Finding a Physical Therapist - Part One
HOW DO YOU LOCATE A PHYSICAL THERAPIST KNOWLEDGEABLE ABOUT CRPS/RSDS?
There have been a lot of questions recently concerning this topic so we thought we would put together some thoughts and tidbits that we have learned over the last decade or so.
The good news is that current CRPS patients have a great head-start on those of us who came before because you have so much more knowledge about CRPS than we did a dozen years ago. Not only what you yourselves have learned but also what is available on the internet through websites and listserves, etc.
With this knowledge in hand, you can call and talk to the lead therapists in these clinics and ask them about their knowledge of CRPS. You can find out very quickly how much they actually know about the disease and about treating it with PT by asking a few simple questions. Their answers will tell you whether or not to trust your body and health with them. In the hands of the wrong therapist your CRPS can actually accelerate and worsen the same as in the hands of the wrong Doctor. But in the hands of a skilled therapist your pain can be diminished significantly.
Here are the basic questions I would ask a Physical Therapist;
1) Are you familiar with Reflex Sympathetic Dystrophy Syndrome, now known as Complex Regional Pain Syndrome?
If the answer is no then you probably should move on. There may be cases where you don't have many options in your area and you may be able to find a therapist who is willing to learn about the disease. In which case we have tapes, brochures, and of course the website to help. Your Doctor may also be able to provide guidelines for them.
I know that some people suggest just only giving them the initials RSDS and seeing if they know what they stand for, or not asking about CRPS and seeing if they are up to date with the latest name change but this isn't about games. You want to determine their knowledge of actually treating the disease. They may not know the letters but may know the disease. They don't have to know everything about the disease, that is where your Doctor comes in. What is paramount here is DO THEY KNOW HOW TO TREAT YOU?
2) Have you treated CRPS patients in the past, and/or currently, and if so, how many?
Ideally the answer should be four, five or more but if you don't live in a large city that may not be feasible based on the number of patients available. However, it isn't enough for them to simply answer "None but we do treat Chronic Pain patients".
CRPS therapy and CP (chronic pain) therapy are two totally different animals due to two key components; allodynia and the adverse reaction CRPS patients have to ice, or hot/cold contrast therapy. We touch on allodynia below and most everyone knows how ice causes CRPS to worsen and/or spread.
3) Do you have a therapeutic or warm water pool?
This is a pool that is at least 88 degrees. It is used for patients with all sorts of injuries as well as diseases like arthritis, fibromyalgia, and of course, CRPS/RSDS. It is the BEST form of therapy for CRPS/RSDS. It is without a doubt the form of therapy CRPS patients should be doing in our opinion. From everything we have seen, heard, and read over the years it seems to have the best results with the least impact. It also has the added benefit of reducing allodynia in many cases while at the same time increasing mobility. The end result being not only a reduction in pain but oftentimes a reduction in medication as well. We do have an article on the website about this;
AQUA THERAPY
Also an article concerning water therapy and Arthritis can be found by going to the MEDICAL TREATMENTS Drop Down Menu or just by clicking or the link above.
Allodynia is part of the First of the Four Symptoms of CRPS.
Allodynia is an extreme sensitivity to touch. Something as simple as a light touch, clothing, sheets, thunder, drops in barometric pressure, even a breeze across the skin on the affected area can cause an extreme amount of pain to the patient. Pain can also be increased by sounds and vibrations, especially sharp sudden sounds and deep vibrations.
This is one of the most painful parts about CRPS and this side effect can be reduced by Aqua Therapy. It takes quite a few visits but eventually you will notice a difference and it is amazing! This also seems to be the least painful way of reducing allodynia. After all, who doesn't like a nice dip in a warm pool? It is especially nice during the winter for those of us who live up north!
If you are on Medicare, this type of therapy is typically paid for by Medicare. Your Doctor just has to write the prescription for it. Being in the pool you greatly decrease the impact on your body because the water displaces your weight.
Land therapy, in contrast, whether it be massage, band therapy, exercises, or any type of stretching where they stretch your body by grabbing you and pulling, can be very painful due to the allodynia as well as the impact of the exercises themselves on CRPS limbs.
