Frequently Asked Questions (FAQ)
What happens during my first visit?
During your first visit you can expect the following:
- Arrive at your appointment with your paperwork completed (you can download it from our website - see the paperwork or forms link)
- You will provide us with your prescription for therapy.
- We will copy your insurance card.
- You will be seen for the initial evaluation by the therapist.
- The therapist will discuss the following:
- Your medical history.
- Your current problems/complaints.
- Pain intensity, what aggravates and eases the problem.
- How this is impacting your daily activities or your functional limitations.
- Your goals with therapy.
- Medications, tests, and procedures related to your health.
- The therapist will then perform the objective evaluation which may include some of the following:
- Palpation - touching around the area of the pain/problem. This is done to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
- Range of Motion (ROM) - the therapist will move the joint(s) to check for the quality of movement and any restrictions.
- Muscle Testing - the therapist is checking for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.
- Neurological Screening - the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
- Special Tests - the therapist may perform special tests to confirm/rule out the presence of additional problems.
- Posture Assessment - the positions of joints relative to ideal and each other may be assessed.
The therapist will then formulate a list of problems you are having, and how to treat those problems. A plan is subsequently developed with the patient's input. This includes how many times you should see the therapist per week, how many weeks you will need therapy, home programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy. This plan is created from input from you, your therapist, and your doctor.
What do I need to bring with me?
Make sure you bring your therapy prescription (provided to you by your doctor) and your payment information. If your insurance is covering the cost of occupational therapy, bring your insurance card. If you're covered by Workers' Compensation, bring your claim number and your case manager's contact information. If you are being covered by auto insurance or an attorney lien, make sure you bring this information.
How should I dress?
You should wear loose fitting clothing so you can expose the area that we will be evaluating and treating. For example, if you have a knee problem, it is best to wear shorts. For a shoulder problem, a tank top is a good choice, and for low back problems, wear a loose fitting shirt and pants, again so we can perform a thorough examination.
How long will each treatment last?
Treatment sessions typically last 45 to 60 minutes per visit.
How many visits will I need?
This is highly variable. You may need one visit or you may need months of care. It depends on your diagnosis, the severity of your impairments, your past medical history, etc. You will be re-evaluated on a weekly basis and when you see your doctor, we will provide you with a progress report with our recommendations.
Why is occupational therapy a good choice?
More than half of all Americans are suffering from pain. Whether it is a recent episode or chronic, an ABC News/Stanford study revealed that pain in America is a serious problem. However, many don't even know that occupational therapists are well equipped to not only treat pain but also its source.
Occupational therapists are experts at treating movement and neuro-musculoskeletal disorders. Pain often accompanies a movement disorder and occupational therapists can help correct the disorder and relieve the pain.
What do occupational therapists do?
Based upon their training in human anatomy and physiology, knowledge of various disabilities and diseases human development, psychology, adaptive technology, and standardized and non-standardized assessments of functioning, OTs evaluate their clients' functional abilities and limitations in a number of different settings and roles. For example, the OT may look at how the person functions in school, home, or work settings as a student, caregiver, or employee. As part of the evaluation, the OT interviews the client in order to get a good sense of the client's priorities. The OT then incorporates all of this material into a treatment plan that outlines specific goals and breaks down those goals into manageable steps.
OT treatment usually consists of weekly or regular sessions in which the OT helps the client to practice the skills that will enable the person to be more functional. This may include being able to accomplish everyday tasks (also known as activities of daily living) such as brushing teeth, preparing a snack, or making a grocery list.
According to the American Occupational Therapy Association (AOTA), in addition to dealing with an individual's physical well-being, occupational therapy practitioners address psychological, social, and environmental factors that may hinder an individual's functioning in different ways.
Who pays for the treatment?
In most cases health insurance, Medicare, Tricare, the Workers' Compensation system, etc will cover your treatment. Depending on your particular plan, you may/will be responsible for co-payments or deductibles. Please make sure to talk to our receptionist so we can help you clarify your insurance coverage.
Who will see me?
You will be evaluated by one of our licensed and highly trained occupational therapists and he/she will also treat you during subsequent visits. Unlike some clinics where you see someone different each visit, we feel it is very important to develop a one-on-one relationship with you to maintain continuity of care. Since only one occupational therapist knows your problems best, he/she is the one that will be working closely with you to speed your recovery.
