Why does it hurt more the first days after physio? After physical therapy the pain is worse. After injury and spinal surgery

Vyacheslav:

My diagnosis: dorsal diffuse protrusions of intervertebral discs c3-c4 and c4-c5 measuring 0.3 cm in the anterior subarachnoid space. There are marginal bone growths along the anterolateral and posterior surfaces of the vertebral bodies in the c3-c5 segment.

Doctor's answer:

If there is no pain syndrome, then you are advised to massage and exercise for the cervical spine without circular movements, limit prolonged sitting, Nucleo CMF Forte 1 caps 2 times a day, regardless of meals, a comfortable pillow so that you do not feel a stiff neck in the morning.

Vyacheslav:

Another question. The doctor prescribed me Ketonal, Mydocalm-Richter and current physiotherapy, my pain syndrome worsened even more. What can you recommend, what is the best physical therapy and drug treatment to relieve pain syndrome?

Doctor's answer:

Pain may become worse during physical therapy. As for medications, you can take Nucleo CMF Forte, Mydocalm 150 mg, 1 tablet 2-3 times a day after meals for about 10 days, Diclak ID 150 mg 1 time a day after meals or Naklofen duo 1 caps 2 times a day after meals for about 5 days -7 days. Replace electrical procedures with manual massage.

In the pelvis and hip area, the connection between the upper and lower parts of the body occurs; this is where many muscles and tendons are attached to the bony protrusions. Near the joints there are synovial bursae, which serve as a kind of shock absorbers: they eliminate friction and pressure between certain types of tissues. These bursae are filled with fluid and when they become inflamed, it is called hip bursitis.

• Symptoms
• Video on the topic

There are several synovial bursae in the above area of ​​the body:

1. Trochanteric, located on the outer part of the femur (near the greater trochanter), inflammation is accompanied by unpleasant pain in this part, trochanteric bursitis.
2. The iliopectineal, which is located on the back of the femur and is closest to it. Because of this, when bursitis occurs in this part, it can often be confused with other diseases (for example, coxitis), the pain is referred closer to the groin.
3. The sciatic, speaks for itself, in which part it is located, it becomes inflamed less often than the others.

When the bursa becomes inflamed, exudate (fluid with protein and blood elements) accumulates in it.

Various types of manifestations, both aseptic (for example, from injuries) and infectious (bacteria, viruses):

• serous;
• purulent;
• hemorrhagic;
• fibrinous;
• depending on the pathogen (gonorrheal, tuberculosis).

Bursitis in the hip area is complicated by the fact that the inflammation spreads to the joint and tendons.

It arises due to:

1. Injuries;
2. Heavy loads on joints;
3. For diseases of the spine;
4. Different lengths of the lower limbs;
5. Ca salt deposits in this area;
6. Rheumatoid arthritis;
7. Surgeries on the hip joint;
8. Joint infections;
9. Hypothermia;
10. Excess weight;
11. Inactive lifestyle;
12. Endocrine diseases;
13. Old age.

Very often, this disease occurs in professional athletes, women, and older people.

Symptoms

If the causes of bursitis for each of the above cases are the same, then the symptoms will be determined by the area of ​​localization of the inflamed bursa and, accordingly, by the distribution of pain. Hip bursitis has very characteristic symptoms, which boil down to one thing - pain and swelling.

Depending on where the inflammation is localized, unpleasant sensations are more pronounced there, spreading throughout the entire hip area, making it painful to lie on your side, walk, and even sit. If inflammation of the synovial bursa occurs with the accumulation of pus, then the pain is very sharp and burning.

When the iliopectineal bursa is affected, the pain covers the front and inner side of the thigh, and mainly radiates to the groin area; if it is a trochanteric bursa, then the pain will radiate to the lateral part of the thigh. The characteristic sensation is pain when the sciatic bursa is affected, which will intensify when bending over.

In addition to the main, pronounced symptoms, hip bursitis is additionally characterized by:

• sleep disturbance (associated mainly with discomfort and physical suffering);
• poor health, weakness and loss of working ability;
• temperature rise.

