Often when we think Women’s health, the most common dysfunction people immediately think of is leakage. Whether that is leakage during a certain activity such as sneezing, laughing, coughing (stress urinary incontinence) or leaking on the way to the toilet (urge urinary incontinence).
Some people often don’t associate other symptoms such as urgency, frequency and increased nighttime voids as bladder related issues.
In actual fact, if I were to ask Women what is more bothersome to them, the leakage or the urgency coupled with or without frequency and nighttime voids, the later would be what is impacting their quality of life more. Leakage on most occasions Women can manage e.g they might be happy to wear a panty liner during exercise in the event that they might have a small leak. But urinary urgency has a significant impact on quality of life.
Urinary urgency is defined by the International Continence Society as the complaint of a sudden compelling desire to pass urine, which is difficult to defer.
Often the urge is very unexpected and unprovoked, and can literally happen at any time.
The issue with urgency is that it’s often followed by a fear/anxiety/stress response because the urge is so difficult to defer that you are compelled to find a place to toilet immediately.
What is pain? A simple three-word question about something so pervasive in life it “should” be simple to answer.
Pain is the most common reason people seek medical attention. All pain is real, and for many people, it is a debilitating part of everyday life.
Pain is like a public service announcement from your brain about a credible threat. Pain is not actually coming from your broken wrist or your sprained ankle. It is, in fact, a result of the brain evaluating information, including danger data. This detection system can be influenced by sensory and emotional experiences, as well as personal beliefs and culture, which essentially motivate us to do something to escape it.
However, chronic pain isn’t so clear cut. Chronic pain produces a state of stress. As time passes, the pain systems become more sensitive and hyper-responsive. For some people, the stress resulting from chronic pain can become consuming, and have the potential to significantly worsen and prolong the pain.
The following link is great for understanding chronic pain. It also highlights the powerful influence our mind has over our perception of pain.
Approximately 15% to 35% of patients with chronic pain also have Post Traumatic Stress Disorder (PTSD).
PTSD is a severe, long-lasting psychological reaction to a distressing event, which can cause significant impairment.
Weighing up conservative versus surgical approach to therapy for musculo-skeletal injuries
It is most likely not a question of ‘if’ but ‘when’ we will experience a musculoskeletal injury in our lifetime. Sometimes it is quite clear to us whether we need physiotherapy or surgery, such as a mild ankle sprain versus a complete anterior cruciate ligament (ACL) rupture. However, often times it isn’t so clear cut.
What is Orthopaedic Surgery
Orthopaedic surgery is performed by a medical specialist trained to deal with problems that develop in the bones, joint and ligaments, and sometimes in the nervous system. The goal of treatment is to relieve pain and restore function.
What do we mean by ‘Conservative Management’ (involving physiotherapy)?
Physiotherapy is a clinical health science which involves assessing, diagnosing and treating through physical means to minimise pain and restore function. A physiotherapist will assess the stability of your joints (and/or stiffness), your flexibility and look at the way you move. They will then give you exercises to improve the way you move, to offload painful joints, mobilise stiff/painful joints, improve your stability with exercise prescription and give you tips for pain relief.
When both approaches aim to minimise pain and restore function it becomes quite difficult to determine which approach is best for you.
Is Surgery a ‘Quick Fix’?
In some cases, the ‘quick surgical fix’ is not always the best way to go, and certainly not always the quickest. Post-surgery there is often a long recovery process involving physiotherapy to restrengthen muscles, facilitate motor relearning (your brain will have to ‘relearn’ how and when to activate certain muscles), and fix any compensation strategies your body has adopted as a result of your injury. Multiple studies now indicate that physiotherapy can have equal or more effective outcomes than surgery without the risks or the costs.
The cortisone injection debate: Pros and Cons
Imagine you are two weeks out from the local triathlon festival and your shoulder has progressively worsened. You hear of a ‘miracle treatment’ called the corticosteroid injection (or ‘cortisone shot’) and naturally you are drawn towards the proclaimed fast and effective results. However, there is a saying ‘if it seems too good to be true, it probably is’. This saying can in many ways apply to the uneducated and inappropriate administration of the corticosteroid injection for many musculoskeletal conditions. While this medicine has been widely used to treat inflammatory pain since the 1950s, it is worthwhile being familiar with the pros and cons of corticosteroid injections to help dictate your decision.
What is a corticosteroid/cortisone injection?
Corticosteroids are medicines that mimic your body’s natural corticosteroid hormones (cortisone and hydrocortisone) produced by the adrenal glands above your kidneys. They are not the same as anabolic steroids sometimes misused by athletes and body builders, and they don’t increase your muscle strength.
