Physical Therapy Assessment, Treatment Plan and Multidisciplinary Algorithm
|
|
|
- Horace Brooks
- 8 years ago
- Views:
Transcription
1 Physical Therapy Assessment, Treatment Plan and Multidisciplinary Algorithm
2 Definitions! Impairment! A loss or sensory abnormality of physiological, psychological, or anatomical structure or function! Functional Limitation! The restriction of the ability to perform- at the level of the whole person- a physical action, activity or task in an efficient, typically expected or competent manner! Disability! The inability to engage in age-specific, gender-specific, or sex-specific roles in a particular social context or environment Guide to Physical Therapy Practice
3
4
5
6 Assessment! Combine history and physical findings! List of impairments! Link impairments to symptoms! Consider diagnoses! Consider severity and co-morbidities! Treatment plan development and goal setting
7 Multi-Disciplinary Approach Physical Therapy Pharmaceuticals Interventional medicine Cognitive Behavioral Therapy
8 Physical Therapy Assessment! Impairments! Connective tissue restrictions! Myofascial Trigger Points! Pelvic floor hypertonus! Adverse Neural Tension! Structure and mechanics! DIAGNOSTIC CONFUSION!!!! Diagnoses! Vulvodynia! Interstitial Cystitis! Chronic pelvic pain syndrome! Pudendal Neuralgia! High-tone pelvic floor disorder
9 Impairments! Connective tissue restrictions! Location, severity, neural involvement! MTrPs! Abdomen, gluteals, lower extremities, PF! Pelvic Floor Dysfunction! Length, strength, motor control, tenderness! Adverse neural tension! Pudendal, sciatic, P Fe Cu, ilioinguinal, iliohypogastric! Structure and mechanics! Strength, LLD, SIJD, LBP
10 Physical Therapy Treatment Plan! Manual therapies! Patient education! Frequency! Duration! Home Exercise Program! Lifestyle modifications! Partner training
11 Treatment: Connective Tissue Manipulation! Goals of CTM:! Improve blood flow! Restore integrity and mobility! Decrease ANT! Eliminate C-V noxious input! Functionally:! Decrease itching/pain/hypersensitivity! Restore normal urination, defecation, sexual function
12 Treatment: Connective Tissue Manipulation! Goals of CTM:! Improve blood flow! Restore integrity and mobility! Decrease ANT! Eliminate C-V noxious input! Functionally:! Decrease itching/pain/hypersensitivity! Restore function
13 MTrPs Treatment: manual, dry needling, TPIs! Goals: eliminate MTrP! Decrease hypertonus! Decrease pain! Restore normal motor function! Decrease S-V noxious input! Decrease CT restrictions! Decrease ANT
14 MTrPs Treatment: manual, dry needling, TPIs! Goals: eliminate MTrP! Decrease hypertonus! Decrease pain! Restore normal motor function! Decrease S-V noxious input! Decrease CT restrictions! Decrease ANT
15 Pelvic Floor Treatment! Digital myofascial release (trans-vaginal or trans-rectal)! Lengthening not strengthening! Motor control (concentric, eccentric, volitional drops)! MTrP release
16
17 Diastasis Recti Correction! Slight RA muscle contraction with compression to approximate mm endings! Other ab work contraindicated until closed! Binder or tape! Surgical correction
18 Diastasis Recti Correction
19 Adverse Neural Tension Treatment! Goals:! Restore mobility! Decrease CT R! Decrease pain! Improve function and ROM
20 Structure/Biomechanics Evaluation and Treatment! Orthopedic manual tests: rotations, flares, upslip, hypermobility! LLD! Length and strength of muscles! Normalize impairments
21 Case Report: Patient Kelly S.! 48 year-old female, Oct 2008! May 2005: symptoms began! Urinary hesitancy! Interrupted stream! Tender in abdomen! Constant feelings of having to go! Aug 2005: prescribed medication
22 Case Report: Patient Kelly S.! Oct 2005: hospitalization for DVT and PE! Oct 2005: self-catheterization! Abdominal/suprapubic pain persisted! June 2006: laparoscopic: Endo! Intenstines, bladder! June 2007: supracervical hysterectomy and bilateral salpingo-oopherectomy
23 Case Report: Patient Kelly S.! Sept 2008: evaluation with Urologist! Urodynamics and cystoscopy! Hypertonic urtheral sphincter, illiococcygeus MTrP, normal bladder and capacity! Refer to PHRC
24 Case Report: Patient Kelly S.! Physical Therapy IE: Oct 23, 2008! Athletic female! Cc: unable to void on own, limited exercise capacity (abd and LB pain), LE numbness, R>L buttock pain when sitting, voiding urge absent! PMH: C-section May 1996! Medications: macrobid 100mg/day, wellbutrin 100mg/day
25 Case Report: Patient Kelly S. Objective Findings! Connective tissue restrictions! Moderate: suprapubic and abdomen! Severe: posterior thigh and gluteal region! 3 1/2 finger sub-umbilical DR! MTrPs: RA, gluteus maximus and medius, piriformis
