Horsham - anrc-uk.com

17 Dec

Ayurveda Massage Therapy

Have you ever felt that you could benefit from a deep, all-the-way-to-your-core cleanse? Or perhaps you feel so depleted and fatigued that you sense a need for deep rejuvenation and nourishment? Is your mind so cluttered that you have a hard time finding the calm within? If so, consider giving yourself the gift of panchakarma/Massage therapy or any of the other healing therapies offered at ANRC Physiotherapy Clinic – massage therapy- Horsham and East Grinstead. This could be the best gift you ever give yourself; the gift of health, and a return to your own true nature. The Ayurvedic Spa at ANRC Physiotherapy Clinic is a place to relax and be nurtured. Using traditional Ayurveda massages, our intention is to restore your sense of balance and well-being, returning you to the level of energy you desire. The nourishing treatments build up the health of the immune and nervous systems and provide you with a fresh start as you complete each three-day programme. Ayurvedic Massage / massage therapy brings instant benefits on physical, psychological and energetic levels, among them: Reduces muscle tension and stress Improves mobility Realigns body posture Improves breathing capacity Increases the circulation of body fluids Balance the proprioceptive sensitivity Reconstitutes energy reserve indication The massage therapy contributes to the alleviation and recovery of injuries and diseases, such as: Joint and muscle related aches Breathing difficulties General problems related to stiffness from lack of exercise Disorders of intestinal/digestive organs Stress, anxiety, depression Headaches Sleep disorders For more information contact as info@anrc-uk.com, www.anrc-uk.com. Physiotherapy Horsham, Physiotherapy East Grinstead

4 Dec

Suffering from Low back pain ? Physio Horsham…

Low back pain- Physio Horsham and East Grinstead The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet.Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain. There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of low back pain helps determine the cause. Range of Lower Back Pain Symptoms- Physio Horsham and East Grinstead Low back pain can incorporate a wide variety of symptoms. It can be mild and merely annoying or it can be severe and debilitating. Low back pain may start suddenly, or it could start slowly possibly coming and going and gradually get worse over time. Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example: Pain that is dull or achy, contained to the low back Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet; can include numbness or tingling (sciatica) Muscle spasms and tightness in the low back, pelvis, and hips Pain that worsens after prolonged sitting or standing Difficulty standing up straight, walking, or going from standing to sitting Physiotherapy for low back pain- Physio near to me For many patients, it is best to follow a stretching routine that has been individually designed for them by a physical therapist or a spine physician. As a general rule, low back pain patients should focus on stretching the lower back muscles, abdominal muscles, hips, and legs. When to see a physio If your back pain is not settling with simple self-care options it can be helpful to make an appointment to see a physio. Your physio can provide treatment to relieve the pain and they can also teach you how to look after your back and prevent future episodes. If you have a long-term back problem the physio can design a suitable exercise program for you. Find a physiotherapist near you. Other indications that it is time to call your physio include: your local physio. Back pain following trauma Back pain accompanied by pain, numbness, pins, and needles in your leg(s), and weakness or balance problems. If your back pain is accompanied by fever/feeling unwell or bladder/bowel disturbance, you should see a doctor immediately. Physio Horsham and East Grinstead may prescribe a tailored series of exercises to prevent and manage injury and help optimise your health. As you can see while lower back pain is common, the diagnosis of the cause of your back pain is specific to you and therefore the treatment or investigation pathway does vary from case to case. A spinal health care professional can assist you a prompt diagnosis, early referral, acute and chronic back pain relief, plus long-term self-management or back pain prevention strategies specific to your back pain. You should feel confident that your practitioner has screened you for specific pathologies that require urgent medical attention. Plus they should also assess you for any neurological deficits such as loss of bowel or bladder function, leg muscle weakness, loss of sensation, diminished reflexes and day-to-day function to determine whether you have a radiculopathy or stenosis, which may require different treatment options to nonspecific low back pain or radicular pain. Read what is our patients telling us – I visited Praveen having been referred by BUPA. I was suffering from lower back and referred pain around the ribs. He quickly established what was causing the problem and following 7 sessions, over a period of time where a number of different techniques were employed, I was able to resume exercising in the Gym. He further diagnosed that the problem would be improved if I visited a podiatrist. As a result, I am now without pain.Praveen takes a holistic approach, has a range of techniques to solve problems, is flexible with his appointments and I recommend him highly. Regards, Peter Jones. For specific guidance regarding your condition, please seek the individual assessment from a health practitioner with a special interest in back pain, such as a musculoskeletal physiotherapist. If you have any questions, physio near to me, please contact physio Horsham and physio East Grinstead ar info@anrc-uk.com Medical tourism packages are available- please ask to www.anrc-uk.com

