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Table 4

Common rationales for recommendations

ModalityCommon Rationales
Exercise• Objective biomechanical testing suggest need for
 - strengthening, endurance training
 - increased flexibility
• Fear of movement or activity

Self Care Education• Aggravating factors could be addressed with
 - ergonomics
 - activity modification

Acupuncture & Oriental Medicine• Stimulate flow of energy (qi) to decrease pain
• Presentation fits classic Oriental medicine pattern

Massage• Tight muscles noted on exam/history
• Benefit from a touch therapy; stress reliever

Chiropractic• Reduce pain
• Increase joint range of motion

Cognitive Behavioral Therapy• Need skills for relaxation or activity scheduling to manage pain
• Address fear of movement

Medication• Pain management
• Review current medication