Tel: 919-910-4015
WHAT WE TREAT...
Headway PT is dedicated to providing expert care to our community in the Raleigh-Durham area. One of the cornerstones of our care is education. Learn about the conditions we specialize in caring for and how physical therapy can help you make headway on achieving a higher quality of life!
Neck Pain
Neck pain is a common issue that affects millions of people worldwide, often stemming from various factors, including poor posture, muscle strain, herniated discs, arthritis, and even stress. Symptoms may range from mild discomfort to debilitating pain, often accompanied by stiffness, headaches, and reduced range of motion. Recognizing the underlying cause is crucial for effective treatment. While medication and rest can provide temporary relief, physical therapy offers a personalized approach to managing neck pain that focuses on restoring function, reducing pain, and preventing future injuries. Here are several key ways physical therapy helps with neck pain disorders: 1. Assessment and Diagnosis: A physical therapist begins with a comprehensive assessment to identify the specific causes of neck pain. This evaluation includes analyzing posture, range of motion, and muscle strength, as well as discussing the patient’s medical history and lifestyle. A physical therapist will also screen for “red flags” that indicate that further medical management may be necessary to treat the underlying cause of your pain. By pinpointing the root of the problem, therapists can create a tailored treatment plan. 2. Pain Relief Techniques: Physical therapists employ various techniques to alleviate pain. These may include: •Manual Therapy: Hands-on techniques such as massage and mobilization can help reduce tension in the neck muscles and improve blood flow, providing immediate relief. •Heat and Cold Therapy: Applying heat can relax tight muscles, while cold therapy can reduce inflammation and numb pain. •Electrotherapy: Modalities like TENS (Transcutaneous Electrical Nerve Stimulation) can help block pain signals and promote healing. 3. Exercise and Strengthening Programs: A cornerstone of physical therapy is exercise. Therapists design customized exercise programs that focus on: •Stretching: Gentle stretching exercises can improve flexibility and reduce muscle tightness, contributing to a greater range of motion. •Strengthening: Strengthening exercises target the muscles supporting the neck, improving stability and reducing the risk of future injuries. •Postural Training: Educating patients on proper posture during daily activities can alleviate strain on the neck and prevent recurrence of pain. 4. Education and Self-Management Strategies: Physical therapists provide valuable education on body mechanics and ergonomics, helping patients understand how to minimize stress on their necks. They also teach self-management strategies, such as: •Proper Ergonomics: Guidance on workstation setup to maintain good posture during prolonged sitting or computer use. •Activity Modifications: Advice on modifying daily activities and exercises to avoid exacerbating neck pain. •Biomechanics: Expert observation and correction of movement during functional activities that otherwise may further contribute to your condition if not addressed. 5. Holistic Approach Physical therapy often incorporates a holistic approach, addressing not just the physical aspects of neck pain but also contributing factors like stress and lifestyle. Therapists may recommend relaxation techniques, breathing exercises, or even mindfulness practices to help manage stress, which can contribute to muscle tension and pain. Conclusion Physical therapy is a highly effective treatment for neck pain disorders, offering a comprehensive approach that focuses on healing, education, and prevention. By addressing the underlying causes of pain and empowering patients with the tools and knowledge to manage their condition, physical therapy can significantly improve quality of life. If you’re experiencing neck pain, consulting a physical therapist may be the key to finding relief and restoring your everyday activities.
Cervicogenic Headache
Cervicogenic headaches are a common yet often misunderstood condition, stemming from issues in the neck and upper spine. Unlike typical tension headaches or migraines, cervicogenic headaches are caused by dysfunction in the cervical spine or its surrounding structures. These headaches can significantly impact daily life, but physical therapy offers effective strategies for identification, treatment, and prevention. Cervicogenic headaches are typically characterized by pain that originates in the neck and radiates to the head. They often present as unilateral headaches, accompanied by neck stiffness, reduced range of motion, and tenderness in the neck or shoulder area. Common triggers include poor posture, muscle strain, and injuries like whiplash, but can also be the symptom of something more serious such as bone spurs or tumors. Physical therapist will screen for red flags to ensure you receive the appropriate care. Your physical therapist will perform a comprehensive assessment that will help distinguish cervicogenic headaches from other differential diagnosis such as tension headaches or migraines. The evaluation may include gathering your medical history, assessing range of motion, observing quality of movement and posture, and testing strength. The assessment will also consider issues with movement patterns that may contribute to neck dysfunction. For example, extended periods of sitting, poor ergonomics, and lack of muscle balance can exacerbate symptoms. Identifying these factors is crucial for developing an individualized treatment plan. Modalities such as TENS, hot and cold therapy, dry needling, and mechanical traction may help to relieve symptoms temporarily, but the primarily focus of treatment will include manual therapy techniques such as soft tissue mobilization and joint manipulation which can alleviate pain and improve mobility in the cervical spine. Exercise and education will also be a pinnacle aspect of treatment to not only alleviate symptoms but to prevent them from returning. One goal of physical therapy is to make our patients as independent as possible.
