Back to Action Physical Therapy


Vermont Physical Therapists, Back to Action PT

General Orthopedic Conditions & Treatment Therapies

Orthopedic physical therapy treats injuries and conditions of the musculoskeletal system. These conditions can occur in all ages throughout the population.

Review Detailed Information on the Following Topics: Future Topics
Neck and Back Pain Whiplash
Low Back Pain & Muscle Strain Thoracic Outlet Syndrome
Sciatica  
TMJ  
Carpal Tunnel Syndrome  
Shoulder Injuries  
Plantar Fasciitis  
Headaches  

Neck and Back Pain

Most neck and back pain is the result of years of overuse, poor body mechanics and posture, weakness in certain muscle groups, and stiff or loose joints. Our expert understanding of the spine and its function enables us to help you regain proper spinal mechanics so that you can live, play, and work pain-free again. Today, most physicians recommend conservative treatment, including physical therapy, prior to surgical intervention.

Low Back Pain & Muscle Strain

Sciatica

Sciatica is a term used to describe pain that is often felt in the buttock and into the back of the leg. This pain may arise from pressure on the sciatic nerve roots in the spine or tightness in the buttock muscles, or both. Joint dysfunction in the lower lumbar and sacral spine can cause repetitive irritation to nerve roots through normal movement such as rising from a seated position. Piriformis Syndrome can also cause sciatica. The piriformis is a deep hip muscle which when shortened or over used can pinch the sciatic nerve. Severe, constant symptoms below the knee, such as complete numbness or weakness, require immediate medical attention and may need more aggressive intervention.

Proper evaluation to determine the origin of pain is the best way to develop a successful treatment program. An evaluation of the alignment of joints, strength of muscles, posture and movement should be performed to find the source of the sciatic nerve irritation. Physical Therapy treatment consists of hands-on techniques to restore posture, joint and soft tissue mobility. Exercises are often necessary to strengthen the deep muscles that stabilize the low back and pelvis and use the hip properly. Learning how to find and use these muscles while using good body mechanics is very important. See additional info on sciatica.

TMJ

TMJ (temporalmandibular joint) pain can be from muscle tightness, joint problems or malocclusions (jaw misalignment). Your dentist or oral surgeon can tell you if you have an injury or joint problem, or if you have wear patterns on your teeth from grinding (bruxing). Often the use of a splint is all that is needed to protect your teeth and eliminate your pain. However, if the problem is long standing, changes in the length of your jaw, neck and facial musculature may cause your pain to continue even with a night guard. Physical therapy can help relieve the stress on your joint and improve range of motion. Home exercises will help you maintain range, strength and flexibility. If you have jaw pain, ear pain, problems opening your mouth (normal range is the ability to place 3 fingers length-wise into your mouth), or painful popping or clicking of your jaw, see your dentist and ask if physical therapy is recommended.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a relatively common condition that is characterized by a numbness and tingling sensation in the hand, thumb, index, and middle fingers. Individuals commonly complain of pain waking them up at night or a burning sensation into the affected hand. These symptoms are caused by irritation to the median nerve as it passes across the wrist and branches out into the hand. Probable causes of the irritation include overuse of the wrist, or trauma such as a sprain or fracture of the wrist.

Individuals who perform repetitive wrist activity, such as those who spend long hours with computers or and manual labor such as picking vegetables, should be careful to avoid excessive bending of the wrist. Most individuals who are diagnosed with carpal tunnel syndrome respond well to conservative treatment such as physical therapy. Only severe cases require surgical intervention.

Treatment for carpal tunnel syndrome includes anti-inflammatory modalities such as ultrasound or electrical stimulation, mobilization of carpal bones if they are found to be stiff, taping techniques, work station changes, and evaluation of body mechanics. A work station set up in a fashion that causes long term or repetitive wrist flexion can lead to or perpetuate carpal tunnel syndrome. Sometimes weakness is determined to be a problem. If active wrist extension is weak, flexion may be overused. Shoulder functioning is also important to assess. The shoulder is responsible for positioning the hand to perform work. If the shoulder is weak, compensations through the wrist may occur.

Shoulder Impingement

Do you have shoulder pain, but you find it difficult to identify where exactly? "It's kind of around the front part, and also down into my arm, and sometimes my fingers get a tingling sensation." Or sometimes, "It only happens with certain movements, like reaching overhead, behind my back or into the back seat of the car." With such vague symptoms it can be difficult to know where the pain is coming from or its cause. This type of shoulder pain may be the result of long hours at a computer or driving, a sedentary life style, overuse of the shoulder (repetitive stress), or neck and back weakness. Poor posture, muscle imbalances, stiffness and poor range of motion may all lead to a dysfunctional shoulder. These all may cause the long bone of the arm to strain against tissues that are out of alignment, creating painful impingements during normal motions. This tightening may also cause excessive pressure on nerves, causing pain or tingling down into the arm or hand. These are functional, dynamic changes to shoulder movement and are difficult to detect on an x-ray.

Manual therapy techniques to help restore normal shoulder mobility and posture, combined with strengthening to correct strength imbalances can help provide pain-free range of motion. Results can be immediate as the person with this condition usually feels significant improvement after even one treatment.

Plantar Fasciitis

If you have foot pain in the area of the heel, that is worst first thing in the morning, or upon rising after being off your feet for a long time, you could have a condition called plantar fasciitis.

The plantar fascia is a broad band of ligament that attaches at the base of the heel. Its role is to support the arch of the foot and help control movement of the foot during weight bearing activities such as walking, running or jumping. In most cases, plantar fasciitis is the result of overuse when the fascia becomes over-stretched due to an increase in the stress to the fascia, either from an increase in activity or a change in biomechanics.

Physical therapy is often the treatment of choice for this condition. Relieving the stress to the plantar fascia is necessary at first, and this may involve an evaluation of biomechanical changes from the feet on up to the pelvis and low back. Once the pain is relieved, conditioning of the fascia will be necessary to prepare it for the person's preferred activities.

Stress Headaches

There are many causes for headaches. One very common cause is tension. Tight muscles through the upper back, head and neck can cause impingement of nerves. This can lead to a headache at the base of the head, behind the eyes, or at the temples. Another common complaint is a headache described as a tight band around the head. Stress can often be the original cause for this muscle tension. If stress is prolonged, the muscles in the head and neck can become adaptively shortened. This sets one up for chronic or frequent headaches.

Another source of headaches is poor posture. Rounded shoulders and a slumped back leads to positional changes in the neck. This leads to joint compression and adaptive shortening or lengthening of muscles which can cause nerve impingement.

In physical therapy we are experts in addressing muscle tone, joint alignment and postural problems.

Headaches accompanied by nausea, vomiting, blurring of vision, dizziness, or ringing in the ears are considered medical problems and require a doctor's attention.

Those with severe headaches of sudden onset should also seek immediate medical attention. These may be early signs of a brain attack (stroke) or other serious medical condition.