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6 | Health Matters: Providence St. Jude Medical Center B ack pain is common. Unfortunately, quick access to successful treatment is not. "Those with back pain often end up seeing multiple doctors, waiting for imaging that offers little or no useful information, and pursuing solutions with no proven benefit," explains Natalia Covarrubias, MD, a board- certified physical medicine and rehabilitation physician at Providence St. Jude. "All of which delays recovery." The St. Jude Back Pain Program uniquely offers patients evidence-based care that avoids the wrong turns and delays often characterizing treatment. "Through a comprehensive musculoskeletal exam we can usually identify the cause and degree of impairment," explains Philip Molina, DPT, a board-certified orthopedic physical therapist experienced in evidence-based approaches to back pain. "Treatment begins during the patient's first appointment." The vast majority of patients, especially those with lower back pain, are successfully treated with noninvasive therapies, which can range from therapeutic exercise and myofascial release to acupuncture and biofeedback. But if more complex care is needed, a Physical Medicine and Rehabilitation physician directs and coordinates the next steps, whether that means a referral to a spine surgeon, more advanced pain interventions, or additional testing. "Having a board-certified rehabilitation physician oversee and 'quarter back' your treatment offers a huge advantage," says Philip. "Their expertise allows patients to sidestep common mistakes, such as waiting to see the wrong specialist." Case in point: Studies show that most back pain referrals sent to orthopedic surgeons fall outside their area of specialty. "We offer care that is convenient, streamlined and highly effective," he explains. "The trifecta of great back care." To make an appointment with the St. Jude Back Pain Program, please call 714-578-8720. A physician referral is needed. V ertigo, dizziness, and balance issues can range from a mild nuisance lasting seconds to putting you flat on your back in bed for weeks. Yet in the search for solutions, many don't know that assessment and treatment by a physical therapist who specializes in vestibular and balance issues is often the most successful answer. "Often patients suffer for months or years with an issue that we can resolve in a few sessions," explains Lori Morris, PT, NCS, a physical therapist with advanced training in neurological, balance and vestibular deficits. In fact, for positional vertigo, the most common cause of dizziness, an individual's symptoms are often eliminated in a single visit. For some, dizziness or poor balance are triggered by "visually busy" areas such as grocery stores, bending down to garden or pick something up, or simply walking on uneven ground. For others, just turning over in bed can create light-headedness and nausea. Causes can include Meniere's disease, concussion, and neck pain caused by tension and muscle inflammation (called cervicogenic dizziness), but most often the problem is the vestibular system. Located inside the ear, the vestibular system provides the brain information about motion, head position, and spatial orientation—making it essential for normal movement and equilibrium. "If there is miscommunication between the brain, eyes, and inner ear, the result is dizziness and unsteadiness," explains Lori. Testing—from gait and postural control assessments, to visual acuity and oculomotor function evaluations—allow the program's therapists to identify weakness in the vestibular and sensory systems. The next step is training the brain and nervous system to adapt and compensate. Individualized therapy might include canalith repositioning procedures, balance retraining, eye exercises to improve coordination with head movements, or any of a dozen other evidence-based strategies and treatments. "It's rare that we can't improve or restore function," says Lori. "Vestibular disorders can wreak havoc on every aspect of daily living, often creating anxiety, depression or isolation. It's very gratifying to return patients to their lives." To make an appointment with a therapist specializing in vestibular and balance issues, please call 714-578-8720. A physician referral is needed. A Better Approach to Back Pain From simple muscle strain to more complex issues Making the Spinning Stop Expert help with finding your footing again

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