Primary care after spinal cord injury. What every physician should know.

Primary care physicians can help patients with spinal cord injury return to the community by accepting them into their practice. The transition from physiatrist to primary care physician after formal rehabilitation is a cooperative effort. Knowing how to treat the common skin, pulmonary, cardiovascular, autonomic, neuromotor, and musculoskeletal complications of spinal cord injury is essential.

Arthritis rehabilitation. A multifaceted process.

Rehabilitation of the patient with arthritis is a multifaceted process that should always involve patient, family, and a wide variety of healthcare professionals and community organizations. The optimal goal is to improve the patient's functional performance. Success depends on correct identification of functionally limiting problems.

Stroke rehabilitation. A problem-oriented approach.

Optimal rehabilitation of stroke disability depends on a detailed analysis of neurologic impairments, associated medical conditions, psychosocial status, activities of daily living, and environmental barriers. Such analysis will permit design of the most appropriate management program, aimed at minimizing disability, maximizing function, and returning the stroke patient to a gratifying existence in spite of residual impairment and disability.

Cervical and lumbopelvic traction. To stretch or not to stretch.

Cervical traction and lumbopelvic traction are commonly prescribed for relief of neck pain and low back pain, respectively. Scientific validation of efficacy is scant, but considerable empirical benefit has been observed. In the absence of contraindications and with appropriate application, cervical and lumbopelvic traction may be used to provide symptomatic relief of neck and low back pain.