A special issue on Musculoskeletal pain

 “Quest for effective treatment for pains is one that has kept many medical researchers busy and keeps many of those suffering from it with empty wallets”.

We all suffer. It’s part of human life. It has fascinating and horrified people through the centuries. For thousands of years we have been slaves to its power, our potions and incantations having little effect. The struggle to understand and investigate pain has been going on for hundreds of years. Especially for those working in the medical areas, pain is an important and challenging problem. Musculoskeletal pain plagues a large percentage of the populace. Whatever the cause, the anguish that it brings can make one do almost anything to have relief and comfort. Physiotherapy offers alternative ways to manage pain and patients are given a choice to cope with the stimulation without the after-effects of anti-pain medications.

This special issue of PHYSIOTIMES is an attempt to cover relevant topics of interest to physiotherapists working relentlessly towards alleviating musculoskeletal pain. Effective pain management entails a joint effort of the physiotherapist and the patient. Physiotherapy methods employed in pain management are quite varied but the education component should always be included. Patients should not only introduce to handle pain but also on how to prevent pain through some changes in one’s lifestyle.

COVER STORY: Are You At Risk For Musculoskeletal Pain?An Evidence-Informed Review Part-1:Anthropometric Factors - SENTHIL P KUMAR

ABSTRACT: Musculoskeletal pain is recognized as global public health burden. Anthropometric factors include age, gender, height, body weight, flexibility, strength, posture and body mass index. Socio-demographic factors involve a combined interaction of personal habits such as diet, coffee-intake, smoking, alcoholism, physical activity, and socio-cultural factors such as family, lifestyle, socio-economic status and home/work environment. The objective of this review paper is to provide an evi... Read More

REVIEW ARTICLE: Musculoskelatal Pain-An Epidemiological Update - Y. RAVI SHANKAR REDDY

Abstract:  Pain and disability associated with musculoskeletal conditions represent a significant health burden in India. An episode of acute musculoskeletal pain is of short duration (Less than three months), although such episodes may recur. Successful management of acute pain reduces the risk of chronic pain. Clinical assessment comprising a history and physical examination is important to identify features of rare but serious causes of acute musculoskeletal pain. In the majority of t... Read More

PHYSIO SPEAKS: Face To Face With India's Only Mulligan Concept Teacher - DEEPAK KUMAR

Q. 1. Can you take us through your life journey in brief, starting from the early childhood, your schooling and family background?

I belong to a middle class family. After heavy losses in my grandfather’s business, my father started working as a hawker and he used to sell clothes in weekend market. I studied from a Hindi Medium Government school. Again, because of heavy loss, slowly my father stopped going to work, and someone had to support the family. Being the eldest son, I... Read More

FEATURE ARTICLE: Clinical Reasoning For Clinical Decisions Of Shoulder Pain - DR.BHAVNA MHATRE

Introduction to direct access or first contact practice has increased the accountability of Physiotherapists within the profession and outside including competing for health practitioners and health-conscious consumers. Hence, a recognized need to define and promote those characteristics that lead to superior clinical performance exists within the profession to firmly establish physiotherapists as autonomous, competent health care professionals capable of sound clinical decision making and ef... Read More

SPECIAL ARTICLE: Towards The Onslaught Of Musculoskeletal Pain - MELLISA ROMER

It may seem rather dreary and morbid to begin a new year with thoughts of slaying but in truth it is a resolution to get rid of all that is unpleasant leaving behind only that which is good. Pain, the most elusive of all unpleasant symptoms has riddled us for decades. It is the most basic and most primitive feeling and yet its solution extends out of our reach. How can we evaluate that which has no measure, a mere sensation so intangible and so subjective, it almost never is the same for two ... Read More


