Painful Food or Food for your pain

How many times have your patients asked you what food to eat and/or avoid to make their pain better?

Is your response a headshake or a shoulder shrug, or just a "I don't think so."?

So are there foods that make pain better or worse?

There are certain foods that have purported analgesic or anti-inflammatory properties, while there are some anecdotal evidence from big surveys.

The objective of this entry is to introduce you to the list of foods that makes pain worse or better.

 Pro-inflammatory foods 

• Sugars
• Fatty Food diet
• Caffeine (>4 cups a day)
• Omega-6 oils
• Eggplants, potatoes, tomatoes

There are some specific conditions in which.... 

Preclinical and clinical research has begun to show how diet influences pain processes

Similarly diet can play a modulatory role in pain mechanisms, resulting in attenuation of pain

Foods that relieve pain

Preclinical and clinical research has begun to show how diet influences pain processes

Similarly diet can play a modulatory role in pain mechanisms, resulting in attenuation of pain

I will now cover the type of foods that will relieve pain.

Last Post

My patient is a 19 yr old WAFL football player with a 3yr Hx of bilateral groin pain L > R, he only played 12 games last yr. Treatment to date has consisted of massage, dry needling of adductor longus, NSAIDS and cortisone injections; all of which have had little change on his functional status. When i started treating player X at the beginning on pre-season i assessed his lumbopelvic stability and found he had poor control in single limb stance and he had an active lumbar extension pattern with poor TA recruitment. Therefore treatment consisted of glute med/TA retraining in NWB positions which progressed over 2/12 to functional football related postures. I slowly introduced running into his program then progressed distances and speed as well as direction changes etc. When pre-season games started i began him with 10 min a quarter and slowly increased his game time, on monday training he goes to the pool for recovery. Happily he is now playing painfree and dominating in the midfield.

The Manipulator

The Road to the End!

Hi everyone,
So as the final core prac comes to an end I have had the opportunity to experience running the whole ward!!
Our supervisor is keen for us to manage a large case load to ensure we get an understanding of what it would be like to be in charge of a whole ward should be get a hospital job upon completing our degrees!!!
So it’s fair to say that fitting in 12 cardiothoracic patients a day has been a challenge especially when some of them need to be seen twice!! It has been a good learning experience however, but means you are on the run from the beginning of the day. And have to accommodate patients having showers, going to xray and just general hospital craziness. It means that you have to learn to manage your time optimally and be flexible to change your plans quickly.
I do sometimes feel like we are being taken advantage of, especially when you see the supervisor sitting down doing emails etc, but I suppose that is what happens when you’re a student! At least it will teach me how I would like to treat any students I may have on pracs!

It has been great to see over the duration of these pracs the progressions of lots of patients-allmost all getting better or seeing improvements that the next person can take over from. It does make you keen to get out there and make a difference!
All the best.

Patella instability.

Hi all, sorry for the lateness of this post.

I would like to discuss one patient that I was seeing on my musculo placement. She presented with a recurrent history of bilateral patella dislocation, with the last incident occurring 3 years previous. The first patella dislocation she experienced was when she was 12 years old. The patient was a self employed cleaner, and consequently performed repetitive bending with her job. She also participated in martial arts, and was keen to continue with this, although was concerned about her knees.

On examination both patellae had an obvious medial tilt in the resting standing posture, and the patella lateral glide apprehension test was positive (and marked). The patient was extremely tight in the lateral structures, especially the ITB, with glut med weakness. VMO activation was extremely poor bilaterally. Crepitus was noted on patella compression. Bilateral proprioception was also decreased, and the patient complained of instability with single leg squat combined with internal rotation.

Perceived single leg squat stability improved with external medial glide applied to the patella. Initial treatment consisted of STM and heat applied to the lateral structures in an attempt to loosen these, VMO retraining +++, HEP for ITB stretching, and taping for medial glide and tilt initially to the right (worse) knee. At the next session the patient stated that the knee felt much improved.

Subsequent treatments continued with glut med and VMO retraining, and bilateral knee taping. The patient felt much more assured of her knee stability, and was more confident with her work as a result. The lateral structures also felt considerably looser.

As this was such a chronic condition I felt the short term improvements were worthwhile, and encouraging. Any other suggestions?

Dale.

hello all soon to be physios.

