Migraine Headache

Migraine is the most common disabling brain disorder. Chronic migraine, a condition characterized by the experience of migrainous headache on at least 15 days per month, is highly disabling. Patients with chronic migraine present to primary care, are often referred for management to secondary care, and make up a large proportion of patients in specialist headache clinics. Many patients with chronic migraine also have medication overuse, defined as using a compound analgesic, opioid, triptan or ergot derivative on at least 10 days per month. Most migraine clients often times complained of not knowing how to manage their symptoms and often times left to depend on pain killers.

Let’s face it, medication such as pain killers are the gold standard when it comes to treating migraine headaches. But more often than none, these medications contribute to other symptoms such as sleepiness and fatigue, racing heartbeat, nausea, and difficulty thinking. However there are good natural ways available to reduce and prevent your migraine symptoms.

Step 1

As migraine attacks are different for everyone, one should keep a migraine note/diary. A really simple diary would consists of:

  • how often they occur
  • where the pain is
  • the type of pain (throbbing, piercing, etc)
  • if there are other symptoms (such as being sick or having vision problems)
  • how long the attacks last
  • what treatment you take
  • how effective treatment is (or isn’t).
  • what and when you eat (think about missed or delayed meals)
  • medication you take for other conditions
  • how much sleep you have
  • exercise you take
  • social and work activities
  • other factors, such as the weather
  • women should record details of their menstrual cycle.

Having to know the details of the attack will help in eliminating or reducing the migraine attacks.

Step 2

Sleep well

Having poor quality of sleep often is one of the complaints from people who suffers from migraine. Here is a tip to better sleeping.

Establish regular sleep hours. Wake up and go to bed at the same time every day — even on weekends. If you nap during the day, keep it short.

Naps longer than 20 to 30 minutes may interfere with nighttime sleep.

Step 3

Eat wisely

Many migraine attacks happen especially when that person’s eating habits is less than ideal. Here are some things you should avoid:

1) Eating foods that may trigger the attack

2) Eating not regularly

3) Fasting

Step 4

Exercise regularly

During physical activity, your body releases certain chemicals that block pain signals to your brain. These chemicals also help alleviate anxiety and depression, which can make migraines worse.

Obesity also increases the risk of chronic headaches, so maintaining a healthy weight through exercise and diet can provide additional benefits in managing migraines.

Step 5

Manage stress

1) Stress and migraines often go hand in hand. You can’t avoid daily stress, but you can keep it under control to help manage your migraines:

2) Simplify your life. Rather than looking for ways to squeeze more activities or chores into the day, find a way to leave some things out.

3) Manage your time wisely. Update your to-do list every day — both at work and at home. Delegate what you can, and divide large projects into manageable chunks.

4) Take a break. If you feel overwhelmed, a few slow stretches or a quick walk may renew your energy for the task at hand.

Adjust your attitude. Stay positive. If you find yourself thinking, “This can’t be done,” switch gears. Think instead, “This will be tough. But I can make it work.”

5) Enjoy yourself. Find time to do something you enjoy for at least 15 minutes every day. It could be playing a game, having coffee with a friend or pursuing a hobby. Doing something you enjoy is a natural way to combat stress.

6) Relax. Deep breathing from your diaphragm can help you relax. Focus on inhaling and exhaling slowly and deeply for at least 10 minutes every day. It may also help to consciously relax your muscles, one group at a time. When you’re done, sit quietly for a minute or two.

Migraine Headache2020-02-26T15:19:42+08:00

Lower Back Pain Gardening

Many clients enjoy gardening as it eases their minds and gives them a sense of connection to nature and their environment. However, with degeneration and aging, or let’s be honest even 20 year olds, pain creeps in during our favourite hobby and it can be upsetting.

Simply put, gardening may be slow paced and relaxing for the mind but it can also be a strenuous activity that requires a lot of muscles and joint movement. You bend, stretch, lift, squat, kneel and extend your arms. This requires your hips, knees, ankles, multiple vertebral sections, shoulders, elbows and wrists to be moving well and in sync. Bet you didn’t think gardening was such hard work!

The key to preventing lower back injuries is to engage your core muscles, keep them strong as well as having good flexibility and mobility in your joints. If this isn’t in place, you would end up with the common strain in the lower back, stiffness in your hips and legs and in a long run injuries and long term numbness or tingling down your extremities (legs and arms).

With that said, we recommend our clients to warm up and cool down after gardening the same way you would before and after going for a work out or to the gym. You would ideally want your muscles to be strong and have good core muscles in your abdomen, pelvic region and glutes. Some squats, planks and light jog would suffice as a good warm up and cool down session.

Another point to note is to use the correct muscles when bending and lifting. Keep the objects you are lifting close to you and bend your knees instead of bending over. When lifting, engaging your core, glutes and your quadriceps are essential when lifting to make sure you are not injuring your back. If you feel a strain, remember to take a break, drink lots of water and rest.

When it comes to your wrist, think about the tools you are using. Use wheelbarrows instead of dragging heavy bags of dirt. Use the correct shovels and digging tools to avoid injuring your wrist. There are now ergonomic tools available and these help you with joint mobility of your elbow and wrist.

Take breaks when you can! It is best just like reps at a gym, to stop every 10 mins for a few minutes before continuing. Most recommend gardening for no longer than 30 mins at a time. We would advise the same and to drink plenty of fluids to keep your muscles hydrated. You can also ice your sore muscles to prevent swelling or to take hot Epsom salt baths after a long day gardening as it can help relief soreness and prevent your muscles from going into a spasm.

