Thoracic Outlet Syndrome
What is Thoracic Outlet Syndrome?
Thoracic Outlet Syndrome is a complex condition in which blood vessels or nerves are entrapped or compressed as they exit the thorax. Thoracic Outlet Syndrome is caused by a compression of the brachial plexus or subclavian vessels as they leave the neck into the shoulder region and pass under the first rib.
Anatomy of the Thoracic Outlet
The structures most commonly compromised in Thoracic Outlet Syndrome are:
- subclavian artery
- subclavian vein
- lower roots of the brachial plexus (bundle of nerves supplying the upper body and arms)
These structures may become compressed in 3 areas:
- between the anterior and middle scalene muscles of the neck
- between the collarbone and first rib
- beneath the coracoid process of the shoulder blade
Types of Thoracic Outlet Syndrome
There are two main classifications of Thoracic Outlet Syndrome: Vascular & Neurological
Vascular Thoracic Outlet Syndrome
- 2% of cases
- Compression of the blood vessels exiting the thorax (subclavian artery or vein)
Neurological Thoracic Outlet Syndrome
- 98% of cases
1. True Neurological Thoracic Outlet Syndrome:
- Compression of nerves exiting thorax due to bony or soft tissue anomaly.
2. Symptomatic Thoracic Outlet Syndrome:
- Intermittent compression of nerves and blood vessels due to repetitive postural, occupational or sporting forces (Watson et al., 2009)
Thoracic Outlet Syndrome Symptoms
Thoracic Outlet Syndrome is characterised by:
- Pain, altered sensation and weakness of the upper limb.
- Pain or discomfort is often felt above or below the collarbone and may radiate down the arm.
- This condition also has an altered sensation and temperature in the arm and hand.
- Symptoms are generally aggravated or exacerbated by lifting your arm or turning your head or neck (Lindgren & Oksala, 1995).
Vascular Thoracic Outlet Syndrome
- Pins & needles, numbness in arm and hand
- Decreased or absent arterial pulse
- Swelling, coldness, colour change in arm and hand
- A feeling of stiffness, heaviness fatigue in the arm (Watson et al., 2009)
Neurological Thoracic Outlet Syndrome
- Pain in the neck, collar bone region, chest, upper back, shoulder, arm, hand
- Pins & needles, numbness in fingers
- Weakness of arm and hand
- Loss of dexterity/coordination in the hand
- Muscle spasms in arm/hand
- A feeling of stiffness, heaviness, fatigue in the arm
- Pain at rest and night pain
- Less commonly dizziness, headaches, vertigo (Watson et al., 2009)
Risk Factors for Thoracic Outlet Syndrome
- Bony abnormalities, e.g. abnormal first rib, cervical rib
- Poor posture
- Jobs or sporting activities involving repetitive overhead movements
- Weight gain
Common Thoracic Outlet Findings
Symptoms may increase with overhead ranges of motion on examination. You may also have a positive: Costoclavicular manoeuver, Roo’s test or Adson’s test.
If you suspect thoracic outlet syndrome, you may consider cervical spine X-rays to evaluate the presence of a cervical rib or prominent C7 transverse process that may contribute to the symptoms. Additional tests (e.g., MRI, EMG) can rule out other causes.
Physiotherapy Treatment of Thoracic Outlet Syndrome
- Postural advice and education
- Ergonomic assessment and intervention
- Rest from aggravating activities
- Correction of ‘dropped shoulder’ position (Watson et al., 2010)
- Strengthening of shoulder blade stabilising muscles
- Mobilisation of the thoracic spine and first rib
- Massage of neck, chest and upper back muscles
- Neural gliding exercises
Surgery should only be considered if conservative treatment fails (MacKinnon & Novak, 2002)
For more specific information, please seek the advice of your physiotherapist.
Thoracic Outlet Syndrome Treatment Options
Thoracic outlet treatment will vary significantly depending on the structure causing your symptoms. Would you please consult your doctor or physiotherapist for specific thoracic outlet syndrome treatment?
Neck Pain Causes
Neck Joint Injuries
Nerve-related / Referred Pain
Neck & Posture Products & FAQs
Neck Pain FAQs
- What Are The Common Causes Of Neck Pain?
- When Should You Be Concerned About Neck Pain?
- How Do You Get Rid Of A Neck Headache?
- Can Your Neck Cause Vertigo or Dizziness?
Posture & Pillow FAQs
- Posture Improvement Products & FAQs
- What Is The Best Pillow For You?
- What's the Classic Signs of an Unsupportive Pillow?
How to Sit Correctly
- Sit up with your back straight and your shoulders back.
- Your buttocks should touch the back of your chair.
- All three standard S-shaped curves should be present while sitting.
- You can use a small, rolled-up towel or a lumbar roll to help you maintain the standard curves in your back.
Here's how to find a good sitting position when you're not using a back support or lumbar roll:
- Sit at the end of your chair and slouch completely
- Draw yourself up and accentuate the curve of your back as far as possible.
- Hold for a few seconds.
- Release the position slightly (about 10 degrees), achieving a good sitting posture.
- Distribute your body weight evenly on both hips.
- Bend your knees at a right angle. Keep your knees even with or slightly lower than your hips. Do not sit with your knees crossed.
- Keep your feet flat on the floor.
- Try to avoid sitting in the same position for more than 30 minutes.
- At work, adjust your chair height and workstation to sit up close to your work and tilt it up at you. Rest your elbows and arms on your chair or desk, relaxing your shoulders.
- When sitting in a chair that rolls and pivots, don't twist at the waist while sitting. Instead, turn your whole body.
- When standing up from the sitting position, move to the front of the seat of your chair. Stand up by straightening your legs. Avoid bending forward at your waist. Immediately stretch your back by doing ten standing backbends.
- It is okay to assume other sitting positions for short periods, but most of your sitting time should be upright with minimal stress on your spine.
What is the Correct Way to Sit While Driving?
- Use a back support (lumbar roll) at the curve of your back. Your knees should be at the same level or higher than your hips.
- Move the seat close to the steering wheel to support the curve of your back. The chair should be close enough to allow your knees to bend and your feet to reach the pedals.
What Is The Best Pillow For You?
Your best pillow is designed to keep your spine in a neutral stress-free alignment. However, just like the three bears in Goldilocks... we are all built just a little bit different... so your best pillow may differ from that of your partner, child or best friend.
In simple terms, the best pillow for you needs to be:
- suitable for your preferred sleeping position
- supportive of your neck and head
- suitable for your head, neck, shoulder shape and size
- comfortable to lie upon
- durable - to keep support for the full night and many years.
If we reflect upon the three bears. Big daddy's pillow is likely to be larger and firmer than mummy bear's pillow. Baby bear's best pillow will be more than likely be thinner and softer than the rest of the bear family.
Your Favourite Sleeping Position Matters
You'll sleep the best in your favourite position. About 70% of people side sleep, 20% back sleep and 10% stomach sleep.
What's Your Preferred Sleeping Position?
Back, side or stomach? Once you've decided which is your preferred sleeping posture, we can start to look at the best pillow shape for you.
Matching Your Pillow to Sleeping Position
The best pillow for you will need to support your spine in a stress-free alignment in YOUR favourite position: whether that is your side, back or stomach.
Side Sleeper Pillow
Most people prefer to sleep on their side. Side sleepers should aim to support your spine in a neutral position. The best pillow for you will fill in the space between the mattress and your head and neck. Contour pillows, as shown above, are a good choice if your neck is thinner than your head.
If your head and neck width are similar, you may gain better support from a conventionally shaped pillow.
Children don't require a pillow until their shoulder width increases beyond the width of their head when a thin pillow would be suitable.
Back Sleeper Pillow
The second most popular sleeping position is on your back. Pillow height is critical.
The more rounded your upper back, the more your head protrudes forward of your neck and upper back, which means the higher the pillow you require.
This is a common reason for older people sleeping on two pillows as their upper back increases its C-curve shape, making their heads sit further forward. One pillow is not enough to support your head and neck.
Stomach Sleeper Pillow
Stomach sleeping is not recommended due to the sustained rotation of your neck. You are essentially looking over one shoulder for a few hours. This compresses one side of your neck and over-stretches the other. This commonly results in neck pain, neck stiffness and neck headaches.