18 Oct

The Whiplash Injuries/ Neck Pain

The Whiplash Injuries/ Neck Pain – Physiotherapy near to me Motor vehicle accidents result in many patients with chronic head and neck pain, some of which meet the criteria for a (The whiplash Injuries)“whiplash syndrome.” The cervical zygapophysial joint synovium, muscular, and ligamentous strains and other anatomical sites are often implicated in the pathophysiology of these cases. Some patients have a characteristic constellation of vague neurological symptoms, often including a headache, posterior neck discomfort, dizziness, nausea, and sometimes visual changes. The pain that results from whiplash injury may come from injury to the muscles in the neck and Shoulder region, or from injury to the spinal joints or intervertebral discs. Either muscle injury or spine injury can reduce the ability to turn the neck. Limited movement of the neck is an important sign of ongoing muscle or joint problems. Physiotherapy Horsham and East Grinstead Early mobilization of the neck to maintain movement is an important principle of treatment; early treatment is therefore directed toward relieving pain and restoring full motion to the neck. In summary, persistent symptoms after whiplash injury should be evaluated to identify the causes, because they can frequently be treated and corrected. This is true when symptoms have been present only for a short time, but it is also true when symptoms have been presented for months and even years. Contact physio Horsham mailto:info@anrc-uk.com The Physio East Grinstead and Physio Horsham offer detailed assessment and physiotherapy management of Whiplash injuries. Late Whiplash Symptoms- Physiotherapy East Grinstead Chronic cervicogenic headaches may be associated with reduced cervical ROM (especially extension), dizziness, and ipsilateral shoulder Payne Late Whiplash Syndrome Cervicogenic vertigo has only recently been recognized in the clinical and scientific domain as a pathological condition that may result because of whiplash. Symptoms of dizziness and impaired balance may occur soon after the neck injury. Local Cervical Syndrome is a disorder that involves local neck complaints, such as neck pain and stiffness. The primary pain generator may be associated with a disc-related or joint-related disorder. In the case of Late Whiplash Syndrome, the symptoms may arise because of a combination of these etiologies. Cervico–Brachial syndrome involves complaints in the local cervical area and one or both upper extreme. Physiotherapy for Whiplash injuries/ Neck pain – physio near Horsham. Most whiplash patients will start to feel better within a few weeks of the injury. Your physiotherapy treatment will aim to: Reduce neck pain, headaches, and inflammation. Normalise joint range of motion. Strengthen your neck muscles. Strengthen your upper back muscles. Improve your neck posture. Normalise your muscle lengths and resting muscle tension. Resolve any deficit in neural tissue extensibility. Improve your neck proprioception, fine motor control, and balance Improve your ability to cope with everyday activities, plus more stressful ones such as lifting. Minimise your chance of future neck pain or disability. We strongly suggest that you discuss your specific whiplash injury after a thorough examination from a physiotherapist who specializes in whiplash associated disorder. Physio near to me- Sit up straight- Postural syndrome is essentially repetitive stress to the neck and thoracic spine, or the 12 vertebrae of the mid-back and chest area, from the so-called flex-forward position. Doctors and physical therapists say that the injury commonly targets the fourth, fifth and sixth discs in the thoracic spine, leading to muscle tenderness, stiffness or, in some cases, nerve irritation. Sure, most office workers and their ergonomic specialists are familiar with the dangers of repetitive motions with a mouse and keyboard at the PC all day, resulting in weakened wrists, tennis elbow or, worse, carpal tunnel syndrome. But some physical therapists say that such injuries lately are taking a backseat to patient complaints of pains in the mid- to upper back and neck. “We call it the flex-forward posture, where your head’s jetting forward, the abdominals shut down and the majority of the pressure comes to the mid-back,” said Caroline Palmer, a physical therapist at the Stone Clinic, based in San Francisco. “Your spine is going to have to give somehow.” Physiotherapy Horsham and East Grinstead A prolonged slouch over many years causes the disc space to narrow, which in turn can cause nerve irritation that spreads underneath the shoulder blades, down the arms, and down the back. If you’re reading this article with hunched shoulders and a craned neck, your “computer slump” could one day give way to what some physical therapists call “postural syndrome.” contact us Info@anrc-uk.comMedical Tourism

