treatment program that alleviates symptoms and restores any function that may have been lost. The benefits of seeing a therapist can be illustrated in the findings of a study published in 2016, which compared the cost-effectiveness of physical therapy to steroid injections, another popular treatment for tennis elbow. The study’s conclusion reads:

Physical therapy was a cost-effective treatment for tennis elbow…A combination of steroid injections and physical therapy was ineffective and cost-ineffective. Physical therapy, not steroid injections, should be considered as a first-line intervention for tennis elbow.

So for all the tennis players out there, keep these tips in mind to keep your risk for tennis elbow at a minimum. And for any elbow-related pain that you do experience, be sure to see a physical therapist right away before it progresses any further.

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Wrist Fracture Exercises After the Bones Have Healed

After a fracture has healed, wrist fracture exercises are an important part of the overall recovery process. We’ve seen some patients lose function because they didn’t receive any physical therapy after their Smith or Colles fracture. Don’t let this happen to you or a loved one.

Here’s more information on wrist fractures:

The wrist is made up of 15 different bones, each of which can get injured if the joint sustains a force that’s significant enough. But some of these bones are more likely to become injured than others, and the term “broken wrist” usually refers to a fracture of the distal part of the radius. These injuries can be serious and possibly even require surgery, but regardless of the treatments used, a course of physical therapy will be essential to ensure a complete recovery.

The radius is located on the thumb side of the wrist and is the larger of the two bones that make up the forearm. Along with the ulna, these bones permit movements of the elbow, hand, and wrist, and the distal radius takes on a great deal of the load that is sent to the wrist. This is one of the main reasons the distal radius are one of the most common injuries in the body. Of all fractures seen in the emergency room, about one-sixth are distal radius fractures. If you’d like to read more about these fracture types in our medical library, click here.

The vast majority of distal radius fractures occur after someone falls and lands with their hands outstretched, which is often called a “fall on an outstretched hand,” or FOOSH injury. Falls in sports like soccer and basketball, as well as biking, skateboarding or rollerblading accidents can all lead to a distal radius fracture if the person lands with enough force. These injuries are usually categorized depending on how the person lands on the wrist, as either a Colles’ fracture or a Smith’s fracture:

Colles’ fracture: these injuries are caused by a fall onto the palm of the hand, which places the wrist in an extended position; the result is a fracture of the distal radius and possibly the ulna
Smith’s fracture: also known as the reverse Colles’ fracture, these injuries occur from falls onto the back of the hand with the wrist in a flexed position

After a Colles’ or Smith’s fracture, the initial treatment for most patients is a reduction, in which the broken bone(s) are situated back into the correct position so that healing can occur. A doctor usually performs the reduction manually, but surgery may be needed if a bone is displaced too far out of position. Reduction is typically followed by a period of immobilization in a cast or brace that must be worn for 4-6 weeks. Regardless of whether or not surgery is performed, a course physical therapy is crucial both during and after the immobilization period to ensure a proper recovery.

Expert Suggestions About Wrist Fracture Exercises After the Break has Healed

While the wrist is still in a cast, a physical therapist can prescribe some gentle exercises the keep the shoulder, elbow, and fingers moving so that these joints don’t lose their flexibility. After the cast is removed, the wrist usually feels stiff and the arm feels weak, so your physical therapist will prescribe some post-injury wrist fracture exercises to address these issues and restore the function of your wrist. This usually includes manual (hands-on) therapy, ice and heat therapy, stretching and stretching exercises, and sport-specific exercises when applicable.

The effectiveness of physical therapy for treating patients with wrist fractures can be seen in the findings of a study published in 2017. Patients who experienced a distal radius fracture were randomly assigned to undergo either a home-exercise program or a supervised physical therapy program, and the results were as follows:

A supervised physical therapy program is effective in the short and medium term, showing a clinically and statistically significant increase in function. This treatment also reduces pain and improves wrist range of motion ROM compared with a home-exercise program.

Colles’ and Smith’s fractures are common injuries that should not be taken lightly, as failing to properly rehabilitate them can lead to long-term issues. This is why all patients should see a physical therapist and complete a comprehensive treatment program to guide them back to full strength.

