Non- pharmacological intervention
Non-pharmacological interventions (i.e. not drugs), range from simple lifestyle modification to physical exercises and rehabilitation programs. Sometimes requiring specialist equipment. These treatments require self-motivation, discipline and self-control.
Who offers these treatments?
Physiotherapists, Occupational Therapists, Chiropractors, Sports scientists, Dieticians, Osteopaths and others have varying treatment options for the muscular and skeletal system.
The goal is to reduce pain, improve function, regain movement and improve strength.
Some of the treatment modalities are: Local therapies like cold, heat, massage and bracing. Stretching and strengthening, exercise programs, posture correction, gait retraining, diet and nutrition modification, lifestyle and activity modification advice, muscle energy and neuromuscular techniques, neural stretching, dry needling, ultrasound, lymphatic drainage and acupuncture.
Ask your Surgeon, General practitioner or use word of mouth referrals for who may help to cure your symptoms.
Weight reduction and physical exercise – Lifestyle changes like improving diet and introducing appropriate physical exercise can result in weight loss in overweight and obese individuals. An added benefit will be improved muscle strength and function. Reduced weight and better muscle strength and function are important in the prevention and management of hip and knee conditions. Improved general health and fitness also results in safer anaesthetics when surgery is required.
The optimal weight (BMI) should be 18.5 to 25. BMI of 25-29 is considered over weight and BMI over 30 is considered as obese.
Strenuous exercise is contraindicated in individuals suffering from cardiovascular and respiratory diseases. Therefore rigorous exercises needs to be individualized to patients and done under the supervision of a trained professional such as exercise scientists, physiotherapists and other trained professionals
Thermotherapy – Is the application of heat or cold to the injured or post surgical area for the purpose of changing the temperature of soft tissue with the intention of improving the symptoms of certain conditions. Thermotherapy is useful for the treatment of musculoskeletal injuries and post surgical swelling. Using ice or heat as a therapeutic intervention decreases pain in joint and muscle as well as soft tissues. Heat and cold have opposite effects on tissue metabolism, blood flow, inflammation, edema and connective tissue.
Heat works by increasing the temperature of the skin/soft tissue, the blood flow increases by vasodilatation. The metabolic rate of the tissue will also increase. Heat increases oxygen uptake and accelerates tissue healing, it also decreases the activity of destructive enzymes, such as collagenase, thereby reducing tissue breakdown.
Cold works by decreasing the temperature of the skin/soft tissue, the blood flow decreases by vasoconstriction. It will be followed afterwards by a vasodilatation to prevent hypoxic. The tissue metabolism will decrease, as will the neuronal excitability, inflammation and conduction rate, thereby reducing pain. At joint temperatures of 30°C or lower, the activity of cartilage degrading enzymes, including collagenase, elastase, hyaluronidase, and protease, is inhibited. The decreased metabolic rate limits further injury and aids the tissue in surviving the cellular hypoxia that occurs after injury. Cold is best in the first 48-72 hrs. post injury.
Apply heat by heating of superficial tissues using hot packs, wax baths, towels, sunlight, saunas, heat wraps, steam baths/rooms. Heat can also get to the deeper tissues through electrotherapy (ultrasound, shockwave and infrared radiation).
Apply cold by using ice packs, ice baths, cooling gel packs, cold air and sprays.
Your physiotherapist or treating doctor can advice you on this treatment.
Transcutaneous electrical nerve stimulation – (TENS) is a therapy that uses low-voltage electrical current for pain relief.
You do TENS with a small, battery-powered machine about the size of a pocket radio. Usually, you connect two electrodes (wires that conduct electrical current) from the machine to your skin. The electrodes are often placed on the area of pain or at a pressure point, creating a circuit of electrical impulses that travels along nerve fibers.
When the current is delivered, some people experience less pain. This may be because the electricity from the electrodes stimulates the nerves in an affected area and sends signals to the brain that block or “scramble” normal pain signals. Another theory is that the electrical stimulation of the nerves may help the body to produce natural painkillers called endorphins, which may block the perception of pain.
You can set the TENS machine for different wavelength frequencies, such as a steady flow of electrical current or a burst of electrical current, and for intensity of electrical current. Your physical therapist or doctor usually determines these settings.
After you receive an introduction to and instruction in this therapy, you can do TENS at home. People use TENS to relieve pain for several different types of illnesses and conditions. Most often to treat muscle, joint, or bone problems that occur with conditions such as osteoarthritis, fibromyalgia, or for conditions such as low back pain, neck pain, tendinitis, or bursitis.
Although TENS may help relieve pain for some people, its effectiveness has not been scientifically proved.
Hydro / water therapy – Is the use of water for therapy, rehabilitation, exercise, relaxation and more. The unique properties of water, including the decreased effects of gravity, the effects of buoyancy, hydrostatic pressure and different temperatures may be utilised to aid in healing of musculoskeletal conditions. In addition, providing a unique environment to maintain health, wellbeing and fitness. Hydrotherapy has traditionally been seen as physiotherapy in water. Physiotherapists used their knowledge of anatomy, physiology, exercise and their hands on skills in the aquatic environment. Water therapy can decrease pain and swelling, increase function, strength and range of movement. It has also been shown to improve mood, sleep, fitness and weight loss.
These days the terminology “aquatic physiotherapy” is often used to describe what health professionals do in a water environment. In the pool, you will find professionals including physiotherapists, exercise physiologists, other exercise professionals and fitness instructors. You will find a range of activities occurring in the pool including aquatic physiotherapy, water exercise classes, deep water walking and running, aquatic massage, movement in water & swimming for people with disabilities.
However, self directed and initiated movement, walking, running and stretching in a pool can offer excellent benefits with out the cost and structure.
Talk to your health care provider or physiotherapist for options and advice.