17 Oct

Upper Back Pain Management at Physio Horsham

Upper Back Pain at Physio Horsham Medically the area requiring upper back pain physiotherapy is known as the thoracic spine, which consists of a series of vertebrae, discs, muscles, and ligaments as well as rib articulations coming off the side of each of these thoracic vertebrae. Upper back pain can be as a result of stress or injury to any of these structures causing pain anywhere from the base of your neck to your rib cage. Although perhaps not as common as low back pain or neck pain, complaints requiring upper back pain physiotherapy are still relatively common. In physiotherapy, ANRC Physiotherapy locations patients complaining of upper back pain is a regular occurrence because sedentary postures at the desk are a common cause of stiffness or tightness in thoracic structures. Common Upper Back Pain Complaints Seen In Physiotherapy ANRC Physio Clinics Prolonged repetitive, forceful or awkward hand movements “Static loading” or holding a posture Poor conditioning of the heart and lungs, and poor muscle endurance Direct mechanical pressure on tissues Cold work environment Poorly fitting furniture Basic inadequacies of workstation design Work organizational and psychosocial issues Similar to low back pain the thoracic spine can suffer from bulging and degenerative discs, pinched nerves, facet joint pain, muscle pain but as well as these other conditions requiring upper back pain physiotherapy can include: Ankylosing spondylitis: Ankylosing spondylitis is a disease causing inflammation and pain in the spine and other joints such as the shoulder, hips, knees, ankles and between your sternum and ribs. Scheuermann’s Disease: Scheuermann’s Disease is a developmental disorder of the spine causing the abnormal growth of the thoracic vertebrae. Thoracic Spondylosis: Thoracic Spondylosis a common form of arthritis in the spine and is one of the most common causes of upper back pain and stiffness once aged over fifty. Side Strain: Side strains also commonly cause thoracic region pain and are strongly related to fast bowlers in cricket, specifically related to bowling speed with the fastest bowlers much more likely to suffer this type of injury. High-Risk Groups Computer users Checkout clerks Musicians Hairdressers Health professionals: surgeons, dentists Nurses Butchers Massage therapists Sportspersons Laboratory workers Children Teachers Housewives Manual labourers Assembly line workers Assistants Management Of Upper Back Pain Upper back pain management at physiotherapy physio East Grinstead practices key aim is to restore normal function and improve any required strength and mobility in the thoracic spine and related areas. Upper back pain physiotherapy following assessment and diagnosis will use a combination of techniques to achieve the above goals. As previously stated upper back pain isn’t as common as low back pain and neck pain however at ANRC Physiotherapy Clinic each year we see a substantial number of patients complaining of upper back pain as a result of a variety of triggers including overuse, poor posture, unaccustomed activity or injury, caught early upper back pain physiotherapy can be a very successful way to manage thoracic complaints of musculoskeletal origin. The trademarked Skilled Hands-on Approach for Release of Myofascia, Articular, Neural and Soft-tissue mobilization (SHARAN) rehabilitation protocol management is followed. There are four interlinked phases here. Phase 1 – Severe discomfort in the initial stage: Management – Myotherapy soft tissue mobilisation, neural mobilisation, rib mobilisation, clavicular mobilisation, scapula thoracic mobilisation and physiotherapeutic modalities like IFT, US. These are followed by assisted stretches. Phase 2 – Moderate discomfort in the upper limb and neck region: Management – It is a follow up to Phase 1 which includes more self-stretching exercises, a range of motion exercises and relaxation techniques like breathing exercises, Alexander techniques and yoga therapy. Phase 3 – Mild discomfort: Management: In this phase, continue with self-stretching exercises, free exercises and begin progressive strengthening exercises followed by relaxation techniques. Phase 4 – Maintenance phase: Management – This consists of postural maintenance, generalized whole body stretching and strengthening exercises in order to maintain the length and strength of muscle. Physio Horsham and physio East Grinstead advice -Adequate micro and macro breaks should be taken in between work: Do the stretches and strengthening exercise at least thrice a week. If there is any flare-up of symptoms in phase 4, stop all the exercises and immediately consult a physiotherapist for further clarification. Find out physio near to me

