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Physical Therapy: Questions and Answers

Peer Reviewed

Physical Therapy (PT), also known as physiotherapy, was introduced to the US following WWI (1914) to rehabilitate soldiers returning from the war. The profession has grown to include many sub-specialties, such as orthopaedic, sports, chronic pain syndrome, ergonomic modification, and industrial rehabilitation for injured workers.

What is physical therapy?
PT combines passive modalities with therapeutic exercise to rehabilitate the spine and other parts of the body. Passive modalities include heat/cold therapy, ultrasound, electrical stimulation, massage, and joint mobilization. These modalities are not the sole treatment, but supplement therapeutic exercise. Active therapy, or therapeutic exercise includes stretching, strengthening, and postural modification to rehabilitate the spine and prevent re-injury.

What is the purpose of PT?
The purpose of physical therapy is to help the patient return to active life as quickly as possible. Therapy strives to reduce pain, increase flexibility, range of motion, and function, build strength, and correct posture.

Physical therapy is often prescribed for patients following spine surgery, to treat soft tissue trauma, nerve inflammation/injury, muscle spasms, fractures, arthritis, and many other problems.

Patient education is an important component in physical therapy. Patients learn about how their spine works, proper body mechanics, common disorders and their causes, benefits of good posture, importance of physical fitness and its relationship to injury and disease prevention.

Who are physical therapists?
Physical therapists are licensed healthcare professionals. Prior to practicing, they must obtain either a bachelor's or master's degree in physical therapy and pass an examination to be licensed. Their didactic and clinical training includes (but is not limited to) anatomy, kinesiology (study of movement), study of disease and injury, healing and recovery, and a myriad of therapeutic treatment techniques. Therapists practice in hospitals, outpatient clinics, rehab centers, home healthcare agencies (serving homebound patients), and private practice.

What does the physical therapist do?
The physical therapist talks to the patient and evaluates their condition by testing joint motion, muscle strength, cardiovascular function, reflexes, and functional skills. If a physician referred the patient, the therapist will review the prescription along with the patient's records. After necessary information has been gathered, the physical therapist designs a treatment plan to fit the patient's needs and goals. The therapist and patient will work together as a team toward wellness.

Is physical therapy painful?
Sometimes PT is uncomfortable or painful. However, the therapist has treatments available that can help minimize pain. As muscles are stretched and exercised, it is only natural to experience some soreness. As therapy progresses, range of motion increases, strength and soreness diminishes. In general, patients feel better following therapy and look forward to the next session.

How long does a therapy session last?
The amount of time needed depends on the type of therapy involved. For example, it may take one patient longer to complete their therapeutic exercises than another. Also, as a patient makes progress, their treatment plan is adjusted.

Updated on: 09/07/12
Dennis J. Maiman, MD
Ms. Davis has nicely defined some of the fundamentals of the physical therapist in the area of spinal disorders. Certainly, a therapist is not only a treater, but also functions to prevent further injury via teaching and conditioning, maintenance of muscle and joint integrity, as well as ergonomics.

The most successful therapists will be those who advise the patient in behavior alteration to promote good spine muscle and joint health. They are not just massagers or back crackers; they are important members of the treatment.

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