Low back pain is one of the most common conditions in healthcare. Unfortunately, the road to relief is not the same for all patients. Yet, the good news is that physical therapy continues to have significant benefits. Several clinical studies have shown that PT is very cost-effective and can prevent unnecessary treatment for the consumer.
Two studies have shown that PT can save patients thousands of dollars. An article(http://www.ncbi.nlm.nih.gov/pubmed/22614792) in 2012 indicated that when patients saw a physical therapist within 2 weeks of onset, the average consumer saved $2700. This is a significant savings with reduced rate of surgeries, injections, unnecessary imaging and medications. Because time can be a factor, patients now have direct access to physical therapy which means they do not need a script from a physician. This law was put into place for cases like low back pain where people can experience significant relief when they see a physical therapist within two weeks.
Furthermore, another study this month (http://www.ncbi.nlm.nih.gov/m/pubmed/25772625) looked at the difference between advanced imaging vs. PT as a first management strategy following a primary care consultation. They found patients that saw a PT first saved $4700 on average if they did not get advanced imaging. Fortunately, a physical therapist has the clinical skills to know when imaging may be necessary in the rare event and send patients back to their physician for further examination. Although advanced imaging (MRI, CTscan) and surgery are sometimes needed for the care of low back pain, it is rare.
Physical therapy is very cost-effective for low back pain. If you are experiencing low back pain, seeing a physical therapist first will allow you to get relief quickly and get you back to what you enjoy most in Colorado.
If you are interested in learning more about how to resolve your back pain, click on the link below for a report on stopping low back pain.
It is always humbling as a healthcare provider to receive a testimonial. A former patient offered to to give a testimonial and I was thrilled to have her do so. She has come a long way and it has been amazing to see her success. Although she had some difficult times over a year and a half, she is finally back to enjoying a life without significant discomfort. I am honored to share her story and wish her only the best for a continued road to recovery.
All physical therapists enter the profession to make an impact on the quality of life for all patients. A recent patient of mine was kind enough to let me share her story with you. It is always humbling to watch a patient meet their goals and leave a lasting impact on their life.
Although opioids are very effective in the short-term, the side effects in a long-term situation can exacerbate a condition. Recent research suggests that pain killers can actually lead to increased pain levels over time. Here is a short video which outlines the current research. The good news is your physical therapist can help you overcome any chronic condition safely and get you back to all the activities you enjoy.
Benign Paroxsmal Positional Vertigo, commonly known as BPPV, can affect up to 9% of adults in their lifetime. This condition is caused by crystals which become dislodged in the ear. Symptoms primarily include dizziness and spinning which lasts for a few seconds up to a minute. Most commonly, symptoms occur when rolling over in bed or looking up.
BPPV can be treated by your physical therapist with a very high success rate. The Epley Maneuver (shown above), performed by your physical therapist, is a very effective treatment. It will allow most individuals to have full relief in 1-3 visits. To learn more about BPPV, here is the Physical Therapist’s Guide to BPPV from the American Physical Therapy Association.
Not all injuries are the same. The diagnosis may be the same, however the course of injury and overall prognosis can be completely different from one person to the next.
Generally speaking, initial healing from an injury occurs over the course of 4-8 weeks. Hence, after a common surgery like an ACL reconstruction, individuals start to feel pretty good in terms of symptoms around 8 weeks as the swelling/inflammation dials down. After the initial healing takes place, symptoms usually are minimal even as the body continues to remodel itself over the next year.
Surgery is a great example because apart from the injury, there is tissue that gets damaged from the actual surgery. It gives an example that after there was tissue damage from the actual surgical procedure, we can expect that most people will start to feel a lot better after the initial healing process.
Yet, something common like “low back pain” or “runner’s knee” can easily persist after that 4-8 week period. Many times people report repeating episodes over years. Why does this happen? There are several reasons why individuals may be prone to the same injury over and over again.
For long-standing injuries, pain does not correlate with tissue damage.
Initially, your pain was more correlated with tissue damage. Given what you now know about the course of tissue healing, the body is actually great at healing itself! In many cases, it is not the actual injury/tissue damage that persists – it is the pain that persists. This happens because your body and its headquarters (your nerves and brain = nervous system) remember how you got into trouble in the first place. With persistent (this is a much better word than “chronic” because it does not have to stay with you for the rest of your life!) pain, your body is trying to protect you too much. In all seriousness, pain is not a bad thing! At the end of the day, it helps keep us alive. In persistent cases of injury, our nervous system can be doing too much of a good thing by keeping us too safe. The consequence is unfortunately way too much pain. The real question is, what can your health provider do for you?
Physical therapy can be very successful in treating long-standing persistent conditions. The trick is to carefully reintegrate people back into activities. The body is incredibly resilient – it can just become over sensitive. The example I often give is that your pain is like a car alarm. Ideally, it should sound when someone is breaking into the car = tissue damage. However, the ideal situation is not always the case. We have all been in a parking lot when no one is even near a car and yet the alarm continues to sound! Like the human body, it is very common that we can have pain even when there is no tissue damage happening (no one is breaking into the car!). For example, individuals without a limb can still have very excruciating phantom limb pain even when there is no tissue there to be damaged.
Let’s take the example of a persistent case of low back pain. Our body can develop a very keen awareness to that low back especially over many years of bending forward, sitting, or every time we move a certain way. Every time we start to bend forward for example and start to feel pain, we are likely not creating any further damage. Your body just may be trying to overprotect you! Most often, low back pain can be resolved within 4-6 weeks with a unique program designed specifically for each person. Research continues to show that the more patients understand their pain, the more pain relief they will likely have. This is in addition to a great regimen of hands-on treatment (manual therapy) and tailored exercise program.
Although an over-responsive car alarm/nervous system can be a factor in persistent injuries, it is just one factor that may be impeding recovery. If you think an over-sensitive nervous system may be contributing to your injury, it is best to seek advice from a physical therapist that specializes in persistent (chronic) conditions. The key point to remember: not all pain correlates with tissue damage.
Moseley, L. Reconceptualizing Pain According to Modern Pain Science. Physical Therapy Reviews 2007;12:169-178.
Increasing evidence continues to show that physical therapy should be considered prior to many orthopaedic surgeries that involve degenerative conditions. In this latest press release, doctors and radiologists found that surgery for meniscal injuries of the knee can lead to a higher risk of developing osteoarthritis. In conclusion, they stated that physical therapy should be sought after because surgery can be “detrimental to the knee joint.”
Although there are times when surgery is necessary, research over the last few years continues to show that physical therapy should be the first choice for degenerative conditions. Physical therapy is a cost-effective option that can provide significant pain relief and allow patients to return to the activities they enjoy!
Knee pain is very common during ski season. Here is a short video with tips to prevent knee pain and one exercise you can perform to have a more enjoyable time on the slopes this year!
Ambulating stairs can be a source of increased knee pain. Oftentimes, simple changes in the way you approach stairs can provide significant pain relief. Whether you are recovering from knee surgery or just always have pain with stairs, this video will help for all types of diagnoses and pathologies that lead to knee pain.
This video demonstrates one way to to prevent low back pain when bending forward and lifting. This exercise will help you engage your hip musculature instead of using too much of your low back muscles that can lead to low back pain.