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physical therapy (PT)

Indications: - musculoskeletal pain - early physical therapy for musculoskeletal pain, including knee pain, shoulder pain, or low back pain is associated with reduced risk for long-term opioid use [3] - physical therapy for neck pain does not seem to reduce long-term opioid use [3] Management: 1) goals: - improve range of motion & functional status of inflamed or deformed joints - decrease muscle spasm - reduce pain & inflammation & improve the mechanics of motion in overuse syndromes, tendonitis & bursitis - correct posture & general body mechanics - improve musculoskeletal mechanics, strength & function 2) techniques: - graded exercise - heat or cold modalities - appropriate use of splinting - education - techniques of joint protection - coping skills Notes: - occupational therapists & physical therapists can predict which patients can have successful skilled nursing facility (SNF) to home discharges - medical providers & social workers can not [4,5,6]

Specific

aerotherapy cold therapy exercise forced use heat therapy hydrotherapy infared therapy massage mechanical chest wall oscillation microwave therapy paraffin bath range of motion exercises whirlpool therapy work hardenging/work conditioning

General

medical therapy; therapeutic intervention

References

  1. Diagnostic History & Physical Examination in Medicine, Chan & Winkle, Current Clinical Strategies, Laguna Hills, CA 1996
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, 18. American College of Physicians, Philadelphia 1998, 2018.
  3. Sun E, Moshfegh J, Rishel CA et al Association of Early Physical Therapy With Long-term Opioid Use Among Opioid-Naive Patients With Musculoskeletal Pain. JAMA Netw Open. 2018;1(8):e185909. Not indexed in PubMed https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2718095
  4. Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  5. Simning A, Caprio T, Seplaki CL et al. Rehabilitation providers'prediction of the likely success of the SNF-to-home transition differs by discipline. J Am Med Dir Assoc. 2019;20(4):492-496 PMID: 30630726 PMCID: PMC6451879 Free PMC article https://www.jamda.com/article/S1525-8610(18)30664-9/fulltext
  6. Gardner RL, Pelland K, Youssef R et al. Reducing hospital readmissions through a skilled nursing facility discharge intervention: a pragmatic trial. J Am Med Dir Assoc. 2020;21(4):508-512 PMID: 31812334 https://www.jamda.com/article/S1525-8610(19)30704-2/fulltext