Are there occupational therapy specialists?
Occupational therapists are healthcare workers who work with people with disabilities, the elderly, newborns, school-aged children, and with anyone who has a permanent or temporary impairment in their physical or mental functioning. The aim of occupational therapy is to help the client to perform daily tasks in their living and working environments, and to assist them to develop the skills to live independent, satisfying, and productive lives.
Interventions used by occupational therapists to achieve greater independence by clients include rehabilitation of:
- Rotator cuff dysfunction.
- Shoulder instability.
- Sport-specific injuries to the upper extremity.
- Neuropsychological deficits (memory, attention, complex reasoning).
- Motor function.
- Sensory function (vision, perception of touch).
- Interpersonal skills (e.g., social skills).
The medium of treatment usually involves the use of purposeful activities, which have some meaning and relevance to clients' lifestyle (these are also called 'occupations' and include routine behaviors associated with work, leisure and self care.)
There are two primary ways that OT can improve people's lives. The occupational therapist (OT) can adapt the person's environment, such as replacing round door knobs with lever door handles, or teach the person strategies to simplify or make a task easier to perform, such using more efficient movements when handwriting. Or, the OT can teach a person new skills that enable him to be more independent or reach a developmental milestone, such as helping a child to learn how to use a pincer grasp to pick up finger foods. Sometimes the OT instructs the client how to strengthen a part of the body so that the person is better able to accomplish a task without adaptations. For example, the OT may create an exercise program for someone with weak arm muscles, so that the person can be more active.
An additional way that OT helps people is through pain management strategies. This can include teaching a child better ways to use his body, or creating splints to hold his fingers in a resting position.
Source: wikipedia.org, www.ontheotherhand.org
Is occupational therapy painful?
For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on techniques, modalities such as ultrasound, electrical stimulation, and/or heat or cold therapy. Movement often provides pain relief as well. Your occupational therapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.
In some cases, occupational therapy techniques can be painful. For example, recovering shoulder range of motion after shoulder surgery may be painful. Your occupational therapist will utilize a variety of techniques to help maximize your treatment goals. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.
What types of treatments will I receive?
There are dozens of different types of treatment interventions. Here is a list of treatment interventions:
Active Range of Motion (AROM) - the patient lifts or moves a body part through range of motion against gravity. AROM is usually one of the first modalities prescribed for arthritis.
Active Assistive Range of Motion (AAROM) - therapist-assisted active range of motion. This is usually prescribed for gentle stretching or strengthening for a very weak body part.
Stationary Bicycle - with or without resistance. This is usually prescribed for improving the strength and/or range of motion of the shoulder and mid back as well as cardio-vascular endurance.
Isometrics - muscle contraction without joint movement. This is usually prescribed for strengthening without stressing or damaging the joint, e.g. arthritis, or exercises to be performed in a cast, or right after surgery if recommended by the therapist/doctor.
Isotonics- muscle(s) contracting through the ROM with resistance. This is usually prescribed for strengthening.
Soft Tissue Mobilization - therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.
Mobilization - hands-on therapeutic procedures intended to increase soft tissue or joint mobility. Mobilization is usually prescribed to increase mobility, delaying progressive stiffness, and to relieve pain. There are many types of mobilization techinques including Maitland, Kaltenborn, Isometric Mobilizations, etc.
Proprioceptive Neuromuscular Facilitation (PNF) - a system of manually resisted exercises performed in diagonal patterns that mimic functional movements. Initially used in developmentally and neurologically impaired patients, but now used in almost every aspect of neuromuscular retraining from athletes in sports facilities to the very weak in hospitals and nursing homes.
Posture Training - instruction in the correct biomechanical alignment of the body to reduce undue strain on muscles, joints, ligaments, discs, and other soft tissues. There is an ideal posture but most do not have ideal posture. Therapists educate patients about the importance of improving posture with daily activities. Stretching and strengthening exercises may be prescribed to facilitate postural improvement and to prevent further disability and future recurrences of problems.
Progressive Resistive Exercises (PRE) - exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.
