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Hi every body I am wondering what is your point of view about the chronic cases of low back pain or O.A knees which take the P.T treatment many times you discharge them and they come back again to you and that because the doctor dont know what to do with them ?!!! so I always have this question on my mind what I should do it seems that pain is not going and they are not suitable for exercises because the joints are already deformed am really confused please help :(
These patients are complex because depending on many variables;
- joint space
- bony spurs
- articular surface abrasion
- loose bodies
- deformity
- decreased synovial lubrication
- decrease muscle force output
- altered biomechanics
and others
significantly effect the results possible. One thing I would state is even though Glucosamine And Chondroitin have not been shown to reduce pain I would recommend prescribing these in light of studies showing that joint space is 'less' diminished over time with concomitant exercise therapy.
The goal is to continue the exercise sessions and ideally you want an extensive progressive home exercise programme to give to your patients
Diet has been shown in recent research to assist with the painful symptoms of chronic OA. Especailly noted is diminisheing simple sugar intake; it has been related to joint degeneration. I would suggest some reading in this area, as it has proven itself beneficaial to some of my geriatric patients.
I believe that diet is affecting the body in many aspects , any unhealthy habits will affect your body anyway so I will do some search in diet and pain and see whats news and if u have articles about that i will be thankful.
Thank u for ur opinion i believe also the patients should stick to their exercise program at home not just doing it in the session