A large part of what makes a good pillow is a personal preference. If the pillow feels comfortable, it is likely to help you relax, get a good night’s sleep, and feel well-rested in the morning. The pillow's surface can also be a source of comfort - some people prefer a pillowcase with a cool, smooth feeling (such as cotton), some prefer warmth (such as flannel), etc. Obviously, a chance of season can alter your favourite pillowslip.
Pillow Fine Tuning
Ideally, your pillow should conform to your various sleep positions and support the weight of your head. New technology such as memory foam has successfully addressed this issue. They adjust to the unique shape and curves, and sleeping position of the user. A pillow should mould to one’s individual shape and alleviate any pressure points.
In reality, a high-quality supportive pillow will last several years before needing to be replaced. Unfortunately, cheap polyester or cotton-filled pillows will usually only last a few months. They lost their oomph and didn't bounce back.
Look for reputable manufacturers who offer longer warranties. You'll find the best pillows last the longest, as reflected in the warranty. In addition to better sleep, they are of better value in the long term.
Over time, most pillows will begin to lose their firmness and no longer support your neck and head adequately. When your pillow has reached this stage, buy a new pillow.
What to Expect on Your First Night?
It is important to know that your neck may feel different or uncomfortable during the first few nights of using any new pillow. This is because it is still adjusting to healthy support. In the vast majority of cases, you'll look forward to extreme comfort within a few days.
However, a pillow that does not ease your neck pain within a week is probably not supportive, or you have a neck condition that requires professional treatment.
What's the Classic Signs of an Unsupportive Pillow?
Most quality pillows will only last you three to four years before you need to change. Some of the lesser quality pillows will only remain supportive for a few months.
The problem is that pillows internal supportive material breaks down with use and time. Whether your pillow is feather, foam, memory foam, rubber, latex or any other natural or synthetic product, they all eventually disintegrate with time and use.
If you are consistently having the following trouble, it's time to change your pillow.
- Waking during the night or in the morning with a stiff neck, neck pain or headache.
- Restless or interrupted sleep with difficulty going off to sleep.
Another sure sign is improved sleep when you visit a friend, borrow your partner's pillow or stay in a hotel.
If any of these sounds like you, it's time to change your pillow.
Neck Pain, Stiffness or Headaches? Maybe it's NOT Your Pillow!
A good night's sleep is dependent on a healthy sleeping position and a good pillow. A quality pillow will support your head in natural alignment with your spine.
Sometimes there is simply no pillow in the world that is best for you.
If you have a neck injury, pain or stiffness, you may not have the available pain-free range of neck motion to have a comfortable, pain-free sleep. The solution on this occasion is to have your neck professionally assessed and treated. Often just one quality treatment of your neck may solve years of sleeping difficulties.
Can An Unsupportive Pillow Cause Neck Headaches?
Yes. Pillows do vary, and the best one for your neck shape and body size will help you prevent neck pain and neck headache. Unfortunately, a non-supportive pillow or one not suited to your neck can predispose you to neck pain or a neck headache. If you suffer neck pain or a problem, it is wise to ask for your physiotherapist's professional advice regarding what pillow style and size they would recommend for you.
Please ask one of our physiotherapists which pillow is best for you for pillow advice specific to your neck.
Why Is Good Posture Healthy?
Good Posture Benefits include:
- keeping your bones and joints in the correct alignment.
- helping to decrease the abnormal wearing of joint surfaces.
- reducing the stress on the ligaments holding the joints of the spine together.
- preventing the spine from becoming fixed in weird positions.
- preventing premature muscle fatigue.
- preventing any backache and muscular pain.
- contributing to a competent and confident appearance.
To Achieve Good Posture, You Will Require the Following:
- Good muscle flexibility
- Normal motion in the joints
- Strong postural muscles
- A balance of muscle forces on both sides of the spine
- Awareness of your posture, plus knowledge of proper postural position, leads to conscious correction.
Practise the correct posture for standing, sitting, and lying down (as described below) to gradually replace your old position.
What is Good Posture?
That's why proud and confident people stand tall with excellent posture. It's a habit! Standing with good posture looks fantastic, plus it's very healthy for your joints, muscles, bones, blood circulation and most importantly, your self-esteem.
How you hold your body in space is your posture. Your posture directly results from the postural habits that you commonly exhibit. You can choose to have good posture or poor posture. Gravity is your worst enemy while standing or sitting. You could also refer to this as your spinal posture, back or neck posture.
