Viewing entries tagged
pain

Early Physical Therapy Means Less Opioids

Early Physical Therapy Means Less Opioids

In a recent study published in the Journal of American Medical Association (JAMA) found that early use of physical therapy for lower back pain can correlate to a a 10-15% reduction in opioid use. Such a study highlights the power of exercise, manual therapy, and some of the evidenced-based modalities PTs can use, such as dry needling.

With such promising evidence, why aren’t patients seeking physical therapists (PTs) for many orthopedic and pain issues? First, many patients don’t realize that they have direct access to PTs. This means they can go straight to their PT and skip the medical doctors “Rx” or referral. Second, physicians often like to prescribe medications first before recommending other therapies; medical doctors are specialists in medicine and they receive little training and education in exercise and nutrition. Third, only about 10-20% of patients that are actually referred to PT choose to go! Perhaps these individuals have had bad experiences with PT or feel that PT was a waste of time in prior ailments. Such feelings can be understandable given the insurance industry has squeezed PTs into forming factory-like practices and limiting sessions/visits.

The amazing thing is that our practice offers you an actual solution. Having a cash-based, concierge practice, our team offers direct access with little to no restrictions. Our appointments can be fulfilled quickly and we can work on a variety of issues with various treatments without insurance squeezing our time or scrutinizing our methods. More importantly: the client pays for what they get! Providing our level of service, if patients don’t get better, then they don’t pay. How many insurance PT clinics offer this such guarantee?

The bottomline from this study is that if you have pain seek your PT and skip the pain killers.

Reference: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2718095

Text Neck: Real or Fake?

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Do you check your phone often? Notice the burn in your neck or arm? Last year, I had a patient who had numbness down his left arm when he looked down at his phone or screen. Was this "text neck", the phenomenon of neck pain caused by frequent checking and texting from a mobile phone? Perhaps...it clearly was cervical radiculopathy, or a compressed/irritated nerve root in the neck. Fortunately my keen PT skills and few steroids later helped to get this patient back to work and pain-free neck movements. But it left me wondering -- did the phone lead to his issue?

A recent study done in Brazil puts into question whether "text neck" even exists. They took pictures of these kids as they looked at their phones, had experts analyze the pictures, and then cross-referenced the postures in the pictures with reported neck pain. This study did not show an association between text neck and neck pain in 18–21-year-old young adults. The findings challenge the belief that neck posture during mobile phone texting is associated to the growing prevalence of neck pain.

Obviously more goes into neck pain than simply posture: exercise status, nutritional care, psyche, medications, and more. Check out the article, pay attention to your posture (maybe), and contact us to learn more!

https://link.springer.com/article/10.1007/s00586-017-5444-5

Gluten: Friend, Foe, or Just Food?

Unless you have been living under a rock the last 5 years, the gluten free movement has produced massive shifts in product lines, menus, and people. Gluten, a protein, found in wheat has been around for thousands of years. How did it go from an essential food, in some areas of the world, to a eschewed substance of inflammation and disease?

Let us start first with facts: gluten allergies occur in less than 1% of the population. Those allergic can have skin rashes, intense gut pain, diarrhea, weight loss, and malnutrition. A researcher studying children in Belgium after World War II saw these findings in young kids after their country went from near famine to feasting on poinds of bread. Shortly after, the substance gluten was isolated and taken out of their diets to improve the kids' symptoms: it worked and so started the investigations that lead to celiac disease.

Celiacs disease is an inflammatory bowel disease due to gluten. The gold standard diagnostic test is a gut biopsy. Celiacs disease is autoimmune in nature; the body attacks the gut as gluten passes through after consumption. Celiacs was well-known in Europe for decades, perhaps due to its identification in Belgium. In the United States, little was known about celiacs, let alone gluten, save for the last decade and a half. The question that remains with many: can you have gluten sensitivity and not an allergy?

