SPINAL REHABILITATION AND MANAGEMENT

What is spinal rehabilitation?

Spinal rehabilitation is all about getting you spine to function the best way possible and also protecting it for the future.

What will this consist of?

Spinal rehabilitation consists of a thorough subjective and objective assessment o allow a firm diagnosis to be made.  You will then with your therapist set goals around what you want to achieve, of course you want it be pain free but it is important you set functional goals so you can see your improvements and ensure you get back doing what you want to do.

If required we will refer you for an x-Ray, specialist appointment or to other health professionals. We can also complete your ACC paperwork so you do not need a referral to see us.

Your physiotherapist and yourself will discuss the best line of treatment, this may include mobilisations, manipulations, soft tissue release, dry needling, clinical Pilates, core strengthening and exercise prescription. As you progress your management will change to meet your current needs. If you are not making improvements, we will send you to another person in our team for a free treatment.

Do I need Spinal Rehabilitation?

If you are experiencing back pain we advise you to come and see our specialised team. Spinal rehabilitation is suitable for all types of back pain including disc bulges/ herniation, sciatica, spondylothesis, osteoporosis (including fractures) and osteoarthritis. It is also great for pre or post spinal surgery.

Why is spinal Rehabilitation important?

Back pain can be very debilitating and can hugely effect your day to day life. If it persists it can effect your mood, work and relationships. It is key you get onto your pain quickly and take control. Ongoing back pain can effect how you move and can cause the muscles around your spine to weaken, this in time can make your back pain worse and impede your recovery. 

Why is a strengthening program an integral part of spinal rehabilitation?

Do you have back pain that keeps on coming back? Do you feel that it is getting worse each time? Maybe the intensity of pain is getting worse or it takes you longer to recover? These are comments we hear over and over again. Spinal rehabilitation can help this! 

Back pain can effect how the muscles around your trunk and pelvis work. It is not as simple as you get weak so you need to go to the gym to 'train your core' by doing planks and sit-ups.  It effects the firing patterns of your deep stabilising muscles that stabilise the spine. Your back can also pick up bad patterns in how it moves which can increase recurrences of pain. Our therapists are trained in this field and will help you retrain both your deep stabilising and local core spinal and pelvic muscles.  They will re-teach your spine to move in the correct way and teach you how to do day to day tasks like lifting and bending to reduce the risk of recurrences. 

OSTEOARTHRITIS CARE

What is Arthritis?

Arthritis or osteoarthritis is the degeneration or wearing down of the supporting cartilage within your joints. It can affect any joint but is generally more coming in weight bearing joints such as hips, knees, and the spine. Osteoarthritis is also more common in joints that have previously been injured and/or have had surgery. It is a progressive condition that generally gets worth with age.

How can Physiotherapy help?

Physiotherapy has shown to be the most effective non-operative management of osteoarthritis. Your physiotherapist will assess your condition and prescribe an exercise and treatment programme that can help you manage your problem. Your physiotherapist will also assess and address other areas in your body that may be contributing to increased loading through your affected joint.

How is Arthritis treated?

There are many different treatment options for people that suffer from arthritis. These may include; joint mobilisation, soft-tissue release, stretching, dry needling and specific exercise rehabilitation. 

Why Auckland Physiotherapy?

All staff at Auckland Physiotherapy hold post-graduate qualifications and are experienced in treating osteoarthritis. Management of these conditions can be successful if treated carefully with many patients noticing significant changes with their symptoms.

RHEUMATOLOGY

SPONDYLOARTHRITIS

What is Spondyloarthritis?

Spondyloarthritis is the name given to a number of inflammatory arthritis conditions. These conditions include Ankylosing Spondylitis, Psoariatic Arthritis, Reactive Arthritis and Enteropathic-associated arthritis. Although all these conditions have slight differences among themselves, the common feature to all is inflammatory lower back/pelvic pain. The exact cause of the inflammation is not yet known.

How Can Physiotherapy Help?

The persons’ involved in the treatment of Spondyloarthritis are multifactorial. These include but are not limited to, yourself, your spouse/family, your GP, your Rheumatologist and your Physiotherapist. The role of physiotherapy is to provide education on the treatment of the condition, provide progressive, tailored, specific exercise programs, constantly be in contact with all persons involved in your treatment at your consent and provide continued long-term support and treatment. At Auckland Physiotherapy the physiotherapist plays the role of being the central point of contact for you. 

How can I find out if I have Spondyloarthritis?

Usually the first person to have discussions with is your GP. From here, a referral to see a Rheumatologist would be required. Alternatively, if you feel you would like to know more about these conditions and feel you may have some symptoms, then Rachael Butterworth is an expert in this field and can help guide you in the right direction. 

ANKYLOSING SPONDYLITIS

What is Ankylosing Spondylitis?

Ankylosing Spondylitis (AS) is one of the conditions that come under the banner of Spondyloarthritides (see above). It is an auto-immune condition where inflammation is prolific within the body. The most common feature of AS is inflammation of the sacroiliac joints that are located at the base of your lower back. The inflammation that occurs in this condition specifically affects sites where tendons or ligaments attach to bone, which essentially means that any joint can be affected. Inflammation can also occur within organs such as the eyes, intestines, heart and lungs. The exact cause of AS is still not yet known. For further information please click here.

