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A discussion with the physiatrist

for “team" therapy

If you suffer from bone and/or joint pains, do not neglect it: early diagnosis is the first step to improvement and resolution of the problem.

It often happens that the warning signs, symptoms and pains, are neglected until the worsening of the situation makes daily activities tiring or impossible. The more complex a joint is, the longer and more difficult the rehabilitation and/or recovery process. Consulting a physiatrist, able to implement a therapeutic plan, is recommended in order to reduce recovery time and inevitable problems. These are the highlights of the physiatric approach:



Orthopedist and physiatrist: the comparison of two professional figures

A first distinction: an orthopedist cures diseases of bones and joints with medical, surgery or physical treatments.

The field of a physiatrist is wider because not only do they cure the joint diseases, but they also work in the neurological sections of the problem, from childhood diseases to those disorders which are typical of older age persons(such as palsy).

The orthopedist often “hands over” the patients to the physiatrist for a post-surgery rehabilitation, or even sends them for a muscular tone up therapy which can make the intervention easier and facilitates the post-surgery course.


Semiotics first of all:

Modern technology offers diagnostic exams (XR, CAT, magnetic resonance) which help the specialist understand the problem. But the observation of the patient, his posture, dialogue and in depth check-ups are as important, “as the doctors used to do once.”

Semiotics: (from the Greek sìmeio¯tiké 'study, examination of the signs', from sìmeio¯tikós 'that observes the signs') field of the medical science which studies the symptoms of diseases with the purpose of diagnosys.


Synergy work:

Finding the cause of, and solution to, pain is not a mathematic process; it is above all a system of human and professional relations. The physiatrist has the task to establish the cause of the problem and give the physiotherapist initial therapeutic directions (diagnosis, type of therapy and sessions of the treatment); the physiotherapist, with his preparation and sensitivity, can treat the patient and give the physiatrist feedback. The patient has to actively interact with the physiotherapist to acquire awareness of his/her state of health and then carry on with the exercises at home.

semeiotica   fisioterapista

“Chase away the pain” therapy:

In case of strong pain let’s not demonize painkiller and anti-inflammatory pharmacology, which allows the necessary relief to continue the mobilization of the articulations. Drugs help, but they have to be considered a temporary solution and not a cure. Don’t forget the gastric surface!

Cortison infiltration kills the pain in a very short time because of its anti-inflammatory effect, but has strong counter-effects (it can, in time, cause tendons to wear away).

As an alternative to drugs, instrumental therapies such as antalgic currents, are also an effective painkiller.


Thermal water:

rehabilitation in the water, especially if thermal, is the most effective therapy ever. Thermal water is heavier and therefore allows better floating. Its heat helps muscular relaxation. With the help of qualified staff specialized in the joint movements with both passive and active exercise, articular mobility improves after just two sessions.


Move with all the possible effort:

the patient’s collaboration is essential, both during the session with the physiotherapist and at home. Joint mobilization is necessary even when the pain is strong. Keeping it blocked leads to the worsening of the situation. Therefore do the effort and exercise when at home, following the physiotherapist’s advice (no ‘do it yourself’ in this case!).

Pieces of advice:

In the acute phase avoid sources of heat near the painful part. Ice gives immediate relief and soothes the pain, but later gives a bounce effect.

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