Many doctors and researchers are binary regarding gluten's issues. Some strongly feel that gluten wrecks havoc on your gut, promotes inflammation, and can promote other diseases like obesity. Unfortunately, the studies for such notions are limited in scope, small in size, or flawed in their methods. In many studies, participants are given doses of isolated gluten to eat, which is unrealistic given we eat whole foods. As we eat whole wheat bread, for instance, any inflammation boosted by gluten is more than negated by the whole wheat's anti-inflammatory properties such as vitamins, fiber, and sterols. Moreover, several studies have highlighted how taking out a whole grain products, like wheat, can negatively impact your heart disease risk, gut, and blood profile. Gluten free (GF) options tend to be low in fiber, higher in sugar, and cost 3 times as much as regular products. As such, going GF may not be a best option for you. Regardless, people will still state they feel better without gluten, or at least moderated gluten consumption. This makes sense, as if you ate any food excessively you likely with see several side effects. Eat 2 bags of broccoli and you will likely have gas and bloating from the sulfur.

Why do TV doctors, oddball neurologists, some dieticianss, and even a few PTs recommend all their patients avoid gluten? Misinformation perhaps, or simply it is popular. Do the right the thing: ask questions, seek answers through testing and elimination dieting, and enjoy this great Freakanomics podcast: The Demonization of Gluten http://freakonomics.com/podcast/demonization-gluten/

Failed Back Surgery Syndrome (FBSS)

Chronic lower back pain is one of the leading causes of permanent disability. Often people with chronic low back pain will try multiple forms of treatment including Physical Therapy, medications, and injection therapy. Once they've exhausted all these efforts, many resort to surgery as the answer for their pain. Unfortunately only 35% of these cases are successful, particularly when Fusion is involved. As such, a group of pain management specialist recently have begun to use the diagnostic "label" of failed back surgery syndrome, or FBSS.

In the article below you can read how many pain specialists feel adding this additional "label" as a beneficial step. I would partially agree that the "label" is beneficial because some Physicians and surgeons are in denial that back surgery can fail. Some surgeons see patients with continued back pain after surgery as fakers or addicted to pain medicine. Physical therapists, as well as modern educated surgeons and Physicians, know that surgery is not always the answer for chronic lower back pain. Moreover, I strongly feel that simply adding a label is not enough.

As a physical therapist, I argue that simply adding a label may not be as beneficial as what occurs in the next steps after a patient is diagnosed or labeled. A large majority of patients with chronic lower back pain never seek psychological counseling. Emerging pain science Concepts are beginning to show that many of these patients with chronic lower back pain, as well as other forms of chronic pain, have larger issues at play. Many of these issues include anxiety, altered pain responses, depression, and chronic systemic inflammation from poor nutrition and lifestyle factors. Physical therapist are being armed with the knowledge of addressing some of these psychological Concepts through cognitive behavioral therapy (CBT) techniques, modern pain science techniques, as well as nutritional counseling.

Our team at Wells Physical Therapy embraces many of these Concepts and can help you or our friend through chronic pain. Contact us today for a consultation and enjoy the below article.

http://www.painmedicinenews.com/Primary-Care/Article/10-17/When-the-Last-Resort-Fails-Failed-Back-Surgery-Syndrome/44735

Is there a magic amount of time to exercise for arthritis?

In a study of 1,600 adults with osteoarthritis (OA), researchers from Northwestern University found the right amount of time to exercise for sustaining function and keeping pain down. The study showed any activity or exercise is better than none; however, those who did at least 45 minutes of moderate activity (such as fast walking, moderate cycling) had the best functioing and pain scores after a 2 year follow up. Unfortunately only 10% of adults with OA meet the 45 minute goal, many due to the misinformed notion that pain means they are damaging their joints further (a concept debunked by modern pain science). So, get out and move or call your local PT today for a tune-up before you start!

Back Pain, Manipulation, JAMA

According to a new, large systematic review done by the Journal of American Medicine (JAMA), spinal manipulation or mobilization significantly reduces pain and improves functioning for acute lower back pain. Nearly half of the Articles reviewed were published by physical therapists! 

Doctors of physical therapy are uniquely trained in spinal manipulation. Two weeks ago I had a unique case of a gentleman with lower back pain. He was in so much pain he was crippled forward over a Walker. After performing spinal manipulation, as well as therapeutic execrises, he no longer need of the Walker... after one treatment! 

Fast responses to treatment is it Priority for us. Call or message us today to schedule a consultation.

Article: https://www.ncbi.nlm.nih.gov/pubmed/28399251

Wells PT Presents at National Conference for PTs

Dr. Sean Wells presents at the 2017 NEXT Physical Therapy conference. His topic covered hip pain, differential diagnosis, and orthopedics. Enjoy the picture and we will share more informant from the conference soon!