Understand complaints

In order to offer you a comprehensive service and initial suggestions of what you can do before and after your visit to my physiotherapy practice in Reichelsheim, I am offering you the information I have collected on typical ailments.

Here you will find information and exercises related to musculoskeletal complaints and common pain. Recognize the symptoms yourself and let me advise you on them.

Deepen your knowledge of existing complaints and learn to prevent severe attacks of pain by optimizing your movements and exercising regularly.

The information that I make available to you here is well-founded and provides you with important medical backgrounds in an understandable manner.

At the same time, I will explain to you what I can do for you as a physiotherapist and osteopath and which therapies I can offer you to alleviate your symptoms.

Correct information always at hand

You probably know the modern adage that doctors don't particularly value “Googled” information that their patients bring with them. 

The problem with obtaining information on the Internet is that many different sites and forums often process medical facts incorrectly or too drastically. 

In this way, an annoying pain becomes an indication of a serious illness. Do not let this information, which is often fundamentally wrong, unsettle you. 

With this library of complaints, I offer you the opportunity to independently obtain correct and objective information on physiotherapy topics.

Nevertheless, knowledge alone does not replace a diagnosis. In the case of acute or chronic pain and complaints, I ask you to make an appointment in my physiotherapy practice in Reichelsheim as soon as possible.

In emergencies in which a regular appointment cannot be kept, you can always contact a hospital near you

Pain

What is pain

One wrong movement and an uncomfortable feeling shoots through your body and paralyzes any further action. Pain can occurred in any part of the body.

In the musculoskeletal system, pain is not always easy to assign. An alleged toothache can be caused by the jaw, an aching arm can start in the elbow and extend into the phalanx. Pain is a perception and is felt differently from person to person. It is difficult to describe it. 

Pain does not always have a physiological origin, it can also be caused by an imbalance of hormones (e.g. prostaglandins), or it can be psychosomatic. But he is never conceited. Pain affects you and significantly reduces your attitude towards life. Therefore, you should always consult a medical professional if the pain persists.

This is how the pain arises and works

The primary source of pain is a triggering of the pain receptors in the brain, which determine through the electrical transmission of a signal that we perceive pain. What the receptors react to is very different. For example, you feel pain from an external injury such as a cut. But joints can also be painful if inflammation occurs due to friction, or if the bone parts meet where there should be a protective layer. 

The brain can signal pain even without direct action if the amygdala, which is responsible for fear and stress, assumes without direct action that pain is imminent. Chronic pain then occurs without a trigger. The signal from the receptors “paralyzes” you with every movement, even if there is no need for it, or the movement itself would have a relieving effect, if it weren't for the fear of it.

Pain medication or therapy?

When they experience pain, many patients like to use medication persistently. If the medication helps to perform movements again and thus to start therapy, I am happy to support the intake.

However, pain medication puts a considerable strain on the organs. Morphines and opiates in particular should therefore only be taken for a short time. They can cause addictive behavior and even worsen pain if they are ingested for no reason or if they interact with other drugs to activate nerve cells.

Exercise therapy is therefore preferable in most cases, unless there are general impairments to the musculoskeletal system, for example after serious accidents or due to special conditions.

 

I can do that for you

As a physiotherapist, I have made it my mission to help you with pain of all kinds. In order to correct the pain, one must first understand it. 

In my physiotherapy practice in Reichelsheim, I will help you track down the causes of the pain and alleviate the symptoms. Movement exercises, diets, medication and therapies are used. In addition to physiotherapeutic movement approaches, my patients have also had good experience with osteopathic treatment.

Omega 3/6/9 complex diets and base complexes also support the body. On my website I also offer you exercise videos to improve movement sequences and to prevent and treat pain. Make an appointment at any time in my physiotherapy practice “Physio van Dijk” in Bad Nauheim and put your pain in professional hands.

Elbow

Causes of pain in the elbow

In my physiotherapy practice in Reichelsheim I repeatedly meet patients who cannot explain the elbow complaints themselves. Typical complaints such as the "golfer's elbow" or "tennis elbow" are just a few of the uncomfortable problems that can occur around the elbow. 

These harmless-sounding terms encompass mechanical and inflammation-related complaints that are not to be trifled with. With a tennis elbow / tennis elbow, the tendons or ligaments are overstretched. Rapid and sweeping movements can also tear the sensitive ligaments or injure the joints themselves. 

