In its three ambulatory clinics, BWH Rehabilitation Services—which includes Occupational, Physical and Speech Therapy—has more than 150,000 patient visits per year. One of the most prevalent patient conditions the team treats is back pain, which is among the most common types of pain in the U.S. and a leading cause of missed work.
“Back pain often occurs as we get older as a result of sitting at computer desks and in our cars all day long,” explained Linda Arslanian, PT, DPT, MS, director of Rehabilitation Services.
Arslanian attributes a large percentage of cases of back pain to muscle imbalances and poor posture, which she said can often be managed effectively with physical therapy instead of invasive surgery. Physical therapy for back pain may include manual techniques, exercises, and instruction in sound body mechanics and posture.
“The most important thing is to first identify the cause of the pain,” said Arslanian. “Then, we can develop a treatment plan to address it.”
Once they have performed a thorough exam to determine the cause of the pain, physical therapists create a tailored intervention based on the patient’s lifestyle, needs and preferences.
“Health is multi-factorial,” said Nancy Kelly, MS, OTR/L, clinical supervisor of Occupational Therapy. “We get to know our patients so we can understand not only their physical being, but their social, psychological and spiritual health. All those elements work together to create well-being.”
Therapists guide the patient toward healing through education, exercises, joint mobilizations, stretches and other activities. They often prescribe a routine made up of stretches and strengthening exercises, which they teach the patient how to perform using proper technique. The patient is then responsible for carrying out their exercises at home on a daily basis.
“It’s important to remember that our patients are only in therapy for one or two hours per week,” said Kelly. “Most of a person’s time is taken up by their everyday activities, not our exercises.”
Therefore, therapists teach patients how to change their daily routines in order to reduce pain. This often requires the patient to make small modifications, such as changing the way they sit at their desk or their sleeping position, stretching, adjusting their posture, getting more exercise and being careful when lifting heavy objects.
“For many patients, change is difficult,” said Kelly. “But as soon as they see an improvement, it’s motivation to continue.”
Added Arslanian: “Our philosophy is to empower patients to be their own agents of change.”
The process of change is a key component of self-care, which is an important part of Rehabilitation Services’ departmental philosophy. Instead of providing a “quick fix,” therapists enable their patients to learn more about their bodies and teach them how to become actively involved in their own recovery process. Their motto is simple: Own it and work on it.
Both Arslanian and Kelly find their work incredibly rewarding.
“We see people at a point where they’re discouraged and frustrated,” said Kelly. “Our therapists offer them hope by providing concrete strategies to address the issues at hand and improve their quality of life.”