26 Case Report: Patient Kelly S. Objective Findings! + ANT on the sciatic nerve! Internal Examination:! Hypertonic pelvic floor muscles! Poor motor control: no conc, ecc or drop! Severe peri-urethral CT dysfunction
27 Case Report: Patient Kelly S. Assessment! DR contributing to PFD! No motor control, short pelvic floor, unable to drop to void! DR causing abd MTrPs! Contributing to abdominal pain, back pain, and urinary dysfunction! Hip ER MTrP contributing to LBP, sciatica! Sciatica contributing to posterior thigh CT restrictions, leg numbness
28 Case Report: Patient Kelly S. Treatment! Visits 1-3! Patient education! CTM: abdomen, posterior thigh, glut! MTrP release: RA, hipe ER! Int MFR and per-urthral CTM! HEP: DR correction, PF drops! Visit 4: minimal abdominal pressure, no buttock pain with sitting, no change in ability to void! Continued manual therapy! Abdominal tape
29 Case Report: Kelley S. Treatment! Visit 5: able to void with tape, increased urine stream and observe normal voiding urges (every 4 hours), catheterizing two times per day! Abdominal pain gone! Abdominal binder! Visit 6: continued improvement in urine stream, minimal hesitancy, no abdominal pain, minimal leg numbness! Visit 11: Catheterizing one time per week, 300 ccs! Butt pain with exercise! Refer to orthopedic PT for supervised, specific strengthening
30 If you are stumped, why not write an illegible prescription and hope the pharmacist comes up with something?
31
32
33
34
35
36 Multi-Disciplinary Approach Physical Therapy Pharmaceuticals Interventional medicine Cognitive Behavioral Therapy
37
38 Physical Therapy Treatment Plan! Connective Tissue Manipulation! Internal and External MTrP Release! Neural Mobilizations! Structure and Biomechanical Correction
39
40
41
42
43 Physical Therapy Pharmaceuticals Medical intervention Cognitive Behavioral T.
44 Patient Tracy H.! 43 year-old female! Spring 2001: urinary frequency! Vaginal numbness, pain in sits bones! Diagnosis with LA Syndrome! May 2001: PT (biofeedback and kegals)! Vaginal pain, burning, dyspareunea, rectal pain! Diagnosed with Vulvodynia! Aug 2001: 2 sets of 3 injections into vestibule! Increased pain! Declined vestibulectomy
45 Patient Tracy H.! Aug 2002: forced to stop working! Severe burning in her vagina, buttocks, and posterior thighs! Voiding every 15 minutes! Relief when supine and for 20 minutes after BM, then increase in symptoms! Bilateral groin pain
46 Patient Tracy H.! Dec 2002: Back specialist in NYC! Feb 2003: Vulvodynia specialist in NYC! Did not do pelvic exam, suggested biofeedback, stretching with baby penises, and 2 orgasms per week! May 2003: Vulvodynia specialist in S. CA! 3 PNB per vagina! June 2003: Anodyne! Nov 2003: PN decompression/transposition in Nante, France! Nov 2004: evaluated in SF
47 Patient Tracy H.! Objective findings! Severe connective tissue restrictions! Lower extremities, abdomen, gluteal region, bony pelvis (PN territory)! Myofascial Trigger Points! Adductors, all hip ER, RA, HS! Adverse Neural Tension! (+) sciatic, P Fe Cu, 3 PN branches! Severe vestibule TTP! Could not tolerate PF internal examination! SIJD secondary to ST/SS severing and no rehab
48 Patient Tracy H.! Assessment: Severe myofascial pelvic pain syndrome and pelvic instability! Plan: Local PT (Seattle), follow up in SF every 4 months! 1 year of PT 2xs/week! Urinary, bowel dysfunction resolving! Pain improving, however cannot tolerate weightbearing exercise, sitting, no attempt at intercourse, clothing intolerance
49 Patient Tracy H! 2006: monthly visits to SF- 4 hours/visit! Cannot tolerate int MFR! PNB - increase in pain for 2 weeks, no change after! Improving slowly! 2006: weekly visits to SF! 4 hours PT/week! Dry needling with our local MD
50 Patient Tracy H.! 2007: Continued improvement! Can tolerate all clothing! Sitting tolerance 3 hours with cushion! Has not attempted intercourse! Increase in symptoms post-exercise! Urinary frequency! Burning in perineum! Burning in P Fe Cu Nerve distribution
51 Patient Tracy H.! Objective findings! Minor PFD! Connective tissue restrictions in vulva, PN territory, P Fe Cu area! Persistent OI MTrP! June 2008: selective PF botox! Result: decreased PF pain! Burning post-exercise persisted! Uncontrolled flatulence 3 months
52 Patient Tracy H.! Aggressive CTM, manual MTrP rls, int MFR! Oct 2008: attempt cymbalta, increase in Lyrica! Continued improvement, began using dilators for vulvar de-sensitization! January 2009: intercourse! March 2009: decrease freq of visits
53 Utilization of Physical Therapy! Refer to PT if patient presents with pelvic pain, urinary, bowel, and/or sexual dysfunction in absence of other pathology!