16 Oct

Suffering from Low back pain ? Physio Horsham and East Grinstead.

The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet. Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by mobilizing an inflammatory healing response. While inflammation sounds minor, it can cause severe pain. There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of low back pain helps determine the cause. Range of Lower Back Pain Symptoms- Physio Horsham and East Grinstead Low back pain can incorporate a wide variety of symptoms. It can be mild and merely annoying or it can be severe and debilitating. Low back pain may start suddenly, or it could start slowly possibly coming and going and gradually get worse over time. Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example: Pain that is dull or achy, contained to the low back Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet; can include numbness or tingling (sciatica) Muscle spasms and tightness in the low back, pelvis, and hips Pain that worsens after prolonged sitting or standing Difficulty standing up straight, walking, or going from standing to sitting. Physiotherapy for low back pain- Physio near to me For many patients, it is best to follow a stretching routine that has been individually designed for them by a physical therapist or a spine physician. As a general rule, low back pain patients should focus on stretching the lower back muscles, abdominal muscles, hips, and legs. When to see a physio If your back pain is not settling with simple self-care options it can be helpful to make an appointment to see a physio. Your physio can provide treatment to relieve the pain and they can also teach you how to look after your back and prevent future episodes. If you have a long-term back problem the physio can design a suitable exercise program for you. Find a physiotherapist near you. Other indications that it is time to call your physio include: Back pain following trauma Back pain accompanied by pain, numbness, pins, and needles in your leg(s), and weakness or balance problems. If your back pain is accompanied by fever/feeling unwell or bladder/bowel disturbance, you should see a doctor immediately. Physio Horsham and East Grinstead may prescribe a tailored series of exercises to prevent and manage injury and help optimise your health. As you can see while lower back pain is common, the diagnosis of the cause of your back pain is specific to you and therefore the treatment or investigation pathway does vary from case to case. A spinal health care professional can assist you a prompt diagnosis, early referral, acute and chronic back pain relief, plus long-term self-management or back pain prevention strategies specific to your back pain. You should feel confident that your practitioner has screened you for specific pathologies that require urgent medical attention. Plus they should also assess you for any neurological deficits such as loss of bowel or bladder function, leg muscle weakness, loss of sensation, diminished reflexes and day-to-day function to determine whether you have a radiculopathy or stenosis, which may require different treatment options to nonspecific low back pain or radicular pain. Read what is our patients telling us: I visited Praveen having been referred by BUPA. I was suffering from lower back and referred pain around the ribs. He quickly established what was causing the problem and following 7 sessions, over a period of time where a number of different techniques were employed, I was able to resume exercising in the Gym. He further diagnosed that the problem would be improved if I visited a podiatrist. As a result, I am now without pain. Praveen takes a holistic approach, has a range of techniques to solve problems, and is flexible with his appointments and I recommend him highly. Regards, Peter Jones. For specific guidance regarding your condition, please seek the individual assessment from a health practitioner with a special interest in back pain, such as a musculoskeletal physiotherapist. If you have any questions, physio near to me, please contact physio Horsham and physio East Grinstead at info@anrc-uk.com Medical tourism packages are available- please ask to www.anrc-uk.com

