Tag Archives: ultrasound

Treatment for a Blocked Milk Duct

By Kelsey Jack

Blocked ductFor nursing or pumping mothers a blocked milk duct is something that can happen with a sudden onset. Early treatment of a blocked milk duct is recommended to prevent progression of the condition. If not treated a blocked milk duct may turn into a condition called Mastitis, a bacterial infection in the breast that requires immediate medical attention.  Fortunately, at BodyTech Physiotherapy all of our therapists are trained to provide ultrasound treatment to help clear the blocked duct. 

What is a Blocked Milk Duct?

Milk ducts are tubes that connect the glandular tissue where the milk is produced to your nipple. There are approximately 15-30 ducts in each breast. A combination of the let-down reflex and proper latching from your baby helps to pull the milk along the ducts and out the nipple. Blocked milk ducts occur when there is a clog in one of the ducts that affects how milk is able to drain.

What causes a Blocked Milk Duct?

Although the causes of a blocked milk duct are not fully understood, common risk factors include:

  • Poor latching
  • Residual milk
  • Irregular, short, or skipped feeds
  • Pressure on the breasts such as tight clothing or restrictive gear

How can I tell if I have a Blocked Duct?

Symptoms of a blocked duct include:

  • Tender or painful area of the breast
  • Lumpy, ropey, or firm feeling breast tissue
  • Swelling and redness around the affected area
  • Warmth over the affected area

Additionally, you may find that your baby is fussy about feeding from that breast as milk flow can be slower than usual.

Signs of Mastitis

Mastitis is inflammation of breast tissue caused by an infection. A blocked duct has the potential to develop into mastitis if left untreated. Other causes include a cracked or sore nipple that allows bacteria to enter the breast. If you develop mastitis, medical treatment is required as soon as possible.

Symptoms of mastitis include:

  • Fever and chills
  • Increased feeling of being run down or tired
  • Increased redness and swelling around the affected area
  • Pain or burning in the breast while feeding
  • Muscle aches and pains

What can I do if I have a Blocked Duct?

Most blocked ducts will resolve on their own within 24-48 hours, however several things can be done to help the issue resolve more quickly:

  • Continue to breastfeed on the affect side. Try and point your baby’s chin towards the area of hardness. It is also beneficial to use breast compressions while your baby is feeding to aid with drainage.
  • Heat to affected area
  • Soak affected breast in a warm, Epsom Salt bath. You can also massage the affected area while the breast is soaking.
  • Massaging the affected area, starting closest to the nipple and working away. Always massage towards the nipple to aid with drainage. Some women find using an electric toothbrush to massage helpful.
  • Pump or hand express after nursing
  • Wear loose fitting clothing and a bra that isn’t overly constrictive
  • Rest as much as possible

How can Physiotherapy help with a Blocked Duct?

If the above self-treatments are unsuccessful at resolving the blockage, therapeutic ultrasound with a trained Physiotherapist can be used to resolve the blockage. The ultrasound treatment is applied directly to the area of the blocked duct. Immediately following a blocked duct treatment pumping or feeding the child is required to help clear the duct. One treatment is often all that is required to resolve the issue. If two treatments on consecutive days do not resolve the issue, further medical attention is recommended.

BodyTech Physiotherapy

Physiotherapy for Carpal Tunnel Syndrome

Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is pain, numbness, and tingling, in the wrist and hand particularly in the thumb, index and middle finger. This syndrome affects approximately 3-6% of the general population. The carpal tunnel is a small passageway at the wrist that tendons and the median nerve run through as they travel into the hand. The tunnel is surrounded by bone and connective tissue so it does not easily stretch or expand, making structures within it susceptible to irritation which can cause the median nerve to be compressed. If left untreated and the condition worsens, symptoms may progress to include weakness in the hand.

Causes and Risk Factors
A combination of several of the following factors can increase the risk of developing carpal tunnel syndrome:

  • Chronic stress on wrist/hand – typically affecting the dominant hand, often due to working posture or repetitive motions (eg. using computers for several hours a day, assembly-line workers, musicians, using vibrating power tools)
  • Trauma to the wrist (eg. fracture, sprain) – can cause damage to the nerve or swelling to other structures that will narrow the carpal tunnel
  • Pregnancy – hormonal changes can affect tendons and cause swelling
  • Arthritis – bony growths into the tunnel narrow the space
  • Congenital Predisposition – women and smaller individuals may have narrower carpal tunnels, reducing space for the nerve
  • Diabetic or Metabolic Disorders – negatively affect the body’s nerves

Symptoms
The most common symptoms of carpal tunnel syndrome include:

  • Gradual onset of pain, burning, tingling, numbness or itching in the palm, thumb and/or index and middle fingers
  • Feeling of weakness and swelling in the hand, with difficulty grasping small items, making a fist and performing fine motor tasks
  • Urge to shake out the hand to relieve the tingling sensations

In the early stages, symptoms will often be intermittent. However, as the condition worsens symptoms are more severe and begin to persist for longer periods of time. Pain and numbness tends to be worse at night for a lot of individuals.

Treatment
It is advised to seek treatment from a professional as soon as carpal tunnel symptoms arise as the condition will not typically resolve on its own.

Medication: Over the counter anti-inflammatory drugs (eg. Ibuprofen) may provide short term relief from mild symptoms. Corticosteroid injections are a much stronger anti-inflammatory, and may also be a temporary option to help relieve pressure and symptoms for those with relatively mild symptoms.

Physiotherapy: Seeking help from a registered physiotherapist is one of the best options for treatment of carpal tunnel syndrome. Physiotherapy will include manual therapy on your wrist to improve the mobility of the joints and stretch tight muscles and tendons in the wrist and fingers, helping to remove any scar tissue buildup that may hinder recovery. The Physiotherapist will also incorporate nerve gliding techniques to help improve the mobility of the median nerve through the carpal tunnel. Ultrasound may be used over the carpal tunnel area to reduce inflammation which helps to relieve symptoms. Your physiotherapist may also suggest a brace or splint to immobilize the wrist while working or performing aggravating activities. They will provide education about activity modification to avoid aggravating positions, such as holding the wrist in a flexed (bent) position. Your physiotherapist will also prescribe specific stretching and strengthening exercises for the fingers, thumb, hand and arm to progress through later stages of recovery. They will provide education on proper posture while working to prevent relapse.

Surgery: With very severe cases of carpal tunnel syndrome where nonsurgical treatment does not provide any relief, surgery may be an option. The surgery typically consists of cutting the roof of the carpal tunnel, to provide more room for the tendons and median nerve and decrease compression. Full recovery back to original strength in the hand may take 6-12 months.

While carpal tunnel is a relatively common condition, it is often misdiagnosed, thus it is a good idea to seek treatment from a registered physiotherapist upon the onset of symptoms in order to have the best chance of full recovery and to prevent irreversible damage. Your physiotherapist will be able to recommend appropriate treatment options, whether that be manual therapy, bracing, or if necessary, surgical intervention.

BodyTech Physiotherapy