Passive Range of Motion (PROM) - the patient or therapist moves the body part through a range of motion without the use of the muscles that "actively" move the joint(s).
Stretching/Flexibility Exercise - exercise designed to lengthen muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.
Cryotherapy or Cold Therapy - used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain.
Neck Traction - a gentle longitudinal/axial pull on the neck, either manual or mechanical, intermittent or continuous for relief of neck pain, to decrease muscle spasm, and facilitate unloading of the spine.
Heat - heat is recommended to decrease chronic pain, relax muscles, and for pain relief. It should not be used with an acute or "new" injury.
Iontophoresis - medications are propelled through the skin by an electrical charge. This modality works on the physical concept that like charges repel each other, therefore, a positively charged medication will be repelled through the skin to the underlying tissues by the positively charged pad of an iontophoresis machine. Iontophoresis is usually prescribed for injuries such as shoulder or elbow bursitis.
Transcutaneous Electrical Nerve Stimulation (TENS) - a relatively low voltage applied over painful areas through small self-adhesive electrodes. The electrical stimulation "disguises" or "overrides" the sensation of pain. It is a small, portable unit, used in intervals, to control pain and reduce dependence on drugs. It is usually prescribed for relief of pain.
Ultrasound - ultrasound uses a high frequency sound wave emitted from the sound head when electricity is passed through a quartz crystal. The sound waves cause the vibration of water molecules deep within tissue causing a heating effect. When the sound waves are pulsed, they cause a vibration of the tissue rather than heating. The stream of sound waves helps with nutrition exchange at the cellular level and healing. Studies have shown that ultrasound is helpful for ligament healing and clinically, for carpal tunnel syndrome, and muscle spasm.
Whirlpool - immersion of a body part into water with small "agitators" to provide a gentle massaging motion. A warm whirlpool provides relief from pain and muscle spasm and is often preparatory to stretching or exercise. Cold whirlpool is used to decrease inflammation and swelling.
Will I get a massage?
Massage may be part of your treatment. Rehabilitation specialists are trained in a variety of techniques that may help with your recovery. Deep tissue techniques, may be part of the rehabilitative process. Massage is used for three reasons typically - to facilitate venous return from a swollen area, to relax a tight muscle, or to relieve pain. Contrary to common thought, massage does not increase circulation.
What happens if my problem or pain returns?
Flare ups are not uncommon. If you have a flare up (exacerbation), give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.
Can I go to any occupational therapy clinic?
In most cases, you have the right to choose any occupational therapy clinic. Our clinic may not be a provider for your insurance plan. You can still come to our clinic, but it is likely that you will have to pay out-of-pocket for the treatments.
The best thing to do is give us a call and we will attempt to answer all of your questions.
How does the billing process work?
Billing for occupational therapy services is similar to what happens at your doctor's office. When you are seen for treatment the following occurs:
- The occupational therapist bills your insurance company, Worker's Comp, or charges you based on CPT (Common Procedure Terminology) codes.
- Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.
- The payer processes this information and makes payments according to an agreed upon fee schedule.
- An EOB (Explanation of Benefits) is generated and sent to the patient and the occupational therapy clinic with a check for payment and a balance due by the patient.
- The patient is expected to make the payment on the balance if any.
It is important to understand that there are many small steps (beyond the outline provided above) within the process. Exceptions are common to the above example as well. At any time along the way, information may be missing, mis-communicated, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 60 days or less, it is not uncommon for the occupational therapy clinic to receive payment as long as 6 months after the treatment date.
What will I have to do after occupational therapy?
Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program. Others will complete their rehabilitation and return to normal daily activities. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you.
Is my therapist licensed?
Occupational therapists (OT's) and certified occupational therapy assistants (COTA's) are licensed by their respective states.
How do I choose an occupational therapy clinic?
- Do they have a service that can address your problem?
- Do they take your insurance or are they willing to work with you if they are not a preferred provider?
- What are the hours of operation?
- Can they provide satisfaction survey results?
- Do they accept your insurance?
- The therapist should provide the treatment.
- Can you briefly interview the therapist before the first visit?
- Ask your family and friends who they would recommend.
- Do they possess specialty certifications in areas that directy relate to the kind of treatment I require?