REPOST: Amputees help advance thought-controlled prosthetic technology

Losing a limb is a traumatic event for most people who go through it. Moving forward usually requires a lot of time and support. Fortunately, there are many paths towards recovery and rehabilitation and this includes prosthesis. The Baltimore Sun reports on an interesting new development in prosthetic technology: thought control.

  

Video: A doctor at Johns Hopkins is working on the development of thought-controlled robotic arms to aid amputees. (Kim Hairston/Baltimore Sun video) | Video source: The Baltimore Sun

One minute, Anne Mekalian's brain is telling her prosthetic arm to unstack a set of multicolored plastic cones, and the shiny black metal limb is listening. Every now and then, the plastic clatters to the table, but quickly the cones are separated and restored to a neat pile.

The next moment, though, the bionic hand doesn't know what to make of slight muscle movements in Mekalian's forearm, interpreted through a set of electrodes touching the skin on the rounded remnant limb that extends just below her elbow. Instead of pinching a red clothespin, the robotic hand spins like Linda Blair's head in "The Exorcist."

"This is why it's experimental, right?" Mekalian, of Joppatowne, joked to a group of scientists who had gathered in an office at Johns Hopkins Hospital to watch her as part of clinical trials of advanced prosthetics.

Despite occasional setbacks — and, perhaps, because of them — the technology is advancing quickly. Over the past several months, Mekalian and two other amputees working with a Johns Hopkins Hospital surgeon and local company have been among the first in the nation to take home thought-controlled robotic arms designed for wounded veterans.

While the devices haven't been perfect replacements for limbs lost, they have brought a glimpse of what patients took for granted before being struck by infection, cancer or violence. Trial and error applying the technology to their daily lives — putting on makeup, cooking, carrying a laundry basket — is leading to refinements. The scientists say the technology could be available within a couple of years to countless others commercially, with plans for U.S. Food and Drug Administration review next year.

Before that can happen, the scientists are learning all they can through the 67-year-old Mekalian and the others.

"We're almost inventing a new field of medicine," said Dr. Albert Chi, a Johns Hopkins trauma surgeon working with the patients. "We're kind of learning as we go. There's no textbooks out there."

Read the entire article here.

Dr. Mary Kneiser and physical medicine experts await this newest development in prosthetic technology eagerly as this may mean better things for amputees. For more on physical rehabilitation, follow this Facebook page.

REPOST: Spinal cord injury: Levels, symptoms & treatment

LiveScience.com's Tanya Lewis writes about the injuries that may affect the spinal cord and the treatments used to address them.

The spinal cord is a bundle of nerves that extends from the brain and runs down the middle of the back. It sends signals to and from the brain and the rest of the body. It is a soft tissue surrounded and protected by the vertebrae in the spine.

Shown here is the nervous system, containing the brain, spinal cord and peripheral nerves.
Image source: LiveScience.com

A spinal cord injury is caused by damage to any part of the spine, including to the vertebrae, ligaments or disks, or the spinal cord itself. Spinal cord injuries can cause permanent loss of function below the level of the injury, including paralysis.

The incidence of spinal cord injury among survivors is about 40 cases per million in the United States, or about 12,000 new cases per year, according to the National Spinal Cord Injury Statistical Center (NSCISC). Estimates of the number of people in the United States living with spinal cord injuries range from 238,000 to 332,000.


Causes

A sudden blow to the spine that fractures, dislocates, crushes or compresses the vertebrae can cause traumatic spinal cord injuries. A gunshot or knife wound can also cut the spinal cord. During the weeks following the injury, bleeding, swelling, inflammation and fluid buildup in or near the spinal cord often cause further damage.

Diseases such as arthritis, cancer, inflammation, infections or degeneration of spinal disks can cause nontraumatic spinal cord injuries.

