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Post-Polio Health (ISSN 1066-5331)

Vol. 13, No. 1, Winter 1997
Pain in Post-Polio Syndrome, continued

TREATMENT FOR BIOMECHANICAL PAIN includes posture and back-care education and decreased weight bearing through use of assistive devices such as braces, crutches, wheelchairs, and scooters. Abnormal biomechanics can often be modified with fairly simple and practical interventions such as cervical pillows, lumbar rolls, glottal pads, dorsal-lumbar corsets, and heel lifts. These pains are usually improved by conservative measures aimed at reducing mechanical stress - pacing activities, supporting weakened muscles, stabilizing abnormal joint movements, and improving biomechanics of the body during common daily activities. Anti-inflammatory agents are used sparingly, and then only in low doses to supplement conservative measures. In particular, efforts should be directed at improving routine daily activities such as sitting, standing, walking, and sleeping, as well as any repetitious activities at work. Weight bearing with the wrist hyperextended and radically deviated should be avoided.

For those with carpal tunnel syndrome who must use a cane or crutch, an Ortho-ease or pistol grip is prescribed to place the wrist in a more neutral position and spread out the weight-bearing surface on the palm. Providing adequate support for weakened muscles and unstable joints can often be a difficult challenge; however, the basic orthotic principles are similar to those used in the management of other neuromuscular diseases. For individuals with low-back pain, lumbosacral corsets, a shoe lift, or pelvic lift can help improve biomechanics. For genu recurvatum (back knee) or genu valgus (knock knee) due to quadriceps weakness or ligament instability, a long-leg brace (KAFO - knee, ankle, foot, orthosis) with a free ankle and an extension stop at the knee is used. Polio survivors with dorsiflexor weakness or ankle instability can benefit from an athletic ankle splint, high-top shoes, or a short leg brace (AFO - ankle, foot, orthosis).

Many individuals need an orthosis that combines strength and lightness. The new plastics and lightweight metals can often be used alone or in combination. Frequently, survivors prefer to repair and use their old braces rather than start over with new ones. Others may resist using any kind of brace for cosmetic and psychological reasons. Orthotics are recommended for the following indications:

Pain can be reduced by altering biomechanics and by changing to a lifestyle that reduces physical activity. These strategies may be difficult to accomplish, however, because they often require developing behaviors unlike the old, familiar ones. Altering the pace and intensity of discretionary activities and learning new ways to gain more control over when and how activities are performed is essential. Restoration of function as well as relief of pain can be accomplished by an interdisciplinary team that includes the polio survivor, physical therapist, occupational therapist, psychologist, rehabilitation engineer, and physician.

Diagnostic Criteria Fibromyalgia Syndrome (FMS)
(according to the 1990 American College of Rheumatology)

To meet the criteria, patients must have:

This criteria was created for research purposes and many people may still have FMS with less than 11 of the required tender points as long as they have widespread pain and many of the common symptoms associated with FMS.

Commonly associated symptoms include:

Reprinted with permission from "Index & Glossary – a reference guide for readers of Fibromyalgia Network." Fibromyalgia Network is a newsletter for people with fibromyalgia syndrome/chronic fatigue syndrome. For a list of publications and subscription information, contact Fibromyalgia Network, PO Box 31750, Tucson, AZ 85751-1750 (800-853-2929; 520-290-5550 fax,