Spinal Issues Attributing to Heel Pain and Physiotherapy as a Treatment

Heel pain can be caused due to a multitude of factors. Often the heel pain is localised and is caused due to shoes misfitting, overuse of feet, and so on. At other times, it is caused by underlying problems such as spinal issues. However, here we will focus on spinal issues often being the direct cause of heel pain.


Spinal issues attributing to heel pain include – cervical spondolysis, sciatica, spondylolisthesis, lumbar degenerative disc disease, spinal stenosis, and herniated disc. They are generally a result of postural problems, muscle tightness / weakness, nutritional deficiencies and ageing.


Common symptoms of heel pain caused due to spinal problems include restricted ability to bring the foot up, foot heaviness and difficulty walking on tiptoes, difficulty in completing everyday functions such as walking and driving, and is usually accompanied by redness, tenderness, thickened skin, or swelling.


It is crucial that the particular reason for foot pain be precisely analysed by a properly prepared doctor. On the off chance that the foot pain might be caused by an issue in one’s lower back it is prudent to see a spine specialist for an entire analysis of potential lower back conditions that might cause the leg pain and foot pain. The diagnosis is done by examination of medical history, taking X-rays, etc.

Treatment: Physiotherapy

Heel pain often lands a patient in surgery and we at Eva Physiocare can prevent that. We are working on preventive care for heel pain caused due to spinal issues as well as non-spinal ones.

Physiotherapy is a non-intrusive treatment process, therapeutic in nature, and is shown to grant quick relief to patients. At the same time physiotherapy helps in preventing heel pain by curbing it before it takes a serious shape. Physiotherapists efficiently make manual assessment by way of clinical reasoning and without having to refer to any kind of imaging such as X-rays, etc. in order to diagnose the causes of the heel pain.

Physiotherapy treatment procedure focuses on biomechanical corrections through heel and foot exercises like stretching and strengthening exercise, etc., to ensure strength and flexibility. In this case the physiotherapist will not just focus on the heel pain but also on the underlying spinal problems that are attributing to it, thereby, treating the spinal issue by means of physiotherapy as well. Physiotherapy for the spine includes controlled, gradual and progressive exercises that induces the free movement of nutrients to the spine, and have healthier discs, muscles and ligaments.

The systematic treatment of physiotherapy allows the patient to avoid surgery altogether and it is considered a good thing by many given its intrusive nature, high costs and associated risks. Additionally, if the patient has to undergo or has already undergone surgery, physiotherapy helps in quick and effective rehabilitation, and enhancement flexibility and mobility.


Physiotherapy: An Effective Treatment for Supraspinatus Tendinopathy


Supraspinatus tendinopathy is a typical and debilitating condition that turns out to be more pervasive after middle age and is a typical reason for shoulder pain. The supraspinatus tendon of the shoulder’s rotator cuff is affected and these affected tendons of the musculoskeletal framework proceed toward degeneration.


Supraspinatus Tendinopathy is generally attributed to resistive overuse and repetitive stress of the shoulder and its surrounding regions during certain occupational activities or sports. Broadly speaking, the causes of this condition can be summarised under two heads – extrinsic and intrinsic factors.

  1. The extrinsic factors can be further subdivided into two areas – primary and secondary impingement.
  2. Primary impingement includes factors such as increased subacromial loading, trauma (direct or repetitive), and overhead activities.
  3. Secondary impingement includes factors such as rotator cuff overload or soft tissue imbalance, eccentric muscle overload, glenohumeral laxity, bicep tendon laxity, glenoid labral lesions, muscle imbalance, scapular dyskinesia, posterior capsular tightness and trapezius paralysis.
  4. The intrinsic factors, on the other hand, include acromial morphology, acromioclavicular arthrosis, coracoacromial ligament hypertrophy, coracoid impingement, subacromial bursal thickening and fibrosis, prominent humeral greater tuberosity, impaired cuff vascularity, ageing, primary tendinopathy, intratendinous issues, articular side partial-thickness tears, and calcific tendinopathy.