In case of such manifestations, it is important not to self-medicate, but to consult a doctor who will make a diagnosis using:

1. History;
2. Palpation;
3. Ober's tests;
4. X-ray.

The most common inflammation of the greater trochanter bursa is trochanteric bursitis of the hip joint. In order to correctly clarify where exactly the inflammation occurs, in this area or subcutaneously, the displacement is noted when the hip moves. If it is there, it means it’s not in the synovial bursa, no, then it’s in it.

An appointment with a specialist is mandatory; only he can give the correct prescription. My patients use a proven remedy that allows them to get rid of pain in 2 weeks without much effort.

Treatment for hip bursitis in most cases includes:

1. The use of medications intended to relieve inflammation, as well as painkillers. In cases where the painkiller does not have an effect, injections of potent drugs are used into the joint.
2. Carrying out a procedure for pumping out fluid, so-called aspiration (when a large amount of purulent inflammatory fluid has accumulated in the cavity of the bag, and therapeutic measures have not achieved an effect).
3. Physiotherapy (ultrasound treatment, heating, use of therapeutic mud, electrophoresis and others).
4. Physiotherapy;
5. Cold compresses;
6. Surgical intervention.

During treatment, they try to immobilize the joint (apply a bandage, tight bandage) or, if possible, use crutches or sticks. It is best to remain quiet so that the pain subsides. If the bursitis is aseptic, then apply compresses through gauze (cloth) made from ice cubes or, on the contrary, warming ones (heating pads, ointments). It is important not to self-medicate, but to follow the doctor’s orders.

Anti-inflammatory and painkillers relieve inflammation and reduce pain. When discomfort in the hip area is eliminated, therapeutic exercises (special exercises) are prescribed. It is also important to have a moderate body weight with this disease. Otherwise, pay attention to nutrition and lose weight.

There are cases when it is necessary to use surgery using an arthroscope (less traumatic). The lesion itself is removed so as not to affect the functions of the hip joint. After the operation, the patient requires rehabilitation. It is important after it not to lie down all the time, but to try to walk with the help of improvised means. This speeds up the process of tissue repair. Complete recovery occurs after a couple of months, and the person can return to normal.

It is important to prevent complications from bursitis. See a doctor in a timely manner, avoid permanent injuries, wear orthopedic shoes, control your weight, keep your muscles toned, do not put stress on your joints - that’s all that is necessary to not only prevent the development of bursitis, but also to feel full of strength and confidence. Remember, it is better to prevent a disease than to treat it.

Reviews about the drug Artra

Chondroprotector Artra is a complex drug that contains two main “building materials” for cartilage tissue - glucosamine sulfate and chondroitin sulfate. You can read about how these substances, which are extremely important for joint health, work in the article about them.

What do patients who have taken this medicine say about the drug Artra? Are they satisfied with the results of treatment with this remedy or not?

Reviews from patients who took the chondroprotector Artra

“I believe that glucosamine without chondroitin is ineffective, so I take Artra, because it contains both. I suffered from severe pain in my knees, even walking with a cane, not to mention climbing stairs.

I took a course of Arthra for four months, and the pain almost disappeared. Two years have passed since then, and everything is fine. But there is one “but”: in addition to Arthra, it is also important to eat foods rich in glucosamine - for example, jellied meat, marmalade and other products rich in gelatin. And repeat Arthra courses. Then it will make sense."

“Two months ago I had severe pain in my knee, which appeared when I bent my leg, but I did not have a knee injury. The orthopedic traumatologist sent me for an ultrasound of my joints, and it was discovered that I had a Baker’s cyst.

The doctor prescribed Arthra for me, I have been taking it for two months now. I don’t see any results, but the doctor said that it won’t happen quickly, only in six months. I continue to take the medicine and wait for the results...”

“The doctors diagnosed me with gonarthrosis of the knee joint. I was prescribed Artra, I’ve been taking it for about a year now, but I haven’t seen any results yet. The annotation says that a sustainable effect will only occur after 6 months of use, which will last 3 months.

I just don’t understand: when I finish the medicine, three months will pass, and if the pain returns, then I have to wait six months and take the medicine until it works again? Or should I take it all the time?”

“I’m 25 years old, I do cycling quite hard. Since childhood, my knees crunched when I squatted, and I had a broken leg, but until some time nothing else bothered me.

And 2 years ago my knee began to ache very much. The doctor prescribed Arthra. I've been taking it for 6 months now, there seems to be no pain, although the crunching in the joints still remains. But the main thing is that it doesn’t hurt and it’s good.”

