Bulging Disk

Understanding the Disc and its Function
It is important to be aware of the disc’s function in the anatomy of the spine to gain a better understanding of the condition you suffer from and in determining the appropriate treatment.
The disc is soft and acts as a cushion between the vertebrae. It is made up of a gelatinous substance and is known as the nucleus pulposus. The outer area of the disc is the annulus fibrosis.
Loss of water content is a primary reason for discs to lose the ability to act as a cushion. Ove4r time, more stress and tears to the disc eventually leads to a collapsed disc thereby allowing the vertebrae it is cushioning to move closer together.
Discs are not able to repair on their own due to the lack of blood supply and very little nerve endings. As a result of this, discs become damaged due to aging and injury and the condition may be periodic occurrences, or may become a chronic condition.

What is a Bulging Disc?
A bulging disc occurs when the nucleus pulposus bulges out. The core of the disc is surrounded by annulus fibrosis or the ligaments and becomes subject to the pressure of the nucleus pulposus.

Treatment Options for Bulging Discs
Physical Therapy Physical therapy is one of the most recommended forms of treatment for bulging discs. Once a physician has determined his diagnosis, a program will be designed that is specific to your needs.
One physical therapy method is traction. Blood circulation is very important, as it transports nutrients and minerals to promote healing. During this form of therapy, the physical therapist will pull the vertebrae allowing blood flow into the affected area.
Another form of physical therapy is massage. This also allows blood flow into the disc, promoting healing.
Stretching exercises as well as strengthening exercises are meant to make the muscles on your back much stronger.
Other therapies are also available for bulging discs such as ice and heat.

Exercises for Bulging Discs
With most back injuries rest is usually all that is required for your back to start to feel better. Resting in a comfortable position on a firm mattress will help to take the pressure off of your spine and the muscles around it. One suggestion to relieve some of the back pain from a bulging disc is to place a pillow under your knees while you are resting. If you stay in bed for more than two or three days of bed rest you may be worsening the situation as your back muscle will start to weaken from lack of activity. When returning to a normal life style (although not as active at first) you may still feel pain in your back from your bulging disc but your normal daily activities are good for your muscles, helping them strengthen to give your back more support. Although with movement in the beginning you may feel some pain, this pain is the beginning of relief for most people. If the few days of best rest and then normal activities fail to provide any relief you may be sent to see a physical therapist. Normal your first few sessions will be spent educating you on the ways to relieve your back of stress while still being able to stay as active as you may possibly want. Short periods of rest combined with brief exercises designed to reduce your pain may be suggested. A well-rounded rehabilitation program assists in calming pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability.Some individuals may require spinal manipulation or mobilization techniques, deep soft tissue mobilization, neural stretching, or various other interventions by trained personnel for successful results. If the disc is herniated the intervention of a physician or orthopedic surgeon may also be necessary. Successful long term results are very likely if the bulging disc is detected early enough.Ice, heat, ultrasound, electrical stimulation or massages are used with the initial management of the pain from the bulging disc. The treatments will switch to the core of the problem once the pain begins to be manageable.The goal of therapy in most situations is to help control your symptoms. By controlling your symptoms you will begin to be able to move and exercise safely and with more ease. The easiest way for someone to combat back problems is through regular exercise. By building the and coordination of the lumbar region and your abdominal muscles you can consider this to be part of a long term health investment by helping to reduce the risks of future back injuries. Most commonly therapy sessions will be scheduled two or three times a week for up to six weeks.

Goals of physical therapy for bulging disc
*learn ways to manage your condition and control symptoms
*maintain appropriate activity levels
*learn correct posture and body movements to reduce back strain
*maximize your flexibility and strength

-information provided by The Spinal Columns Network.

Headache / Migraines

Did you know that weakness of the neck muscles can cause neck pain and headaches? Weak muscle more readily develop triggerpoints which often refer to the head and neck causing pain, tightness, numbness and tingling, pressure, burning and a weak feeling.

What is a headache?
Headache is defined as pain in the head or upper neck. It is one of the most common locations of pain in the body and has many causes.

How are headaches classified?
Headaches have numerous causes, and in 2007 the International Headache Society agreed upon an updated classification system for headache. Because so many people suffer from headaches, and because treatment is sometimes difficult, the new classification system allows health care practitioners to understand a specific diagnosis more completely to provide better and more effective treatment regimens.