Corticosteroids that are used appropriately can help a variety of conditions such as arthritis and common sports-related injuries, including:
- Tennis elbow
- Golfers elbow
- Bursitis of the hip, knee or shoulder
- Frozen shoulder
- Plantar fasciitis
- Carpal tunnel syndrome
- Herniated disc
- Rotator cuff injury
In some cases, they can reduce inflammation, relieve pain, and improve function for up to several weeks or even months. When cortisone injections work, they work really well. Still sounds like a miracle right? However, many studies have drawn attention to the common side effects, and the detrimental and failed outcomes that can result from cortisone shots.
Studies have found that people who had corticosteroid injections for tennis elbow had significantly less pain in the short term than those who had no treatment. However, they had much lower rate of full recovery six to 12 months down the track and a significantly higher rate of relapse. It is because of these statistics that many health professionals are concerned that reducing inflammation might mask serious injury. Studies have shown that high concentrations of cortisone or repetitive use can lead to tissue damage, which can lead to softening of cartilage in joints and/or weakening of tendons.
Article adapted from What is Pain by Lorimer Moseley
What do you think pain is? We are often told “pain is there to protect you” or “pain means there is something wrong in the body”. Have you heard of Referred pain? or Phantom Limb pain? In these cases pain is present in the body in places where there is no trauma, sometimes not even a limb, yet pain is still felt. How does this happen?
Previously pain has been described as an indicator that tissue is damaged. However Science no longer agrees with this explanation. Pain is now considered a “complex and highly sophisticated protective mechanism” (L, Moseley)
It’s like rain – people say they love the smell of rain but rain does not actually smell. It is the chemical reaction from the plants and bacteria (actinomycetes) in the earth that release the smell called “Petrichor” that ACTUALLY make the smell of rain. With pain we have millions of nociceptors (pain receptors) in our body that send messages to the brain when they are stimulated. It is the BRAIN however that sends the message back to that body part saying OUCH my _____ hurts!
Messages to the brain are simply chemical sensations – it is the BRAIN that ACTUALLY interprets them as pain in conjunction with all of the other data surrounding the situation. Data can include expectation, previous experience, cultural norms/beliefs and sensory data that you see and hear.
Nociceptors detect a sudden change in the environment around them. With change in temperature pressure acidity etc. they instigate our inflammatory pathways that cause healing to occur. Inflammation then intensifies the sensitivity of these receptors reinforcing the pain message the brain is sending. This can cause the brain to protect and guard even more than is necessary.
So how do can we decrease the pain output from the brain?
There are numerous ways to decrease the pain output;
Acupuncture has been proven to reduce inflammation therefore reduce pain. Remedial Massage techniques help the body to remove the waste from the inflammatory process, reducing swelling and desensitizing the nociceptors that respond to pressure. The power of distraction is a wonderful thing. If you can make something else seem more important to the brain it will reduce pain – this is how some competitors will finish a race with a broken limb. At Physio North we are the masters of distraction. Connect therapy is the use of mental cueing to correct structural imbalances, by engaging the brain in activity so you both achieve proper muscle activation and the brain is so busy thinking it reduces the painful signalling. Our therapists will engage you in your treatment and empower you to continue treatment at home so you can reinforce the safe message to your brain and be responsible for your own pain minimisation.
We can help!
For the brain to reduce pain, it must believe the situation is safe and the evidence of danger from the body’s receptors has ceased or reduced significantly. It is here that exercises allocated during your Physio consultation will encourage your body to believe it is strong enough to proceed. Pilates is a controlled gentle exercise program that encourages the muscles to protect unstable joints thus making the brain feels safer to move thereby inhibiting the pain mechanism.
Call our friendly receptionists on 07 4724 0768 for an appointment with one of our Physiotherapists today so you can move and feel your best!
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At Physionorth our treatment approach is quite different to other Physiotherapy clinics, we use fewer machines and treat our patients as a whole using the ConnectTherapy approach.
Our standard appointment times need to be longer because our treatment approach takes more care and thought.
This attention and consideration get results. Our patient outcomes could not be as successful as they are without taking this extra time to do things right. Continue reading
How to Prevent Pain
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What is Massage?
Massage is the manipulation of superficial, deep and connective tissues utilised to speed up the body’s natural healing process and enhance repair and function of muscles. Target tissues are muscles, tendons, ligaments, fascia, skin, cardiovascular and lymphatic systems, and various techniques are performed in order to get the best result. Massage is quickly expanding among natural therapies as it has been recognised as clinically effective to relief tension, stress, chronic pain and gain greater muscles flexibility.