The US Centers for Medicare and Medicaid Services believes that medicaid should be providing more access to non-drug pain management such as rehabilitative, physical therapy, and preventive services. This stems from the fight against opioid misuse that has been plaguing the country more and more recently.

Tuesday, March 05, 2019

Could states be doing more to increase access to nonopioid and nonpharmacological approaches to management of chronic pain under Medicaid? The US Centers for Medicare and Medicaid Services (CMS) thinks so, and has issued guidance that outlines options and shares examples of some states’ promising initiatives. The approaches are largely consistent with APTA’s #ChoosePT opioid awareness campaign, which emphasizes the importance of patient access and choice in the treatment of pain.

The CMS information bulletin released in late February is anchored in the US Centers for Disease Control and Prevention’s (CDC) guidelines for prescribing opioids for chronic pain, published in 2016. Those guidelines, which recommend nonopioid approaches including physical therapy as the preferred first-line treatment for noncancer chronic pain, have been increasingly acknowledged and adopted by state health care entities, and early reports are positive, according to CMS. The new CMS document is designed to help states understand possible avenues for incorporating programs that help support the CDC guidelines.

In outlining possibilities that could allow for the use of nonpharmacological approaches to chronic pain, CMS offers states a wide palette of mandatory and optional benefits, from more effective use of inpatient, outpatient, and health center services to expanded coverage for rehabilitative, physical therapy, and preventive services. The bulletin also offers home health benefits, special “demonstration” projects, and potential waivers as ways states could take creative steps to strengthen their nondrug offerings.

CMS also offers examples of states that have changed or extended their Medicaid coverage options, including Oregon, which expanded its list of Medicaid-covered services for uncomplicated back and neck pain to include physical therapy, cognitive behavioral therapy, and other services; and California, where a 14-county Medicaid program implemented an intensive prescriber education program on nonopioid options for pain management.

APTA has been engaged in the fight against opioid misuse in multiple ways. In addition to its flagship #ChoosePT opioid awareness campaign, the association has produced a white paper on reducing opioid use and contributed to the National Quality Partners Playbook on Opioid Stewardship. On the advocacy front, APTA continues to meet with legislators and agency representatives to address the opioid crisis, and comments on a range of topics, including a federal Pain Management Best Practices Inter-Agency Task Force draft report. Additionally, a recent formal partnership between APTA and the Department of Veterans Affairs includes collaboration to promote veterans’ access to nopharmacologic approaches to pain management.

“Providers and beneficiaries need access to effective therapy for chronic pain,” CMS writes. “A multidisciplinary approach…that incorporates nonopioid pharmacologic and nonpharmacologic therapies, well-communicated treatment goals and expectations, and a careful consideration of the benefits and risks of available treatment options is the most appropriate approach for most patients and has the potential to lead to more appropriate prescribing of opioids.”

Source: http://www.apta.org/PTinMotion/News/2019/03/05/CMSMedicaidPain/

Muscle aches are a common, often times unexplained medical issue that individuals face. There are many factors that play into your muscles being sore. They extend through medical issues, trauma, over-use and more. This article breaks down the causes of muscle aches as well as information to speed up the healing process.

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Source: https://www.medicalnewstoday.com/articles/322869.php

Not only are your deltoid muscles in charge of lifting your arms and giving your shoulders its range of motion, it’s one of the most common areas we experience pain post-workout or activity. Symptoms vary from person to person, and remedies depend on the type of injury or strain you are experiencing. If you are experiencing muscle pain, contact us today on how we can help you!

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Visit www.medicalnewstoday.com for medical news and health news headlines posted throughout the day, every day.

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2018 Healthline Media UK Ltd. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

Source: https://www.medicalnewstoday.com/articles/322031.php

Everyone it seems needs to have a good binge watching TV session every once and a while. It helps us de-stress, unwind, relax, and clear our heads, as well as being a form of entertainment. This process though, may not be always good for us as researchers are finding out. Being a couch potato may come with risks that exercise can’t reverse:

Tuesday, April 03, 2018

Dedicated binge-watchers take note: a new study has found that in addition to its link to other well-established negative health effects, regular long periods of television viewing can also increase risk for venous thromboembolism (VTE)—and it’s a risk that isn’t dramatically offset by increased levels of physical activity (PA).