Hand Arthritis Treatment in Hanford

Physical therapist-led exercises are the best solution for any type of hand arthritis

Despite what you may have read about arthritis, it’s often NOT a debilitating disease. If you have chronic pain in your hands, you should seek out the expert advice of our therapists…they provide exceptional hand arthritis treatment in Hanford. Here’s more about the hand and how we can help.

The hand is made up of 27 bones, and the end of each of these bones is covered by a smooth, shiny surface called articular cartilage. This cartilage protects the bones where they meet one another—a joint—and provides them with a smooth surface that allows the bones to slide freely and not come in contact during movement. Articular cartilage usually does a great job at helping these joints to move smoothly, but over time, it can wear away. When this occurs, the condition is called arthritis.

Arthritis is general term that’s used to describe the loss of articular cartilage in one or more joints in the body. Approximately 54 million people are currently affected by arthritis to some extent, making it one of the most common medical conditions in the U.S. There are over 100 different types of arthritis, but the two that are seen most often are osteoarthritis and rheumatoid arthritis.

Osteoarthritis, by far the most common type of arthritis overall, involves a gradual wearing away of cartilage in certain joints, which makes them more vulnerable to bone-on-bone contact and damage over time. It typically affects weight-bearing joints like the knees and hips, but can also occur in various joints of the hands. Older adults—especially those over the age of 40—are most at risk for developing osteoarthritis, which is primarily related to age-related changes like bones become more dense and less water in the cartilage.

Rheumatoid arthritis is an autoimmune disease, meaning it’s caused by the body’s own immune system mistakenly destroying healthy cartilage in joints unknown reasons. It can affect any joint of the body, but usually starts in the small joints of the hand. Rheumatoid arthritis also tends to be associated with older age, but unlike osteoarthritis, does not occur due to age-related changes and is usually seen earlier in life. The average age for onset of rheumatoid arthritis is between 30-60, but it’s also seen in younger individuals as well.

Regardless of the type, these and other types of hand arthritis typically lead to a similar set of symptoms, which may include:

Severe pain and aching in the hand
Weakness and/or loss of range of motion
Stiffness, swelling, and/or redness
A sensation of “cracking” or “crushing” in the hand joints
Increased size or deformity of the hand

Unfortunately, there is currently no cure available for arthritis. Instead, treatment focuses on relieving pain and managing the patient’s underlying condition, and the best way to accomplish this is through physical therapy. By working one-on-one with each patient, your physical therapist can identify the particular type of arthritis that’s present, and then design a personalized treatment program to address your most bothersome symptoms. A typical treatment program for hand arthritis will consist of the following:

Manual (hands-on) therapy: may include soft-tissue massage, stretching, and joint mobilizations to reduce pain and improve alignment, mobility, and range of motion
Stretching exercises: to improve the flexibility of joints affected by arthritis
Strengthening exercises: to build back up strength of the muscles of the hand
Modalities: ultrasound, electrical stimulation, ice, and/or heat to decrease pain and inflammation of the involved joint

The results of a 2017 study show just how beneficial physical therapist-led exercises can be for patients with rheumatoid arthritis. Its conclusion reads:

A hand exercise program is an effective adjunct to current drug management to improve hand function (for rheumatoid arthritis patients)

Arthritis of any sort can truly prove to be a nuisance that interferes with your ability to function normally in everyday life. So if you’re affected by hand arthritis, contact a physical therapist and get started on a road to less pain and better function.

Carpal Tunnel Syndrome Treatment in Visalia

A course of physical therapy can bring about relief carpal tunnel syndrome

From turning door knobs and driving cars, to picking up children and pointing out stars, we all use our wrists on a nearly constant basis. Sometimes this can lead to tingling and numbness. If you are looking for carpal tunnel syndrome treatment in Visalia, keep reading and we will share with you why seeing one of our physical therapists is a great choice.

The wrist is the converging point where the hand meets the forearm, and it consists of 15 unique bones. Often thought of as a single joint, the wrist is actually made up of three primary joints and several other smaller joints where each of these bones connects with one another. Muscles, ligaments, and tendons further reinforce these connections, and communication is accomplished through a series of nerves. But with such a complex arrangement, there are also many things that can go wrong with the wrist and lead to pain.

