Physiotherapy is the most ancient branch of healing and is a word of Greek origin, meaning healing with natural energies. Within this, physical therapy involves therapy performed with physical energy. The toolkit of physical therapy at our medical departnment is as follows:Electrotherapy: Low-frequency treatments: stabile galvanic, iontophoresis, diadynamic current Mid-frequency treatments: interference High-frequency treatments: magnetotherapy
Mechanotherapy: ultrasound, sonophoresis, underwater ultrasound, shock wave therapy Phototherapy: laser light treatment Thermotherapy: cold therapy (cryotherapy)
Physical therapy is mostly a symptomatic treatment. It treats abnormal symptoms, such as: decrease in local metabolism, decrease in blood circulation, decrease in nervous excitability, increased muscle tone, convulsion, stiffer connective tissue, increased fluid retention, local inflammation, narrowing of arthritic trajectories, pain. The effects of physical therapy are:pain relief, congestion enhancing, inflammation reduction, muscle strengthening, muscle relaxation. It exerts its effect in a cure-like manner, which means a cure consisting of at least 10 occasions. General contraindications:- feverishness
- acute infections
- menstrual cycle
- thrombosis
- damaged, inflamed skin
- pregnancy
- cardiac insufficiency
- cancerous diseases
- implanted metal or prosthesis in the area determined for the treatment
- patients with a pacemaker cannot receive any high-frequency treatment
Mechanism of action:the galvanic current has pain relieving, anti-inflammatory and vasodilatory effects. It improves the driving ability of nerves. It causes local congestion, resulting in reddening of the skin. It is used in musculoskeletal diseases, primarily for pain relief and to increase blood circulation in superficial blood vessels. Important contraindications:see also the general contraindications. Mechanism of action:in case of Nemec’s mid-frequency treatment, two intermittent circuits create interference currents. The frequency value of crossed circuits is between 4000 and 4250 Hz. At a frequency of 4000 Hz, the resistance of the skin decreases, so deeper tissues can be stimuated, as well. Another advantage of interference circuits is that they are less irritating to the sensory receptors in the skin, and therefore they do not cause any discomfort or leave redness. Important contraindications:see also the general contraindications. Treatment process:ultrasound is the sound over the 16000 Hz frequency range. Therapeutic ultrasound has been used for medical purposes for nearly 70 years. Its applicability is enabled by its physical, chemical and biological effects. Physical effects:- micromassage effect (the ultrasound as a mechanical stimulus makes tissues vibrate) - heat effect (the absorbed energy becomes transformed into heat) Biochemical effects:medicaments can be passed through the skin into the body (a non-steroidal ointment) The biological response develops as a result of these. They result in vasodilation and increase in local blood circulation, and they heat and relact the area affected. It has an excellent pain relieving and muscle relaxant effect. It increases the oxygen supply of the area treated, thereby improving the healing process. It is extremely effective in distributing painful muscle nodules. Important contraindications:see also the general contraindications. A procedure for treating small joints of the hand and the foot. Mechanism of action:The development of the laser beam is associated with the name of Maiman. It is a particularly special form of light. Its characteristics are: - monochromatic: single-wavelength light, with no wavelength range - coherent: the photons involved in the radiation are in the same phase with each other - has a high power density
The penetrating laser beams interact with the cells or the molecules within the cells. The excitation of photosensitive molecules within the cells by light stimulates biochemical processes, thanks to the bioregulative effect of which, the below biological and clinical effects occur. Biological effects- it stimulates cell regeneration (the damaged cellular metabolism is restored, while not affecting healthy cellular activity) - it stimulates the vasculature, improves capillary dilation, thereby improving microcirculation - vascular reinforcement - anti-inflammatory effect (regeneration accelerates, inflammation is delimited, the pain and swelling decreases, the impaired function improves significantly already after the first treatments) - stimulation of the immune system (after the soft laser irradiation, the number and activity of immune cells is demonstrably increased) Clinical effects:- it has a pain relieving effect - it reduces inflammation - it reduces muscle tension - it improves tissue circulation, thereby reducing edema - it increases metabolism - it increases tissue regeneration - it has antibacterial effect Important contraindications:see also the general contraindications. Physical therapy is a special movement therapy, which aims to restore the ability to move by means of the exercises determined by the physical therapist, and if this is not possible, to adapt to the changed state. Physical therapy can be divided into active and passive procedures. The active parts of physical therapy are: the guided active movement and the dictation-driven movement. Its aim is to improve muscle strength, to relax and improve movement coordination. As a passive part of physical therapy, the patient relaxes the moved body part and the control is made by the treatment provider. As a result of cure-like application of physical therapy, muscle strength enhancement, movement coordination and balance improvement, and - in addition to the improvement of endurance - circulation enhancement can be achieved. The duration of this