The basic physical therapy treatment approach at the Pain Management Program utilizes education, manual therapies and exercise.

Education

Education is designed to inform the patient why previous treatments were not successful. The education may also include explanations of how the nervous system changes as a result of persistent pain and what aspects of the patient's medical status, environmental status or problem-solving abilities have contributed to the persistence of pain. Each patient is informed as to what their therapist has determined to be the “starting point” for treatment, why he or she has come to this conclusion and how the situation is expected to change. Communication will also include an explanation of treatment plan, changes to treatment plan based on specific responses to the provided treatments, as well as information regarding the medical and practical differences between acute (new) pain, sub acute (unsuccessfully treated acute pain) and chronic/ persistent (long term) pain.

Manual therapies

Manual therapies are not the same for everyone and are provided after the patient has been evaluated considering the patient's age, body type and current medical status. Manual therapy is part of a complete treatment plan that includes: manual therapy, education and exercise. Many times, persons have unique pain difficulties that must be worked through various aspects of medical understanding of pathoanatomy or pathophysiology. We understand that by this point, many individuals have seen a variety of medical professionals and tried various forms of therapy that have not worked. We will evaluate these treatments and help each patient understand why they may have failed. It is in these cases that the amount of one-on-one time with the pain management physical therapy staff is invaluable and even necessary. One-on-one time for all patients is a distinguishing factor and an important treatment philosophy at the Pain Management Program. Even though a massage is a manual therapy, the manual therapy utilized at the Pain Management Program involves the use of the hands with the intention of inducing a positive physical, mechanical or physiologic change in a person’s body, regardless of the bodily tissues being treated. There are varied and numerous types of manual therapies utilized for specific purposes at the Pain Management Program.

When patients consult the physical therapists at the Pain Management Program, exercise therapies have typically been tried previously and have not been effective. The lack of normal or adaptable anatomy (abnormal biomechanics) may have prevented a previously prescribed exercise therapy from being effective. Once the mechanical issues interfering with normal or near normal biomechanics are addressed, exercise therapy may be more effectively utilized.

In addition, exercise is used to assist a person to literally re-train the nervous system to become less sensitive to the pain and the things that historically have triggered the pain in that particular patient. This is the case in reference to the mechanical nervous system, physiologic nervous system and the emotional nervous system.

At the Pain Management Program, manual therapy does not include massage therapy. The therapist’s hands are used to specifically alter the mechanics and physiology of the specific tissues treated. The tissues treated are not limited to muscles, fascia or joints. These manual therapies differ specifically from massage in that repetitive or rhythmic movements or techniques are not typically used. The only exception would be for techniques designed to improve lymphatic circulation.

Exercise

The exercises provided by our physical therapy specialists are designed to improve:

• neuromuscular control
• range of motion
• peripheral nervous system adaptability
• central nervous system adaptability

All therapeutic and functional benefits stem from the above parameters.

Acute care physical therapy treatments and exercise programs are not provided by our physical therapy program. However, if these services are needed, the patient will be referred to an appropriate facility so these needs may be met.