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A Brief on Interventional Pain Management Procedures

Interventional Pain Management may be the solution chronic pain sufferers seek after exhausting other therapy options. Here's all about interventional pain management procedures.

Chronic pain affects about 100 million Americans. To find a pain treatment that works, you must try many different things. Interventional pain management procedures may help people with long-term pain deal with it. Like other ways to deal with pain, like taking prescription drugs, IPM can help you deal with your pain better without letting it distract you from everyday tasks.

So, what is interventional pain management? Let's get in-depth and understand in brief.

Interventional Pain Management

IPM is a type of pain management that focuses on many different ways to stop the pain, most given as injections. IPM techniques and pain procedures are sometimes used as part of a multi-disciplinary plan to treat pain and other symptoms. These techniques can be used with therapy for the mind, emotions, and prescription drugs.

An IPM specialist doesn't just prescribe medicine or suggest physical therapy; instead, they use all types of treatment to get rid of pain in the quickest, most effective, and direct way possible for each patient.

Types of Interventional Pain Management Treatments

After knowing what is interventional pain management, it's essential to know the types of IPM treatments. 

IPM is a broad term for many different kinds of treatments. The type of treatment you get will depend on your specific condition, and symptoms since every kind of treatment are different in how invasive it is. Some of the most common techniques for interventional pain management are:

Blocking nerves

Pain signals are sent to the brain by nerves. To stop the pain, nerve blocks are used to stop these signals. Your treatment plan will determine the type of nerve block you get. Some nerve blocks are minimally invasive and last for hours or days. Some nerve blocks are done through surgery and can last for long or be permanent.

Infusions

During an infusion, painkillers are given directly into the body. Most of the time, these are for longer-term use. Intrathecal infusions are given into the subarachnoid space in the brain, while epidural infusions are given into the spinal cord.

Injections

Epidural Steroid Injections, Facet Joint Injections, and Trigger Joint Injections are all common types of injections. Each of these injections goes to a different place in the body where the pain is felt. Most injections have a numbing agent and a steroid in them.

Ablation with radio waves

This treatment is mainly used to treat pain in the lower back and neck, especially pain caused by arthritis. A radio wave is used to make an electrical current and then heat nerve tissue. With this method, the pain signals from that area will be less intense.

Peripheral Nerve Field Stimulation (PNFS)

This type of treatment is similar to Spinal Cord Stimulation, but it works on other parts of the body. The electrical leads are placed as close as possible to where the pain is coming from, similar to how Spinal Cord Stimulation works.

What to expect from your IPM specialist?

When you see an IPM specialist for the first time, you will get a thorough physical exam. The doctor will also ask you about your health in the past. Try to bring any x-rays or test results from the past related to your pain condition.

It's also essential that you tell the doctor about any other treatments or pain procedures you've tried and any medications you're taking now. List any alternative therapies you've tried, such as acupuncture, massage, or herbal medicine. 

Your current condition will be talked about, including where the pain is, how bad it is when it happens, and if you have any other symptoms that might get linked to the pain.

Before starting any treatments, your doctor specializing in interventional pain management will do diagnostic tests to rule out other conditions that could cause similar symptoms. These tests could be x-rays, CT scans, MRIs, or blood tests. At this time, psychological tests may also be done. 

The doctor may do more studies (but doesn't have to if the studies are up-to-date and correct) and look at studies already done.

After a thorough physical and diagnostic evaluation, your medical information can be carefully examined. As a result, your IPM specialist can make an entire pain program just for you.

Once the treatment plan is set, your doctor specializing in IPM will help you organize the therapies you need. Most of the time, treatment and services for interventional pain management are offered in the same place, so you don't have to go from place to place to get care. Make sure to follow what your doctor tells you carefully. For your treatment to work, you need to do everything to help.

To Conclude:

If you have chronic pain and haven't been able to find a treatment that helps, you might want to see a doctor who specializes in Interventional Pain Management Procedures. The comprehensive approach developed and designed per your needs may be the answer you're looking for.

[physical-and-procedural-medicine]

Interventional Pain Procedures During Pain Management

Interventional pain management focuses on relieving or managing pain to enhance the patient's quality of life through non-invasive strategies. Let’s find out more.

Patients who can no longer manage chronic or severe pain with medication and other conservative or non-surgical treatments need pain interventions. Applying techniques to prevent pain and reduce inflammation can help make daily activities easier for patients and successfully restore their quality of life.

