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.

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.

Systemic Lupus Erythematosus SLE is an inflammatory disease of connective tissue, which affects several organic systems. It is characterized by the production of antibodies against components of the body itself that can cause damage to various organs. SLE affects 0.07% of the Portuguese, typically women of reproductive age. The onset of the disease occurs between 16 and 49 years of age in about 75% of cases. SLE is a disease of unknown cause. However, studies suggest that its etiology is multifactorial, in which genetic, hormonal, immunological and environmental factors are involved. Sun exposure seems to play a crucial role in triggering the disease and also in triggering exacerbations. Patients with SLE have a variety of clinical manifestations that can differ dramatically from patient to patient. In most cases (90%) skin and/or joint manifestations are present. Some patients may have more severe manifestations, such as kidney involvement (37%) or neuropsychiatric changes (18%). The treatment of SLE is complex and depends on clinical manifestations and its activity. 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

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

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 +

Musculoskeletal Pain Musculoskeletal pain can be caused by diseases of the bones, joints, muscles, tendons, ligaments, bursae or a combination of these conditions. Bone pain is usually deep or penetrating. It is usually the result of a traumatic injury. Less frequently it occurs in problems related to protest material, in cases of infection of the bone (osteomyelitis), hormonal disorders and/or tumors. Muscular pain (known as myalgia) is generally less intense than bone pain, although it can be limiting, especially if it results from a muscle spasm (continuous painful muscle contraction), also known as cramp. Muscle pain can also be manifested by hardened muscle cords/painful points (trigger points) /, located predominantly in the cervical region, gluten region, and/or pelvic waist. All of us have latent trigger points that can be activated in case of overload or incorrect posture. The pain in the tendon and ligament is generally less intense than the bone pain, usually worsens when the affected tendon or ligament are elongated or moved and relieves with rest. The most common injury is sprain. The pain in the bursae (small bags filled with liquid that provides a protective cushioning of the joints) and a pain that worsens with movement and relieves with rest. It appears in situations of trauma, excessive joint overload, gout or infection. Joint pain (called arthralgia) may or may not be accompanied by inflammation (called arthritis). Arthritis-related pain can be acute (e.g., when caused by infection, injury or gout) or chronic (e.g., when caused by rheumatoid arthritis or osteoarthritis), although with periods of exacerbation. Other signs/symptoms usually co-exist (heat, swelling and redness). Sometimes the pain originates in structures close to the joint, such as ligaments, tendons and bursa. Fibromyalgia pain is a generalized pain with hypersensitivity to the palpation of specific painful points (muscles, tendons or ligaments). It is also accompanied by other symptoms such as: general fatigue, poor quality sleep, among others. Sometimes, a pain that appears to be musculoskeletal is actually caused by a disease in another organic system. For example, shoulder pain can be caused by a disorder that affects the lungs, spleen, or gall bladder. Back pain can be caused by a kidney stone, abdominal aortic aneurysm, inflammation of the pancreas, or, in women, by pelvic disorders. Arm pain may be associated with a heart attack (myocardial infarction).

Magnetotherapy Magnetotherapy consists in the use of magnetic fields for therapeutic purposes, taking advantage of their influence on the electrical and ionic charges of the body. Main effects with therapeutic utility: - Trophic effect, - Anti-inflammatory effect, - Analgesic effect, - Relaxing, antispasmodic effect, - Piezoelectric effect with bone callus stimulation, - Stimulating effect on wound healing, - Sedative effect, - Generalized relaxing effect. Indications: Locomotor apparatus pathology: delays in fracture healing, congenital and acquired pseudoarthrosis, total hip arthroplasty, vertebral arthrodesis, osteoarthritis, sprains, contusions, tendinopathies, complex regional pain syndrome (CRPS), rheumatoid arthritis, osteoporosis. Vascular pathology: Peripheral venous insufficiency, phlebitis, varicose ulcers, chronic obstructive arterial disease. Dermatology: Atrophic dermatitis, pressure ulcers, burns. Neurologic pathology: Cerebral vascular insufficiency, stroke, multiple sclerosis, peripheral neuropathies, nevrites and neuralgias. SERVIÇOS

Tumor Pain At the time of cancer diagnosis, between 30 and 50% of patients experience pain - a prevalence that in advanced stages of the disease can reach 70-90%. In advanced cancer disease, 70% of the pain is due to the progression of the disease itself, while the remaining 30% is related to treatments and associated pathologies. Most cases of cancer pain originate from the compression of the tumour in bones, nerves or other organs. Sometimes, the pain is also caused by treatments - for example, some types of chemotherapy can cause paralysis and tingling of the hands and feet; they can also be the cause of a burning sensation at the injection site. Radiotherapy can also cause redness and skin irritation. When pain is insufficiently controlled, it can significantly interfere with daily activities and have a negative impact on the quality of life of patients. Oncological pain can be acute or chronic. Acute pain is due to damage caused by a specific injury and tends to last for a short time, for example after surgery. Chronic pain is due to changes in the nerves - either because the tumour compresses the nerves or because of the chemical agents produced by the tumour. Treatments for cancer can also cause changes in the nerves. TYPES OF CANCER: - Nerve pain - Bone pain - Soft tissue pain - Phantom pain - Referred pain