Physiotherapy Treatment

The treatment of supraspinatus tendinopathy comprises of various progressive exercises. There are three phases of treatment: Immobilization, passive/assisted range of motion, progressive resistance exercises; in the acute and the recovery stages.

1.  Acute Phase

The objectives of the acute phase are to alleviate torment and irritation, avert muscle decay without compounding the torment, restore non-painful scope of movement, and standardize the arthrokinematics of the shoulder complex. This incorporates a time of dynamic rest, dispensing with any movement that may cause an expansion in side effects.

Range-of-motion exercises may incorporate pendulum activities and indication constrained, dynamic helped scope of-movement works out. Joint preparation might be incorporated with substandard, front, and back floats in the scapular plane. Fortifying activities ought to be isometric in nature and work on the outside rotators, interior rotators, biceps, deltoid, and scapular stabilizers. Neuromuscular control practices additionally might be started. Three different PNF patterns can be used. Further, stretching exercises must be incorporated which will involve a 3-time repetition for a period of 30 seconds each.

In addition, therapeutic Kinesio taping and exercises; ultrasonic laser therapy; have shown to be effective in treating Supraspinatus Tendinopathy patients. They have advantageous impact in diminishing pain intensity, reducing the disability and improving shoulder ROM in chronic subacromial impingement syndrome of shoulder.

Modalities that likewise might be utilized as an aide incorporate cryotherapy, hyperthermia, transcutaneous electrical nerve incitement and ultrasound. Concentrated ultrasound treatment has been appeared to build calcium resorption, but this requires frequent visit treatment that may not generally be viable.

2.  Recovery Phase

Additionally, the physiotherapist may recommend self-exercise during the recovery phase. These may include isotonic resistance exercises involving the supraspinatus, internal rotators, external rotators, prone extension, horizontal abduction, forward flexion to 90°, upright abduction to 90°, shoulder shrugs, rows, push-ups, press-ups, pull-downs, upper extremity ergometry exercises, trunk exercises, and general cardiovascular conditioning for endurance. This aims at standardize scope of movement and shoulder arthrokinematics, perform manifestation free exercises of day by day living, and enhance neuromuscular control and muscle quality.


Physiotherapy has been proven to be the most effective for the purposes of rehabilitation. But this does not mean that the other procedures are to be foregone entirely. One should consult their doctor for proper treatment. Physiotherapy including laser therapy and Kinesio taping works as a complementary treatment to other forms of treatments which generally include medicines and surgeries.

Please note that Evaphysiocare has been recommended as the best physiotherapy clinic in Noida by many Supraspinatus Tendinopathy patients in Delhi NCR.


Physiotherapy- A Solution for Backache

Backache: An Introduction

Backache is the pain caused in any region of the back. Human back can be divided into four regions: Cervical segment, Thoracic cavity, lumbar and tailbone (sacral spine). The pain in any of these four regions is called backache. The most sensitive part of the back, which is prone to back pain is lumbar, as it supports most of our body weight. Back pain can originate from muscles, joints, nerves or bones in the spine. Also internal organs like gall bladder, pancreas or kidneys may also cause ‘referred pain’ in the back. It may be acute or chronic pain and can easily radiate into upper or lower parts of the body.

Causes of Backache:

Causes of backache include Strains (Muscles or ligaments or muscular spasm), Structural problems (Disc problems, Arthritis, etc.), infections and autoimmune diseases, obesity, etc.  Muscle weakness is fast becoming one of the major causes for backache. It is also called reduced muscle strength or weak muscles and occurs when the full effort does not produce a normal muscle contraction or movement. It is generally a symptom of a variety of skeletal muscle diseases like chronic fatigue syndrome, muscular dystrophies, hypnotia, polio, rheumatic fever, etc. It can be both, short term and long term.