Interventional pain procedures use less usual medical procedures to disrupt the nervous system's transmission of pain-stricken messages from nerve endings to the brain, thus disrupting the pain cycle.

Pain interventions can help alleviate many conditions, such as arthritis, back and neck pain, joint pain, muscular pain, cancer-related pain, Osteoporosis and Crohn's Disease, and pain syndrome, such as fibromyalgia. You will work with pain management professionals who can assist you in preventing pain without delay.

What is Interventional Pain Management?

Interventional pain management refers to a medical specialty that focuses on a range of pain prevention strategies, usually through injection therapy. Interventional pain management strategies play a role in a multidisciplinary approach to relieve your pain and other symptoms. These methods are used together with psychiatric and emotional therapies and prescription medications.

However, what makes interventional pain management so different from other pain management procedures is that it emphasizes the importance of an accurate diagnosis so that treatment can begin quickly.

Rather than simply prescribing medication or recommending physical therapy alone, a qualified pain management specialist uses all available resources to eliminate pain as quickly and effectively, and efficiently as possible for each patient.

Types of Interventional Pain Management procedures

The pain management specialists provide epidural steroid injections, nerve barriers, radiofrequency ablation, spinal cord stimulation, joint facet injections, lumbar sympathetic plexus blocks, and trigger point injections. Every procedure is performed based on hospitalization.

Several other interventional pain management procedures can help you deal with pain. Intra-intradiscal electrothermal therapy, for example, uses heat to destroy nerve fibers to reduce your pain. Another example is cooling cryogenic, which is similar to a radiofrequency rhizotomy, but instead, it temporarily shuts down the nerves by freezing.

Interventional pain management uses less common techniques such as nerves or artificial drug delivery systems. It includes the following most common interventions:

Radiofrequency Nerve Ablation: It refers to the application of radio waves to heat and destroys the nerve tissue, thus reducing the pain symptoms emitted from the source. It uses X-ray guidance, and radiofrequency nerve ablation brings precisely controlled heat to disable temporarily and selects nerves that identify as causing pain.

"Internal" Discography: "Internal" Discography looks at the spinal discs to determine if they are not a source of pain.

Percutaneous Discectomy / Nucleoplasty: Percutaneous Discectomy / Nucleoplasty is a procedure that removes tissue from the spinal disc to reduce and reduce stress.

Imaging: Steroid injections target pain points in the body to reduce inflammation. Commonly used injections are tissue and joints, facet joints, trigger joints, and epidural injections, joint injections (to relieve pain from osteoarthritis and other conditions).

Pain Pump. This device is surgically inserted and delivers pain medication directly to the area where the pain begins.

Nervous, root, and central branch blocks: Nervous, root, and central branch blocks are processes that disrupt sensory signals to the brain to relieve pain. The block can also help reduce inflammation. In some cases, a block is used as a diagnostic tool.

Rhizotomy: Rhizotomy is a procedure that uses hot electrodes to "close" the pain signals when applied to arteries.

Spinal Cord Stimulation: Spinal Cord Stimulation uses electrical energy in a pain source with the help of an implanted medical tool. Electrical signals block the brain's ability to detect symptoms of pain.

Conditions treated with Interventional Pain Management

Some of the conditions of pain and discomfort treated with pain management intervention strategies include

Arthritis.

Central pain syndromes (post-stroke pain, spinal cord injury.)

Cervical and lumbar strain.

Pain in the chest walls.

Chronic backache and neck pain.

Complex Regional Pain Syndrome ( CRPS)  Can be called Reflex Sympathetic Dystrophy).

Degenerative disc disease (cervical, thoracic and lumbar.)

Facet disease - cervical, thoracic and lumbar.

Facial pain - TMJ, neuromas (trauma), atypical facial pain

Headache (occipital neuralgia, migraines, headache, group headache.)

Herniated disc.

Unya.

Musculoskeletal pain.

Myofascial Pain Syndrome.

Peripheral or diabetic neuropathy.

Phantom limb pain / postoperative pain.

Postherpetic neuralgia and herpes zoster

Postoperative pain.

Post-traumatic pain syndrome.

Radiculopathy, cervical, thoracic and lumbar

Sacroiliac joint pain.

