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Old 01-07-2013, 06:41 PM   #1
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PT making me worse post op?

Yes, it's me again, with another PT question: Can moist heat really be irritating my lumbar where I had my fusion? I told them today at PT how I feel SO GOOD lately on the days I do not have PT. I walk into PT today feeling very well also in the afternoon but then I have to go lay on moist heat for 15-20 minutes and I dread it. While the heat feels good, I have the hardest time rolling off the table afterwards and I am all weak in the lower back. I do not have this problem in the am rolling out of my bed. So, today, as usual, this all happens, but this time, I go to step up onto the treadmill next and my back spasms! OMG: I haven't felt a spasm in MONTHS. So I slowly walk around and eventually get on the treadmill using my other leg first and walk slower than normal. I go over and tell the therapist what I just wrote here and as I"m telling her my back spasms again! She had me lean against the wall and do a small core exercise, and I think it helped. I tell her how the massage I used to get there at the end of each session made my back feel similar to this too, and could we stop the heat and see how I do next visit.
I'm just SO FRUSTRATED. I feel like I've hit a wall with PT. Dont' get me wrong: it's helped me come along way, but if it's just making me feel worse why keep going is what I want to know?
I"m not sure what to do. I don't really "like" my new Dr. either, so it's either call him or find a new Dr. to follow me but I can't help but think that any Dr. that I tell this too will say to stop therapy right?

I know many of you can enlighten me on this as you have more experience than I do. Thanks in advance for all advice.
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Old 01-07-2013, 10:32 PM   #2
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Re: PT making me worse post op?

Hi workinmom, Im sorry that you dont like the new dr & ive often wanted to tell you im sorry that your surgeon left you post op like that, i know its hard I still miss my neurosurgeon that retired. Back then, after my last surgery if I had trouble with one of the PT modalities I would tell the physical therapist, he would call & get a new order from my NS. I think it wouldnt be hard to just have heat &/or massage discontinued & keep PT ordered for strength, exercise etc. Are you sure its not from laying on the hard tables in pt, that they call beds? I always had to have the PT tech put pillows under my legs from lnee down, parallel to bed, because it caused my back to hurt, spasm, feel weak too. In fact I can feel it remembering! Hope it works out! I would just refuse the heat if it doesnt!

 
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Old 01-08-2013, 12:14 PM   #3
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Re: PT making me worse post op?

If there's something in PT that's hurting you and not helping, just tell your therapist you don't want to do that again (because it's hurting) and they'll substitute something different. You don't 'have' to lay on moist heat if an icepack works better for you. Some people do better with heat to relax the muscles, some prefer cold to chill out the nerves. Sometimes I lay on the icepack after my therapy, but often I don't need it.
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Old 01-08-2013, 05:48 PM   #4
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Re: PT making me worse post op?

I am also 3 months Post Op TLIF L5 S 1 and yes PT hurts me too. Those beds are boards with 2 inches of thin foam. They had me doing some kind of leg kick backward while on my knees and it made me get out the pain meds i worked so hard to stop taking. Is this right?
I wont do things that make me worse. I will tell mine next time.
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Old 01-09-2013, 08:55 PM   #5
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Re: PT making me worse post op?

I wish I had thought and asked and acted on this sooner. I am going in tomorrow again and I will suggest Ice, while sitting in a chair, no more of this lying on a rock hard table for over 30 minutes and then more for core strengthening. I will ask for ice in a chair, then I'll do my treadmill to get the blood moving to warm up my back/body. Then I will lay down to do my core work but only on a pad I saw they have on top of my table. and from now on I will stop immediatley if something causes pain. I'm also going to say hey, after all these months now (I'm 6 months I think now) I want some OT-show me ways to move to do things I need to do rather than all these reps. I need help with like putting on my socks for pete's sake, I'm done using a device, I want to function on my own, but while I can do that, it's hard. Show me how to bend down to pick up things properly, or to load the bottom of the dishwasher, washer and dryer, etc. things I use to peform more daily tasks safely. Ugh, I'm actually SO VERY TIRED of even going at this point after this many months. If they don't change things up and teach what I want at this point I will stop going all together since I feel so much better when I do not go. I can go back to my own health club and walk on the treadmill there. Ugh. I just want my life back.
Thanks for the replies. They really help.
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Old 01-10-2013, 07:34 AM   #6
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Re: PT making me worse post op?