There are three major categories of headaches:
-primary headaches,
-secondary headaches, and
-cranial neuralgias, facial pain, and other headaches

What are primary headaches?
Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.
Tension headaches are the most common type of primary headache; as many as 90% of adults have had or will have tension headaches. Tension headaches are more common among women than men.
Migraine headaches are the second most common type of primary headache. An estimated 28 million people in the United States (about 12% of the population) will experience migraine headaches. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. An estimated 6% of men and up to 18% of women will experience a migraine headache.
Cluster headaches are a rare type of primary headache, affecting 0.1% of the population. An estimated 85% of cluster headache sufferers are men. The average age of cluster headache sufferers is 28-30 years of age, although headaches may begin in childhood.
Primary headaches affect quality of life. Some people have occasional headaches that resolve quickly, while others are debilitated. Tension, migraine, and cluster headaches are not life-threatening.

What are secondary headaches?
Secondary headaches are those that are due to an underlying structural problem in the head or neck. There are numerous causes of this type of headache ranging from bleeding in the brain, tumor, or meningitis and encephalitis.

What are cranial neuralgias, facial pain, and other headaches?
Neuralgia means nerve pain (neur= nerve + algia=pain). Cranial neuralgia describes a group of headaches that occur because the nerves in the head and upper neck become inflamed and are the source of the head pain. Facial pain and a variety of other causes for headache are included in this category.

What causes tension headaches?
While tension headaches are the most frequently occurring type of headache, their cause is not known. The most likely cause is contraction of the muscles that cover the skull. When the muscles covering the skull are stressed, they may spasm and cause pain. Common sites include the base of the skull where the trapezius muscles of the neck inserts, the temple where muscles that assist the jaw to move are located, and the forehead.

There is little research to confirm the exact cause of tension headaches. Tension headaches occur because of physical or emotional stress placed on the body. Physical stress that may cause tension headaches include difficult and prolonged manual labor, or sitting at a desk or computer for long periods of time Emotional stress may also cause tension headaches by causing the muscles surrounding the skull to contract.

What are the symptoms of tension headaches?
The symptoms of tension headache are:
A pain that begins in the back of the head and upper neck as a band-like tightness or pressure.
Described as a band of pressure encircling the head with the most intense pain over the eyebrows.
The pain is usually mild (not disabling) and bilateral (affecting both sides of the head).
Not associated with an aura (see below) and are not associated with nausea, vomiting, or sensitivity to light and sound.
Usually occur sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people.
Most people are able to function despite their tension headaches.
What can I do to get relief from my headaches?
Treatment for headaches can very greatly depending on the practitioner who is diagnosing and treating the headache. Our physical therapists focus on determining the cause of the headache and treating that cause to decrease the pain.
Many people suffering from headaches remark that their head is too heavy for their neck. Could it be as simple as weak neck muscles? Most people with chronic headaches also have a weak neck. We are able to objectively evaluate your strength and range of motion and develop a treatment plan centered on alleviating symptoms and customizing a strengthening program tailored to your individual weaknesses.
Multi-cervical Strengthening
Did you know that your neck muscles can cause your headache and migraine pain? Triggerpoint Dry Needling and IMS (intramuscular stimulation) can alleviate pain and allow the muscles of the neck to rehab more effectively with less discomfort and more speed.

Whiplash-Associated Disorder (WAD)

Whiplash-Associated Disorder (WAD)

The term “whiplash-associated disorder” is used to describe the clinical manifestations of a whiplash injury – which occurs when an “acceleration-deceleration” force is applied on the neck. The neck is injured by a sudden jerking or "whipping" of the head – straining the muscles and ligaments of the neck beyond their normal range of motion. While many associate the occurrence of WAD with car accidents, it can occur in any mishap when an acceleration-deceleration force is applied on the neck – for example, in a diving accident, on roller coasters, sports injuries, or being punched or shaken.

Symptoms:

- Pain in the neck, head, shoulder, and arms

- Pain and stiffness in the neck – muscles may feel knotted and stiff

- Pain when moving head from side-to-side, front-to-back, and rotation

- Tenderness

- Headaches

Our necks are exposed to a lot of stress. Often, people experience pain in this region caused by a number of different factors. The pain may begin in any of the structures in the neck (muscles, nerves, vertebrae and the disks between them, etc.) and can radiate down to the back and arms. Pain can also be radiated from other areas like the shoulder, jaw, head, or upper arms. A common cause of neck pain is muscle strain or tension – and everyday activities are the culprit. Being bent over a desk all day, poor posture while reading or watching TV, or sleeping in an awkward position can all be causes. It can also be caused by more serious incidents, like falls or accidents. Other causes may include a cervical herniated disk, arthritis, and meningitis.

Symptoms:

- Stiffness and soreness of the neck

- Headaches

- Difficulty moving head

- Pain that spreads to shoulders, arms, or back

- If neck pain involves nerves, you may feel numbness, tingling, or weakness in your arm, hand, or elsewhere

Rotator Cuff Tear

ROTATOR CUFF TEARS

What is the anatomy of rotator cuff?

