WALK-IN Consultation Medical Consultation on the same day (Monday to Friday) Have you a intense pain and need help? Avoid unnecessary ER visits and several hours of waiting time. With us at Portifisio, you'll be in the best hands. We relieved your complaints on time. We treat different kinds of pain: - Back pain (Lombalgy, Sciatica) - Headache (Headaches) - Rheumatological pain - Arthrosis Pains - Muscular/ligament pain (sprains, intense cramps) Documents required: - Citizen card, - List of current medication - Health Insurance Card/Subsystem (if any)

Physiotherapy Physiotherapy aims to preserve/improve physical functioning and reduce eventual disabilities. It includes a wide range of techniques that presuppose the treatment of osteoarticular, muscular, neurological and respiratory problems, as well as gait and portural balance disorders, among others. The aim of these techniques is to improve the general state of health by improving the quality of life in daily life activities. Ask our Flyers for your Hometraining at the doctor's appointment SERVIÇOS

Elbow Epicondylitis The most common type of pain in the elbow is known as "Tennis Elbow", that is, epicondylitis. The repetitive movements of the elbow joint cause small tears in the tendons, especially where the tendons are inserted in the bones. These injuries currently occur more frequently as a result of a professional occupation than as a result of sports activities Objectives of a rehabilitation program: Improving mobility and joint movement Relief from pain and inflammation General physical reconditioning Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities

Physiothrapy Treatments Physical Reconditioning Magnetotherapy Physiotherapy Joint Amplitude Improvement Muscle Strengthening Equilibrium/Coordination and Posture Training Walking Training Bio-Beedback + Physical Reconditioning Cardio-respiratory training Muscular Strengthening Bio-Beedback + Magnetotherapy Anti-inflammatory effect Analgesic effect Relaxing and antispasmodic effect Wound healing Sedative and general relaxing effect + Schockwave Therapy Plantar fasciitis and calcaneal spur Medial and lateral epicondylitis (golfer and tennis elbow) Femuropatellar syndrome Trochanteric bursitis Aquilodynia Calcified rotator cuff tendinopathy (shoulder) Myalgia (muscle aches), Trigger points + Ecoguided invasive Techniques Intra and Peri-Articular Infiltrations Pain Relief in Arthrosis/Cartilage Damage + Pelvic Floor Reeducation Urinary incontinence (involuntary loss of urine); Fecal incontinence (involuntary loss of solid or liquid stools) Prolapse of the pelvic organs (drop or descent of one or more organs) + Manual Medicine Mobilizations/ Joint manipulation Neuro-Muscular Techniques ... + Tension and Muscle Spasms Trigger Point Therapy Acute and chronic pain relief + Mesotherapy Myofascial/osteoarticular pain relief + Electrotherapy Electrical Stimulation Ultrasound + Medication Acute pain Chronic pain Nociceptive Pain Neuropatic Pain Mixed Pain + Schockwave Therapy Ecoguided invasive Techniques pelvic floor Therapy Neural Therapy Electrotherapy Medication Manual/ Chiropractic Medicine Trigger Point Therapy

Osteoporosis Osteoporosis is a generalized skeletal disease characterized by a decrease in bone mineral density (BMD) and changes in bone tissue quality, leading to an increase in bone fragility and, consequently, a high risk of fracture. Vertebral, hip and wrist fractures are among the most common osteoporotic fractures, but osteoporosis is associated with an increased risk of any type of bone fracture. The decrease in bone mass is closely linked to the increase in age and, in women, to a set of hormonal changes related to menopause. However, there are other risk factors for osteoporosis, such as smoking; excessive alcohol consumption; low body mass index; chronic medication with corticoids. Osteoporosis is a silent disease, causing no symptoms until bone fracture occurs. Osteoporosis is diagnosed by evaluating the BMD measured by bone densitometry. The prevention of osteoporosis starts from childhood with healthy living habits to acquire an adequate peak bone mass, because it is in childhood that bone mass forms parallel to skeletal growth. In adulthood, a series of measures must be taken to slow down the decline in bone mass, and this is particularly important in post-menopausal women. Regular exercise, especially heavy activities (such as walking, running or aerobics) or resistance exercise (e.g. with weights) are associated with an increase in bone mineral density and a decrease in the risk of fractures. A balanced diet with adequate calcium and protein intake is essential. Calcium, an essential element for normal bone metabolism, is present in greater quantities in milk and milk products, but can also be found in other foods such as green vegetables (broccoli and spinach for example). Frequent exposure to the sun (exposure of the face, arms and hands 15-20 minutes daily, without sun protection) should be stimulated in order to stimulate the production of vitamin D, essential for the absorption of calcium in the intestines and a correct mineralization of the bone. As risk factors for the development of osteoporosis, smoking cessation and moderate alcohol consumption are also essential. The aim of osteoporosis treatment is to prevent fractures of fragility and consists of adopting the measures described above for the prevention of osteoporosis, with which pharmacological therapies are associated. Objectives of a rehabilitation program: Improving mobility and joint movement Relief from fracture pain Stabilization of spine static and dynamics General physical reconditioning Improvement of gait, balance and coordination Teaching and counseling of support products (orthoses, splints, etc.) Return to work activities , daily life and sports activities Ask our Flyers for medical consultation

