Medical information
Physical therapy

What is physical therapy (rehabilitation)?

Physical therapy it is a type of treatment, during which the physical exercise and natural factors are applied in order to restore health, physical condition and working capacity of patients. Physical therapy trainings help to overcome feeling of pain and return to daily physical activity.

Physical therapy is used as an independent method of treatment, also can be used in combination with other methods of treatment of the disease.

Physical therapist together with a team of doctors analyzes disease and patient’s routine physical activity, discusses the treatment plan and combines individualized program. Recovery objectives are: to reduce or eliminate pain, restore range of motions, strengthen muscles, increase body endurance, improve coordination of movements.

Physical therapy trainings always consist of specially, individually designed exercise. Physical therapists may also use manual therapy, massage, physiotherapy procedures (heat, cold and electrotherapy), teach how to care for one’s own body.

Who is a physical therapist?

Specialists of physical rehabilitation/physical therapists are leading specialists in restoration, correction and maintenance of motor functions. They have systematic knowledge in the field of locomotor activity.

Specialists of physical rehabilitation/physical therapists examine patients in order to identify musculoskeletal dysfunctions and motor capacity, develop and implement individual plan for physical rehabilitation/therapy. They work in collaboration with patient and other professionals (doctors, social workers, psychologists).

Medical information

Pain medicine

What does Pain Medicine studies?

Nowadays, one of the most frequent reasons of applying for medical care is pain caused by locomotor apparatus disease. From 20 to 45 % of the world’s population suffers from pain connected with locomotor apparatus lesions (women and older adults are affected more often). Chronic pain is the reason for work capacity loss and social activity of person. It is connected with pathological conditions, such as: depression, sleep disorders, destabilization of the cardiovascular system.

In the structure of locomotor apparatus pathology, depending on the underlying pathogenetic mechanism, such things can be outlined: inflammatory diseases of the joints and surrounding tissue (arthritis, tenosynovitis, myositis), degenerative joints, trauma, tumors.

Pain as a disease

Pain is a positive feeling, because it is the first signal of danger. Since childhood we from our own experience, learn to get away from what hurts. Trauma pain forces us to restrict functioning of affected limb, and contribute to its healing. Such “positive” pain is called “acute”, which is based on the pathological process associated with trauma, inflammation or infection.

Chronic pain lasts for more than 3-6 months, which exceeds the period of tissue healing. This type of pain loses its useful signal value and it occurs for other pathological laws. Prominent role in the development of which is mental factor. If acute pain is considered as a symptom, chronic pain partakes features of the disease, which manifests itself in emotional and mental disorders with the development of pain behavior.

The perception of pain

Everyone has a different perception of pain, which may depend on upbringing and sex. For example, person used to suffer in silence usually says that it is not so painful, when something hurts. One who is accustomed to the express their feelings, will tell that something hurts a lot. It is proved that women are capable of easier response to pain than men.

Pain feels differently during the day and at night. The pain, which gives us no opportunity to sleep at night for a long time, during the day feels easier. It happens so, because at night pain captures our attention, and during the day we can be distracted from it when taking to a friend or watching movies, working. The fear that appears as a result of a misunderstanding of pain causes, leads to fixation of attention and increases suffering generally.

Causes of pain

In 90% of all cases pain is hidden in five biological structures: soft tissues (skin, muscles, ligaments, etc.), joints, bones, blood vessels and nerve fibers. Therefore, it is divided into tissue, joint, bone, vascular and neurogenic pain.

Tissue pain. Causes of pain are formed in the skin, muscles, ligaments, internal organs.

Kneecap pain. Reasons for this pain are: intra-articular and non- articular pathology. Intra-articular pain occurs during rheumatic diseases, infections, osteoarthritis, injuries. Often it is accompanied by inflammation and excessive production of intra-articular (synovial) fluid. It while movement stretches a joint cavity and causes pain. Non-articular lesions included: diseases and injuries of tendons, synovial bursas and ligaments.

Bone pain. Characterized by aching pain, which extends along the bone. Causes of bone pain are: osteoporosis, increased intraosseous pressure, tumors.

Vascular pain. Caused by blood supply disorders due to narrowing of the arteries or blood flow at the extended or thrombosed veins. Characterized by numbness, gait disturbance, edema and ulceration on the skin.

Neurogenic pain. Occurs due to irritation by pathological factors of pain conductors (nerves). In addition to pain, there are disorders of sensitivity (increase or decrease, up to the absolute loss) at certain parts of the body.

Diagnostics of pain

In order to find out causes of pain, it is necessary, to go through complex diagnostic path. Doctor finds out the information on development of disease, patient’s complaints and which system has disorders (cardiovascular, musculoskeletal, nervous, immune, etc.). This allows him/her to determine the location and character of pain, to ascertain musculoskeletal disorders and to identify the probable cause of pain.

