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DESCRIPTION
James, a 47-year old refinery pipe fitter, felt a 'pull' in his neck while operating a pallet jack. Over the
weekend, pain and stiffness extended to his right shoulder. On Monday, he was sent to the doctor who subsequently
referred to CORA for physical therapy.
TREATMENT GOALS
During the evaluation, James' physical therapist developed a specific plan of care for his return to full duty
employment. At this point, the insurance case manger became involved and assisted with coordination of a modified
duty job, physical therapy and return to work programs.
- Return to work with no restrictions.
- Increase cervical rotation to facilitate needed skills required for driving.
- Eliminate inflammation and spasm to allow normal, uninterrupted sleep.
PLAN OF CARE
A treatment program was developed relative to James' specific job requirements, current condition and the available
modified job. The case manager and occupational health nurse were intimately involved throughout the rehabilitation
process. Additionally, the physical therapist incorporated useful knowledge obtained during a jobsite visit into the
treatment plan.
Initially, James' physical therapist used manual techniques and mobilizations to help reduce muscle spasms and
to restore normal joint motion. A home traction device was ordered, which combined with a home exercise program,
promoted proper joint alignment, pain reduction and thereby prolonged sleep at greater intervals.
As mobility increased, gentle stretches were progressed to purposeful and job specific movement. Also, the home
program evolved to include progressive techniques to perform self-mobilization, isometric strengthening, and gentle
stretching.
OUTCOMES
The case manager requested the therapist perform a jobsite analysis in preparation for James' return to full work
status. While there, recommendations were made for safety modifications and instruction was provided to James'
supervisor relative to his use of pacing skills and intermittent stretching to reduce the risk of re-injury.
Good motivation and steady progression of increased motion and strength led to James' release to full work duty.
He returned to work with minimal residual affects, while experiencing no lost workdays.
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