RESUMEN
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.
Asunto(s)
Manipulaciones Musculoesqueléticas , Fisioterapeutas , Trastornos de la Articulación Temporomandibular , Femenino , Humanos , Adulto , Dolor , Articulación TemporomandibularRESUMEN
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.
Asunto(s)
Síndrome del Túnel Cubital/terapia , Codo/inervación , Dolor Musculoesquelético/terapia , Agujas , Modalidades de Fisioterapia/instrumentación , Nervio Cubital/fisiopatología , Adulto , Fenómenos Biomecánicos , Síndrome del Túnel Cubital/diagnóstico , Síndrome del Túnel Cubital/fisiopatología , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor Musculoesquelético/diagnóstico , Dolor Musculoesquelético/fisiopatología , Dimensión del Dolor , Recuperación de la Función , Resultado del TratamientoRESUMEN
This case report describes a 45-year-old male who presented with chronic right lateral elbow pain managed unsuccessfully with conservative treatment that included anti-inflammatory medication, injection, massage, exercise, bracing, taping, electro-physical agents, and manual therapy. Diagnosis of radial tunnel syndrome (RTS) was based on palpatory findings, range of motion testing, resisted isometrics, and a positive upper limb neural tension test 2b (radial nerve bias). Conventionally, the intervention for this entrapment has been surgical decompression, with successful outcomes. This is potentially a first-time report, describing the successful management of RTS with dry needling (DN) using a recently published DN grading system. Immediate improvements were noted in all the outcome measures after the first treatment, with complete pain-resolution maintained at a 6-month follow-up. A model is proposed describing the mechanism by which DN could be used to intervene for nerve entrapment interfaces.
Asunto(s)
Codo/inervación , Dolor Musculoesquelético/terapia , Agujas , Modalidades de Fisioterapia/instrumentación , Nervio Radial/fisiopatología , Neuropatía Radial/terapia , Fenómenos Biomecánicos , Diseño de Equipo , Humanos , Masculino , Persona de Mediana Edad , Dolor Musculoesquelético/diagnóstico , Dolor Musculoesquelético/fisiopatología , Dimensión del Dolor , Neuropatía Radial/diagnóstico , Neuropatía Radial/fisiopatología , Recuperación de la Función , Resultado del TratamientoRESUMEN
This case report describes a 45-year-old female who presented with lateral knee pain over the right proximal tibiofibular joint (PTFJ) managed unsuccessfully with rest, medications, bracing, injection, and physiotherapy. Clinical diagnosis of PTFJ hypomobility was based on concordant symptom reproduction with palpatory tenderness, accessory motion testing, and restricted anterior glide of the fibula. Intervention consisted of Mulligan's mobilization with movement and taping over the right PTFJ with immediate improvements noticed in pain, range of motion, and function. The patient was seen twice a week and was discharged after four treatment sessions. A follow-up after 6 months revealed that the patient was pain free and fully functional.
Asunto(s)
Artralgia/terapia , Articulación de la Rodilla/fisiopatología , Manipulaciones Musculoesqueléticas/métodos , Artralgia/diagnóstico , Artralgia/fisiopatología , Cinta Atlética , Fenómenos Biomecánicos , Femenino , Humanos , Persona de Mediana Edad , Dimensión del Dolor , Rango del Movimiento Articular , Recuperación de la Función , Resultado del TratamientoRESUMEN
This case report describes a 40-year-old male who presented with posterior thigh pain managed unsuccessfully with massage therapy, chiropractic adjustments, and physical therapy. The diagnosis of myofascial pain syndrome (MPS) involving the quadratus femoris (QF) was purely clinical, based on palpatory findings and ruling out other conditions through deductive reasoning. This is potentially a first time report, describing the successful management of MPS of the QF with dry needling (DN) using a recently published DN grading system. Immediate improvements were noted in all the outcome measures after the first treatment, with complete pain-resolution maintained at a 4-month follow-up.
Asunto(s)
Síndromes del Dolor Miofascial/terapia , Modalidades de Fisioterapia , Adulto , Humanos , Masculino , MusloRESUMEN
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.
Asunto(s)
Conducta Adictiva/psicología , Dolor Crónico/rehabilitación , Ejercicio Físico/psicología , Dolor de la Región Lumbar/rehabilitación , Modalidades de Fisioterapia , Adulto , Dolor Crónico/diagnóstico , Dolor Crónico/fisiopatología , Dolor Crónico/psicología , Estado de Salud , Pasatiempos , Humanos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/fisiopatología , Dolor de la Región Lumbar/psicología , Masculino , Salud Mental , Persona de Mediana Edad , Dimensión del Dolor , Educación del Paciente como Asunto , Calidad de Vida , Recuperación de la Función , Participación Social , Factores de Tiempo , Resultado del TratamientoRESUMEN
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.