NSCISC lists the following causes of spinal cord injury since 2010:

• Motor vehicle accidents (36.6 percent)
• Falls (28.5 percent)
• Violence (14.3 percent)
• Sports (9.2 percent)
• Other/Unknown (11.4 percent)

Spinal cord injury levels

Spinal cord injuries vary in their location and severity. The "level" of injury refers to the lowest part of the spinal cord with normal function. Higher-level injuries affect the arms, hands, trunk, legs and pelvic organs, whereas lower-level injuries affect only the legs, pelvic organs and trunk. These can result in paralysis of all four limbs (tetraplegia or quadriplegia) or paralysis of the lower limbs (paraplegia).

The severity of the injury is classified as either complete, in which nearly all movement and sensation below the level of the injury is lost, or incomplete, in which some residual movement and sensation remains.

Image source: LiveScience.com

Symptoms

Symptoms of spinal cord injury include:

• loss of movement
• loss of sensation (sense of touch, heat or cold)
• loss of bowel or bladder control
• exaggerated reflexes or spasms
• changes in sexual function or sensitivity
• pain or stinging due to nerve damage
• difficulty breathing, coughing, or clearing the throat

Emergency symptoms of an injury include:

• severe pain or pressure in the neck, head or back
• weakness, lack of coordination or paralysis of part of the body
• numbness, tingling or loss of feeling in the hands and feet
• loss of bladder or bowel control
• difficulty walking or balancing
• difficulty breathing after the injury
• a twisted neck or back

People with these symptoms should seek immediate medical attention.

Treatment

Treatment options are limited, but prosthetic technologies and therapeutic drugs that may help nerve cells regenerate or improve how well remaining nerves function are being developed.

Immediately after an accident, emergency responders immobilize the spine using a stiff neck collar and carrying board in order to transport the patient. Emergency treatment involves maintaining breathing ability, preventing shock, keeping the neck immobilized, and preventing complications such as blood clots.

Once a patient is diagnosed with a spinal cord injury, they may receive medications, such as Methylprednisolone (Medrol), which can cause mild improvement in some patients, if taken within eight hours of injury. Doctors may use traction (often by attaching metal braces and weights to the skull to prevent it moving) to stabilize the spine and/or realign it. Surgery may be needed to remove fragments of bone, herniated disks, fractured vertebrae or foreign objects, or to stabilize the spine to minimize pain or future deformity.

A variety of experimental treatments may also be available.

Rehabilitation

A team of therapists and specialists work with patients during their early stages of recovery. Physical therapists focus on having the patient maintain and strengthen existing muscle function, while occupational therapists, rehab psychologists and others help the patient learn basic tasks and new skills.

Modern technology can provide some independence to individuals living with spinal cord injury. Assistive equipment includes wheelchairs, computer adaptations, electronic aids, robotic gait training and electrical stimulation.

Researchers are currently developing neural prostheses, known as brain-computer interfaces. These systems use electrodes on the scalp or implanted in the brain, which record electrical signals from neurons and translate them into control of a computer or prosthetic limb. The technology is still in its early stages, however, and not available for general use.
  
Get more updates on physical medicine and related disciplines from this Mary Kneiser blog. 

REPOST: What Kids Should Know About Spinal Injuries in Sports

Laura Landro discusses efforts to raise awareness of a little-understood but dangerous risk to young athletes: injuries to the cervical spine which can lead to paralysis or even death. More from this Wall Street Journal article.

There is a new push to alert high school athletes about neck injuries.
(Image source: wsj.com)

It could be a hard tackle in football, a cross-check in ice hockey or a fall off the top of a cheerleading pyramid.

A new push is under way to raise awareness of a little-understood but dangerous risk to young athletes: injuries to the cervical spine, the highly vulnerable area between the first and seventh vertebrae that protects the spinal cord connecting the brain to the body. Players and teammates may not instantly recognize the severity of the damage, and the wrong move can damage or sever the spinal cord, resulting in paralysis or even death.

In addition to programs to educate coaches, parents and students, a number of groups are pressing for more certified athletic trainers who are qualified to quickly recognize and respond to spinal and other injuries.