I must apologise for my late entry but to be truthful with PCR looming I totally forgot to make an entry. So here I am writing my entry 2 hrs before I sit my PCR so that should get me back in the good books???Well my last week in neuro was great. I got to consolidate the skills that I had picked up on the way. However the last week was a test of my patience. I had a new pt on the ward who had suffered a brainstem stroke and apart from the usual impairments that go with the pathology he had significant short term memory loss. It was like banging my head off a brick wall. I tried all approaches to try and get carryover between sessions but it was impossible. In fact for example when teaching STS between the first and 5th repetition the pt had forgotten my cues entirely. I felt as if I was stuck on replay. The sad thing was, he was trying really hard in therapy and was making progress (with continuous prompting by yours truly) but when left for second to do his own thing all previous information was gone. So I thought of the usual strategies to try and make tasks move from being cognitive to automatic ex. written cues in his room that he and nursing staff would have to adhere to when he was STS. But unfortunately the ward was extremely busy and nursing staff short so I doubt very little that much time would be given to my little project. I was stuck, and still am. I know I won't be seeing this pt again but I know this will happen again, then what???Any ideas welcomed...
ps best of luck with the PCR today
see you all tonight,yay...

The 4^th week of inpt neuro placement was spent on preparing for final assessment, progressing patient’s treatments, writing handover summary. Nothing significant, hence I thought: maybe I will list a summary of learning points from this placement:

a)Evidence-based practice in neuro

- not that I went to read up on all the current research. Reading up on the clinical practice guidelines for Stroke rehabilitation (sept 2005) gave me an overview of some of the current research points and level of evidence for some of the stroke rehab techniques. For instance, I was curious about the use of FES for stroke patients with subluxed shd as I had 2 stroke patients (acute, subacute) with 1 – 3 fingers shd subluxation. Research revealed that there is some short term improvement, however, nothing is conclusive or very little research is done about the long term effects/ improvement for subluxed shd. Hence, ?usefulness of FES?

- The clinical supervisors also shared that UL WB ex has been shown in research to help address UL ataxia problems.

- N finally from what I can recall about what Anne said before about ax, rx and re-ax.

b) Communication

I realized from all 3 placements, communication skills is an essential component of physio – if we can’t communicate properly or phrase the questions properly, we won’t be able to get a good subj ax fr patients for musculo for instance, and this is essential in directing our obj ax; We won’t be able to give an effective patient education with regards to explaining condition, or teaching exercises; Patients may not be compliant to our treatment plans, coz they are clueless about what they’ve to do or what’s going on or how our Rx can help them.

Communication skills were also important in terms of verbal/ written handover to fellow colleagues, and other allied health stuff, because very often in inpatient settings, the patients require multi-disciplinary team approach.

c) Teamwork

I learnt from my neuro placement it is not just about teamwork with other allied health professionals, but also teamwork within the physios. Throughout the whole placement, we’ve to “share” patient cases; or require assistance of another physio to treat a patient requiring 2person (A). We’ve to come together to plan the treatment for a specific patient, and to cooperate on who leads the treatment session. Sometimes we may even have differences regarding our thoughts about the patient, or even scoring the different outcome measures. Nonetheless, this has helped me learn from my peers and receive feedback on how I can improve my handling or clinical reason better.

I guess this sort of end my blog (for now) for this clinical education unit. It was good fun meeting new pals and going through placement together, learning about one another, and for me, experiencing a new culture.

All the best for tomorrow’s PCR!!

Common sense...or lack there of it

Hello everyone hope everything is going well for the PCR!! So I thought for my last entire I would talk about a patient of mine who has been testing my patience!! This man presented to the musculo outpatient clinic with a history of chronic pain and fibromylagia. This was not his first time to the clinic; he has attended at least 6 different times with various complaints. His complaint this time was of neck and shoulder pian/stiffness. My assessment did not reveal anything of concern, ie: ROM was full, Cx mobility was normal… he only had some tightness of his UT and LS. When I questioned him why he thought he had this problem he stated it was because he has his computer set up so that the screen is to the right of him, so he has to constantly look to the right while typing. So my obvious suggestion was put your screen so that it is face on, that way you don’t have to keep your head turned. He thought that was a brilliant idea and would try it and see if that helped.
He returned two weeks later and said he had adjusted his screen and that seemed to help, but he was still getting some neck pain and pain between his shoulders. Again, with further questioning I discovered that he was using a sun lounger as his computer chair. That’s right….a sun lounger!! I thought to myself….are you kidding me, do people not have any common sense…..surely you would have thought to yourself this can’t be good for my posture or neck. But he obvious did not so again I educated him on the importance of having a proper supportive chair and how the one he was using was not ideal!! So I have come to realise, what seems so obvious to us as physios is not obvious to the rest of the population and that is why education is so important.