Whiplash-related issues.

Conclusion

Interventional pain procedures can be another beneficial option for those suffering from chronic pain who have not experienced relief from other pain management procedures. A doctor estimates that a minimum of 100 million Americans live with chronic pain. Usually, the pain makes it difficult to sleep and carry on daily activities and affects energy levels.

Interventional pain medicine uses a range of techniques. A team of health care professionals provides a comprehensive list of treatments and services to patients with chronic and or critical illnesses. Doctors implements interval methods when pain is significant enough to create disturbance in daily routine.

[physical-and-procedural-medicine]

Pain Management For Arthritis or Joint Pain

Managing pain is not easy when you get injured or have chronic arthritis. Still, it is crucial to get the right help for your pain management. Let’s know more about it.

No one can feel your pain. While various health professionals can help, you are the best person to manage your pain: knowing when treatment is working and when to get help. You may find it helpful to keep track of your symptoms, move them, and try different ways to control your pain.

Each treatment may be different depending on the type of pain you are experiencing or the type of arthritis you are experiencing. Dividing into short-term and long-term pain management strategies to help you understand the options.

Short-term pain relief intends to reduce the severity of the pain you experience at the moment, while long-term management of pain intends to reduce the effects of pain over time; in that case, you need to be involved and committed.

Where does arthritis pain come from?

As physicians continue to study the mechanisms of pain in the body, pain management doctor knows that most arthritis pain usually comes from one or more of these sources:

Inflammation - pressure on the nerves in and around the joints due to inflammation

Joint Damage - damage to the internal and adjacent tissues of the joints, nerves, or surrounding tissues due to long-term injury or inflammation.

Pain sensitivity - chronic pain can cause the body to send pain signals to the brain, even when there is no specific source of ongoing pain.

Some of the things that can contribute to your arthritis pain experience - how it feels to you - include

Physical activity - combined weight resulting from excessive or insufficient physical activity

Muscle tension - muscles can become tight due to stress, insufficient body function, or poor mobility

Fatigue - fatigue due to chronic pain management, inability to walk, or sleep deprivation due to pain may impair coping skills.

Anxiety or depression - stress and a low mood can increase pain intensity and reduce your coping ability.

Focusing on pain - a strong association between the mind and body means focusing on your pain can increase your pain sensitivity and reduce coping skills.

Attitude and belief system - your view of life can directly affect the level of pain you feel and your ability to cope.

Social environment and support - people with the support and understanding of families and social media feel less stressed and better cope with their pain than people who do not have that support. 

Physical activity / Exercise

Pain may cause you to avoid exercise for fear of getting injured again, because movement worsens your pain, or because you are tired. Pain relief center also provides facilities to help you reduce your pain through many exercises.

There are many benefits to exercise if you live with chronic pain. Regular exercise can increase your strength, stamina, and flexibility. Studies show that exercise helps people to manage their AC joint pain.

Getting started

There are a few fundamental ways that will help you get started:

Contact your healthcare team about exercise/exercise that will work for you if you are looking at your condition,

Start small and hold your own,

Find activities you like as you may be stuck with them over time,

Exercise with a friend,

Warming up before exercise and cool down afterward.

Types of exercise/physical activity

There are three main types of physical activity/exercise, and they are all crucial. Depending on your needs and abilities, you may be emphasizing one over another - a physiotherapist or other Pain management doctor who can help you determine your specific needs.

Extension and range of motion These tests are vital for people with arthritis or chronic pain as they risk losing flexibility. These exercises should be done daily and help reduce morning stiffness when you get up or just after a bath or shower.

While you may need to limit the range of motion of the burning joint when facing a flare, these exercises help rotate and maintain joint mobility.

Strengthening

These exercises use resistance to increase strength and control of muscle and bone strength and help reduce the risk of injury. These are important for the safety of standing.

Endurance or aerobics

These exercises increase your heart rate and include the use of large muscle groups in rhythmic or repetitive movements. These exercises also push you to breathe faster and work than doing throughout the day.

Conclusion

Although work is important, always listen to your body, especially if it gets swollen or if a joint or area is swollen or swollen. The sixth rule is that you may gain weight if your arthritis pain is severe two hours after physical activity.

Instead of stopping work altogether, the next time you do your work, limit your energy and the amount of time you spend on it and listen to your body again.

