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This chapter focuses on physical therapeutics and their prescription to treat diagnoses with a significant symptom of pain. However, physical medicine and rehabilitation professionals attend or administer to persons with a wide variety of diagnoses, and they practice with a variety of allied health professions. To apprise professional services that the specialty of physical medicine and rehabilitation can offer a patient, this chapter opens with a synopsis of rehabilitation philosophy, methods, and goals. Antecedent to discussing this specialty as it applies to pain, the chapter references current review works that define the types of exercise and modalities. The chapter concludes by addressing specific diagnoses and referencing the current literature that guides the physical medicine and rehabilitation prescription.

The field of physical medicine and rehabilitation spans the settings of inpatient, outpatient, and home health medicine. The philosophy of physical medicine and rehabilitation embraces an intradisciplinary approach to patient care, with not only the patient and physician working toward the patient’s recovery but also a team of allied health care professionals. This team includes physical, occupational, and speech therapists, social workers, nurses, pharmacists, psychologists, recreational therapists, and vocational specialists.

The goal of physical medicine and rehabilitation interventions is the improved function of the patient, despite the presence of permanent disease or impairment. Physical medicine and rehabilitation teams treat a spectrum of diagnoses referred from medical, surgical, pediatric, and traumatic specialties. The severity and complexity of diagnoses varies from catastrophic entities such as spinal cord injury and stroke to routine soft tissue injuries, for example, shoulder impingement and shin splints. With more complex disease entities in which tissue loss or tissue death has occurred (e.g., amputation or traumatic brain injury), successful physical medicine and rehabilitation intervention compensates for impairment rather than resolves or cures the disease process.

For diagnoses with soft tissue injury (e.g., ankle sprain and shoulder impingement), physical medicine and rehabilitation interventions promote soft tissue healing. For all levels of injury, physical medicine and rehabilitation interventions aim, however, to restore function and prevent recurrent injury. Physical medicine and rehabilitation uses a team treatment approach to restore function to patients with soft tissue injury or permanent tissue loss. Tools of the field include exercise, thermal and electrical modalities, as well as education and new learning.

Except in the case of chronic pain syndrome where pain and dysfunctional behavior in response to the pain have become the impairment and disease,1 pain is a symptom of a disease process or tissue injury. This chapter discusses the physical medicine and rehabilitation interventions for diagnoses in which pain is a complaint or symptom; these interventions involve straightforward, applied progressive exercise and education.

For the treatment of the soft tissue injuries in patients who have pain, the physician prescribes physical therapeutics, which a physical or occupational therapist administers. The treatment and improvement of the symptom of pain generally cannot be separated from the treatment and improvement of the ...

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