Article A Mechanism-Based Approach to Physical Therapist Management of Pain

I am an orthopaedics surgeon and have been working on chronic pain management for more than 15 yrs.

We had an evidence based evolution of practice for chronic pain and are having some wonderful results around the globe .

It's very simple and efficient. You can have ur data on this.

We are predispose to alot of stressess in our life time. Female gender increases the proportionate several times.

Neuroendocrine responses to any insult or stress causes sympathetic response. Increases catabolic harmones and suppression of anabolic hormones.

Persistent stressess can lead immune suppression which can lead to acute or subacute clinical infections mostly asymptomatic.

No of UTI in life time are far more than any other infections

Proceessed food lead to Malnutrition which can lead to malfunction of immune system Incidence of autoimmune diseases is increasing so as Incidence of other micro and macro nutritional deficiencies such as vit D, B12 , and Folic acid

Cold acids (Sour) and Asymptomatic urinary tract infections as top trigger of immune system. Micro or macro nutritional deficiencies can lead to repeated low grade infections and can result in other imune malfunction. Life style modification and muscles Strengthening is key in treatment of Imune diseases. Immune Modulation rather than immune suppression.

Any non neoplastic Atraumatic primarily aseptic myalgia or arthralgia is predominantly reactive phenomena due to asymptomatic urinary tract infections of exposure to allergens like cold and ingestion of sour (acids)Its about stressess

Malnutrition

Low grade infections mostly urinary tract infections

And resulting in immune diseases

Our protocol is IV Alfacalcidol inj

.5microgram once a day 4 days for osteomalcia

IV Zoledronic acid for osteoporosis

Antibiotics according to urine culture in non Traumatic aseptic non neoplastic arthralgia or myalgia

Hydroxychloroquine for immune Modulation

Avoidance of allergens like exposure to cold and sour

In more 15000 patients visiting orthopedic OPD its identified that intake of acids (any thing Sour in taste) and cold or exposure to cold water air in contact with decrease temperature can trigger immune response or activate ur immune system . Any pain as result of stiffness after period of rest is reactive phenomena in hypertrophic secretory membranes. Distention of capsules causes pain which relieve after a period of activity.

Low grade sub acute or acute infections are common in people with stress.

Just Avoidance of allergens like exposure to cold and sour can change the Natural history of any disease.

Strengthening of the anti gravity muscles and maintaining length of gravity assisted muscles can prevent deformation of joints.

You can have ur data on this

https://www.linkedin.com/posts/muhammad-abubakr-42a9691b4_autoimmunediseases-coldabracidsabrandabrasymptomaticabrutiabrtopabrtriggerabrofabrimmuneabrsystem-activity-6702071722386042880-QD33?utm_source=linkedin_share&utm_medium=android_app

http://dx.doi.org/10.13140/RG.2.2.35795.09765

Thank you for answers

http://dx.doi.org/10.13140/RG.2.2.35795.09765/1

http://dx.doi.org/10.13140/RG.2.2.14659.78880

History examination and routine base line investigation

Lifestyles modification

1. Avoidance of allergens like exposure to cold and sour

antigravity muscles

2. Strengthening simple walk

3. Treatment of asymptomatic urinary tract infections

4. IV treatment for osteomalcia and/Or osteoporosis

5. Immune Modulation with Hydroxychloroquine

6. Symptomatic pain relief