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Get the latest and most reliable information on pain relief & physiotherapy treatments at Macquarie Street Physiotherapy Clinic blog.

Benefits of Visiting a Physiotherapist

Admini Si - Thursday, September 24, 2015

 

Why visit a Physiotherapist?  

This is a good question, particularly considering there is choice between many different therapists available. When you have pain, you are vulnerable to the advice of many people.

Everyone wants you to see their therapist!

Fortunately for you there is Physiotherapy!

When you go to a registered physiotherapist in Sydney, you know that they have completed at least a Bachelor of Applied Science from a recognised university in order to be allowed to register to practise. Most physiotherapists (all at Macquarie Street Physiotherapy) become members of their professional body, the Australian Physiotherapy Association (APA). This association provides continuing education and advocacy for physiotherapists, and advice to the public, among other things. The letters APAM after your physio’s name demonstrates that they are a member of the APA.

A reflection of the professional standing that physiotherapy has in the medical community is that one no longer needs a doctor’s referral to visit a physiotherapist. If further medical imaging or opinion is required, it is understood that the physiotherapist has the expertise to decide upon and arrange this.

Physiotherapy prides itself in adhering to “evidence based practise” – this means that assessment and treatment techniques used by physiotherapist are backed up by research, rather than just “anecdotal” (unsubstantiated) evidence.

How did the physiotherapy profession develop?  

Physiotherapy has developed from a medical background – in the late 1800s throughout the world, there were medical practitioners seeking other forms of specialised knowledge and skills. One of the areas was physical treatment - exercise and massage. Massage was becoming recognised as useful to encourage healing by promoting circulation to the area of injury. The Australasian Massage Association was formed in 1906. Progressively, various other forms of treatment were added: ‘gymnastic’ exercises, medical ‘galvanism’, passive movement, postural drainage and manipulation. These types of treatments were closely associated with improvements and changes in the medical world.

World wars in the 1900s resulted in wounded soldiers requiring rehabilitation. This further advanced our approach to physical therapy. The name of the profession was changed from ‘massage’ to ‘physiotherapy’ in 1939.

Physiotherapy and Medicine  

Physiotherapy has continued to have a close connection with the medical and surgical world, there being physiotherapy departments in hospitals, inpatient and outpatient rehabilitation, pain management services, as well as private physiotherapy clinics.

When you seek the opinion of a physiotherapist today, they will have had experience in hospitals either as a student or a professional. They are familiar with pre- and post-operative patient requirements. Therefore you can have confidence in their skills to treat you after surgery or a stay in hospital for other reasons.

How can a Physiotherapist help?  

A great strength of the physiotherapy profession is assessment. Rather than treating all patients in the same manner, physios seek to find the source of the problem and tailor the treatment to the individual.

If you require more than a clinical assessment, liaison with your doctor regarding X-ray or MRI imaging, blood tests or referral to a medical specialist, this can be arranged.

What treatment will a physiotherapist give?  

Although hands-on treatment (mobilisation/massage) is regarded as an integral part of treatment, exercises and education are equally important. This gives you the ability to improve your situation further when at home, at work or at the gym. It reduces your reliance on coming in for physio, so that the number of treatments you require can be minimized. If you are able to have a ‘toolbox’ of exercises or positions you can use to make yourself more comfortable, you feel more in control of your situation. It may be that you then consult your physio intermittently or less frequently for review, depending on the problem.

How do I find a Physiotherapist?  

There is a “Find a Physio” tab on the Australian Physiotherapy Association (APA) website, which directs you depending on speciality or location.

As with any profession, trade or business, it is helpful to be recommended by someone you trust.

This may be your doctor, or other health professional. At Macquarie Street Physiotherapy half of our referrals are from friends, family and colleagues who have been satisfied clients of ours.

Overview   

Whether your problem relates to work, sport, or too much sitting and whether it be relating to joints, muscles on the spine, there is sure to be a physiotherapist to assist, educate and provide treatment of your problem.

