Physical therapy is an essential component of treatment for many neurological disorders
Getting diagnosed with a neurological disorder may be confusing since these issues involve the nerves rather than the muscles and ligaments. Some patients may be uncertain what the diagnosis means and how it will affect their life, which can make it difficult to know what to do next.
For some nervous system disorders, a specialist may be the best choice to lead the treatment process providing and explain various treatment options and a plan of care for a particular diagnosis. For some peripheral nerve problems like pinched nerves and entrapments, physical therapist directed care is a great place to start.
A physical therapist can help with pain relief, strength problems, and assists with mobility so that patients can recover/retain their function and maintain independence. Increasing mobility and physical activity levels will also improve overall health and reduce the risk for other conditions that can result from inactivity.
Helping patients retain and regain their abilities through physical therapy
Physical therapists are usually part of a team of medical professionals that all approach different aspects of the disorder present, with treatment for some of the most common diagnoses consisting of the following:
- Hands-on manual therapy to relieve pain and recover spine mobility
- A combination of stretching and strengthening exercises are typically used in conjunction with hands-on techniques
- The therapist will likely provide instruction on postural positions which can prevent the condition from getting worse
- As treatment progresses, functional training is usually added, which is aimed at helping patients return to their job, sport, or other activities
- Initial treatment usually includes manual therapy to take pressure off the affected nerves; as the pressure diminishes, the therapist will perform mobilizations of the soft tissue and stretches to help bring back normal movement to the spine
- Once the patient has regained normal spinal movement, treatment will progress to strengthening to help recover any muscle dysfunction
- Stretching and strengthening exercises that focus on the outer hip and piriformis muscle in the buttocks are often a core component of most treatment programs for this disorder
- The physical therapist may also use deep massage and soft-tissue mobilization to alleviate pain and increase flexibility, and may educate patients on lifestyle changes that will reduce their symptoms
Carpal tunnel syndrome
- Exercises to increase the strength and flexibility of the muscles of the arm, forearm, and hand are commonly recommended
- Patients are also educated on how to avoid further irritation of the median nerve, such as practicing good workplace ergonomics and making modifications or taking precautions when using vibrating tools
- Many therapists provide manual therapy interventions to improve nerve and joint mobility in the neck, shoulder, arm, wrist and hand; some examples of nerve gliding exercises for carpal tunnel syndrome can be found here
Other nerve entrapments
- Treatment usually consists of posture correction when poor posture is a contributing factor responsible for the entrapment
- The therapist may also prescribe bracing or splinting to encourage rest for the damaged nerve, and nerve gliding exercises if the nerve is at the appropriate phase of healing
- Range of motion and strengthening exercises are usually prescribed and performed at the clinic and/or at home as well.
- Physical therapists will focus on addressing range of motion, strength, and stamina to improve movement, safety, independence
- Traditional physical therapy includes general conditioning exercises, training to address balance and gait (walking) issues, and guidance on ways to reduce shuffling movements and function better in everyday life
- A relatively new treatment is called the Lee Silverman Voice Technique, which physical therapists must obtain a special certification to administer
- Aerobic training using a treadmill, stationary bike, or rowing machine is often recommended to help patients stay mobile and continue performing their daily activities normally
- In addition to aerobics, the physical therapist will often prescribe general strengthening exercises for the arms and legs, balance training, stretching exercises, and relaxation techniques
- If accessible, aquatic exercise has also been found to be particularly effective for patients with multiple sclerosis
- Avoiding excessive fatigue is important when working with MS patients
- The goal is to help patients regain the functional skills that they have lost after a stroke in order to return to home, work, and social activities
- Physical therapists will help patients with walking and balance, how to use an assistive device (if used), and provide training to caregivers (when needed)
- As patients become more mobile, functional activities and strengthening exercises will become part of the treatment plan