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12/23/2015 0 Comments the mulligan approach - by Brent DodgeGary Gales, DPT, CMP of Alpine Physical Therapy for 11 years recently earned international certification as a Certified Mulligan Concept Practitioner (CMP). Having attained this advanced training, Gary expertly applies hands on care using the Mulligan approach to help patients move and feel better. Notably, Gary is one of two Mulligan Concept Practitioners in the Missoula area. Contact Gary at Alpine’s south clinic at (406) 251-2323.
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12/4/2015 0 Comments A recent article from spineSpecial thanks to star physical therapist Brace Hayden, DPT, CSCS of Alpine Physical Therapy for providing this write up on a recent article from Spine. ************ Low back pain with radiating leg pain or sciatica is a common problem in the United States and often highly expensive to manage. Conservative treatment by general medical practitioners, or the non-surgical approach of patient education, pain medicine and rehabilitation cost upwards of $55,000 per case, per five years. One in ten cases of low back pain have an irritated nerve root or radiculopathy that radiate pain down the leg past the knee. This type of back pain with sciatic leg complications from a bulging disc defined in this paper as “lumbosacral radicular syndrome”, often takes a large financial toll, as there is lost time from work and expensive medical costs. Shortening the painful, acute phase of lumbosacral radicular syndrome using a steroid shot to the level of the bulging disc is a widely-accepted and often effective treatment. Dr. Spijker-Huiges and her team of Dutch researchers assessed the costs of possibly shortening the duration of this injury and the medical costs to provide it. The study used a randomized control design where half of the 73 subjects received “care as usual” treatment from their provider and the other half were given a steroid shot to the back at the injured level and the usual medical care. The Dutch providers used the nationally recommended guideline for back pain treatment that includes pain medication, recommendations to maintain normal daily activities as much as they are able, and referrals for other rehabilitative treatments as necessary.  This study found small, but significant differences in many of the research variables they measured over the course of a year in the subjects in both the control and steroid intervention group. Interesting findings turned up less expensive and more cost-effective treatments in the steroid intervention group. The addition of a steroid shot cost $259 or 191 Euros, but saved the individual the costs of lost work wages, increased total medication use, and increased time in physical therapy and other alternative therapies. Intervening with a steroid shot during the acute phase also had a small, but clinically measurable effect on reducing the individual’s initial pain and disability scores. The authors noted that careful selection of patients during the acute phase (less than six weeks in duration) of this low back injury is important, as longer durations of radiating back pain do not respond as well. They concluded that implementing steroid injections is a win-win medical treatment for this disabling back injury with few negative side effects and many cost-saving benefits to society over the typical medical care. The patient’s pain and return to work time are also improved; thus, their productivity and income are increased. ************ Spijker-Huiges A., MD, et al. Costs and Cost-effectiveness of Epidural Steroids for Acute Lumbosacral Radicular Syndrome in General Practice. An Economic Evaluation Alongside a Pragmatic Randomized Control Trial. In SPINE. Nov. 2014. Vol. 39, Pp. 2007 – 2012. For more information on this topic, view our clinical module on steroid injections for back and sciatic pain by clicking here.  |
Author
Brent Dodge is the founding owner of Alpine Physical Therapy and is a board certified orthopedic specialist. He holds additional certifications in Functional Dry Needling, Manual Physical Therapy, and Strength and Conditioning. CategoriesAll Alpine Physical Therapy Alpine Soccer Team Alpine Softball Alzheimer's Disease American Cancer Society Ana Soulia Angela Listug Vap Angela Listug-Vap Ankle Sprains Antara Quinones Aquatics Audrey Elias Back Pain Balance Biking Boston Marathon Brace Hayden Brent Dodge Cancer CDC Certified Chiropractic Climbing Concussion CoreAlign Core Studio Crossfit Dance Medicine Dennis McCrea Diabetes Diane Cummins Diva Day Dr. Liz Walker Eating Emily Jones Ergonomics Events Excercises Fall Prevention Fall Prevention Awareness Day Fishing Fitness Fit To Fight Foot Pain Functional Dry Needling Gary Gales Golf Good Food Store Headaches Health Her Health Hiking Hip Pain Jamie Terry Jeannette Kittredge Jessica Kehoe Jonathan Hoffman's Foundation Training Josie Sweeney Kayla Johnson Kerri Houck Knee Pain Kristi Moore Leah Versteegen Lindsy Campbell Linsey Olson Low Back Pain LYMPHEDEMA Mary Mischke Matt Schweitzer MISA Missoula Marathon Missoula's Choice Moms Montana Geriatric Society Morgan York Singer Morgan York-Singer MT Alpha Cycling National Cancer Institute National Falls Awareness Neck Pain Oncology Rehab Program Pain Pamela Pack Peak Health & Wellness Center Peak Triathlon Pelvic Pain Physical Therapy Physical Therapy (Journal) Pilates Primal Practice Relay For Life Resources Roger Sperry Ron Clijsen Ron Veilleux Runner's Edge Running Samantha Glaes Sam Schmidt Sarah McMillan Shoulder Pain Sitting Skiing Skye Folsom Soccer Spine Magazine Spine Rehab Sports STEADI (Stopping Elderly Accidents Tai Chi Tamarack Brewing Company Tara Mund The Runner's Clinic Tips Travis Dye Ultrasound Imaging University Of Montana Urinary Incontinence Walking Wellness Wellness Program Westside Dance Physical Therapy Who Is Perfect? Women's Health Archives
May 2018
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