Dr. Carla Enriquez is an Assistant Professor of Physical Therapy at Stockton University located in Galloway, NJ and has been a practicing clinician for 20 years, specializing in orthopedic conditions and chronic pain. She holds physical therapy licenses in the states of New York and New Jersey; and is a Board-Certified Orthopedic Clinical Specialist by the American Board of Physical Therapy Specialties. She earned her Doctorate degree in Physical Therapy from the University of Medicine and Dentistry of New Jersey and Master of Science degree in Health Sciences from Rutgers University. She received her Bachelor of Science degree in Physical Therapy from Silliman University, Philippines and is a PhD Candidate in the Health Sciences program at Trident University, International. Her primary teaching responsibilities in the DPT program at Stockton University are Human Gross Anatomy, Kinesiology, Prosthetics, and Musculoskeletal Physical Therapy. Her research agenda is in orthopedic physical therapy, quantitative sensory tests, and chronic pain. She has a productive scholarship which includes publications in various peer-reviewed medical and rehabilitation journals as well as poster and platform presentations in various national and international professional conferences.
Note: You should consult with your doctor or physical therapist for recommendations on treatment. The views and opinions expressed in this article are those of Dr. Enriquez and do not necessarily reflect the official policy or position of OnlinePhysicalTherapyPrograms.com
How did you become interested in integrative pain management?
I became interested in integrative pain management when I started working with colleagues in various disciplines to address various painful conditions of the neuromusculoskeletal systems. Being in clinical practice for decades made it evident how certain patients benefit more positively to physical therapy interventions. Various patient populations respond more quickly and effectively to physical therapy interventions when provided in conjunction with other complementary therapies. Interdisciplinary approach to patient care has, and continues to provide various patients/clients with meaningful outcomes and patient satisfaction.
What are some of the most significant developments in PT’s consideration of pain management over the years?
The most significant developments in physical therapy practice on pain management is the deeper understanding of chronic pain beyond the biophysical context and treatment-by-impairment model. As it is understood today, chronic pain encompasses the physical, cognitive, and psychosocial levels of individual functioning. It is in the management of patients/clients with chronic pain where an integrative and interdisciplinary pain management approach is crucial and fundamental.
What are some important integrative modalities for physical therapy? How has our use of these modalities developed over the years?
Various modalities continue to emerge, as much as they have over the years. Breakthroughs of newer treatment options are ongoing, such as blood flow restriction training, dry needling, and cold laser or laser light therapies. However, utilization of integrative therapies in physical therapy practice may be, in part, a matter of professional preference and of “clinical culture” whereby patient management approach is highly a reflection of professional and/or personal philosophies of providers and/or stakeholders within a clinical setting. With the emergence of newer, more sophisticated treatment options and promising outcomes however, particular attention to scientific evidence to support integration into patient care is always prudent.
What are some of the obstacles to getting professionals to take an integrative approach to therapy? Is integrative medicine widely accepted in the field?
One potential challenge in the integrative pain management approach is the lack of provider’s awareness on the efficacy or access to available resources. However, physical therapists are always innovative in the approach to patient care so that acceptance and integration of evidence based examination or treatment strategies are welcomed.
You also have an interest in quantitative sensory tests- what do we need to be mindful of to create effective tests in this area?
Quantitative Sensory Tests (QST) are fairly new in physical therapist practice, at least in their role in direct patient care. However, growing evidence of their utility in the patient management process, such as their potential role in patient classification, is promising. For example, appropriate recognition and classification of unique patient characteristics that contribute to increased pain sensitivity or inefficient pain modulation is crucial in creating effective treatment strategies and meaningful outcomes.
What aspect of your work are you most proud of?
I am most proud of my ability to impact my patients’ lives in both simple and complex terms – from being able to help them walk safely and comfortably around their homes to being able to help them participate and engage in the lives of their loved ones, despite their debilitating chronic pain symptoms. I am also equally proud and honored to be a part of my students’ journeys as they pursue their education in physical therapy.
What advice do you have for those considering a career in physical therapy?
Physical therapy is an incredibly rewarding healthcare profession, where potential for personal and professional growth abounds. Physical therapy practice has many areas of specialization to channel one’s passion: Cardiovascular and Pulmonary, Clinical Electrophysiology, Geriatrics, Neurology, Oncology, Orthopaedics, Pediatrics, Sports, and Women’s Health. Additionally, various practice settings exist to meet various personal and professional goals.