Physiotherapy may be defined as a science that seeks to improve movement
dysfunction, promote optimal health and functions of the human body. It
involves the assessment, maintenance, restoration of the physical function and
performance of the body. It is practiced in India since the last fifty years.
It plays a big role in preventive aspects.
Physiotherapy is "tending to the cure or providing relief from disease or
injury." It involves rehabilitating the patient from "bed to job".
Be it acute or intensive care, respiratory and cardiac rehabilitation, pain
management, Arthritis, headache, post-operative pain, heel pain, fitness, or
sports injury, physiotherapy has a role to play in restoring the patient to
normal or at least a functional capacity.
Physiotherapy today is an independent health care profession for all the age
groups from neonatal to geriatrics. (From birth to old age.)
- Electro Therapy
- Exercise Therapy
Commonly used electro modalities are,
Short Wave Diathermy:
Short Wave diathermy current is a high frequency alternating current. The heat
energy obtained from the wave is used for giving relief to the patient. Its
frequency is 27,120,000 cycles per second and the wavelength is 11 meter.
Types of Applications:
The condenser field method (commonly used).
Ultrasonic involves the use of sound waves. It is useful for localized pain and
helps to reduce pain, muscle spasm, and loosens adhesions.
It is also useful in neuralgic pain like Post-herpetic neuralgia. Care should be
taken for the dosage.
Generation of Ultrasonic waves
Ultrasonic waves are generated by vibration of a Crystal mounted on a special
Initial Stage - 3 to 4 min
Severe Stage - 6 to 8 min
Interferential Therapy (I.F.T)
is an analogue interferential stimulation device which is used for symptomatic
relief and management of post surgical and post traumatic acute and chronic
This type of stimulation is characterized by the crossing of two electrical
medium, independent frequencies that work together to effectively stimulate
large impulse fibers. These frequencies interface with the transmission of pain
messages at the spinal cord level. Because of the frequency, the interferential
wave meets low impedance when crossing the skin to enter the underlying tissue.
This deep tissue penetration can be adjusted to stimulate parasympathetic nerve
fibers for increased blood flow. Interferential Stimulation differs from TENS
because it allows a deeper penetration of the tissue with more comfort
(Compliance) and increased circulation.
Pre and Port Orthopedic Surgery, Joint Injury Syndrome, Cumulative Trauma
Disorders, Increasing Circulation & Pain Control of Various Origins.
Can be used for
Diagnostic and Therapeutic purposes, Direct Galvanic current is mainly used for
Ionization i.e. transference of ions of drugs into the tissues through the skin
for pain relief. It is also used for stimulation of weak muscles.
Faradic Current is surged with different wave forms. It is used for pain &
swelling eg post operative knee surgery-it is given to improve muscle strength,
prevent atrophy, & reduction of muscle swelling.
Paraffin Wax Bath
Paraffin wax is used for the treatment.
The temperature of the wax is in the range between 40° to 44°c.
The heat energy obtained from the hot wax is used to relieve pain and stiffness
of the joints.
Paraffin wax has a low melting point. A special wax is used for small joints of
hands and feet. Skin acts as an insulator. It is used for stiff joints
(post-plaster, fracture of hands, feet) , Arthritic cases of small joints. It
should not be given in certain skin conditions.
T.E.N.S (Trans Cutaneous Electrical
This instrument has a
simple theory "gate control" i.e. Pain can be blocked by non destructive means.
A gentle application of electrical stimulation (with special rate, width, &
voltage control) helps to close the gate, thereby blocking the pain message to
the brain at the spinal cord level giving immediate pain relief in certain
conditions. Using of T.E.N.S. since 1979 and is found good results in chronic
back pain and neck pain. It is biologically safe to use. (Except when pacemaker
Other Electrical Modalities:
Continuous Passive Motion (C.P.M),
Infra Red (I.R),
Hydro Collateral Packs,
Importance of exercise
Proper exercises promote joint and muscular nutrition. Be it arthritis, back
pain, neck pain, calf muscle pain, Depression, shoulder pain or cancer,
exercises have been proved effective.
Exercises help to improve the range of motion. Breathing and relaxation
exercises must be done twice a day. Repetition of exercises varies with the
individual and the condition of the patient.
Too much exercising can damage joints or cause fatigue.
Exercises must be done under the supervision of the physiotherapist.
Common Conditions for Physiotherapy
- Mainly includes muscular and joint pain eg.
Arthritis-Osteo or Rheumatoid, Ankylosing Spondylitis (Bamboo Spine) etc.
- Pain in heel, elbow or shoulder due to arthritis,
injury, or infection.
- Sports Injuries: Ligament, muscular or fractures,
- Neck pain, back pain, due to injury, infection,
wrong posture, or muscular soft tissue Injuries, eg. ankle sprain.
All the above mentioned conditions are treated by physiotherapy.
Aches and pains are more common in old age. Osteoporosis, muscles fatigue,
stiffness of the joints, frequent falls, imbalance, difficulty in walking, lack
of concentration, impaired vision etc. are the common problems where
physiotherapy plays an important role.
Early Physiotherapy is beneficial. Daily exercises of arms legs, back, neck, and
breathing exercises are a must.
Computer related problems:
Computer hazards are increasing these days.
They include Arm, Elbow, Shoulder and Neck pain, which may be associated with
tingling and numbness in the arm or fingers.
Sitting in one position for long hours can cause Back, Knee, Calf muscle, and
Headache is another problem.
All such Problems can be minimized or nullified by Physiotherapy.
Ergonomics i.e. work postures is very important,
Warm up exercises for neck, back, Shoulder, elbow, wrists & fingers, knees; foot
etc. must be done.
Do not sit for more than 45 minutes at a stretch in one position.
If ergonomics is given importance and priority in offices and industries, then
work output will be more and healthy with less absenteeism.
Obesity is the root cause of many ailments and such persons can be benefited by
In Neurological cases Physiotherapy should be started as early as possible.
Conditions where physiotherapy can help:
- Facial Palsy: paralysis of one side of face.
- Paralysis - Hemiplegia (one arm & one leg),
Paraplegia (paralysis of both legs),
Monoplegia, (paralysis of one extremity),
Tetraplegia (paralysis of all four limbs) etc.
- Muscular Dystrophy - weakness of muscles
- Parkinson's disease
- Migraine and Tension headache
These conditions are treated by exercises and electrotherapy, If physiotherapy
is started in time, then disabilities can be minimized.
Chest Physiotherapy: Asthma, Bronchitis, air pollution, allergic conditions etc.
Pre and post - operative Bronchial hygiene care, special breathing exercises and
postural drainage helps to reduce medications and get better life.
Pediatric cases like Cerebral Palsy, Poliomyelitis, Talipes Equinus Varus (Foot
deformities), Flat feet, Meningitis, Asthma etc.
Gynecology & Obstetric cases:
Pelvic inflammation cases can be treated by the Physiotherapist.
In Obstetrics cases it has now been established that ante-natal and post-natal
exercises play an important role in the toning up of the pelvic floor muscles
- Pre (From 5th month) and Post natal (From 2nd day
if no complications) exercises (before & after delivery),
- Incontinence of urine-dribbling of urine,
- Pelvic Inflammation,
- Special exercises for women above 45years for
Physiotherapy may help to treat frontal and maxillary sinus cases.
Chronic allergic rhinitis is also treated by physiotherapy.
- Vitiligo (White Patches).
- Wounds are treated by special modalities