Though less common than concussions, cervical-spine injuries most often occur when players in contact sports lower their head or tuck their chin into their chest and collide with another player, the ground or objects such as goal posts. While players often recover from injuries such as fractures of one or more vertebrae, commonly referred to as a broken neck, cervical spine injuries can also be quickly fatal.

De'Antre Turman, a 16-year-old Atlanta-area high school football player, died in August after being injured during a scrimmage, suffering a fracture to his third vertebra on the field, Fulton County Medical Examiner investigator Mark Guilbeau said in a telephone interview.

San Diego-based Athletes Saving Athletes co-founder Tommy Mallon, kneeling, conducts a demonstration with volunteer Danny Kolts during a 2012 seminar.
(Image source: wsj.com)

The Centers for Disease Control and Prevention estimate as many as 20,000 spinal-cord injuries occur annually in the U.S., with sports accounting for about 12%, and new cases most often occurring in 15-to-35-year-olds.

Robert Cantu, chief of neurosurgery at Emerson Hospital in Concord, Mass., and medical director of the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill, says new rules put in place in 1976 to discourage headfirst contact in football—known as "spearing"—aren't consistently followed.

The number of reported cervical-spine injuries that lead to permanent or temporary neurological damage, such as partial or complete paralysis, remains small but appears to be on the rise. The center's Annual Survey of Catastrophic Football Injuries in high school and college last year found that in four of the previous 10 years, the number of such injuries that led to some paralysis was in the double digits—14 in 2008, for example—after dropping into the single digits throughout the 1990s. Many severe spinal-cord injuries in sports also go unreported, Dr. Cantu says.

Coaches who were surveyed told the researchers that they teach players to tackle with the head up, but many players still lower their heads before making contact and many ball carriers are injured with their heads down.

"There is a sense of invulnerability in young athletes who think it's not going to happen to them," says Ron Courson, director of sports medicine at the University of Georgia. In addition to training players on proper blocking and tackling techniques, his team practices injury response scenarios on the field with trainers, physicians and emergency responders before football season begins.

At Penn-Trafford High School in Harrison City, Pa., there are three athletic trainers on staff for the 1,600 athletes in grades 9 to 12, says Larry Cooper, head athletic trainer. Parents can attend classes for coaches about injury risks and a sports emergency action plan is available on the school's website.

While college athletic programs nearly always have athletic trainers on staff, the National Athletic Trainers' Association says only two-thirds of U.S. secondary schools with athletic programs have access to full- or part-time athletic trainers, who are typically licensed by the state and work under the direction of physicians. That's up from 40% to 45% in 2005, but leaves a third of schools without one, the nonprofit association says. The group is conducting a state-by-state ranking of public schools and a similar study on private schools to determine why schools don't have trainers. (Expense is one factor.) The group also is analyzing the medical care available at games when an athletic trainer isn't present.

Athletes Saving Athletes graduate Tucker Boucher, left, with fellow San Diego-area student-athletes. ASA focuses on sports safety education and injury prevention.
(Image source: wsj.com)

"Parents who would never leave their kids off at a public swimming pool without a lifeguard think nothing about dropping them off at football or soccer without an athletic trainer. But they need to ask who is taking care of their kids when they are participating in these sports," says Jim Thornton, president of the athletic trainer association and director of sports medicine and athletic training at Clarion University in Clarion, Pa.

The association issued recommendations for management of cervical-spine injuries in athletes in 2009 which include special care in removing a helmet, face mask and shoulder pads and immobilization techniques on the field. Erik Swartz, an athletic trainer and associate professor at the University of New Hampshire who co-wrote the recommendations, says one of the highest risks in a spine injury is moving an athlete.

Tommy Mallon, now 22, collided with another player during a lacrosse game in 2009 at Santa Fe Christian high school in Solana Beach, Calif. A teammate ran to his side but fortunately didn't attempt to help him up until athletic trainer Riki Kirchhoff got to the scene. She kept Mr. Mallon on the ground until emergency medical responders arrived.

