Anatomy of the Nervous system

Anatomy of the Nervous system

A nervous system can be defined as an organized group of cells called neurons which is
specialized for the conduction of an impulse – an excited state from a sensory receptor through
a nerve network to an effector, the site at which the response occur.
Functions of the nervous system
1) Sensory function – gathers information from both inside and outside of the body.
2) Transmit information to the processing areas of the brain and spine .
3) Process the information in the brain and the spine – integration function
4) Motor function – sends information to the muscles, glands, and organs so they can respond
The Nervous system is divided in to two divisions
1) Central nervous system
2) peripheral nervous system .
Peripheral nervous system is divided in to #somatic nervous system and autonomic nervous system.

A nervous system can be defined as an organized group of cells called neurons which is
specialized for the conduction of an impulse – an excited state from a sensory receptor through
a nerve network to an effector, the site at which the response occur.
Functions of the nervous system
1) Sensory function – gathers information from both inside and outside of the body.
2) Transmit information to the processing areas of the brain and spine .
3) Process the information in the brain and the spine – integration function
4) Motor function – sends information to the muscles, glands, and organs so they can respond
The Nervous system is divided in to two divisions
1) Central nervous system
2) peripheral nervous system .
Peripheral nervous system is divided in to #somatic nervous system and autonomic nervous system.

Autonomic nervous system has further sub divisions in to sympathetic nervous system and =parasympathetic nervous system.

Neuron – unit of nervous system
Transmit impulses up to 250 mph.
1) Dendrite – receive stimulus and carry impulse toward the cell body.
2) Cell body – with nucleus and most of the cytoplasm.
3) Axon – fibres which carry impulses away from the cell body.
4) schwann cells- cells which produce myelin or fat layer in the peripheral nervous system
5) myelin sheath- dense lipid layer which insulates the axon.
6) Nodes of Ranvier – These are gaps in myelin sheath.
1) Sensory neurons – beings information to CNS
2) Motor neurons – carry messages from CNS
3) Interneuron – between sensory and motor neurons in the CNS
1) a stimulus is a change in the environment with sufficient strength to initiate a response.
2) Excitability is the ability of a neuron to respond to the stimulus and convert it into a nerve
impulse .
3) All of nothing rule – the stimulus is either strong enough to start and impulse or nothing
4) Impulses are always the same length along a given neuron and they are self propagation .
Once it starts it continues to the end of the neuron in only one direction from Dendrite to cell
body to axon.
5) The nerve impulse causes a movement of ions across the cell membrane of the nerve cell.

● SYNAPSE – small gap or space between the axon of one neuron and the dendrite of another .
It is junction between neurons which uses neurotransmitter to start the impulse in the second
neuron or an effector. The synapse insures one way transmission of IMPULSES.
●Neurotransmitters – Chemicals in the junction which allow IMPULSES to be started in the
second neuron.
Components of REFLEX ARC
A) Receptor – reacts to stimulus
B) Afferent pathway – conducts impulses to CNS
C) Interneuron – consist of one or more synapses in the CNS
D) Efferent pathway – Conducts impulses from CNS to effector .
E) Effector – muscles fibers or glands responds by contracting or secreting a product.
Spinal reflexes – initiated and completed at the spinal cord level. Occur without the involvement
of higher brain centers.
Brain stem –
•medulla ,
•pons, midbrain
•Diencephalon – thalamus and hypothalamus
•Cerebellum , cerebrum
2) spine
•Spinal cord

Meninges are the three coverings around the brain and spine and help cushion, protect and
nourish the brain and spinal cord.
1) Duramater is the most outer layer
2) Archanoid mater is the middle layer and adheres to the duramater and has web like
attachments to the innermost layer, the pia mater.
3) pia mater is very thin , transparent but tough and covers the entire brain .
4) Cerebrospinal fluid which buffers, nourishes and detoxifies the brain and spinal cord , flows
through the subarachnoid space , between the arschanoid mater and the pia mater.

• Regions of the brain
1) Cerebellum – coordination of movement and aspects of motor learning
2) Cerebrum – conscious activity including perception, emotions,thought and planning
3) Thalamus – filters and then relay information to various brain regions
4) Medulla – vital reflexes as heartbeat and respiration
5) Brainstem – medulla, pons, midbrain and relays information from spine to upper brain.
6) Hypothalamus – involved in regulating activities of internal organs,monitoring information
from the autonomic nervous system, controlling the pituitary gland and its hormone , regulate
sleep and appetite.