15 Oct

Pain on neck & upper back, shoulders, arm or forearm?

Myofascial Pain Syndrome-Physio Horsham and East Grinstead Pain on neck & upper back? shoulders, arm or forearm? Myofascial pain is a chronic condition that affects the fascia (connective tissue that covers the muscles). Myofascial pain syndrome may involve either a single muscle or a muscle group. In some cases, the area where a person experiences the pain may not be where the myofascial pain generator is located. Experts believe that the actual site of the injury or the strain prompts the development of a trigger point that, in turn, causes pain in other areas. This situation is known as referred pain. The physio in Horsham and East Grinstead specializing in treatments of hands-on techniques for pain management. What causes myofascial pain? Myofascial pain may develop from a muscle injury or from excessive strain on a particular muscle or muscle group, ligament or tendon. Other causes include: Injury to intervertebral disc Post surgery Post fracture, post injection General fatigue Repetitive motions Medical conditions Lack of activity (such as a broken arm in a sling) Sitting under the cold draft of the air conditioner or an open window Cold, damp weather Viral infections, sore throat, respiratory infections, etc. Chronic allergies, including food allergies Excessive, uncompensated emotional stress or psychological tension Depression Sleep disturbances Hypothyroidism Nutritional deficiencies, especially folic acid and pyridoxine deficiency Smoking, caffeine, and alcohol Anaemia Recurrent bouts of hypoglycaemia Hyperuricemia (high uric acid levels) What are the symptoms of myofascial pain? Myofascial pain symptoms usually involve muscle pain with specific “trigger” or “tender” points. The pain can be made worse with activity or stress. In addition to the local or regional pain associated with myofascial pain syndrome, people with the disorder also can suffer from depression, fatigue, and behavioral disturbances How is myofascial pain diagnosed? Physio Horsham and Physio East Grinstead-Trigger points can be identified by pain that results when pressure is applied to an area of a person’s body. In the diagnosis of myofascial pain syndrome, four types of trigger points can be distinguished: An active trigger point is an area of extreme tenderness that usually lies within the skeletal muscle and which is associated with a local or regional pain. A latent trigger point is a dormant (inactive) area that has the potential to act as a trigger point. A secondary trigger point is a highly irritable spot in a muscle that can become active due to a trigger point and muscular overload in another muscle. A satellite myofascial point is a highly irritable spot in a muscle that becomes inactive because the muscle is in the region of another trigger pain The treatment phases for physio Horsham and physio East Grinstead