Traumatic brain injury Traumatic brain injury (TBI) is a brain injury caused by an external force and results in temporary or permanent disability Symptoms may vary according to the severity of the injury and the stage of recovery. Seizures, contractures, spasticity, disturbed vision, smell, dizziness or vertigo may occur soon after the acute phase. Common late symptoms include memory deficits, attention, headaches, disruption of sleep/wake cycles, emotional lability, apathy, depression, fatigue, impulsiveness, anxiety, social and motor disinhibition. Functional limitations involve motor disorders, with difficulty in mobility and/or self-care as a result of motor, coordination and activity planning deficits. Behavioural changes, with personality change and interpersonal relationships may occur. Often patients will be unable to return to work at their economic level and in family relationships. 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 Prevention of vicious postures and contractures Teaching the sick and family Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities

Credencial p/ Fisioterapia Serviço Nacional de Saúde (SNS) PASSOS PARA REALIZAR UMA CONSULTA ATRAVÉS DO SNS FIQUE A SABER COMO É FÁCIL REALIZAR UMA CONSULTA NA PORTIFISIO ATRAVÉS DO SNS O seu Médico de Família, após avaliação, deverá prescrever-lhe uma credencial (ligue-nos caso não disponha de credencial). Com a credencial poderá agendar a Consulta de Fisiatria: aqui será avaliado pelo nosso Médico Fisiatra que irá definir o plano de tratamentos a realizar. No final da consulta deverá dirigir-se à receção e solicitar a marcação dos tratamentos prescritos. Em caso de necessidade de continuação dos tratamentos, o Médico Fisiatra passará um relatório dirigido ao seu médico de Família, a solicitar a continuação do mesmo.

Stroke Stroke is a brain disorder acquired after occlusion of a vessel or inadequate perfusion in the brain parenchyma. Stroke is the leading cause of death in Portugal. Worldwide, it is estimated that: one in six people will have a stroke; every second a person suffers a stroke; and every 6 seconds the stroke is responsible for the death of someone. According to the Portuguese Society of Stroke, Portugal is, in Western Europe, the country with the highest mortality rate, especially in the population under 65 years of age. Risk factors for stroke include age, sex, obesity, diabetes, high blood pressure, hypercolest sedentary lifestyle. Symptoms In general, it is simple to recognize a stroke using the 5 F's rule. These symptoms can appear in isolation or in combination: Face : the face can suddenly become asymmetrical, looking like a "corner of the mouth" or one of the eyelids is drooping. These signs can be better perceived if the affected person tries to smile. Strength : it is common for an arm or leg to suddenly lose strength or to experience a sudden lack of balance. Speech : speech may seem strange or incomprehensible and speech does not make sense. Often, the person does not seem to understand what is said to him. Sudden lack of vision: Sudden loss of vision in one or both eyes is a common symptom in a stroke, as is double vision. Severe headache : likewise, it is important to value a sudden and very intense headache, different from the usual pattern and with no apparent cause. Other problems may arise, such as urinary retention, pain, depression, fatigue and increased muscle tone (spas. Functional limitations resulting from stroke are usually difficulties in walking and cognitive performance such as loss of memory, attention and perception visuospatial, difficulties in communication, not being present. As a result of these disabilities, many individuals may have difficulty using public transport as a previous professional. Some will need supervision. What is the treatment for stroke? The most useful drugs for the treatment and prevention of stroke are antihypertensive agents, antiplatelet agents and anticoagulants. Taken together, these three classes of drugs improve circulation and ensure a better supply of blood, oxygen and nutrients to brain cells. The choice of the best combination of drugs should always be made by the doctor. In some cases, surgery may be instrumental in unblocking a clogged artery. How to prevent a stroke? It is important to control all the components of our health, regularly checking blood pressure and cholesterol, not smoking or consuming alcohol or excess salt, maintaining a healthy diet and exercising. What is the recovery after a stroke? Recovery from a stroke takes time. About a third of patients recover significantly in the first month, but many patients will experience sequelae throughout their lives. Recovery will depend on the location and extent of the stroke, but also on the time that has elapsed, which is why it is crucial to call the Hospital immediately when a stroke is suspected. Physiotherapy and lifestyle changes are important aspects for recovery. Maintaining a positive attitude, professional and family support are important parts so that everything can run as smoothly as possible. 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 Prevention of vicious postures and contractures Teaching and reducing cardio-vascular risk factors Teaching and counselling of support products (orthotics, splints, etc.) Return to work activities , daily life and sports activities