• CEREBRUM – Its the largest portion of the brain encompasses about two third of the brain
mass. It consist of two hemispheres divided by a fissure called corpus callosum.
It includes
• the cerebral cortex ,
• the medullary body,and
• basal ganglia.
• cerebral cortex – it’s the layer of the brain called gray matter as it has cell bodies and
synapses but no myelin.
• Medullary body – is the white matter of the cerebrum and consist of mayelinated axons
• Basal ganglia- they are the gray matter in each hemisphere which are involved in the control of
voluntary muscle movement.

1) frontal – motor area involved in movement and in coordinating behaviour.
2)parietal- sensory processing , attention, and language
3) temporal – Auditory perception, speech and complex visual perception .
4) Occipital – visual center – plays a role in processing visual information.
Special regions
1) BROCA’S Area – located in the frontal lobe, aids in speech
2) WERNICKE’S area – Comprehension of language
3) LIMBIC system – help regulates the expression of emotions and emotional memory.
BRAIN WAVES – are rhythmic fluctuation of electric potential between parts of the brain as seen
on EEG .
Electrodes are placed on to the scalp using the EEG .
There are 4 types of brain WAVES
• Beta
• Alpha
• Theta
• Delta
• Cranial 12
• Spinal 31
• Somatic nervous system ( voluntary)
1) relays information from skin, sense organs and muscles to CNS
2) Brings responses back to skeletal muscles for responses.

• Autonomic nervous system ( involuntary)
1) regulates bodies involuntary responses
2) relays information to internal organs.
3) Two divisions
A) sympathetic nervous system in times of
Emergency response , fight or flight.
B) Parasympathetic nervous system – when body is at rest or with normal functions. Normal
everyday conditions.
Major sense organs.
Sensation and perception.
Vision – eye
Hearing – ear
Taste – taste receptors
Smell – olfactory system
Skin – hot, cold, pressure, pain
Sense organs
Eye- the organ used to sense light

Three layers –
Outer layer consists of sclera and cornea
Middle layer consist of choroid, ciliary body and iris
Inner layer consist of retina
Sclera – A tough protective layer of connective tissue that helps maintain the shape of the eye
and provides an attachment for the muscles that move the eye.
Cornea – the clear, dome shaped part of the sclera covering the front of the eye through which
light enters the eyes.
Anterior chamber – is a small chamber between the cornea and the pupil.
Choroid layer – middle layer of the eye containing many blood vessels
Optic nerve – the nerve that transmits electrical impulses from the retina to the brain.
Retina – sensory tissue that lines the back of the eye. It contains millions of photoreceptors that
convert light rays in to electrical impulses that are relayed to the brain via optic nerve.
Lens – a crystalline structure located just behind the iris . It focuses light on to the retina.
OUTER EAR & EAR CANAL – brings sounds into eardrum.
Eardrum – vibrates to amplify sound and separates inner and middle ear
Middle ear has 3 small bones anvil, stirrup, stapes ( amplify sounds ) which vibrates sound.
Eustachian tube – connects middle ear to throat and equalizes pressure on eardrum
Cochlea – has receptors for sound and send signal to brain via auditory nerve.

Taste and smell
Taste buds – the mouth contains around 10,000 taste buds, most of which are located on and
around the tiny bumps on your tongue . Every taste buds detect five primary tastes.
1) sour
2) sweet
3) bitter
4) Salty
5) umami – salts of certain acids
Each of your tastebud contain 50 -100 specialized receptors cells.
Sticking out of every single one of these receptors cells is a tiny taste hair that checks out the
food chemicals in your saliva. Each taste hair responds best to one of the basic tastes.

Smell receptors or olfactory receptors
1) humans are able to detect thousands of different smells
2) olfactory receptors occupy a stamp sized area in the roof of the nasal cavity, the hollow space
inside the nose.
3) tiny hairs are covered with mucus
4) olfactory hairs easily fatigued so you do not notice smell.
5) if a smell , formed by chemicals in the air , dissolves in the mucus , the hair absorbs it and
excite your olfactory receptors .
6) smell leave long lasting impressions and our strongly linked to your memories.