54 International Pelvic Pain Society
55 Questions? THANK-YOU!!!!
An advanced diagnostic
Pelvi-perineal myofascial syndromes: clinical presentation, differential diagnosis and electrophysiological characteristics An advanced diagnostic Dr. Zarza Dr. Itza There's an elephant in this room What
URINARY INCONTINENCE
URINARY INCONTINENCE What is urinary incontinence? Urinary incontinence is the uncontrollable loss of urine. The amount of urine leaked can vary from only a few drops when you cough or sneeze to entirely
Lumbar Disc Herniation/Bulge Protocol
Lumbar Disc Herniation/Bulge Protocol Anatomy and Biomechanics The lumbar spine is made up of 5 load transferring bones called vertebrae. They are stacked in a column with an intervertebral disc sandwiched
DIFFERENTIAL DIAGNOSIS OF LOW BACK PAIN. Arnold J. Weil, M.D., M.B.A. Non-Surgical Orthopaedics, P.C. Atlanta, GA
DIFFERENTIAL DIAGNOSIS OF LOW BACK PAIN Arnold J. Weil, M.D., M.B.A. Non-Surgical Orthopaedics, P.C. Atlanta, GA MEDICAL ALGORITHM OF REALITY LOWER BACK PAIN Yes Patient will never get better until case
Urinary Incontinence in Women. Susan Hingle, M.D. Department of Medicine
Urinary Incontinence in Women Susan Hingle, M.D. Department of Medicine Background Estimated 13 million Americans with urinary incontinence Women are affected twice as frequently as men Only 25% will seek
Urinary Incontinence Dr. Leffler
Urinary Incontinence Dr. Leffler The involuntary loss of urine at socially unacceptable times occurs in both women and men, but more commonly in women. It has multiple, far-reaching effects on daily activities,
About the Uterus. Hysterectomy may be done to treat conditions that affect the uterus. Some reasons a hysterectomy may be needed include:
Hysterectomy removal of the uterus is a way of treating problems that affect the uterus. Many conditions can be cured with hysterectomy. Because it is major surgery, your doctor may suggest trying other
Female Urinary Disorders and Pelvic Organ Prolapse
Female Urinary Disorders and Pelvic Organ Prolapse Richard S. Bercik, M.D. Director, Division of Urogynecology & Reconstruction Pelvic Surgery Department of Obstetrics, Gynecology & Reproductive Sciences
Regain Control of Your Active Life Treatment Options for Incontinence and Pelvic Organ Prolapse
Regain Control of Your Active Life Treatment Options for Incontinence and Pelvic Organ Prolapse Nearly one quarter of all women in the United States have some sort of pelvic floor disorder such as urinary
FEMALE INCONTINENCE REVIEW
200 S. Wenona Suite 298 Steven L. Jensen, M.D. 5400 Mackinaw, Suite 4302 Bay City, MI 48706 Frank H. Kim, M.D. Saginaw, MI 48604 Telephone (989) 895-2634 Adult & Pediatric Urologists (989) 791-4020 Fax
Spine University s Guide to Cauda Equina Syndrome
Spine University s Guide to Cauda Equina Syndrome 2 Introduction Your spine is a very complicated part of your body. It s made up of the bones (vertebrae) that keep it aligned, nerves that channel down
URINARY INCONTINENCE IN WOMEN
URINARY INCONTINENCE IN WOMEN Definition Urinary incontinence (UI) is defined as involuntary loss of urine that is a social or hygienic problem (International Continence Society, 1973) Magnitude of the
Urinary Incontinence. Anatomy and Terminology Overview. Moeen Abu-Sitta, MD, FACOG, FACS
Urinary Incontinence Anatomy and Terminology Overview Moeen Abu-Sitta, MD, FACOG, FACS Purpose Locate and describe the anatomy of the Female Urinary System Define terminology related to Incontinence Describe
Urinary Incontinence (Involuntary Loss of Urine) A Patient Guide
Urinary Incontinence (Involuntary Loss of Urine) A Patient Guide Urinary Incontinence (Urine Loss) This booklet is intended to give you some facts on urinary incontinence - what it is, and is not, and
Normal bladder function requires a coordinated effort between the brain, spinal cord, and the bladder.