Overstressing the elbow can also lead to an elbow fracture, which is rare. If there is pain in the elbow, inflammation caused by cubital arthrosis, i.e. osteoarthritis that particularly affects this joint, is possible. Arthritis in the elbow joint caused by bacteria or disease also causes severe pain. In the case of bursitis, the elbow swells visibly.

Elbow problems put a strain on the body

The elbow is one of the two-sided joints in our body that we unconsciously use throughout the day. With every movement of the hands and arms, and even the upper body, the elbow is also used.

The elbow connects the lower and upper arm bones. Three partial joints come together in the joint capsule. If it is blocked or injured by an injury or inflammation, pain occurs around the elbow.

I can do that for you

Elbow problems are also uncomfortable because the arm can no longer be touched or laid on painlessly. Make an appointment in my physiotherapy practice in Bad Nauheim and I'll look into the problem. I have had good experiences with kinesio tape, exercises and osteopathic techniques for elbow problems. 

For pain relievers, I like to use natural remedies before I go for strong inhibitors. This can prevent or interrupt pain memory. Movement exercises and osteopathic approaches restore the mobility and resilience of the elbow. 

Shoulder

Causes of shoulder pain

Acute shoulder pain occurs most often after an overload with accompanying injuries. This overload can happen, for example, when lifting objects that are too heavy when moving or doing sports. But unfamiliar movements during sporting activities and overstretching of the tendons also have painful consequences. If the joint is stressed too much or rotated in the wrong direction, the shoulder can become dislocated, known as a dislocation. 

Particularly severe pain is to be expected if there is a fracture of the collarbone or the head of the humerus. The arm is then rigid and movement is no longer possible or only possible with great pain. In these cases, please go to a hospital in your area independently.

If movement is severely restricted but a break is unlikely, it may be impingement syndrome, in which tendons or muscles are painfully trapped. This syndrome is relatively common and can lead to limited mobility in the long term because tendons and muscles are no longer used correctly.

The Frozen Shoulder is also associated with restrictions. If you once had severe shoulder pain, which then subsided, but have since been able to use your shoulder more and more heavily, sticking and adhesions are to blame. In this case, I mobilize the joint again through exercises.

Frozen shoulder mainly affects women between 40 and 60 years of age. Injuries and wear and tear of the rotator cuff affect older or particularly active people. The rotator cuff comprises the tendons of the four muscles that keep the shoulder blade and humerus head mobile. Wear, overstretching or a tear along the tendons causes pain, which can also become chronic.

Shoulder discomfort as a limitation in everyday life

The shoulder joints are the most flexible of our joints in the human body. Depending on the training, they allow a large range of motion for the arms. But diseases around the neck and cervical spine also radiate into the area around the shoulders. If you have acute shoulder problems, you should visit me in my physiotherapy practice in Reichelsheim to have the problems clarified.

We often only notice how important healthy shoulders are for an active everyday life when there are problems in this area. We use the shoulder joint as soon as the upper body or arms are moved. All nerve tracts and muscle cords that control movements in the arm run over the shoulders and the shoulder joint. A blockage or pain in the shoulder therefore affects the respective arm, neck and thus also the upper back, sometimes up to the head.

I can do that for you

Shoulder complaints are diverse and an exact determination of the type of inflammation or injury is not possible without an expert opinion. If you have shoulder problems, make an appointment in my physiotherapy practice in Reichelsheim. I look at the mobility of the shoulder joint and assess your pain. In order to prevent the pain from becoming chronic and to prevent pain memory from developing, I rely on natural pain relievers. 

Anti-inflammatory medication may be necessary to start exercises for the shoulders. I have also achieved good results with osteopathic methods around the shoulder joints. On my website I have put together some exercise videos for you, with which you can keep your shoulders gently moving and guarantee a natural sequence of movements. If you experience pain while performing exercises, please make an appointment for a consultation.

Move

Back pain - is it the intervertebral disc?

Back pain is a kind of widespread disease. Many people only move a few hours in the course of their everyday life, mostly in their free time. At work, prolonged sitting prevails. Newly emerging bad posture and muscles that are not adjusted to movement lead to the fact that the back is suddenly overstrained when subjected to stress. 

Chronic back pain in particular often prompts patients and doctors alike to assume that there is a herniated disc without further ado. One in four patients who come to my physiotherapy practice in Bad Nauheim suffers from some kind of back pain. In many of these, the intervertebral disc was diagnosed as a trigger by a general practitioner.

