Physical Medicine, Rehab Approach to Pain Management

Aerobic exercise can help improve functioning after stroke.
Aerobic exercise can help improve functioning after stroke.
A comprehensive rehabilitation program should promote strong improvement in function.

A comprehensive rehabilitation program should promote strong improvement in function. Not only should it take care of pain problems, but it should also stress preventive therapies, too. The patient should become an active participant in the process.

There are a variety of rehab and physical therapy modalities used to treat pain problems

In terms of using heat, tissues are warmed by conduction (transfer of heat from surface to another), convection (transfer of heat due to the movement of water or air across a body surface) and conversion (transfer of heat via a change in energy). Heat modalities are beneficial in assisting patients with pain control muscle relaxation collegiate extensibility.

Hydrotherapy may be used to submerge part of a body. Water temperatures should not go above 40 degrees Celsius when large areas of the body are heated. It provides a gravity-eliminated environment where there is a facilitation of joint movement and the agitation created by waterfall may create alternate sensory input.

Ultrasound therapy is a modality used to achieve deep heat. The waves are classified on the acoustic spectrum above 20,000 hertz. Its unique production of heat is due to its high frequency alternating current of 0.8 to 1 megahertz.

When using cryotherapy, it is important to note that physiological effects of cold are vasoconstriction with reflexive vasodilation, decreased metabolism, decreased enzymatic activity and decreased oxygen demand. Indications for cryotherapy include acute trauma, hemorrhage, pain, muscle spasm, reduction of metabolic activity.

Exercise is another modality used to manage and treat patients with pain. Stronger muscles may develop with strength training. Exercises should be adapted to preferential direction of movement. 

An interdisciplinary team may be needed to evaluate certain patients. The team’s involvement may address different aspects of the pain as well as assess what’s going on in a patient’s home, since there are psychological and social factors that could be exacerbating a patient’s pain.

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DISCLAIMER: Dr. Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This blog and related podcast is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment.