TRULY AFFORDABLE PAIN MANAGEMENT

Pain is a general term that describes uncomfortable sensations in the body. It stems from activation of the nervous system. Pain can range from annoying to debilitating, and it can feel like a sharp stabbing or a dull ache. Pain can also be described as throbbing, stinging, sore, and pinching. Pain can be consistent, can start and stop frequently, or can appear only under some conditions. People respond to pain differently. Some people have a high tolerance for pain, while others have a low tolerance. For this reason, pain is highly subjective. Pain can bring about other physical symptoms, like nausea, dizziness, weakness or drowsiness. It can cause emotional effects like anger, depression, mood swings or irritability. Perhaps most significantly, it can change your lifestyle and impact your job, relationships and independence. Pain can be acute or can occur over a longer period of time. It may be related to a specific injury or issue, or it may be chronic, with ongoing sensations lasting for longer than three months. Pain can be localized, affecting a specific area of the body, or it can be general—for example, the overall body aches associated with the flu. With many chronic conditions, the cause of the pain is unknown. Pain is the means by which the peripheral nervous system (PNS) warns the central nervous system (CNS) of injury or potential injury to the body. The CNS comprises the brain and spinal cord, and the PNS is composed of the nerves that stem from and lead into the CNS. PNS includes all nerves throughout the body except the brain and spinal cord.

nerves throughout the body except the brain and spinal cord.

ROLE OF PHYSICAL THERAPY IN PAIN MANAGEMENT

Physical Therapy helps to relieve pain, promote healing, and restore function and movement. Physical Therapy is practiced by a professionally trained physical therapist. “Physical therapy can be highly effective for all types of chronic musculoskeletal and neuropathic types of pain,” One of the goals of physical therapy is to help chronic pain patients become stronger, because they’re usually weak from not moving. A physical therapist works with each patient to understand his or her particular pain — what causes it and what can be done to manage it. This is the kind of attention that a regular doctor doesn’t often have the time to give, but a physical therapist can ask questions and talk about pain issues as you are going through your exercise routine. Physical therapy tackles the physical side of the inflammation, stiffness, and soreness with exercise, manipulation, and massage, but it also works to help the body heal itself by encouraging the production of the body’s natural pain-relieving chemicals. Physical therapy is often one of the best choices you can make when you have long-term pain (also called chronic pain) or an injury. It can make you stronger and help you move and feel better.

These professionals may use ice, heat, electrical stimulation, massage therapy, and/or ultrasound technology during your sessions. Many may use a combination of all.

Additionally, your Physical Therapist will walk you through various types of highly therapeutic exercises that are designed to alleviate pain and pressure, build up your strength levels, provide a boost to your range of motion, and improve your overall functioning.

You will receive information on your condition and will likely be assigned steps you can take at home to aid in your healing.

Physical therapists will talk with you to make sure they understand your pain history, and help set realistic expectations about your treatment. Physical therapists are able to directly work with you and assess how your pain responds to treatment. Patients that experience chronic pain may require continuous physical therapy, and a more proactive approach to pain management than prescribed medications can provide. Whether sub- acute or chronic, pain is a leading reason for patients to seek physical therapy.

Pain reduction is a primary goal of physical therapy for patients who present with sub- acute or persistent pain conditions. The purpose of this review is to describe a mechanism-based approach to physical therapy pain management. It is increasingly clear that patients need to be evaluated for changes in peripheral tissues and nociceptors, neuropathic pain signs and symptoms, reduced central inhibition and enhanced central excitability, psychosocial factors, and alterations of the movement system. In this Perspective, 5 categories of pain mechanisms (nociceptive, central, neuropathic, psychosocial, and movement system) are defined, and principles on how to evaluate signs and symptoms for each mechanism are provided. In addition, the underlying mechanisms targeted by common physical therapist treatments and how they affect each of the 5 categories are described. Several different mechanisms can simultaneously contribute to a patient’s pain; alternatively, 1 or 2 primary mechanisms may cause a patient’s pain. Further, within a single pain mechanism, there are likely many possible subgroups. For example, reduced central inhibition does not necessarily correlate with enhanced central excitability. To individualize care, common physical therapist interventions, such as education, exercise, manual therapy, and transcutaneous electrical nerve stimulation, can be used to target specific pain mechanisms. Although the evidence elucidating these pain mechanisms will continue to evolve, the approach outlined here provides a conceptual framework for applying new knowledge as advances are made.

