Physiotherapy is an ancient science that provides physical treatment techniques such as massage and uses electrotherapeutic and mechanical agents rather than drug therapy. It helps people to overcome disability and pain related to orthopedic, musculoskeletal, neurological and rheumatic illness.
A diabetic person with aching legs can be treated with a massage which gives a relief to the feet. After the message, the painful feet will be testified by soaking in cold water.
Diabetes can be controlled by lifestyle modifications which include intensive exercise rather than pharmacological therapy. Physiotherapists can help people by planning an individualized exercise program. This exercise program helps to control the glucose level in blood and achieves optimal weight.
Physiotherapy can reduce the frequency of cardiovascular events and improves the life expectancy. It also helps to improve the metabolic movements of the body in absence of weight loss. In addition to physical exercise, the use of alternate therapies such as yoga can help to achieve optimal cardio-respiratory health.
Physiotherapists can suggest specific exercises for the people with coexisting complications and caution certain movements that might be detrimental to their health. Effective counseling for physical exercise can ensure both cardio-respiratory and musculoskeletal fitness.
For example, an isotonic exercise like jogging helps a person to control high blood pressure and diabetes. But a repeated foot trauma associated with jogging may cause Sensory neuropathy or Charcot’s foot.
Most of the people suffering from diabetes have musculoskeletal complications like frozen shoulder, back pain or osteoarthritis. People with poorly managed type 1 diabetes have a syndrome of limited joint mobility. Diabetic amyotrophy is a type of neuropathy that has muscle wasting and weakening in the thighs. Carpal tunnel syndrome and sciatica are the other neurological conditions that occur in people suffering from diabetes.
In all these conditions, physiotherapy plays a major role in returning people to their normal life. The physiotherapist uses a combination of active and passive exercises, and mechanical and electrical aids to promote musculoskeletal and neurological functions.
Physiotherapy offers various non-pharmacological techniques for pain relief such as Transcutaneous electrical nerve stimulation (TENS) and Interferential therapy (IFT).
Transcutaneous electrical nerve stimulation (TENS) involves electrical nerve stimulation through the skin and sends painless current to the specific nerves. This mild electrical current generates heat that helps to relieve stiffness and pain by improving mobility.
Interferential therapy (IFT) uses the strong physiological effects for the low frequency of electrical stimulation of nerves.
TENS and IFT are considered as gold-standard therapies for neuropathic pain relief. They have proven benefits in the management of painful diabetic neuropathy, resistant foot ulcers, and edema (build-up of fluid in tissue). TENS are most effective against burning and stabbing pain but are less effective against sensitive skin and restless leg syndrome.
TENS and IFT are adopted as primary treatments for painful neuropathy as they are safe and have fewer drug interactions. Other methods such as ultrasonic therapy and hot wax are used for specific conditions of people with both diabetes and other conditions.
Physiotherapy helps to prevent and manage foot problems. Many numbers of foot complications can be reduced by teaching the importance of correct gait and posture along with the basic principles of off-loading. For people with typical diabetes-related foot problems, the usage of crutches or foot splints can ensure off-loading and early healing.
People who are unfortunate to undergo an amputation can be helped with post-operative pain relief, limitation of disability, rehabilitation, and the optimum use of a prosthesis. Similarly, rehabilitative measures are available for people who are recovering from heart attack, stroke, peripheral vascular surgery, other traumas, and other surgical interventions.
Physiotherapy interventions are usually delivered on a one-to-one basis. It will provide a contemporary approach to chronic medical care. The time spent with the physiotherapist during treatment can strengthen the bonding and enhance communication between them.
The need for physiotherapy services continues to grow as the number of people with diabetes continues to rise with the existing diabetes population. A team of diabetes care with the specialized physiotherapists helps to improve the health and well-being of people with diabetes.