Asunto(s)
Analgesia por Acupuntura , Músculos de la Espalda/fisiopatología , Dolor de Espalda/terapia , Fascia/fisiopatología , Manejo del Dolor/métodos , Modalidades de Fisioterapia , Vértebras Torácicas/fisiopatología , Analgesia por Acupuntura/instrumentación , Puntos de Acupuntura , Adulto , Dolor de Espalda/diagnóstico , Dolor de Espalda/fisiopatología , Fenómenos Biomecánicos , Femenino , Humanos , Agujas , Manejo del Dolor/instrumentación , Dimensión del Dolor , Modalidades de Fisioterapia/instrumentación , Rango del Movimiento Articular , Recuperación de la Función , Factores de Tiempo , Resultado del Tratamiento , Puntos DisparadoresRESUMEN
This case report describes a 47-year-old female who presented with complaints of pain in the right elbow radiating down to the thumb. Physical examination revealed symptom reproduction with Spurling A test, upper limb neurodynamic testing-1 and right cervical rotation along with reduced symptoms with neck distraction. Clinical diagnosis of cervical radiculopathy (CR) was made based on a clinical prediction rule. This case report speculates a potentially first-time description of successful conservative management of CR in a patient utilizing simultaneous combination of sustained natural apophyseal glide and neurodynamic mobilization. Immediate improvements were seen in pain, cervical range of motion and functional abilities. The patient was discharged from physical therapy by the second week after four treatment sessions with complete pain resolution maintained at a four-month follow-up period.
Asunto(s)
Manipulaciones Musculoesqueléticas/métodos , Radiculopatía/terapia , Femenino , Humanos , Persona de Mediana EdadRESUMEN
This case report describes a 31-year-old male who presented with complaints of chronic pain in his right elbow. Detailed subjective examination revealed that the patient had searched Google for extensive online information relating to his pain, ultimately self-labeling with various diagnoses. After researching in YouTube, the patient self-treated with ice, exercises, neural mobilization, self-massage and taping, all resulting in a failed outcome. Clinical findings revealed trigger points in his right brachioradialis muscle with added symptoms of central pain. This is a potential first-time description of physical therapy management of brachioradialis myofascial pain syndrome with superadded central pain caused as a result of cyberchondria where the patient used the Internet for arriving at a wrong self-diagnosis and incorrect self-treatment with failed or worsening pain outcomes leading to pain sustenance or chronicity. Physical therapy consisted of Pain Neuroscience Education, dry needling and exercise therapy. The patient was completely pain free and fully functional at the end of the sixth session, which was maintained at a one-month follow-up.
Asunto(s)
Dolor Crónico/terapia , Mialgia/terapia , Educación del Paciente como Asunto , Trastornos Somatomorfos/terapia , Adulto , Dolor Crónico/psicología , Codo , Terapia por Ejercicio , Humanos , Internet , Masculino , Mialgia/psicología , Neurociencias/educaciónRESUMEN
STUDY DESIGN: Double blind pre-test post-test control group design. OBJECTIVES: To compare the isokinetic quadriceps torque, standardized stair-climbing task (SSCT) and pain during SSCT between subjects diagnosed with knee osteoarthritis pre and post kinesio tape (KT) application with and without tension. BACKGROUND: Strength of the quadriceps and torque producing capability is frequently found to be compromised in knee osteoarthritis. The efficacy of KT in improving isokinetic quadriceps torque in knee osteoarthritis is unknown, forming the basis for this study. METHODS AND MEASURES: Forty subjects were randomly allocated to either the experimental (therapeutic KT with tension) or control group (sham KT without tension) with the allocation being concealed. Pre and post test measurements of isokinetic quadriceps torque, SSCT and pain during SSCT were carried out by a blinded assessor. RESULTS: A large effect size with significant improvements in the peak quadriceps torque (concentric and eccentric at angular velocities of 90° per second and 120° per second), SSCT and pain were obtained in the experimental group when compared to the control group. CONCLUSION: Application of therapeutic KT is effective in improving isokinetic quadriceps torque, SSCT and reducing pain in knee osteoarthritis.
Asunto(s)
Cinta Atlética/estadística & datos numéricos , Fuerza Muscular/fisiología , Osteoartritis de la Rodilla/rehabilitación , Músculo Cuádriceps/fisiología , Torque , Distribución de Chi-Cuadrado , Intervalos de Confianza , Método Doble Ciego , Terapia por Ejercicio/instrumentación , Terapia por Ejercicio/métodos , Femenino , Humanos , Contracción Isotónica/fisiología , Quinesiología Aplicada/métodos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Osteoartritis de la Rodilla/diagnóstico , Dimensión del Dolor , Satisfacción del Paciente/estadística & datos numéricos , Rango del Movimiento Articular/fisiología , Valores de Referencia , Resultado del TratamientoRESUMEN
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.