In my opinion, this is the most frequently wrong diagnosis, if only because the herniated disc should be able to be displayed on an MRI. However, the MRI is performed lying down if the intervertebral disc is already positioned to favor prolapse. Only when standing and as dynamically as possible could the MRI show whether the intervertebral disc is really the cause of the pain.

What is the intervertebral disc?

Intervertebral discs are not a solid body like a joint in its joint shell. They are a silicone-like pillow with the nucleus in the middle. The soft disc is constructed like a tree disc. The soft gelatinous core or annulus fibrosi is located in the middle of the “annual rings”. It shifts depending on the load on the spine. The intervertebral disc itself lies between two vertebrae and acts there as a kind of shock absorber. When bending forward, the core is pushed backwards. If the vertebra is overloaded, the damping no longer works and the annulus fibrosi “break”. 

The nucleus “runs out” towards the spinal cord. As a result, the spinal nerve is pinched, resulting in a herniated disc. If a doctor tries to prove the incident and sends the patient to the MRI, the core is in a different position by lying down than it is for the pain when standing or when walking upright. The situation in which the patient suffers the complaints is therefore not shown at all. Both the vertebra and the intervertebral disc are stressed differently, and it is not possible to prove this without any doubt. 

I am therefore skeptical if patients continue to have pain even though they have been treated for their intervertebral discs. In the case of severe herniated discs, the insertion of an artificial disc is possible. However, there must be sufficient reasons for this; an operation this close to the spinal cord is always associated with a considerable risk.

Different causes of back pain

If you have also been diagnosed with a problem with the intervertebral discs, but the therapy does not bring any improvement, I invite you to an appointment in my physiotherapy practice in Reichelsheim to get to the bottom of the pain. Numerous other diagnoses are available, which often explain the symptoms more conclusively and have to be treated differently. One cause is the triggering of local trigger points. If these are burdened, it will radiate to surrounding regions. 

An indication of proven trigger points is when the legs hurt in addition to the back. In the case of visceral adhesions or organ adhesions, the organs in the body do not have sufficient space. The kidneys alone must be able to move four to six centimeters in the body when we inhale and exhale. If she cannot, this can also be a trigger for referred pain from the back. Blockages in the back also lead to pain and discomfort with every movement. 

They start from the facet joint. This is filled with a fluid, the synovia. The liquid ensures that movements are smooth instead of choppy. In the case of a “wrong movement”, a negative pressure arises in the facet joint and it “sucks in”. This blocks the vertebra. A minimum of two vertebrae are affected by these blockages, and there can be more. You will feel the blockage of immobility and pain while trying to loosen your back.

Exercise, obesity and back problems

Back pain occurs most often when the vertebrae are suddenly heavily stressed by a load or unfamiliar movement. When moving, doing housework and doing sports, people like to “overdo” themselves when they think they can lift a load through incorrect posture. Strength athletes know that weights must be increased slowly and safely. However, if you suddenly lift your washing machine without prior training, the damage cannot be foreseen.

Obesity also puts a strain on the back. It often causes postural damage to develop in the long term, as a higher weight in the abdomen and chest area has to be supported by the spine. The vertebrae themselves cannot strengthen to support this weight. Even at normal weight, you are permanently stressed and you cannot allow yourself a break by sitting and lying down.

Most back problems arise around the lumbar spine. This is located in the lower part of the back and consists of five vertebral bodies. They are followed by the coccyx and sacrum. This area is particularly stressed when sitting. The back pain does not get better even if the person concerned refrains from running and standing for long periods of time.

I can do that for you

It is important to see more than one doctor for back problems that obviously cannot be treated. In many cases, a physical therapist or osteopath will be able to tell you more about your vertebrae than a general practitioner and other things than an orthopedist. At an appointment in my physiotherapy practice in Reichelsheim, I can first examine your back and your ability to move. 

Together we will find the right exercise therapy for you or we will decide on pain-relieving, natural remedies that initially block the pain memory. In this way we can prevent the pain from becoming chronic. 

I also provide various exercise videos on my website. This is how you keep your back active and moving. Regular exercise without overloading the vertebrae is the best therapy to prevent back pain from occurring in the first place.

Hip

What are hip problems?

The hip connects the upper body with the legs. With every upright movement, it is therefore considerably burdened by the entire body weight. If pain occurs in this area, moving is difficult and even sitting and lying down can be torture. Most of the time, the pain occurs around the joint between the thigh and hip. If they pull up into the back, the spine can also be affected. 

