Primary Spine & Rehab are private practices that incorporate physical therapy as part of the process of wellness. Our goal is to improve your quality of life by decreasing pain and improving your function and mobility. We specialize in manual integrative therapy which includes such techniques as Myofascial Release, Jones Strain and Counterstrain, Mulligan, Muscle Energy, McKenzie, Graston Technique and Core Stabilization. We treat chronic pain, fibromyalgia, strains, sprains, back and neck pain, and post surgical patients. We also offer ergonomic analysis of your workstation and will work with you and your employer to help set-up you up in an ergonomically sound work area.
The Initial Visit to your Physical Therapist
On your first visit, the physical therapist will have you complete a form about your past medical history and your current problem. The information you give will determine the goals and objectives of your personal treatment plan. Your level of pain will be measured on a scale of one to ten. This will enable the physical therapist to evaluate your improvement during and after treatments. The physical therapist will be especially interested in learning about changes in your pain during your daily activities. What activities make the pain more intense? When is the pain less intense or alleviated altogether? How long has the pain persisted? Is your pain accompanied by any numbness or tingling? The physical therapist will spend time listening carefully to your symptoms and gathering information about the problem. The next step will be a thorough evaluation.
During the evaluation, the physical therapist will examine your posture, check your range of motion, complete a manual examination, screen you for possible neurological problems, perform specific tests, and check the skin for tender points or muscle spasms. The physical therapist will begin by observing your posture. Poor posture will cause various problems with muscles, joints, and nerves. Maintaining the same position for extended periods of time can also cause problems. By helping you to improve your posture, the physical therapist will reduce the strain on your body.
It is important to check the patient’s range of motion at the problem area. How far can you bend and/or turn your neck? How much movement do you have in your back? How much mobility do you have with your arms or your legs? By carefully measuring the mobility or lack of mobility of your neck, back, arms, and legs, the physical therapist next determines a treatment plan that is personally designed to fit your needs.
During the manual examination, the physical therapist is checking the flexibility of the involved joints. Is a particular joint too tight or is a certain joint allowing too much mobility? The physical therapist will complete a neurological screening. This screening will determine any problems with your reflexes, sensations, or muscle weakness. Your physical therapist may determine that a specific test should be included in your examination. Different tests that are sometimes completed include the Quadrant Test, Adson’s Test, Phalen’s Sign, and the Squish Test. Selecting which test is appropriate will be determined by the physical therapist. Palpation is also used and it is basically touching the muscles to find tender points and feel for possible muscle spasms. Warmth or swelling in an area may indicate inflammation of the muscle.
When the initial evaluation is completed, the physical therapist will determine the number of visits as well as the frequency of visits. The treatment goals will be based upon documented impairments and functional limitations which are specific to your diagnosis.
The Physical Therapy Treatment Plan
Your therapist may choose from the following interventions and modalities in order to help improve your symptoms:
Rest: Resting the muscles and joints reduces the amount of irritation and often relieves the pain. Any activities that increase the level of pain should be temporarily avoided.
Ice or Heat: Ice is used to constrict the blood vessels and reduces the amount of blood flow to a specific area in order to reduce any swelling. Heat, on the other hand, will cause the blood vessels to dilate allowing more blood flow to a specific area. Increased blood flow means an increase in nutrients and oxygen to help the healing process.
Ultrasound: Ultrasound is a deep heating agent that increases tissue temperatures to depths up to five centimeters. It uses inaudible acoustic mechanical vibration to produce thermal and non-thermal effects. It can increase extensibility of collagen structures, decrease muscle spasm, increase blood flow, relieve pain, decrease joint stiffness, and repair soft tissue.
Iontophoresis: Iontophoresis describes the use of ultrasound for trans-dermal delivery of medication. This means that some medications are transferred or carried directly through the skin and into the treatment site. Anti-inflammatory agents or analgesics are delivered directly to the painful area bringing needed relief from pain.
Massage: Massage is a manual therapeutic modality that can reduce swelling, relieve muscle spasms, loosen adhesions, enhance circulation, stimulate nerve endings, remove metabolic waste from an area, and improve lymphatic return.
Electrical Stimulation: An electrical current is gently sent through your skin. The electrical stimulation travels through the skin heading toward the central nervous system. The electrical impulse reaches the central nervous system before the pain message and subsequently reduces your level of pain.
Traction: What is traction? Traction is a modality that uses mechanical forces (or a pulling motion) to the body in order to separate joint surfaces and decrease pressure on the spine.
Exercises: Your physical therapist will determine which specific exercises are needed as you recover from your injury or pain. Your personal treatment plan should include positioning instructions, stretching techniques, and relaxation exercises. As your condition improves and movements become less painful, your physical therapist will concentrate on increasing your muscle flexibility, improving your strength and coordination, and enhancing your aerobic conditioning. The physical therapist wants to reduce your pain, as well as reduce or prevent the possibility of a relapse in the future.
Ergonomics: Health and wellness strategies in the work place will also be reviewed. How can you be more productive at work without jeopardizing your health? What strategies could be used at work to reduce the risk of injury? What safety precautions could be taken to ensure a better future?
A Final Home Treatment Program
Once you pain is under control and your overall condition is improved, your physical therapist will develop a home treatment program specifically for you and your needs. The home treatment plan will included specific exercises to continue working on range of motion and strength training. Remember that rest, relaxation, and exercise and important components of any recovery process. Whether you are at work or at home, it is important to do everything you can to reduce the possibility of recurrent pain or future injury. Together with your physical therapist, you will both plan a final home treatment program that will increase your chances for health and wellness in the future.