2. LOW BACK PAIN LBP which affects nearly every one of us at some stage of our life, is described in many ways such as slipped disc, back sprain, arthritis or spondylosis, rheumatism; or when it causes pain extending into the leg, sciatica. Chronic LBP is pain that persists for longer than ??? 6 weeks and recurrent LBP is episodic pain that became pain free for a period of time but the similar symptoms return again and cause low back disorder to the sufferer. In the area of the low back the spine consists of five bones or the vertebrae. Each vertebra has a special cartilage called the discs as well as many holes and openings called the spinal canal. The discs separate the vertebrae and located just in front of the spinal cord. The spinal canals serve as a protected passageway for the spinal cord and the bundle of nerves which extends from head to pelvis. The vertebrae and discs are linked by a series of joints to form the lumbar spine. Each joint is held together by soft tissues such as capsule, ligaments and muscles. The lumbar spine bears the compressive weight of the body above it and provides a flexible connection between the upper and lower half of the body. It has a natural curve which is an inward curve or hollow in the low back and medically it is known as lumbar lordosis. In the lordotic posture, the lumbar spine is most efficient and mechanically advantage during activities. If the lordosis is lost often and for long enough periods, the low back problems may develop. Statistics show that back problems arise more often in the low back than in any other part of the spine. Most low back pain is caused by prolonged overstretching of ligaments and other surrounding soft tissues.

3. A frozen shoulder can be a terrifying and painful condition for a patient. They are literally unable to move the shoulder at all due to inflammation caused by an injury or condition. When this happens, immediate treatment is necessary to help restore the range of motion to the joint. This condition is actually pretty rare and only affects about 2% of the population and mostly people between the ages of 40 and 60. The good news is there are many physiotherapy solutions to a frozen shoulder and relief can be obtained quickly once treatment begins. With treatment, pain will decrease and the ability to move the joint will slowly return. What causes a frozen shoulder? There are many factors in the case of a frozen shoulder and no one thing causes this to happen. The main factor is inflammation that disables the joint completely. Things that can cause inflammation in this area are: Arthritis Disorders of the cervical spine (Neck) Diabetes Acute injury to the shoulder Shoulder surgery Heart surgery Thyroid conditions A frozen shoulder can also be caused by non-use of the shoulder joint for long periods of time. People who have had surgery or are bed-ridden are at higher risk for this condition.

4. Common treatments for a frozen shoulder Physiotherapy for a frozen shoulder is focused on reducing inflammation and restoring motion to the joint. The treatments aim at preventing further inflammation during treatment. The patient usually sees their physician first and the doctor prescribes and anti-inflammatory medication and refers the patient to physiotherapy. The underlying conditions that are contributing to or causing the condition must be addressed and treated by the physician as well. Then a referral will be made to a physiotherapist to begin a treatment program. Some of the different physiotherapy solutions to a frozen shoulder are: Hot compresses - Used to loosen the muscles around the joint prior to treatment. Cold packs - Used to help relieve swelling and inflammation. The patient may be instructed to use these at home before and after treatment. Passive stretching with external rotation of the joint – The patient will hold onto a stationary object and rotate the body in towards the object and away from the object. Forward flexion while in the supine position – Using the good arm to lift the affected arm while lying on the back and holding the arm in the overhead position for 15 seconds prior to releasing. Arm crossover – Pulling the affected arm across the body and holding for 10 to 15 seconds. The physiotherapist will prescribe stretching exercises for the home setting only after the inflammation has decreased. The treatment plan must be carefully balanced, allowing the patient to rest the shoulder in between therapy sessions to prevent further inflammation. In order for full release to occur with a frozen shoulder it is important for the patient to take all medications as prescribed by the doctor, keep all appointments with the physiotherapist and follow instructions for home very carefully. Doing too much too fast with this condition could mean major set-backs in treatment.

5. 1 Raffles Place, One Raffles Place (Former OUB Centre) #23-04, Singapore 048616 Ph: +65 64388725, +65 97821601 http://singapore-physiotherapy.com/