Q: Doctor, how can a physiotherapist help in depression?
A: A critical aspect of a physical therapist's role is recognizing signs and symptoms of depression and related disorders. By being attuned to these indicators, therapists can systematically document them in the care plan and promptly notify physicians, facilitating timely medical interventions for patients experiencing depression. This heightened awareness is especially valuable given the emotional instability often associated with depression. Therapists skilled in identifying these signs can adeptly navigate various situations, redirecting patients to alternative activities, providing relevant instructions, or engaging them in more positive conversations.

The comprehensive management of depression within physiotherapy involves a holistic approach that integrates physical activity and exercise with psychological support. Numerous studies have shown the positive impact of physical activity on mood and mental well-being, due to the increased release of endorphins, natural mood-boosting chemicals in the brain. It is essential to select enjoyable and sustainable activities—such as walking, cycling, swimming, or dancing—for long-term adherence to the treatment plan. Physiotherapists, recognizing the importance of regular exercise, incorporate it into their treatment plans, leveraging its proven efficacy in alleviating depression symptoms and enhancing overall mental health.

Additionally, physiotherapists may introduce relaxation exercises, breathing techniques, and mindfulness-based interventions tailored to each individual. This multifaceted approach improves stress management and contributes to overall mental health. Emotional support and encouragement from physiotherapists are pivotal, creating a positive and supportive treatment environment. This, in turn, empowers patients to feel more comfortable and motivated to adhere to their treatment plans, fostering both physical and mental well-being. By actively promoting a healthy lifestyle encompassing exercise, emotional support, and a positive treatment environment, physical therapists play a crucial and holistic role in addressing the multifaceted dimensions of their patients' overall health.

Q: At the age of 38, my sister is dealing with a herniated disc in her lower back. I am seeking guidance on the appropriate physical therapy measures for her condition.
A: A herniated disc in the spine, a condition where the nucleus pulposus is displaced from the intervertebral space, stands as a prevalent cause of back pain. Those afflicted with pain linked to a herniated disc often recall a triggering event that initiated their discomfort. Diverging from mechanical back pain, the sensation associated with herniated disc pain is frequently characterized by a burning or stinging quality that may extend into the lower extremity. Moreover, in more severe instances, the presence of weakness or changes in sensation may be observed. In certain cases, a herniated disc injury may exert pressure on the nerve or spinal cord, resulting in pain consistent with nerve compression or dysfunction of the spinal cord. The severity of these symptoms depends on the type and cause of the disc herniation.

Physical therapy emerges as a pivotal element in the recuperation process for herniated disc patients. Key components of physical therapy include promoting ambulation and the gradual resumption of exercise, implementing strategies for pain control, and educating patients on maintaining a healthy weight. Physical therapy programs are routinely recommended to address pain and restore functional and neurological deficits associated with symptomatic disc herniation. Various exercise programs cater to the treatment of symptomatic disc herniation, encompassing aerobic activities like walking and cycling, directional preferences such as the McKenzie approach, flexibility exercises like yoga and stretching, proprioception, coordination, and balance exercises involving tools like medicine balls and wobble/tilt boards, as well as strengthening exercises and motor control exercises (MCEs).

In cases where surgery becomes necessary, rehabilitation programs typically commence around 4-6 weeks post-surgery. Physical therapists play a crucial role in guiding patients through the rehabilitation process, providing information about the upcoming weeks' program. Patients receive instruction and support in daily activities, including getting out of bed, using the bathroom, and dressing. Emphasis is placed on the ergonomics of back care, fostering an environment conducive to optimal recovery.