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Old 08-16-2012, 06:48 PM   #1
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Physical Therapy Making Pain Worse

I went to my MD with two separate issues about pain. One was my PN pain in my feet that I addressed in another post. I also had pain in my shoulder due to straining it. My MD prescribed physical therapy. The first two visits my shoulder began to feel better. On the third treatment the therapist was pressing on various nerves in my arm. As a result my neck pain flared up. The next visit the head therapist started treating my neck and shortly after the visit I came down with a nasty neuralgia headache that has remained for the past three days. Now my neck is worse than my shoulder and I still have the neuralgia headache.
I have an appointment tomorrow. Unless they can offer an explanation I am terminating the therapy.
In searching the web I have found a few posts that physical therapist can make pain worse.
Comments appreciated, thanks.
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Old 08-16-2012, 07:42 PM   #2
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Re: Physical Therapy Making Pain Worse

Yes, physical therapy can make people's pain worse. It may be a sign that your treatment plan needs tweaking.

Talk to the PT, let him or her know what's going on, and ask for a modified treatment plan that hopefully won't set off so much pain afterwards. During the therapy, do not hesitate to speak up when something hurts. Some treatments are supposed to hurt, but most aren't, and almost none of them should hurt a lot.

 
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Old 08-16-2012, 07:54 PM   #3
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Re: Physical Therapy Making Pain Worse

I have severe nerve damage from my spine to my shoulder. The pain is a constant 7/8. My PM doc said that this is partly due to the neurons spasming and over-firing. Because of this, I am not allowed to do physical therapy as that would exacerbate the situation. Although I don't know much about your physical pain issues, I can fully state that sometimes physical therapy could do more harm than good.

 
Old 08-16-2012, 08:35 PM   #4
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Re: Physical Therapy Making Pain Worse

I would give this therapist a chance to work with you in a modified treatment plan. Knowing that you are susceptible to certain pain triggers is helpful information. But yes, for some folks, pt will trigger more pain. There are some other options such as water pt or massage though. But the fact that you can pinpoint what caused the pain should be helpful. You may want to take it easy for this next appointment, mostly discussing the future treatment plan, and then figure out if this headache needs more time before continuing. Sorry you had to deal with this. Sometimes we need to go through more pain before finding what will reduce our pain.

If this therapist turns out to not be the best fit for you, I'd urge you to try someone else before just giving it up. A good therapist wouldn't take offense even if you saw someone in the same clinic. Some places even have you work with a couple people the first couple times to see if there is a better fit. Some therapists are more used to rehabbing an injury than working with someone in chronic pain too. Best wishes.
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Old 08-17-2012, 12:31 PM   #5
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Re: Physical Therapy Making Pain Worse

Thanks for your replies.

Last night I could not sleep the neuralgia pain was so bad. I spent a lot of time on the web trying to learn what had happened to me. I found one site that cited several reasons for neuralgia in the head among them was the irritation of the occipital nerve that is located at the base of the skull. This was exactly where the therapist was working. I think my neuralgia headache is now termed occipital neuralgia. Regardless it is very painful and the pain is ongoing.

I met with the physical therapist today and once again stated my complaints. He acted as though he was surprised to hear about my increased pain and painful locations. He offered no alternative other than to get an appraisal from another therapist employed by the same group. I think that would be like complaining about a meal at a restaurant and sending your food back to the kitchen. I cancelled my future appointments and hope that rest will do the healing. If not I will go back to my MD and hope he has a viable alternative.
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Last edited by don444; 08-17-2012 at 12:32 PM.

 
Old 08-17-2012, 06:03 PM   #6
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Re: Physical Therapy Making Pain Worse

I think it could be helpful to try some different therapists to see if they can come up with something which could help your pain without triggering more, but I can see why you are frustrated and probably in too much pain to even be trying it now. I'd rest up and keep pt in mind to try again in the future. I'd hope this one experience wouldn't discourage you as some folks do find it helpful. I personally don't see why going to someone else in the same clinic is a problem, as they should each have different training, expertise, interests, specialties, etc.

