Physical Therapy
Commonly asked questions about physical therapy
What is physical therapy?
Physical therapy is a process by which trained professionals use hands-on methods, modalities (i.e. heat, electrical stimulation, massage etc.), and education to reduce pain, restore function, and prevent further injury.
What kind of training do physical therapy professionals have?
A physical therapist (PT) has a minimum of four years in a professional program with a bachelor’s degree. Many programs are now 6 years with masters programs. The coursework is extensive and includes anatomy, physiology, pathophysiology, kinesiology, diagnostic testing & evaluations, treatment planning, treatment techniques. The physical therapy assistant: (PTA) as an associate’s degree after two years. Training includes anatomy, treatment techniques and assessment. Both the PT & PTA undergo internships in several different settings, and the PT is required to take a licensing examination before practicing.
What are the benefits of physical therapy?
Physical therapy can provide pain reduction, prevent further injury, and increase strength, motion and function.
How much time does physical therapy require?
The average session for physical therapy last anywhere from 30 to 60 minutes depending on the needs of the patient. The total number of sessions needed depends on the patient and can range from a minimum of 1 – 2 visits to over 18 visits. The frequency of treatment is anywhere from 1 – 3 times per week. A specific idea of the patient’s physical therapy needs is obtain following the therapists evaluation. The total number of depends on the complexity of the patient’s problem, compliance of the patient with prescribed exercises, and response to treatment.
What sort of treatments are available?
Generally, there are two categories of treatment. One involves passive modalities that are designed to reduce pain while patient progresses through exercises. The other involves the actual exercises and body mechanics education. Physical therapy modalities include ultrasound, electrical stimulation techniques, iontophoresis, manual therapy, application of heat or cold.
What type of physical therapy modalities are available?
1. Ultrasound. This machine produces sound waves which can penetrate tissue and cause vibration of molecules resulting in heat from friction. A small instrument called a transducer applies sound waves through a gel that is applied to the patient skin. The strength and depth of penetration can be varied by the operator of the machine. Ultrasound useful in relaxing muscles, increasing blood flow, and promoting healing. Commonly treated conditions include myofascial pain syndrome, bursitis, tendinitis, muscle spasms, scar tissue, joint contractures.
2. Electrical stimulation techniques. Electrical current in small increments can help excite nerves or muscle tissue to help promote the restoration of lost function. The flow of a electrons is able to transfer the flow of ions within biological tissues to the application of electrodes to the patient skin. Studies have shown that the application of electrical modalities can increased local blood flow, stimulate soft tissue regeneration, increase the level of endorphins (the body’s own pain controlling substances), and increase absorption of excess fluid from the affected site.
3. Iontophoresis. This modality uses continuous low voltage current in one direction to drive medications applied to the skins surface into deeper tissues. Typically, medications used are local anesthetics, and corticosteroids. Local anesthetics are used to provide anesthesia and increase blood flow. Corticosteroids are typically used to reduce inflammation.
4. Transcutaneous Electrical Nerve Stimulation (TENS). This form of treatment helps to decrease pain by release of endorphins and stimulating other pain inhibiting nerve pathways. TENS units are used for both cute and chronic pain. Small adhesive gel pads are placed over the patient’s area of pain. Electrical stimulation flows from the device to gel pads. The frequency and amplitude of stimulation can be adjusted. Patients can use these devices at home or work.
5. Cryotherapy (the application of cold). Cold is used to help decrease edema, inflammation, pain as well as reducing spasticity. The application of cold results in constriction of blood vessels and reduction of nerve transmission. Cold is usually applied in the form of cold packs, ice packs, ice massage, coolant sprays.
6. Heat. Heat is used to reduce stiffness, pain, muscle spasms as well as improving the range of motion at joints. Collagen fibers which are a major component of ligaments and attendance typically resist stretch. Heat can help to relax these fibers and promote stretch. Hot packs are most commonly used to apply heat.
7. Manual Therapy. This involves the movement of muscle and ligamentous tissue to reduce muscle spasm and improve body mechanics.
What type of exercises are usually required?
Exercise is any physical activity that is planned, purposeful, and structured. It includes aerobic, anaerobic, isometric, isotonic, stretching, relaxation, passive movement. Aerobic exercises involved the utilization of large amount of oxygen. Repetitive movements of major muscle groups such as in walking, running, swimming are common forms of aerobic exercise. Anaerobic exercise typically requires less oxygen consumption. Isotonic exercise involves contraction which moves a body part. Isometric exercise involves contraction that does not result in movement of the body part. A careful evaluation by a physician and physical therapist is necessary in designing the optimal exercise program for the patient.
What sort of things need to be done for an exercise program to be successful?
To obtain meaningful results from physical therapy is important to consider the following:
1. The patient should have a reasonable degree of pain control. This can be accomplished by medical management, interventional pain management techniques, as well as other conservative modalities. Because pain can indicate other serious conditions, an accurate diagnosis is essential.
2. The exercise should be meaningful to the patient.
3. The exercise should be incorporated into the clients everyday schedule. A general target goal would be for the patient to engage in moderate exercise 30 – 35 minutes per day.
4. The patient should keep a diary and evaluate the effects of the exercise.
5. The patient should also incorporate aerobic, stretching, and relaxation techniques in the morning or early evening.
What sort of conditions can physical therapy be used to help patients?
Physical therapy can benefit almost any person. It is well known that exercise can control weight and improve mood. At our clinic, physical therapy is an integral part of the patient’s treatment. Common diagnoses include neck and lower back pain, sciatica from herniated discs, osteoarthritis, fibromyalgia, headaches, reflex sympathetic dystrophy, myofascial pain syndrome. Both acute and chronic conditions are treated.
What is required of a physical therapy patient?
In order to get the full benefit of physical therapy, it is important patient is compliant in attending sessions as well as doing home exercises instructed by the therapist.
Will the treatment hurt?
Sometimes the patient may experience increased pain or soreness after the initial evaluation because specific movements are being tested. This is important in helping to make a diagnosis and formulate a treatment plan. At times, patients may be sore after certain specific exercises or manual therapy (deep tissue work).
Does the doctor know what physical therapist is doing?
Yes. The physical therapist typically works under a positions prescription. The doctor receives notes and updates as to the patient’s progress. At Milwaukee Pain Treatment Services, the physical therapist and physical therapy assistant have daily contact with the physician and can make adjustments in treatment right away.
What if physical therapy doesn’t work?
Physical therapy is not the answer for every patient. If the patient tries physical therapy and doesn’t make any progress in exercise progression, pain control, or functional abilities, the physician is re-consulted. Physical therapy may be discontinued or the doctor may need to intervene medically or with other interventional pain management procedures before continuing physical therapy.
Does insurance cover physical therapy services?
Most insurance companies cover physical therapy services. However, you should understand that certain insurance companies specifically dictate where patients may receive physical therapy. Obviously, we will check to see if your insurance company covers physical therapy services at our clinic before receiving treatment.
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