Why is Physiotherapy Important for People with Ankylosing Spondylitis?

The inflammation related to AS leads to stiffening and immobility of a joint over many many years. The input of physiotherapy is vital to help maintain and in some cases improve, the amount of mobility or movement each joint has. The bigger picture to this is that people with AS can then continue to be involved in the activities important to them without restrictions of immobility, thus improving quality of life.

Why Auckland Physiotherapy?

Although some physiotherapists’ may be aware of this condition, very few have had much exposure to Ankylosing Spondylitis. Auckland Physiotherapy (is lucky) to have a highly skilled Rheumatology physiotherapist as part of their team. You will be in the hands of a most skilled physiotherapist when attending Auckland Physiotherapy.

HEADACHES

Many people may suffer from cervicogenic headaches and not know about what causes them or that they can be successfully treated with physiotherapy. 

Can physiotherapy help my headache?

DID YOU KNOW that headache is the most prevalent pain disorder, affecting 66% of the global population, disturbing both quality of life and work productivity? Overall there are 14 different forms of headaches, therefore incorrect diagnosis will often lead to treatment failure (Hall et al, 2008). Many people may suffer from cervicogenic headaches and not know about what causes them or that they can be successfully treated with physiotherapy. 

What does 'cervicogenic' mean and how do these types of headaches present?

It is not commonly known that up to 1 in 5 people suffer from headaches arising from neck problems. "Cervicogenic" means coming from the neck and these headaches are generally associated with some neck pain.  Some people may not notice much pain in their neck as your often brain interprets the pain as coming from your head rather than from the source in the upper cervical spine (top of your neck).  Cervicogenic headaches usually last for several hours and may last days.  They can be associated with some nausea and dizziness but are not generally associated with any vomiting or visual changes.  If you experience any vomiting, visual changes or aura your headache is more likely to be a migraine and you should see you doctor. 

How do I know I have a cervicogenic headache?

At Auckland Physiotherapy our therapists are all specifically trained to treat headaches. After being asked some specific questions about your headaches and undergoing special orthopedic tests, your Physiotherapist will be able to assess whether or not your headaches may be coming from your neck. 

How can it be treated?

Many symptoms of cervicogenic headaches can actually be eased by doing things yourself such as correcting your posture, home exercises, and adjusting your work station.  We can assist you with these adjustments but also treat your headache with soft tissue release, dry needling, mobilisation, manipulation (if indicated), and guided strengthening exercises to ensure it does not return.

PRE & POST OPERATIVE PHYSIO

How can Physiotherapy help?

Many studies have shown better post operative outcomes when Physiotherapy is included both before and after your operation. Some people find that they may have slow progress after operations such as hip replacements or ACL reconstructions, this is often due to weakness in your deep stability muscles.  Without specific exercises to regain the strength in the smaller stabilising muscles you may find that you continue to walk with a limp, feel tired or have ongoing pain or swelling.  Physiotherapy may involve home or gym based exercises, stretches, trigger point release and manual therapy. 

What will my rehabilitation involve?

After a thorough assessment of your muscle strength, joint movement and walking pattern (if appropriate) your physiotherapist will prescribe you a tailored exercise programme to meet your personal needs. You will then meet with your physiotherapist regularly to progress your exercises and receive some "hands on" treatment if required to ensure you recover as quickly as possible. At Auckland Physiotherapy we have an online exercise programme that includes videos and specific instructions to make sure that you are doing your exercises correctly.

Will my Physio work with my surgeon?

Our therapists work closely with surgeons and specialists so that they have a good understanding of your particular operation and the specific pre and post operative requirements. Your post-operative rehab will move through different phases, and will initially consist range of motion exercises, followed by strengthening exercises and then return to sport, running or specific work related exercises. It is up to the physiotherapist to progress you through your rehab and also to make sure you are meeting the specific requirements that are set by your surgeon. If there are any issues we can arrange an appointment with your surgeon or specialist for you. 

When will I be able to return to my normal daily activities?

Every operation has different time frames and expected outcomes. Your physiotherapist will advise you when it is safe to progress onto the next level. 

N.B. Please remember to check with your insurance company before you start driving as you may not be insured if you have an accident.

CHRONIC PAIN CONDITIONS

What is chronic pain?

Chronic pain is defined by ongoing for lasting for more than 3 to 6  months or pain that extends beyond the expected period of healing.

What conditions can physiotherapy help with?

Many people don't realise that physiotherapy can assist with chronic pain conditions. Clinicians at Auckland Physiotherapy hold post-graduate qualifications and are trained to manage complex and/or chronic pain conditions. Conditions that we can help treat are; Fibromyalgia, complex regional pain syndrome (CRPS), phantom limb pain, headaches, and nerve damage.

What does treatment consist of?

