I would like to dedicate this article of mine to Ms Sofea, a physiotherapist working at the Kuala Lumpur Hospital and also to her colleagues who knows more on physiotherapy than I do.
The Role of Physiotherapy in Medicine
Summary
Physiotherapy is a vital adjunct to medical treatment, especially for chronic diseases and common injuries. Medication often provides immediate relief from pain and inflammation, allowing patients to begin physiotherapy exercises that would otherwise be too painful. Physiotherapy, however, addresses the underlying issues, muscle weakness, poor posture, limited mobility, providing long-term recovery and reducing reliance on medication.
Let me give some examples here:
1. Osteoarthritis: NSAIDs relieve joint pain; physiotherapy strengthens supporting muscles for stability and function.
2. COPD: Bronchodilators improve breathing; pulmonary rehabilitation enhances exercise capacity and quality of life.
3. Chronic back pain: Medication helps during flare-ups; physiotherapy corrects posture and muscle imbalances.
4. Venous stasis ulcers & lymphedema: Targeted exercises, compression, and manual drainage support healing and circulation.
While physiotherapy is not a universal cure and often needs medication for initial pain control, it is crucial in achieving long-term independence.ol) Patients who commit to physiotherapy gain strength, flexibility, and functional resilience, often reducing their reliance on long-term drugs and their side effects. The most effective approach is multidisciplinary, combining medication for symptom control with physiotherapy for root-cause treatment.
Let me explain further that physiotherapy is an adjunct to medical treatment - a path to long-term healing.
Physiotherapy has become one of the cornerstones of modern healthcare, offering benefits that extend far beyond simple pain relief. While some still view it as a set of exercises or massages for sports injuries, physiotherapy today is a scientifically grounded, multidisciplinary approach that restores function, builds resilience, and supports long-term independence. When used alongside medication, physiotherapy can provide both immediate relief and lasting recovery, an approach that is often more effective than either treatment alone.
A common misconception is that physiotherapy merely treats acute injuries or that it serves as a substitute for medication. In truth, medication and physiotherapy play different but complementary roles. Medication is vital in controlling acute symptoms such as pain and inflammation. For example, non-steroidal anti-inflammatory drugs (NSAIDs) can quickly reduce swelling and discomfort in patients with osteoarthritis. This immediate relief enables patients to begin physiotherapy exercises that might otherwise have been too painful to perform (Zeng et al., 2015). Yet medication by itself only masks symptoms: when its effects wear off, the underlying dysfunction remains. Physiotherapy, on the other hand, focuses on the root of the problem, weak muscles, restricted joints, poor posture, or inefficient movement patterns, helping patients to restore and maintain function (Taylor et al., 2010).
The strength of physiotherapy lies in its long-term vision. By addressing the physical causes of dysfunction, patients often gain independence, reducing their reliance on drugs that can carry risks of side effects, especially with prolonged use. Chronic pain patients, for instance, who rely on opioids may face risks of dependence, yet those who integrate physiotherapy into their care plans learn strategies to manage pain naturally while improving mobility (Ballantyne & Sullivan, 2015). In this way, physiotherapy transforms temporary relief into sustainable recovery.
Chronic conditions provide some of the clearest evidence of the power of this integrated approach. In osteoarthritis, medication can relieve joint pain, but physiotherapy strengthens the muscles around the affected joints, improving stability and slowing disease progression (Fransen et al., 2015). For patients with Chronic Obstructive Pulmonary Disease (COPD), bronchodilators open the airways, but physiotherapists introduce pulmonary rehabilitation, teaching breathing techniques and safe physical activity that enhance endurance and quality of life (Spruit et al., 2013). Chronic back pain is another example: medication may help during painful flare-ups, but physiotherapy identifies postural problems and muscle imbalances, correcting them through targeted exercise so that recurrences are less likely (Qaseem et al., 2017).
Nevertheless, physiotherapy has its limitations. Patients suffering from severe pain or extreme immobility often cannot begin therapy without some form of initial medical intervention. It is also not a universal cure, neuropathic pain, systemic illnesses, or progressive neurological conditions often require additional treatments beyond physiotherapy. Furthermore, unlike medication, which acts quickly, physiotherapy requires patience and commitment from the patient; progress is gradual and built over time.
Emerging trends are helping to expand physiotherapy’s reach and effectiveness. Tele-rehabilitation now enables patients to receive guided therapy remotely, while robotics and exoskeletons support recovery after strokes and spinal cord injuries. Wearable technologies are also being used to design personalized rehabilitation programs, while collaborative care models are ensuring that physiotherapists, physicians, and other health professionals work together for holistic patient care.
Physiotherapy’s role also extends into conditions that are less commonly associated with physical therapy. For venous stasis ulcers, ankle-pumping exercises and walking, in combination with compression therapy, improve venous return and help healing (O’Meara et al., 2012). For patients with lymphedema, physiotherapists use manual lymph drainage, bandaging, and gentle therapeutic exercises to improve lymph flow and reduce swelling (Ezzo et al., 2015).
