Медицинские услуги
© 2017-2021 Сайт «БЕЛМЕД.БАЙ», info@belmed.by
Q. Did you know that the average American will spend 13 out of 75 years with some type of activity limitation?
· Sprains and Strains
· Neck and Back Pain
· Pinched Nerve
· Carpal Tunnel Syndrome
Q. Do you know how to minimize the impact of activity loss?
· Injuries to muscles, ligaments, tendons and bones?
· Pain, like lower back pain or neck pain?
· Sports injuries?
· Occupational injuries?
A. A physical medicine and rehabilitation specialist, (also called physical medicine specialist or a physiatrist) — the physician who best understands the musculoskeletal system.
It takes a lot of knowledge to understand the roles of the many specialties that exist today. For most of us, it's difficult to know which kind of doctor treats which conditions. The key is to identify the physician who will treat your condition in the most comprehensive, cost-effective manner, provide a proper plan for healing your condition, and prevent further problems.
The vast majority of injuries to muscles, ligaments, tendons, and bones are not surgical problems. Neither are most sports injuries, occupational injuries, or pain syndromes. The categories of medical conditions described above are usually problems of the musculoskeletal system, the system that consists of muscles, tendons, ligaments and bones.
Over 90 percent of sports and occupational injuries do not require surgery.
Physical medicine and rehabilitation physicians specialize in non-surgical treatment of the musculoskeletal system — a whole body approach that goes beyond the resolution of symptoms to prevention of recurrence. Physical Medicine and Rehabilitation has been board-certified by the American Board of Medical Specialties for 50 years and has over 80 training programs.
Physical medicine and rehabilitation specialists are experts in occupational medicine, sports medicine, spine medicine and pain management. The breadth of their diagnostic expertise allows a complete and accurate treatment program that puts people back into fully functional lives, often more functional than before, rather than into lives on the sideline. Instead of using an approach that merely treats the affected area, the physical medicine and rehabilitation physician's expertise and approach to the entire musculoskeletal system leaves patients enabled rather than disabled. Physical medicine and rehabilitation specialists are trained in electrodiagnostic medicine; diagnostic spinal injections; and interpretation of magnetic resonance imaging (MRI), computer tomography (CT), and bone scan imaging.
The case studies that follow demonstrate the way that physical medicine and rehabilitation specialists approach medical conditions and the kinds of results patients get.
Case Studies
Case Study I
A 53-year-old male with a work-related, low-back injury
had been out of work for 18 months. He had significant medical attention and
little improvement. He could not sleep. He saw a physical therapist briefly for
treatments, including hot packs, ultrasound and massage. He was deconditioned,
depressed and overweight. The patient was referred to a physical medicine and
rehabilitation specialist for a detailed evaluation. After review with the
patient, the treatment plan was changed to include a non-addictive medication to
improve sleep patterns and an anti-inflammatory medication for the
musculoskeletal pain. The physical medicine and rehabilitation specialist also
prescribed an aggressive physical therapy program that emphasized cardiovascular
conditioning, flexibility and lumbar stabilization. Persistent sciatica
necessitated a fluoroscopically-directed epidural cortisone injection to reduce
the pain and inflammation so he could continue with physical therapy. Following
the epidural, the patient progressed quickly to a general conditioning program
with emphasis on lifting and carrying. Thirty days later, the patient was back
at work on light duty while continuing a work-conditioning program in physical
therapy. In another 30 days, he was able to stop physical therapy and return to
his regular work status as a line man. He left treatment on a daily home
exercise program, aware of ergonomically correct lifting techniques and fitter
than when he sustained the injury.
Case Study II
A 16-year-old high school baseball pitcher presented to
a physician for a pre-season physical with chronic shoulder pain. His pitching
stamina, velocity and accuracy were adversely affected. His physician at the
time prescribed physical therapy consisting of hot packs and ultrasound, but
these didn't improve his symptoms so arthroscopic surgery was recommended. The
young pitcher didn't want surgery, which would put him out the entire season,
and sought treatment from a physical medicine and rehabilitation specialist. A
thorough history and physical exam revealed a knee injury six months earlier
that hadn't been fully rehabilitated. As a result, his throwing mechanics were
poor, which in turn overstressed his shoulder musculature. His new physician
directed a course of lower extremity, trunk, and rotator cuff strengthening and
stretching. A graduated throwing program returned him to the baseball field,
mid-season, without surgery.
Case Study III
A 42-year-old female meat-packing employee presented
with a six-week history of tingling and numbness in the hand. The symptoms were
worse in the morning and with repetitive activity. Her company referred her to a
physical medicine and rehabilitation specialist. The history and physical
revealed signs and symptoms consistent with carpal tunnel syndrome. The patient
was placed in night splints and told to do five minutes of specific forearm and
wrist stretches every morning and at the beginning of each shift and break. The
symptoms resolved over the course of three weeks.
The physical medicine and rehabilitation specialist also noted that all the employees worked in a refrigerated environment and were at risk for upper-extremity overuse injuries. Indeed, a pattern of these injuries had occurred at the plant. After conferring with the plant manager, the physician implemented a program where all employees performed upper-extremity stretching exercises before each shift and during each break. Within three months of implementation of this pro-active stretching program, the company's incidence of overuse injuries decreased by 76 percent.
Treatment Options
Comprehensive prescription for:
· Physical therapy
· Occupational therapy
· Therapeutic exercise
· Orthotics and braces
· Performance of:
· Epidural cortisone injections
· Facet joint injections
· Sacroiliac joint injections
· Sympathetic blocks
· Peripheral nerve blocks
· Advanced pain management intervention
Areas of expertise:
· Sports medicine, including athletes with disabilities
· Non-operative spine medicine
· Pain management
· Industrial medicine
· Electrodiagnostic medicine
· Injury prevention and wellness
Common diagnoses treated:
· Low-back pain
· Pinched nerve
· Strains and sprains
· Whiplash and neck pain
· Failed back surgery syndrome
· Tendinitis and bursitis
· Rotary cuff injury
· Arthritis
· Carpal tunnel syndrome
· Reflex sympathetic dystrophy