The shoulder complex is made up of three bones, which are connected by muscles, ligaments, and tendons. The large bone in the upper arm is called the humerus. The shoulder blade is called the scapula and the collarbone is called the clavicle.

The top of the humerus is shaped like a ball. This ball sits in a socket on the end of the scapula. The ball is called the head of the humerus and the socket is called the glenoid fossa, hence the term "glenohumeral" joint. The glenoid fossa has a rim of tissue around it called the glenoid labrum. The glenoid labrum makes the glenoid fossa deeper.

Tendons connect muscles to bone. There are four muscles (supraspinatus, infraspinatus, subscapularis and teres minor) that surround the glenohumeral joint. These four muscles are attached to the scapula. They turn into tendons, which in turn attach to the humerus. The tendons of these four muscles make up the "rotator cuff" that blends into and helps support the glenohumeral joint capsule. The muscles of the rotator cuff and their tendons provide stability to the glenohumeral joint, the most mobile joint in the body.

What is a rotator cuff tear?

When the rotator cuff becomes injured or torn, it is described as a rotator cuff tear. These tears may be classified as partial-thickness tears or full-thickness tears. A partial thickness rotator cuff tear is the term used when the tendon is not completely torn. A full-thickness rotator cuff tear is the term used when the tendon is completely torn.

What can cause a rotator cuff tear?

A rotator cuff tear may occur suddenly or develop gradually. Sudden rotator cuff tears usually occur during falls or while lifting heavy objects. A rotator cuff tear may develop gradually for a variety of reasons, including: :

- Repetitive overhead lifting.
- Degeneration of the rotator cuff due to aging.
- Poor blood supply to the rotator cuff.
- Narrowing of the space between the humerus and the acromion (subacromial arch). This can cause progressive "fraying" of the rotator cuff.

What does a rotator cuff tear feel like?

People with a rotator cuff tear may complain of any of the following:

- Pain in the shoulder during lifting and with overhead activities.
- Pain in the shoulder at night or while sleeping.
- Weakness in the shoulder, especially when attempting to lift the arm.
- Catching, grating or cracking sounds in the shoulder when the arm is moved.
- Limited motion.

Can a rotator cuff be detected on X-rays?

X-rays can rule out chips, cracks or other problems with bones but they can not identify soft tissue injuries like rotator cuff tears. In most cases special tests such as an arthrogram, diagnostic ultrasound or an MRI are required to determine if there is a tear in the rotator cuff.

What is the treatment for a rotator cuff tear?

A lot can be done to help people who have torn their rotator cuff. A program of stretching and strengthening exercises, icing, pain medications, anti-inflammatory medications or a cortisone injection may decrease pain and improve function of the shoulder. Partial thickness tears usually respond to this type of treatment. Doctors and physical therapists who deal with people who have rotator cuff tears can help outline an individualized treatment program.

If the conservative approach to managing a rotator cuff tear is not effective, surgery may be required. An orthopaedic surgeon may be able to repair the rotator cuff through arthroscopic surgery or through an open shoulder procedure. Surgery is often required for full thickness rotator cuff tears.

 

Adhesive Capsulitis (Frozen Shoulder)

ADHESIVE CAPSULITIS (FROZEN SHOULDER)

In order to understand this condition it is important to understand the anatomy and function of the shoulder. Please read Shoulder Pain Info's section on basic shoulder anatomy. For additional background information on the biomechanics of the shoulder please read Shoulder Pain Info's section on basic shoulder biomechanics.

What is important to know about the anatomy of the shoulder joint?

The shoulder joint (glenohumeral joint) is the most mobile joint in the body. It is a ball and socket joint that is part of the shoulder complex. The shoulder complex is made up of three bones, which are connected by muscles, ligaments, and tendons. The large bone in the upper arm is called the humerus. The shoulder blade is called the scapula and collarbone is called the clavicle. The top of the humerus is shaped like a ball. This ball sits in a socket on the end of the scapula. The ball is called the humeral head and the socket is called the glenoid fossa, hence the term glenohumeral joint.

The glenohumeral joint is surrounded by a large, loose "bag" called a capsule. The capsule has to be large and loose to allow for the many movements of this joint.

What is a "frozen shoulder"?

"Frozen shoulder" is the term used to describe a condition where the shoulder joint capsule becomes thickened and contracts (shrinks). When the capsule shrinks the glenohumeral joint does not move as easily and gradually more and more motion is lost until the shoulder becomes "frozen" and does not move any more.

There are varying degrees of frozen shoulder. Sometimes there is a mild restriction of motion and sometimes the shoulder is so frozen that there is very little motion of the shoulder at all.

What causes frozen shoulder?

