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  • Ecoguided invasive Techniques | Portifisio

    Ecoguided invasive techniques Ecoguided invasive techniques consist of injecting a drug, usually local corticoid/anesthesia, directly into the body area affected by pain and/or inflammation. ​ Ultrasound applied to the joint/ periarticular injection allows a more accurate and effective technique. In addition to a detailed assessment of the joint pathology, the use of real-time imaging allows an exact positioning of the needle, reducing the possibility of injury to neighboring structures such as tendons, ligaments, or vessels. ​ For more information we are available to answer your questions in the medical consultation and ask for our Flyer. SERVICES

  • Medicação | Portifisio

    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

  • Esclerose Múltipla | Portifisio

    Multiple Sclerosis Multiple Sclerosis (MS) is a chronic neurological disease, more common in young adults, which usually appears in the third decade of life, with twice the frequency in women. Most cases are diagnosed between the ages of 20 and 50, although it can affect people between the ages of 2 and 75. Although it is not a fatal disease, it is very disabling, significantly affecting all aspects of patients' lives. This disease affects the central nervous system. The nerve fibers of cells in the nervous system are lined with a sheath called myelin, which is essential for stimuli to be properly propagated. In multiple sclerosis myelin is destroyed, thus preventing proper communication between the brain and the body. On the other hand, the inflammatory process that occurs in this disease damages the nerve cells themselves, causing permanent loss of several functions, depending on the affected territories. ​ The exact cause of this disease is not known, but it is admitted that several factors of a genetic, immunological, viral, bacterial, environmental nature (diet, industrial toxins present in the soil or water), reduced levels of vitamin D, allergies, physical trauma, etc. ​ Symptoms The first symptoms may be of a sensitive nature, such as loss of sensation or tingling that start at one end and extend to the entire limb over 3 or 4 days. These symptoms can last for 1 to 2 weeks and then gradually disappear. MS can initially manifest itself in other ways, with blurred vision, double vision, motor deficits, tremors, difficulty in walking, balance changes, speech difficulties, memory and concentration problems, fatigue, or even paralysis and complete loss of vision. The symptoms will always be dependent on the areas of the nervous system where the loss of myelin occurs and the consequent inability to transmit nerve stimuli. These symptoms can progress in several ways, as described above, appearing and disappearing or progressing gradually. The evolution to complete paralysis is rare, although many patients will need assistance in walking, given the presence of fatigue, weakness and imbalance. ​ Treatment Multiple sclerosis has no cure and the available drugs can only "modify" or delay its evolution, reduce the frequency and severity of outbreaks, reduce the accumulation of damaged areas in the nervous system and help patients deal with symptoms. The definition of the best treatment for each case will always depend on a medical evaluation. The most commonly used groups of drugs include corticosteroids, which help to fight inflammation and interferons, which reduce the risk of multiple sclerosis outbreaks, while also reducing their severity and the damage caused by them. In the most severe forms, medicines of another nature, such as cytostatics, can be used. All of these treatments can be complemented with other types of support, defined according to the difficulties experienced by each patient. ​ ​ Objectives of a rehabilitation program: Sensitive- motor re- education Relief from pain and spasticity Training of speech disorders, swallowing, vision, cognitive changes General physical reconditioning Functional training and day-to-day activities Improvement of gait, balance and coordination Bladder training Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities ​ ​

  • Physical Reconditioning | Portifisio

    Physical Reconditioning The recovery process after surgery, after an injury involving prolonged immobilization, or after discharge from hospital usually leads to a marked general physical deconditioning. In this way, global therapeutic training is advised, i.e. joint, muscle and cardio-respiratory training. ​ This program of exercises must be prescribed by your doctor, taking into account your co-morbidities (diseases and medication) in order to run unevenly. Our physiotherapists will help you in the adjustment and eventual correction of your movement pattern. ​ SERVICES

