A few conclusions include that no one exercise is better than the other and it is better to find an exercise that people enjoy and is easy for them to do that will probably get done and hence have a positive effect.
Results of a recent systematic review last year which analysed the available research over the last 25 years found that 66% of herniated discs in the lumbar spine heal spontaneously. The looked at studies from United Kingdom, Japan, France, Korea and Italy.
The study concluded that due to the high percentage of discs resorbing that conservative treatment may become the first choice of treatment for lumbar herniated discs.
Milltown Physiotherapy are delighted to introduce new Neurological Physiotherapy service led by Chartered Physiotheraist Una Cusack who has expertise as a Neurological Physiotherapist with extensive clinical experience in adult and paediatric Neurological rehabilitation as well as having completed a Masters in Clinical Neuroscience from Kings College London.
Recently a large Milltown Physio contingent attended IFOMPT – the prestigious conference showcasing the latest and most cutting edge evidence in physiotherapy. I’m delighted to say that our clinical specialist chartered physiotherapist Gráinne Wall has agreed to share her review below.
Jeremy Lewis – The Conundrum That Is The Shoulder: Expanding Our Ability To Manage Shoulder Pain.
Jeremy Lewis presented a comprehensive keynote lecture on managing shoulder pain. He outlined the complexity in treating shoulder pain and the emerging evidence in the conservative versus surgical debate.
Much like other joints of the body, shoulder imaging provides limited information to the clinician as imaging studies do not correlate with the presence or intensity of pain and up to 96% of asymptomatic individuals have structural changes on imaging. He then followed his presentation discussing how “orthopaedic special tests aren’t special” and they are not specific in identifying structural pathology. He asked the delegates to consider this; how many patients have a false positive clinical test followed by a false positive scan result which is often followed by an unnecessary surgical intervention?
He outlines his Shoulder Symptom Modification Procedure (SSMP) and like many others he encourages a holistic approach to the management of shoulder pain, ensuring adequate assessment of the whole body kinematics. SSMP systematically investigates the influence of scapular and thoracic postures and humeral head position on shoulder symptoms. The assessment findings from the SSMP that are found to reduce symptoms are then incorporated into rehabilitations methods. Rehabilitation should be gradual, tailored and specific to the individual’s needs. Scapular rehabilitation was touched upon yet our research into both posture and scapular positioning shows poor correlation in relation to shoulder pain.
Smart rehabilitation matches up to surgical treatment of common shoulder conditions such as subacromial pain, rotator cuff tendinopathy and rotator cuff tears and this conservative regime would seem like a favorable and cost effective treatment plan.
Did you know back pain costs this country more than cancer and diabetes combined!
Around this time last year Mary O’Keeffe (University of Limerick), Dr Kieran O’Sullivan (University of Limerick), Dr Derek Griffin (Tralee Physiotherapy Clinic) wrote a brilliant article in the Irish Independent on 15 things you may not have known about back pain.
The article is definitely worth a read, and @DerekGriffin86 and @kieranosull are worth a follow on twitter for some really up to date knowledge.
We all know the importance of getting a good nights sleep. Evidence has shown that having our sleep interrupted, even when not in pain, can make people more sensitive to pain (Smith et al 2007).
We often get asked here in Milltown Physiotherapy what is the best sleeping position for my neck, shoulder, lower back or hip pain. Well the Cleveland Clinic have come up with a nice handy graphic that helps illustrate the best and worst sleeping positions for your pain.