The 15 bones that make up the wrist are as follows:

5 long bones in the hand (metacarpals) that connect the fingers to the wrist
8 small bones in the center of the wrist, which are arranged in two rows of four
The ends of the 2 bones of the forearm (radius and ulna), which make up the largest joints of the wrist

These bones are connected by numerous ligaments and surrounded by cartilage, which allows for movements and cushion the bones from rubbing against each other. Any of the structures of the wrist can be damaged by extreme movements—like twisting, bending, or a direct impact—that force it beyond its normal range of motion. The result of this damage may be a sprain, strain, fracture, or dislocation, all of which are most commonly seen in sports and other physical activities.

If You Have More than Pain (i.e. tingling and numbness), It Could be Carpal Tunnel Syndrome

Another frequently seen wrist condition is called carpal tunnel syndrome (CTS). The carpal tunnel is a space at the base of the palm that contains a number of tendons and the median nerve, which provides sensation to most fingers. If these tendons thicken or any other swelling occurs, this tunnel narrows, which puts pressure on the median nerve and causes CTS. The greatest risk factors for CTS are repetitive hand motions, awkward hand positions, mechanical stress on the palms, and vibration, and symptoms usually start with a burning or tingling sensation, but eventually pain, weakness and/or numbness develop in the hand and wrist, and then radiate up the arm.

Other common wrist-related issues include rheumatoid arthritis and osteoarthritis, tendinitis (inflammation of one or more tendons), De Quervain’s tenosynovitis (tendinitis on the thumb side of the wrist), Dupuytren’s contracture (abnormal thickening of tissue between skin and tendons in the palm), and ulnar tunnel syndrome (similar to CTS). All of these conditions have their own unique characteristics and arise for different reasons, but they do share one thing in common: each can be effectively treated with physical therapy.

Despite What You May Have Been Told, Surgery is NOT Your Only Treatment Option

Physical therapists are movement experts that can work with patients to identify the source of their symptoms, and from there, will design a treatment program that’s customized to each patient and based on their personal abilities and goals. This one-on-one approach to treatment has been proven to work because it identifies the patient’s impairments and targets them with a unique set of active interventions meant to reduce their symptoms. The findings of a recent study highlight the effectiveness of a physical therapy intervention for CTS called manual therapy based on neurodynamic techniques. The conclusion reads:

The use of neurodynamic techniques in conservative treatment of mild to moderate forms of CTS has significant therapeutic benefits in the short term

So if you’re dealing with symptoms that might suggest CTS or any other wrist-related problems that are getting in the way of your daily life, physical therapy may be the very solution you’re seeking.

Contact us for more information at (559) 733-2478

Physical Therapy Instead of Opioids For Seniors

Even seniors are at risk for opioid overuse and abuse, but steering towards physical therapy is a much safer option

Pain is the number one reason people seek out medical care, and painful conditions are more common in the U.S. than diabetes, cancer, and heart disease combined. This is one of the driving forces behind the opioid epidemic, which continues to rage on and claim lives in its wake. There were more than 47,000 opioid-related overdose deaths in just 2017 alone, meaning that about 130 people die because of opioids every day.

In thinking about the opioid crisis and who is affected by it, you might have a general picture of the types of individuals who use and abuse these drugs. For most of us, senior citizens are probably not the first group that comes to mind, but the truth is that they are also impacted by the prevalence of opioids in this country in very alarming ways.

Chronic pain is particularly common in seniors, and about 8 in 10 of them struggle with multiple health conditions at once. As a result, many of these seniors are being prescribed opioids to cope with their pain, with the same types of risk for abuse as are seen in other age groups. Two government reports published in 2018 warn that opioid prescriptions for older adults are very high and often associated with a number of negative effects.

Issued by the Agency for Healthcare Research and Quality, a team focused on trends regarding opioid-related hospitalizations and emergency department visits in the senior citizen population. Their findings included the following key points:

Opioid-driven complications were the cause of nearly 125,000 hospitalizations and more than 36,000 emergency department visits for seniors in 2015
Between 2010-2015, there was a 34% jump in the number of opioid-related inpatient hospital admissions among seniors
Nearly 20% of seniors (one in five) filled at least one opioid prescription between 2015-2016, which equated to about 10 million seniors; more than 4 million of these individuals (about 7%) filled prescriptions for four or more opioids, which was characterized as “frequent” use

Why physical therapy is a great alternative to opioids

Whether you’re surprised by it or not, older adults are still at risk for being caught up in the opioid epidemic, which can have some seriously negative consequences. This is why it’s crucial to promote alternatives to opioids in this population, and the best possible option out there is physical therapy. Unlike opioids, which only mask the sensation of pain, physical therapy focuses on identifying its source and helping patients overcome it with a series of carefully designed movements and exercises. And perhaps best of all, physical therapy is universally regarded as a safe intervention with nearly no risk for side effects, and the more sessions that are completed, the better the outcomes are.