Treatment is often multi-faceted and dependent on your disorder. Your physiotherapist will thoroughly assess your condition to ensure an accurate diagnosis and treatment plan. Treatment may consist of pain modulating exercises, manual therapy, tailored exercise programmes, graded exposure, mirror box therapy, Pilates, acupuncture, and trigger point therapy. Read below for specific disorders.

What is CRPS?

Complex regional pain syndrome (CRPS) formerly reflex sympathetic dystrophy (RSD) is a chronic systemic disease characterized by severe pain, swelling, and changes in the skin. It may initially affect an arm or leg and spread further up or down the limb; 35% of people report symptoms throughout their whole body. CRPS can occur after fracture, periods of immobilisation, nerve damage, and/or major traumatic injuries. 

How can CRPS be treated?

Recent research has shown that a graded motor imagery or 'mirror box therapy' can help reduce your pain and improve your function. All clinicians at Auckland Physiotherapy are trained in this and can guide you through this process. Follow this link if you would like to read more about graded motor imagery.

What is Fibromyalgia?

Fibromyalgia is characterised by chronic widespread pain and a heightened and painful response to pressure. Other symptoms include fatigue, sleep disturbances, and joint stiffness. The primary symptom of fibromyalgia, namely widespread pain, appears to result from neuro-chemical imbalances including activation of inflammatory pathways in the brain which results in abnormalities in pain processing. The exact cause of Fibromyalgia is unknown.

How can Fibromyalgia be treated?

After a thorough assessment your physiotherapist will prescribe and then take you through a tailored treatment programme to assist you with your symptoms. This may consist of stretches, strengthening exercises, Pilates, and also other pain modulating treatments such as soft tissue release, acupuncture, and manual therapy.

DRY NEEDLING & ACUPUNCTURE

WESTERN ACUPUNCTURE

Acupuncture dates back over 3000 years and the fact that it is still being practised today not only in China, but all over the world, says a lot about its effectiveness. It is considered a form of complementary or alternative treatment, but is arguable moving towards conventional Western medicine. There is a growing body of evidence not only demonstrating its effectiveness, but also providing the science behind how it works.

Acupuncture is the practice of inserting very thin needles into the body to elicit a physiological change. It stems from Chinese Medicine, which utilises over 400 Acupuncture points over the body that lie on traditional meridian channels. Although we use the same Acupuncture points as traditional Chinese medical practitioners, our clinicians are trained in Western Acupuncture and therefore apply a different theory to its use.

In physiotherapy, we typically treat musculoskeletal injuries, biomechanical dysfunction and pain conditions. Acupuncture has been described as ‘bringing balance to the body’ or ‘returning the body to a state of homeostasis’. In this way, patients receiving Acupuncture have described it as a ‘reset switch’. Although Acupuncture can be used in many different ways, physiotherapists use it to promote tissue healing, reduce inflammation, improve blood flow, modulate acute or chronic pain, regulate the autonomic nervous system, improve flexibility and improve function. Conditions that can be treated include:

  • Acute sports injuries
  • Overuse and tendon injuries
  • Trigger point and muscular pain
  • Joint pain including arthritis
  • Neck and back pain
  • Headaches and whiplash
  • Chronic pain conditions
  • Post-surgical pain and scar management
  • Neurogenic pain including sciatica
  • Inflammation
  • Stress

Our physiotherapists will perform a thorough assessment and select the appropriate acupuncture points for your condition, anywhere from one point up to 20 points. Very thin needles are then inserted into the body and are left for up to 30 minutes. Usually the patient feels very little as the needles are inserted, but will feel a sense of heaviness or dullness during the session. It is also important to consider that Acupuncture is used as an adjunct treatment, part of a holistic management approach. Patients should expect other forms of treatment during a session and an exercise program as well if required.

DRY NEEDLING

‘Dry needling’ is a term used to describe a form of Acupuncture used to treat the dysfunction of muscle tissue and trigger points. For this reason, it can also be referred to as myofascial trigger point release. The same needles are used as in Acupuncture, but the application can be very different.

Typically the therapist will first palpate the muscle to locate a trigger point. Trigger points are a very sensitive local spot within a taut band of muscle tissue (often can be felt as a ‘knot’). These can occur for a multitude of reasons and can cause pain, stiffness and muscle dysfunction. The Acupuncture needle is then inserted directly into the trigger point and manually stimulated for anywhere between a few seconds to a minute. This can elicit muscle twitches and can feel quite uncomfortable. However, this form of Acupuncture can be very effective in a short period of time. 

After the treatment, pain arising from the muscle is much less, movement is much freer and the muscle is able to activate as it should, appearing stronger. Although dry needling is a very effective treatment in its own right, it is a tool therapists use as part of a holistic management approach. It is likely your physiotherapist will also address underlying biomechanical imbalances, postural dysfunction, muscle inflexibility, strength deficits or joint injury.

How Can We Help?

If you would like to chat to us about your problems, aches and pains or injuries we'd love to hear from you. For an obligation free chat, simply give us a call on (09) 366 4480 or email us admin@aucklandphysiotherapy.co.nz and we'll be in touch as soon as possible.