why SWD and IFT in sciatica?

[sdkashif]

Thanks for positive feedback alophysio. I fully agree that once the patient comes to for physiotherapy, its problem should be analysed by routine subjective and objective examination to analyse the disorder to provide a rational basis for addressing the right treatment for physiotherapy. There are cases out there which do not simply require physiotherapy and receive the sessions without getting their problems fully diagnosed. But this seldom happens. A proper physiotherapy referral is necessary. In addition physiotherapist should also avoid treating patients who simply don't need Physiotherapy. For example let us have a look over the possible causes of Back Pain. These are

Traumatic

These include fractures and other associated injuries

Mechanical

Muscular Pain
Postural back pain
Prolapsed Disc
Lumbar Sponylosis +/- Spinal Stenosis
Disseminated Idipathic Skeletal Hyperostosis
Spondylolisthesis

Inflammatory

Infective Lesions of the Spine
Ankylosing Spondylitis

Metabolic

Osteoporis + Fractures
Osteomalacia
Paget's Disease

Neoplastic

Metastases
Multiple Myeloma
Primary Bone Tumours

Referred Pain

Only Mechanical Disorders, among inflammatory disorders (non Infective) ankylosing Spondylitis, traumatic disorders like spains/strains, metabolic disorders requiring other therapies or referral in conjuction with physiotherapy come under the appropriate referral for physiotherapist. The rest of the disorders require referral to the other clinicians.

I was just highlighting the importance of the modalities where they are required to be applied along with other popular regimes of physiotherapy like different forms of exercises, mobilizations and manipulation where indicated ( not every care require manipulation). Analysing the cause and addressing the right management plan is all that is required. I was just discussing where the superficial modalities should be applied and where deep modalities or agents should be applied. Which modality or agent is better to be applied when required to be prescribed.

Among the different treatment approaches, there are different school of thoughts each having its merits and demerits & rational use where they are required to be used. There are certainly many good manipulative therapists there in Australia, England and in America with their originators. But certainly manipulation has its own role where it is required having good results & where not required having no results giving no benefits. Also there are other approaches like McKenzie Method etc where required to be indicated. So it is important to see where that particular approach is required and where not required. I guess you would agree in many aspects.