Hello Susan:

This  is  a  90  y/o  man  who  has  been  VERY active most of his life,
especially when he was younger. He played lots of contact sports and has
worked with his hands all his life.

Alas,  age  has  caught up with him and while still active he does a lot
less than he once did. However, he still gets up in the early morning to
do  his  exercise which he readily demonstrated for me.

I  asked  him  how his OA was limiting him and he could not identify any
specific   areas.  He  is  independent  with  self-care.  He  does  have
considerable  pain  during  UE  ROM  (especially in his elbows) and even
during  rest. At times, the pain is quite debilitating (7 out of 10). He
could NOT identify any pattern to his pain and has not been able to find
any  relief.  I  did not observe any deformation in his joints, although
there  is  obviously some secondary to the OA. He is on a limited income
so purchasing equipment/braces, etc may not be an option.

It seems his primary complaints are related to pain.

Here's  the  funny  part.  The man is currently seeing PT secondary to a
total  knee  replacement, pain in his hip and pain in his cervical spine
secondary  to  a stenosis. It just kills me that they referred him to OT
for  his  upper  extremity  problems.  Of  course  the  order  from  the
orthopedic doctor did state "OT/hand therapy".

The  man  may  find some temporary relief from some modalities but these
are just temporary measures. Short of saying "take your pain meds, don't
over-stress your joints, take it easy when it hurts, and be as active as
you can tolerate", I don't know what else to say.

Ron

----- Original Message -----
From: susanne <[EMAIL PROTECTED]>
Sent: Friday, October 21, 2005
To:   [email protected] <[email protected]>
Subj: [OTlist] Treatment Ideas

s> Tell us a bit more, Ron, about the OA, the pain, and his
s> occupations.

s> Also - which previous therapy? Was he taught joint protection
s> techniques, and is he using them? Does he have the right
s> tools/assistive devices, and is he using them? How's the pain
s> corresponding to activity, rest, heat, cold, time of day...?
s> How is he responding to the pain? What would he be doing
s> (more of) if it wasn't for the pain?

>> I  don't  think  there's  anything  that I can do that will be
>> medically
>> necessary

s> Like preventing joint deformities and thus further loss of
s> function, and further pain... ?

s> susanne, denmark

s> ----- Original Message ----- 
s> From: "Ron Carson" <[EMAIL PROTECTED]>
s> To: <[email protected]>
s> Sent: Friday, October 21, 2005 1:33 AM
s> Subject: [OTlist] Treatment Ideas


>>I  have  received  a  referral  for  a  client for UE rehab - gotta
>>love
>> THAT!!!
>>
>> Anyway,  the  guy  has some OT in his UE and I don't know what to do.
>> He
>> has  good  ROM  but pain. He is not limited in his daily occupations
>> but
>> has  pain  while  doing  them.  He has found no relief from any
>> previous
>> therapy.
>>
>> I  don't  think  there's  anything  that I can do that will be
>> medically
>> necessary. But I am looking for suggestions!
>>
>> Thanks,
>>
>> Ron
>>
>>
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