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Comprehensive Centers for Pain Management provides the area’s premier physical therapy team as part of our comprehensive approach to pain management. Our goal is to help with pain relief by improving a patient’s stability, strength, endurance, flexibility and functionality.

There are multiple convenient locations throughout the Toledo area. Although doing exercise may sound like a difficult process to a pain patient, it is one of the best pain management options for helping to manage acute or chronic pain conditions.

By partnering with Thomas Hallett, DPT, and the staff of PT Link, we offer the most complete physical therapy and integrated pain management program locally. Our team has helped thousands of Toledo physical therapy patients with their pain management and therapy needs.

Physical therapy is a highly effective treatment for all types of chronic musculoskeletal and neuropathic types of pain. One of the goals of physical therapy is to aid chronic pain patients to become stronger and more limber while focusing on functionality and pain reduction, because chronic pain sufferers often become weak due to their lack of movement.

The Multi-System Approach

The multi-system approach to physical therapy is based on the concept of evaluating and assessing all of the body’s interrelated systems. Developed by our Toledo, Ohio physical therapy director, Thomas Hallett, DPT, it is a unique system that incorporates the most highly researched and outcome driven treatment systems. The body systems addressed include the central nervous, musculoskeletal, cardiovascular, lymphatic, immune, endocrine and proprioceptive, along with soft connective tissues.

Our physical therapists are able to have meaningful and lasting change for patients, restoring functionality and limiting pain significantly by combining a variety of modalities and therapy techniques. Through CC4PM’s physical therapy, the body’s systems once again learn to work effectively together.

Pain patients can benefit from this approach by reactivating and retraining the body’s systems to work together, helping them achieve maximum rehabilitation potential as quickly as possible and ensuring longer lasting results for patients with all types of chronic and acute pain.

Physical therapy techniques utilized by the Multi-System Approach include:

The McKenzie Method
The McKenzie Method, also known as Mechanical Diagnosis and Therapy (MDT), was conceptualized in the 1950s by physiotherapist Robin A McKenzie. This is a standardized approach that uses a defined algorithm of exercises and mechanical forces to assess patients who present with neck pain, lower back pain, or sciatica (leg pain) in an effort to identify and treat musculoskeletal disorders of the spine. It is based on the cause-and-effect principle, where the patient is evaluated for their normal postures while sitting, standing, and moving, as well as any other actions that may cause pain. The treatment involves moving through a series of activities and test movements to gauge the patient’s response to pain. This information is then used to design a physical therapy or exercise protocol for the patient to alleviate their pain. 

The method can be used effectively for a number of musculoskeletal problems, such as back pain, pain in the neck and extremities, as well as sciatica, sacroiliac joint pain, arthritis, degenerative disc disease, and muscle spasms, to name a few. 

Joint Mobilization / Manipulation
When a particular joint is “locked” or “stuck,” join mobilization or manipulation may be necessary. These are symptoms commonly found in the spine, shoulder, elbow, wrist, knee, or ankle joints. In these cases, manual therapy techniques like joint mobilization and joint manipulation are done. 

Joint mobilization: This is the slow movement of a joint in a specific direction, with the application of gentle pressure to loosen a stiff joint. 

Joint manipulation: This is a quick, small thrust to a joint, which is done to provide fast-acting pain relief, improve mobility, and decrease the tension in the surrounding muscles. The movements are characteristically, but not always, accompanied by an audible “click” or “pop” sound.

Movement of the joints is re-assessed after manipulation, followed by soft tissue massage or taping of the joints to maintain stability. Exercise therapy may be advised, as well.

Joint mobilization works well for shoulder pain and stiffness, frozen shoulders, tendonitis, back pain, cervical neck pain, or stiff ankles. 

Mulligan Concepts
Mulligan Concepts are also known as therapist-applied mobilizations with movement (MWM) and can be used in nearly all major joints in the extremities, as well as the spinal column for a variety of conditions where the patient experiences pain. MVM refers to the application of sustained accessory mobilization of joints in the extremities by a therapist while the patient attempts the move the joint along with its full range. Similarly, Sustained Natural Apophyseal Glides (SNAG) is used to restore motion in the spinal joints, the rib cage, and the sacroiliac joint, while Natural Apophyseal Glides (NAG) is used for the cervical and upper thoracic spine. During the process, the therapist constantly monitors the patient to ensure that no pain is recreated and that the range of movement is improved. The PILL response, P- pain-free, I- instant result, LL- long-lasting, is used as an indication of whether the same treatment should be continued.