At the hospital, he was diagnosed with a fracture in his spine at the C1 vertebra and a damaged artery restricting blood flow to the brain. After months of grueling rehabilitation, including traction in a massive "halo" device to immobilize his head and neck and physical therapy, he was able to start classes at the University of San Diego in the spring of 2010. Though he won't be able to play contact sports again, he sustained no permanent neurological damage.

Mr. Mallon and his mother, Beth Mallon, a photographer who was at the game when his injury occurred, formed a nonprofit group, Advocates for Injured Athletes, to help other families navigate the challenges of injuries and lobby for certified athletic trainers at every high school.

Last year the Mallons also launched Athletes Saving Athletes, a program which offers classes taught by athletic trainers to help student-athletes understand signs and symptoms of different types of sports injuries and conditions. About 1,500 athletes in the San Diego area have participated and Ms. Mallon aims to expand the program. "We can educate athletes to recognize basic symptoms, and if they suspect a neck injury, don't move them. Don't touch them. Just stay with them until help arrives," she says.

Tucker Boucher, 16-year-old junior at Cathedral Catholic High School in San Diego, says after going through the program, he talked to his lacrosse team about risks and how to recognize symptoms of injury. His mother, Annie Boucher, who also attended a session, says the training "empowers these kids with knowledge of certain situations that can save somebody's life."

Dr. Mary Kneiser works with athletes as they regain their strength and form after suffering an injury. Learn more how physiatrists help injured athletes get back on their feet on this Facebook page.

REPOST: Children who live in "smart growth" neighborhoods get 46% more physical activity

A study by the American Journal of Preventive Medicine shows that children living in places close to parks and green space areas get 46% more physical activity compared to those who do not. News-Medical.net reports on the study's findings. 

Image Source: cdn.sheknows.com

Children who live in "smart growth" neighborhoods--developments that are designed to increase walkability and have more parks and green space areas--get 46 percent more moderate or vigorous physical activity than kids who live in conventional neighborhoods, finds a study in the American Journal of Preventive Medicine.

"We were surprised by the size of the effect," said Michael Jerrett, Ph.D., professor in the School of Public Health at the University of California, Berkeley and lead author on the study. He and his colleagues evaluated activity patterns in children aged 8 to 14 who recently moved to a smart growth community called The Preserve near Chino, CA. The researchers compared them with children living in eight nearby conventional communities, matched for ethnicity and family income.

The children wore small accelerometers and global positioning system (GPS) devices to measure their activity levels and determine how much activity occurred outside the home but within the neighborhood. The devices collected and recorded information about their physical activity for seven days and determined that living in a smart growth community would add 10 minutes of activity for each child each day.

"Ten minutes of extra activity a day may not sound like much, but it adds up," said Jerrett. Taking in as little as 15 calories more than you expend on a daily basis can lead to weight gain over time, he noted. A child who weighs 100 pounds might burn an extra 30 calories in those 10 extra minutes of physical activity each day. "The basic idea is that even small things count," he said.

Previous research has found that only 42 percent of children aged 6 to11 get the recommended amount of physical activity. This drops to 8 percent for those aged 12 to 19 years, Jerrett said. In fact, younger children in the smart growth community were 62 percent more active in their neighborhood than older children. Boys were 42 percent more active in the smart neighborhood than girls, Jerrett said.

The conclusions of the study are very consistent with current thinking and research, commented Kaid Benfield, director of sustainable communities at the Natural Resources Defense Council in Washington, D.C. Smart communities are being planned and created, but existing communities can be retrofitted to be smarter and encourage more exercise, he reported.

"The best way to retrofit suburbs is to redevelop parcels of land that become available as strip malls, big-box shopping, and regional malls go out of service - replacing them with more walkable, mixed-use development."

Mary Kneiser is a physical medicine and rehabilitation specialist who has been helping patients for more than two decades now. Know more about her professional career by visiting this Facebook page.

Boxing? Bring your boxing shoes first

Image Source: boxingscene.com

The unbelievable feats and global renown of Filipino boxing champion Manny Pacquiao are largely credited for restoring popular interest in boxing, after seasons of slumping ticket sales in the sport. Boxing is also moving out of the professional ring, for many fitness enthusiasts consider it effective for trimming down and becoming healthier.