The Role of Infrared Light Therapy in Physiotherapy:
Infrared (IR) light therapy appears to be an effective adjunct treatment for chronic venous stasis ulcers with studies showing it can accelerate healing, reduce pain, and improve the appearance of granulation tissue. Its mechanisms include increasing blood flow, stimulating mitochondrial activity, and ATP production, which provides cells with the energy to repair damaged tissue, and promoting cell proliferation and tissue regeneration. IR therapy is considered a form of bio-stimulation and is integrated into physiotherapy as an adjunct treatment to enhance conventional therapies like compression therapy.
Mechanisms of Action:
Increased Blood Flow -
Infrared radiation can cause microvascular dilatation, leading to augmented blood flow and improved circulation to the wound area.
Cellular Energy -
IR light stimulates mitochondria, the powerhouses of the cell, leading to an increase in ATP production. This provides more cellular energy for tissue repair and regeneration.
Cell Proliferation -
The increased energy available to cells promotes cell proliferation and the formation of new tissue.
Reduced Pain -
Studies have shown a significant reduction in pain associated with the ulcer, which improves the patient's quality of life.
Improved Granulation -
There is an increase in the area of healthy granulation tissue on the ulcer floor.
Integration with Physiotherapy:
Infrared therapy is not a standalone treatment but is used as an adjunct or complementary treatment alongside other therapies. It enhances the effectiveness of physiotherapy for venous ulcers in several ways:
Enhances Compression Therapy:
Physiotherapists often use compression therapy as a primary treatment for venous ulcers. IR therapy can be used in conjunction with compression to improve outcomes.
Provides Pain Relief:
By reducing pain, IR therapy makes it easier for patients to participate in therapeutic exercises and other physical therapy interventions.
Promotes Healing:
The bio-stimulatory effects of IR light promote a more favorable healing environment, supporting the overall goals of physiotherapy in managing chronic wounds.
Even in neurological rehabilitation, specialized programs such as constraint-induced movement therapy encourage neuroplasticity, giving patients opportunities to regain lost functions.
Physiotherapy also use water (hydrotherapy) as part of its therapeutic modality similar to those used in naturopathic medicine, and I have casually mentioned this here:
https://scientificlogic.blogspot.com/search?q=Naturopathic+medicine
In summary, infrared therapy is an effective bio-stimulatory treatment for venous ulcers that can be effectively integrated into a comprehensive physiotherapy plan to accelerate healing and alleviate pain.
The ultimate value of physiotherapy lies not only in symptom relief but in promoting long-term independence. As patients gain strength, flexibility, and confidence in managing their own bodies, their reliance on medication often diminishes. This shift empowers patients to live more fully, with fewer restrictions imposed by disease or disability.
In conclusion, while physiotherapy is rarely a complete solution on its own, its integration with medication provides a balanced and highly effective approach to managing both acute and chronic conditions. Medication brings immediate relief; physiotherapy builds lasting recovery. Together, they form a multidisciplinary strategy that addresses both symptoms and causes, restoring not only movement but dignity and independence.
References
1. Ballantyne, J. C., & Sullivan, M. D. (2015). Intensity of chronic pain — the wrong metric? New England Journal of Medicine, 373(22), 2098–2099.
2. Ezzo, J., Manheimer, E., McNeely, M. L., Howell, D. M., Weiss, R., Johansson, K. I., & Bily, L. (2015). Manual lymph drainage for lymphedema following breast cancer treatment. Cochrane Database of Systematic Reviews, (5).
3. Fransen, M., McConnell, S., Harmer, A. R., Van der Esch, M., Simic, M., & Bennell, K. L. (2015). Exercise for osteoarthritis of the knee: a Cochrane systematic review. British Journal of Sports Medicine, 49(24), 1554–1557.
4. O’Meara, S., Cullum, N., Nelson, E. A., & Dumville, J. C. (2012). Compression for venous leg ulcers. Cochrane Database of Systematic Reviews, (11).
5. Qaseem, A., Wilt, T. J., McLean, R. M., Forciea, M. A., & Clinical Guidelines Committee of the American College of Physicians. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline. Annals of Internal Medicine, 166(7), 514–530.
6. Spruit, M. A., Singh, S. J., Garvey, C., ZuWallack, R., Nici, L., Rochester, C., ... & Wouters, E. F. (2013). An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine, 188(8), e13–e64.
7. Taylor, N. F., Dodd, K. J., Shields, N., & Bruder, A. (2010). Therapeutic exercise in physiotherapy practice is beneficial: a summary of systematic reviews 2002–2005. Australian Journal of Physiotherapy, 56(1), 7–16.
8. Zeng, C., Wei, J., Persson, M. S., Sarmanova, A., Doherty, M., Xie, D., & Zhang, W. (2015). Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies. British Journal of Sports Medicine, 52(10), 642–650.
No comments:
Post a Comment