The good news for you is that you can quite easily change your postural habits and train your body to sit, stand, walk, and even rest in great postures. Good posture also places the least strain upon your supporting muscles and ligaments.
As humans, we move from posture to posture to avoid muscle fatigue and abnormal sustained tissue loading. Your best posture is your next posture! No single postural position is good to maintain all day.
Benefits of Good Posture
- prevents postural muscle fatigue.
- correctly aligns your joints and bones while encouraging efficient muscle activity.
- help minimalise joint stress.
- avoids passive ligament overload.
- prevents backache, neckache and muscular pain.
- contributes to your enhanced confidence and a pleasing appearance!
Standing comfortably with good posture should feel natural and energy-efficient. Bad postural habits can cause a few muscular aches and pains for a few days during the early transition (posture habit change) phase. You may experience temporary joint or muscle discomfort or fatigue as your joints realign, ligaments stretch, and postural muscles start working. The good news is that your body will quickly adapt and feel more comfortable and strong in your new normal posture if you keep maintaining a good posture.
Plus, the upside is that you will be less likely to suffer pain, but you'll also look confident and feel fantastic!
How to Improve Your Standing Posture:
The number one tip to achieve an excellent standing posture is to "stand tall"! All the muscles that you need to push you taller are the same ones that improve your posture.
- Stand tall!
- Extend your head directly up (think balloon lifting your head with a string on the top of your skull) - but keep your chin tucked in. Avoid tilting your head forward, backward or sideways.
- Your earlobes will line up with the middle of your shoulders.
- Keep your shoulders back, your knees straight, and your back straight.
- Let arms hang naturally down the sides of the body
- Lightly draw in your core stomach muscles. Avoid tilting your pelvis forward.
- Avoid locking the knees.
- Ensure your foot arches are in a neutral (not flat) position.
- Stand with weight over the centre of your feet.
- Stand with your feet slightly apart (shoulder-width).
- When standing for sustained periods, shift your weight from one foot to the other, or stand in a walk stand and rock your weight from your front to back foot.
How to Quickly Check Your Standing Posture
Stand against a wall with your shoulders and bottom resting against a wall. The rear of your head should also lightly touch the wall without your face tilting skywards.
How to Correct Your Posture?
If you experience discomfort in the above test and can't quickly correct your posture, you may have some restrictions on a joint, ligament, or muscular movement. These problems can be rapidly assessed and promptly improved by your physiotherapist. Please consult them for advice.
Were you having difficulty maintaining a regular upright posture? You are probably suffering from reduced muscle endurance or strength. But these can be easily improved with some practice of the right exercises. Your physiotherapist is an expert in prescribing the best postural exercises for you in a stage-appropriate manner to help you improve your posture without causing unnecessary pain or injury.
Contact your physiotherapist for posture advice specific to you and your needs.
What is the Best Way to Sleep?
Your Best Sleeping Position?
Everybody has their favourite sleeping position. However, some are better for you than others. Try to sleep in a posture that helps you maintain the curve in your lower back. We recommend lying on your back with a pillow under your knees (if more comfortable) or on your side with your knees slightly bent.
It is preferable to not sleep on your side with your knees drawn up to your chest (the foetal position). However, some back conditions will find this preferable. You should seek the advice of your physiotherapist if you are in doubt.
If you are suffering from back pain, you could try lying over a lumbar roll or peanut cushion at night to make you more comfortable. A rolled sheet or towel tied around your waist may also be helpful. You may wish to avoid sleeping on your stomach, especially on a saggy mattress. This sag can cause back strain and can be uncomfortable for your neck.
What is Your Best Mattress?
Select a firm mattress or an ensemble that does not sag. If necessary, place a board under your bed's mattress. You can also set the mattress on the floor temporarily if needed. If you've always slept on a soft surface, it may be initially painful to change to a more rigid shell. Try to do what's most comfortable for you.
How to Rise from Bed
When standing up from the lying position, turn on your side, draw up both knees and swing your legs over the side of the bed. Sit up by pushing yourself up with your hands. Bend forward at your waist with your core muscles activated.
What is Your Best Pillow?
The human neck curves slightly forward (to sustain the head's weight when upright), and it is crucial to maintain this curve when in a resting position. If the pillow's height is too high or low when sleeping, your neck is bent abnormally out of alignment, causing muscle and joint strain. You can even wake up with headaches.