However, in line with the easy recreational culture surrounding boxing these days, there seems to be little regard for the sport’s modicum : there are too few available boxing shoes in the market, and many boxing gyms today teem with “boxers” wearing inappropriate shoes. Certainly, tennis, cross training—even slacker sportswear Chuck Taylors—and basketball shoes aren’t suitable for the canvas. Especially not for a physically demanding and ankle-breaking sport like boxing.

Image Source: boxingsocialist.com

Wearing proper shoes in the boxing ring has benefits.

For safety purposes, boxing shoes are the perfect cushion for running on the slippery canvas. Also, boxing is a sport that demands a lot of rhythmic footwork. Wearing shoes that are designed for frequent pivoting of the ankles protects the boxer from foot injuries.

Apart from feet protection, comfort is the main idea behind the ergonomics of boxing shoes. These are manufactured with lightweight and non-slip rubber that articulates perfectly with the canvas.

Image Source: ultfitev.com

Lastly, aesthetics: Oscar dela Hoya in basketball shoes would be laughed out of the ring, and recreational boxers may well look the part. The elongated, slick, and classy design of boxing shoes is beyond ergonomics. Manny Pacquiao’s image is burnished by the distinctive aura lent by his boxing shoes.


As a physiatrist, Dr. Mary Kneiser believes in the importance of wearing proper sports attire to avoid physical injuries. Follow this Twitter page for more information on physical medicine and rehabilitation.

Bionic hands, prosthetic legs, and rehabilitation therapy

Life is hard for people who have undergone hand and leg amputations. Without hands to “keep things in order” and feet to “go about doing business,” daily routines will never be as normal as how they used to be. Fortunately, prostheses exist to provide amputees their newfound function and independence.

Video Source: cnn.com

One of the latest developments in prostheses is the i-limb ultra prosthetic hands. More commonly known as bionic hands, the technology uses unique biosim software that enables movement akin to natural hands, including the ability of each finger to bend at the natural joints to precisely fit around the shape of objects. Among the hand amputees who use this technology is Aimee Copeland, a woman who was infected with flesh-eating bacteria. Her hands had to be cut in order to stop the spread of infection, but she can now groom her hair, chop vegetables, and pick up tiny items with the help of her artificial hands.

Image Source: touchbionics.com

Paralympic athlete Oscar Pistorious is one of the famous people who don prosthetic legs. The sprint runner, whose legs were amputated when he was 11 months old, competes in sprint running events for amputees and able-bodied athletes using his lightning-fast prosthetic legs. He is known as the “Blade Runner” who runs on carbon-fibre prosthetics called the “Flex-Foot Cheetah.”

Image Source: ubergizmo.com

Bionic hands and prosthetic legs are just two of the many prostheses that help amputees grasp, stabilize, and maneuver objects just like normal people. In physical and rehabilitation medicine, prostheses function as support to help patients recover from medical treatments and improve their quality of life. The Amputee Coalition of America emphasizes the role of physiatry in improving the physical and emotional well-being of amputees. Physiatrists, like Dr. Mary Kneiser, can also prescribe the right prosthesis and rehabilitation services for amputees.


Visit this Facebook page to learn how a physiatrist can help patients recover from amputations.

Young and at risk: The rising incidence of stroke among adolescents

It seems that no one is really too young to have a stroke.

Image Source: theweek.com

A recent study published in the journal Neurology found that the proportion of young people who are having stroke increased from one in eight stroke patients in the mid-‘90s to one in five in just over a decade. This supports a previous report that found trends toward increasing stroke incidence in younger adults (age 20 to 54). The Centers for Disease Control and Prevention also noted a steep increase in stroke incidence among people in their 30s and 40s.

Many factors have been recognized that raise the incidence of stroke among young adults. These include the usual cardiac risk factors: obesity, high blood pressure, high cholesterol, and smoking. Abuse of alcohol and drugs are also contributing factors. People prone to migraines also have a somewhat higher risk of stroke. Recently, a study noted how being depressed nearly doubled the risk for stroke among young women.