Skin receptors
Most of your touch receptors sit close to your skin’s surface.
Light touch – Meissner s corrupslces are enclosed in a capsule of connective tissue.
They react to light touch and are located in the skin of your palms, soles, lips, eyelids ,external
genitals and nipples. These areas are particularly sensitive.
Heavy pressure – paccinian corrupslces sense pressure and vibration changes deep in your skin .
Pain – skin receptors register pain, pain receptor are the most numerous
Temperature – skin receptors registers warmth and cold. Each square centimetre of your skin
contains 6 receptors for cold and one receptor for warmth. Thermoreceptors are found all over
the body , but cold receptors are found in greater density than heat receptors – most of the
the time of our environment is colder than our body temperatures. The highest concentration
of thermoreceptors can be found in the face and ears so your nose and ears always gets cold
faster than the rest of your body on a chilly winter day


It is an autoimmune disease which causes cells to develop rapidly on the skin. The overgrowth
an lead to thick, scaly plaques which causes itch and discomfort.
Parts of the body which are affected by psoriasis are
1) elbows and knees
2) face, scalp
3) genitals
4) low back
5) arms, palms and feet
Types of psoriasis
80 to 90% of the psoriasis type is plaque psoriasis. Other types are
1) inverse psoriasis- this appears in skin fold. It looks like thin pink plaques without scales.
2) guttate psoriasis – it may appears after sore throat as it is caused by streptococcal infection.
It looks like small, red drop shaped scaly spots.
3)pustular psoriasis- has small, pus filled bumps on top of the red patches.
4) sebopsoriasis- appears on the face and scalp as red bumps and plaques with greasy yellow
Note- psoriasis is most common in winter , when people gets less sunlight. And male gender are
most prone. The rash is not contagious . You can’t get it from affected ones. Psoriasis has no
Risk factors1) family history- psoriasis can run in genes. If one of the parent is carrier then 50% of the
chances are there that one of the child will have psoriatic symptoms .
2) stress- excessive stress can hamper your immune system, increased level of stress can
become the cause of this disease
3) smoking- smoking will play a vital role in the initial development and will deteriorate the
Complications of psoriasis
1) eye conditions such as blepharitis, conjunctivitis.
2) hypertension
3) depression
4) cardiovascular disease
5) type 2 diabetes
6) psoriatic arthritis
7) chron’s disease, celiac disease, scelerosis, inflammatory bowel disease
Main aim of the treatment is to reduce the growth of the cells and releive symptoms like itching,
dry skin. Common treatment includes
1) steroid creams
2) moisturizer for dry skin, aloevera gel.
3) retinoid creams, vit d based creams, coal tar.
For severe psoriasis treatment includes
Light therapy which includes ultraviolet light on the skin. PUVA is a treatment includes psoralens
tablet with ultraviolet rays.
Psoralen tablets should be taken 2 hours before sunlight exposure. Psoralen Mgs will be
dependable on patient’s weight and age.
10mg for less than 30 kg
20mg for 30 to 50 kg
30mg for 51 to 65kg
40mg for 66 to 80kg
50mg for 81 to 90kg
60mg for 91 to 115kg
70mg for more than 115kg