So true, useful OT things make us feel back to normal. I am turned of having to ask others to do things for me! Good luck! I have PT today and I am using your suggestions.
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Old 01-10-2013, 11:17 AM   #7
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Re: PT making me worse post op?

I figure a little pain is to be expected and it means I'm working hard... My therapist stops me from doing something because it's hurting me more often than I complain about it. I have a pillow under my backside if I have to lay flat on the table for long. It feels like it's digging right into my spine otherwise.
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Old 01-10-2013, 12:37 PM   #8
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Re: PT making me worse post op?

I stopped and started PT several times with my first fusion. They don't always know what is best for you as an individual. The surgeon I had with that first fusion didn't even send patients to physical therapy unless they insisted. Too often the PTs try to wedge every patient into the same routine, without really paying very specific attention to details that make us unique as patients. After that I learned to listen to my body and react accordingly.

That surgeon really believed the best thing one could do was to walk, and that as one got stronger and was able to do more, the muscles gradually gained strength and flexibility. That's what worked for me with my second fusion. If you have access to a warm pool, walking and doing simple exercises are the most effective, least harmful way to go as far as I am concerned.

I guess I was lucky in that I never needed any help with stuff like putting on socks, every day activities, etc.

 
Old 01-10-2013, 04:23 PM   #9
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Re: PT making me worse post op?

wow Teteri66, you could put on your own socks post op? Gosh, I just recently am able to do that, and I still have to be cautious! I went into PT today with ALOT of questions! I got alot of support from the two I talked too, a PT and a PTA. Basically though, I was told that I have come so far (I do acknowledge that) but that also I am right where I should be I asked could/should I be doing certain things and was told no to all I asked about-no vacuuming or sweeping still, no I can't get on the stationary bike yet, etc. I was bummed but also encouraged. They talked for almost 40 minutes with me. Then I also met a new patient who was in her 70's post op 3rd fusion over the past few years, and it was very nice to talk with her, this is her 3rd PT facility. I guess I am just getting antsy I realized as I talked everything out with them, and they fully agreed. I'm in a rut too. So, today, I tried to do the treadmill first, went great, no pain, etc. Then I went to lay down for work and they put a pretty thick yoga mat on the table and as soon as I got on my back and moved my leg I felt the horrible pain again. So, we realized that 1.) heat very well could have been making my back open up too much, 2.) the table is BAD for my back so no more table and I'm very happy about that.
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Old 01-10-2013, 08:39 PM   #10
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Re: PT making me worse post op?

I just crossed one leg over the knee of my other leg (when sitting) and put on my sock. To me that is easy but I guess not for everyone.

I'm so glad you had a chat with the therapist people. It is hard to know how much to follow their suggestions and how much to resist when you feel they are wrong or making you worse.

 
Old 01-11-2013, 05:36 AM   #11
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Re: PT making me worse post op?

workingmom ~ This is a reply to a question you asked me on another thread.

Once you learn those OT things you need to know, I would suggest you stop PT and work with your friend whose treatments are providing some relief. The only thing wrong with my "rearranger" is that it is out of pocket payments -- I went to rearranger # 1 for several years, sometimes two or three times per week when I was really suffering and right before my fusions. I wanted to be sure my spine was structurally aligned before I had the fusion because I knew my doctor wouldn't be paying attention to those small details.

Then as soon as I was allowed to drive, I was back so that he could work on breaking up any adhesions as soon as they formed...and I went twice a week until I was about 14 weeks post surgery, when the time for major development of scar tissue has passed.

It is difficult for me to describe what Doug, and now Luke who learned everything from Doug do. First they check my alignment standing and lying on a table. Then they insert needles and I rest for about 20 minutes. Then they come back in, remove the needles and the fun begins. There are certain "points" in the body that relate--and this is the part I don't understand and can't explain...but he'll poke a spot on my leg that is sore and there will be a corresponding area up in my upper back/shoulder that is equally tender...and there will be adhesions in both spots.