Poor pillow support can also cause narrowing of the air pipe, resulting in obstructed breathing and sometimes snoring, hindering sleep.
The best lying or sleeping position may vary, depending on your symptoms. No matter what posture you lie in, the pillow should be under your head, but not your shoulders, and should be a thickness that allows your head to be in a normal position.
To give your body the proper rest it needs and ensure your spine's health, physiotherapists recommend only two sleeping positions: Side sleeping and supine sleeping.
Proper alignment can help to reduce the number of neck aches, backaches, pinched nerves, shoulder and arm referred pain, insomnia, and mental fatigue from a lack of adequate sleep. Try sleeping on your side, with the spine straight, or sleeping on your back, maintaining the primary curvature of the cervical spine. Both of these positions prevent poor alignment of the neck and upper back.
When Should You Be Concerned About Neck Pain?
There is one situation where there’s no need to wait several weeks before deciding if your neck pain is serious.
If you’ve had an accident with forces that may have been sufficient to fracture your spine or tear nerves, seek a medical assessment as soon as possible. In this instance, either call an ambulance or head to a hospital emergency department.
Red Flags for Neck Pain
Otherwise, the rule of thumb is to start a more thorough medical investigation only when you meet all three of these conditions.
The three general red flags for neck pain are:
- it’s been bothering you for more than about six weeks
- it’s severe and/or not improving, or getting worse
- there is at least one other “red flag” (see below)
Red flags are reasons to seek a professional opinion rather than to worry. Seek the advice of your physiotherapist or doctor if any of these red flags apply to you.
- Light tapping on the spine is painful.
- A torn artery may cause severe, throbbing or constrictive (novel pain), with a high risk of a stroke. Pain is the only symptom of some tears. Most cases are sudden, on one side, and cause neck and head pain (in the temple or back the skull), but the pain is usually strange. Any hint of other symptoms? Promptly attend a hospital emergency.
- There are many possible signs of spinal cord trouble in the neck, with or without neck pain, mainly affecting the limbs: e.g. poor hand coordination; weakness, “heavy” feelings, and atrophy; diffuse numbness; shooting pains in the limbs (especially when bending the head forward); gait awkwardness. Sometimes patients present with both neck pain and more remote symptoms and don't realise they are related.
- Unexplained episodes of dizziness or nausea, and vomiting may indicate a problem with the stability of the upper cervical spine.
- Weight loss without dieting (it's a potential sign of cancer).
- Mystery fevers or chills, especially in people with diabetes).
- A severe headache that comes on suddenly is a “thunderclap headache”! Most are harmless, but it is always wise to investigate thoroughly.
- Symptoms of meningitis (inflammation of the membranes covering the brain and spinal cord, caused by infection or drug side effects). The presence of a fierce headache or an inability to bend the head forward, fever, or an altered mental state.
- The main signs that neck pain might be caused by autoimmune disease specifically include:
- a family history of autoimmune disease,
- gradual but progressive increase in symptoms before the age of 40,
- marked morning stiffness,
- pain in other joints as well as the low back,
- difficult digestion,
- irritated eyes, and
- discharge from the urethra (bladder).
- Steroid use, other drug abuse, and HIV are all risk factors for a serious cause of neck pain.
- If you feel pretty unwell in any other way, that could indicate that neck pain isn’t the only thing going on.
More info: Neck Pain
- How Can You Correct Your Posture Fast?
- What Is Good Posture? Why Is It Important?
- What is the Correct Way to Sit?
- What Is Correct Posture For Standing?
- How To Improve Your Standing Posture
- What Are The Healthiest Sleeping Postures?
- What Products Help Posture?
- Can You Correct Years Of Bad Posture?
- Do Posture Trainers Work?
What's Causes Cervicogenic Headache?
Your neck headache originates from a variety of musculoskeletal and neurovascular structures. These structures include the upper three neck joints, C2/3 disc, spinal cord coverings, and neck muscles. Dysfunction in these areas can trigger pain signals that travel to your trigeminocervical nucleus (TCN) in your brainstem. This information is then transmitted into your brain and interpreted as a headache (Bogduk 2003).