The pain can be caused once by overexertion or a wrong sitting posture, or it can become a chronic problem for the entire musculoskeletal system. I can only determine the exact reason for your hip discomfort through a precise assessment in my physiotherapy practice in Bad Nauheim.

This is how hip problems arise

Hip problems occur due to various symptoms and injuries. Like any pain, they make themselves felt through a signal in the pain receptors. You can feel the "hip snap" yourself most clearly. This audible and perceptible cracking and jumping of the hip occurs when stretching or putting pressure on the hip region. There are three different types of jump. Most often the muscles or tendons jump over the bones. 

Jumping or moving the joint itself in the joint socket is less common. Any unintentional shifting is usually accompanied by pain. With osteoarthritis, joints wear out faster than is healthy for the body.

Injuries, obesity, rheumatic inflammation or an incorrect load often trigger the ailment here. If there is no inflammation or "hip snapping," the problem may be in the tendons. In tendinopathy, pain occurs during exercise or at the beginning of unusual stress. 

Bursitis, also known medically as bursitis, is also particularly common in athletes and is noticeable as bulges in the joints.

I can do that for you

To relieve hip discomfort, I need to examine the hip first. Make an appointment in my physiotherapy practice in Reichelsheim. Depending on the trigger, we achieve good results with movement exercises and posture corrections.

You can also find exercise videos for everything to do with the hips on this website. Dietary nutrition alleviates the symptoms of rheumatism and obesity. Osteopathic therapies are also used for hip problems.

Knee

Knee discomfort

The knees are among the most stressed joints in the human body. As we walk upright, our entire body weight rests on our legs and thus on our feet, ankles and, of course, our knees.

So it's no wonder that knee problems are relatively common. They cannot always be explained by the patient. Patients often visit my physiotherapy practice in Reichelsheim after they have knee pain or knee discomfort after exercising.

But knee problems can also be triggered and worsened in everyday life and at work. In the legs and the region around the knee joints, numerous muscle strands and tendons work together to enable fluid and powerful movement.

I will find out exactly which part is affected in a personal appointment (contact form) in my practice at Health Center van Dijk in Reichelsheim.

Common causes of knee problems

Sudden or chronic knee pain can have a number of causes. One of the most obvious is the immediate injury. If you fall or twist your ankle after a wrong movement, internal injuries to the knee can always occur in addition to open wounds such as abrasions or cuts. Fractures in the thigh bone or connected with a cruciate ligament tear, but also a broken kneecap, are possible. 

If an injury to the joint capsule is suspected, you should always contact the nearest hospital directly with the emergency. Less obvious but just as painful are strains and overstretching of muscles, tendons, ligaments or an injury to the capsule. The fact that a strain is present, for example after overstressing the joints during sport, is often noticeable through the lower stability when stepping on. 

If the ligaments or muscles are overstretched, the leg feels unsteady and weak when you step on it. A tear in the tendons, the tendon attachment or the collateral ligaments is accompanied by a bruise and severe loss of stability. It can also be an injury to the meniscus. A combination of bending and twisting can damage the meniscus and block the knee joint.

The inner meniscus is particularly often affected. Another typical athlete movement is the combination of changes in direction and abrupt movements. If you move too quickly or pull too far, a cruciate ligament tear occurs, which is extremely painful. Usually this affects the anterior cruciate ligament.

In martial arts, but of course also due to accidents or other violence on the knee, the muscles cannot cushion the rapid, strong movement. Periostitis caused by bacteria such as streptococci, or periosteum inflammation, is also possible. Obesity, arthritis and gout put stress on the knee as well as on all joints. Lifting heavy loads incorrectly at work or around the house can lead to knee problems.

Take precautions and train properly

If you are prone to frequent joint problems, you can do something for your knees yourself. This includes, on the one hand, the reduction of severe obesity.

A nutritionist or your family doctor can help you by prescribing dietary food. On the other hand, you should use your knees persistently. Long periods of sitting overwhelm the joints with sudden stress more than continuous moderate exercise. 

On my website I have put together some exercise videos for mobility and against the ailments around your knees. Athletes should avoid excessive demands and weights and fast movements that are too heavy for their training level.

If your knees are already painful, it is time to stop training and, if the symptoms persist, make an appointment in my physiotherapy practice in Reichelsheim.

I can do that for you

Since knee problems are manifold, there is no therapy that I can suggest to you without an expert opinion. I will examine the reflexes and mobility of the affected knee and increase them through targeted exercises. Osteopathic approaches can also produce good results for knee problems.