Medication As such, a correct diagnosis and assessment of the patient are essential to initiate a pharmacological treatment appropriate to the patient's characteristics and pain. Currently, to treat pain, there is a wide variety of non-opioid analgesics, such as non-steroidal anti-inflammatory drugs, weak opioids (e.g. Tramadol, Codeine) and, lastly, potent opioids, such as Oxycodone, Fentanyl and Morphine. In addition, there are a number of drugs called Co-analgesics as anticonvulsants and antidepressants that help us to complete this treatment, according to the pain and the patient. SERVICES

Manual Medicine Manual Medicine is often used to treat acute and chronic spinal pain or limited joint movements ("blockages"). The aim of Manual Medicine is to restore harmony in the movement of the entire spine by "unlocking" individual vertebral segments or joints (shoulder, elbow, hand, hip, knee, ankle and foot). Through targeted techniques of Mobilization/Manipulation/Neuro-Muscular Techniques, it is possible to treat functional disorders of the musculoskeletal system, as well as tissue changes, thus contributing to a sustainable pain relief. In this way, Manual Medicine allows not only a differentiated diagnosis, but also a gentle therapy of functional disorders of the musculoskeletal system. This combination makes Manual Medicine an efficient and pleasant treatment method for the patient. Indications: - Acute or chronic pain/Limitation of movement in the spine - Pain/Limitation of movement in the peripheral joints (e.g. hip, shoulder, elbow, hand, ankle). Services

Schockwave Therapy Shock waves are high-energy acoustic waves generated with a special device and transmitted through the surface of the skin and diffused into the pain zone. Shockwaves with clinical use were first used in 1980 to destroy kidney stones. Since the 1990s they have been increasingly used successfully in the musculoskeletal area, especially in tendon insertions and musculature. The biological effects of shock waves include the stimulation of osteogenesis, the induction of neovascularization and the neuromodulatory effect. Besides stimulating the osteoclasts and fibroblasts, the shockwave treatment allows the reconstruction of the affected tissues, promoting a correct healing of tendons and ligaments; it increases the blood flow in the injured area, controls the inflammatory process and reduces pain. In situations of existing calcifications, their dissolution occurs and in fibrous tissues they are revitalized and rejuvenated. In most cases, treatment leads to a significant improvement in symptoms with less pain and more mobility. Often, only a series is needed to obtain complete relief from complaints. Indications: - Plantar fasciitis and calcaneal spur - Medial and lateral epicondylitis (golfer and tennis elbow) - Femuropatellar syndrome - Trochanteric bursitis and anserine - Achilles tendon, adductor and peroneal tendinopathy - Calcified rotator cuff tendinopathy (shoulder) - Quervain Tenosynovitis - Myalgia (muscle aches), Trigger Points (painful muscle contraction points) - Bone pathologies (delayed bone healing, stress fracture, avascular necrosis, osteochondritis dissecans, Osgood Schlatter's disease) - Dupuytren's Disease, Plantar Fibreomatosis (Ledderhose Disease) For more information we are available to answer your questions in the medical consultation and ask for our Flyer. SERVICES

