Q: I am a 38-year-old female and have been experiencing neck pain for over a month now. There is no other medical condition. Should I go for physical therapy session to get relief from pain?
A: A physical therapist has to take a detailed history with proper assessment and evaluation for the condition. Once a final diagnosis has been made, a physical therapist can proceed with a variety of available treatment options like mobilizations, modalities, stretching, and exercises for it. We usually go for neuromuscular exercises such as coordination, proprioception, postural training, endurance training, aerobic conditioning, dry needling, laser and intermittent mechanical/manual traction. A physical therapist can also work on patient education and counseling strategies that promote an active lifestyle and address cognitive and affective factors.

Q: My mother is 58 years old and has Rheumatoid Arthritis. Her hands are painful and she can hardly work. Kindly guide.
A: (RA) is a chronic inflammatory disease affecting the and leading to impairment ins. The hand is one of the main elements of the rehabilitation of patients with rheumatoid arthritis (RA) due to deformities, which occur in approximately 90% of patients. It is a serious problem, both in the psychological and functional aspects, connected with muscle strength reduction, a limited range of motion, and non-acceptance of the changes in the shape of the limb. Progressive hand dysfunction contributes to various limitations in the personal, social, and professional aspects of life. Most commonly joint involvement occurs insidiously over months, however, in some cases, joint involvement may occur over weeks or overnight. Stiffness in the joints in the morning may last up to several hours, usually greater than an hour. On examination, there may be swelling, stiffness, deformity, and tenderness of the PIP, MCP wrist, and synovitis, and there may be a decreased range of motion. Rheumatoid nodules may be present in 20% of patients with rheumatoid arthritis; these occur over extensor surfaces at elbows, heels, and toes.

Rehabilitation is a long-term process depending on the grade and type of deformity and activity of the disease. Exercises which strengthen muscles and increase joint mobility are beneficial. Exercise intensity needs to be constantly controlled and adjusted to the activity of the disease. During the exacerbations, the exercises should be performed in a hospital or on an outpatient basis under the strict supervision of a therapist. Numerous therapeutic regimens are introduced during the chronic stage. These address both the dysfunctions and individual needs of the patient, including professional activity or hobbies. Irrespective of the activity of the disease, it is extremely important to teach the patient how to behave and perform activities of daily living safely to limit excessive joint loading. The improved function of the hand may be maintained with the continuation of an exercise program at home. Functional assessment is a basic tool to determine hand dysfunction severity.

Q: Doctor my son is 2 months old and has been diagnosed with torticollis. How can physical therapy help?
A: torticollis (CMT) is a condition in infants commonly diagnosed at or soon after birth. This condition is also known as a twisted neck or wry neck. CMT occurs when there is reduced length and increased tone of (SCM) on one side. Infants present with the same side bending and opposite rotation. Treatment approaches for CMT include manual therapy (therapist-led stretching exercises), repositioning therapy (tummy time), and botulinum toxin (botox) / surgery may be necessary for more severe cases that do not resolve. A physical therapist first examines the child for passive cervical range of motion with an arthrodial goniometer, active range of motion, global assessment, neurological, auditory, and visual function assessments to rule out other conditions, Physiotherapy (stretching, strengthening, and developmental facilitation) and aggressive repositioning are first-line treatments. Education, guidance, and support can reassure and help parents. It is important to educate parents/caregivers on positioning and handling skills to encourage active neck rotation towards the affected side and to discourage side flexion to the affected side. Kinesio taping is an alternative intervention for CMT. It has been suggested that kinesio taping might decrease treatment duration for CMT and that it can have an immediate effect on muscular imbalance in children with CMT. There are certain measures that caregivers can take at home to help their child with CMT, place toys/decorations to encourage the infant to turn to the other side, positioning the crib, or changing table, so the infant must turn to the other side to see/interact with caregivers. If conservative treatment is not successful, botox or surgical options may be considered.