Make an appointment in my practice to counteract the knee pain.

Pain memory

Why doesn't my pain go away?

Many patients come to my physiotherapy practice in Reichelsheim with chronic pain and report persistently violent attacks of pain over many years. How can it be that pain lasts so long and no therapy is successful?

The answer can be found in the theory of active pain memory. Put simply - this medical theory that the longer the pain persists, the greater the likelihood that the nerve cells will adapt to it and constantly send pain signals, even when there is no stress.

The pain memory can maintain the pain for years or, in the worst case, a lifetime, even after it has completely healed, if no doctor is consulted.

As a physiotherapist, I consider it my calling to give people more mobility. If the sequence of movements is blocked by pain, this is the first point at which I start to give you a piece of quality of life back.

The pain memory as a burden

In physiotherapy, we speak of chronic pain when pain persists for more than a few weeks and no new trigger can be found. For example, if you distort a tendon while exercising, the pain will ideally subside over the next few days the less the limbs are stressed. The injury will heal and you can carefully start exercising again. In the case of chronic pain, movement is often no longer an option. The pain that was triggered at one point or another is permanently present. It burdens everyday life and, in the worst case, forces people to give up their work and only move with difficulty.

While the nerve cells reported the pain correctly to the brain at the beginning and thus triggered the stimulus, they learn more in the chronic course. The human body is constantly automating processes in order to increase its performance. He does not always make the decision that really supports us in our life. While the WDR neurons (wide dynamic range) no longer have to evaluate whether a pain signal is present or not, the nerve cells can strengthen themselves.

They support each other and pass the well-known signal on permanently. This frees up resources for other learning processes. It is through this automation that our vital functions such as heartbeat, breathing and electrical impulses function, which keep us alive. Persistent pain shouldn't really be part of our everyday life.

Unwanted habituation and classic conditioning

Our brain is capable of high performance and the body quickly gets used to things that it would actually like to reject. One of the earliest experiments in this regard was the famous “Pavlovian Dog”. Ivan Pavlov, a Russian researcher, conditioned the first of his test subjects in 1905 to change their salivation behavior. In a nutshell, Pavlov used food to stimulate the flow of saliva. Then he taught the dog that the neutral stimulus of a ringing bell was related to the food. After adequate conditioning, the dogs responded with salivation when the bell rang, even if no food was in sight.

It is similar with pain. You make a wrong move and the pain occurs. You repeat the movement for a few weeks and the pain keeps coming back.

Ultimately, the injury heals or you correct the bad posture. But over a long period of time you have conditioned yourself to the fact that this movement means pain. The body reports pain, even if there is actually no stimulus that could be translated into pain sensation. An X-ray or ultrasound of the affected areas cannot find any injury, but you can still feel the pain as if it had just been caused.

Gate Control Theory and Preventing Chronic Pain

The most important pointers of the medical professionals that the prevention of pain memory should be used in the treatment of chronic pain include the findings from the gate control theory. This means, very simply, that a barrier in the nerve tracts of the spinal cord is used to decide whether or not the pain stimuli can be accessed. If the pain is not “let through” into the crucial nerve cells, a chronification, that is, the pain from growing into chronic pain, can be prevented.

The cells do not adapt, automation does not take place. According to the gate control theory, also known as the control barrier theory, the pain must be stopped at the barrier. If the pain is relatively fresh, this can also be done through medication. In my physiotherapy practice in Reichelsheim, however, I like to rely on natural remedies instead of immediately deciding on strong opioids together with you.

Another conclusion from the findings of the research on the gate control theory is that the pain inside the body can be reduced by external action on nearby regions.

If the chronic pain is near the bones, pressure on the surface of the skin near the painful area can stop the pain or briefly redirect it to the pressure point. This is where different types of acupuncture come into play, which I would like to introduce to you.

I can do that for you

In order to be able to assess your current pain situation, it is essential that we make a personal appointment in my physiotherapy practice in Reichelsheim.

The procedure differs depending on whether the pain is already anchored in the pain memory and thus chronic or new. For pain therapy myself, I like to use natural pain relievers and anti-inflammatory drugs such as devil's claw, MSM (sulfur), curcumin and proteolytic enzymes.

You can relieve your pain through natural means and if exercises to increase mobility due to the pain are not possible, I will be happy to advise you on a suitable therapy.

The goal of the treatment of chronic pain is to get you fit again for your active everyday life and in the long term to overwrite the pain memory with the normal reflexes.

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