Introduction to Rehabilitation
“Rehabilitation” helps patients to regain physical functions after illness. Many patients may lose certain body functions as a result of stroke or injuries like fractures. Specialist in rehabilitation can help patients to return their body functions to the pre-injury or pre-illness state.
Patients with chronic pain or limbs numbness often fail to reach a certain diagnosis after consulting their family physicians or other specialists. They should consider seeing a specialist in rehabilitation. With comprehensive training in assessing muscles, joints and nerves, rehabilitation specialists can help to identify the underlying problems and recommend appropriate treatment. Rehabilitation specialists can help to confirm diagnosis and facilitate recovery.
Q2. Is rehabilitation equals to physiotherapy?
Definitely not. The role of rehabilitation specialist include observation of patients’ conditions, review their medical history, perform bedside examinations and arrange investigations, and assess functional impairments. A comprehensive rehabilitation plan is then designed with physiotherapy as one of its components. For example, in addition to physiotherapy, stroke patients may also require occupational therapy and speech therapy, while those patients with trauma such as nerve injuries in the limbs or limb loss may need to consult a prosthetist-orthotist for assessment and prescription of appropriate prostheses, orthoses or other assistive devices. Rehabilitation is therefore not limited to physiotherapy.
Q3. How is a patient being assessed for rehabilitation?
A typical rehabilitation consultation usually takes 30 minutes to an hour. For more complex cases, such as stroke, the doctor will first review one’s medical history based on previous investigation and assessment reports, e.g. MRI, CT scans, etc. Bedside physical examination will then be carried out to evaluate one’s body functions and to formulate a rehabilitation plan. The plan may include physiotherapy, occupational therapy, speech therapy, or referral to prosthetist-orthotist for appropriate treatment.
Q4. I sometimes feel pain with no obvious reason. Are pain relief patches and painkillers useful solutions?
The key to successful pain treatment is accurate diagnosis. Using over-the-counter pain medications often is ineffective. Rehabilitation specialists are trained in musculoskeletal and neurological function assessments. With these two assessments and specialised tests such as Nerve Conduction Studies (NCS) and Needle Electromyography (EMG), rehabilitation specialists can identify the root cause of the pain and prescribe proper treatments. Different medications are used to treat musculoskeletal pain and nerve pain. An accurate diagnosis is crucial to prescribing effective medications for specific patients.
Q5. Is surgery the only way to treat degenerated or herniated intervertebral discs?
Degenerated or herniated intervertebral discs are frequently seen in imaging studies. Previous systemic review showed in a sample of 3110 individuals without back symptom, the prevalence of disk degeneration in asymptomatic individuals increased from 37% of 20-year-old individuals to 96% of 80-year-old individuals. Disk bulge prevalence increased from 30% of those 20 years of age to 84% of those 80 years of age. Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age. Therefore, the abnormalities seen in imaging studies may not necessarily be the actual source of back symptoms.
Surgery may be required only if the herniated disc is severely compressing a number of nerve roots or the cauda equina. In most cases, even though the disk is pressing on a single nerve root, treatment with nerve-pain killers and physiotherapy are often effective to manage majority of patients. While degenerated and herniated disks are common, most cases require no surgical intervention. Rehabilitation specialist consultation will be able to help you in the pain management.
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