When establishing the diagnosis, modern medicine bases on the data of additional methods of examination. For example, during the diagnostics some technical tools, such as: radiography, magnetic resonance imaging, computer tomography, ultrasound may be used This allows doctors to see how affected organ looks, to visualize what kind of tissue is a substrate of pain and state, whether the process spreads to nearby tissues or not.

Separate effective method of diagnostics is laboratory tests: based on changes of blood parameters, “invisible” causes of disease can be determined (infection, damages to the immune system, etc.). Therefore, if any patient has this or that disease, doctor chooses the most optimal method of diagnosis.

Final stage of the diagnostic process is the analysis of the examinations and establishment of definitive diagnosis, then treatment will be prescribed.

Pain at irregular sport

Physical activity is becoming an increasingly popular lifestyle choice. A lot of people for a whole week give themselves to work and at weekends they exercise. This phenomenon became so common, that the term “weekend sportsman’s” was coined. Often this type of physical activity is the cause of the pain itself. Due to irregular physical loads, patterns of locomotor system are overloaded, causing pain and violation of working activity.

Medical information
Traumatology and orthopedics
What does Traumatology and Orthopedics studies?

Traumatology is a branch of medicine that studies injuries and diseases connected with them, develops methods for the treatment and prevention of injuries.

Orthopedics is the branch of medicine that deals with prevention, diagnostics, treatment of deformities and functional disorders of the locomotor apparatus (bones and muscles). They are caused by congenital defects or arise because of injury or disease.

Orthopedics is traditionally connected with Traumatology – a branch of medicine, that studies damages of the locomotor apparatus (bones, joints, muscles, ligaments, tendons). Prosthesis it is complex medical engineering discipline, that deals with manufacture and use of prosthetic and orthotic devices (braces, bands, machines, special footwear and insoles). It comprises into Orthopedics and Traumatology. Prosthetic and orthotic devices are used for restoration of lost forms and functions of the musculoskeletal system.

Orthopedics is an important part of Sports Medicine that studies changes in the body during trainings. Knowledge in the field of sports and physical culture is simply necessary for the modern orthopedist. It is hard to imagine Orthopedics without a science called Medical Rehabilitation or Podiatry – а branch of medicine that studies structure and treatment of various feet diseases.

Soft tissue injuries

Soft tissue injuries are divided into 2 types: closed and open. Closed injuries, in particular, of soft tissue and bone differ from open (wounds) because they are not accompanied by wounds and microbial contamination of tissues. Closed injuries include bruises, concussion, compression of soft tissues, aborticulation, broken bones and damaged organs, etc.

Mar– closed mechanical soft tissues damage , that cases no harm to skin (occurs often). The degree of injury depends on the size and circuit of the object that caused the injury, as well as form, force of the blow and tissue resistance. Muscles can be easily injured in tension. The weakest, in this respect, is the subcutaneous tissues, which is full of blood vessels and nerves. Every injury is usually accompanied with tearing of the blood vessels, which causes interstitial hemorrhage.

Strain. The term “stretching” does not match its meaning, because all soft tissues have elastic properties and tensile strength, those are their normal functions (e.g. strain of ligament). Because of hyperextension, micro-tears in tissues appear. So, the gist of such injury is a strain still.

During strains often damage to the ligamentos apparatus of the joints appear. This is caused by a sudden curt movement in the joint (flexion with rotation of the fixed feet, excessive flexion or extension). Strain is typical for athletes in most sports. Ankle, knee, wrist joints most often can be affected.

In the case of a strain mechanism of damage is different, then with mar, but they have similar clinical picture: local pain and mild bleeding with dysfunction of the limbs, excessive movement in the joints. Anamnesis (the elucidation of the mechanism of injury) together with additional methods of examination (ultrasound, MRI, etc.) will help to set a diagnosis.

Treatment of fractures

In the treatment of fractures we should follow two principles: need to put together debris properly (if they exist) and fix them for time of fusion.

or fixing of uncomplicated fractures solid (gypsum or plastic) bands are used. Term for imposition of such bandages is immobilization of the joints above and below the fracture, which creates optimal conditions for healing, but requires mandatory rehabilitation treatment after removal of fixation.

One of the modern trends in the world of Traumatology and Orthopedics is the application of methods of surgical fixation of fragments by various metal constructions. Often, this method does not involve immobilization of the joints. So, advantage is that it does not hinder the mobility of the affected limb. And it gives opportunity for early and rapid recovery, reducing disability level and rapid social adaptation of the person injured.