A good rule of thumb for determining the level of strength of exercise is "start over and move slowly." Remember that you know your body better, and it is crucial to listen to the signals you are sending.

Visiting pain management centers can help you deal with arthritis. Lifestyle will also be an essential factor, and physical and other therapies may be helpful.

[physical-and-procedural-medicine]

How does Pain Management Doctor Diagnose the Cause Of Pain?

Humans can experience different types of pain, and there are many ways to treat them. Here’s A to Z on how a pain management doctor diagnoses and treats the pain.

Pains such as headaches, joint aches, backaches, etc., are common, and everyone experiences them at some point in life. However, it is challenging to determine which treatments to try or best suited to keep the pain at bay.

So, to determine the treatment, diagnosing it’s essential to visit a pain management doctor. This article explains how pain management professionals diagnose the cause of pain.

Diagnoses of Pain

Your pain management specialist will examine you and evaluate the areas you are experiencing pain. The doctor may touch or press different places on your body to understand the root cause and ask about your pain. 

The healthcare provider may also suggest you keep the following to check how much pain you have or find the reason for the pain.

A pain diary

Maintaining a pain diary may help to find the cause of your pain. You can note your pain cycles for when it occurs. In your pain diary, you should note things such as when the pain starts, how long it lasts, how bad it was, etc., in your pain diary. Do not forget to include things that make the pain worse or better.

Pain scales

You can measure the level of pain you feel with the help of pain scales. The pain scale may include numbers or faces, and you are supposed to rate the pain on a scale of 1 to 10.

An X-ray, CT, or MRI scan

The healthcare provider may use an X-ray, CT, or MRI scan to find the cause of your pain. The doctor may give you contrast liquid to help the pictures show up better. Ensure to tell any allergic reactions to the healthcare provider. 

Stimulation tests 

These tests may help find nerves or muscles affected by the pain. Ways in which pain management professionals manage pain without medication. 

You might be surprised to know that you might not need pain medication to get rid of your pain. Pain management professional helps treat or eliminate all back pain or headaches.

When to Visit Pain Management Professionals?

Most pain is an expected outcome of an injury or illness and doesn’t usually require a trip to a healthcare provider. But how can you figure out if your pain is not a normal one but something serious? 

If you fall asleep in an uncomfortable or awkward position and wake up with pain in the neck or back is most likely normal. If you suffer minor first-degree burns, the pain associated with burns is normal and probably doesn’t require a doctor’s or a healthcare provider’s attention. 

If your pain only lasts for the minor amount of time you expect it to be, it’s probably normal. However, if the pain is severe, lasts longer than expected, and worsens with time, you may want to contact your pain management specialist without making any delays.

Let’s look at some examples of both normal and severe pain.

Causes of normal pain

A minor burn

Labor and delivery

A pulled or strained muscle.

Muscle, tendon, skin, or bone injury

A tension headache

A minor ankle sprain

A broken bone

A skinned elbow or knee

Post-surgical pain at the incision site

Sometimes pain that seems normal still requires a visit to the healthcare provider or the emergency room. If you got a severe injury, you should make no delays in consulting a doctor. 

Some causes of pain requiring medical attention:

Arthritis

Diabetes

Cancer

A compressed or pinched nerve

Chronic fatigue syndrome

Stroke

Fibromyalgia

Chronic migraine headaches

Sciatica

Heart attack

If the pain lasts for more than six months, the pain is severe and won’t go away on its own. A person can suffer many kinds of pain and may need many treatments for that pain. 

Pain makes doing normal things in day-to-day life difficult. Pain management centers can evaluate your pain and design a treatment that is best suited for you, which can help in easing your pain.

To conclude –

If you or your loved one is experiencing any pain that doesn’t seem normal, make no delays in seeking the medical help of a healthcare provider. If a pain started as usual but has elevated to severe pain and is not going away after months, a pain management doctor can help you ease the pain, as the doctor is an expert in diagnosing and treating such pains.

[physical-and-procedural-medicine]

Commonly Asked Questions About Physical Medicine and Rehabilitation

Physical medicine and rehabilitation (PM&R) work to restore the functional ability of physical impairments or disabilities. Here are some common questions about PM&R.

The American Board of Medical Specializations certifies PM&R as one of 24 medical specialties. PM&R provides integrated therapy for all brain, muscles, and bones problems, from traumatic brain injury to lower back pain.

