I just asked my PCP for a referral to PT. And I have never been to any type of physical therapy and have no idea what to expect. I have yet to make the appointment. While I realize it is not the most rationale response, I am apprehensive about going. I was diagnosed almost two and a half years ago. I am now long term disabled. My neck and SI joint are always bothering me. I have difficulty walking with chronic issues in my feet, and ankles. I also have issues with my wrists and hands. Hips and shoulders. You get the idea.
My rheumy has never really done a comprehensive check of my joints such as range of motion or other hands on clinical exams for joint involvement. In fact, my relationship with my rheumy is less than ideal. When I have tried to discuss various issues he is dismissive. And does little more than renew my prescription and make small talk. Fortunately, my PCP is fairly responsive now but has typically been reluctant to go near anything related to my PsA. Ultimately I need to find a new rheumy but am deferring that until I move. So, to be clear, I am not asking advice on communicating with my docs. I am making the best of that for now.
My concern with PT arises out of the fact that I clearly have SI and spinal inflammation but have not had imaging to assess that or any other issues aside from some hand and feet xrays very early on. I was an engineer by profession where a scientific approach means taking data and making information-based decisions. And I feel like I am going into this blind. And at some level I fear that it may do more harm than good. The rational side of me says that I should just make the appointment and go. That I should trust that these are professional that deal with patients like me on a regular basis. But that doesn't seem to have quelled my procrastination.
So I wanted to ask those with experience what I should expect when going to PT for the first time. Is there some sort of initial physical exam or assessment? What types of therapies are used? An overview of the PT process and any suggestions or cautions are much appreciated. Thanks!
Good morning Dandlyons! I had PT earlier this year. My therapist had a boyfriend that has PsA, so she was very knowledgeable. What luck! My first visit was an assessment. She checked my range of motion from my head to my toes, watched how I walked across the room, we talked about the issues I was having, and she asked about other medical problems that I have. The exercises that we did were not aggressive. I was told,"If it hurts, don't do it." Overall my experience was a good one. I hope this little bit helps. :)
I too was very apprehensive about having PT. The department in my local hospital are fantastic and take time over treating the individual as just that…an individual! I was referred for hand therapy by the Rheumatology nurses way back in the beginning. But when my therapist realised my hands were just a tip of the iceberg, she did the assessment on my hands, measuring and recording my hand mobility and giving me exercises.She made splints for my wrist, she then referred me on to the OT exercise team which assessed me and all my movements walking sitting standing reaching…the list is endless. I went on to an exercise programme of 8 weeks which taught me shibashi tai chi, along with advice on how to make my life easier…gadgets etc and how I thought about my restrictions.
I found the whole team to be full of empathy and understanding without patronising or dismissing my concerns.
I do physical therapy as needed. So for example, last year I went in with a prescription for PT for my hips. No specific diagnosis, just hip pain. So I was given a very thorough evaluation, to determine what was going on, what was too tight, too loose, too painful, etc. A good PT will be able to figure out exactly what is going on. Make certain to use good communication, including if you have any pain, increased soreness, etc.
I also see PT. My insurance pays for 30 visits every year so I go and get a "tune up". I exercise in a heated Program Pool. I see PT to learn new exercises and they always find an area for me to work on. Right now I am having significant SI pain and she has me doing very gentle exercises "to open" my hips. After just 2 weeks of PT I am seeing significantly less pain. Amazing. She never pushes me and never "shames" me. We look at where I am and build on it. The exercises are very gentle and the water is soothing. I actually enjoy it. Go and see if you love it too.
I just started PT for low back / SI joint pain, and neck pain. I had a 1 hour assessment for my first appt, and my PT started some work on my low back. This is rare, but within one appt. she had figured out that my SI / low back pain was inflamed because my right SI joint wasn't moving. She got it moving with some gentle manipulation, gave me exercises, and within a day I felt much better. My neck is another story, turns out it's pretty messed up and it's going to take awhile. Gentle manipulation, progressive gentle exercises, heat, etc is what will make the difference.
I have seen a hand PT in the past, and it was very helpful. Assessment, gentle treatment, custom splints, etc. I'm thinking of going back as my hands have become a mess in the past 2 months.
Well thank you all for the timely and detailed responses. It sounds like this is a definite step in the right direction. Especially if there is an assessment of my current state and an active dialog. As I mentioned, my rheumy is quick to dismiss. Just as a sanity check I reviewed a copy of my records and found that he had not recorded any of my complaints over the last few appointments. In fact, he recorded that I have normal range of motion and no pain which is far from accurate. No mention of any of my more recent symptoms. So needless to say, I am looking for a new rheumy. Thank you for helping me to understand the role of physical therapist and more about the process of therapy itself. It truly is a blessing to have the benefit of your advice and experience. Now, rather than being apprehensive, I am actually looking forward to perhaps gaining some new strategies or skills.