FAQs

Q?

What type of Rehabilitation programs are provided at MetroMed?

A.

MetroMed HealthCare Centre provides Interdisciplinary Pain and Occupational Rehabilitation Programs.

1) Interdisciplinary Pain Rehabilitation Program

An interdisciplinary pain rehabilitation program provides outcomes-focused, coordinated, goal-oriented interdisciplinary team services. The program delivers services that focus on the unique needs of patientns who have persistent pain, including:

— Minimizing impairments and secondary complications.

— Reducing activity limitations.

— Maximizing participation and quality of life.

— Decreasing environmental barriers.

An interdisciplinary pain rehabilitation program recognizes the individuality, preferences, strengths, and needs of the persons served, their families/support systems, and stakeholders.

This program encourages appropriate use of healthcare systems and services by the persons served and their families/support systems, and supports their efforts to promote personal health and wellness and improve quality of life throughout their life span. The program provides ongoing access to information, services, and resources available to enhance the lives of the patients within their families/support systems, communities, and life roles.

An interdisciplinary pain rehabilitation program fosters an integrated system of care that optimizes prevention, recovery, adaptation, inclusion, and participation. The program utilizes current research and evidence to provide effective rehabilitation and supports future improvements in care by advocating for or participating in pain research.

2) Occupational Rehabilitation Program

An Occupational Rehabilitation Program is individualized, focused on return to work, anddesigned to minimize risk to and optimize the work capability of the patients served. The services provided by MetroMed are integrative in nature, with the capability of addressing the work, health, and rehabilitation needs of those served. Such a program provides for service coordination and management of those persons served with injuries or illnesses. In view of the multiple stakeholders involved in Occupational Rehabilitation Programs, informed consent to obtain or share information about the persons served is provided by the persons served as required.

This Medical Rehabilitation Program  program may be provided as a hospital-based program, an outpatient program, or a private group practice, and/or it may be provided in a work environment (at the job site).

Note: For Canadian providers of Occupational Rehabilitation Programs, the concept of occupation is broader than a person’s employment and might include functional roles such as homemaker, student, volunteer, etc.

3) Occupational Rehabilitation Program—Comprehensive Services

Persons admitted to an Occupational Rehabilitation Program—Comprehensive Services tend to have more complex needs due the nature of their injury, illness, or impairment; length of time they have been off work; home or work circumstances; or other reasons. Through the comprehensive assessment and treatment provided by occupational rehabilitation specialists, Occupational Rehabilitation Program—Comprehensive Services directly provide and coordinate services to address the behavioral, functional, medical, physical, psychological, and vocational components of employ-ability and return to work.

Q?

What types of pain are treated at MetroMed?

A.

Our medical practitioners treat all types of pain. Acute pain is described as severe or sharp and may signal something is wrong. Pain lasting 6 months or longer is defined as chronic. This type of pain varies from mild to severe and is consistent. Spinal arthritis (spondylosis) pain is often chronic. Although chronic pain is difficult to manage, combining different treatments often produces a good outcome.

  • Degenerative disc disease
  • Facet joint pain
  • Sciatica
  • Cervical and/or lumbar spinal stenosis
  • Spondylolisthesis
  • Vertebral compression fracture
  • Whiplash

Q?

What to expect during an appointment?

A.

Pain specialists perform a physical and neurological examination, and review your medical history paying particular attention to pain history. The focus is on your pain, the cause or contributing factors, and quickly managing it. You may be asked many questions about your pain, including:

  • On a scale from zero to 10, with 10 being the worse pain imaginable, rate your pain.
  • When did pain start? What were you doing when pain started?
  • Does pain spread into other areas of the body?
  • Is its intensity constant, or is it worse at different times of the day or night?
  • What helps to relieve the pain? What makes pain worse?
  • What treatments have you tried? What worked? What failed?
  • Do you take over-the-counter medications, vitamins, or herbal supplements?
  • Do you take prescription medication? If so, what, how much, and how often?

Q?

What is the purpose of Physiotherapy?

A.

The purpose of physical therapy is to help the patient return to active life as quickly as possible. Therapy strives to reduce pain, increase flexibility, range of motion, and function, build strength, and correct posture.

Physical therapy is often prescribed for patients following spine surgery, to treat soft tissue trauma, nerve inflammation/injury, muscle spasms, fractures, arthritis, and many other problems.

Patient education is an important component in physical therapy. Patients learn about how their spine works, proper body mechanics, common disorders and their causes, benefits of good posture, importance of physical fitness and its relationship to injury and disease prevention.

Q?

What does the physical therapist do?

A.

The physical therapist talks to the patient and evaluates their condition by testing joint motion, muscle strength, cardiovascular function, reflexes, and functional skills. If a physician referred the patient, the therapist will review the prescription along with the patient's records. After necessary information has been gathered, the physical therapist designs a treatment plan to fit the patient's needs and goals. The therapist and patient will work together as a team toward wellness.