.. Urinary Incontinence Urinary incontinence is not an inevitable part of aging, and it is not a disease. The loss of bladder control - called urinary incontinence - affects between 13 and 17 million adult
Painful Bladder Syndrome and Interstitial Cystitis
Painful Bladder Syndrome and Interstitial Cystitis PAINFUL BLADDER AND INTERSTITIAL CYSTITIS OVERVIEW Painful bladder syndrome/interstitial cystitis (PBS/IC) is a disorder with symptoms of mild to severe
TREATMENT OPTIONS FOR PERSISTENT PAIN FOLLOWING PUDENDAL NERVE DECOMPRESSION SURGERY
1 TREATMENT OPTIONS FOR PERSISTENT PAIN FOLLOWING PUDENDAL NERVE DECOMPRESSION SURGERY Jerome M. Weiss, M.D. Pacific Center for Pelvic Pain and Dysfunction San Francisco, California In general, patients
Urinary Incontinence. Types
Urinary Incontinence Leakage of urine is called urinary incontinence. It is a common problem in women. Some women occasionally leak small amounts of urine. At other times, leakage of urine is frequent
Sciatica Yuliya Mutsa PTA 236
Sciatica Yuliya Mutsa PTA 236 Sciatica is a common type of pain affecting the sciatic nerve, which extends from the lower back all the way through the back of the thigh and down through the leg. Depending
PERFORMANCE RUNNING. Piriformis Syndrome
Piriformis Syndrome Have you started to experience pain in your hip or down your leg while beginning or advancing your fitness program? This pain may be stemming from the piriformis muscle in your hip.
Understand Your Back & Pelvic Girdle Pain
Understand Your Back & Pelvic Girdle Pain Written by Diane Lee Physiotherapist Updated January 2011! Introduction Back pain happens to everyone and, for some, is a life-changing occurrence. The causes
June 2010 Case Study: 33-year-old Male with Pudendal Pain Tuesday, 01 June 2010 13:44
Welcome to the June 2010 Neurography Institute Case Study. In this issue, we learn how MR Neurography (MRN) and Interventional MR (IMR) helped a thirtysomething male regain his active lifestyle without
Bowel Control Problems
Bowel Control Problems WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 Bowel control problems affect at least 1 million people in the United States. Loss of normal control of the bowels is
Get the Facts, Be Informed, Make YOUR Best Decision. Pelvic Organ Prolapse
Pelvic Organ Prolapse ETHICON Women s Health & Urology, a division of ETHICON, INC., a Johnson & Johnson company, is dedicated to providing innovative solutions for common women s health problems and to
Overview of Urinary Incontinence in the Long Term Care Setting
Overview of Urinary Incontinence in the Long Term Care Setting Management Strategies for the Nursing Assistant Ann M. Spenard RN, C, MSN Courtney Lyder ND, GNP Learning Objectives Describe common types
Dr. Kenneth A. Giraldo, MD, P.A. Patient Controlled Substance Agreement Informed Consent Form
Dr. Kenneth A. Giraldo, MD, P.A. Patient Controlled Substance Agreement Informed Consent Form The following agreement relates to my use of controlled substance for chronic pain prescribed by Dr. Kenneth
Hysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy?
ROBERT LEVITT, MD JESSICA BERGER-WEISS, MD ADRIENNE POTTS, MD HARTAJ POWELL, MD, MPH COURTNEY LEVENSON, MD LAUREN BURNS, MSN, RN, WHNP OBGYNCWC.COM What is a hysterectomy? Hysterectomy Hysterectomy is
Groin Pain Syndromes
Groin Pain s 4 3333 N CALVERT ST, SUITE 370, BALTIMORE, MD 21218 T410 467 5400 F410 366 9826 delloninstitutes.com your compaints are Pain, numbness or burning in the lower abdominal wall, and/or the pubic
Fecal incontinence (Encopresis) It is the fecal incontinence condition observed in children with chronic constipation over 1-2 years.
