It should always include a combination of these things, not just one, or it really isn't physical therapy. The most important part is exercise! Muscles, tendons and ligaments that don't move results in shortening of the fibres and loss of function over time. "If you don't use it, you lose it!" Physical exercise improves your endurance, your mood, balance, co-ordination and your flexibility. Physical exercise can reduce pain, spasms, and swelling.
Some people with chronic pain have become afraid of movement, thinking it will hurt them more. More often than not, this will not occur. Getting a specific targeted exercise program for yourself, that gradually builds up your strength and flexibility over time is key to success.
Stretching, walking, hot and cold therapies, topicals (putting on the skin), TENS machines, and self-massage and acupressure can all be done at home.
Stretching should be slow, steady and sustained for a period of time that feels good. Avoid bouncing or jerking with any stretching.
Hot and cold is just that - some times body parts will feel better with an ice pack (never leave on longer than 20 minutes at a time even if it feels good), and some times will feel wonderfully relaxed after a hot shower, a paraffin wax dip (for the hands or feet), or putting on a heating pad (don't leave on for longer than 20 minutes even if it feels good).
TENS machines work by distracting your spinal cord from sending pain signals up to your brain. The machines that are sold in most pharmacies or department stores are also EMS machines (electrical muscle stimulation device). These are similar, but instead of producing high frequency pulses like a TENS, they produce low frequency signals that produce motor contraction (muscle twitch).
There is not great evidence about these, but if they work for you, then you have another weapon in your fight against pain. ***NOTE: always follow the directions on these machines***
Self-massage and acupressure can be done with your hands or with special balls, rollers, and other strange looking instruments. By massaging out trigger points or providing sustained pressure on a trigger point, you can relieve pain in the area. See some of the videos below for how to do this. These can be picked up at most sporting goods stores, yoga studios, and online.
physical therapy at home is possible!
Self massage for the levator scapulae muscle - often involved in headaches, neck and upper back pain.
This short video does a nice job of introducing the use of the theracane tool to perform "myofascial release" (help massage out tight muscles).
A nice home routine from the National Institute of Health in the United States.
A more advanced example of how to stretch out the buttocks and hips using a massage ball and just the weight of your own body. Start slow and move up gradually.
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