At Macquarie Street Physiotherapy there are three physiotherapists, all with post graduate qualifications. As such we boast a broad range of experience and skill in management of musculoskeletal conditions.

Back Pain and the “Slipped Disc”

Admini Si - Monday, April 20, 2015


 

Acute (recent onset) lower back pain is commonly seen at Macquarie Street Physiotherapy. 80 percent of people will experience lower back pain at some time in their life. Whether it be quite debilitating or just bothersome, it is worthwhile having your back pain checked out. If pain is related to a disc injury, management of it may be different than if you have a spinal joint sprain or back muscle spasm.


“Slipped Disc”   

Sometimes the term “slipped disc” is used to describe a disc injury. However, the disc doesn't actually "slip". Nor can it be "put back in". Part of the jelly-like inner part of the disc (nucleus) can escape through a weakening in the fibrous outer layer (annulus). This is known as a herniation. The three classifications of a herniated disc are protrusion, extrusion and sequestration. A disc bulge implies that there is pressure from within the disc on the annulus, pushing it out, without a disc rupture.

As a general rule, irritated or injured discs do not like the “flexion” activities of bending, sitting and lifting. These activities put more strain on the disc. Chances are you are happier to be upright and on the move if you have a disc bulge or prolapse.


Spinal joint sprains or back muscle strains   

If your back pain is due to joint or muscle injury, it may also not like bending, but problem movements are more likely to include getting up from sitting, and twisting or standing.


Combination back pain  

In many situations there is a combination of disc, joint and muscle involvement causing back pain, especially if there are degenerative changes which involve both discs and joints. These changes can be seen on x-ray, CT scan or MRI. It is interesting to note, however, that 25% of asymptomatic (pain-free) patients below 60 years old show disc herniation on MRI. In the population over 60 years, this number is increased to 33%. This suggests that a disc herniation will not always cause pain. The findings on any scan need to correlate with clinical findings in order to be relevant and determine the plan of action.


Treatment of Back Pain  

When there is a disc injury, there is a significant chemical inflammatory reaction. This inflammation alone can cause the pressure on a nerve which might give sciatic pain down the leg. As such, initial management needs to concentrate on reducing inflammation. This can be achieved by rest from aggravating activities, avoiding bending, lifting and sitting, using anti-inflammatory medication, and ice. Physiotherapy for “slipped disc” may include spinal rotations, extension in lying (McKenzie exercises) as well as therapeutic ultrasound, strapping or bracing. Exercises to improve core muscle recruitment may be used, as well as stretches for tight surrounding muscles (e.g., hip muscles).


Recovering from back pain and disc injury  

Most disc injuries heal with no need for surgery. If there is leg pain associated with the problem and treatment results in “centralisation” (pain moving closer to the back, and out of the leg) this indicates that treatment is being successful.

If back pain is due to muscle spasm or joint sprain, this often responds well to spinal mobilisation and massage.

At Macquarie Street Physiotherapy we see back pain in all its forms and will be able to treat you or direct you for further tests. These tests, along with specialist referral, are particularly important if your back pain is associated with significant leg pain, weakness, numbness or pins and needles.


Prevention  

Many back injuries occurs as a result of a trivial movement on a background of instability or poor posture. For example, acute pain can result from bending to pick a pen from the floor. Functional stability appears to be a paramount necessity for efficient movement and to reduce mechanical stress on the back. This stability is derived from postural training and specific exercises to improve motor control of both the deep core muscles (transversus abdominus, multifidus, pelvic floor and diaphragm) and the outer core (obliques, and rectus abdominus muscles). A general fitness programme is also helpful: this ensures activity of other important muscles, such as gluteals, and thigh muscles.


Chronic Pain  

If you have chronic (longstanding) back pain, whether it be due to disc injury or other cause, the direction of treatment is more to do with exercise and movement, as inflammation is usually not a major factor. Hands-on treatment may still be necessary, but emphasis will be on moving well and moving often. Your physiotherapist can help determine whether your problem is to do with too much or too little activity.


Macquarie Street Physio