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Peter Benalla asked:




Superficial heat treatments are very commonly used for aches and pains by the public although rather less so by physiotherapists nowadays. These types of treatment do not heat deep into the body so cannot affect muscles directly as the subcutaneous fat layer below the skin functions as a heat insulator. Superficial heating also causes increased blood flow through the skin of the heated area, which carries off some of the heat being applied. The methods of heating are varied and are generally described as heat conduction, heat convection and heat conversion. Transfer of heat in conversion heating occurs from the hot object to the cooler one by direct contact and without movement of the medium, the two objects being in close contact for best effectiveness. Typical treatment techniques of conversion heating are hot packs, electric heat pads, wax baths or paraffin baths, hot compresses and electric heat pads. Hot air devices and whirlpools baths which employ convective heating are less commonly used and use motion of the water or air to transfer heat. Light energy from radiant sources such as an infra-red lamp is converted into heat in the superficial tissues in the conversion heating technique. Various parameters of the heat application determine how the bodily tissues react to the temperature changes. This depends on the size of the region under treatment, how quickly the temperature rises, how long the heat is applied for and the level of temperature achieved in the tissues. Hot packs, sometimes called hydrocollator packs, uses the conductive heating effect and can be effective but there is a risk of burns as the tissues can be overheated. Hot packs do not mould very effectively to uneven body parts such as the foot or ankle, making predictable heating unlikely. Reduction in the local blood supply can occur with pressure of the pack on the leg or vice versa, giving increased heating. Refractory ankle swelling after fractures or repeated sprains of the ankle and joint inflammatory problems can be treated by contrast bathing where a 25 degree centigrade difference is established between a cold and a hot bath. Moving from one to the other causes great changes in the circulation and typically initial treatment is ten minutes in the hotter container then one in the colder one, then changing to four minutes in the hotter with one following in the colder. Repeated cycles can be performed for up to thirty minutes a few times a day. Pool therapy or hydrotherapy uses this therapeutic technique also, by convective heating. Pool therapy is a popular option especially for patients with rheumatological diseases due to the joint support and soothing heat provided by water which is thirty four degrees centigrade or higher. Hydrotherapy pools allow several patients to be treated with the physiotherapist and can be very useful provided the contraindications for medical conditions are observed. Infra-red radiation, a form or radiant energy which uses the conversion heating pathway, is commonly used and the effect is produced by the conversion to heat of the high-energy light particles from the source. Infra-red lamps are common domestic appliances and easily bought in shops, usually with a red light visible spectrum added to make the treatment clear as infra-red is invisible. People use them for minor musculoskeletal conditions such as back pain, muscle spasm and arthritic joint pains. The tissues do not undergo deep heating with this method and the superficial heating gives some sensory nerve sedation and heat input to the spinal cord processing areas. Physiotherapists are very careful with the distances between skin and heat source to prevent burns, as a quadrupling of heat intensity is achieved by merely halving the distance between the two. Heat therapy should not be routinely applied and physiotherapists make careful clinical judgements as to whether superficial heating is indicated in the light of the effects being small, short lived and not deep. Skin sensibility should be normal for this method as a deficiency in this could risk a burn as the patient cannot tell when their skin is being overheated. Heating should be avoided in areas of infection and its use in inflammation should be clinically reasoned for appropriateness.



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Jason Tirado asked:




A new chiropractic twist is spreading. It is called manipulation under anesthesia and it’s being used throughout hospitals and surgical centers throughout New Jersey.

Chronic pain sufferers across the nation have already discovered tremendous health benefits that can be restored by Manipulation Under Anesthesia, or M.U.A.

MUA as we call it is a well established, Mercy guideline accepted, procedure that osteopaths have performed for years and have since given up. Proponents of MUA say it’s indicated mostly for the 5% to 10% of those chiropractic patients whose spinal adjustments would be too painful without anesthesia.

The combination of manipulation and anesthesia is not new, as this treatment has been part of the manual medical arena for more than 60 years. Manipulation Under Anesthesia is an established medical procedure with a CPT Code designate of 22505. This is noted in the American Medical Association’s Current Procedural Terminology Publication.

Chiropractic patients and chronic pain sufferers throughout New Jersey are discovering that manipulation under anesthesia has tremendous health benefits.

The physical and emotional outcomes have been miraculous when using MUA and quality of lives have been restored. People who previously could not perform normal daily activities are now able to shop, wash their hair, go dancing, bend over to pick up a child, do simple household chores, or rid themselves completely of agonizing chronic back pain without having to go under the knife.

For those of you that are unfamiliar with the procedure, MUA is exactly what it sounds like. Occasionally, certain spinal conditions fail to respond sufficiently to conventional care of chiropractors, physical therapists or even medical doctors. Some of the impediments to in-office adjustment of the spine that may require the aid of an anesthetic are

1. Buildup of scar tissue (adhesions) both in and around the spinal joints commonly caused by multiple injuries or failed back surgery.