Upper Neck Joints
The most likely source of your neck headache is a dysfunction of your upper neck joints. Your neck muscles or nerves become involved from pain signals that travel to your trigeminal nucleus in your brainstem, where you interpret the pain signals as a neck headache.
The most common cause of a neck headache is the dysfunction of your upper three neck joints. The most common neck joints involved are your:
- atlantooccipital joint (O-C1),
- Atlanto-axial joint (C1/2), and
- C2/3 cervical spine joints.
In simple terms, your neck joints can cause a neck headache or pain if they are either too stiff or move too much (e.g. wobbly and unsupported by weak muscles) or locked in an abnormal joint position, e.g. a locked facet joint or poor neck posture. Once your neck joint becomes stressed and painful, the pain signals refer to the trigeminocervical nucleus in your brainstem. You start to feel a neck headache or, in some cases, face pain!
Your neck and headache physiotherapist can assess and correct neck joint dysfunctions that result in a neck headache. Their professional diagnosis and treatment are essential for neck headache sufferers.
Your neck and shoulder blade muscles that originate from your neck will cause pain if they are overworking, knotted or in spasm. Some of your neck muscles overwork when protecting injured neck joints. Other neck muscles become weak with disuse—this further demands your overworking muscles resulting in muscle fatigue-related symptoms. Your deep neck flexors are frequently weak or lack endurance. Your neck muscles work best when they have healthy resting tension, length, strength, power and endurance.
Your skilled physiotherapist assesses and helps you correct any muscle imbalances that result in a neck headache.
Cervical and Occipital Nerves
Nerves in your upper neck may become pinched by extra bony growths, e.g. arthritis, disc bulges or swelling. The results can result in nerve irritation or a reduction in the neural motion known as neuromechanosensitivity or abnormal neurodynamics. Irritation of your upper neck structures refer to pain messages along the nerves and cause your headache. In simple terms, your neck is the "switch", nerves are the "power cords", and your headache is where the "light" comes on.
Your headache physiotherapist can assess your neuromechanosensitivity.
How Do You Get Rid Of A Neck Headache?
Quality neck physiotherapy can have a speedy and effective result for relieving your neck headache—the key to better treatment response in confirming your diagnosis. After your assessment, your physiotherapist will start you with treatment techniques that address your problems.
Your neck headache treatment may include all or some of the following techniques:
- Stiff neck joints may need to be loosened or unlocked via joint mobilisation (gentle gliding techniques), joint traction or, in specific cases, a gentle and localised joint manipulation technique.
- Hypermobile (or dynamically unstable) joints may require specific deep neck muscle strengthening exercises to stabilise, control and limit the joint movement available.
- Tight or overactive muscles may require muscle stretching, neck massage, acupuncture, dry needling, trigger point release or other relaxation techniques.
- Weak muscles may require specific strengthening exercises. This weakness may include your postural shoulder blade and neck muscles.
- Nerve dysfunction identified by your physiotherapist will depend upon your specific examination findings. Neurosensitivity is a common finding that needs addressing with attentive, professional care.
- Posture correction via specific posture exercises, posture awareness techniques, posture taping, or a brace.
- Provide helpful advice on preventing neck dysfunction in the future, e.g. workstation setup, ergonomics, awkward neck positions and postures to avoid.
Who Treats Cervicogenic Headaches?
In addition to relieving your neck headaches, your physiotherapist aims to address why you are experiencing neck headaches. After all, helping you to avoid future neck headaches is a crucial component of your rehabilitation. Chronic headache sufferers typically resolve their neck headaches within days or weeks.
Relief of your neck headache is quite often immediate! If a neck headache solely causes your trouble, it is common to experience instant relief as you walk out of the clinic.
Depending on the severity and the specific underlying causes of your neck headaches, most sufferers will experience a reduced headache after your initial consultation.
For more information, please consult your neck headache physiotherapist.
What is Physiotherapy Treatment?
Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques, education and advice. Physiotherapists maintain physical health, allow patients to manage pain and prevent disease for people of all ages. Physiotherapists help encourage pain relief, injury recovery, enabling people to stay playing a sport, working or performing daily living activities while assisting them to remain functionally independent.
There is a multitude of different physiotherapy treatment approaches.