WHAT IS DYSFUNCTIONAL URINATION (URINATION FUNCTION DISORDER)? It stands for the urination phase disorders, which appear due to wrongly acquired urination habits during the toilet training of some neurologically
FEMALE ANATOMY. the Functions of the Female Organs
FEMALE ANATOMY the Functions of the Female Organs An educational video for every woman who is told she needs pelvic surgery, including exploratory surgery or removal of the uterus, fallopian tubes, or
Understanding Chronic Pelvic Pain : The Role of Physical Therapy in Pelvic Floor Health. Heather Moky P.T., D.P.T
Understanding Chronic Pelvic Pain : The Role of Physical Therapy in Pelvic Floor Health Heather Moky P.T., D.P.T Disclosures No true disclosures Work for UIC Medical Center- Program Coordinator for the
Incontinence. What is incontinence?
Incontinence What is incontinence? Broadly speaking, the medical term incontinence refers to any involuntary release of bodily fluids, but many people associate it strongly with the inability to control
Overactive Bladder (OAB)
Overactive Bladder (OAB) Overactive bladder is a problem with bladder storage function that causes a sudden urge to urinate. The urge may be difficult to suppress, and overactive bladder can lead to the
Coccydynia. (Coccyx Pain) Information for patients. Outpatients Physiotherapy Tel: 01473 703312
Information for patients Coccydynia (Coccyx Pain) Outpatients Physiotherapy Tel: 01473 703312 DPS ref: 4508-12(RP) Issue 1: February 2013 Review date: January 2016 The Ipswich Hospital NHS Trust, 2013.
Bowel and Bladder Dysfunction in MS. Tracy Walker, WOCN, MSCN, FNP C Nurse Practitioner MS Institute at Shepherd Center. Bladder Dysfunction
Bowel and Bladder Dysfunction in MS Tracy Walker, WOCN, MSCN, FNP C Nurse Practitioner MS Institute at Shepherd Center Bladder Dysfunction Approximately 75% of people with MS experience bladder problems
Tone Up Your Pelvic Floor. A regular pelvic floor exercise ( Kegel ) routine can prevent symptoms before, during, and after childbirth.
Will Breastfeeding Affect Incontinence and Pelvic Symptoms? Yes, often for as long as you re nursing. Many breastfeeding women are unaware that a natural drop in estrogen which persists for as long as
WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Endometriosis
Endometriosis WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 The lining of the uterus is called the endometrium. Sometimes, endometrial tissue grows elsewhere in the body. When this happens
More information >>> HERE First Year. PT7040- Clinical Skills and Examination II
First Year Summer PT7010 Anatomical Dissection for Physical Therapists This is a dissection-based, radiographic anatomical study of the spine, lower extremity, and upper extremity as related to physical
LOSS OF BLADDER CONTROL IS TREATABLE TAKE CONTROL AND RESTORE YOUR LIFESTYLE
LOSS OF BLADDER CONTROL IS TREATABLE TAKE CONTROL AND RESTORE YOUR LIFESTYLE TALKING ABOUT STRESS INCONTINENCE (SUI) Millions of women suffer from stress incontinence (SUI). This condition results in accidental
Gwen Griffith Clinical Nurse Specialist Bolton NHS foundation Trust
Gwen Griffith Clinical Nurse Specialist Bolton NHS foundation Trust Overview Setting the Scene Beginning of the journey & specialist nurse role Why people with MS experience bladder problems MS and the
CLINICAL PRACTICE GUIDELINES FOR MANAGEMENT OF LOW BACK PAIN
CLINICAL PRACTICE GUIDELINES FOR MANAGEMENT OF LOW BACK PAIN Low back pain is very common, up to 90+% of people are affected by back pain at some time in their lives. Most often back pain is benign and
New York State Workers' Comp Board. Mid and Lower Back Treatment Guidelines. Summary From 1st Edition, June 30, 2010. Effective December 1, 2010
New York State Workers' Comp Board Mid and Lower Back Treatment Guidelines Summary From 1st Edition, June 30, 2010 Effective December 1, 2010 General Principles Treatment should be focused on restoring
Current Concepts of Low Back Pain. Terry L. Grindstaff, PhD, PT, ATC, SCS, CSCS
Current Concepts of Low Back Pain Terry L. Grindstaff, PhD, PT, ATC, SCS, CSCS 28% population reports LBP in past 3 months (CDC 2010) 60% recurrence rate (Turner et al, 1992) Low Back Pain Low Back Pain
Urinary Incontinence Definitions
(AADL) Program Urge Stress Overflow Functional Mixed DHIC (Detrussor hyperreflexia with impaired contractility) Reflex Incontinence Leakage of urine (usually larger volumes) because of inability to delay
Urinary Incontinence FAQ Sheet
Urinary Incontinence FAQ Sheet Are you reluctant to talk to your doctor about your bladder control problem? Don t be. There is help. Loss of bladder control is called urinary incontinence. It can happen
Consumer summary Minimally invasive techniques for the relief of stress urinary incontinence
ASERNIP S Australian Safety and Efficacy Register of New Interventional Procedures Surgical Consumer summary Minimally invasive techniques for the relief of stress urinary incontinence (Adapted from the
Chiropractic Physician: Emphasis in neurology, sports medicine and muscle rehabilitation
Chiropractic Physician: Emphasis in neurology, sports medicine and muscle rehabilitation Practice locations: NeuroBalance Center - Barrington Il Physical Medicine Associates - Naperville Il Alternative
How do I know if I need to have surgery?