Lastly, if your spinal joints or muscles continue to ache after sitting for too long, you can always come to us at Healthworks. We have chiropractors, physiotherapists and physical trainers. All with enough experience and knowledge to help you with your condition, pain or injury. Remember, when it comes to lower back pain, prevention is always better than cure!

Lower Back Pain Gardening2020-02-21T11:30:19+08:00

Physiotherapy For Tennis Elbow (Lateral Epicondylitis)

Your elbow hurts, you’ve been told to have tennis elbow but have never played tennis. You are referred for physiotherapy by your GP, but first you want to have a good understanding of the symptoms and problem to make sure you get the best treatment.

What is Tennis Elbow?

Tennis elbow or lateral epicondylitis is a common condition and is treatable with physiotherapy. However, not all tennis elbows are the same, and they have to be assessed and treated differently in order to reach optimal result.

Tennis Elbow is the most common overuse syndrome on the lateral part of the elbow. It is a tendon injury involving the common extensor muscle of the forearm. These muscles originate from the lateral epicondyle of the distal humerus. Overuse of these muscles and tendons of the forearm and elbow together with repetitive contraction or manual tasks can put too much strain on the elbow tendons. This injury is often work-related, any activity involving wrist extension, pronation or supination during manual labour, housework and hobbies are considered as important causal factors.

Clinical Presentation

Tennis elbow may cause the most pain when you:

  • Lift something
  • Turn a door knob
  • Make a fist
  • Turn a bottle cap

Factors that cause tennis elbow

  1. Repetitive Motions

People who have jobs or hobbies that involve repeated movements of the hand,      wrist or elbow are at higher risk for developing tennis elbow. When you increase this activity faster than your arm can adapt, tennis elbow will begin.

  1. Ergonomics

When it comes to tennis elbow, the following factors should be looked into and needs alteration if necessary:


Seating Posture – Is the keyboard and mouse height ideal to your elbow position? Do the forearm has proper support during typing and does the chair provides good support to the back?

Vibration – do any of the tasks that you need to perform expose your arm to vibration? This can be very stressful on the joints and supporting muscles so these tasks must be performed well, with high quality tools and regularly planned breaks from the task.

There are many ways to treat tennis elbow and following a thorough assessment of your elbow, arm and neck, the physiotherapist will discuss the best strategy for you to use based on your symptoms and your lifestyle. Physiotherapy treatment can include gentle mobilisation of your neck and elbow joints, electrotherapy, elbow kinesio taping, muscle stretches, neural mobilisations, massage and strengthening.

Here in Healthworks, our physiotherapist will do a thorough assessment and design a comprehensive treatment plan for your condition. If there are any queries regarding this article, feel free to contact us at 018-9828539 or drop us an email at contact@myhealthworks.com.my

Physiotherapy For Tennis Elbow (Lateral Epicondylitis)2020-02-18T15:35:01+08:00

Infraspinatus Trigger Point: The Culprit of Many Shoulder Pain Cases

One of the more common complaints that we see in the clinic is shoulder pain. Patients presented with such complaint usually seek alternative treatment but to no avail. So, what is this unexplainable pain deep in the shoulder joint? Is there something wrong with the joint itself?

Infraspinatus Muscle

The infraspinatus muscle is part of the rotator cuff muscles that are responsible in stabilizing the shoulder joint and assisting movements such as lateral rotation of the shoulder. It is a muscle that is involved in almost every movement of the shoulder. Hence, a dysfunction to this muscle can restrict the quality of our daily living.

Our muscles need to contract and relax for movement to occur. Without this contraction and relaxation, we will be immobile. When there is a trigger point, the normal movement of the muscle is disrupted due to formation of knots along the muscle.

Imagine our muscle fibre as a bundle of rope. When there is a knot along the rope, the movement of overlapping during contraction and relaxation is not smooth anymore. Hence, the formation of pain.

Infraspinatus trigger points

Our infraspinatus has several trigger points within the muscle fibers, they all refer pain to different parts of the shoulder and arm.

As seen in the diagram above, the infraspinatus trigger point commonly refer pain to:

  • The front of the shoulder
  • Deep in the shoulder joint
  • Shoulder blade
  • Biceps
  • Forearm and hands

Types of pain referred are not limited to achiness. Numbness, tingling, weakness, sharp pain, dull and burning are common symptoms as well.

Due to this pain, daily activities such as lifting the arm to wave “hello”, fastening their bra strap, reaching out to turn the door knob, lifting arms to wash their hair, brushing teeth and disturbed sleep due to sleeping positions can also be affected.

How do we get infraspinatus trigger points?

An overload of the muscle can lead to formation of trigger points. Activities such as raising the arm for a prolonged period of time or repetitive movements of the shoulder can cause muscular overload.

Listed below are common causes of infraspinatus trigger points.

  • Working for long hours in front of the computer without arm support.
  • Driving for long hours with the hands positioned on top of the steering wheel.
  • Starting a new resistance workout routine
  • Rotation of the shoulder in swimming
  • Forehand stroke in tennis
  • Arm swing in badminton

How can Healthworks help with treating this shoulder pain?

After undergoing a consultation by our practitioners, a diagnosis will be derived from the history and physical assessment of the patient. Treatment approach would revolve around myofascial release, spinal adjustments to relieve restricted joints as a result of movement dysfunction, exercises (stretching and strengthening affected muscles) and ergonomic advice.

If this condition sounds like something you are experiencing, don’t hesitate to contact us at 03-6211 7533 for further enquiries. Our practitioners will be more than willing to tend to your questions.

Infraspinatus Trigger Point: The Culprit of Many Shoulder Pain Cases2020-02-05T14:53:23+08:00
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