PHYSICAL THERAPY AND PHYSICAL MODALITIES IN MANAGEMENT OF CHRONIC MUSCULOSKELETAL PAIN

Abstract

Growing concern over the side effects to pharmacological and surgical treatments for chronic pain has spurred an interest in nonmedical interventions for such conditions. Examples of these interventions include: ultrasound and thermal agents, acupuncture, laser, TENS and manipulative exercises. Ultrasound and thermal agents has a great biological effects including enhanced blood flow, increased membrane permeability and alter connective tissue extensibility and nerve conduction. Ultrasound and thermal agents are accepted treatment procedures in shoulder disabilities and muscle spasm, relieving contracture and joint stiffness. Acupuncture originally used in traditional Chinese medicine for at least two thousand years but introduced to western medicine in the l71 h century. The (Qi) energy flows in the body through special channels and meridians, which join all acupoints with the internal organs. When the flow of energy is interrupted by an illness, the disease is perceived via symptoms created by imbalance of energy. Physiological effects of acupuncture are (I) analgesic, (2) regulatory, (3) immunity and (4) psychological effects. A brief account was given on acupoints, meridians, needles, insertion instructions, point selection, advantages and complications. Low-power laser irradiation causes biochemical alteration in cells attributed to non-thermal mechanisms. It is used in rheumatoid arthritis, osteoarthritis, myalgia, myofascial pain, orofacial pain, peripheral neuropathy, tennis elbow, low back pain and in dentistry but without conclusive relevant effects which vary from application to another and from study to another within a given disease.