“I drank Artra for 6 months, and at the same time I started going to yoga. I am very pleased with the result: the pain in my knees is gone. Now I don’t take pills anymore, but I go to yoga and don’t plan to quit!”

“My opinion about this medicine is positive. I tried a lot of chondroprotectors, but almost all of them caused me allergies. Fortunately, this did not happen to Arthra.

Since then I have been taking it in courses for 3 months, after which I take the same break, and then again for a 3-month course. The pain has practically disappeared, and over the past year I have even been able to give up NSAID painkillers. There are no problems with the stomach and intestines. I am pleased".

Valentina

“I am forty-six years old, I was diagnosed with coxarthrosis of the hip joint. After treatment with Arthra for 4 months, the joints ached, and they continue to ache, and they were also accompanied by pain in the elbow joints, which had never existed before!!! I am very unhappy with this “medicine”!

“At some point, I began to notice pain in my right knee after a heavy load, which quickly went away with rest. Over time, the pain began to become stronger and passed more slowly until it became almost constant. Doctors prescribed me all sorts of medicinal gels and balms, but there was little use. They threw up their hands and said, well, what do you want - arthrosis cannot be cured.

I want to say that I feel better. I can’t say that I run like a girl, but at least I don’t drink handfuls of painkillers, the pain has become less piercing and the constant crunching in the joint has almost disappeared. In general, I am satisfied with the medicine and have no plans to change it for something else yet.

I’ll say right away: Arthra is not cheap, it costs a decent amount, but due to the fact that for the first three weeks you need to drink only one capsule a day, a large package lasts a long time. I didn’t find any side effects from the medicine.”

“My experience with this drug is very sad. On the doctor’s advice, I started taking Artra, and after about 5-6 weeks of taking the medicine, some strange spot appeared, first on one arm, and a little later on the other. But, unfortunately, I did not attach due importance to this and continued to take the medicine.

Later, problems with the gastrointestinal tract appeared, and by the fifth month of taking it, my ears became covered with crusts and I began going to the doctors with these problems.

By that time I had stopped taking Arthra, but the allergy did not go away. Since then, I have been examined for almost a year, I was in the hospital 3 times, but this did not give any results, and allergic rashes on my hands and face continue ... "

“Last fall, as if due to the weather, my knee joints and spine in the lumbar and back areas began to ache. The doctor recommended taking the medicine "Arthra".

I drank it for seven months, approximately in the second or third month of treatment the pain began to go away, and soon I practically forgot about it. I told my neurologist about this when I came to see him. He just laughed and said in the spirit of “it’s all money down the drain.” In general, in the spring I stopped taking this medicine.

And in the summer it so happened that there was a lot of physical stress on my back and legs. And as a result, in July the same pains began again in the same places. I started treatment with Arthra again, I’m waiting for the results.”

“I tried taking the Artra supplement. For the first three weeks everything was fine, no problems. And towards the end of the first month of treatment, my joints began to crack quite sharply, literally all of them. I got scared and stopped taking this medicine, now I’m waiting for these strange squeaks to go away. I really hope for it…"

“The drug helps me, I don’t notice any side effects, which makes me happy. But, unfortunately, arthra helps me only as long as I drink it for a long time. As soon as I stop drinking, the pain in the joint returns.”

Vyacheslav

“My mother was diagnosed with coxarthrosis of both hip joints.” The doctor said that soon it would be necessary to undergo joint replacement surgery. He prescribed arthrosis and a course of special therapeutic exercises.

Mom drank a large jar of this medicine for six months, and with the exercise she felt much better. We refused the operation, but we drink arthra every six months. Mom says she’s noticeably better.”

Have you tried treatment with Arthra chondroprotector? What was your personal experience using this product? Do a good deed and share your opinion about this medicine in the comments below. Our readers will be grateful to you!

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Headache (cephalgia) is a condition that is probably familiar to everyone. According to statistics, this is the most common complaint at the reception. More than 40 diseases are known that are accompanied by unpleasant sensations in the head and neck area. Sometimes they are so severe that a person is unable to carry out daily activities and requires sick leave. Some types of cephalgia are easily relieved with medications, while others are difficult to treat with medications. In any case, the quality of life of such patients is significantly reduced.