Mulligan Manual Therapy can be used to help treat a variety of injuries and pain, including neck pain, back pain, and upper and lower extremity injuries.

Proprioceptive Neuromuscular Facilitation (PNF)
Proprioceptive Neuromuscular Facilitation (PNF) is an advanced version of flexibility training based on stretching and contracting a particular targeted muscle group. It is known to be one of the most effective ways of improving flexibility, muscle strength and increasing the range of motion in joints in both active and passive movements. Done regularly, PNF also has an impact on athletic performance, as well as on medical conditions that affect neuro-muscular functions like polio or multiple sclerosis. 

The different types of PNF stretching are:
1. Contract-Relax (CR) stretching or Hold-Relax stretching: contracting, holding, releasing, and stretching the target muscle.
2. Antagonist-contract method (AC): contraction of the opposite muscle before stretching the target muscle 
3. Contract-Relax-Antagonist-Contract (CRAC): a combination of the above two techniques

Sound Assisted Soft Tissue Mobilization (SASTM)
SASTM is a derivative of instrument-assisted soft tissue mobilization (IASTM), a treatment technique that helps therapists heal soft tissue, muscle, ligament, tendon, or fascial lesions. These could range from areas of restriction, built-up scar tissue (adhesions or fibrosis) trigger points, and inflammation. Once these abnormalities are detected, the therapist can use sound-assisted instruments to apply pressure and stimulus to the affected areas, which improves the healing process by increasing blood and nutrient supply to the area, building up proteins like collagen to assist with tissue regeneration, thereby reducing the pain and inflammation. 

Injuries that respond well to SASTM are bicep tendonitis, plantar fasciitis, knee sprains, neck or back pain, and a variety of soft tissue issues, with improved range of movements in the areas treated and decreased levels of the discomfort of pain. 

Kinesio Taping
Kinesio Tape is a latex-free hypoallergenic cotton fiber tape with an acrylic heat-activated backing that stretches only lengthwise when applied to the skin. It can be stretched to around 40%-60% larger than its resting length. The tape itself has no medicinal properties. However, it is the unique method of applying the tape that provides benefits. Kinesio Taping is currently being used by therapists to:

Improve muscle tone
Increase the flow of blood and lymphatic fluids, which reduces swelling and inflammation around an injured muscle or joint 
Correct movement patterns after physical therapy by aligning fascia, tendons, and ligaments properly 
Improve posture to prevent worsening of an injury 
Restore biomechanical movement in a specific area with decreased pain
Provide support for muscles and reduce muscle fatigue to decrease strain and encourage healing
 
Kinesio taping is useful after sports injuries to reduce pain and inflammation in sprains or muscle spasms and inflammations like tendonitis or fasciitis.

Dry Needling and Biomechanical Acupuncture
Trigger-point dry needling is an invasive procedure where a fine needle or acupuncture needle is inserted into the skin and muscle. These are filiform needles or fine, short, stainless steel needles that don’t inject fluid into the body. The needles are aimed at myofascial trigger points, which are hyperirritable, painful points in skeletal muscles. Dry needling can be done at superficial or deep tissue levels to provide mechanical stimulation around the trigger point, which in turn reduces the perception of pain from that area. Needles applied at the junction between nerves and muscles (neuro-muscular synapses) help improve communication and facilitate better movement by restoring muscle activation and strength. Dry needling is most often performed for sports injuries and any conditions that cause muscle spasms, trigger points, or fibromyalgia.

Visualization Therapy
Visualization therapy or mental imagery is used as an addition to physical therapy during a patient’s journey of rehabilitation and recovery. It is used to help patients cope with pain, speed up the healing process, and encourage them to stick with a rehabilitation program that may seem like a long and tough road to recovery. It is based on the theory that the mind and body are integrated systems that work in unison to help with disease recovery. The types of imagery used may be images of the injury being healed or mended, positive images of the person performing sports or activities with ease and without pain. The benefits of visualization therapy are most often seen in patients with chronic, debilitating diseases like stroke, multiple sclerosis, or phantom limb pain. Athletes also use mental imagery to reduce stress levels before sporting events. 

Cold Laser Therapy
Cold laser therapy is a low-intensity laser therapy that stimulates healing in skin and soft tissues while using low levels of light. It is called “cold” laser therapy because the levels of light used are not high enough to generate heat, vibration, or sound. Different wavelengths and outputs of low-level light are applied directly to a targeted area. The body tissue absorbs the light, causing a localized, physiological reaction with the damaged cells, promoting healing and regeneration. Recurrent sessions may be required, and each session is generally short.