There have been a lot of questions recently concerning this topic so we thought we would put together some thoughts and tidbits that we have learned over the last decade or so.
The good news is that current CRPS patients have a great head-start on those of us who came before because you have so much more knowledge about CRPS than we did a dozen years ago. Not only what you yourselves have learned but also what is available on the internet through websites and listserves, etc.
With this knowledge in hand, you can call and talk to the lead therapists in these clinics and ask them about their knowledge of CRPS. You can find out very quickly how much they actually know about the disease and about treating it with PT by asking a few simple questions. Their answers will tell you whether or not to trust your body and health with them. In the hands of the wrong therapist your CRPS can actually accelerate and worsen the same as in the hands of the wrong Doctor. But in the hands of a skilled therapist your pain can be diminished significantly.
Here are the basic questions I would ask a Physical Therapist;
1) Are you familiar with Reflex Sympathetic Dystrophy Syndrome, now known as Complex Regional Pain Syndrome?
If the answer is no then you probably should move on. There may be cases where you don't have many options in your area and you may be able to find a therapist who is willing to learn about the disease. In which case we have tapes, brochures, and of course the website to help. Your Doctor may also be able to provide guidelines for them.
I know that some people suggest just only giving them the initials RSDS and seeing if they know what they stand for, or not asking about CRPS and seeing if they are up to date with the latest name change but this isn't about games. You want to determine their knowledge of actually treating the disease. They may not know the letters but may know the disease. They don't have to know everything about the disease, that is where your Doctor comes in. What is paramount here is DO THEY KNOW HOW TO TREAT YOU?
2) Have you treated CRPS patients in the past, and/or currently, and if so, how many?
Ideally the answer should be four, five or more but if you don't live in a large city that may not be feasible based on the number of patients available. However, it isn't enough for them to simply answer "None but we do treat Chronic Pain patients".
CRPS therapy and CP (chronic pain) therapy are two totally different animals due to two key components; allodynia and the adverse reaction CRPS patients have to ice, or hot/cold contrast therapy. We touch on allodynia below and most everyone knows how ice causes CRPS to worsen and/or spread.
3) Do you have a therapeutic or warm water pool?
This is a pool that is at least 88 degrees. It is used for patients with all sorts of injuries as well as diseases like arthritis, fibromyalgia, and of course, CRPS/RSDS. It is the BEST form of therapy for CRPS/RSDS. It is without a doubt the form of therapy CRPS patients should be doing in our opinion. From everything we have seen, heard, and read over the years it seems to have the best results with the least impact. It also has the added benefit of reducing allodynia in many cases while at the same time increasing mobility. The end result being not only a reduction in pain but oftentimes a reduction in medication as well. We do have an article on the website about this;
AQUA THERAPY
Also an article concerning water therapy and Arthritis can be found by going to the MEDICAL TREATMENTS Drop Down Menu or just by clicking or the link above.
Allodynia is part of the First of the Four Symptoms of CRPS.
Allodynia is an extreme sensitivity to touch. Something as simple as a light touch, clothing, sheets, thunder, drops in barometric pressure, even a breeze across the skin on the affected area can cause an extreme amount of pain to the patient. Pain can also be increased by sounds and vibrations, especially sharp sudden sounds and deep vibrations.
This is one of the most painful parts about CRPS and this side effect can be reduced by Aqua Therapy. It takes quite a few visits but eventually you will notice a difference and it is amazing! This also seems to be the least painful way of reducing allodynia. After all, who doesn't like a nice dip in a warm pool? It is especially nice during the winter for those of us who live up north!
If you are on Medicare, this type of therapy is typically paid for by Medicare. Your Doctor just has to write the prescription for it. Being in the pool you greatly decrease the impact on your body because the water displaces your weight.
Land therapy, in contrast, whether it be massage, band therapy, exercises, or any type of stretching where they stretch your body by grabbing you and pulling, can be very painful due to the allodynia as well as the impact of the exercises themselves on CRPS limbs.
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