Migraines
Migraines are more than just severe headaches; they are a complex neurological condition characterized by recurrent episodes of intense, often debilitating pain, typically on one side of the head. Accompanying symptoms may include nausea, vomiting, sensitivity to light and sound, and visual disturbances known as aura. The exact cause of migraines is not fully understood, but they are believed to involve a combination of genetic, environmental, and neurological factors. Types of Migraines Migraines can be categorized into several types, each with distinct features: 1.Migraine with Aura: Also known as classic migraine, this type is preceded by neurological symptoms, such as visual disturbances (flashing lights or blind spots) or sensory changes, which can last from 20 to 60 minutes before the headache begins. 2.Migraine without Aura: This is the most common form, characterized by unilateral head pain without the preceding aura. Symptoms can vary in intensity and duration, typically lasting from 4 to 72 hours. 3.Chronic Migraine: Occurring 15 or more days per month, chronic migraines may develop from episodic migraines and often require more intensive management. 4.Hemiplegic Migraine: A rare type that can cause temporary weakness or paralysis on one side of the body, mimicking a stroke. This type can be hereditary and usually requires careful medical evaluation. 5.Vestibular Migraine: Characterized by episodes of dizziness or vertigo along with headache symptoms, this type affects balance and coordination. The Role of Physical Therapy in Migraine Treatment Physical therapy offers a multifaceted approach to managing migraines, particularly for those whose symptoms may be triggered or exacerbated by musculoskeletal factors. Here are several ways physical therapy can help: 1.Manual Therapy: Techniques such as myofascial release and trigger point therapy can alleviate muscle tension in the neck and shoulders, which may contribute to headache onset. By reducing tension in these areas, physical therapists can help decrease the frequency and intensity of migraines. 2.Posture and Ergonomics: Poor posture and improper ergonomics are common contributors to migraine triggers. Physical therapists assess body mechanics and provide guidance on proper alignment during daily activities, including sitting at a desk or using a computer. This proactive approach can minimize stress on the neck and upper back, reducing headache risk. 3.Strengthening and Stretching Exercises: Customized exercise programs focus on strengthening neck and upper back muscles while improving flexibility. This balance can enhance overall stability and reduce tension that may lead to migraines. 4.Education and Self-Management: Physical therapists educate patients about potential triggers, lifestyle modifications, and self-care strategies. This empowerment helps individuals better manage their condition, fostering a proactive approach to migraine prevention. 5.Relaxation Techniques: Incorporating relaxation strategies, such as deep breathing or mindfulness practices, can help manage stress levels, a known trigger for many migraine sufferers. Physical therapists often teach these techniques to support overall well-being. Several recent studies have shown tremendous efficacy for the reduction of frequency and intensity of migraines by utilizing progressive muscle relaxation techniques. Migraines are complex and challenging and often require a multidisciplinary approach, but physical therapy can play a vital role in their management, providing a non-pharmaceutical option for management. By addressing underlying musculoskeletal issues, educating patients on trigger identification, and providing personalized exercise programs, physical therapists can help reduce the frequency and severity of migraine attacks. If you struggle with migraines, consider seeking the expertise of a physical therapist to explore effective treatment options tailored to your needs.
