How To Use A Heating Pad Safely

The colder weather is upon us and many people have an increase in chronic joint or muscle pain. Are you using heat or rubs to treat your pain? If you find relief with these items it is important that you know how to use them safely.

A hot pack can provide pain relief to the chronic aching joints that accompany arthritis. Here are some tips on safe use of a heating pad.

• Do not sleep with a heating pad or you may get a burn.
• Only use a heating pad for 15-30 minutes per hour.
• Be extra careful if you are using a heating pad on an area of your body where you don’t have as much feeling and avoid heating numb areas. If you can’t feel the heat as strongly, you might not realize if
you burn yourself.
• Placing towels between the heating pad and your skin can help reduce the risk of burns.
• If you are using topical rubs and ointments like BenGay, only use after applying a heating pad.
• If you have an acute injury (one which is less than 3 days old), you should use ice instead of heat. Heat is appropriate for chronic injuries or pain more than 3 days old.

If you find that your chronic pain is limiting your normal functional activities, or if your acute injury doesn’t begin to get better with ice and rest, visit your local Physician or Physical Therapist.

Sleeping Positions

Positions you should avoid:

1. Lying on your stomach– This position makes you maintain a position of head rotation. This causes your neck muscles to shorten and can result in pain and stiffness in the morning. Also, sleeping flat on your stomach extends your low back which causes shortening and tightening of the low back muscles.

2. Lying on your side with your arm above your head– This position can create shoulder pain. You can compress the nerves in your shoulder causing your arm to go numb. Also, you are impinging the shoulder joint. This can cause stiffness and soreness at the shoulder joint.

Ideal sleeping positions:

1. Lying on your side with your arms in front of your body and a pillow between your knees– This causes decrease strain on your shoulder and allows your back muscles to remain relaxed. The amount of pillows under your head should be determined by your neck position. Your neck position should be in a slightly flexed position compared to the rest of your body.

2. Lying on your back– In this position, you should make sure you are using the correct amount of pillows as noted above. Also, place pillows under your knees to create a position of decrease strain on your lower back.

Please note if you have current or previous injuries, the position you favor will depend upon making the area of injury as comfortable as possible. If you continue to have difficulty getting comfortable in bed, make an appointment to your local physical therapist. The therapist will determine which position will better suit you based upon your past and current medical history.

“No Pain, No Gain” Theory

When working out, it is normal to feel fatigue and muscle burn with strength/endurance training. But you should be aware of the difference between muscle fatigue versus pain. If you experience pain while working out, you should stop the activity you are doing. Pain can develop from inflammation, bad form with exercise, and overuse of a specific muscle. Pushing yourself too far could lead to an injury that can prevent you from doing the sports or exercises you enjoy. Use ice to decrease the pain developed from the exercise. If your symptoms do not lessen with ice and rest, visit your local physician or physical therapist.

Frozen Shoulder

What is Frozen Shoulder?

Frozen shoulder has an idiopathic gradual onset resulting in pain, stiffness, and decreased range of motion. Due to pain, the person tends to use the shoulder less.  Frozen shoulder causes the shoulder joint to become inflamed resulting in thickening, scarring, and shrinkage of the joint capsule that surrounds the shoulder joint. Scar tissue and adhesions form around the shoulder joint resulting in chronic stiffness.

 Some reasons people may get a frozen shoulder are from having poor posture, prolonged immobility from a previous injury, diabetes, or disuse from pain. Research shows, frozen shoulder is often the first sign of undiagnosed diabetes.  This is more commonly found in women over 50 years old. 

 Diligent physical therapy is the key to recovering from a frozen shoulder. Rehabilitation from a frozen shoulder can take weeks to months, depending on the severity. Your therapist may apply heat and ultrasound to warm up the joint and instruct you in stretching/strengthening exercises to restore the range of motion and strength of your shoulder. Ice is often applied after exercises to reduce inflammation.

What is Electrical Stimulation?