What is physical medicine?

PM&R aims to improve and restore functional ability and quality of life in people with physical impairments or disabilities that affect the brain, spinal cord, bones, joints, ligaments, etc.

A physiatrist is a doctor who has completed specialized training in this specialty. Physiatrists aim to maximize patients' independence in daily activities and increase their quality of life, unlike other medical disciplines that focus on a medical "cure."

Physiatrists are skilled at complete, patient-centered treatment programs and are an essential part of the care team. They use cutting-edge and tried-and-true treatments to help their patients, who range from infants to octogenarians, improve their function and quality of life.

What is a physiatrist?

Since now you know what is physical medicine, you would better understand who a physiatrist is. Physiatrists, often known as rehabilitation physicians, are medical professionals:

Experts in pain diagnosis and treatment

Experts in regaining maximum function lost due to injury, illness, or other handicapping situations.

Treat the person as a whole, not just the problem.

In charge of a medical team

Make non-surgical treatments available.

Describe your medical issues and treatment options.

Work on both treatment and prevention.

Rehabilitation physicians are experts in the areas of nerves, muscles, and bones who treat injuries or illnesses that impact your ability to move. 

From aching shoulders to spinal cord injuries, rehabilitation physicians handle various issues. Their goal is to reduce pain and improve performance without resorting to surgery. 

Physicians specializing in rehabilitation spend the time necessary to establish the exact cause of an illness. They then devise a treatment plan that the patients can carry out on their own or with the assistance of the rehabilitation physician's medical team. 

Other physicians and health experts may be part of this medical team, such as neurologists, orthopedic surgeons, and physical therapists. 

Rehabilitation physicians assist patients in being as active as feasible at any age by offering an appropriate treatment plan. Their extensive medical knowledge enables them to treat debilitating disorders across a person's life.

What is the physician's role in treatment?

Once a diagnosis has been made, rehabilitation physicians create physical medicine treatment plans that the patients can follow on their own or with the assistance of the rehabilitation physician's medical team. 

Medical professionals such as neurologists, psychiatrists, orthopedic surgeons, urologists, and non-physician health professionals such as physical therapists, occupational therapists, speech pathologists, vocational counselors, psychologists, and social workers may be part of this interdisciplinary medical team. 

Each patient's team is unique, and the team's makeup shifts throughout treatment to meet the patient's changing needs. Rehabilitation physicians assist patients in being as active as feasible at any age by offering an appropriate treatment plan. Their extensive medical knowledge enables them to treat debilitating disorders across a person's life.

What type of treatment and procedures does a physician perform?

Physiatrists perform the following physical medicine treatments:

Therapeutic exercise

Prosthetics/orthotics

Pain medications

EMG (electromyography)

NCS (nerve conduction studies)

Soft tissue injections

Joint injections

Spine injections

Musculoskeletal ultrasound

Interventional spinal therapeutics

Spasticity management

What are some of the most common medical issues that physiatrists treat?

Physiatrists diagnose and create physical medicine treatments plan to treat a wide range of patients suffering from several illnesses, including:

Back pain

Neck pain

Strokes

Brain injuries

Neuromuscular disorders

Sports injuries

Spinal cord injuries

Arthritis

Carpal tunnel

Herniated disc

Pinched nerve in the neck or back

Sciatica

Fibromyalgia

Work injuries

Amputees

Parkinson's disease

Multiple sclerosis

Guillain-Barre syndrome

Cancer rehabilitation

Pelvic floor disorders

What does a rehabilitation physician's practice involve?

A rehabilitation physician's role is to treat any handicap caused by disease or injury to any organ system. 

The focus is not on a single portion of the body but instead on creating a holistic program for putting the pieces of a person's life back together after injury or disease - physically, socially, emotionally, and vocationally.

To Conclude:

Physiatrists focus on the bigger picture. Their education is diverse, allowing them to examine the entire body rather than just one organ. 

Physiatrists can help locate difficult-to-diagnose pain by looking at the interactions between all of the body's moving parts. A physical medicine and rehabilitation physician aims to help patients with injuries, diseases, and disorders regain the function of their bodies.

[physical-and-procedural-medicine]

Role of Physical Medicine and Rehabilitation Physicians

Physical medicine and rehabilitation (PM&R) treat a wide range of conditions, including impairments and limitations of the brain, spinal cord, etc. Here's a brief about PM&R.