Image Source: nytimes.com

 Stroke is a leading cause of death in the United States with more than 800,000 people dying annually from strokes and cardiovascular disease. Medical experts advocate healthy living to cut down stroke risk among young adults. Moreover, recognizing the signs of stroke is vital to recovery. The National Stroke Association’s Five Sudden, Severe Symptoms campaign provides stroke signs people should watch out for, including a sudden numbness or weakness of face, arm, or leg, especially on one side of the body.

Video Source: nbcnews.com

Physiatrist Dr. Mary Kneiser works with patients’ post-stroke rehabilitation. More information on stroke rehabilitation is available at this website.

The tennis elbow, outside the pro circuit

Like a notorious misnomer, the tennis elbow afflicts a good number of patients who never picked up tennis racquets. It could very well be an archer’s, shooter’s, or golfer’s elbow. Outside the ownership of sports, it goes by the official medical term lateral epicondylitis, which, by etymology, indicates an inflammation or soreness on the outer part of the elbow.

Image source: counselheal.com

The condition reduces the cause to overuse, and its association with tennis stems from the number of affected tennis players and the logical elbow strains common in the dominant arms of those practicing racquet sports. Also prone to the condition are gym rats who lift weights in excess, or gardeners and other crafty hobbyists prone to repetitious arm movements. All are in agreement that pain is debilitating enough to discourage future elbow exertions.

Image source: webmd.com

Pain from the tennis elbow also affects one’s grip. The resulting paralysis can be treated with painkillers or movement inhibitions to allow frayed and inflamed elbow tendons to heal. Several methods are recommended for long-term healing. These involve topical ointments, braces, and a deep-tissue massage. Surgery is also an option for those so-disposed, and it involves repairing torn tendons or reattaching them with just enough tension.

Image source: g4physio.co.uk

The tennis elbow lays off people from their normal activities. Surgery is an easy way out of it, but it may require consistent physical therapy. Experts like Dr. Mary Kneiser advise patients to seek rehabilitation programs suited to their occupational needs. Follow this Twitter page for more information on physical medicine and rehabilitation.

A list of lisps and the unpronounceable ‘s’

In the Spanish language, lisp is a special way to pronounce and utter particular words properly or to convey a certain word’s meaning efficiently. However, in other languages, speaking with a lisp is undoubtedly unacceptable.

Image Source: leitrimadultguidance.com

Having a lisp, as speech experts, like Veronica Noah, and rehabilitation doctors, like Mary Kneiser, would believe, is not a hindrance for one to live his life normally. It is not an impairment exclusive only to ordinary people. British crooner Morrissey did not let his incapacity to pronounce words with ‘s’ hold him back to achieving a supernova rock star status, and American author Truman Capote’s speech disability did not become a detrimental factor for him not to be blatant during his book signings.

Image Source: warm-glass.co.uk

A lisp is not a disease, but anyone who has a lisp can go to a speech therapist or rehabilitation expert to improve the way he speaks. However, in order to fix one’s speech, a person must first be aware of the specific type of lisp that he has.

The four kinds of lisp


The interdental/frontal lisp, in which the tongue juts on the back of the front teeth, is the most common lisp of all. It creates a hissing /th/ sound whenever the speaker utters a word with ‘s’ or ‘z’ in it.  

Dentalised lisp happens when the speaker’s tongue touches the front teeth every time he talks. Intoxicated people may also produce this kind of lisp.

In palatal lisp, the speaker’s tongue comes into contact with the soft palate (roof of the mouth) as he pronounces words with ‘s,’ ‘z,’ and, sometimes, those with ‘r’ and ‘l’ in it.

Lateral lisp, or most commonly known as the wet lisp, is a kind of lisp in which a wet, sludgy sound comes as the /s/ and /z/ sounds are pronounced.

Image Source: beaut.ie

 This Twitter page has more links to articles related to physical medicine and rehabilitation.