Q?

Is physical therapy painful?

A.

Sometimes PT is uncomfortable or painful. However, the therapist has treatments available that can help minimize pain. As muscles are stretched and exercised, it is only natural to experience some soreness. As therapy progresses, range of motion increases, strength and soreness diminishes. In general, patients feel better following therapy and look forward to the next session.

Q?

How long does a therapy session last?

A.

The amount of time needed depends on the type of therapy involved. For example, it may take one patient longer to complete their therapeutic exercises than another. Also, as a patient makes progress, their treatment plan is adjusted.

Q?

What is a Catastrophic Injury?

A.

Catastrophic injuries are extreme injuries that arise from a motor vehicle accident that cause:

  • Paraplegia or quadriplegia – paralysis that results in the partial or total loss of use of the limbs and torso;
  • The amputation of an arm or a leg or other impairment causing the total and permanent loss of use of an arm or a leg;
  • The total loss of vision in both eyes;
  • Brain impairment that results in a score of 9 or less on the Glasgow Coma Scale, or a scale of 2 (vegetative) or 3 (severe disability) on the Glasgow Outcome Scale;
  • Any impairment or combination of impairments that results in a 55 percent or more impairment of the whole person;
  • Any impairment that results in a class 4 impairment  or class five impairment (extreme impairment) due to mental or behavioural disorder

Q?

What do Chiropractors do?

A.

14As alternative medicine practitioners, chiropractors do a lot of things, and they treat a variety of ailments, based largely on a scientifically-invalid vertebral subluxation theory which proposes that nerve interference resulting from a misaligned vertebra or a dysfunctional spinal segment can affect general health.

Q?

Are subluxations causing my health problems?

A.

A spinal nerve is rarely compressed by a misaligned vertebra. When a spinal nerve is compressed, usually by disc herniation or osteophyte formation, symptoms occur in the musculoskeletal structures supplied by the affected nerve but the body’s organs are not affected. Severance of the spinal cord at or above the 4th cervical vertebra, shutting off brain impulses to spinal nerves, can cause paralysis of muscles from the neck down while the body’s organs continue to function.

Although the original theory of chiropractic defines a subluxation as a vertebral misalignment that places pressure on a spinal nerve, more recent theories define a subluxation as a “vertebral subluxation complex” that affects nerve, blood vessel, and connective tissue structures in a spinal segment, causing nerve interference without misalignment of a vertebra. Both types of subluxations are alleged to affect general health; neither has been proven to exist. Nevertheless, it is common practice among chiropractors to treat a health problem by adjusting the spine to “realign the vertebrae” or to “remove nerve interference.”

Q?

Why is every chiropractor’s treatment different?

A.

The techniques of manual generic spinal manipulation performed by science-based practitioners are pretty much the same, no matter who does the manipulation, whether done by a chiropractor, a physical therapist, an osteopath, or a physiatrist. Spinal manipulation, called a “spinal adjustment,” performed by subluxation-based chiropractors, however, may involve dozens of different techniques, each one different from the other, some of which do not require manual manipulation of the spine, none of which are compatible with conventional manual therapy.

Chiropractic: An Illustrated History, published in 1995 by Mosby-Year Book, listed 97 different chiropractic techniques, ranging from Activator Technique to Zindler Reflex Technique. When a patient goes from one chiropractor to another, each using a different technique that is claimed to be superior to the other, an apparent lack of standards would suggest that it might be best to bypass the chiropractor and seek manipulative care from a physical therapist or an orthopedic manual therapist.

Q?

What is that “thumper” my chiropractor uses on my back?

A.

An adjusting instrument using a spring-loaded stylus.

An adjusting instrument using a spring-loaded stylus.

Once a patient has been convinced that his or her spine harbors vertebral subluxations that can cause disease or affect general health, any one of dozens of chiropractic adjustive techniques might be used to correct and prevent recurrence of such subluxations. One of the most bizarre methods of adjusting the spine uses a handheld instrument with a spring-loaded or electrically powered mallet or stylus to tap on selected vertebrae. A dubious leg-length check might be used to determine if correct alignment has been restored, a procedure so implausible that it is the subject of many of the letters I have received from chiropractic patients.

Some computerized adjusting instruments use a piezoelectric sensor that will allegedly locate and correct a vertebral subluxation by analyzing the echo of an oscillating force applied to a vertebra. Such an instrument has proved to be an effective way to sell chiropractic care and is often advertised as “advanced chiropractic technology.” While some chiropractors genuinely believe that the vertebral subluxation theory is valid, subluxation-based “chiropractic technologies” have more to do with marketing than with health care.