PHYSICAL CAUSE OF PAIN: Pain due to trauma, injury, or as a consequence of physical dysfunction will cause the muscles’ guard to protect itself from the pain. Muscle guarding creates muscle tightness. When the muscles become tight, the covering of the muscles, called “fascia” or soft tissue, also becomes tight, making the muscles even tighter. When that occurs, the joint(s) in the spine or extremity also become tight and restricted. Then the levels above and/or below the joi... Read More

"ORIGINAL ARTICLE: Prevalence Of Mechanisms Based Subgroups Among Patients With Musculoskeletal Pain-A Cross-Sectional Study - SENTHIL P KUMAR"

Abstract : Mechanism-based classification of musculoskeletal pain was originally put forth and was further emphasized in hypothetico-deductive model of clinical reasoning. Five categories of mechanisms were proposed- central sensitization, peripheral sensitization, cognitive-affective, sympathetically mediated, and nociceptive. The objective of this paper is to assess the prevalence of mechanism-based classification subgroups in a patient population with musculoskeletal pain referred for phys... Read More

GUEST COLUMN: Osteopathy For Musculoskeletal Pain-Implication For Physical Therapists - RAFAEL ZEGARRA-PARODI

As an Osteopath, trained and experienced in management of patients for pain management in neuromusculoskeletal disorders for 13 years, I take my opportunity to share my views and thoughts on the plausible yet perceptible relation between the two professions- Osteopathy and Physical Therapy. Numerous treatment approaches exist within manual and manipulative therapy for the management of a variety of musculoskeletal and non-musculoskeletal conditions. Osteopathic medicine is an approach to heal... Read More

HEALING HANDs: Application Of the Mulligan Approach For Lumbar mechanical Derangement - RUSSELL WOODMAN

Due to the complexity of the lumbar spine, when first introduced to an approach for examination and treatment of lumbar mechanical derangement, therapists frequently inquire “How does it all fit in?”

 By no means does this article advocate the utilization of only one manual therapy approach to lumbar mechanical derangement.  The objective of this article is to introduce the approach developed by Brian Mulligan.      

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PHYSIO YOGA: Physioyoga In Upper Crossed Syndromes - DR.NILIMA PATEL

Musculoskeletal disorders comprise one of most common and costly public health problems in the present times. Epidemiologic research has provided evidence for a relationship between development of musculoskeletal disorders and physical workplace factors such as repetitive work tasks, static contractions, and tiring postures (National Research Council and Institute of medicine, 2001). Neck/shoulder pain is widespread among office workers with intensive computer use (Jensen, 2003, Juul-Kristens... Read More

HISTORICAL PAPER: History Of Manual Therapy In Treatment Of Musculoskeletal Pain - DR.PETER HUIJBREGTS

Definition of orthopaedic Manual physical therapy: IFOMPT, the international federation of orthopaedic manipulative physical therapist defines OMPT as Orthopaedic Manual (physical) Therapy is a specialized area of physiotherapy/ physical therapy for the management of neuromusculoskeletal condition, based on clinical reasoning, using highly specific treatment approaches including manual techniques and therapeutic exercises. Orthopaedic manual therapy also encompasses, and driven by, the availa... Read More

MARKETING MANTRA: A Simple Step---Step Marketing Plan For Private Physical Therapy Practices - ERIKA TRIMBLE

If your goal is to have more clients and more freedom, and to build a truly prosperous practice, this simple 5-step guide will show you how. Follow these steps, and watch your patient referrals and revenues double.

1. Identify a target audience to which you want to market.

You cannot market to the whole world, so choose an audience which you know has a need for, and could derive great benefit from, your services. Consider who you truly enjoy working with, and what your spe... Read More

BOOK REVIEW: Musculoskeletal Physiotherapy:Its Clinical Science and Evidence-Based Practice - Refshauge, Kathryn M

Presents Scientific Knowledge in clinical practice, and provides a text in the musculoskeletal area of physiotherapy. In this book, Evidence is examined and application to the clinical setting is discussed. This second edition offers information about the explicit and implicit assumption which form the basis of practice

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