2. Chronic muscle spasm

3. Super-sensitivity of injured areas making the patient unable to cooperate for effective treatment

4. Herniated and or bulging discs.

5. Spinal surgery.

After medical clearance, the patient is lightly anesthetized to achieve total relaxation, then manipulations and stretching movements, which would normally be too painful to perform in the private office setting to even consider, are easily, painlessly and quickly performed.

Typically the chiropractor will recommend MUA when joints in the vertebral column become locked and immovable. It is the chiropractors’ responsibility to restore the function to previously movable joints.

Anesthesia is especially needed when movement or manipulation of the spine becomes extremely and intolerably painful, the benefit of being unconscious becomes obvious, but the anesthesia performs other important functions, such as:

• Shuts down the muscle spasm cycle to allow spinal movement

• Sedates the pain perceiving nerves that have been irritated due to the dysfunctional spine.

• Allows complete muscle relaxation to allow the doctor to stretch fibrotically shortened muscle groups and breakdown these adhesions caused by scar tissue.

M.U.A. has also been shown to be effective in relieving pain in cases of persistent shortening of muscles, ligaments damaged intervertebral discs. Some disc injuries are serious enough to require surgery, but they are relatively infrequent.

Manipulation under anesthesia uses a combination of specific short lever manipulations, passive stretches and specific articular and postural kinesthetic maneuvers in order to break up fibrous adhesions and scar tissue around the spine and surrounding tissue.

The manipulation procedures can be offered in any of the following ways:

• Under general anesthesia

• During conscious sedation “twilight sleep”

• Following the injection of anesthetic solutions into specific tissues of the spine.

The doctor performing the MUA must be a licensed physician with specialized training from a CCE accredited college regardless of whether the doctor is an MD or DC.

The true benefit of MUA is that it requires a team approach in order to have a safe and successful outcome. The team must include the physician/surgeon/chiropractor who performs the manipulation, and the first assistant, also a physician/chiropractor certified in manipulation under anesthesia. The procedure is commonly performed in a hospital or surgical center.

Which patients should be considered for manipulation under anesthesia? Certain neck, mid back, low back or other spinal conditions respond poorly to conventional care. One proposed theory for this is that, as a result of past or present injury, adhesions and scar tissue have built up around spinal joints and within the surrounding muscles and causes chronic pain.

Patients often undergo various treatments, such as physical therapy, chiropractic care, epidural injections, back surgery, or other treatments that do not address fibrous adhesions. Some patients feel temporarily better with these treatments, but their pain often returns.

In general, patients selected for manipulation under anesthesia are those who have received conservative care for six to eight weeks. If limited or no improvements in symptoms or objective findings have occurred, then manipulation under anesthesia may be an appropriate alternative.

Prior to treatment, protocols of diagnostic testing should document the nature of the diagnosis, support the need for treatment and eliminate questions of psychosocial factors that can influence pain responses. In addition to X-ray, MRI scan or CT scan, a musculoskeletal sonogram or nerve conduction velocity test may be ordered.

Of course there are those patients who should not be considered for MUA. Being that the main reason for having an MUA is the persistence of a dysfunctional and disabling spine that has built up fibrotic adhesion, the absence of joint dysfunction is a good reason not to undergo MUA. The following conditions would be contraindications for MUA:

• Severe osteoporosis

• Heart disease and uncontrolled hypertension

• Advanced age

• Bone weakening diseases

• Cancer

• Some circulatory diseases

• Uncontrolled diabetes

• Previous stroke.

The following are several research studies about the effectiveness of manipulation under anesthesia, including:

1. 83% of 600 patients with EMG verified radiculopathies reported significant improvement – Robert Mensor, MD

2. Patients that had back pain for a minimum of 10 years reported an 87% recovery rate after MUA – 1987 with Ongly et al

3. 51% of patients with unrelieved symptoms after conservative care had been exhausted reported good to excellent results three years post MUA – Donald Chrisman, MD

4. 71% of 723 MUA patients had good results (return to normal activity relatively symptom free) and 25.3% had fair results (return to normal activity with slight residuals) and that flexibility, elasticity and range of motion can be restored following MUA – Bradford and Siehl

5. 83% of 517 patients treated with MUA responded well – Paul Kuo, MD professor of Orthopedic Surgery

6. Krumhansi and Nowacek reported on an MUA study done on 171 patients who experienced constant intractable pain for several months to 18 years.

All of the patients of the study failed other conservative intervention. The results of the study showed that 25% of the patients had no pain, 50% were much improved with pain markedly decreased, 20% were better and could tolerate their pain but it interfered with work and recreation. Failures comprised 5% where there was minimal or no pain relief periods.