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease and inflammatory disease. RA commonly
afffects joints in the hand, wrist and knees. In a joint with RA the linings of the joint becomes
inflamed, causing damage to the joint tissue. This tissue damage leads to severe joint pain and
RA can affect other tissues throughout the body and can cause problems in organs such as
lungs,heart and eyes.
Sign and symptoms of RA
1) pain in more than one joint
2) stiffness in more than one joint
3) tenderness and swelling in one or more than one joint.
4) deformities
5) the same symptoms on both sides of the body
6) weight loss
7) fever, fatigue, weakness.
Risk factors of RA
1) age- RA can begin at any stage , but the likelihood increases with advanced age. Most
common in sixties.
2) sex- women are more prone to this than men
3) genetics- people born with certain genes are more likely to develop RA . These genes are HLA
( human leukocyte antigens) class 2 genotypes, can also make your arthritis worse.
4) smoking- smoking increases a person’s risk of developing RA and can make the disease
5) history of giving birth- women who have never given birth may be at a greater risk of
developing RA.
6) obesity- being obese can increase the risk of developing RA.
Diagnosis of RA
Rheumatologists will look for sign and symptoms and medical history.
1) looking for swelling and redness.
2) examining joint function,ROM
3) to check warmth and tenderness
4) examining for skin nodules.
5) testing for reflexes and muscle strength.
Since no single test can detect RA. They may also request certain imaging test such as x ray,
MRI, Ultrasound.
Blood test for RA:
1) rheumatoid factor test- this check for a protein called rheumatoid factor. High level of
rheumatoid factor are associated with autoimmune disease .uu9uuu99uu9uu
2) Anticitrullinated peptide antibody test- this test looks for an antibody thats associated with
RA . People have this antinody usually have this disease . The anti ccp test is more specific for
RA then RF blood test and is often positive before the RF test.
3) Erthrocyte sedimentation rate: The ESR helps to determine the degree of inflammation
anywhere in your body. However it doesnot indicate the cause or site of inflammation.
4) C reactive protein test: A severe infection or significant inflammation anywhere in your body
can trigger your liver to make C reactive protein. Higher levels are associated with RA.
Note- There is no cure for RA.
Treatment aims to reduce the inflammation and symptoms.
1) NSAIDS- it can releive pain and lessen inflammation . It includes ibuprofen and naproxen
sodium. Side effects could be heart problems, kidney damage, stomach irritations.
2) Steroids: prednisone reduces inflammation and slow joint damage side effects may include
thinning of bones, weight gain, diabetes.
3) Conventional DMARDs : these drugs can slow the process of joint damage. Common
DMARDs are methotrexate, lefluonomide, hydroxychloroquine. Side effects may include liver
damage and lung infections.
4) Surgery includes synovectomy, tendon repair, joint fusion, total joint replacement.
5) Exercises can improve joint range of motion, apply heat or cold to ease pain.
Rheumatoid hand: it includes the joint deformities of hand in RA.
1) Boutonniere deformity- it occurs when the middle or proximal interphalangeal joint of a finger
is flexed and the distal joint is extended.
2) swan neck deformity- the most common in RA . It occurs when there is weakness or tearing
of ligament due to inflammation . This laxes the joint of the finger and flexion of the distal joint.
3) Hitchhiker’s thumb: it occurs when the thumb flexes at the metacarpophalangeal joint
hyperextends at the interphalangeal joint. It is also called z shaped deformity.
4)Rheumatoid nodules: these are hard lumps that form under the skin near the joints. They can
occur in multiple areas, most commonly near your elbows. Usually these are not painful.
Assesment and evaluation
1) Assesment of posture
2) Testing muscle strength and power
3) Measuring joint movement
4) gait analysis
1) cold therapy in acute phase for 10 to 20 mins twice a day.
2) Heat therapy in chronic phase for 20 to 30 mins twice a day
3) TENS will give short term pain releif.
Exercises for acute phases1) assisted movement through normal range .
2) static muscle contraction helps to maintain muscles tone without increasing inflammation.
3) for chronic cases we can progress the above exercises to include light resistance.
4) postural, core stability exercises.
5) Swimming, walking, cycling to maintain cardiovascular fitness.
6) gentle stretching of tight muscles.
7) maintaining muscle strength is important for joint stability & preventing injury.
8) Muscles can become weak following reduced activity.
9) Muscles length can be affected by prolonged positions and immobilization and tightness can
limit daily activities.
10) Splints will be provided for every deformity to keep the joint in correct position.
11) Advanced physiotherapy techniques like dry needling, manual muscle release will be
unbeatable in correcting muscle stiffness and releiving joint pains.
12) Iontophoresis is believed to work through the transcutaneous deleivery of charged
medications like lidocaine,corticosteroids, salicylate, antibiotics. It is used for deleivery of
substances that need local penetration in order to avoid systemic effects.
13) orthotic devices can make activities of daily living much easier, leading to a greater degree
of independence.