Cold laser therapy is generally used for tissue repair and relief from pain and inflammation in cases of tendonitis, bursitis, sprains, tennis elbow, or muscle spasms.

Cupping
Cupping is a massage technique that uses local suction created on the skin with the help of plastic cups or hand cups. It increases blood circulation and releases the strain of taut or tight muscles or fascia in addition to reducing muscle tone. Cupping can be used over any region of the body as long as an unbroken seal can be created between the skin and cup, making it more suited to larger areas of muscles, like the back or extremities.

Placing suction cups on the body creates a partial vacuum to reduce the tension on the skin and tissues underneath. By creating this vacuum pressure, tight muscles are relaxed, adhesions are loosened, and restrictive connective tissues are lifted to bring about pain relief in that area. Improved blood and nutrient flow aids in the release and drainage of excess inflammatory fluid or toxins by opening up lymphatic pathways to reduce swelling. Cupping causes an increase in the local temperature of the affected area, which helps to break down adhesions, decrease muscle tone, and bring down cortisol (stress hormone) levels, which in turn brings about a state of deep relaxation.

Cupping can be used as a way to relax sore muscles after any form of exercise or after sporting events. However, it is also beneficial to those with high blood pressure, anxiety, fatigue. 

How Physical Therapy Helps Chronic Pain

Medical studies across the world have shown that physical therapy is the best tool in reducing pain from an injury and reducing the risk of further injury for both chronic and acute pain conditions. We can help restore your functionality and keep you from further injury or re-injuring the same site by working with our physical therapy team to create a program tailored to your abilities and your needs. Exercising for just 30 minutes a day on at least three or four days a week will help you with chronic pain management by:

  • Increasing strength in the muscles
  • Improving endurance
  • Increased stability in the joints
  • Assisting flexibility in the muscles and joints
  • Re-training the body’s systems to work together
  • Improved functionality and work or sports participation

Keeping a consistent exercise routine will also help control chronic pain. Regular therapeutic exercise will help you maintain the ability to move and function physically, rather than becoming disabled by your chronic pain. Physical therapy tackles the physical side of the inflammation, stiffness, and soreness with exercise, manipulation, and massage, but it also works to help the body heal itself by encouraging the production of the body’s natural pain-relieving chemicals. This two-pronged approach is what helps make physical therapy so effective as a chronic pain treatment.

Occupational Health Physical Therapy Services

We offer all our Toledo area patients a variety of services to assist both employees and employers with returning to work function as part of CC4PM’s comprehensive physical therapy program. We understand this process can be difficult and time consuming for both employee and employer, so our physical therapy team works hard to keep things moving. Our reports are timely, comprehensive, and reader friendly. Our therapy programs can be tailored to a specific industry or work-required function. We can customize evaluations to meet a variety of work environments, and we are thorough in both our testing and retraining therapy processes.

Our Toledo Occupational Therapy program includes:

  • Functional capacity evaluations (FCE)
  • Ergonomic studies
  • Job site analysis
  • Transitional work therapy (return-to-work)
  • Work conditioning
  • Post-offer screening

Within each of these categories, there’s much a physical therapist has to offer as far as variety of treatments. A physical therapist works with each occupational therapy patient to understand his or her particular pain, what causes it, and what can be done to manage it. This is the kind of attention a regular doctor doesn’t often have the time to give, but a physical therapist can ask questions and talk about pain issues as the patient goes through their exercise routine.

Pain Management: Finding the Right Combination

The less you move, the more pain you’ll experience. Conversely, the more safe, therapeutic activity and exercise you get — and the more you learn how to exercise to accommodate your pain, the less pain you’ll feel and the more you’ll be able to function on a daily basis.

Chronic Painful Conditions that benefit from Physical Therapy Treatment

  • Back and neck pain
  • Headaches
  • Tendinitis, tendinosis and bursitis
  • Balance and vestibular disorders
  • Musculoskeletal injuries
  • Transitional work and onsite work therapy
  • Post-operative pain
  • Pain management
  • Multiple sclerosis
  • Diabetic neuropathy
  • Disease process Management
  • Parkinson’s disease

For more information about Comprehensive Center for Pain Management’s Toledo physical therapy locations, or about the pain management programs we offer, please contact us today at (419) 873-6862 Option 2.

Looking for more information?
Visit our patient resources pages to learn more about the many kinds of pain we treat and the wide variety of treatments and procedures available to our patients. Learn More