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8:24 AM Thu, Sept. 20th

Physical therapists help reduce pain

The Daily Courier/Nathaniel Kastelic
Warren Mitchell walks on an underwater treadmill in the Hydroworxs therapy pool to exercise with his lower back pain at Peterson Physical Therapy in Prescott Wednesday.

The Daily Courier/Nathaniel Kastelic Warren Mitchell walks on an underwater treadmill in the Hydroworxs therapy pool to exercise with his lower back pain at Peterson Physical Therapy in Prescott Wednesday.

Arthritic Prescottonians are turning to physical therapists to alleviate pain and improve their quality of life.

The patients are usually age 40 and older, and use physical therapy in conjunction with anti-inflammatory medications, alternative therapies such as massage, or both, according to several local therapists.

"Usually, I use a combination of therapeutic exercises and joint mobilizations and modalities like ultrasound, or hot and cold," said Nichole Boy, physical therapist at Lone Tree Physical Therapy in Chino Valley. "What I typically do for ultrasound is superficial heating of the (skin) tissues, or where the pain is."

Boy estimated that 60 percent of her patients have some form of arthritis.

Sufferers face constant pain and challenges to being able to live independently, Boy said.

Two forms of arthritis exist, said Ruth Backway of Backway's Physical Therapy in Prescott. They are rheumatoid arthritis and osteoarthritis, she said.

Backway said rheumatoid arthritis is believed to be an autoimmune disorder, while osteoarthritis is considered a "wear and tear" disease.

In rheumatoid arthritis, a capsule of tissue surrounds all the major joints in the body, Backway said.

"That tissue has a lining called the synovial lining, and in rheumatoid arthritis this lining becomes inflamed and can exude chemicals that eat away at the joint surfaces," she explained. "It's not a wear-and-tear thing. It's an inflammatory autoimmune process."

By contrast, trauma can cause osteoarthritis, Backway said.

"My general opinion is it is caused because the muscles and tendons around the joint become too tight, and they pull the joint surfaces too close to each other, which causes excessive wear and tear," she continued. "It wears the cartilage off the bones at the joint."

Backway said she uses manual therapy to treat sufferers of osteo-arthritis.

"We manually mobilize the soft tissues with our hands to lengthen the muscles and tendons and fascia in order to allow the joint to function properly," she continued.

Therapists in the tri-city area use manual methods and other treatments for arthritis sufferers. They stressed the importance of exercise, both at the therapists' offices and at home.

"Exercise is one of the best medications to help our bodies, to keep our bodies well," said Rich Tenney, a physical therapist who practices with Jay Tipton of Tipton Physical Therapy in Prescott Valley.

The exercise regimen depends on the patient, Tipton and Boy said.

"A lot of times we get them to calm down a little before we work them into exercise," Tipton said. "They will have associated muscle guarding: Tight, stiff, don't want to move."

A number of people who have rheumatoid or osteoarthritis respond well to aquatic therapy, according to Chris Markey of the Center for Physical Excellence in Prescott. His practice features an indoor pool that measures 20 by 40 feet, has depths of 4 to 6 feet and maintains temperatures between 90 and 92 degrees.

"A lot of the arthritic population often cannot tolerate the land-based therapies immediately after their injury or surgery," Markey said. "And the water is a good way to slowly get into an exercise."

Aquatic therapy enables patients to exercise and move their joints "in a non-painful manner," Markey remarked. "It's extremely popular with a lot of chronic pain patients."

He said the frequency of treatment depends on the condition of the patients. Markey and other physical therapists also recommend exercises that patients can take home with them.

Tenney said, "You are not going to cure the disease, but you can manage the symptoms."

Therapists said that would-be patients may make appointments without seeing a doctor first. However, they said most insurance companies will not reimburse patients for physical therapy unless they have referrals from their doctors.