A Cancer Rehabilitation Story

Providing a dynamic diagnosis method part 2

In this second newsletter I would like to follow up with the interesting case that I shared with you last week. As a reminder, a new patient called for an appointment due to the onset of shoulder pain. At the evaluation, he reported sudden onset of pain earlier in the week, a high fever, and instruction to go to the ER by his physician. At the ER the patient was left waiting for nearly 12 hours and after examination, he was prescribed pain medication and sent home. The pain did not resolve, and so he was seeking PT evaluation to identify if the cause was muscle or skeletal. As I performed my examination I observed that the pain was not typical of muscle injury or skeletal impairments. I suspected an inflamed lymph node as the cause of the pain, likely due to an infection which could explain the high fever. I recommended that the patient call his physician and ask about antibiotic prescriptions. CT Scan or MRI would be indicated if no improvements were observed within 3 days of that.

The patient called his MD who ordered antibiotics (AB) for the patient. The patient began his AB however was still in pain after the first day and went back to the ER and requested a CT scan. The patient reported that his CT scan did not reveal any concerns for a tumor and that his pain completely resolved within 3 days of his AB treatment. A great success for the patient! It is important to realize that a physical therapist cannot prescribe medication, nor can a PT refer a patient for medical imaging. Nevertheless, a well trained, highly educated and experienced doctor of physical therapy should be able to diagnose patients’ pain as either being musculoskeletal and thus within the scope of practice of a PT, or non-muscular or skeletal and thus not within the scope of treatment of a PT.

Come on in for your evaluation today and get back to life.