Electrical stimulation is a treatment modality used by physical therapists to help relieve pain.  Electrical stimulation uses a low voltage electrical current to stimulate nerves and sends signals to the brain that block or interrupt normal pain signals. It can be used for muscle pain, joint pain, tendonitis and bursitis.

Another use for electrical stimulation is to strengthen muscles. This type of stimulation is called NMES (Neuromuscular Electrical Stimulation). When there is muscle weakness (atrophy), electrical stimulation is used to elicit a contraction of the muscle. The electrical impulses work to retrain muscles to function normally. This is most commonly used after ACL surgery and a stroke.

Electrical Stimulation

Guidelines to Prevent Injury While Shoveling Snow

It’s that time of year again when you may have to deal with the snow.  Many people injure themselves when shoveling snow.  Therefore,  here are some tips you can use to avoid a shoveling injury this year.

Guidelines to Prevent Injury While Shoveling Snow

  1. Prior to shoveling, you should warm your body up.  This can be done by taking a 5 minute walk and moving your arms in a circular motion.  This causes increase blood flow to the areas of your body you will be using to shovel snow to prevent injury.
  2. Use an ergonomic snow shovel. One with a curved handle to keep your back straight while shoveling.
  3. Push the snow if possible. Pushing the snow away is better than lifting the snow. It you have to lift it, make sure to squat with feet shoulder width apart, and bend your knees and tighten your abdominals. Don’t bend over at the waist rounding your back. You want your legs to do the work, not your back.
  4. Scoop small amounts of snow at a time.
  5. Use a shovel with a plastic blade rather than metal because it is lighter.
  6. Keep the shovel close to your body and dump the snow in front of you or pivot your feet to turn and dump the snow to the side (never twist your body).  The worst position you can be in while shoveling snow is bent over at the waist, scooping and then twisting to throw the snow.  That position puts a great deal of pressure on the discs in your spine.
  7. Use boots with good traction and once you have cleared an area, put sand or salt down to help with your traction, while continuing to shovel.
  8. Also, make sure you take breaks. Drink lots of water and avoid caffeine or smoking before you shovel.  Caffeine can cause an increase in your heart rate and constrict your blood vessels. If you experience any chest pain, make sure you call for help.

Shoveling with Good Biomechanics

Why Do My Joints Ache When the Weather Gets Cold?

Many patients come to physical therapy asking ‘why’ – why they have increased pain when it rains, snows, or just when the weather gets cold.  This question has been researched minimally and considering the amount of patients that report these findings, one would think there would be more research on this topic.

The main theories are as follows:

1. Change in Barometric Pressure – This theory is based on a study of a balloon in a Barometric Chamber.  The Barometric pressure is decreased and the balloon increases in size.  Therefore, the drop in pressure can similarly cause tissues around the joints to swell.  Because a drop in barometric pressure precedes a storm, patients can ‘predict’ when a stormfront is approaching.  Typically, patients with arthritis or a previous joint injury are the patients that report these weather-related findings.

2. Psychological – Another theory mentions that people tend to feel pain in their joints during bad weather, rather than preceding bad weather.  The theory claims that people are less likely to feel the pain on warm, sunny days.  This concept could be due to the increased release of endorphins, with increased sun light and people mentally feel better when it is nicer outside.

3. Humidity – This is my personal theory.  I believe patient’s joints have increased lubrication when there is more humidity in the air.  Just like a hinge requiring lubrication to move in a fluid motion, our joints require constant lubrication to move without restriction and pain.  Therefore, when the humidity decreases, there is a decrease in lubrication of our joints, which in turn causes pain.  This is why most people with arthritis like to move down south to enjoy year-round warmer weather.

In summary, there is no definitive reason why people report increased pain at their joints when the weather changes.  It is suprising how little research is done on this topic.  I believe there is validity for people feeling the change in weather in their joints; however, there does not seem to be a clear reason why it is experienced.  Thoughts?