World-class work injury care

PRO Medical is home to one of the best work related injury recovery programs in the region, and our proven protocols encompass the entire recovery process. Our treatment plan begins with the gathering and documentation of objective findings and analysis of subjective information, leading to the pinpointing of a clearly defined, work-related cause. The core of the program is our team of highly experienced specialists including physicians, physical therapist and nurses.

Work injuries and worker’s compensation cases present a unique set of challenges...not just for employees, employers and insurance providers, but for healthcare professionals as well. At PRO, we combine renowned medical knowledge and skills with exceptional case management expertise to bring work injury cases to their swiftest, most positive and most practical resolutions.

At PRO we understand the objectives of the case manager. To this end, our protocols are based on providing the most appropriate care and the most efficient allocation of resources. Our team meets weekly in conference to review complex cases and provides timely and complete communication with our case manager partners.

MedX Back Pain Treatment at Pro Medical

What is Med-x?

Med-x is a comprehensive rehabilitation program that incorporates the sports medicine approach to the treatment of chronic neck and back pain. A key component in this program is the Med-x equipment, developed by the founder of the Nautilus exercise equipment Arthur Jones. The Med-x machines are specially designed to provide the most effective means of isolating, safely testing, and directly strengthening the muscles in the low back and neck. The Med-x program also incorporates general strength and fitness building activities that are supervised by a licensed physical therapist to ensure the patient’s safety and progress.
The primary goals of this program are to improve range of motion, improve muscle strength, decrease pain, and return the patient to normal function. The entire program generally takes less than one hour, twice a week for 8 to 12 weeks.

The Science behind the Treatment

If pain does not resolve 8 to 10 weeks after an injury, a clinical phenomenon takes place. The muscles in the injured area will begin to suffer from 'disuse atrophy.' Following an injury, the patient begins to protect that area by bracing themselves and moving differently. The lack of use further weakens the muscles in the lumbar and cervical spine, often times resulting in an increase in pain.

The Med-X rehabilitation equipment is designed to isolate the injured muscles, and safely increase strength and range of motion. The result is a decrease in pain and functional restoration of normal mobility. There is no other equipment currently available that can safely and effectively isolate and rehabilitate the lumbar and cervical muscles.

Treatment Based on Knowledge of Tissue Repair: The key components of any rehabilitation program designed to address weakness, deconditioning and substitution is overload, progression, and isolation. An overload stimulus demands that the involved segment work at greater than normal levels. An overload stimulus improves neural control and increases the muscle contractile protein size. Strength and structural integrity will improve through a facilitation of neural control and muscular hypertrophy. Isolation is the key to targeting the specific area of dysfunction (weak link). Isolating a movement makes it possible to provide a progressive overload stimulus to the weakened segment. In the lumbar spine the glueteal and hamstring muscles can substitute for a weak back by producing movement through pelvic rotation. By stabilizing the pelvis in the Med-X machine during the movement of extension, the spinal erectors and lumbar spine can be isolated for an overload stimulus. This environment also allows for neuromuscular re-education of alienated muscle tissue. Without isolation the exercise stimulus will not target the muscle group and specific movement in question, and the efficacy of the rehabilitation program will be compromised. Isolating a movement prevents substitution and provides the safest environment in which to provide a therapeutic overload stimulus.

Isolated mechanical loading helps align new collagen or connective tissue. If random alignment of collagenous tissue occurs during the healing process then cross fibers and adhesions develop. When movement is finally initiated these cross fibers are disrupted and the collagen repair process must start all over. By providing mechanical loading during the repair process the fibers are aligned along lines of mechanical stress, adhesions do not develop and collagenous repair will be optimized. Providing frequent movement of the lumbar spine and facet joints in an isolated manner will increase the production of synovial fluid, which acts as a lubricant and assists in the smooth gliding operation within a joint capsule. Loading and unloading the disc increases the rate of diffusion through an otherwise avascular area. This increased diffusion can help regulate inter discal pi-I which may be a source of pain. Specific exercise also increases localized blood flow which facilitates healing through the removal of metabolic waste products and the delivery of nutrients. Wolfe's Law states that bone mass and density will be increased in areas of stress. The detrimental effect of immobilization and non-weight bearing environments is the significant reduction in bone density. Specific exercise that provides an overload stimulus will increase calcification and bone density of the spine. Rational care must be based on physiological principles and knowledge of the repair processes. Exercise should be precisely prescribed and given in dosages that elicit a specific response.

The Med-X equipment has been available since 1988. It takes years to complete research and publish results. There is now a rapidly growing body of published research documenting the efficacy of specific intensive exercise for chronic back pain patients.

Profile of a Successful Patient

Med-X rehabilitation program is appropriate for patients who have recurrent back and neck pain or those who are still experiencing pain 8 to 10 weeks after an injury. Patients with degenerative disc disease, bulging discs, stenosis, non-specific back pain, sciatic pain, and low grade spondylolysthesis (grade 1 or 2) have had positive results with this program.

Cervical patients treated include non-surgical, post-surgery, non-specific neck pain, whiplash syndrome, degenerative disc disease, and patients with sciatic pain into the arms. Some of the patients have cervical pain that manifests itself in continuous headaches and some of the patients treated have TMJ. In most cases, the patients treated at the Med-X Clinic of Northern Colorado \ Wyoming have had chronic spine problems for several months to many years. Many of these patients have not had surgery, and in some cases surgery is being considered if treatment is not successful. In many of the cases being considered for surgery, the patients are able to successfully avoid surgery after completing the 12 weeks of rehabilitation. For those who still require surgical intervention, a specialized rehabilitation program for post-surgery patients is available at many clinics.

Patient Profile:

• Chronic back or neck patient.
• Greater than 6 weeks post injury.
• No sooner than 4-6 weeks post surgery.
• No sooner than 3 months post fusion.

• LumbarHNP.
• Lumbar HNP, with non progressing LE signs and symp.
• Low back pain.
• Spondylolisthesis.
• Chronic lumbar strain.
• Post laminectomy/fusion rehab.
• CervicalHNP.
• Cervical HNP with non progressing UE signs and symp.
• Chronic cervical strain.
• Whiplash.
• DDD.
• DJD.

• 16 to 80 years old.

1. Absolute Contraindications
• Tumor
• Recent Fracture
• Infection
• Cauda Equina Syndrome
2. Relative Contraindications
• Metabolic Bone Disease
• Inflammatory Arthritis
• Referred Pain
• Immature Skeleton

Post-Surgery Rehabilitation

For patients who have had back surgery, rehabilitation is as important following back surgery as it is following knee, shoulder, arm, or foot surgery. Although surgery can often times relieve the symptoms the patient was having prior to surgery, it can also result in an increase in back or neck pain as well as contribute to an increase in strength and flexibility problems.

When a patient has surgery, the lumbar or cervical muscles are weakened and lose strength. As those key muscle groups atrophy, pain and inflexibility increase. Until the strength of those muscles is addressed, the downward cycle of muscle guarding, pain, more muscle guarding, more muscle atrophy, and more pain will continue.
Rehabilitation can speed recovery and return of function.

Contraindications

tumor
aortic aneurysm
progressive neurological symptoms
Cauda equine syndrome or signs
severe osteoporosis
severe cardiopulmonary disease
fresh fracture
recent abdominal surgery.