  • Osteoporose | Portifisio

    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

  • Schockwave Therapy | Portifisio

    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

  • Artrite Reumatóide | Portifisio

    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

  • ABOUT US | Portifisio

    About us ​ We are a multidisciplinary team of more than a dozen professionals dedicated to the rehabilitation of orthopaedic, rheumatologic and neurological problems and pathologies. We also have extensive experience in amputees, geriatrics, oncologists and paediatricians. In addition, we are dedicated to the comprehensive treatment of acute and chronic pain situations, as well as palliative care. ​ ​ It is our duty as providers of the National Health Service and the private system to provide our users, and within the scope of our competences, with a quick and effective response to their health problems. Our goals are: ​ Assessment and treatment of disability/physical disability, Rapid diagnosis and treatment of acute pain, Chronic pain relief, pain chronification prevention, Rationalization in the prescription of medication, Improved quality of life, Rapid return to physical activity or daily life activity, Medical orientation in case of surgical need or second opinion Our mission is to give back to the Algarvian and foreign population our vast national and international experience based on the provision of high quality health care and expertise. ​ ​ Medical Director: ​ Dr. Cátia Galvão ​ - Doctor of Medicine (M.D), University of Lisbon - Specialist for Physical and Rehabilitation Medicine - Ordem dos médicos Portuguesa, Bundesärztekammer (Germany), FMH/MEBEKO- Switzerland - Pain Medicine - Swiss Society for the Study of Pain (SGSS) - Post-graduate course, Sports Medicine - University of Lisbon +

  • Manual/ Chiropractic Medicine | Portifisio

    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

  • Osteoartrose | Portifisio

    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

  • Neuropatic Pain | Portifisio

    Neuropatic Pain Neuropatic pain is a pain caused by an injury to the Peripheral Nervous System or the Central Nervous System. Neuropathic pain may result from: ​ Compression of a nerve - e.g., by a tumor or a disc hernia. Own nerve lesion-like occurs in systemic diseases (e.g., Diabetes mellitus) or infectious diseases (e.g., Herpes Zoster). Abnormal or interrupted processing of pain signaling pathways between the spinal cord and brain (phantom limb pain, complex regional pain syndrome, etc.). ​ It is usually a poorly located pain, difficult to describe (burning, stabbing, electric shock or burning pain) accompanied by symptoms of hypersensitivity to touch or cold, numbness or tingling). ​ If the movement is painful, people become reluctant to move the painful part of their body. In such cases, the muscles that control the painful part atrophy and movement may become limited. People may continue to feel the pain even after the cause has been resolved, as the structures in the nervous system are altered, and as such are hypersensitive to painful stimulation. Examples of this are herpes lesions or the pain of a scar. Neuropathic pain can contribute to/aggregate, when dragged out over time, to deansiety and/or depression or vice versa. Diabetic neuropathy In people with diabetes, the persistence of high levels of glucose (sugar) in the bloodstream can damage nerve endings. As a result, complaints of loss/change of sensation, especially in hands and feet, can arise, and in more serious cases, can lead to complaints of pain and muscle weakness. ​ Complex Regional Pain Syndrome (CRPS) This is a condition that usually arises after a trauma, usually a fracture, which leads to damage to the nerve itself. The pain is disproportionate to the severity of the initial injury and is usually felt as a burning or stabbing pain, accompanied by changes in sensitivity, swelling and stiffness of the affected joints, changes in color, sweating and/or hairiness of the skin. It can lead to muscle weakness and loss of bone mass. CRPS is an uncommon pathology, the causes of which are still unclear. Treatment is most effective when started early. In these cases, there can be a significant improvement in symptoms or even remission Post-Herpetic Neuropathy In the case of post-herpetic neuralgia, any nerve can be affected. The most painful phase and the one that follows after the vesicles phase, typical of infection by the Herpes virus. Any body area can be affected, although it usually affects only one side of the body. This is usually an intolerable, continuous, burning or stab-like pain that appears along the path of the nerve and its branches. This type of pain can persist for months or even years, deeply affecting the quality of life of the patient.

  • Headaches | Portifisio

    Headaches Headache (commonly described as headache) is a localized pain in any part of the head. Because it is a frequent complaint with limited work activity and the performance of daily tasks, it often motivates the search for medical help. Although headaches can cause suffering and anguish, they rarely indicate a serious problem. However, since they can result from diseases of the brain, eyes, nose, throat, sinuses, teeth, jaws, ears, or even from a systemic disease, they deserve to be clarified in a medical consultation. Trigeminal Neuralgia Trigeminal neuralgia is a severe facial pain associated with injury to a cranial nerve (trigeminal nerve). This nerve is responsible for transmitting sensitive information from the face to the brain and controls the muscles involved in chewing. The most frequent cause is nerve compression through an abnormally positioned artery; it usually tends to manifest in middle-aged and elderly people, but can affect adults of any age. Medication (anticonvulsants, antidepressants) can relieve pain, although surgery is sometimes necessary. ​

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