Reactive arthritis

Reactive arthritis is joint pain and swelling triggered by an infection in another part of the body
mostly in genitals, intestines, genitals and urinary tracts.
This condition usually targets the knees, ankles and feet. Inflammation also can affect the eyes,
skin and the tube that carries urine out of the body (urethra). Previously, reactive arthritis was
sometimes called Reiter’s syndrome.
Sign and symptoms
Incubation period is 1 to 4 weeks.
Pain and stiffness- pain in joints of knee, ankles, low back, heels.
Eye – people who have this arthritis develops an eye inflammation ( conjunctivitis ).
Urinary problems: inflammation of prostate gland and cervix, discomfort during urination.
● Reactive arthritis occurs in reaction to an infection by certain bacteria. Most often, these
bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella,
Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms but can
cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhea. If
you develop arthritis within one month of a gastrointestinal or a genital infection especially with
a discharge see a health care provider. You may have reactive arthritis.
Reactive arthritis tends to occur most often in men between ages 20 and 50. Some patients
with reactive arthritis carry a gene called HLA-B27. Patients who test positive for HLA-B27 often
have a more sudden and severe onset of symptoms. They also are more likely to have chronic
(long-lasting) symptoms. Yet, patients who are HLA-B27 negative (do not have the gene) can still
get reactive arthritis after exposure to an organism that causes it.
Patients with weakened immune systems due to AIDS and HIV can also develop reactive
There is no specific test for diagnosing reactive arthritis, but the doctor may check the urtheral
discharge for STD. Stool samples may also be tested. Blood reports shows positive for the HLAB27 genetic marker and alongwith wbc count esr increases. Patient will also have less rbc.
X rays reports shows bone loss, signs of osteoporosis , bony spurs , back joints and pelvis may
show abnormalities.
Doctor will also test for eye and UTI which can confirm the disease.
Treatment/ Medical Management
Microbial therapy is strongly recomended for 3 to 6 months for an microbial infection.
Antibiotics should be started soon without any delay. NSAIDS are the first choice of treatment.
Main goal is to reduce the symptoms and prevent complication.
Mechanical devices like orthotics, insoles can be used.
Medical management:
Goal of physiotherapy management
1) reduce inflammation
2) reduce pain
3) improve rom
4) increase cardiovascular fitness
Cryotherapy should be intiated to intiated early at acute stage to control inflammation and
swelling around the affected joints.
Electrical stimulations like TENS, IFT to ease pain . Range of motion and stretching exercises
for all joints to avoid any stiffness in the joint, strengtheing exercises will be intiated to improve
power of muscles.
Patient education – this is necessary to promote joint protection and proper body mechanics
when performing daily activities to maintain joint integrity.
Aerobic exercises should include low impact activities such as swimming, walking depending on
patient’s age and cardiovascular level.
Other advance techniques like dry needling and taping have shown great benefits in releiving
pain and stiffness.
Physiotherapy management will target the affected joint and its attachments

the right shoe

Why you need “The right Shoe” ?

Are your daily wear shoes giving you pain and health problem?

We know once upon a time people walked and worked whole day without wearing any footwear but now we have lot of options in footwear. The shoes we wear are actually central to our everyday health. Poorly designed shoes or footwear that doesn’t fit properly can cause a number of short or long term pain and health problem that effect various part of our bodies and life ,so it’s important to know and be aware what you’re putting on your feet.

The cost of wearing heel –

Some kind of pains are difficult to avoid but one that can be easily prevented is foot pain. Much of the time you can trace foot pain directly to the shoes you decide to wear. Experts say a bad shoe can create potential foot, leg, low back or general health problems and high heeled shoes and improperly fitted shoes cause health problems such as bunions ,heel pain and deformed toes as well as nerve damage. A survey found that most women also experience leg cramps and  tired of wearing shoes that hurt’s their feet. As well as high heel gives you muscle pain and spasms in calves causing Plantar fasciitis and Calcaneal spur. Long term wear of high heels can shorten the muscles in your calves and back leading to backache.

Ill-fitting and high shoes wearing can cause damage to your feet can create nail and fungal problems, back, joint and hip pain, calf strains.

 Flip flops: Flat shoes with little or no arch support cause fallen arches, can be extremely painful and makes walking difficult and tiring for prolonged periods and on uneven surfaces such as hilly areas. One may also get inflamed and worn fascia at the bottom of the foot (plantar fasciitis) which can be debilitating for the patient as well as flats without arch support can cause lower back and ankle pain due to the flopping gait.

Ballet flats: Ballet flat shoes that are too tight across the toes and bell of the foot increase the pressure on the toenails and nail beds as the toes and nails themselves have no room for movement , the nails are often encouraged to bend and curl inwards. If the nail pierces the skin, an infection can occur. In particularly severe cases, this infection can lead to amputation.

Thigh high shoes: When it comes to foot pain, thigh high boots can cause some of the same foot health issue as shoes with stiletto heels, depending on their heel height and they present the additional risk of causing leg issues if the boots are too tight. Tight non stretchable thigh high boots can put pressure on the peroneal nerve in the knee and cause burning and tingling.

