Case Studies Category Archive

Understanding Pain

We are big fans of this video and its explanation of pain, enjoy!

Arthritis!

Arthritis of the KNEE

We recently had a 68 yr old male patient who had been complaining of knee pain since a fall 6 months ago. He saw his family doctor who recommended X-Rays that showed he had some arthritis in his knee. Over the past 6 months he had tried two kinds of anti inflammatory medication and steroid injections to his knee with no improvement. The next step was going to be lubricant injections to his knee. The client decided to try physiotherapy on his own with the encouragement of his wife who had been treated successfully here for a previous knee injury. After a thorough assessment, the physiotherapist was able to prescribe a simple exercise for the client. He had to perform 10 repetitions every 2 hours for the next few days. By his second visit, his range of motion had returned to normal and he no longer had knee pain on the stairs or arising from sitting. The client was very happy with his rapid improvement but wished he had come in for treatment sooner!

Arthritis of the HIP

We recently saw a 58 yr old male patient who had been complaining of intermittent right hip and groin pain over the past 2 years. His x-rays showed some very early signs of arthritis. His symptoms were worsened with golfing successive days, walking up hill, and prolonged sitting. On examination, the physiotherapist found his hip to be extremely stiff. After performing 2 simple exercises repeatedly for a few days, his symptoms were significantly less and function was noticeably better. Again, the client wished he had come sooner and maybe he wouldn’t have missed so much golf!

Physiotherapists are uniquely qualified to educate and treat for disability and pain related to osteoarthritis. As well, if we can see clients early enough and treat them for the stiffness that is often present before bony changes start to occur, perhaps we can play a role in prolonging the “life” of the joint.

Physio for a Fractured Ankle

A patient arrived to physio for a fractured ankle after seeing his surgeon and having his cast removed.  Rehabilitating a post fracture typically requires a standard assessment and treatment. However, upon first observation of the unusual swelling in his calf, I probed further and discovered he had occasional discoloration, tenderness in the calf muscle and some other classic signs of a Deep Vein Thrombosis (or blood clot). After completing my basic examination, I explained the concerns I had to the patient and recommended that he immediately visit the urgent care for further investigation.  The next day I received a phone call from the patient thanking me, as they had discovered a massive blood clot in his leg that could have led to a potentially fatal pulmonary embolism. As a physical therapist we are trained not only rehabilitate the obvious injury or illness, but rather look at the patient in a holistic manner and take into consideration the patient’s well-being in it’s entirety.

McKenzie Method at Work :: Neck Pain Casestudy

I recently had a client (50 yrs old) who came to the clinic complaining of a stiff neck of over 6 months duration. She said the pain was not too bad and that it tended to come and go. She could not remember any particular incident where she injured it. She delayed coming in because the pain was tolerable and she thought it would just “go away on its own”.

When I began taking her history, it came out that she was also suffering from occasional dizziness and nausea. She was not sure if it was related to her stiff neck or not. When I looked at her posture I noticed a significant forward head position. As she tended to spend a lot of time sitting and in the car, I could imagine this was a posture she spent quite a bit of time in. Her range of motion was limited as well. I assessed her using the McKenzie Method and during the assessment, it became apparent that her nausea was indeed related to her neck as we were able to turn it on and off with movement. I was able to identify an exercise that worked for her (ie. Her movement was better after this exercise) and prescribed it for a home program. She was instructed in how to properly support herself in a chair to improve her posture as well.

After 3 days, I followed up with this client who reported that her nausea did not return and her neck was much better. I progressed her exercises and saw her once more for follow up. At her last appointment, she had full range of motion and no nausea. Both the client and I were happy with the results but she regretted not having come in sooner. She was impressed it only took 2 sessions to sort out and treat the problem effectively.

This is a great example of how well MDT can work! For very little time and money, we can show you what to do to fix and or manage your problem. Call for an appointment today! 403 278-0705.

Kari Lambden

Back Pain

Over 80% of adults suffer from back pain at some point in their lifetime. Audrey Long, a Calgary researcher is gaining international attention for her innovative study on a proven and effective way to treat back pain.

Answers for Back Pain Found in New Study

Calgary, AB – Eighty percent of adults will experience back pain in their lifetime. Calgary researcher and physical therapist, Audrey Long has received international attention by demonstrating that “one size does not fit all” when prescribing exercises for low back pain. Her study “Does it matter which exercise?” demonstrates that the wrong exercises can hinder recovery; while the right ones can enhance pain reduction and recovery of function.

Previous studies have stated that there has not been enough evidence favoring certain exercises over others therefore, international guidelines simply recommend advice to stay active. Although activity is typically painful, the new study shows that if certain movements can cause pain, other movements can also relieve pain. The fault in most prior studies was the assumption that most back pain is “non specific”. The trend was to prescribe the same exercises to all patients in the group studied.

The key feature of the new study is 30-45 minute individual assessments. “A skilled assessment makes all the difference,” says Long. Those likely to benefit start seeing results in the first session with highly significant pain reduction in back and leg pain within four visits. It does not take weeks of exercise to see the results in pain reduction and the techniques and exercises taught in the assessments are tools that patients take away with them and can treat their own pain. The ultimate goal is that the clients become independent and can both prevent and self treat recurrences. This will minimize the need to see the health care provider, which saves the patient time and money in the long run.

Part two of the study, released by Long in June 2005 at an international conference in Greece, shows that if patients were originally prescribed ineffective exercises, this assessment can lead to a change in the exercise prescription that can reverse the poor result and bring significant pain relief in an average of four visits. Co-author of the study, orthopedic surgeon Ron Donelson, says, “It is no longer appropriate to say that this exercise is good for a bad back, the key is to skillfully assign the right exercise to the right patient”. Many Alberta physical therapists are trained to conduct this form of assessment and more information can be found at www.McKenziemdt.org

Contact Information
Audrey Long
BScPT, Dip MDT
Bonavista Physical Therapy
739 Lake Bonavista Dr. S.E.
Calgary, Alberta
Phone: (403) 278-0705
Email: bonavistaphysio@telus.net
Website: www.McKenziemdt.org

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