According to WHO, 47% of the population regularly experiences headaches, about 90% of adults at least once in the past year. The prevalence of this disease varies from country to country. Thus, Europeans suffer more from primary headaches associated mainly with stress than residents of developing African countries. Migraine is significantly more common in women, and cluster headaches, rare (about 0.5%) in general, more often affect men.

Types of headaches: classification

According to the international classification, there are 14 main types of headaches (see table). The first four are considered primary. These are independent diseases, which are based on dysfunction of muscles, nerve trunks or the vascular system. The remaining cephalgia are secondary, that is, they are a symptom or complication of another disease, be it organic damage to the brain or disorders in any other system of the body.

Table 1. International classification of headaches (2nd edition, 2004) and frequency of occurrence in the population, according to various sources.

The occurrence of tension headaches (TTH) and migraines is directly related to stress, physical or emotional overload. These are primary cephalgia, that is, there are no organic lesions in the nervous system or other organs, but the patient’s condition can be so severe that everyday duties become overwhelming for him.

TTH is a classic example of a stressful condition. Emotional overload in combination with prolonged forced head position (sedentary office work, driving a car) leads to a pathological increase in the tone of the pericranial muscles. In this case, their blood supply is disrupted and muscle soreness occurs. Heredity and hormonal disorders are more involved in the development of migraines, but in many cases attacks are triggered precisely by stress.

The treatment of primary cephalgia is carried out by a neurologist. Only he can correctly diagnose, identify causes and predisposing factors. However, if the painful condition is caused by stress, it is necessary to involve a psychotherapist, he will help find the source of emotional stress and control the disease. Reflexologists and physical therapists can help you choose a set of non-drug treatments to reduce emotional stress and eliminate muscle dysfunction.

When emergency assistance is required:

• headache appeared suddenly, without reason, against the background of complete health (“thundering”);
• it is constant and increases in intensity;
• pain appeared after injury;
• cephalalgia is accompanied by nausea, vomiting, changes in speech, consciousness, loss of orientation or motor disturbances;
• severe pain combined with tension in the neck muscles and increased body temperature.

Diagnostics

Diagnosis of tension-type headache and migraine, like all primary pains, is based primarily on the analysis of clinical manifestations, and abuse headache should also be considered as a possible diagnosis. The mechanism of its formation is as follows: constant painful sensations force the patient to take painkillers. If this happens uncontrollably, over time their effect is dulled, the person is forced to take large doses, which become less and less effective. Sooner or later, a situation arises when pain is constantly present and is only slightly alleviated by analgesics. In this case, they talk about abusive cephalgia.

Table 2. Comparative characteristics of the clinical picture of socially significant types of headaches.

To facilitate diagnosis, universal questionnaires are used at the appointment to help systematize clinical data.

Questionnaire scale for conducting a diagnostic conversation:

By preparing answers to the questions listed in advance, you can significantly simplify the diagnostic search for the doctor, but you should not try to make a diagnosis yourself. The specialist takes into account a lot of factors: examination data and instrumental research methods. The latter are prescribed if a specialist suspects the secondary nature of cephalgia.

Additional research methods

Most often this is radiography of the skull in various projections, computed tomography or magnetic resonance imaging.

General principles for the treatment of primary headaches:

• use of medicinal and non-medicinal treatment methods;
• movement from simple to complex;
• use of minimal effective doses of drugs;
• detailed information to the patient about his condition and the mechanisms of development of the disease.

An individual treatment regimen should be prescribed by a specialist, based on the diagnosis, taking into account the frequency of attacks and the severity of clinical manifestations. Non-drug treatment methods include massage, physiotherapy and sessions with a psychotherapist. An important role is played by the normalization of the daily routine, nutrition, rational alternation of physical and mental labor, adequate sleep and the elimination of provoking factors. Unfortunately, more often you have to resort to drug therapy.

Drug therapy

In addition to relieving acute pain, interictal treatment is carried out aimed at preventing the occurrence and reducing the frequency of attacks. Experts do not recommend using painkillers without a doctor's prescription. Uncontrolled use of analgesics is a sure way to the development of abusive headaches, damage to the liver and other organs. In order for drug therapy to be rational, all drugs must be used strictly according to indications, and only a doctor can determine them correctly. Effective treatment for headaches is possible, and the sooner it is started, the more successful and easier it will be.