Then he'll make adjustments, but they are not like a chiropractic adjustment. He'll poke a finger into one spot and move my leg or arm or whatever in a specific way that makes the point release. Last time I was in I asked how they described the treatment: ..." fusion of bio mechanically based structural bodywork and the tissue mapping and theory of five-element acupuncture." I guess I don't need to understand how all this works, but I wish everyone had access to someone like this!

Your friend sounds good too and I would let her work with you if you think it helps/makes you feel better.

Last edited by teteri66; 01-11-2013 at 09:28 AM.

 
Old 01-11-2013, 07:15 AM   #12
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Wink Re: PT making me worse post op?

[QUOTE=teteri66;5115537]Once you learn those OT things you need to know, I would suggest you stop PT and work with your friend whose treatments are providing some relief. The only thing wrong with my "rearranger" is that it is out of pocket payments -- I went to rearranger # 1 for several years, sometimes two or three times per week when I was really suffering and right before my fusions. I wanted to be sure my spine was structurally aligned before I had the fusion because I knew my doctor wouldn't be paying attention to those small details.

Then as soon as I was allowed to drive, I was back so that he could work on breaking up any adhesions as soon as they formed...and I went twice a week until I was about 14 weeks post surgery, when the time for major development of scar tissue has passed.

It is difficult for me to describe what Doug, and now Luke who learned everything from Doug do. First they check my alignment standing and lying on a table. Then they insert needles and I rest for about 20 minutes. Then they come back in, remove the needles and the fun begins. There are certain "points" in the body that relate--and this is the part I don't understand and can't explain...but he'll poke a spot on my leg that is sore and there will be a corresponding area up in my upper back/shoulder that is equally tender...and there will be adhesions in both spots.

Then he'll make adjustments, but they are not like a chiropractic adjustment. He'll poke a finger into one spot and move my leg or arm or whatever in a specific way that makes the point release. Last time I was in I asked how they described the treatment: ..." fusion of bio mechanically based structural bodywork and the tissue mapping and theory of five-element acupuncture." I guess I don't need to understand how all this works, but I wish everyone had access to someone like this!

Your friend sounds good too and I would let her work with you if you think it helps/makes you feel better. [/QUOTE]

Thank you so much for your input. Yes I could use a rearranger. I have tried acupuncture but it only last for the day I had it. So after 6 weeks of weekly treatments I gave up. It's not cheap!
I had a long talk w my PT and I am doing so well he thought I might tolerate intermediate exercises. I said I was hurting too much for too long after thy visit, it made me drag out the pain pills I had discontinued. See my frustration? Two steps forward, then falling back.
Walking is the best for my back but the rest of me is really atrophying. My first surgery was ACDF Aug 2012 then the TLIF Nov 2012. So I am becoming the impatient patient....
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Old 01-11-2013, 07:19 AM   #13
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Re: PT making me worse post op?

[QUOTE=Kaji;5115129]I figure a little pain is to be expected and it means I'm working hard... My therapist stops me from doing something because it's hurting me more often than I complain about it. I have a pillow under my backside if I have to lay flat on the table for long. It feels like it's digging right into my spine otherwise.[/QUOTE]

True, I do expect that but not so much, that I am down the next day or unable to sleep from spasms. I think we went too far and now we discussed it and will resume beginner exercises not intermediate.
Thanks!
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Old 01-11-2013, 09:14 AM   #14
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Re: PT making me worse post op?

Hi ag, Its very good to see you though i hate that you are having trouble progressing. My best advice came from my neurosurgeon who said recovery is like stacking blocks. He said that when in recovery take it slow making sure that you dont overdo b/c when you do the whole stack falls down & you have to start all over again! I hope your better soon.

 
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Old 01-11-2013, 09:30 AM   #15
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Re: PT making me worse post op?

I like that advice. It was really true with my sciatic pain. The minute it became irritated, things went back to zero and the recovery clock started over again!

 
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