The study tracked the self-reported television viewing and PA habits of 15,792 participants aged 45-64 over a series of surveys that began in 1987-1989, with follow-ups every 3 years after that, through 2011. Participants were part of the Atherosclerosis Risk in Communities (ARIC) research initiative administered in Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and suburbs of Minneapolis. Researchers excluded participants who reported baseline VTE or anticoagulant use.

Participants were asked to rate their television viewing habits during leisure time as “never,” “seldom,” “sometimes,” “often,” or “very often” at baseline, visit 3 (1993-1995), and visit 5 (2009-2011). Researchers also tracked estimates of physical activity using the Baecke physical activity questionnaire, which asks respondents to estimate the duration and intensity of PA during the previous year. Demographic variables and body mass index (BMI) also were recorded. Results were published in The Journal of Thrombosis and Thrombolysis (abstract only available for free).

For purposes of the study, researchers divided PA responses into 3 levels based on American Heart Association recommendations: “recommended” (75 or more minutes per week of vigorous intensity PA or 150 or more minutes of a combination of moderate and vigorous intensity PA), “intermediate” (up to 74 minutes per week of vigorous intensity PA or up to 149 minutes per week of a combination of moderate and vigorous intensity PA), and “poor” (no reported vigorous or moderate PA). They also reduced television-viewing categories from 5 to 4 after finding that no participant reported “never” watching television. Here’s what they found:

• Among all participants, 18.6% reported watching television “seldom,” 46.8% reported watching “sometimes,” 26.5% reported watching “often,” and 8.1% reported watching “very often.”
• Age, sex, and race-adjusted models showed a positive dose-response correlation between frequency of television viewing and VTE incidence (a total of 691 events during the study period), with participants who watched television very often having a 1.71 times higher risk of VTE than those reporting “seldom” watching television.
• The relationship of VTE risk to television viewing remained in place despite levels of PA. Participants who reported “recommended” levels of PA and watching television “very often” were found to have a 1.8 times greater risk of VTE than the seldom-watch group—a risk rating not much different from the 2.07 times increased risk associated with the group that reported watching television very often and having no PA.
• BMI did play a role. Obese individuals who reported watching television “very often” were found to have a 3.7 times higher risk of VTE than normal-weight individuals who reported watching television “seldom.” However, authors note that higher BMI did not explain the associations observed between television viewing and PA.

The relationship between sedentary behavior and poorer health may be well-known, but authors of this study believe they’ve added a new dynamic—the inability of PA to counteract the risk for VTE caused by prolonged sitting.

“These results suggest that sedentary behavior is not just the opposite issue from [PA],” authors write. While they acknowledge that individuals who engaged in more PA did lower their risk of VTE independent of television viewing frequency, the researchers also point out that “even individuals who met the…recommended level of [PA], when they viewed TV very often, had an increased risk of VTE compared with those who met the recommended level and seldom watched TV.”

The results echo findings in a study from 2017 that concluded that risk of a mobility disability increased relative to television-viewing time, regardless of hours spent in PA.

[Editor’s note: for more information on the role of the physical therapist in the treatment of individuals diagnosed with VTE, check out this clinical practice guideline available at PTNow.]

Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association’s PTNow website.

Source: http://www.apta.org/PTinMotion/News/2018/04/03/VTERiskTV/

Do you have a job that requires you to sit at a desk for about 8 hours a day staring at a computer screen?  Do you find that your neck feels stiff at times for no reason?  We’re here to tell you that it could be related to sitting at your desk.  The good news is that there are ways to stretch and exercise your neck and back to relieve the pain.  The article below gives you a more thorough explanation as to why your neck is hurting and examples of exercises to try anywhere – even in your office.

Try these simple exercises to help stop neck pain giving you grief at work

Updated 8 Jan 2018, 5:43pm

As the Christmas-New Year break draws to a close, many of us will trudge back to office buildings and sit down in our cubicles to start the working year.

If the prospect of sitting in front of a computer for 40 hours (or more) a week for another 12 months triggers a sudden need to massage or stretch your neck, you’re not alone.

A 2010 study reviewing the global burden of diseases ranked neck pain as the fourth most common disability, and it’s a common problem affecting men and women in the so-called knowledge workforce.