Thoracic Outlet and T4 Syndrome
Thoracic Outlet Syndrome (TOS) and T4 Syndrome are both commonly overlooked differential diagnosis, as their symptoms heavily replicate those that would be associated with cervical radiculopathy which is a much more common diagnosis. While TOS is often misdiagnosed, it is a fairly common condition. T4 (indicating the fourth vertebrae in the thoracic spine) Syndrome is a much less common condition but shares very similar symptoms despite having very distinct origins of dysfunction. Thoracic Outlet Syndrome is a condition characterized by compression of the nerves and blood vessels in the space between the collarbone and the first rib, leading to pain, numbness, and weakness in the shoulder, arm, and hand. It can result from anatomical abnormalities, poor posture, or repetitive activities, usually movements that may help to alleviate the compression or nerve pain. T4 Syndrome, on the other hand, involves pain and dysfunction stemming from the thoracic spine, particularly around the T4 vertebra, often presenting as upper back and neck pain that radiates to the arms and hands, along with associated symptoms like headaches and fatigue. Both conditions are considered “diagnosis of exclusion” which means they’re typically only assessed for when other conditions either originating from the neck or the joints of the upper extremity are unlikely to be present. Some common physical therapy findings during an assessment that may help to distinguish these two conditions is that numbness and tingling often does not follow what’s called a “dermatomal” pattern, and sometimes doesn’t even correlate with a specific nerve since blood vessels could be causing some of the symptoms the patient is experiencing. Findings of nerve pathology related to dermatomal patterns indicates that the symptoms are originating at a specific spinal nerve that can be identified through patterns of numbness/tingling, certain reflexes, as well as weakness of certain muscle groups that would be controlled by that nerve. Because TOS can cause compression in irregular patterns at the brachial plexus which is the nerve bundle found near the axilla (armpit), the symptoms may or may not correlate with a specific nerve. With T4, along with pain referral patterns stemming from the thoracic spine, the patient may also present with elevated heart rate, respiratory rate, dilated pupils, and increased blood pressure due to the proximity of a sympathetic (“fight or flight”) nerve bundle that is located at T4. The Role of Physical Therapy in Diagnosis and Treatment: Physical therapy plays a crucial role in both diagnosing and treating TOS and T4 Syndrome, particularly since many other providers do not assess for these conditions. Initially, a physical therapist will conduct a comprehensive assessment, including a detailed patient history and physical examination, to identify the specific symptoms and their causes. For TOS, therapists may evaluate posture, neck mobility, and muscle strength, while for T4 Syndrome, they will assess thoracic spine alignment and function. Treatment strategies for both conditions typically include manual therapy techniques to relieve muscle tension and improve joint mobility, targeted exercises to strengthen the muscles supporting the shoulder and thoracic region, and postural training to reduce strain on affected areas. Additionally, physical therapists provide education on activity modification and ergonomic adjustments to help patients manage symptoms and prevent recurrence. Through a tailored approach, physical therapy can effectively alleviate pain, enhance mobility, and improve overall function in individuals suffering from these conditions.
Vestibular Hypofunction and Disorders
Vestibular hypofunction is a condition characterized by reduced function of the vestibular system, which is responsible for maintaining balance and spatial orientation. This dysfunction can lead to symptoms such as dizziness, imbalance, and difficulty with coordination. The vestibular system is located in the inner ear and consists of structures that detect head movement and position. When it becomes impaired, individuals may experience sensations of spinning, lightheadedness, or instability. Types of Vestibular Hypofunction Vestibular hypofunction can be categorized into two main types: peripheral and central. 1.Peripheral Vestibular Hypofunction: oDescription: This type occurs when there is damage or dysfunction in the inner ear structures, which can affect the signals sent to the brain about balance and spatial orientation. oCommon Causes: Conditions such as Meniere's disease, vestibular neuritis, or acoustic neuroma can lead to peripheral hypofunction. Benign Paroxysmal Positional Vertigo (BPPV) also falls under this category, where small crystals of calcium carbonate become dislodged in the inner ear, causing brief episodes of vertigo when the head is moved in certain positions. 2.Central Vestibular Hypofunction: oDescription: This type results from issues within the central nervous system, affecting how the brain processes vestibular information. oCommon Causes: Conditions such as stroke, multiple sclerosis, traumatic brain injury, or vestibular migraines can lead to central hypofunction. Symptoms may be more complex and can include cognitive disturbances in addition to balance issues. Distinguishing BPPV Benign Paroxysmal Positional Vertigo (BPPV) is a specific type of peripheral vestibular hypofunction caused by the dislodgement of otoliths (calcium crystals) in the semicircular canals of the inner ear. This condition leads to brief episodes of intense vertigo triggered by specific head movements, such as rolling over in bed or looking up. How Physical Therapy Can Help: Physical therapy can be highly effective in diagnosing and treating vestibular hypofunction and its associated conditions 1.Vestibular Rehabilitation Therapy (VRT): oPeripheral Hypofunction Treatment: For peripheral conditions, such as vestibular neuritis, VRT focuses on promoting compensation for the reduced vestibular function through specific exercises and balance training that often involve head and eye movements in specific patterns. For BPPV, therapists may use maneuvers like the Epley maneuver to reposition dislodged crystals. Patients with BPPV often experience immediate relief following the performance of the maneuver. Occasionally, additional maneuvers may need to be performed, and the patient may also need other VRT exercises to fully address their condition. oCentral Hypofunction Treatment: In cases of central vestibular dysfunction, therapists will focus on a combination of balance training, coordination exercises, and strategies to improve gaze stability and enhance the brain’s ability to process sensory information. It is very important that a multidisciplinary approach is used to treat central disorders. 2.Assessment and Diagnosis: oPhysical therapists conduct comprehensive evaluations to determine the specific type of vestibular dysfunction, utilizing tests that assess balance, coordination, and eye movements. With these assessments, therapist can differentiate between peripheral and central disorders and provide an individualized care plan based off those findings. 3.Education and Self-Management: oPatients receive education on managing symptoms, avoiding triggers, and implementing strategies to improve safety during daily activities. Vestibular hypofunction encompasses a range of conditions that can significantly impact an individual’s balance and quality of life. By distinguishing between peripheral and central vestibular dysfunctions and addressing specific issues like BPPV, physical therapy offers a targeted approach to treatment. Through vestibular rehabilitation, personalized exercise programs, and patient education, therapists can help individuals regain balance, reduce dizziness, and enhance overall function.
