Corridor physical therapists treat patients, deal with cost increases

When your parents and teachers told you to quit slouching, or to get up and move around, it turns out they knew what they were talking about.

Physical therapists say lower back pain is one of the biggest challenges they deal with - and it's something that could be reduced.

“Inactivity contributes to lower back pain and neck pain. People are not moving around enough, not exercising enough, said Jean Hammill, a physical therapist in Marion with 34 years of experience. “Many are sitting at computers for hours during the day and sometimes at night” and they need to get up and move around more.

Adam Callonder of Physiotherapy Associates in Iowa City said he's seeing “more posture-related injuries, such as neck, upper and lower back pain. Often the result of more sedentary life styles, or working longer hours while taking less breaks and dealing with more stress.”

Exercise is especially important as we age.

“We get stiffer as we age. After age 50, we get 2 percent weaker every year if we don't do something about it,” Hammill said.

That something, she suggested, is a combination of cardio and strength exercises.

Red flags

A pain in the wallet for patients may be non-physical, but it is a major concern for patients and physical therapists, according to Callonder and Molly Bailey of Physiotherapy Associates. Bailey works in the Cedar Rapids office.

“The rise in co-pays for patients ... means patients are paying a lot more out of their own pockets (for treatment),” Callonder noted.

Those increased costs can cause patients to shun physical therapy for injuries. That often results in the severity of the injury increasing, Callonder reasoned.

In turn, that can lead to a need for surgery that might have been avoided with prompt, proper treatment, he said.

Insurance co-pays for physical therapy often are less than those for physicians, increasing patients out-of-pocket expenses, Callonder explained. A bill is pending in Congress that would make the co-pay system more equal, but Callonder has not idea about the bill's chances of passing.

Another issue, Workers' Compensation, raises red flags for Physical Therapist Todd Neighbor of Physiotherapy Associates's Hiawatha office. Poor communication between those involved in Worker's Comp cases can result in patients not being promptly certified to return to work.

And this delay also affects how employers operate their businesses, Neighbor said.

What can happen is doctors order physical therapy for a patient. A case manager, often overloaded with cases, is assigned and sends the patient to a physical therapist.

There is no one information system that provides the doctor, case manger and therapist access to case information, Neighbor said.

“The result is the patient is not back to work as soon as they could be - or they get stuck in PT (physical therapy) land” longer than they should, Neighbor said.

Thumb texting

Neighbor also believes that overall there are fewer work-related back injuries because “a lot of companies have done a fairly good job of education and ergonomics” in recent years.

Callonder said he's seeing more people with headaches - migraines or tension headaches - that medicine cannot control. He pegs the causes as higher stress levels. He noted more people want to treat these conditions by fixing the problems causing the headaches instead of just treating the symptoms with medicines.

Physical exercise also can cause problems. Molly Bailey sees many patients with injuries incurred while running, such as runner's knee, calf and hip pain.

Carpal tunnel injuries also remain strong due to today's computer-oriented jobs and social use. Callonder also said there's a theory that carpal tunnel may also result from heredity, diabetes and obesity.

Jean Hammill said she's read about thumb tendinitis due to overuse of thumb muscles from too much texting. But she has yet to see it in her practice.