So if you’re an older adult that’s currently dealing with pain or you have a loved one that falls into this category, we strongly recommend that you consider physical therapy over opioids as a movement-based strategy that’s proven get to the root of pain and relieve it.

Laser Therapy For Chronic Pain … Over Opioids

Laser therapy is a new and promising alternative to opioids for chronic pain

Chronic pain is defined as any type of pain that lasts for more than three months. About 30% of Americans are currently affected by chronic pain of some sort, causing many of these individuals to be impaired or disabled in their everyday lives.

For a long while, the most common method for managing chronic pain was with pain-relieving medications. Doctors would often tell patients to start with over-the-counter drugs like ibuprofen (Advil) and acetaminophen (Tylenol), and if those didn’t relieve pain, many would go on to be prescribed opioids. But this approach to chronic pain has proven to be misguided and ineffective for a number of reasons, including the fact that opioids don’t actually “fix” pain, and only serve as a temporary solution to a permanent problem for these patients. Opioids are also extremely addictive and associated with a significant amount of abuse, overuse, and overdose-related deaths that are rocking the country in the midst of an ongoing epidemic.

In response, medical professionals are trying to change this trend and recommend effective alternatives treatments to their patients instead of opioids. There are number of alternatives out there for chronic pain, but physical therapy is consistently recognized as one of the best available options, and it’s supported by medical literature as a beneficial method for relieving pain. A physical therapy treatment program can include a wide variety of strategies and interventions, and in some cases it’s paired with laser therapy, a newer, emerging treatment showing some promise for chronic pain patients.

The term “laser” is an acronym for light amplification by stimulated emission of radiation. Lasers are devices that are created artificially to emit light through a process called optical amplification. They produce a monochromatic (one color) light of a single wavelength in a very tight, narrow beam, that be used for numerous different applications.

Low-level laser therapy (LLLT) is a non-invasive treatment that makes use of these beams of light for the purpose of alleviating pain related an injury or condition. LLLT uses a red infrared light and focuses it on areas that are damaged from injury or chronic painful conditions. When this laser is targeted upon a painful region of the body, particular changes take place within the cells in a process called photobiomodulation. When used properly and appropriately, the expected result of this process is less pain.

As the popularity of LLLT grows, it’s now starting to be used in physical therapy treatment plans for patients with conditions that can benefit from it, such as chronic pain. Patients with chronic pain that are candidates for LLLT are likely to experience shorter treatment times, reduced swelling from bruising and inflammation, and increased circulation to damaged cells while their pain is safely alleviated.

LLLT has also been the focus of growing amounts of evidence to better understand its effectiveness, much of which has been supportive. In one review, researchers evaluated some of the relevant research on LLLT for various conditions and found the following:

Studies have demonstrated that LLLT may have positive effects on symptoms associated with chronic pain.

The review also identified other studies that showed “LLLT caused an immediate decrease in pain for acute neck pain and up to 22 weeks in chronic neck pain patients,” and also a powerful, double blinded placebo control study that reported “a decrease in pain and increase in function in patients with knee pain.”

Patients dealing with chronic pain are therefore encouraged to see a physical therapist and ask them if laser therapy is right for their condition while avoiding opioids at any cost.

Physical Therapy for Lower Back Pain Instead of Opioids

Seeing a physical therapist early reduces chances of being prescribed addictive opioids

Back pain, especially low back pain, is one of the most common medical problems out there. In fact, if you’ve never experienced low back pain, you’re part of a small minority, and there’s a strong chance you’ll deal with it at some point. The statistics should help put matters in perspective: about 80% of Americans will be affected by low back pain to some degree at least once in their lifetime.

Low back pain can develop over time in a gradual manner or it may come about suddenly. For some, this leads to symptoms on a nearly constant basis, while symptoms only arise every so often for others. Symptoms vary in each individual as well, but typically include the following: pain, tenderness and/or stiffness in the lower back, difficulty with bending, lifting or twisting, weak or tired legs, discomfort in the back while sitting, difficulty standing or standing for extended periods, and pain that spreads to the buttocks or legs.

