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Spinal Pain-Method of Treatments Stand Up Straight and Enjoy Life!

Spinal Pain-Method of Treatments Stand Up Straight and Enjoy Life!. Management of Pain J. Michael Calhoun, MD 3500 Springhill Drive Suite 201 North Little Rock, AR. 72117 501-771-2000. Acute vs. Chronic. Three Recent Developments Affecting Treatment. Reimbursement for Physical Therapy

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Spinal Pain-Method of Treatments Stand Up Straight and Enjoy Life!

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  1. Spinal Pain-Method of TreatmentsStand Up Straight and Enjoy Life! Management of Pain J. Michael Calhoun, MD 3500 Springhill Drive Suite 201 North Little Rock, AR. 72117 501-771-2000

  2. Acute vs. Chronic

  3. Three Recent Developments Affecting Treatment • Reimbursement for Physical Therapy • MRI Authorization • Arkansas State Medical Board

  4. Low Back Pain +/- Radicular Symptoms

  5. Evaluation • History and Physical • X-Rays?

  6. Treatment • Non-Pharmacological Pain Control Methods • Pharmacological Pain Control • Education • Therapeutic Exercise • Mental Health

  7. Initial Phase of Specialized Care

  8. Goal of Intervention • Symptom control to facilitate rapid recovery and return to normal occupational/social activities before deconditioning or psychosocial barriers occur.

  9. Description This intervention is generally performed in the acute phase following symptom onset or recurrence, when little or no deconditioning has occurred due to inactivity. This phase of care may be used for any level of severity of symptoms according to the clinical indicators. Successful treatment leading to maximum medical improvement(MMI) is accomplished in 60%-80% of spinal disorders with this phase of care, generally requiring very limited intervention.

  10. Assessments • History and physical examination, including neurological evaluation. Physical and/or functional capacity evaluations may be necessary to assess work tolerance before intervention and return to work release.

  11. Types of Intervention Pharmacological Pain Control Methods • Opioids • Muscle Relaxants(tranquilizers) • Hypnotics • Non-Steroidal Anti Inflammatories (NSAIDS) • Oral Corticosteroids Pharmacological

  12. Types of Intervention Non-Pharmacological Pain Control Methods • Activity Modifications • Passive Modality Procedures • Injections (epidural steroid injection) • Transcutaneous Electrical Nerve Stimulation (TENS) • Traction • Bracing Non-Pharmacological

  13. Types of Intervention Education • Back School • Ergonomics Instruction • Home Exercise Education

  14. Types of Intervention Therapeutic Exercise • Positional Exercises (various methods) • Home Exercise Instruction • Return to Limited Activity (with comparison to job and daily living demands) Exercise

  15. Types of Intervention Mental Health • Pain and Symptom Control Techniques • Behavioral Techniques Mental Health

  16. Expected Outcome Return to normal occupational/social activities and/or maximum medical improvement (MMI).

  17. Resumption of Activities of Daily Living This initial phase of specialized care assumes a mild level of severity, allowing return to usual work and recreational activities within 0-8 weeks, with or without modified or transitional activity return.

  18. When To Refer To A Spine Specialist • Progressive Neurological Deficit • Foot Drop • Loss of Bowel/Bladder Control

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