Electrophoresis has found wide application in various fields of medicine. The method is used for the treatment of pathologies of the cardiovascular system, hypertension, hernias of any part of the spine, arthritis, inflammation of the ENT organs, gynecological diseases, etc. Side effects of electrophoresis in adults are rare, mainly in case of non-compliance with the doctor’s recommendations and in the case of an individual reaction for the drug.

Benefits of physical therapy

Electrophoresis is prescribed not only to adults, but also to newborns for the treatment of many pathological conditions. Its therapeutic effect is multifaceted:

• analgesic effect;
• inhibition of the inflammatory process;
• reduction of swelling;
• normalization of blood circulation;
• stabilization of the nervous system;
• improvement of metabolic processes.

Introducing drugs into the body using a physiotherapeutic method has a number of advantages compared to injections or oral administration. Pros of physiotherapy:

• a concentration of the required substance is created at the injection site, with the formation of a “subcutaneous depot”;
• local impact;
• delivery of the drug in active form;
• painless and non-invasive procedure.

The concept of allergy to electrophoresis is incorrect. Side effects such as redness, itching, and rash are the result of an allergic reaction to a specific medication. The risk of such complications can be reduced by carefully considering the absolute and relative contraindications to a specific procedure. Otherwise, the symptoms may worsen and the rash may itch. Without adequate therapy, the effect of electrotherapy will be negative.

During electrotherapy, there should be no abrasions, scratches, cuts, rashes, moles or birthmarks at the place where the pads come into contact with the medicine. If they are available, the physiotherapist will select the technique in such a way as to avoid impact on these areas.

Rules for electrotherapy

Before starting a course of therapy, you need to make sure that the patient is not allergic to the drug. In addition, it must withstand the effects of galvanic current well.
The essence of the method is to deliver the necessary medications through the skin, bypassing the gastrointestinal tract. List of products approved for use during electrophoresis:

• penicillin antibiotics;
• vitamins;
• lidocaine, novocaine;
• chemicals (potassium, copper, iodine, zinc).

Depending on the lesion, electrophoresis is applied to the lumbar region, joint (leg, arm), and abdomen. If after electrophoresis the lower abdomen hurts, most likely the session was performed during an exacerbation of the disease. Red spots after electrophoresis indicate an allergic reaction to the drug.

For effective action, minimal concentrations of medicinal substances are sufficient. Solutions are prepared immediately before use. They can be stored for up to 7 days. Solution concentrations:

• iodine, calcium, potassium – 1-10%;
• copper, zinc – 0.1%;
• Novocaine – 1g dissolved in 100 ml of 0.5% soda solution.

If the permissible values ​​are exceeded, a burn may occur after electrophoresis.

Indications for electrophoresis in newborns

Physiotherapy can be prescribed to a baby for musculoskeletal pathologies, neurological disorders, diseases of the digestive tract, stomatitis, birth injuries, to speed up rehabilitation after surgery. This technique is safer for the child’s health than drug injections. Depending on the localization of the pathological process and the place of attachment of the electrode, a rash after electrophoresis in an infant may appear on the neck, lower back, chest, and in the joint area.

To prevent irritation after electrophoresis, contraindications must be taken into account:

• renal or heart failure;
• blood clotting disorder;
• a history of allergies of any kind;
• skin rashes;
• acute infectious process.

Red spots after electrophoresis in a baby are a reaction of the skin. If they appear some time after the procedure, you should consult a doctor. In this case, the method of drug administration must be changed to another.

The choice of medication is influenced by the child's diagnosis. Most often, doctors prescribe:

• aminophylline for joint dysplasia, muscle hypertonicity;
• calcium for fractures and frequent bleeding, gingivitis;
• magnesia for the treatment of respiratory tract pathologies, pain syndrome and jaundice;
• papaverine to eliminate spasms of various types;
• dibazole for neurological disorders;
• lidase in case of diseases of the organs of vision.

It is worth noting that the drug and its concentration are determined only by a doctor.

Pain after electrophoresis can occur with the interstitial method of administering the drug due to injections. During the procedure and after it, you need to monitor the child so that there are no unwanted reactions: rashes and irritations. You may also experience shortness of breath or a coughing fit. A side effect such as red spots sometimes occurs due to the child’s high mobility.