Take care of your feet:

It’s easy to take our feet for granted. They’re just there, handling with a lot of challenges, from being stiffened into high heels and elevated to heights to perspiration inside sweaty socks or tight nylon pantyhose.

While suffering those indignities, our feet take hundreds of tons of force impact just during an average day of walking.

You don’t need an expensive spa treatment to take care of your feet. Spending just a few minutes a day on foot care and choosing the right shoes can keep you free of problem that may lead to pain and even disability.

Make point to wash your feet with a washcloth carefully and regularly. Be sure to dry your feet completely, including between the toes. This can lessen problems such as athlete’s foot, odour, bacteria and fungus.

For soaking your feet, forget the Epsom salts as they’re too drying and are of least medical benefit. Instead, just use warm water and a little liquid soap containing skin softeners. Moisturize your feet after washing during winter months, you may need to moisturize several times a day. Nothing fancy is needed just basic lotions and creams are fine.

Pre-habilitation, What’s that?

Pre-habilitation – A lateral thinking towards prevention of injuries

Rehabilitation of athletic injuries such as ligament and muscle injuries is common at present which takes longer period of time to get recovered and require great deal of patience throughout, ultimately leading to longer period out of play. On the other hand it is already known that tissue damage had been done.

Why not prevent injuries before it happen? There is a need of awareness and education among sporty and general exerciser individuals about pre-habilitation and its importance.

So what it actually is?

Pre-habilitation is a exercise program set for an individual knowing his/her weak links in body which can cause injury in near future. Pre-habilitation works on decreasing risk of injury, focuses on strength, flexibility & neuromuscular control of the areas vulnerable to injuries. This will also minimize the resting time or out of completion period due to injury and its recovery.

Pre-habilitation is sports specific and individual body based approach means it’s not common for all. Strengthening, flexibility, proprioception and agility exercises can reduce risk of injuries and also can help to enhance performance.

As according to American journal of Sports medicine , agility drills reduced ACL injuries among female soccer players by 88%.

Science behind Pre-habilitation –

Continuous training while having bio-mechanical fault can lead to injury, it becomes necessity to have a bio-mechanical approach towards athlete assessment. Pre-habilitation focuses on the regimes which will counter these faults. Biomechanical assessment follows functional activities to reach to weaker links in the body and the structures to be worked on. As for example pronation distortion syndrome can cause stress on ACL or PFPs over a period of time. Pre-habilitation works upon correcting the faulty mechanics thus reducing injury risks.

Beneficiaries of Pre-habilitation –

Elite athletes, occasional exercisers, gym going individuals & also those who are not regular exercisers are vulnerable to get injury , can benefit by pre-habilitation. Individuals having past injury can also have pre-habilitation program for themselves in order to prevent recurrence of same injury or other associated with it.

Why to get treated or rehabilitated after injury or any musculoskeletal pain when we can prevent it as it is rightly said “prevention is better than cure”.

Right choice of professional for pre-habilitation –

Physiotherapist is best choice when it comes to rehabilitation after injury similarly in prehabilitation physiotherapist is right selection. Biomechanical analysis is key for pre-habilitation for exercise planning and for that who can be better than physiotherapist.

Role of Physiotherapy in Bell’s Palsy

Bell’s palsy is the unexpected and temporary facial paralysis that can affect a person’s daily function, communication with others, self-esteem, and quality of life. There’s no specific cause for its development (idiopathic). So far no conclusive cure has been established but it has been observed that most patients regain their facial strength and expression between 2 weeks and 6 months after the onset.

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Role of Physiotherapy in Breast Cancer Recovery

Treatment to the chest and axilla for breast cancer can lead to secondary complications in the arm like pain, reduced movement of the shoulder joint, muscle weakness, swelling (lymphedema) and difficulty to carry out activities of daily activities. The problems can persist for many years after treatment. Guidelines state that when indicated patients with breast cancer should be referred to physiotherapy early, however this is not a routine practice.
There is a need for a proactive model of care which encourages early exercise-based rehabilitation.

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Tingling and Numbness

Tingling and Numbness

Sometimes we can feel a sensation of pins and needles pricking us in any part of the body. In medical terms, this is known as Paresthesia. People generally notice these sensations in hands, feet, arms, and legs. If numbness and tingling persist and there’s no obvious cause for the sensations, it could be a symptom of a disease or injury, such as multiple sclerosis or carpal tunnel syndrome.

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