Prolonged Sitting Linked to Serious Health Risks:

Sitting for prolonged periods of time can be a major cause of muscle weakness which further results in back pain or worsen an existing back problem. It causes increased stress of the back, neck, arms and legs and can add a tremendous amount of pressure to the back muscles and spinal discs. Additionally, sitting in a slouched position can overstretch the spinal ligaments and strain the spinal discs leading to damaged spinal structure in the long run.

Role of Physiotherapy:

If the above condition persists, it is advisable to visit a physiotherapist, who after determining the cause and intensity of the problem, may recommend the patient to undergo physiotherapy treatment. Dr. Aneeta Verma, a renowned physiotherapist in Noida, in her entire career so far, has found that most the backache problems are caused due to muscles weakness and tightness.

Under physiotherapy, a lot of techniques are followed to help relieve the pain. Application of heat/ice pads and electrical simulations may help alleviate the initial pain. Massage therapy, a part of the physical therapy also gives short term relief. As the pain subsides, the therapist introduces some flexibility and stretching exercises for the back and abdominal muscles. These exercises are performed gently first, thereby increasing the intensity to improve the muscle strength. Evaphysiocare, one of the best physiotherapy clinics in Noida, has recorded that patients suffering from backache problems, mostly belong to IT sector, who work tirelessly in their offices. The prolonged sitting in the office leads to muscles weakness and tightness, resulting in the problem of backache.

Then techniques on improving posture are focused upon. Wrong posture is one of the major culprits behind backaches, and correcting the posture will go a long way in avoiding and reducing the misery. Regular physical activity and exercise are the only ways through which long term outcomes can be achieved, so that even after the pain is gone, it should not reoccur.


Frozen Shoulder: Symptoms, Causes and Treatment

Feeling a stiff shoulder accompanied by pain and inability to move your arm? Well, you might be suffering from ‘Frozen Shoulder’ that affects your shoulder joint. Also called Adhesive Capsulitis, it causes the tissues surrounding the shoulder joint, to thicken and tighten, thereby making it difficult for the arm to move. The condition is often confused with arthritis, but the two are not related. It can affect one or both of the shoulders.

The human shoulder comprises of three bones that resemble a ball and socket joint. They are your upper arm called humerus, shoulder blade called scapula, and collarbone called clavicle. These bones are held together by tissues called the shoulder capsule. When these tissues become hard, scar tissues develop over time, resulting in pain and restriction of arm movement. This is what is referred to as a frozen shoulder.

Symptoms of this condition can be easily detected. They could be:

  • Acute pain and stiffness that restrict and obstructs shoulder and arm movement
  • Dull pain in one or both shoulders
  • Pain in the shoulder muscles that wrap the top of your arm

The symptoms develop in three stages. The first stage is the freezing stage where shoulder movement causes pain and the range of movement becomes limited. As the condition advances to second stage called frozen stage, the pain may diminish, but shoulder becomes stiffer and it using it becomes more difficult.  At the last stage, called the thawing stage, the range of motion starts to go back to normal and the pain reduces to a large extent. All this can take place from a year to three years.


Hormonal imbalance, diabetes and a weakened immune system might make a person vulnerable to joint inflammation. Long period of inactivity due to an injury or illness might also make shoulder tissues prone to the condition. Frozen tissue affects adults over 40 years and is more common in women.


Medications such as anti-inflammatory drugs or steroidal injections are normally administered to reduce the inflammation in the tissues. But these are often not beneficial in the long run and might cause side-effects. What comes to the rescue of patients suffering from this condition is the physical therapy or physiotherapy. Physiotherapy is most useful in restoring the full and unrestricted movement of shoulders. It can help to reduce the pain and stiffness and if caught early enough can prevent full onset of the condition. Various stretching and strengthening exercises can help release a frozen shoulder. Appropriate exercise programs done under the supervision of a trained physiotherapist can go a long way in relieving the patients of their pain. However, if the frozen shoulder does not respond to non-surgical treatment, then surgery to release or stretch the scar tissue is also resorted to in some cases.