An allergic reaction to drugs can be immediate or appear over time. Its main symptoms are a rash in the form of blisters all over the body, hives, and increased heart rate. In this case, treatment is stopped.

Types of medicinal physiotherapy

Electrophoresis with caripain is prescribed for the treatment of herniated intervertebral discs and spinal curvatures. The effect of the procedure is analgesic and anti-edematous. After completing a course of physiotherapy, the strength and elasticity of the intervertebral disc increases. The physiotherapy procedure is well tolerated and does not cause unwanted reactions.

To avoid negative consequences, during the first session the dosage should be minimal.

Contraindications:

• oncological formations;
• violation of skin integrity;
• heart and kidney diseases.

Sometimes at the end of the procedure the patient may feel discomfort and pain; these phenomena are short-term and do not need to be treated. Electrophoresis should be performed at home with extreme caution. Prolonged pain after electrophoresis indicates intolerance to the drug.
Electrotherapy with dimexide is indicated for the following diseases:

• pain syndrome due to osteochondrosis;
• “pinched” nerves.

The procedure is used when traditional drug treatment is impossible due to peptic ulcer of the stomach and duodenum. To avoid irritation after electrophoresis and other side effects, it is not performed in a number of cases:

• if you are allergic to dimexide;
• in the third trimester of pregnancy;
• for somatic diseases in the stage of decompensation;
• in old age;
• in the presence of wounds on the surface of the skin.

A low concentration of the substance (5-10%) ensures the safety of the physiotherapy procedure. According to patients, it is painless and side effects are extremely rare.

Physiotherapeutic treatment can be used as a primary or secondary procedure, depending on the indications for use. If your doctor has prescribed a course of electrophoresis, do not miss sessions and follow the recommendations to speed up your recovery.

After an active summer holiday and intensive work in the garden beds, we remember our joints and spine. Or rather, they remind themselves of themselves. Autumn is traditionally considered a time of exacerbation of arthritis, arthrosis and osteochondrosis. When knees swell, feet hurt when walking, or lower back ache, citizens run to pharmacies. But it would be necessary - to What is the difference between a pill and physiotherapeutic treatment and what myths about physiotherapy are misconceptions, says a physiotherapist at the Panorama Med medical center.

- Alexandra Valerievna, what happens to bones and joints in the fall?

Old injuries and chronic diseases worsen after intense physical activity in the summer and as a result of autumn hypothermia. Moreover, not only large joints - the knees and hips - become inflamed, but also small ones - on the hands and feet. And of course, osteochondrosis shows itself and spinal hernias appear.

Many people prefer to take pills, considering physiotherapeutic treatment as a side effect and not serious. Where does this mistrust come from?

I think because the pill works much faster, I took it and after a while the pain went away. And the fact that it will appear again tomorrow does not bother a person at that moment. Just like the fact that all non-steroidal anti-inflammatory drugs and analgesics have severe side effects on the stomach and kidneys. For those who have gastritis and ulcers, these drugs are strictly contraindicated. Even when administered intramuscularly, they cause strong side effects, not to mention allergic reactions. Well, physical therapy, of course, takes time and patience. But this method of treatment practically does not produce side effects or allergic reactions, and its effectiveness is much higher.

- How does the effect of medication differ from the effect of physiotherapy?

Not a single tablet affects the cause of inflammation and pain, but eliminates the symptom. Entering the body through the mouth, the medicine spreads everywhere, and physical therapy is aimed at the specific inflamed organ. This targeted effect does not produce side effects. If we administer the same drug, then it is localized in a specific place and will not enter either the stomach or the kidneys. Moreover, its dosage is several times less than in a tablet. Therefore, neither ulcers nor gastritis are a contraindication to physiotherapy. Moreover, it is multi-component. For example, for osteochondrosis, we prescribe either SMT therapy or pulsed current, which, in addition to the analgesic effect, also has an antispastic and anti-inflammatory effect.

Perhaps the natural factors used in physical therapy do not really convince patients that such treatment can be highly effective?

There are many methods of physiotherapy, and they are all really based on natural factors - solar radiation, heat, magnetic and electric fields. However, you should not underestimate the power of nature. The volumes of physiotherapeutic effects are calculated with no less accuracy than the dosages of medications. Physical therapy can cause serious harm if used inappropriately or incorrectly. And at the same time, with its help you can achieve high results in treatment, much more effective and lasting.

But are patients right that one should not expect immediate results from physiotherapy? How long can this treatment last?

It cannot be cured by physical therapy in one session. The minimum course of treatment is five procedures, but we usually prescribe about ten. During each procedure, we influence the diseased organ with minimal doses, so the therapeutic effect accumulates and increases with each procedure.

- Is it possible to skip a few days and continue physiotherapeutic treatment again?

In no case. The break between procedures can be no more than three days, otherwise you will have to undergo the course of treatment again.

People are often frightened when, after several procedures, their condition worsens. Some even quit treatment, blaming the doctor or the physical therapy method itself, which allegedly did not help them. What's really happening?

This is a normal reaction of the body, because any physiotherapeutic procedure increases blood flow to the sore spot and a person experiences subjective sensations of increased pain. But over time, these sensations decrease and pass. In addition, the positive effects of physiotherapeutic techniques continue for one to three weeks after the end of the treatment course. Therefore, you should not lose faith in physiotherapy, much less trust the doctor.

How wide are the options for physical therapy? For example, if a joint is very swollen and hurts unbearably, should you still contact a physiotherapist, and not run for a pill?

Of course, because the method and amount of impact is selected individually. And even with advanced arthrosis, we can choose a technique that will help a person get back on his feet and forget about pain. When choosing a treatment method, the doctor focuses not only on the degree of inflammation of a particular organ or joint, but also on the general condition of the body and the presence or absence of concomitant diseases. We meticulously ask the patient whether he has had any injuries and whether he currently has a cold or fever. For some reason, many people hide these symptoms and consider them unimportant. But even a slight head injury can provoke displacement of the vertebrae in the cervical spine, and this, in turn, is a contraindication for certain types of physiotherapy.

- So, there are still contraindications?

Of course they do. But for different types of physiotherapy. In this case, it is possible to select such treatment or dosages that will be absolutely safe for the patient. After all, there are a lot of physiotherapeutic techniques. For example, we will never prescribe pulsed currents to a patient who has uterine fibroids. But in this case, you can use a local effect on the diseased organ (with the exception of the lower back) with direct current. The only absolute contraindication to physiotherapy is oncology. These procedures cannot be performed in case of bleeding disorders and febrile conditions with a body temperature above 37.5 degrees.

Can I immediately contact a physiotherapist or should I first visit a therapist, traumatologist or other specialist?

Usually, patients with a certain diagnosis are referred to me. After all, a person himself can guess and assume, but he is unlikely to assess his condition correctly. As a physiotherapist, I myself often refer my patients for consultations with other doctors to clarify the diagnosis. For example, a woman comes to me complaining of lower back pain. She is sure that she has osteochondrosis, and a neurologist confirmed this diagnosis. But I need to make sure she doesn't have uterine fibroids, which often happens with back pain. Therefore, I will suggest that she go to the gynecologist. After all, the choice of a safe treatment method depends on this. Or the patient has many birthmarks on his back that fall into the area of ​​physiotherapeutic treatment. I'll ask him to see a dermatologist to make sure it's not cancer.

Women often prescribe massages for themselves, considering this procedure completely harmless and purely health-improving, body-correcting. This is right?

It also has contraindications, so it can play a bad role if a person hides diseases, such as fibroids, from the doctor. I had a case when a girl came for a massage, believing that she had lumbar osteochondrosis. Our experienced masseuse became wary and called the doctor. It turned out that the patient had frequent urination and even had a fever the day before. They sent her to a urologist, who discovered kidney stones. If not for the vigilance of the masseuse, the massage could have provoked increased pain and even renal colic and, as a result, hospitalization.

- Is a herniated disc a contraindication for massage?

This is a common misconception. A hernia can be perfectly treated with massage, but in this case we use gentle techniques. Osteopathic and acupressure massage will be useful here, but deep massage is indeed contraindicated. When contacting a physiotherapist, it is very important to know your diagnosis accurately and not to hide concomitant diseases from the doctor. Then physiotherapeutic treatment will be of great benefit.