Dr Satyajit Mohanty blogs

According to Rubik & colleagues (1994) massage therapy, the manual manipulation of soft body tissues to enhance health and well-being, is one of the oldest forms of medicine known to mankind and has been practiced worldwide since ancient times. Today, more than 80 different forms of massage have been identified, many developed in the last 30 years. Lack of consistent terminology for describing the treatments given by therapists are felt world wide. Sherman & colleagues developed taxonomy to describe therapist guided module delivery for patients with musculoskeletal pain. Due to this work a new classification system evolved. Using this, practitioners using different styles of extramural medicine (manual medicine technique) can describe the techniques they employ using consistent terminology. About the study: A review of the literature for treatment musculoskeletal pain was done for creating the taxonomy & neck pain was the matter subjected to further studies. The results war...

Mulligan's mobilization with movement treatment technique for the elbow (MWM), a peripheral joint mobilization technique, produces a substantial and immediate pain relief in chronic lateral epicondylalgia. Abbott JH & colleagues reported MWM is a promising intervention modality for the treatment of patients with Lateral Epicondylalgia. They found immediate impact on grip strength in making it pain-free (48% increase in pain-free grip strength). Both pain-free grip strength and maximum grip strength of the affected limb increased significantly following the intervention. Pain-free grip strength increased by a greater magnitude than maximum grip strength. Non-opioid pain modulation of spinal manual therapy: Naloxone antagonism and tolerance studies, which employ widely accepted tests for the identification of endogenous opioid-mediated pain control mechanisms, have shown that spinal manual therapy-induced hypoalgesia does not involve an opioid mechanism. However immediate hypoal...

Introduction: Fibromyalgia syndrome includes symptoms of widespread, chronic musculoskeletal aching and stiffness and soft tissue tender points. It is frequently accompanied by fatigue and sleep disturbance (1). The impact of the disease is considerable both for those directly affected (restriction in activities of daily living and in ability to take part in family, professional, and social life) and for society as a whole (direct and indirect costs) (4). Fibromyalgia requires a comprehensive treatment care (2). Definition: Fibromyalgia is a fairly common syndrome characterized by chronic, widespread musculoskeletal pain, multiple "tender points", fatigue, sleep disturbance, stiffness and other symptoms such as headache, dizziness, trouble with concentration, irritable bowel syndrome, urinary urgency, depression (2). The disease usually has a chronic course (3). Epidemiology: Fibromyalgia is a common chronic pain syndrome affecting particularly middle aged women as it occurs ...

(Part of one of my paper in a upcoming journal……….) Lateral epicondylitis is degenerative than an inflammatory process. Old treatment methods based on anti-inflammatory module delivery are facing theoretical nihilism. Currently few researchers are trying to inject autologous blood in to the painful area of the lateral elbow. The thought behind injection of autologous blood in such case is; it might provide the necessary cellular and humoral mediators to induce a healing cascade. Example of a study: Edwards SG et al injected 2ml autologous blood under the extensor carpi radialis brevis to treat refractory lateral epicondylitis. All patients had failed previous nonsurgical treatments including all or combinations of physical therapy, splinting, nonsteroidal anti-inflammatory medication, and prior steroid injections. The average follow-up period Edwards SG et al’s study was 9.5 months (range, 6-24 months). They found: After autologous blood injection therapy 22 patients (79%) in whom nons...

(This is a form of MFR to upper anterior thoracic ) Many hemiplegics presents with shoulder hand syndrome. Shoulder hand syndrome is also known as CRPS (complex regional pain syndrome) or RSD (reflex sympathetic dystrophy). In past and also recently I have used SPAM to mid thoracic vertebrae & MFR to upper posterior thoracic level (precisely in physiotherapeutic terms bilateral rhomboidus stretch) with moderate results on pain & disability plus overall reduction menifestation of RSD in my patients. Peers usually associate these effects of mobilization & MFR with autonomic balancing act in the zone. Various grades of touch has been shown to affect central neuronal out puts to endocrine perturbations. Myofacial release is unique in this aspect however not many research papers are there. Relief of vasospasm by MFR is claimed by researcher Walton in 2008. Following is a micro review of that paper that found MFR is a effective modality in treatment of primary Raynaud's pheno...