Rheumatoid Arthritis Rheumatoid Arthritis (RA) is a chronic, inflammatory, autoimmune disease that is characterized by inflammation of the joints and can lead to destruction of joint and periarticular tissue. There is also a wide variety of extra-articular changes. It is a chronic disease because it has no cure, but if effectively treated, it has a good vital and functional prognosis. In recent years, there has been a substantial improvement in the treatment of this disease. On the one hand, there has been an improvement in treatment strategies with more effective use of existing disease-modifying drugs, and on the other hand, new drugs have emerged. RA patients often experience pain and difficulty in mobilizing the joints, but the symptoms can be very varied. Suppression of inflammation in the early stages of the disease, i.e. early treatment, can result in a substantial improvement in the long-term prognosis. RA is not a rare disease, its prevalence (frequency) varies from 0.5-1.5% of the population in industrialized countries. In Portugal it is estimated to affect 0.8-1.5% of the population. The overall occurrence of AR is two to four times higher in women than in men. The peak incidence in women is after menopause, but people of all ages can develop the disease, including adolescents. What's the cause? Being an autoimmune disease means that in the patient with RA his immune system is not functioning properly and there are products of the immune system that react against the patient's tissues. The cause of this deregulation of the immune system that occurs in the RA is unknown, however, research is being done in this area and some risk factors have already been discovered, such as smoking. Scientific studies also suggest that the disease is caused by the interaction of risk factors with the existence of genetic predisposition. Joint inflammation is thus triggered by the presence of molecules (cytokines) that interact with some white blood cells causing a local and systemic inflammatory reaction (throughout the body). This process translates into edema (swelling), pain, and sometimes redness (redness) and an increase in temperature in the affected joints, causing inability to move them properly. What complaints and symptoms do patients have? The presentation can be very variable. The presence of arthritis (inflammation in the joints) is a fundamental characteristic of the disease. Joint inflammation causes characteristic changes: oedema, joint pain, and sometimes redness and heat. It also causes stiffness, a sensation of prison of movements, especially in the early morning or after periods of rest. Often the disease starts as a symmetrical polyarthritis (more than 4 swollen and painful joints on both sides of the body). Any joint with a synovial membrane (membrane that coats some joints and produces a liquid that lubricates, nourishes and facilitates joint movements) can be affected, but usually affects the small joints of the hands and feet first. As the disease progresses, more joints may ignite, including shoulders, elbows, hips and knees. In addition to joint symptoms, constitutional symptoms (e.g., tiredness, flu symptoms, fever, sweating, and weight loss) are common. If left untreated, inflammation leads to progressive joint destruction and loss of function. Joint deformities, some of which are very characteristic of the hands, may appear at this time. To the joint damage, loss of muscle mass can be added by atrophy, which can progressively lead to motor difficulties. The tendons are surrounded by sheaths and these are also made up of synovial membranes and can become inflamed, just like the joints. Objectives of a rehabilitation program: Improvement of joint movement and manual dexterity Pain and inflammation relief General physical reconditioning Teaching and counseling of support products (orthoses, splints, etc.) Return to work activities , daily life and sports activities Ask our Flyers for your Hometraining at the doctor's appointment