As physical therapists, evaluation and treatment of the movement system is a key component of our care for patients with pain. Clearly, we recognize “antalgic gait” patterns as movement influenced by pain; overuse syndromes as painful conditions induced by repetitive movement; and the nociceptive withdrawal reflex as a well-characterized link between afferent pain pathways and the efferent motor system. However, the relationships between pain and the movement system are complex and often highly variable between individuals. Pain can produce increased muscle contraction, tone, or trigger points; it can result in muscle inhibition or fear-avoidance behaviors resulting in disuse and disability, or both facilitation and inhibition in opposing muscle groups. Thus, targeted interventions may help reduce motor responses that exacerbate pain or improve function by minimizing the motor effects of pain. The integration of physical therapists’ expertise in the movement system with the other pain mechanisms has the potential to elevate our level of care to more effectively evaluate and treat pain conditions.

They have the skill set, the knowledge, and the general level of expertise to help patients regain and reach optimal functional mobility and be as independent as possible, for as long as possible.

Physical Therapists (PTs) are extensively educated and licensed health care professionals who diagnose and treat individuals of all ages with medical problems or other health-related conditions or injuries that limit their ability to move and perform functional activities in their daily lives

Physical Therapists work with patients to achieve these overall goals:

• Reduction in pain
• Increased movement or flexibility
• Increased strength and endurance
• Increased functional capacity to perform daily tasks

Reasons Physical Therapy Should be a Priority:

Regardless of age, medical conditions, illnesses, or injuries, there are several advantages to making physical therapy a priority in treatment. The following outlines the benefits of this type of care:

• The exercises and manual therapy provided help to reduce or completely eliminate any pain that is being experienced.
• Physical therapy may help you avoid having to undergo surgery to correct the issue in which you suffer.
• The therapeutic exercises will help to improve your overall mobility.
• If you have suffered from a stroke and have experienced issues with your general functioning and movements, physical therapy can help in your recovery.
• If you have suffered an injury, you will be provided with specific exercises that promote quick healing and full recovery.
• Physical therapy helps to boost your balance and prevent the likelihood of experiencing a fall that could be detrimental to your health and general quality of life.
• If you have diabetes or any type of vascular-based medical condition, you will benefit from the techniques performed by a physical therapist.
• Physical therapists can help in reducing the detrimental effects that occur with the natural aging process.
• If you have a lung disease or suffer from heart disease, physical therapists offer rehabilitation to help in your recovery and to boost your health.
• Physical therapy is the most cost-effective solution for your health.

 

ASSOCIATING PAIN MANGEMENT WITH COST SAVINGS

Individuals who received physical therapy as an initial intervention tended to rack up fewer additional costs than the injection and surgery groups. Physical therapy not only improves outcomes when used together with other medical treatments; it can also be used to prevent the need for more invasive and risky medical interventions – such as scans, imaging, surgery, opioids and other prescription pain relief.

Patients who begin care with a physical therapist for neck or back pain, rather than first seeing a physician, may realize comparable improvement in their condition at significantly reduced costs. Within this context, there is a growing recognition that a treatment approach beginning with early physical therapy (PT) not only reduces short- and longer term healthcare costs, but often decreases pain, improves function, and helps patients return to work.

Physical Therapy is a cost-effective first intervention that saves time and money, especially when utilized early in the treatment process. Physical therapy is one of the most cost-effective treatments available to patients. Plus, it can help you return to your health baseline more quickly and provides long-lasting positive results. In order to truly appreciate the value of physical therapy and how it can save you money, it is first important to consider the average costs of the most prescribed medical interventions as recommended by medical doctors. Treatment is personal and customized based on your individual needs. In this way, Physical therapy is very effective and important in recovery.

Physical therapy offers similar long-term outcomes to those of surgical intervention. Surgery requires additional inpatient expenses and a prolonged recovery time. These long-term patient healthcare costs can be greatly reduced with physical therapy.

For shoulder injuries, physical therapy patients saved 5 times the costs of surgery.

For knee injuries, physical therapy patients saved almost 7 times the costs of surgery.

For neck injuries, physical therapy patients saved over 10 times the costs of surgery.