7 Oct

Sports Physio & Physiotherapy East Grinstead, Thoracic Outlet Syndrome

Physio East Grinstead, Thoracic Outlet Syndrome- Thoracic outlet syndrome is a condition that involves pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collarbone.Physio East Grinstead and Horsham. Contact us on info@anrc-uk.com Causes, incidence, and risk factors- Physi East Grinstead Blood vessels and nerves from the spine or major blood vessels of the body pass through a narrow space near the shoulder and collarbone on their way to the arms. As they pass by or through the collarbone (clavicle) and upper ribs, they may not have enough space. Pressure (compression) on these blood vessels or nerves can cause symptoms in the arms or hands. Problems with the nerves cause almost all cases of thoracic outlet syndrome. Compression can be caused by an extra cervical rib (above the first rib) or an abnormal tight band connecting the spinal vertebra to the rib. Patients often have injured the area in the past or overused the shoulder. People with long necks and droopy shoulders may be more likely to develop this condition because of extra pressure on the nerves and blood vessels. Types of Thoracic Outlet Syndrome True neurologic: caused by congenital anomalies, generally occurs in middle-aged women and almost always on one side of the body Disputed TOS: also called common or non-specific TOS: caused by injury to the nerves in the brachial plexus Arterial TOS occurs on one side of the body. It affects patients of both genders and at any age but often occurs in young people. Venous TOS: a rare disorder that affects men and women equally. The exact cause of this type of TOS is unknown. It often develops suddenly, frequently following unusual, prolonged limb exertion. Traumatic TOS: may be caused by traumatic or repetitive activities such as a motor vehicle accident or hyperextension injury- Physio Ease Symptoms of Thoracic Outlet Syndrome Pain, numbness, and tingling in the little and ring fingers, and the inner forearm Pain and tingling in the neck and shoulders (carrying something heavy may make the pain worse) Signs of poor circulation in the hand or forearm (a bluish color, cold hands, or a swollen arm) Weakness of the muscles in the hand Physio East Grinstead- contact us on 01342 537610 Physiotherapy Management of Thoracic Outlet Syndrome ANRC Physiotherapy Clinic follows the TOS SHARANS Rehabilitation Protocol management of Physiotherapy. Its four phases are interlinked to each other. Physio East Grinstead Phase 1 – Severe discomforts in the initial stage Management – Myotherapy soft tissue mobilisation, neural mobilisation, rib mobilisation, clavicular mobilisation, scapula thoracic mobilisation and physiotherapeutic modalities like IFT, US followed by assisted stretches. Physio East Grinstead follows SHARANS protocol for rehab. Phase 2 – Moderate discomfort in the upper limb and neck region Management — It is a follow up of phase 1 which includes more self-stretching exercises, the range of motion exercises, relaxing techniques like breathing exercises, Alexander techniques and yoga therapy. Phase 3 – Mild discomfort Management – – In this phase continue with self-stretching exercises, free exercises and begin progressive strengthening exercises followed by relaxation techniques. Phase – 4 – Maintenance phase Management-This consists of postural maintenance, generalized whole body stretching and strengthening exercises in order to maintain the length and strength of muscle. Adequate micro and macro breaks should be taken in between work.Do the stretches and strengthening exercise at least thrice a week.If there is any flare-up of symptoms in phase 4, stop all the exercises and immediately consult a physiotherapist for further clarification. physio near to me Medical tourism In India

