MetroHealth’s Musculoskeletal Rehabilitation Program is a dedicated, physician-supervised program that helps patients recover from musculoskeletal conditions using a combination of advanced imaging, physical and occupational therapies, pain management procedures, as well as the latest treatments made available through our clinical research programs.
The program continues to grow substantially, with an average annual growth of 12 percent for physician and advanced practice provider outpatient visits. Outpatient therapy visit volumes are growing at 5 percent per year.
Specialists at our multiple outpatient musculoskeletal rehabilitation sites address acute and subacute neck and back pain; facilitate recovery from sprains, strains, fractures, joint replacement surgery and rotator cuff tears; and provide management of arthritis, osteopenia, osteoporosis and temporomandibular joint syndrome.
Our physical therapists are board-certiﬁed in orthopaedic physical therapy or have specialized training in the treatment of speciﬁc musculoskeletal conditions. Occupational therapists are available to help patients return to their activities of daily living. We have a large number of occupational therapists who have subspecialty training and certiﬁcation in hand therapy and work very closely with our hand surgeons.
MetroHealth’s Musculoskeletal Ultrasound Medicine program is helping PM&R physicians to quickly and accurately assess injuries to muscles, joints and tendons. Ultrasound is also used to guide interventions such as viscosupplementation and radiofrequency ablation. Therapeutic ultrasound that delivers high frequency soundwaves is being used to break down and remove scar tissue caused by chronically diseased tendons.
Healthcare providers in our spine and pain program diagnose and treat conditions including spinal stenosis, instability, nerve root entrapment, fractures, osteoarthritis, tumors, radiculopathy, disc herniation, spondylosis, spondylolisthesis, scoliosis, myelopathy, facet arthropathy and sacroiliac joint disorders.
An Interdisciplinary Team
After conducting a thorough examination that may include high-resolution magnetic resonance imaging and diagnostic injections to localize the pain source, our PM&R physicians, nurses, physical therapists, interventional spine specialists, psychologists and vocational counselors create a comprehensive treatment plan to alleviate discomfort and improve function. Other members of the team include orthopaedic and neurological surgeons who are available for surgical consultations.
Approaches to Care
In addition to physical and occupational therapy and the judicious use of medications, treatment may include interventional injections under ﬂuoroscopic guidance. These can include sacroiliac joints, facet joints and epidural injections of anti-inﬂammatory steroids or analgesics.
Radiofrequency ablation may be suitable for some patients with chronic pain. Similarly, implantation of a spinal cord stimulator offers relief for many patients. Other treatment options include intrathecal pain pump, intravenous infusion therapy, intradiscal electrothermal therapy and nucleoplasty.
While reducing pain is an important goal, the primary objectives are to restore function and facilitate community and vocational reintegration and improve quality of life. Therefore, in addition to the above interventions, rehabilitation psychologists and vocational counselors have major roles in the interdisciplinary team.
The Sports Medicine Program addresses any acute or overuse sports-related injury, including fractures, sprains, strains, tendonitis, bursitis, rotator cuff tears and neck and spine injuries. Some of our treatment approaches include physical and occupational therapy, bracing and taping, injections for muscle, ligament and joint injuries, including platelet-rich plasma injections and viscosupplements and injections for spine-related pain. We also offer referrals to our concussion clinic or to orthopaedic surgery, when appropriate. Our surgeons can provide minimally invasive approaches to care such as arthroscopic surgery, fracture repair and ligament reconstruction.
Training room services are available to local high school athletes and to participants in community sporting events. Our certiﬁed athletic trainers evaluate acute injuries that occur during practices or games and refer patients to appropriate providers. Patients are typically seen within 48 hours of their initial assessment.
Future Sports Medicine Program goals are to expand services to more inner city high schools, collegiate athletes and recreational sports leagues.
Electrodiagnostic medicine enables our clinicians to hone in on the physiologic severity of neurologic and neuromuscular conditions. Some of the more common conditions we assess include carpal tunnel syndrome, diabetic polyneuropathy, entrapment neuropathy and radiculopathies. Rarer disorders include myasthenia gravis, Guillain-Barré syndrome, amyotrophic lateral sclerosis, polymyositis and muscular dystrophies.
Our staff includes board certiﬁed electromyographers and a staff of electromyography (EMG) technicians. Our state of the art technology can instantly and automatically upload test results to the electronic medical record. EMG services are available at the MetroHealth’s main campus, as well as at ﬁve satellite locations in the community. Evening hours are now offered.
Our PM&R physicians and cancer rehabilitation specialists assess the diverse needs of our cancer patients to develop personalized rehabilitation programs. We have a PM&R physician embedded in the cancer center to maximize patient convenience and our collaboration with oncology staff. Newly diagnosed patients with cancer are systematically screened for functional needs. Some of the many services we provide include physical therapy and interventional injections to manage pain and neurological changes caused by spinal tumors, speech and swallowing expertise for head and neck cancer patients, and a protocol in which all surgical breast cancer patients see a PM&R physician and a physical or occupational therapist. The MetroHealth Rehabilitation Institute is the home of the only PM&R-based Cancer Rehabilitation and Lymphedema Clinic in the region, and we currently have four physical therapists with lymphedema certiﬁcation.
MetroHealth’s Industrial Medicine Program helps injured employees return to work quickly and safely with specialty outpatient care for work-related injuries.
The Injured Workers Walk-In Clinic is staffed by our industrial medicine-certiﬁed physicians, who assess, diagnose and provide initial treatment for the injury. Our team then develops a treatment plan aimed at eventual return to work. Our physicians continue to provide ongoing medical care. They also help patients access other specialists such as physical and occupational therapists, orthopedists or neurosurgeons in a timely manner as indicated.
Our goal is simple: Get people injured at work back to work as quickly and safely as possible.
Our Amputee Rehabilitation Program serves patients who have undergone amputation of upper or lower limbs resulting from trauma or vascular disease, such as peripheral artery disease. Our program features a modern inpatient rehabilitation facility and several locations for outpatient services as patients progress with their recovery. In addition to PM&R specialists, our interdisciplinary team includes prosthetists, physical therapists specially trained for lower limb amputation, occupational and hand therapists specially trained for upper limb amputation, as well as rehabilitation psychologists to provide counseling. We coordinate with trauma, orthopaedic and vascular surgeons to anticipate and address postoperative complications and rehabilitation.