Pandiculation (whole body stretch) We like to stretch our whole body after getting off the bed which usually comes with a yawning. This stretch is different form the regular stretching exercise we do. Noteworthy is the difference between the pandiculation-type stretch, which arises spontaneously, is pleasurable and increases joint stability, with the regular stretching, which is produced by a volitional action, may produce displeasure and joint instability (because of this, stretching has been contraindicated before physical activity). Pandicular stretching activity is remarkably reduced after spine & proximal appendicular pathologies (Luiz Fernando Bertolucci). Following is more on the description of Pandiculation form following site: http://www.baillement.com/stretching-fraser.html. The symmetrical, coordinated stretching and stiffening actions of the body as one unit is true pandiculation. This action typically occurs in man and animals alike, as an exertion which sweeps wavelik...

Your coaches lie to you. you do not require any supplement just because all supplement you take comes in your food. if the caloric requirement is more, the increase of it (calories & proteins. fruits & vegetables) in a balanced way assures a adequate intake of all the nutrients. renowned researchers in exercise physiology & nutrition sciences (Katch & Mcardle) refute the idea of taking supplements in training. More to it you can not assess the deficiency of particular nutrient (that you take as supplement) in common laboratory conditions. Toxic levels too occur with high intakes. However generally the nutrient requirement is in a vary wide range. That means one can tolerate increased nutrients as supplements in a wide range which does not mean that we require it more than a adequate level. More than adequate range do not also mean a high training output or competitive result or augmented health. Following are self-explanatory terms associated with nutrient requirements....

Many authors & researchers claim & have demonstrated that therapeutic effects of manual therapy are due to pain modeling via sensory inputs through their well designed researches. But many clinicians believe that manual therapy lead to subtle bony adjustments which leads to it’s therapeutic effects. However, it is not well demonstrated that adjustments occurs in such cases. This following paper by Keller & colleagues is one among the many papers that indicates but do not clearly demonstrate the potential mechanical adjustments by manual therapy. The experiment was carried out on a replica (model) of the spine & model validity was determined which showed good agreement with in vivo human studies. This study reveals following: 1. Quasi-static and low-frequency ( 2. Impulsive forces (Such as used in HVLA manipulative techniques) produced much lower segmental displacements in comparison to static and oscillatory forces. 3. Differences in inter-segmental displacemen...

There is increase in PA spine stiffness during voluntary contraction of the lumbar extensor muscles. PA dynamic spinal stiffness at rest and during lumbar isotonic extension tasks ware studied by Colloca & colleagues (2004) in patients with low back by a dynamic mechanical impedance study. About the study: 13 patients with LBP underwent a dynamic spinal stiffness assessment in the prone-resting position and again during lumbar extensor efforts. Same measurements are taken after PA manipulative thrusts (approximately 150 N, Dynamic spinal stiffness characteristics revealed that 1. A significant increase in the PA dynamic spinal stiffness was noted for thrusts over spinous process during isotonic trunk extension tasks compared with prone resting. 2. But no significant changes were noted for the same measures over the transverse processes. This study suggest in trunk extension tasks normally the spine stabilization occurs by the paraspinal muscles any PA force to the central spi...

SPAM includes commonly applied forces of low-frequency sinusoidal oscillations ( Spinal mobilization is usually applied to 1. modulates pain 2. improve mobility of a stiff segment 3. finally, to assess the condition However these benefits are marked in the subject suffering from mechanical spine disorders. Fundamental to this concept is the belief that spinal mobilization will influence the mechanical properties of the symptomatic motion segment. Nothing is known about what are the effects of SPAM in asymptomatic subjects. Using proper control methods trained physiotherapist applied the standardized PA mobilization technique to L1, L3 & L5 spinous process for two minutes. The mean force of 146 N (standard deviation = 8 N) at a frequency of 1.5 Hz was applied. It was found that SPAM has no segmental effect on spinal PA stiffness (1). Discussion: This paper of Allison & colleagues questions “Which mechanisms contribute to the changes that occur after PA spinal mobilizat...

A part of my review for a journal.................. Functional radiography or Cineradiography refers to radiography in the time course of the movement. Spine Cineradiography reveals many interesting aspects of stable (normal) & unstable (lysthetic) spine. I. Normal spine flexion-extension kinesis During flexion, initial lumbar motion starts stepwise from the upper level to the lower levels with phase lags. Angular velocity at the onset of motion increases as the level descended. On the contrary, during extension, initial motion started from the lower level (L5/S1) to the upper levels. There is no relation between velocity and spinal levels during backward flexion. Through out the F-E excursion there is a harmonious relation between the angular motion and translatory motion of the motion segment (10). The motion profiles at L5/S1 were different between flexions & extension (11). In extension, motions in upper lumbar segments were small, and the L5-S1 segmental motion only contri...