RESUMO
This case report describes the successful physical therapy management of a 40-year-old female who presented with left ear pain referred from the temporomandibular joint. Diagnosis was primarily based on clinical examination findings and ruling out of red flags. Guidance was given on active self-care approaches consisting of pain neuroscience education designed with individualized pain curriculum, exercise therapy, manual therapy, and breathing exercises for a period of sixweeks. Clinically meaningful improvements were obtained in the outcome measures of Numeric Pain Rating Scale (NPRS), Patient-Specific Functional Scale (PSFS), and Global Rating of Change (GROC) scale and progress in Pain-Self Efficacy Questionnaire (PSEQ) and Tampa Scale for Kinesiophobia (TSK) scores. Positive changes were achieved with functional activities (chewing, eating, yawing, brushing teeth and physical intimacy), and the patient was pain-free on discharge, which was maintained at a six-month follow-up.
Assuntos
Manipulações Musculoesqueléticas , Fisioterapeutas , Transtornos da Articulação Temporomandibular , Feminino , Humanos , Adulto , Dor , Articulação TemporomandibularRESUMO
This case series describes three patients who presented with right medial elbow pain managed unsuccessfully with conservative treatment that included medication, massage, exercise therapy, ultrasound therapy, neurodynamic mobilization, and taping. Diagnosis of cubital tunnel syndrome was based on palpatory findings, a positive elbow flexion test, and a positive Tinel's sign. Conventionally, the intervention for this entrapment has been surgical decompression, with successful outcomes. This is potentially a first-time description of the successful management of cubital tunnel syndrome with dry needling (DN) using a recently published DN grading system. The patients were seen twice a week for 2 weeks with immediate improvements noted in all the outcome measures after the first treatment session. At discharge, they were pain-free and fully functional, which was maintained up to a 6-month follow-up.
Assuntos
Síndrome do Túnel Ulnar/terapia , Cotovelo/inervação , Dor Musculoesquelética/terapia , Agulhas , Modalidades de Fisioterapia/instrumentação , Nervo Ulnar/fisiopatologia , Adulto , Fenômenos Biomecânicos , Síndrome do Túnel Ulnar/diagnóstico , Síndrome do Túnel Ulnar/fisiopatologia , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/fisiopatologia , Medição da Dor , Recuperação de Função Fisiológica , Resultado do TratamentoRESUMO
This case series describes two patients, aged 35 and 45 years, respectively, who presented with chronic nonspecific low back pain (NSLBP) having exercise addiction (EA) behaviors. Diagnosis of EA was based on clinical findings, exercising patterns and withdrawal symptoms along with high scores in the EA inventory. This report is a potential first-time description of the successful physical therapy management of NSLBP associated with EA utilizing pain neuroscience education (with individualized curriculum), mindfulness, breathing, quota-based reduction in exercises and modification of exercises into social participation, pleasure activities and hobbies. Both the patients were seen once a week, for 8 weeks. At discharge, they were pain-free and fully functional, which was maintained at a six-month follow-up.
Assuntos
Comportamento Aditivo/psicologia , Dor Crônica/reabilitação , Exercício Físico/psicologia , Dor Lombar/reabilitação , Modalidades de Fisioterapia , Adulto , Dor Crônica/diagnóstico , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Nível de Saúde , Passatempos , Humanos , Dor Lombar/diagnóstico , Dor Lombar/fisiopatologia , Dor Lombar/psicologia , Masculino , Saúde Mental , Pessoa de Meia-Idade , Medição da Dor , Educação de Pacientes como Assunto , Qualidade de Vida , Recuperação de Função Fisiológica , Participação Social , Fatores de Tempo , Resultado do TratamentoRESUMO
This case report describes a 42-year-old female who presented with complaints of diffuse pain in her thoracic paraspinal region from T2 to T7. Physical examination revealed tenderness, increased turgor and restriction of her superficial fascia. A potential first time description of successful management utilizing fascia dry needling is described in this report with improvements noted in pain, range of motion, and functional activities. The patient was discharged from physiotherapy after four treatment sessions, and a follow-up after 3 months revealed that she was pain free and fully functional. A grading system (Sudarshan and Murugavel Dry Needling Grading Scale©) is proposed describing the various grades of dry needling to guide clinical reasoning and decision-making.
Assuntos
Analgesia por Acupuntura , Músculos do Dorso/fisiopatologia , Dor nas Costas/terapia , Fáscia/fisiopatologia , Manejo da Dor/métodos , Modalidades de Fisioterapia , Vértebras Torácicas/fisiopatologia , Analgesia por Acupuntura/instrumentação , Pontos de Acupuntura , Adulto , Dor nas Costas/diagnóstico , Dor nas Costas/fisiopatologia , Fenômenos Biomecânicos , Feminino , Humanos , Agulhas , Manejo da Dor/instrumentação , Medição da Dor , Modalidades de Fisioterapia/instrumentação , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Fatores de Tempo , Resultado do Tratamento , Pontos-GatilhoRESUMO
This case report describes a 48-year-old female who presented with complaints of right shoulder pain, hyperesthesias and swelling of the hand along with added symptoms of pain centralization following a cerebrovascular accident. On clinical evaluation, the patient satisfied the Budapest diagnostic criteria for Complex Regional Pain Syndrome (CRPS) type-1. Physical therapy management (1st three sessions) was initially focused on pain neurophysiology education with an aim to reduce kinesiophobia and reconceptualise her pain perception. The patient had an immediate significant improvement in her pain and functional status. Following this, pain modulation in the form of transcutaneous electrical nerve stimulation, kinesio tape application, "pain exposure" physical therapy and exercise therapy was carried out for a period of 7 weeks. The patient had complete resolution of her symptoms which was maintained at a six-month follow-up.