A number of conditions can cause frozen shoulder. One of the most common causes is immobilizing the shoulder after injury or because of another painful shoulder problem such as bursitis or tendonitis. There are many conditions that have been linked to frozen shoulder. Some of these conditions are listed below:

- Rotator cuff tears
- Osteoarthritis of the shoulder joint or the acromioclavicular joint
- Diabetes
- Thyroid problems
- Heart attacks
- Fractures (broken bones) of the upper arm
- Certain cancers

What does a frozen shoulder feel like?

Frozen shoulder can be divided into three different phases or periods.

a) The painful period - This period can last anywhere from six weeks to eight months. Towards the end of this period shoulder pain usually decreases.

b) The frozen or stiff period - This period can last anywhere from six weeks to one year. There is often minimal pain during this period. The most bothersome thing in this period is the lack of shoulder range of motion. During this period shoulder range of motion does not change.

c) The recovery period - This period can last anywhere from six months to two years. During the recovery period there is a gradual increase in shoulder range of motion. Usually there is full recovery of shoulder range of motion. Unfortunately, sometimes the last degrees of range of motion do not come back.

Can a frozen shoulder be detected on X-rays?

X-rays cannot identify frozen shoulder. Special tests such as an arthrogram or an MRI can be ordered to identify frozen shoulder but they are not usually required. These tests may be used to determine tears in the rotator cuff or other shoulder problems that may have caused frozen shoulder.

What is the treatment for a frozen shoulder?

A lot can be done to help people who have frozen shoulder. Most times, treatment will begin with a conservative approach. The following conservative treatments should be tried and continued according to how much pain relief or improvement in shoulder function they produce:

- A program of stretching and strengthening exercises.
- Ice therapy.
- Anti-inflammatory or pain medications.
- Active release therapy.
- Cortisone injections.
- Acupuncture

Doctors and physical therapists who deal with people who have frozen shoulders can help outline a conservative treatment program.

If the conservative approach to managing a frozen shoulder is not effective, surgery may be required. An orthopaedic surgeon may perform arthroscopic surgery or they may move the shoulder through its full range while the patient is under an anaesthetic thus breaking up scar tissue and loosening the joint capsule.

 

Why Benton Physical Therapy?
At BPT we utilize a comprehensive approach to treating our patients. We utilize modalities to relieve pain and inflammation, advance exercise for conditioning, and hands on care for joint mobilizations and myofascial release. If this is greek to you, the bottom line is, we utilize all techniques and options available in our field to treat your specific condition. This starts with evaluating the cause of your condition, includes a specific plan of care and results in optimizing your return to normal function.

Benefits of Physical Therapy
Physical Therapy is beneficial in treating many different conditions including: sports injuries, surgical recovery, back pain, knee pain, and herniated discs. The main criteria for Physical Therapy is a loss in function. If you have experienced a loss in function due to an injury or medical condition, Physical Therapy can more than likely be a benefit. If you have questions about the benefits, feel free to reply to this post or give us a call: 501 778-4960.

About Physical Therapy

What is physical therapy?
It's an important question, and the answer will help you understand how a physical therapist can improve your ability to move and function, while also benefiting your general fitness and health.
Physical therapists are experts in the science of healing and the art of caring.

The Science of Healing.
Patients and physicians are demanding the talents of physical therapists for conservative management of a wide variety of conditions. In many cases, patients are being sent to physical therapy instead of surgery.
Physical therapists help people with orthopedic conditions such as low back pain or osteoporosis; joint and soft tissue injuries such as fractures and dislocations; neurologic conditions such as stroke, traumatic brain injury, or Parkinson's disease; connective tissue injuries such as burns or wounds; cardiopulmonary and circulatory conditions such as congestive heart failure and chronic obstructive pulmonary disease; and workplace injuries including repetitive stress disorders and sports injuries.
Physical therapists practice in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes.

The Art of Caring.
The individualized, "hands on" approach that characterizes physical therapist care is highly valued by patients. When a physical therapist sees a patient for the first time, he or she examines that individual and develops a plan of care that promotes the ability to move, reduces pain, restores function, and prevents disability. The physical therapist and the patient then work side-by-side to make sure that the goals of the treatment plan are met.
Therapeutic exercise and functional training are the cornerstones of physical therapist treatment. Depending on the particular needs of a patient, physical therapists may "manipulate" a joint (that is, perform certain types of passive movements at the end of the patient's range of motion) or massage a muscle to promote proper movement and function. Physical therapists may use other techniques such as electrotherapy, ultrasound (high-frequency waves that produce heat), hot packs, and ice in addition to other treatments when appropriate.
Physical therapists will also work with individuals to prevent loss of mobility by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

For more information please visit the American Physical Therapy Association http://www.apta.org/