How do I know if I need to have surgery? Deciding whether or not to have surgery for your bladder, bowel and/or prolapse problems is an individual decision. The success or failure of someone else's operation
More information >>> HERE LOW BACK PAIN EXAMINATION
LOW BACK PAIN EXAMINATION John Petty, M.D. Medical Director Department of Physical Medicine & Rehabilitation Kettering Medical Center February 8, 2014 PRE-TEST QUESTION What part of the low back physical
Fecal Incontinence. What is fecal incontinence?
Scan for mobile link. Fecal Incontinence Fecal incontinence is the inability to control the passage of waste material from the body. It may be associated with constipation or diarrhea and typically occurs
MEDICAL BREAKTHROUGHS RESEARCH SUMMARY
TOPIC: Relief for Pelvic Pain REPORT: MB #4082 MEDICAL BREAKTHROUGHS RESEARCH SUMMARY BACKGROUND: As many as one in four women suffer from chronic pelvic pain. Pudendal neuralgia (PN) is a condition in
Low Back Injury in the Industrial Athlete: An Anatomic Approach
Low Back Injury in the Industrial Athlete: An Anatomic Approach Earl J. Craig, M.D. Assistant Professor Indiana University School of Medicine Department of Physical Medicine and Rehabilitation Epidemiology
Ask the Expert - Answers
Ask the Expert - Answers Q. I had a hysterectomy four years ago. Since then, I have been experiencing progressively increasing urgency. I drink one XL cup of coffee per day but when I have to go, I have
6/3/2011. High Prevalence and Incidence. Low back pain is 5 th most common reason for all physician office visits in the U.S.
High Prevalence and Incidence Prevalence 85% of Americans will experience low back pain at some time in their life. Incidence 5% annual Timothy C. Shen, M.D. Physical Medicine and Rehabilitation Sub-specialty
Bard: Continence Therapy. Stress Urinary Incontinence. Regaining Control. Restoring Your Lifestyle.
Bard: Continence Therapy Stress Urinary Incontinence Regaining Control. Restoring Your Lifestyle. Stress Urinary Incontinence Becoming knowledgeable about urinary incontinence Uterus Normal Pelvic Anatomy
Fact Sheet. Queensland Spinal Cord Injuries Service. Pain Management Following Spinal Cord Injury for Health Professionals
Pain Management Following Injury for Health Professionals and Introduction Pain is a common problem following SCI. In the case where a person with SCI does have pain, there are treatments available that
Patient Guide. Sacroiliac Joint Pain
Patient Guide Sacroiliac Joint Pain Anatomy Where is the Sacroiliac Joint? The sacroiliac joint (SIJ) is located at the bottom end of your spine, where the "tailbone" (sacrum) joins the pelvis (ilium).
Transobturator tape sling Female sling system
Transobturator tape sling Female sling system Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm
Lumbar Spinal Stenosis
Lumbar Spinal Stenosis North American Spine Society Public Education Series What Is Lumbar Spinal Stenosis? The vertebrae are the bones that make up the lumbar spine (low back). The spinal canal runs through
This is my information booklet: Introduction
Hip arthroscopy is a relatively new procedure which allows the surgeon to diagnose and treat hip disorders by providing a clear view of the inside of the hip with very small incisions. This is a more complicated
Rehabilitation Documentation and Proper Coding Guidelines
Rehabilitation Documentation and Proper Coding Guidelines Purpose: 1) Develop a guide for doctors in South Dakota to follow when performing reviews on rehabilitation cases. 2) Provide doctors in South
Injury Prevention for the Back and Neck
Injury Prevention for the Back and Neck www.csmr.org We have created this brochure to provide you with information regarding: Common Causes of Back and Neck Injuries and Pain Tips for Avoiding Neck and
Palm Beach Obstetrics & Gynecology, PA
Palm Beach Obstetrics & Gynecology, PA 4671 S. Congress Avenue, Lake Worth, FL 33461 561.434.0111 4631 N. Congress Avenue, Suite 102, West Palm Beach, FL 33407 Urinary Tract Infection About one of every
1 in 3 women experience Stress Urinary Incontinence.
