Pain management in physical rehabilitation

Pain management for the physical rehabilitation patient, whether post operative, post injury, because of a disease state or because of the aging process, is absolutely vital to recovery. Optimum pain management will help ensure that the patient is cooperative and willing to participate in the programme designed by the physiotherapist. A painful patient will resist not only the exercise programme designed, but is likely to resent touching possibly even trying to aggressively bite the veterinary nurse. In the USA veterinary technicians can become certified in physical rehabilitation and work alongside veterinary physiotherapists. This article discusses the role of the certified physiotherapist technician, as well as pain management in physical rehabilitation.

It is imperative that the patient that undergoes physiotherapy is not suffering from pain that can be aided by analgesic medications. If it is at all possible the rehabilitation veterinarian should be in contact with the surgeon before a surgical patient is referred for rehabilitation so that they are aware of the perioperative pain management plan. If the patient is brought directly with their owner because of a lameness, orthopaedic or neurologic issue, then the rehabilitation veterinarian will need to assess what analgesic medications could aid that particular patient in transitioning to a pain-free physiotherapy programme. An excellent review of multimodal pharmaceutical management of pain can be found in Canine Sports Medicine and Rehabilitation (Epstein, 2013).