For me they couldn't do much directly for my pain, but it did make me aware of some postural changes which reduce my pain or can keep some of the spikes at bay. I find massage helpful, but again, you have to find the right person and style of massage...similar to pt, if you go to someone doing deep tissue and they cause you pain, you can get discouraged and swear off of it. Best wishes.
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Old 08-18-2012, 05:55 AM   #7
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Re: Physical Therapy Making Pain Worse

Perhaps try seeing another therapist. Mine was so gentle. He would manually manipulate the sore areas and give me a massage, and he would ask constantly if he was putting too much pressure. I ended up feeling a little better actually, but my insurance said I had had enough visits and I assume I can go back this new calender year. Some soreness might be expected, but if you're having so much pain it's time to try a new therapist or a new type of therapy all together like hydro-therapy or something.

 
Old 08-18-2012, 06:49 AM   #8
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Re: Physical Therapy Making Pain Worse

Fourth day now with neuralgia pain. I am taking Gabapentin that I had prescribed for another occasional ailment. It doesn't stop the pain but it does lessen it and I was able to get a decent nights sleep.

I have had three experiences with physical therapists. The first one was in PA when I injured myself on the job and saw a PT for about six months. They did a wonderful job and while I may have experience some discomfort from time to time I never had an severe pain.
My second experience with a PT was in TN. I met with a new doctor when I moved to TN and she told me of a new treatment for peripheral neuropathy and prescribed treatment by a PT. Before starting the treatment I had to sign a form promising thirty days of treatment. After a week my feet began to hurt worse. I was told this was normal. By the end of the thirty days I could hardly walk and was taking pain meds. The PT told me I needed more treatments and I declined. After a month or better of no treatment my feet were back to the PN pain I had in before starting the therapy.
Third experience was the one described in this post.
The first rule of medicine is to do no harm. I went to this third PT with shoulder pain that would wake me. I now have the same shoulder pain, neck pain, and occipital neuralgia pain. I have had massages I thought were fairly rough but never had any pain afterwards. I now believe that this latest PT has irritated several nerves in an attempt to relax my muscles by stimulating trigger points. Instead of recognizing a problem they tried to ignore and wanted to continue treating me. In reading other posts I believe I did the right thing by canceling any future treatment. Many of these posts state that after enduring treatment they had to undergo surgery to correct what the PT had done. Some said they would have to be on pain meds the remainder of their lives.

I firmly believe in speaking out when a treatment seems wrong. There are many medical facilities whose soul goal is to collect money from SS and insurance companies and could care less about the patients needs. When and if they are found out they simply close the doors, put an out of business sign up, and open up under a different name.
The first rule of medicine is to do no harm.
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Old 08-18-2012, 07:08 AM   #9
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Re: Physical Therapy Making Pain Worse

That is unfortunate that your PT wasn't open to feedback. Definitely, keep trying. There's probably someone else out there who can address your shoulder issues without causing so many other issues.

 
Old 08-18-2012, 01:19 PM   #10
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Re: Physical Therapy Making Pain Worse

You have to do what you think is right for your body. If you don't think the PT is helping, then you have to do what you have to do. Maybe sometime in the future you might find a great PT.

 
Old 08-23-2012, 07:55 PM   #11
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Re: Physical Therapy Making Pain Worse

OP Update - I finally could take no more and went to see my MD. He said the PT had irritated and inflamed related nerves causing the pain. He prescribed a steroid pack to reduce the inflammation and Hydrocodone for the pain. I asked him about the itching with Hydrocodone and he told me it was OK to take Benydrl along with it to counteract the itching. It worked for me. I am happy to report that after a few days on the steroid pack my pain has been alleviated and I have no more need for pain meds. My MD also apologized for the outcome at the PT he sent me too and told me not to go back.
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Last edited by don444; 08-23-2012 at 07:56 PM.

 
Old 08-23-2012, 08:50 PM   #12
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Re: Physical Therapy Making Pain Worse

Glad you are doing better. I still hope down the road you could give it another try with a different therapist and maybe something less hands-on, but I know in the immediate future its probably not a good idea. Best wishes.
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Old 08-24-2012, 06:23 PM   #13
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Re: Physical Therapy Making Pain Worse

I'm so glad you're feeling better!

 
Old 08-25-2012, 04:29 PM   #14
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Re: Physical Therapy Making Pain Worse

I have different opinions about PT and it really depends on the therapist. The last one I went to for sciatica was awful, could not understand why I couldn't tolerate the tens unit, did not do any stretching and only focused on core building exercises. The one I went to last year was wonderful, (I went for cerviocogenic headaches) At the first appt she spent 15 minutes covering good pain v bad pain and would focus on massage/myofascial release and gentle stretching. I would definitely try again with a different therapist and see if that helps.

 
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