A PATIENT S GUIDE 1 in 3 women experience Stress Urinary Incontinence. It s time to talk about SUI Get the facts. This Patient s Guide is intended as a public resource on the issue of Stress Urinary Incontinence
Stress Urinary Incontinence
Saint Mary s Hospital Gynaecology Service Warrell Unit Stress Urinary Incontinence Information for patients What is Stress Incontinence? Stress incontinence is a leakage of urine occurring on physical
SPINE. Postural Malalignments 4/9/2015. Cervical Spine Evaluation. Thoracic Spine Evaluation. Observations. Assess position of head and neck
SPINE Observations Body type Postural alignments and asymmetries should be observed from all views Assess height differences between anatomical landmarks Figure 25-9 Figure 25-10 Figure 25-11 & 12 Postural
Empower Physical Therapy
PAYMENT AND COLLECTION POLICY Payment is expected at the time of service. Unpaid balances left by your insurance companies will be your responsibility. In the event you are unable to pay the balance in
Refer to Coaptite Injectable Implant Instructions for Use provided with product for complete instructions for use.
Questions for my Doctor Refer to Coaptite Injectable Implant Instructions for Use provided with product for complete instructions for use. INDICATIONS: Coaptite Injectable Implant is indicated for soft
A Syndrome (Pattern) Approach to Low Back Pain. History
A Syndrome (Pattern) Approach to Low Back Pain Hamilton Hall MD FRCSC Professor, Department of Surgery, University of Toronto Medical Director, CBI Health Group Executive Director, Canadian Spine Society
Early Prostate Cancer: Questions and Answers. Key Points
CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Early Prostate Cancer:
.org. Herniated Disk in the Lower Back. Anatomy. Description
Herniated Disk in the Lower Back Page ( 1 ) Sometimes called a slipped or ruptured disk, a herniated disk most often occurs in your lower back. It is one of the most common causes of low back pain, as
Abdominal Wall Pain. What is Abdominal Wall Pain?
Abdominal Wall Pain What is Abdominal Wall Pain? Abdominal Wall Pain is a syndrome (an experience) of abdominal pain that can occur at any time of life and is not unique to children. It is diagnosed by
Surgical Treatment for Female Stress Urinary. Continence. Consumer Education
Surgical Treatment for Female Stress Urinary Incontinence By: Amy Rosenman, MD Geffen School of Medicine at UCLA Santa Monica, California Promoting Quality Continence Care through Consumer Education Always
Low Back Pain Mansour Dib MD Physical Medicine and Rehabilitation Pain generators Disc Posterior elements Sacro-iliac joint Education - Spine Positioning Neutral Extension Flexion Disc disease Discogenic
The Essential Lower Back Exam
STFM National Convention 2011 New Orleans The Essential Lower Back Exam Judith A. Furlong, M.D., Cathee McGonigle, D.O. & Rob Rutherford, MD Objectives Brief review of the anatomy of the back, (hip and
OVERVIEW. NEUROSURGICAL ASSESSMENT CERVICAL PROBLEMS Dirk G. Franzen, M.D. WHAT IS THE MOST IMPORTANT PART OF THE PHYSICAL EXAM?
NEUROSURGICAL ASSESSMENT CERVICAL PROBLEMS Dirk G. Franzen, M.D. Neurological Surgery Bluegrass Orthopaedics and Hand Care OVERVIEW SCOPE OF THE PROBLEM PREVALENCE PATHOLOGY ANATOMIC CONSIDERATIONS ASSESSMENT
Hip Arthroscopy Post-operative Rehabilitation Protocol
Hip Arthroscopy Post-operative Rehabilitation Protocol Introduction Since the early 20 th century, when hip arthroscopy was regarded as being almost impossible to undertake, the procedure has developed
Brown Bag Lecture Univ. California Medical Center San Francisco (March 2001) Jerome M. Weiss, M.D. Pelvic Pain
Brown Bag Lecture Univ. California Medical Center San Francisco (March 2001) Jerome M. Weiss, M.D. Pelvic Pain I plan to discuss myofascial pelvic pain, but the first step is to go back and look at the
Endometriosis. Information and advice. Page 12 Patient Information
Endometriosis Information and advice Page 12 Patient Information Contents page What is Endometriosis?... page 3 Symptoms page 5 Treatments.. page 7 Further information and support.. page 9 Contact us page
SOGC Recommendations for Urinary Incontinence
The quality of evidence is rated, and recommendations are made using the criteria described by the Canadian Task Force on Preventive Health Care. Clinical Practice Guidelines: The Evaluation of Stress
Case Based Urology Learning Program
Case Based Urology Learning Program Resident s Corner: UROLOGY Case Number 21 CBULP 2011 068 Case Based Urology Learning Program Editor: Associate Editors: Manager: Case Contributors: Steven C. Campbell,
