Patients that suffer from chronic pain have typically regressed into debilitating inactivity, muscle atrophy, weight gain, and decreased endurance. These changes can lead to decreased ability for work, household chores, or participation in social and / or recreational activities. Many people attempt to change this cycle, but find difficulty with increased symptoms and complaints resulting in continued or increased inactivity. For some, rest and inactivity may feel like the best treatment for pain due to an immediate reduction of pain when at rest. However, this can actually cause increased overall pain levels. When the body becomes inactive, muscles become weak and tight, joints become stiff, and low energy levels result. This leads to higher pain levels and more stress on the affected areas. For others, they attempt to continue their busy lifestyle and try to "work through their pain". However, this usually results in suffering from a flare-up. When increasing activities to the point before suffering a flare-up, this is called pacing. The lack of pacing usually causes increased pain and increased frustration with an increase in fear that any increased activity will result in increased pain. How is physical therapy at SCPWC different than the physical therapy at other clinics? A typical physical therapist has minimal to no training in treating chronic pain. In school, therapists are taught how to treat acute injuires, not chronic pain. The treatment provided for acute injuries is vastly different from treatment provided to a chronic pain patient, and therefore, when a person with chronic pain visits a typical physical therapy facility, they receive acute injury treatment. Unfortunately, this is usually unsuccessful and may even result in concerns for exaggeration, malinguering, or histrionic responses by the patient. Acute injury treatment focuses on passive treatments. Passive treatments usually do not require much participation or effort from the patient. These treatments usually consist of modalities such as ultrasound, electrical stimulation, ice/heat, massage and some mild exercise. This initial treatment for an acute injury typically is unsuccessful. It may, however, provide temporary and partial relief of chronic pain. Thus, for chronic pain patients, their pain levels are either unrelieved with these treatments or return to their familiar level of discomfort shortly after this type of treatment is provided. Chronic pain treatment focuses on teaching the patient to manage pain by using taught skills such as pacing, flare-up management, slow and safe exercise development, and progression and relaxation techniques. This specialized treatment also focuses on assisting patients to overcome their fear of re-injury or fear of increased pain with movement. Urgent care, occupational medicine, or other types of acute care clinics often focus on one body part at a time. At SCPWC, the patient is treated in their entirety. We understand that the entire body works as a complete unit in order to perform all daily activities. Many people suffer from chronic pain in multiple areas and these need to be treated as a whole instead of piece by piece. What are the services provided in our 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, Myofascitis, and Fibromyalgia. Work Conditioning: A program designed to increase the injured worker's endurance and lifting, carrying, sitting and standing capacities, restore musculoskeletal functioning, increase core strength, and to increase the worker's tolerance for job-related activities. This program is for the injured worker who may or may not have a specific job to return to, or has not ready to begin work hardening due to extremely low functional level. Each program is tailored specifically for each individual client. 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. The amount of effort provided is also measured through a variety of tests. An FCE is typically a 6-hour evaluation over 2 consecutive days, 3 hours per day. What does functional restoration mean? 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 is taught to deal with the fact that the pain will be a part of their life over 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 6/10 level, and your pain limits you to minimal activities, this program helps you to be become more active, even if your pain is remains at 6 /10.
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