Short-lived—or acute—low back pain is most common, while pain that lasts for more than three months is considered chronic and requires additional care. Anyone can get low back pain and it can develop for a variety of reasons, but there are certain risk 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, and depression/anxiety.

For individuals with acute low back pain looking to improve, there is a wide range of options available. These range from simply resting and waiting for the pain to go away on its own, to having surgery to address it in more severe cases. Today, many patients with low back pain are also prescribed opioids by their doctors, which usually provide a “quick fix” for their problem. Unfortunately, opioids don’t really solve the issue, as they only mask the pain temporarily without actually addressing the cause of it. Opioids are also highly addictive and associated with abuse and overuse, as over 45,000 individuals died of an opioid-related overdose in 2017 alone.

Physical therapy, on the other hand, offers a hands-on approach to treating low back pain that actually gets to the heart of the problem and targets it with various interventions that are known to be effective. This is why physical therapy—especially early physical therapy that begins soon after the pain starts—is strongly recommended for patients with low back pain. Following this course can help patients work on improving their condition while also reducing their risk for being prescribed opioids, since physical therapists focus on active treatments and avoiding medications.

A recent study investigated how early physical therapy affects each patient’s use of healthcare resources and chances of being given an opioid prescription, and it concluded with the following:

Early physical therapy for acute low back pain reduces healthcare utilization and cost, reduces opioid use, and may improve healthcare efficiency. This may assist patients, healthcare providers, healthcare systems, and 3rd party payers in making decisions for the treatment of acute low back pain. 

Patients with low back pain are therefore encouraged to consult a physical therapist before any other medical professional, and to do so as early as possible. Following this course will increase their chances of experiencing a positive outcome while also avoiding addictive and dangerous opioids.

Physical Therapy for Knee Osteoarthritis

Physical therapist-guided exercises are best for patients with knee arthritis

Osteoarthritis (OA) is a condition in which cartilage—the natural cushioning between joints—gradually wears away. Over time, this causes the bones of these joints to rub more closely against one another and leads to symptoms like pain, stiffness, swelling, and a decreased ability to move the joint normally.

OA is the most common form of arthritis, and although it can occur in any joint in the body, it’s seen most often in the knees. Knee OA can also occur at any age, but the risk for developing it increases with older age because the body gradually loses its ability to heal the damaged cartilage. This is why about 10% of men and 13% of women over the age of 60 have knee OA. Being obese or overweight also increases the chances of developing knee OA, since the additional weight puts added pressure on the knees and accelerates the damage to cartilage.

Unfortunately, there is no cure for knee OA, but treatments like physical therapy are strongly recommended to reduce patients’ symptoms and help them function better in their everyday lives as a result. Physical therapy treatment programs typically consist of a number of components, such as education, manual (hands-on) therapy, and pain-relieving interventions like heat/ice and ultrasound, but the most important part of treatment is structured exercises.

Since the muscles of the leg affected by knee OA tend to become weaker and less flexible due to symptoms, a specific set of exercises are needed to target these areas. In particular, stretching and strengthening exercises should be performed for muscles of the calves, hips, and those in the front of the thigh (quadriceps) and the back of the thigh (hamstrings). Completing these exercises will help to better support and stabilize the knee, reduce stiffness, and increase fitness levels, which will allow patients to do more and improve their quality of life in the process.

For these reasons, doctors like general practitioners should be referring patients with knee OA to physical therapy for an appropriate treatment program, which research has shown to be a beneficial approach. But according to a recent study, this is not always the case. The study examined the attitudes and beliefs of 5,000 general practitioners regarding the use of exercise for knee OA patients, and it concluded with the following:

While general practitioners’ attitudes and beliefs regarding exercise for knee OA were generally positive, initiation of exercise was often poorly aligned with current recommendations, and barriers and uncertainties were reported.

These results suggest that although most doctors regard exercise and physical therapy in a positive light, many of them are not referring patients to receive these treatments. The reasons for this are not clear but may be related opioids and other treatments being prescribed, which can actually serve as a barrier to knee OA patients’ road to recovery. This is why individuals who are currently dealing with knee OA should see a physical therapist first, as doing so will lead to a faster start to treatments that are intended to help them improve, without delays or obstacles to their care.