Employers often rely on ergonomic adjustments to improve the health and comfort of their staff — lifting or lowering chair heights, repositioning computer screens or fiddling with the angle of keyboards.

However, a researcher from the University of Queensland has found regular exercise can do a better job of reducing neck and shoulder pain than ergonomic adjustments alone.

Dr Xiaoqi Chen, a physiotherapist and post-doctoral researcher, asked 760 Brisbane office workers to pair ergonomic adjustments with a set of regular strengthening exercises to study the effect on pain levels.

Those who performed the exercises regularly (at least two-thirds of the time) reported a reduction in neck pain at work.

“We found that general fitness exercises such as walking, running and cycling were useful, but neck and shoulder-specific strengthening exercises were more beneficial and there was a larger effect size with our meta-analysis,” she said.

Despite the high prevalence of neck and shoulder pain around the world, a lack of research means little is known about the numerous causes of neck pain and the best methods of prevention and treatment.

“Neck pain is a very complex phenomenon,” Dr Chen said.

“Some risk factors are modifiable, such as a lack of physical activity, a lack of physical capacity of the neck and shoulder muscles or a poor ergonomic set up.

“That’s good news because these are factors we can modify to improve neck pain.”

Two factors that can’t be controlled are age and gender.

Dr Chen said current research showed women were at a higher risk of developing neck pain, especially those with office jobs.

“We’re hoping that perhaps employers and industries would pay more attention to exercise because all this time people have been spending a lot of money and effort on ergonomic adjustments.

“It’s not to say that ergonomic adjustments are not useful, but perhaps we could start doing a combination of ergonomic adjustments as well as introducing exercises into the workplace which might benefit more people.”

Exercises to prevent neck, shoulder pain

Front raise

• Hold a weight (or resistance band) in each hand in front of your thighs, palms facing down
• Raise your arms in front of you, pausing when they reach shoulder height
• Slowly lower your arms to the starting position

Side raise

• Hold a weight (or resistance band) in each hand and rest your arms at your sides
• Raise your arms until they’re parallel with the floor, pausing when they reach shoulder height
• Slowly lower your arms to the starting position

Reverse fly

• Hold a resistance band in front of you at shoulder height
• Pull your arms, and the band, apart and pull your shoulders back
• Hold the stretch while gently squeezing your shoulder blades together
• Return to the starting position

These exercises strengthen your deltoid, trapezius and rhomboid muscles.

So why is it so hard to keep your back strong if you’re sitting at a desk all day?

“I reckon this is related to the computerisation of work in recent years,” Dr Chen said.

“And also these days people are using iPhones and iPads a lot more so they’re having to look down on their phones and also having to be in stationary postures for long periods of time.

“It’s definitely not a natural position to adopt and I reckon that might be related to why some of these people are getting neck pain.”

Strengthening your muscles takes time — up to 10 weeks if you’re making it a regular part of your routine.

Dr Chen said finding an exercise buddy and tracking your improvements was a good way to keep motivated and stay on track.

“We suggest people to start off with a weight that is about 50 per cent of their one repetition maximum to be safe and do about 10 to 15 repetitions of those, maybe about 20 minutes each time, three to five times a week for 10 weeks,” Dr Chen said.

“We would also strongly suggest to people, when they’re starting a new exercise, to consult their doctor and physiotherapist before doing so.”

Exercise at work

Associate physiotherapy professor Dr Venerina Johnston is collecting data from Dr Chen’s research to see how employee exercise at work affects productivity.

She said many workplace health initiatives required staff to participate after work or during their lunch hour, but in this case employees were allowed to exercise during work hours.

“One of the criteria was that the organisation had to give the staff time off to do the exercises, which is about an hour a week, so that’s why we looked at productivity as one of our outcomes,” Dr Johnston said.

“If you’re going to give people time off to exercise, then you want to know what the impact is, negative or positive.”

She and Dr Chen said employers looking to incorporate exercise into strategies to improve employee health could foster competition by setting up a leaderboard or offer incentives to groups that completed strengthening exercises regularly.

 

Source: http://www.abc.net.au/news/2018-01-02/simple-exercises-to-reduce-neck-pain-for-office-workers/9283044