Physical therapy services are utilized in a variety of different programs. We provide care in the following programs as well as offer the following classes:
In any traditional setting, physical therapy is directed towards rehabilitation of acute related injuries, or prevention of recreational/sport/work related injuries. Its role in the management of chronic pain is unique and often makes one wonder “What does PT have to do with pain?” Well, the answer is “Quite a bit!” A physical therapist specializing in chronic pain management can assist an individual in many aspects of rehabilitation. This ranges from global strengthening and developing a safe exercise program, to specific flare up management skills and application of specific cognitive strategies to shift an individual’s relationship with their pain. These factors make physical therapy an essential ancillary service in the successful management of chronic pain.
Patients that suffer from chronic pain have typically drifted into inactivity, muscle atrophy, weight gain and decreased endurance. These changes can lead to decreased ability to work, perform household activities and engage in social and recreational activities. Many people attempt to change this cycle, but find difficulty due to increases in pain and then further inactivity.
For some, rest and inactivity may feel like the best treatment for pain due to a reduction of pain when at rest, but actually, this causes increased pain levels overall. When the body becomes inactive, your muscles become weak and tight, your joints become stiff and you have low energy levels. This leads to higher pain levels and more stress on the affected areas. For others, they attempt to continue their busy lifestyle, but end up burnt out by the end of the day. This lack of pacing also causes increased pain and often frustration.
How is physical therapy at BAPWC different than the physical therapy at other clinics?
A typical chronic pain therapist has minimal to no training in treating chronic pain. In school, therapists are taught how to treat acute pain, not chronic pain. The treatment is vastly different and therefore when a person with chronic pain visits a typical PT clinic, they receive acute pain treatment. Unfortunately, this is largely unsuccessful. Acute pain treatment focuses on passive treatments including modalities (ultrasound, electrical stimulation), ice/heat, massage and some exercise. This treatment typically is not successful or provides only a temporary benefit for chronic pain. Chronic pain treatment focuses on managing your pain using skills such as pacing, flare-up management, slow and safe exercise development and progression and relaxation techniques. Treatment also focuses on assisting patients to overcome their fear of re-injury or fear of movement.
Acute care clinics often focus on one body part at a time with use of many passive modalities. At BAPWC, you are treated like a whole, as we understand that your entire body works together to perform all daily activities. A low back injury can affect your neck or knees. Many people suffer from chronic pain in multiple areas and these need to be treated as a whole instead of piece by piece. We believe in teaching our patients transferable skills to manage their chronic pain independently.
What are the services provided in the physical therapy department?
Individual Physical Therapy: One on one evaluation and treatment of musculoskeletal dysfunction. Specialty areas include treatment of spine dysfunction (both non-surgical and post-operative), shoulder, knee and ankle dysfunction, chronic pain, CRPS I (RSD), Thoracic Outlet Syndrome and Fibromyalgia.
Work Hardening: A program designed to increase the injured worker’s endurance and lifting capacity, restore musculoskeletal functioning and to increase the worker’s tolerance for job-related activities. This program is for the injured worker who has a specific job to return to but lacks the function abilities to meet their job demands. The program is tailored for each individual client with simulation of specific job tasks.
Functional Capacity Evaluation (FCE): An evaluation when in-depth information regarding the patient’s physical or functional level is needed. The evaluation is a systematic approach to monitoring and reporting performance. This evaluation contains a battery of tests that focuses on selected work tolerances and/or physical capacities. Observation and objective measurements are used as well as the therapist’s reasoning and judgment. Maximum voluntary effort and consistency of performance is also measured through a variety of tests. An FCE is typically a 3-6 hour evaluation which may be spread across two days in order to assess the impact of the evaluation on the patient.
A functional restoration approach focuses on increasing the patient’s ability to complete their daily tasks, instead of focusing of eliminating pain. With pain that is chronic, the patient begins to deal with the fact that the pain will be a part of their life in the long term. Therefore, treatment must focus on management of the pain as well as increasing the patient’s ability to perform their daily tasks. A functional restoration program focuses on posture, body mechanics, strength, flexibility, endurance and tolerance to allow the patient to return to their functional activities. Here’s one way of looking at it: If you suffer from a pain level that is at a 6 out of 10 and your pain limits you to minimal activity, this program helps you to be more active, even if your pain is still at a 6 out of 10. Most people choose to be more, instead of less, active if they must be at that pain level.