PHYSICAL THERAPY FOR PAIN Karissa Ward, DPT ABOUT ME WHAT IS THIS - - PowerPoint PPT Presentation

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

 Opioids reduce the sensation of pain  Prescription  Opioids have harmful side effects

 Depression, overdose, addiction, and withdrawal when they are discontinued

Physical Therapy

 Treat pain with movement  Prescription  Maintain and improve mobility and quality of life

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

Moderate intensity: heart beat a little faster, but can still talk Vigorous intensity: heart beat a lot faster, but may not be able to talk

• Brisk walking
• Bicycling
• Swimming
• Mowing the grass
• Doubles tennis
• Social dancing
• Conditioning machines
• Tai Chi and Yoga
• Sports (softball, baseball, volleyball)
• Skiing, roller and ice skating
• Jogging/running
• Singles tennis
• Swimming
• Jump roping
• Conditioning machines
• Sports (soccer, basketball, football,

racquetball)

• Aerobic dance or spinning classes
• Aerobic activity
• Strengthening activity
• Flexibility and balance

PHYSICAL ACTIVITY AND EXERCISE

PAST: “Eating alone will not keep a man well, he must also exercise”

• Hippocrates

PRESENT: “The most effective therapy available to my patient’s right now is exercise” – Dr. Mark Tarnopolsky FUTURE: New research is coming

• ut about the

effects of physical activity and exercise on pain and overall health.

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

• utweigh 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  Traci Board, RPT  Haley LeBlanc, CPTA  Karissa Ward, DPT  Steve Wilgers, RPT  April Higgins, CPTA

PHYSICAL THERAPY AT HRMC

Settings:

 Inpatient

 Acute care:  Admitted to the hospital  After surgery  General mobility is the main focus  Inpatient Rehab  3 hours of therapy a day (PT,OT, and Speech)  Goal is to return home as independently as possible  Skilled Nursing Unit  Require extra medical services, therapy included  No specific time required, depends on patients’ ability  Goal is to return home as independently as possible

 Outpatient

 Patient comes to PT from home  After surgery  For pain relief  Improved mobility and balance  Usually a couple of times per week for several weeks  30 minutes to an hour at a time  Take home exercises to do at home  Goals is to improve quality of life and independence at home

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

REFERENCES

Hobson, K. (2016, September 26). Walking Fends Off Loss Of Mobility, And It's Not Too Late To

• Start. Retrieved October 1, 2016, from http://www.npr.org/sections/health-

shots/2016/09/26/495477531/walking-fends-off-disability-and-its-not-too-late-to-start Oaklander, M. (2016, September 12). The New Science of Exercise. TIME. Pahor, M., Guralnik, J. M., Ambrosius, W. T., Blair, S., Bonds, D. E., Church, T. S., . . . Williamson, J. D. (2014, June 18). Effect of Structured Physical Activity on Prevention of Major Mobility Disability in Older Adults. Jama, 311(23), 2387-2396. doi:10.1001/jama.2014.5616 Physical Activity and Health. (2015, June 04). Retrieved October 16, 2016, from https://www.cdc.gov/physicalactivity/basics/pa-health/ Physical Activity for Arthritis. (2016, May 09). Retrieved October 16, 2016, from http://www.cdc.gov/arthritis/basics/physical-activity-overview.html Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management. (2016). Retrieved October 16, 2016, from http://www.moveforwardpt.com/Resources/Detail/physical- therapy-vs-opioids-when-to-choose-physica