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Physical Therapy and MS

By Matt Cavallo

Physical therapy is the treatment of an injury, disease, or other deformity through physical interventions including exercise, heat, ice, or massage. Physical therapy is performed by licensed physical therapists. According to the APTA, PTs are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility.

PTs practice in a variety of care settings including hospitals, inpatient rehabilitation facilities, skilled nursing or extended care, outpatient practices or home health. Physical therapy is an alternative to drugs or surgery in some cases. PTs also educate their patient on how to prevent or manage their condition in order to help them achieve long-term health benefits.

From diagnosis to long-term management of the disease, physical therapy can be an important component of living well with MS. Physical therapy can help a person living with MS manage many symptoms including:

To manage the symptoms, there are generally three types of visits with a PT:
  • Initial evaluation – The initial evaluation is your first appointment where you will visit with a PT to discuss your symptoms, as well as be evaluated in your area of concern (i.e., walking). During this evaluation, a plan of care will be established which will include the frequency and duration that the PT recommends for treatments (follow-up visits).
  • Treatments – Treatments are the follow-up appointments that focus on physical interventions to address your area of concern. Treatment interventions could include gait training, strength and conditioning, and manual manipulation (i.e., massage) designed to help you work on your deficit. Home exercises could also be introduced to help you continue your recovery at home in between appointments.
  • Re-evaluation or discharge – The final appointment is a re-evaluation to assess the progress you have made in your area of concern. During this time, the PT may recommend more visits or discharge you from therapy.

Throughout therapy, the PT may prescribe durable medical equipment, which could include gait-aids like ankle foot orthosis devices or walkers, therabands, and home traction. PTs are educators and will show you how to use prescribed DMEs safely. PTs will also show you how to safely perform your home exercise plan for continued success outside of the appointments. They will also teach you compensatory strategies, or techniques to make up for your deficits, which will promote safety and help you achieve the best quality of life despite MS.

Most states and insurance plans require a referral from a doctor to start physical therapy. Refer to the benefits of your policy to determine whether or not you need to consult with your doctor before starting therapy. Your neurologist can also write you a referral for PT. Once you have completed your initial evaluation, the PT will recommend the amount of visits that you need to work on your area of concern. Most insurance plans will allow for a certain number of visits either during the year or per plan of care. Before starting therapy, make sure that you validate your benefits and eligibility with the physical therapy center, so you can learn what financial responsibility you may have.

Physical therapy is an important part of an overall wellness strategy to achieve the best possible outcomes while living with MS. A physical therapist can help you manage, improve, or prevent symptoms, while educating you on how to work on your deficits at home. Working with a PT may also reduce pain and the need for prescriptions, while improving functionality, strength, and conditioning. It is important to understand your insurance benefits, so that you make sure you are covered. If you are living with MS and want to learn more about the benefits of physical therapy, talk to your doctor or neurologist.