kind of physical therapy is 30 minutes. During the examination performed based on the McKenzie method, the McKenzie therapeutist (qualified physiotherapies) has special postures and movements repeated by the patient. Application areas of the McKenzie method are:- Spinal disc herniation - Spinal disc diverticulitis - Pain radiating into the arm or foot - Numbness of the arm, palm, thigh, leg or foot - Waist-, back- and neck pain due to improper posture - Waist-, back- and neck pain due to contraction, scarring or adhesion Contraindications:- Canalis stenosis - Spondylolisis - Spondylolistesis - Central hernia - Ruptured hernia - While taking painkillers - Directly after surgery or trauma - Local edema, cyst, hematoma - Degenerative diseases of the spine that result in tissue transformation (e.g. SPA, Scheuermann) - High degree of osteoporosis - Cancerous diseases of the spine The application of carbon dioxide as a refrigerant in cryotherapy procedures has a therapeutic effect, which is manifested in the following:- analgesia due to high levels of endorphin release - reduction of inflammatory processes - reduction of muscle tone - edema reduction - improvement of the clinical and movement state of the patient due to the increased mobility of the cooled joints and increasing muscle strength. Treatment process:making the body part to be treated free, the patient receives the treatment while holding the nozzle at a suitable distance. Its duration is 3 minutes on average, which may be influenced by the following factors: - the size of the chilled surface – the more surfaces must be cooled, the longer the process lasts (a procedure can last for up to 12 minutes, and in case of 4 surfaces, all surfaces can be treated for 3 minutes) - the muscle of a particular body part. The more muscle, the longer the procedure. - the fat layer of the patient. The thicker the fat layer, the longer the procedure.
As a result of the treatment, the skin is temporarily whitened and the treatment may be accompanied by blunt pain. Indication:chronic spine diseases of abrasive character (various stages of intervertebral disc degeneration, in the status afer intervertebral disc herniation surgery) and limb joint disorders (shoulder, elbow, wrist, hip, knee, ankle arthrosis) non-active stage of inflammatory joint and spinal disorders, muscle aches, pains caused by muscle cramp the disease of muscles and ligaments, jerks inflammation of the sciatic nerve dissolution of rigid limb joints after fracture for faster regeneration after fracture and bruising it allows for the non-invasive treatment (i.e. without intervention) of the vascular network (spider angioma) Main contraindications:see also the general contraindications, or sensitivity to cold, certain circulatory disorders, significant anaemia, severe polyneuropathy, emotional distress, autoimmune vascular diseases, Raynaud’s syndrome. The shock wave therapy device produces mechanical energy by using compressed air, and it makes more than 600 small hits per minute on the area to be treated. According to the laws of mechanics, if the wave reaches a hard material, it achieves a crushing effect. We use this impact of the shock wave to the most extent. Biological effect of the shock wave:if absorbed by the tissues, it has a cellular effect by increasing the permeability of the cell membrane and stimulating cell division expansion of blood vessels in the tendons and muscles, improvement of blood circulation in the given place due to congestion, factors reducing inflammation become concentrated stimulation of bone healing collagen production support
As a result of these listed biological responses, physiologically the following changes occur: - reduction of inflammation - pain relief - improvement of lymphatic circulation and metabolism - muscle relaxant effect - solubilization of lime deposition
The shock waves trigger the body’s own healing mechanisms. The treatment terminates the real cause of pain, and thanks to it the injured tissues become gradually regenerated, and the calcification that becomes deposited during the inflammatory reaction of the joints is gradually absorbed. The advantage of this form of treatment is that is is very effective, fast and non-invasive, i.e. without the need of surgical intervention. Treatment procedure:the patient is lying on the treatment bed in a comfortable position, making the body part to be treated free. Ultrasound gel is applied on the area to be treated and the treatment is performed with massaging movements. With regard to the fact that there is a strong mechanical impact on the body surface, it can cause discomfort, which can be mitigated by changing the strength. Over time, the extent of this decreases. The duration of the treatment can be measured in minutes, and the required number of strokes can be given in 5 minutes, the time of which may vary from person to person. Its application takes place in a cure-like manner, and according to experience, at least treatments are needed, but 10-15 occasions are not uncommon either. Indication:usually it is recommended for such contumacious chronic musculoskeletal diseases that do not respond to other treatments, when the possibility of surgical intervention is already occurred, such as: - calcaneus spur - Achilles tendonitis, - golf elbow, - epicondylitis, - frozen shoulder, - sports injuries, - Carpel tunnel syndrom, - plantar fascitis - aponeurosis plantaris Contraindication:varicose veins in the given area, thrombosis, blood disorder and the use of anticoagulants, venous insufficiency, acute inflammation, pregnancy, growing cartilage (in case of a child), for 6 weeks after therapeutic radiography, use of steroids in the preceding 6 weeks, fever, flu, tumor, proliferative disorder in the area treated, TBC, pacemaker, stent implantation, ulcerated skin, diabetic foot. |