Physicians who specialize in Physical medicine and rehabilitation (PM&R), often known as physiatrists, focus on diagnosing, treating, and rehabilitating patients who suffered injuries and get disabled by disease, disorder, or accident.

What is PM&R?

What is physical medicine and rehabilitation is a commonly asked question. PM&R, commonly known as physiatry, is a medical specialty that focuses on helping people regain function after being handicapped by a disease, condition, or injury.

Physiatry is a branch of medicine that provides integrated, interdisciplinary care to help people restore their full selves by addressing their physical, emotional, medical, vocational, and social requirements. So, a physiatrist or a PM&R physician is a doctor specializing in physical medicine and rehabilitation.

Understanding rehabilitation?

The procedure of assisting a person in achieving maximum function, independence, and quality of life is called rehabilitation. Rehab does not repair or undo the damage caused by sickness or accident, but it helps restore a person's health and well-being. The word "rehabilitate" means "to render capable."

The Program of Rehabilitation

Since rehabilitation medicine is designed per each individual's needs, each program is unique. The following are some general therapy components for rehab programs:

Taking care of the impairment and enhancing function

Providing adaptive tools and a change in the environment

Teaching the patient and their family about the changes in their lifestyle and assisting them in adapting to them

Many factors determine the success of rehabilitation, including:

The disease, disorder, or injury's nature and severity

Any resulting impairments and disabilities and the type and severity of said impairments and disabilities

The patient's general well-being

Support from family

What is a PM&R physician?

Since now you know what is physical medicine, you can get a good idea of who a PM&R physician is. PM&R physicians, sometimes known as physiatrists, treat various medical disorders affecting the brain, spinal cord, bones, joints, muscles, tendons, etc.

Their role is to enhance mobility and overall quality of life. Physicians who specialize in PM&R look at the patient as a full person, not just one part of the body.

What Does a PM&R Physician Do?

PM&R physicians can address physical medical issues affecting any part of the body.

Physicians at PM&R provide treatment strategies for clients of all ages. 

They'll assess your condition, needs, and objectives, rule out any major medical causes for your problems, and devise a physical medicine treatments plan to assist you in achieving your goals.

How Can a Physician Help?

Physicians specializing in PM&R devise a comprehensive plan to assist their patients physically, socially, emotionally, and vocationally. They can help you manage various physical issues and keep you as active as possible at any age.

There is a good chance of PM&R physicians prescribing braces or splints to improve arm or leg position or function to assist you in moving more safely if you have experienced physical damage. 

Wheelchairs, standers, walkers, bath benches, and lifts are examples of this type of equipment.

What Condition Does a PM&R Physician Treat?

PM&R doctors deal with issues that arise from an injury, sickness, or chronic condition. The following are the most common physical medicine treatments:

Rehab for medical conditions

Rehabilitation in pain-neuromuscular medicine

Medicine of the musculoskeletal system

Disorders of the central nervous system 

Rehabilitation for children

Physical medicine and rehabilitation are the two main areas where a PM&R physician specializes.

How Does the Physician Diagnose the Illness?

Physiatrists evaluate musculoskeletal injuries and issues by taking a complete medical history and thorough physical examination. Laboratory tests, X-rays, MRI scans, electromyography, nerve conduction studies, and psychological evaluations may be used to diagnose the problem further.

Reasons to see a PM&R physician.

A visit to a PM&R physician may be necessary if you have experienced physical injuries, discomfort, or mobility issues.

They can identify and design physical medicine treatments linked to impairments, such as:

Cognitive problems

Orthopedic issues

Mobility concerns

Bowel and bladder problems

Disorders that affect your walking

Feeding and swallowing problems

Trouble with communication

Pain

Muscle stiffness or poor muscle tone

Depending on your needs, a PM&R physician might collaborate with a team of neurologists, orthopedists, neurosurgeons, physical therapists, occupational therapists, speech therapists, and primary care doctors.

To Conclude:

To enhance total rehabilitation and prevent the recurrence of back pain or other sources of dysfunction, physical medicine and rehabilitation physicians try to treat the full patient, not just the individual injury or ailment. 

From a physical, emotional, psychological, and occupational standpoint, the treatment goals are always to restore the patient's normal function and increase the quality of life.