6 Oct

Fibromyalgia-Physiotherapy- ANRC Physiotherpay clinic East Grinstead & Horsham

Physio East Grinstead, Fibromyalgia Fibromyalgia is a chronic condition of widespread pain and profound fatigue. The pain tends to be felt as diffuse aching or burning often described as head to toe. The fatigue ranges from feeling tired to the exhaustion of flu-like illness.Physio East Grinstead and Horsham. 1. The name fibromyalgia is a combination of three terms-fibro from latin which is fibrous tissue such as tendons and ligament, Greek prefix ‘myo’ indicating muscles and ‘algia’ from Greek indicating of pain. 2. It is known as a syndrome because it is a collection of symptoms rather than a specific disease process that is well understood.Physio East Grinstead & Horsham contact us on info@anrc-uk.comThe definition of fibromyalgia syndrome (FMS) as stated by the American College of Rheumatology (ACR 1990)3 is as follows: 1. A history of widespread pain for at least 3 months.Pain is considered widespread when all of the following are present: pain in the left side of the body, the right side of the body, below the waist and above the waist. In addition, there should be axial pain (cervical spine or anterior chest or thoracic spine or low back). 2. Pain (with the patient reporting ‘pain’ and not just ‘tenderness’) in 11 of 18 tender point sites.The sites are all bilateral and are situated: At the suboccipital muscle insertions (close to where rectus capitis posterior minor inserts) At the anterior aspects of the inter-transverse spaces between C5 and C7 At the midpoint of the upper border of upper trapezius muscle At the origins of supraspinatus muscle above the scapula spines At the second costochondral junctions, on the upper surface, just lateral to the junctions 2cm distal to the lateral epicondyles of the elbows In the upper outer quadrants of the buttocks in the anterior fold of gluteus medius Posterior to the prominence of the greater trochanter (piriformis insertion) On the medial aspect of the knees, on the fatty pad, proximal to the joint line DIAGNOSTIC CRITERIA To confirm the diagnosis the concomitant systemic diseases should be ruled out and common coexisting conditions should be recognized.Time ruleAccording to American College of Rheumatology criteria, there should be chronic widespread of pain for at least 3 months on a more or less continuous basis.3Sign and symptomsPain should be present at multiple fibromyalgia tender points when pressure (approximately 4 kg/cm2) is applied manually, with pressure increases gradually at the rate of 1 kg per second over 4 seconds, as depicted in the image below. The pressure should cause no referred pain.5Besides pain and fatigue fibromyalgia symptom often include: Unrefreshing sleep – waking up tired and stiff Headaches – ranging from ordinary to a migraine Irritable bowel frequent diarrhea or constipation sometimes accompanied by gas in the abdomen or nausea Cognitive disturbance including lack of concentration and word mix up Clumsiness and dizziness Sensitivity to changes in the weather and to noise, bright light, smoke and other environmental factors Allergies PHYSIOTHERAPY ASSESSMENT TOOLS Numerous instruments have been used in clinical trials of fibromyalgia syndrome. Pain – Vastly used and validated methods are Visual Analog Scale (VAS) Numeric rating scale McGill Pain Questionnaire CLASSIFICATION Many rheumatologists recognize 2 types of fibromyalgia6 Primary Secondary Primary fibromyalgia is the most universally accepted form of fibromyalgia and is normally diagnosed when no underlying causes are present (such as arthritis, lupus etc) and at least 11 of 18 designated points are confirmed. The cause of primary fibromyalgia syndrome is unknown but it can be induced by trauma, infection, stress, inflammation or their factors. Secondary fibromyalgia may be triggered by conditions such as RA, Lupus, hypothyroidism, HIV. It may also be triggered by physical trauma. Secondary fibromyalgia is sometimes referred to as post-traumatic fibromyalgia. It is also known as regional fibromyalgia and is present in the patient who experiences pain at fewer than 11 of the 18 positive tender points Physio East Grinstead and Horsham- for more details please visit www.anrc-uk.com. ANRC Physiotherapy clinic East Grinstead and Horsham ETIOLOGY AND PATHOGENESIS The etiology of fibromyalgia is multifactorial and includes both environmental and genetic factors. Biologic variablesCertain biologic variables contribute to the development and persistence of fibromyalgia (eg, physical trauma, exposure to toxins). Inheritance FMS has a genetic predisposition. First degree relatives of individuals with FMS display an eightfold greater risk of developing fibromyalgia than those in the general population. Gender Sex-related effects are important in fibromyalgia and with pain in general. Aversive stimuli and stressful tasks are more likely to evoke SNS, HPA axis, and psychological responses in females than in males. Sleep Almost all patients with fibromyalgia sleep poorly, and a night of poor sleep is followed by a more painful day. This contributes to negative mood and cognitive difficulties. Other variables Age is a variable; most cases occur between the ages of 20 and 50 years. Physical de-conditioning is also a variable. Physiotherapy management of Fibromyalgia please contact Physio East Grinstead Physiotherapist near to me- contact us on info@anrc-uk.com, for more details please visit www.anrc-uk.com Medical tourism – Physiotherapy