PHYSICAL THERAPY FOR PAIN Karissa Ward, DPT
ABOUT ME
WHAT IS THIS ALL ABOUT? What is Physical Therapy? What is pain? What can exercise and/or physical therapy do for me and my pain?
ABOUT PHYSICAL THERAPY According to the APTA (American Physical Therapy Association): Highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility Teach patients how to prevent or manage their condition so that they will achieve long-term health benefits. Examine each individual and develop a plan, using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. Work with people of all ages in hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes.
STATS ABOUT PAIN Pain affects more Americans than diabetes, heart disease and cancer combined. more than 1.5 billion people worldwide suffer from chronic pain Most common reason Americans access the health care system. The total annual cost of health care due to pain ranges from $560 billion to $635 billion (in 2010 dollars) in the United States 1out of 4 Americans have suffered from pain that lasts longer than 24 hours. Chronic pain is the most common cause of long-term disability. Back pain is the leading cause of disability in Americans under 45 years old Adults with low back pain are often in worse physical health Pain can be a chronic disease, a barrier to treatment, and can occur with other diseases and conditions As much as 80% of the population will experience a back problem at some time in their lives There are differences in pain perceptions and responses to treatment by gender.
WHAT IS PAIN? Pain is a sensory experience Also linked to emotion and beliefs. Acute pain normal sensation triggered in the nervous system to alert you to possible injury Also known as “noxious stimuli“ Chronic pain Persists for weeks, months, even years. May have been an initial injury, or there may not have been Affect older adults. Headache, low back pain, cancer pain, arthritis pain, neurogenic pain, psychogenic pain
COMMON TREATMENTS FOR PAIN Rest Modalities Ice Heat E-stim Medication: Over the counter Prescription Physical activity (physical therapy!)
PHYSICAL THERAPY VS. MEDICATION Opioids Physical Therapy Opioids reduce the sensation of Treat pain with movement pain Prescription Prescription Maintain and improve mobility and Opioids have harmful side effects quality of life Depression, overdose, addiction, and withdrawal when they are discontinued CDC actually recommends that opioids should be combined with non-opioid therapies (such as PT.)
STATS ABOUT EXERCISE People who move a lot during the day reduce there risk of death by 30% (Times) Doing housework a few times a week can reduce your risk of stroke and heart disease (Times) Standing more is linked to lower risk of cancer, diabetes, and early death of any cause (Times) 7 hours a week of physical activity have a 40% lower risk of dying early than those who are active less than 30 minutes Benefits of physical exercise (CDC) Control weight Reduce risk of cardiovascular disease, type 2 diabetes, some cancers (colon, breast, endometrial, lung) Strengthen bones and muscles Improve mental health and mood Reduce risk of falls and improved ability to do daily activities Increased chance to live longer and improved quality of life
WHAT IS PHYSICAL ACTIVITY • Aerobic activity • Strengthening activity • Flexibility and balance Moderate intensity: heart beat a little faster, Vigorous intensity: heart beat a lot faster, but can still talk but may not be able to talk • Brisk walking • Jogging/running • Bicycling • Singles tennis • Swimming • Swimming • Mowing the grass • Jump roping • Doubles tennis • Conditioning machines • Social dancing • Sports (soccer, basketball, football, • Conditioning machines racquetball) • Tai Chi and Yoga • Aerobic dance or spinning classes • Sports (softball, baseball, volleyball) • Skiing, roller and ice skating
PHYSICAL ACTIVITY AND EXERCISE FUTURE: New research is coming PAST: “Eating alone out about the will not keep a man effects of physical well, he must also activity and exercise” exercise on pain and overall health. - Hippocrates PRESENT: “The most effective therapy available to my patient’s right now is exercise” – Dr. Mark Tarnopolsky
CDC RECOMMENDATIONS 150 minutes of moderate physical activity with 2 days a week of strength training Only about 28% of those 75 and up get aerobic activity and 8% strength training Half of American Adults do aerobic activity and 20% do any kind of strength training The health benefits of physical activity outweigh the risks of injury. Regular physical activity helps with arthritis and other conditions affecting the joints
WALKING FENDS OFF LOSS OF MOBILITY, AND IT'S NOT TOO LATE TO START “Physical activity is… the secret ingredient to successful aging.” Bradley Cardinal, a professor of kinesiology at Oregon State University Exercise can improve memory and reverse muscle loss Reduces time spent with a mobility limiting disability Lower risk of heart disease, diabetes, certain cancers, depression, cognitive impairment, functional decline Prescribing exercise may be just as important as prescribing medication
THE EXERCISE CURE TIME MAGAZINE “If there were a drug that could do for human health everything that exercise can, it would likely be the most valuable pharmaceutical ever developed” -Mandy Oaklander, TIME magazine Scientific benefits: Slower aging Better mood Less chronic pain Stronger vision Good for the brain: less depression, better memory, quicker learning Best way to prevent or delay the onset of Alzheimer’s Lack of physical activity can cause: worse arthritis symptoms, increased low back pain, depression, anxiety, sallow complexion, and increased risk for hearth disease, Alzheimer’s disease, and early death by any cause. Exercise is not just for professional athletes, everyone can benefit Can extend your life by up to 5 years!
WHAT CAN PHYSICAL THERAPY DO FOR PAIN? Individualized treatment plans Increase strength Utilize non-destructive stress on joints, bones, and muscles Increase cardiovascular health Start Movement Early Manual Therapy Modalities Traction for spine Heat/cold pack E-stim
WHAT CAN YOU DO FOR PAIN? “Start low, go slow.” Modify as needed Talk to a health care professional Stay active CDC recommends 150 minutes of moderate physical activity per day Do at least 10 minutes at a time. Physical activity includes all movement A little bit of pain, stiffness, and swelling is normal when you first start activity Remember to lift weights not just do aerobic activity Light weight, more reps
SOME OF THE BEST EXERCISES DO NOT REQUIRE A GYM!
ANKLE PUMPS
SEATED HAMSTRING STRETCH
KICKS (LONG ARC QUADS)
SEATED MARCHES
CHAIR PRESS UPS
SQUATS
RUNNER’S STRETCH
HEEL RAISES
3 WAY HIPS
PHYSICAL THERAPY AT HRMC Mike Miller, RPT Karissa Ward, DPT Traci Board, RPT Steve Wilgers, RPT Haley LeBlanc, CPTA April Higgins, CPTA
PHYSICAL THERAPY AT HRMC Settings: Outpatient Inpatient Patient comes to PT from home Acute care: After surgery Admitted to the hospital For pain relief After surgery Improved mobility and balance General mobility is the main focus Usually a couple of times per week for several weeks Inpatient Rehab 30 minutes to an hour at a time 3 hours of therapy a day (PT,OT, and Speech) Take home exercises to do at home Goal is to return home as independently as possible Goals is to improve quality of life and independence Skilled Nursing Unit at home Require extra medical services, therapy included No specific time required, depends on patients’ ability Goal is to return home as independently as possible
HOW TO START PT PT is a prescription Visit your doctor Ask about PT Call Jo in Rehab Services at Hutchinson Medical Center at (620) 665-2104 to set up an appointment
QUESTIONS
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