The temporomandibular joint (TMJ) is a synovial bi-condylar joint with 3 degrees of freedom. One-third of the adult population reportedly suffers from temporomandibular joint dysfunction (TMD). Females are more commonly affected than males. Almost 50% of TMD patients do not require any intervention, and the symptoms are self-limiting within one year after the onset; however, 75-80% of adults suffering from TMD require medical intervention and it takes up to three years for the complete remission of the symptoms. The clinical features of TMD are clenching, clicking, and locking of the jaw, and occlusion due to faulty posture. Based on the diagnostic criteria for temporomandibular disorder (DC/TMD) criteria proposed in the year 2014, the classification of TMD is done based on axis I and axis II diagnoses. This review aims to provide an overview of TMD and examine available treatment strategies for TMD. Various conservative treatment methods have been proven to be effective, including self-care strategies, dental treatment strategies, pharmacological treatment, physical therapy modalities, manual mobilization, electrotherapy and dry needling, relaxation techniques, intra-articular injections, cognitive behavioral therapy, and surgical corrections.

Osteomyelitis is an infectious disease of the bone and bone marrow caused by pyogenic organisms that may be acute or chronic. Early diagnosis and treatment prevent complications like limb deformity and limb length discrepancies. A 14-year-old girl presented to the orthopedic department with complaints of pain, fever, swelling, tenderness, and pus discharge across the right leg below the knee. Previously, she visited a local hospital where after initial investigations, she underwent saucerization followed by antibiotic bead application. After experiencing no improvements, she came to Acharya Vinoba Bhave Rural Hospital, Sawangi Meghe, Wardha. After investigations, she was confirmed to have chronic right tibial osteomyelitis, after which she underwent sequestrectomy with an Ilizarov Fixator application. After three months, she started experiencing pain over the right leg, discharge from the wound site, on and off fever, and difficulty walking, for which she was again admitted to this hospital. She was primarily managed by dressing and medication and subsequently received physiotherapy intervention with proper rehabilitation protocol which was found to be very effective in achieving functional mobility and independence. This case study concludes that a multidisciplinary team involving a definitive surgical approach and physiotherapy rehabilitation protocol which resulted in improved functional mobility and independent ambulation for the patient, which plays a significant role in a fast and successful recovery.

Low back pain is a leading cause of functional disability. Low back pain is a problem that every one of all age groups faces and there are various methods used to correct low back pain. Manual therapy is a specialized area in physiotherapy which manages neuromuscular pain. Manual therapy techniques include the Maitland mobilization technique, Kaltenborn mobilization technique, Mulligan technique, Active release technique, and many more. Manual therapy mainly works on arthrokinematics and osteokinematics of the joint. It is one of the main strategies used to manage low back pain. Low back pain can be because by spinal dysfunction, Sacroiliac dysfunction, muscle pathology, or any ligamentous strain. The cause of the low back pain should be identified and treated accordingly. Articles using keywords -chronic low back pain, Mulligan, and non-specific low back pain were searched on the database of Pubmed and Scopus a total of 30 articles from the timeframe of 2011 to 2021 were included in the study. From this review, we can conclude that Mulligan mobilization with movement is an effective way to reduce low back pain. Further studies need to be conducted to check the effectiveness of manual therapy techniques in chronic low back pain.

BackgroundPain lasting more than three months is termed chronic pain. Treating chronic pain is always a challenge for the therapist. Low back pain (LBP) with a high prevalence is a point of concern. Various treatment methods are available. The two treatment methods are integrated neuromuscular inhibition technique (INIT) and Mulligan mobilization with movement (MWM). In this study, we have compared INIT with MWM. MethodIt was an interventional study carried out at Ravi Nair Physiotherapy College and Acharya Vinoba Bhave Rural Hospital. A total of 80 participants with nonspecific LBP were included in the study. The participants were randomly divided into two groups and treated for two weeks with three weekly sessions. Statistical analysis and resultStatistical analysis was done post the completion of sampling. Paired and unpaired t-tests were used. A pvalue of <0.05 was considered significant. The result was obtained after comparing the pre-and post-values of the numerical pain rating scale (NPRS), modified Oswestry disability index (MODI), and range of motion (ROM) of the lumbar joint. After two weeks of treatment, a reduction in functional disability and pain was seen in the INIT and MWM groups. ROM was increased after two weeks of treatment in both INIT and MWM groups. When compared, INIT showed better results than MWM. ConclusionIn conclusion, we saw that the integrated neuromuscular inhibition technique might be a better technique than Mulligan mobilization with movement in terms of reducing pain and functional disability.

The lower back is a complex area, with joints having a very limited range of motion and vast muscular activity. Low back pain is common, and its management depends upon the pain generators. There are various treatment options available, depending on the cause of the pain. In this case, a medical student with pain on a scale of 8/10 on activity came to the physiotherapy department for rehabilitation and pain relief. Her low back pain was chronic and non-specific. The aim of rehabilitation was to reduce the pain and make the patient pain-free. An integrated neuromuscular inhibition technique (INIT), along with a conventional physiotherapy approach, was given to the patient. The integrated neuromuscular inhibition technique can be used to reduce lower back pain and functional disability. After physiotherapy rehabilitation, the range of lumbar flexion improved. In patients presenting with low back pain, early physiotherapy should be started to maintain strength, reduce pain, and reduce functional disability.