Hip Coxarthrosis (Hip arthrosis) Coxarthrosis or Hip arthrosis is the result of wear and tear on the cartilage of this joint. Locally, there is disorganization of the collagen matrix and a decrease in proteoglycans, which have a chondro-protective effect, calling water by osmosis to its interior. As a result of the reduced osmotic effect of proteoglycans, the water content of the cartilage is reduced, as well as its thickness, and then osteoarthritis occurs. Hip arthrosis is, together with knee arthrosis, one of the most frequent arthrosis in the body. It affects 10-20% of the population after the age of 60, with a higher incidence in men up to 45 years old and in women after this age. Primary coxarthrosis is one that has no apparent (ideopathic) cause, other than joint wear and degeneration. However, coxarthrosis can have other causes and is then called secondary coxarthrosis. The most frequent causes are the following: Traumatic (fractures and dislocations); Femoral-acetabular conflict and hip dysplasia; Avascular necrosis of the femoral head; Sequelae of congenital hip dislocation and childhood Perthes disease; Rheumatological and infectious diseases. Hip osteoarthritis or osteoarthritis causes the following symptoms: Pain in the hip, with a mechanical character, that is, that worsens with movements, sometimes with irradiation to the groin, thigh or knee; Crackling, joint stiffness and limited range of motion; Claudication during the march, which sometimes requires the support of Canadians; Muscle atrophy due to disuse; Progressive reduction of gait perimeter without pain. In bilateral coxarthrosis, symptoms cause more marked functional impotence, and may even interfere with personal hygiene and activities of daily living. One of the ways to control the symptoms of hip arthrosis may be the use of appropriate physiotherapy. Trochanteric Bursitis Bursitis results from an inflammation of the synovial pouches (or bursae). A synovial pouch (or bursa) is a small bag filled with a gelatinous (liquid) fluid. The bursae are located between the bone and the tendons / muscles and allow to reduce friction. In other words, they work as “shock absorbers” to reduce impacts, that is, as a kind of “cushion” to reduce friction. In addition to the hip, we can find synovial pouches all over the body (shoulders, knees, heel, etc.). . Trochanteric bursitis (or trochanteritis) is the inflammation of the trochanteric bursa that is located in the trochanteric region (between the greater trochanter of the femur and the ilio-tibial band and the tendon of the middle gluteal muscle). The symptoms are characterized by tenderness and pain in the lateral region of the thigh (“part of the side and outside the hip”), which sometimes radiates to the inguinal region (groin area). See superior images to better understand where the trochanteric bursa is located. Pain tends to intensify with activity (walking, walking up or down stairs, etc.). Patients, as a rule, find it difficult to lie "on their side" under the affected hip, often causing difficulty sleeping at night. Femoro-acetabular conflict It is a set of pathologies that are characterized by a mechanical block to normal hip movement, causing progressive lesion of the labrum and articular cartilage, which can result in arthrosis. It is characterized by changes in bone anatomy, which favor traumatisms that are repeated with the movements, until the appearance of the lesions. Generally, there are two types of deformity that can arise independently or together: the CAM type and the PINCER type. Labral injury can occur without changes in bone anatomy. In these cases, its appearance is often associated with the practice of sport (football, handball, basketball, ballet, golf, athletics, etc.), due to movements of greater joint amplitude. What are the patient's complaints? Complaints vary with the course of the disease. Initially, the pain can be quite localized and appear with a specific movement (for example: pain in the groin whenever the hip is flexed at a given rotation). “C” pain is very common, which is characterized by a pain located between the buttock and the groin. Conservative treatment should always be the first approach. It consists of physical therapy, anti-inflammatory painkillers and reduced activity that causes symptoms. Surgery is reserved for cases of failure in well-conducted conservative treatment Hip Arthroplasty Hip Arthroplasty is an operation performed with an incision of 10-12 cm, and through which the femoral head and acetabulum cartilage are resected to allow its replacement by a metal implant (prosthesis). Hip prostheses can be attached to the bone by applying a special cement (cemented prostheses), which adheres and hardens after a few minutes, allowing patients to load immediately after surgery. It is ideal for older patients, with more osteoporotic bone, or who have worse bone stock due to rheumatismal pathology. Cementless prostheses are applied under pressure (press-fit). They are produced with a rough and porous surface, usually coated with hydroxyapatite, to allow a process of incorporation by bone growth into the interior of your pores, allowing a very firm and lasting fixation. Hip Arthroplast is a surgery that has undergone a great evolution. Its application is possible by mini-invasive techniques, which provide the patient with better and easier recoveries. Recovery after performing an Hip Arthroplast is increasingly quick and simple for the patient, as surgeries are less invasive, pain control is more effective and rehabilitation protocols are faster. Objectives of a rehabilitation program: Improving mobility and joint movement Relief from pain and inflammation General physical reconditioning Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities Ask our Flyers for your Hometraining at the doctor's appointment