Concussion
A concussion is a mild traumatic brain injury (TBI) that occurs when a blow to the head or body causes the brain to move rapidly inside the skull. This sudden movement can result in the brain bouncing or twisting, which affects normal brain function. Some common causes of concussions include: 1. Sports Injuries: High-impact sports like football, soccer, hockey, and rugby are major contributors to concussions. Athletes in these sports are frequently at risk for head impacts. 2. Falls: Particularly common in older adults and young children, falls are a significant cause of concussions. They can happen from slipping, tripping, or losing balance. 3. Car Accidents: The rapid acceleration and deceleration forces in car crashes can cause concussions, even if the head doesn’t directly strike an object. 4. Physical Assaults: Being struck in the head during an altercation or an accidental hit in a crowded environment can also lead to concussions. Explosive Blasts: Military personnel can suffer concussions due to the pressure waves from explosions. Symptoms of Concussion The symptoms of a concussion can vary depending on the individual and the severity of the injury. They can appear immediately or may take hours or even days to develop. Some common symptoms include: 1. Physical Symptoms: Headaches, dizziness, nausea, vomiting, sensitivity to light or noise, fatigue, balance problems, and blurred vision. 2. Cognitive Symptoms: Confusion, difficulty concentrating, memory problems, slowed thinking, and feeling "foggy" or mentally fatigued. 3. Emotional Symptoms: Irritability, mood swings, anxiety, depression, and an unusual sense of emotional detachment. 4. Sleep Disturbances: Difficulty falling asleep, sleeping more or less than usual, or feeling drowsy and fatigued throughout the day. Physical Therapy Assessment for Concussion Physical therapists (PTs) play an important role in assessing and treating concussions. The assessment typically involves: 1. History and Symptom Reporting: A thorough discussion with the patient about the injury event, symptoms, and any worsening or fluctuating patterns in symptoms. 2. Cognitive Assessment: PTs may perform simple cognitive tests to check for issues with memory, concentration, and mental processing. 3. Balance and Coordination Testing: Concussions can impact balance, and PTs use specialized tests like the Balance Error Scoring System (BESS) or dynamic balance tests to assess stability. 4. Oculomotor Testing: Since concussions often affect eye movement, PTs might evaluate eye tracking and coordination, such as how the eyes move when following an object. 5. Vestibular Function Assessment: The vestibular system (which helps with balance and spatial orientation) is often impacted. Testing might include checking for dizziness, nausea, or motion sensitivity when moving the head. Physical Therapy Treatment for Concussion After assessment, physical therapy can help manage and treat the symptoms of a concussion. Some common treatment approaches include: 1. Vestibular Rehabilitation: If the vestibular system is affected, specific exercises can help the brain adapt to and compensate for dizziness and balance issues. This can include gaze stabilization exercises, head movements, and balance retraining. 2. Balance and Coordination Exercises: For patients with ongoing balance problems, PTs will use various exercises to improve stability and coordination. This might involve standing on one leg, walking on uneven surfaces, or more dynamic balance tasks as the patient improves. 3. Oculomotor Training: For individuals with eye tracking issues, PTs will prescribe exercises to improve the coordination between the eyes and the brain, such as tracking objects or focusing on items at different distances. 4. Graduated Return to Activity: PTs guide patients through a carefully graded return-to-activity plan, ensuring that they only progress as their symptoms allow. This involves a step-by-step increase in physical exertion, starting with light activity and gradually moving to more intensive exercise. 5. Manual Therapy: Some patients may develop neck pain or tension after a concussion. Manual therapy techniques, including massage, mobilization, or stretching, can help relieve tension and pain in the neck and shoulders. The Role of Physical Therapy in Long-term Recovery Physical therapy can help manage lingering symptoms of post-concussion syndrome, a condition where symptoms persist for weeks or months after the initial injury. The individualized care provided by PTs aims to improve both the physical and cognitive aspects of recovery, ensuring that patients return to their regular activities safely and efficiently. The collaboration with other healthcare professionals, such as neurologists or neuropsychologists, is often essential in achieving a comprehensive recovery. In summary, physical therapy can play a critical role in both the early and long-term management of concussions by offering targeted rehabilitation exercises, improving physical function, and assisting with a gradual return to everyday activities.