Notice of Independent Review Decision DESCRIPTION OF THE SERVICE OR SERVICES IN DISPUTE:
Notice of Independent Review Decision DATE OF REVIEW: 08/15/08 IRO CASE #: NAME: DESCRIPTION OF THE SERVICE OR SERVICES IN DISPUTE: Determine the appropriateness of the previously denied request for physical
ALL ABOUT SPASTICITY. www.almirall.com. Solutions with you in mind
ALL ABOUT SPASTICITY www.almirall.com Solutions with you in mind WHAT IS SPASTICITY? The muscles of the body maintain what is called normal muscle tone, a level of muscle tension that allows us to hold
The menopausal transition usually has three parts:
The menopausal transition usually has three parts: Perimenopause begins several years before a woman s last menstrual period, when the ovaries gradually produce less estrogen. In the last 1-2 years of
Primary Care management of Overactive Bladder (OAB)
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) Primary Care management of Overactive Bladder (OAB) Prescribing Tips All medicines for OAB have similar dose-related efficacy. More than one agent (up
Information on the Chiropractic Care of Lower Back Pain
Chiropractic Care of Lower Back Pain Lower back pain is probably the most common condition seen the the Chiropractic office. Each month it is estimated that up to one third of persons experience some type
Management of spinal cord compression
Management of spinal cord compression (SUMMARY) Main points a) On diagnosis, all patients should receive dexamethasone 10mg IV one dose, then 4mg every 6h. then switched to oral dose and tapered as tolerated
OVERACTIVE BLADDER DIAGNOSIS AND TREATMENT OF OVERACTIVE BLADDER IN ADULTS:
2014 OVERACTIVE BLADDER DIAGNOSIS AND TREATMENT OF OVERACTIVE BLADDER IN ADULTS: AUA/SUFU Guideline (2012); Amended (2014) For Primary Care Providers OVERACTIVE BLADDER Diagnosis and Treatment of Overactive
The Work Up of Pelvic Floor Dyssynergia and Fecal Incontinence. Gina R. Sam, MD/MPH Director, Mount Sinai Gastrointestinal Motility Center
The Work Up of Pelvic Floor Dyssynergia and Fecal Incontinence Gina R. Sam, MD/MPH Director, Mount Sinai Gastrointestinal Motility Center Constipation Overview Constipation Normal Transit Constipation
Trochanteric Bursitis Self Management for Patients
Trochanteric Bursitis Self Management for Patients Updated May 2010 What is the Trochanteric Bursa? The trochanteric bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between
Bladder and Pelvic Health
A Woman s Guide to Bladder and Pelvic Health Symptoms Tests Conditions Treatments 937-277-8988 1-888-808-1016 Dayton Center Englewood Center Huber Heights Center Trotwood Satellite Table of Contents About
Effective treatment of pudendal neuropathy
Pudendal Nerve Perineural Injections. Effective treatment of pudendal neuropathy Stanley J. Antolak, Jr. MD Edina, MN ICS Glasgow, Scotland August 2011 Three sequential treatments may relieve pelvic pain
How To Treat Pain With Pain Management
SUTTER PHYSICIANS ALLIANCE (SPA) 2800 L Street, 7 th Floor Sacramento, CA 95816 SPA PCP Treatment & Referral Guidelines Pain Management Developed June 1, 2003 Revised - (Format Revisions) November 13,
What you should know about Stress Urinary Incontinence
Gynecare TVT Stop coping. Start living. What you should know about Stress Urinary Incontinence Have you ever leaked urine when you laughed, coughed or sneezed? You are not alone. Many women suffer from
Stress Urinary Incontinence & The Pelvis
Stress Urinary Incontinence & The Pelvis Updated January 2011 by Diane Lee Introduction The research in the last decade has led to a clearer understanding of how load is transferred through the low back
Herniated Lumbar Disc
Herniated Lumbar Disc North American Spine Society Public Education Series What Is a Herniated Disc? The spine is made up of a series of connected bones called vertebrae. The disc is a combination of strong
Sciatic Nerve A Case Report of the Treatment of Piriformis Syndrome (Muscle Related)
Sciatic Nerve A Case Report of the Treatment of Piriformis Syndrome (Muscle Related) Elyse Silvia West August 5, 2007 Pacific Palisades Abstract Objective: The study assessed the benefits of Pilates training
How to Get and Keep a Healthy Back. Amy Eisenson, B.S. Exercise Physiologist
How to Get and Keep a Healthy Back Amy Eisenson, B.S. Exercise Physiologist Lesson Objectives Statistics of Back Pain Anatomy of the Spine Causes of Back Pain Four Work Factors Core Muscles Connection