Diagnosis of herniated disc reported excellent to good results in:

60% – PC Colonna and ZB Friendenberg: 1949

64% – Merrill C Mensor, MD: 1949

60% – Donald Sielh, DC: 1963

In reading the latest medial literature it clearly demonstrates that for over forty years chronic neuromuscular skeletal conditions that have failed the conservative protocol respond well to manipulation under anesthesia.

The overall effectiveness of spinal manipulation under anesthesia has been reported by researchers with success rates varying according to case selection criteria.

Without a doubt this procedure has been used effectively for years by chiropractors and other manual practitioners. Make no mistake that although this procedure may or may not change the face of chiropractic. It will change the lives of many people for the better. I urge the reader to consider incorporating this technique into your arsenal of treatment.

Dr. Jason Tirado

MUA Research Institute

http://www.muamastery.com/



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George Best asked:




Herniated disc sufferers have traditionally had the treatment options of medication, physical therapy, spinal injections, and/or surgery, and because of the limited effectiveness of these approaches, many simply have had to learn to live with the pain. But a new option is now available and while not appropriate or effective for every person with a herniated disc, it does represent a huge leap in effectiveness and safety in treating herniated discs.

Spinal decompression is a new form of spinal traction. Traction has been used for many years in the treatment of herniated discs, but with minimal effects in many cases, and it even aggravated symptoms in some patients. Regular traction triggers the body’s muscle guarding reaction resulting in pain and possibly even raised pressure inside a herniated disc.

Spinal decompression has solved these problems though. Although still technically traction machines, true spinal decompression systems pull very slowly and gradually in order to keep the muscles relaxed and avoid triggering spasm. In addition, the more advanced of the spinal decompression systems also have computer-controlled motors and have sensors to measure the body’s resistance to treatment. If the body’s muscles begin to contract and resist the treatment, the system will immediately reduce its pull and the body’s muscles will relax again. The most advanced spinal decompression systems are able to modify treatment in response to the body’s muscle activity within a remarkable 1/17th of a second. Since the body’s reactions take place in approximately 1/5th of a second, these advanced spinal decompression systems can modify treatment before the muscles can spasm, allowing for comfortable herniated disc relief.

This avoidance of the muscle spasm response gives spinal decompression systems the ability to drastically lower pressure inside a herniated disc. In fact, disc pressure is actually dropped into the negative pressure range, creating a suction that pulls the bulging disc material back towards the center of the disc and away from sensitive nerves. An additional effect is that nutrients and fluid are pulled into the disc to stimulate disc healing. Over time and repeated treatments, the herniated disc material is pulled back in, and the healing of the disc provides stabilization of the outer wall of the disc to prevent further bulging.

The frequency and duration of spinal decompression treatment will vary depending on the age and condition of the patient, the severity of the herniated disc, and the number of herniated discs. Herniated discs can be treated effectively with spinal decompression in both the lumbar and cervical spine.

Statistically, spinal decompression with the more advanced machines, and with appropriate patient selection has a success rate of 80-90%, and of those who are successfully treated, the results hold up well long-term in most cases. Because of the high success rate and the fact that there are only minimal side-effects such as some post-treatment muscle soreness, spinal decompression is now one of the best treatment options for most herniated disc sufferers.

Unfortunately, the aggressive advertising and hype, and inapproriate use of spinal decompression by some health care practitioners in recent years has led to unrealistic patient expectations and crackdowns by regulatory agencies on advertising claims that have sullied the reputation of spinal decompression. While spinal decompression does represent a major advance in the treatment of herniated discs, it is not a cure-all, it is not 100% effective, and it is not appropriate for every patient.

Spinal decompression, when used appropriately, does produce enough improvement and disc healing in the vast majority of cases to allow patients to resume normal lives and return to most activities (even playing golf or tennis and working in the yard), but it does not restore a herniated disc to 100% normal. No treatment can. Even the still-experimental disc replacement surgery does not restore the spine to a normal condition and future back problems following disc replacement are to be expected. Overwork, poor posture, or failure to use good bending and lifting techniques can set the stage for a recurrence of disc problems no matter how good the results of treatment are initially.

With appropriate patient selection and by giving patients realistic expectations, spinal decompression providers can supply a very safe and effective treatment option for those with a herniated disc.



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Muna wa Wanjiru asked:




The heated mattress pad is the best option to make your room warm at night and particularly in the cold season like winter; it is used immensely to make the cold room temperature hot. Users can adjust the electric blanket under the heating mattress pad and keep warm during cold nights. Several kinds of heating mattress pad from branded companies are available on online bedding sites and interior furniture shops.