Acute & Sub-Acute Injury Management
Hands-On Physiotherapy Techniques
Your physiotherapist's training includes hands-on physiotherapy techniques such as:
- Joint Mobilisation (gentle joint gliding techniques)
- Joint Manipulation
- Physiotherapy Instrument Mobilisation (PIM)
- Minimal Energy Techniques (METs)
- Soft Tissue Techniques
Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, to name a few.
Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.
Alternatively, your physiotherapist may recommend a supportive brace.
Acupuncture and Dry Needling
Many physiotherapists have acquired additional training in acupuncture and dry needling to assist pain relief and muscle function.
Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly skilled in prescribing the "best exercises" for you and the most appropriate "exercise dose" for you, depending on your rehabilitation status. Your physiotherapist will incorporate essential pilates, yoga and exercise physiology components to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.
- Muscle Stretching
- Core Exercises
- Strengthening Exercises
- Balance Exercises
- Proprioception Exercises
- Real-Time Ultrasound Physiotherapy
- Swiss Ball Exercises
Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.
Aquatic water exercises are an effective method to provide low bodyweight exercises.
Sports physio requires an extra level of knowledge and physiotherapy to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports & Exercise Physiotherapist.
Women's Health Physiotherapy is a particular interest group of therapies.
Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstations set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.
Plus Much More
Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your problem, please get in touch with your PhysioWorks team.
Nerve pain is pain caused by damage or disease that affects the nervous system of the body. It is also known as neuropathic pain or neuralgia. Nerve pain is a pain that comes from problems with signals from the nerves. It is different to the typical type of pain that is due to an injury. It is known as nociceptive pain.
What Causes Nerve Pain?
A problem with your nerves themselves, which sends pain messages to the brain, causes neuropathic pain.
What Are Nerve Pain Symptoms?
Nerve pain is often described as burning, stabbing, shooting, aching, or like an electric shock.
What Causes Nerve Pain?
Various conditions can affect your nerves and cause nerve pain. Familiar sources of nerve pain include:
- Shingles (post-herpetic neuralgia).
- Trigeminal neuralgia.
- Diabetic neuropathy.
- Phantom limb pain (post-amputation).
- Multiple sclerosis.
- HIV infection.
- Other nerve disorders.
Nerve Pain & Nociceptive Pain
You can suffer both nerve pain and nociceptive pain simultaneously. The same condition can cause both pain types.
Nerve Pain Treatment
Nerve pain is less likely than nociceptive pain to be helped by traditional painkillers. Paracetamol and anti-inflammatories seem less effective. However, other types of medicines often work well to ease the pain. Nerve pain is often relieved by anti-depressant or anti-epileptic medication. Please ask your doctor for more advice.
What is Pain?
Pain is the built-in alarm that informs you something is wrong!
Pain is your body's way of sending a warning to your brain. Your spinal cord and nerves provide the pathway for messages to travel to and from your brain and the other parts of your body. Pain travels along these nerve pathways as electrical signals to your brain for interpretation.
Receptor nerve cells in and beneath your skin sense heat, cold, light, touch, pressure, and pain. You have thousands of these receptor cells. Most cells sense pain. When there is an injury to your body, these tiny cells send messages along nerves into your spinal cord and then up to your brain.
In general, pain receptors are classified according to their location.
Receptors that respond to injury or noxious stimuli are termed nociceptors and are sensitive to thermal (heat), electrical, mechanical, chemical and painful stimuli. Each nociceptor is connected to a nerve that transmits an electrical impulse along its length towards the spinal cord and then, ultimately, your brain.
It is your brain that informs you whether or not you are experiencing pain. Plus, your pain can plays tricks - especially when you suffer chronic pain.
Pain messages travel slower than other nerve stimulation.
Nerves can also be categorised according to their diameter (width) and whether a myelin sheath is present.
Three types of nerves are concerned with the transmission of pain:
A-beta fibres, which have a large diameter and are myelinated
A-delta fibres, which has a small diameter and also have myelinated sheaths.
C fibres have small diameters, are non-myelinated (slowing their conduction rate), and are generally involved in the transmission of dull, aching sensations.
Nerves with large diameters conduct impulses faster than those with a small diameter. The presence of a myelin sheath also speeds up the nerve conduction rate.
One method of easing your pain is to provide your nervous system with high speed "good feelings", such as rubbing your injured area. This is the same principle that a tens machine (pain-relieving machine) utilises to provide pain relief.