Pelvic pain: Diagnosis and treatment

Pain in the pelvis is a symptom that may indicate an underlying abnormal psychoneuromuscular function. Pelvic pain can be acute or chronic. Acute pelvic pain is often experienced after surgery or other soft tissue trauma. If the pain lasts longer than three to six months, it is categorized as chronic pelvic pain. Although pelvic pain is experienced by both men and women, it is more prevalent among women and is usually associated with dysmenorrhea.

Image source: bodyconfidential.co.uk

Diagnosis
Pelvic pain can be caused by different conditions, including visceral pain and pelvic girdle pain.
In women, pelvic pain may result from various gynecological conditions such as dysmenorrhea, endometriosis, ectopic pregnancy, ovarian cysts, ovarian torsion, Mullerian abnormalities, and pelvic inflammatory disease. The pelvic pain may also be caused by abdominal problems like appendicitis, colitis, proctitis, and long pain hematuria syndrome.

Chronic pelvic pain in men is called chronic prostatitis. Men with this problem do not have known infections unlike women.

Image source: alive.com

Treatments
The International Pelvic Pain Society states that chronic pelvic pain is one of the most difficult clinical problems to treat because many patients do not respond to conventional medical or surgical treatment. Doctors who treat patients of chronic pelvic pain must have adequate knowledge about the disorder and must have special skills in physical examination and history-taking in order to uncover all sources of the patient's pain.

Physiatrists like Jung Ahn, Mary Kneiser, and Kathleen Francis are examples of doctors who are trained in treating pelvic pain.

After examining the patient’s medical history, physiatrists conduct diagnostics tests. Men with chronic pelvic pain are usually treated with multimodal therapy, with the goal of relaxing the pelvic nerves. Women may be required to take a pregnancy test, too, before undergoing on a trial of anti-inflammatory medications, hormonal therapy, or neurological agents. In some cases, the chronic pelvic pain can only be treated by the surgical removal of the uterus.

Image source: healthtap.com

When planning a consultation with a physiotherapist for chronic pelvic pain, make sure the doctor is licensed and has sufficient training in physical therapy and rehabilitation. Mary Kneiser, for instance, is a physiatrist certified by the American Board of Physical Medicine and Rehabilitation. Learn more about her practice at www.abilityassessments.com.

Good Posture Helps Reduce Back Pain

By John Schubbe, DC
Full article accessible at spine-health.com

Correct posture is a simple but very important way to keep the many intricate structures in the back and spine healthy. It is much more than cosmetic—good posture and back support are critical to reducing the incidence and levels of back pain and neck pain. Back support is especially important for patients who spend many hours sitting in an office chair or standing throughout the day.

Problems Caused by Poor Back Support and Posture

Not maintaining good posture and adequate back support can add strain to muscles and put stress on the spine. Over time, the stress of poor posture can change the anatomical characteristics of the spine, leading to the possibility of constricted blood vessels and nerves, as well as problems with muscles, discs and joints. All of these can be major contributors to back and neck pain, as well as headaches, fatigue, and possibly even concerns with major organs and breathing.

Identifying Good Posture

Basically, having correct posture means keeping each part of the body in alignment with the neighboring parts. Proper posture keeps all parts balanced and supported. With appropriate posture (when standing) it should be possible to draw a straight line from the earlobe, through the shoulder, hip, knee, and into the middle of the ankle.

Because people find themselves in several positions throughout the day (sitting, standing, bending, stooping, and lying down) it's important to learn how to attain and keep correct posture in each position for good back support, which will result in less back pain. When moving from one position to another, the ideal situation is that one’s posture is adjusted smoothly and fluidly. After initial correction of bad posture habits, these movements tend to become automatic and require very little effort to maintain.

Ergonomic Office Chairs for Back Support

Office work often results in poor posture and strain to the lower back. Many people work sitting in an office chair that is not properly fitted to their body and does not provide enough lower back support. One strategy is to choose an ergonomic office chair that often provides better support than a regular chair and may be more comfortable for the patient.