The people who are suffering from health problem like arthritis, then for such people the heating mattress pad is helpful. In the cold season, by using the heated mattress pad, people get rid of feeling like stiffness and tenderness. So by using such heated mattress pad, people start their morning with energetic feeling and proper fluid movement in their body.

In a very hot temperature like summer, the mattress is shielded by the heating mattress pad. We easily keep away such heating mattress pad which is fixed to the mattress on the beds. Therefore, it is very easy to dry-clean and wash out such heated mattress pad. The material that is used in the heating mattress pad is of several qualities. It ranges from polyester to cotton. Various kind of fabric material like cotton, wool, feathers are used to make two types of coating on the heating mattress pad and these coatings are tightly sewed up  together. Therefore, such type of manufacturing provides the softness and comfort to the heating pad. 

One of the technical objectives of the manufacturing of the heated mattress pad is to generate the heat according to the room temperature directly to the body instead of growing into the air. So that makes your body temperature maintain with respect to the coldness, warmness in surrounding temperature. So indirectly, the heating mattress pad assists us to minimize and save our electricity bills.

If we compare the heating mattress pad with electric blanket, then the warmness in the heating mattress pad is much more than it. Through heating pads, the heat moves surrounding the human body instead of dispersing it into the air. So this also assists us to get rid of the habit of walking up in the middle of the night.

When we sleep on such mattress with heating pads, the pad is stayed in place and never bunch up in one particular side of the mattress. So the user can easily fix the combination of sheets on the heated mattress pad. Various fixing techniques of heated pad are available with such mattress. We can fix such heated pad on the pillow at the top of the mattress, on the box of the spring mattress and even on the adjustable beds.

Such heated mattress pad assists us to relax our tired and strained body muscles gentle. Also in sleep problem like Insomnia, we can get comfort and relaxation from using a heating mattress pad. 

The heating mattress pad consists of various kinds of technical features like adjustment for making the temperature warmth, auto off function for 10 hours. It also contains a series of pre-heating function before the particular bedtime having digital electronic control system.



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malo asked:




It does not matter if you are a girl or a boy, old or young — Football is a sport for everyone. In some European countries, almost every school has a football team of their own. Football is a popular sport among teenagers, all of whom were probably inspired by their idols in the international football teams.

Football’s growing popularity is best exemplified by its “ambassador” — David Beckham, a popular (and gorgeous!) football player whose advertisement billboards can be seen almost everywhere. He is like the looked upon as the “epitome” of a football player since he is the best there is. In England, for example, they have Manchester United as being the most popular football club there is, with almost 50 million supporters worldwide.

Football, also called as soccer, is a team sport wherein two teams go against each other to score a winning goal for their team. Eleven players are included in a team, and the sport is played in a rectangular grass field. The goalkeeper is one member of the team that guards their respective goal, and the only one who can use their hands or arms to prevent the ball from reaching the goal. All the other players use their feet in kicking the ball, and is also using their torso and head for mid air passes.

Of course, in every physical game we play, there is always a possibility of having an injury within the team. In football and in any other games that require physical strength, they are trained to do stretching and pre-game exercises, prior to playing the game. But in some cases, other players may not get to stretch certain parts of their bodies properly, and while during the game, they may be injured due several factors.

Usual injuries in this kind of sport, or in any other physical sports include ankle sprains and strains, knee pain, lower back pain, elbow pain, shoulder injuries, and muscle spasms, among others. Ankle sprains or strains are often experienced when there is uneven terrain, or a poorly executed technique. The right footwear is essential in avoiding this, and a brace could also provide extra resistance. Knee pain during a football game can be caused by poor and improper technique, absence of conditioning and lack of flexibility. It is important to have suitable training to avoid overuse, and such aspects in bio-mechanics like flat feet or high arches give out more knee pain. In playing football, for example, knee pain is the result of an injury, like a ruptured ligament or a torn cartilage. Lower back pain is common among those older and less active, since they lose the strength and balance in the muscles (abs and lower back), leading to bad posture. Elbow pain is mostly experienced by people playing tennis or golf, but anyone can develop elbow pain. Shoulder injuries are often seen in throwing sports like baseball, or other track and field games. Muscle spasms are experienced when there is tightness in any particular muscle area, and more often than not, can be painful. Football players usually have this kind of problem in their leg areas, where they usually stretch out their feet to kick the ball. A spasm is an unexpected contraction of the muscle, and is felt on the neck, back, shoulder, or legs. Muscle spasms can be avoided by football players using good and proper stretching techniques, most especially in their leg areas.

Playing football is fun and fulfilling for football players and even sijmple spectators of the sport everywhere. Still, it is important to know the safety and health conditions of the players before playing, to avoid such injuries that might lead to more serious problems in the future.



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