Osteoarthritis Osteoarthritis is a disease that primarily affects the articular cartilage, which is an elastic connective tissue that is found at the ends of the bones that articulate with each other. Articular cartilage is nourished by joint fluid or synovial fluid, so called because it is produced by synovial, a membrane rich in vessels that lines the interior of the joints. This joint fluid contributes to lubricate the joint, facilitating its movements, and allowing healthy joints to slide the cartilages on top of each other without friction, that is, without wear. As a result of this, the ulcerative articular cartilage and the bone beneath the cartilage react, thickening and giving rise to bone growths called osteophytes. Osteophytes are known as "parrot beaks", because some of them, on radiographs, give images that resemble a parrot's beak. In this degenerative process, joint inflammation phenomena often occur, causing pain and swelling of the joint. Hence the term "arthritis" is also used for these clinical conditions. Arthrosis is one of the multiple rheumatic diseases and is by far the most common. It is a disease of a degenerative nature that involves the entire joint. In Portugal there are about half a million patients with arthrosis and pain, although, in fact, this number is close to 1 million, as many patients have osteoarthritis and have no complaints. Osteoarthritis is a very important cause of disability in the elderly and one of the most frequent causes of permanent disability and early retirement. The climate is not a cause of osteoarthritis, although the cold and humidity aggravate the complaints of these patients, and the warm climate relieves the pain. There are joints in which arthrosis is more common: knees, hands, hips, spine and feet. In the hands, are the joints of the fingers and, in the wrist, at the base of the thumb the most common joints. In the spine, the cervical and lumbar region. On the feet is the base of the first toe, which when deformed is often called a "bunion". What causes arthrosis? All those who expose their locomotor system to overload or excessive work, such as sports people and the obese, and those who have joint or limb malformations, such as deformities of the knees, hips or feet, will tend to develop arthrosis earlier. . How are arthrosis manifested? There is no correlation between the degree of joint damage and the intensity of pain. Many patients have advanced arthrosis and little pain, while others who are very complaining have poorly evolved arthrosis. The main symptoms of osteoarthritis are pain, stiffness, limited movement and, in more advanced stages, deformations. Pain has a rhythm characterized by the fact that the pains get worse throughout the day, with movements and efforts, and improve when the patient rests, particularly when lying down. As a rule, patients with osteoarthritis have no pain at night and sleep well, although in some very advanced cases of arthrosis of the hips and knees the pain may also appear at night. The limitation of joint mobility gets progressively worse over the course of the disease. Periods with swelling of the joint may occur due to inflammation. In the fingers this inflammation takes the form of nodules and in the knees fluid can accumulate, which coincides with an aggravation of complaints. Limitation of movement can generate great disability in patients with osteoarthritis. Thus, for example, patients with osteoarthritis in the upper limbs, particularly at the level of the shoulders, may have great difficulty in dressing and eating. On the other hand, arthrosis of the lower limbs can make walking difficult and make certain tasks difficult or even impossible, such as putting on shoes. In the end, the joint is unable to perform its function, without cartilage and with the bone developed in the periphery. Patients become more and more limited, to the point where they are unable to move the joint without great effort and severe pain. Objectives of a rehabilitation program: Improving mobility and joint movement Relief from pain and inflammation General physical reconditioning Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities Ask our Flyers for medical consultation

Parkinson's disease Parkinson's disease results from the reduction of levels of a substance that functions as a brain chemical messenger in the centers that control movements. That substance is dopamine. We are a family owned and operated business. Since dopamine controls muscle activity , symptoms are essentially related to movement. In addition to the tremors, stiffness and sluggishness, there are other manifestations that translate into patients' sleep, thought, speech and state of mind. The first sign of the disease is, in general, a slight tremor in a hand, arm or leg that occurs when the affected extremity is at rest but which can increase in moments of greater tension. As a rule, it improves when the patient voluntarily moves the affected extremity and may disappear during sleep. As the disease progresses, the tremor becomes more diffuse and can affect the extremities on both sides of the body. When the muscles of the face are affected, the expression may be erased and, in the case of other muscles, the patient may be unable to take care of himself. Depression or anxiety is common in Parkinson's patients, as well as memory disorders. Visual, chewing and swallowing difficulties, urinary incontinence, changes in sexuality, cramps, as well as increased sweating can also occur. Postural instability and difficulties in walking make it quite incapacitating, making it difficult to sit and stand and forcing you to walk with small steps, dragged and without the normal pendulum movement of your arms. Objectives of a rehabilitation program: Re-education motor Speech training General physical reconditioning Functional training and day-to-day activities Improvement of gait, balance and coordination Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities Ask us to consult the Parkinson's Disease Manual