jackson'smama Posted February 4, 2013 Share Posted February 4, 2013 did you get relief/improvement? i have 3 herniated discs in my lower back and it has become chronic (as in daily/constant) pain with little relief in some sitting/standing positions. this is over 2 years duration (since birth of my 3rd child). i am in my second round of PT and i do not see improvement. the first time was over a year ago and i went twice weekly for at least 3 or 4 months (plus the home exercises). now i'm going to a new PT (that came highly recommended) and they are doing pretty much the exact same thing the first one did. So i'm driving one hour each way and paying a $25 copay for "exercises". i've never joined a gym b/c i'm too frugal and believe one can work out without having to pay a facility to make it happen. and here i am paying way more for very little in return. if i were feeling better, it'd be one thing, but i'm not. i'm starting to wonder what, if anything, will make this better. i've done oral steroids but refused injected. surgery is nowhere on my radar. i take NSAIDs (prescription) but oftentimes, i might as well have a glass of water. i didn't make a PT appointment last week and haven't made one for this week. I figure i can look online to find exercises to do. any advice? Quote Link to comment Share on other sites More sharing options...
TravelingChris Posted February 4, 2013 Share Posted February 4, 2013 Have you considered going to a pain clinic? I am sure you need stronger medications. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 Have you considered going to a pain clinic? I am sure you need stronger medications. my doctor mentioned that, but honestly if meds is what they offer, i feel like i'm not getting to the root of the problem. i have used stronger stuff without great relief. honestly, the first few days of prednisone were the best, but it dwindled as soon as i started the tapering. my pain greatly affects my quality of life, but i'm terrified of getting hooked on something. Quote Link to comment Share on other sites More sharing options...
Starr Posted February 4, 2013 Share Posted February 4, 2013 I've done better with a chiropractor. But they aren't all equal. Quote Link to comment Share on other sites More sharing options...
besroma Posted February 4, 2013 Share Posted February 4, 2013 I found that the results depend entirely upon the PT. Some PTs teach you how to improve your situation, thus reducing your reliance on going to them. Others take you through the motions of the exercises without really teaching you what you need to know. (Same thing with chiropractors. ) Quote Link to comment Share on other sites More sharing options...
Swimtaxi234 Posted February 4, 2013 Share Posted February 4, 2013 Sending you a PM. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 I've done better with a chiropractor. But they aren't all equal. i went to one for upper back problems years ago and was kinda scared of him. the popping and cracking and sudden jerking were mentally unsettling and didn't feel so hot either! i'm worried about finding the wrong one because it seems that for every good review of chiropractors in or near my area, there is an equally bad review. this stinks. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 I found that the results depend entirely upon the PT. Some PTs teach you how to improve your situation, thus reducing your reliance on going to them. Others take you through the motions of the exercises without really teaching you what you need to know. (Same thing with chiropractors. ) interesting that you say this b/c i specifically ASK at every visit what i could be doing differently to make this better, how could i change daily life stuff to improve this, etc... and i really haven't gotten much more than a "it's gonna take time" kind of response. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 I did, but I had a completely different problem so it might not be comparable. I will say that the first PT I tried made it worse. He sent me to someone else within the same practice and that person fixed me up within a couple of weeks. did you have things to do at home that enhanced your recovery or was it strictly based upon your PT visits? Quote Link to comment Share on other sites More sharing options...
Momof3littles Posted February 4, 2013 Share Posted February 4, 2013 This isn't a requirement for finding a good PT, but you might be able to hone in on someone good using a tool like this http://www.abpts.org...vid=10737423513 to identify a PT with the OCS designation (orthopedic clinical specialist). There are certainly wonderful PTs with great manual therapy skills that aren't OCS, but if you need to narrow the pool, I'd look there. PT has very good long term outcomes when compared to surgery in many cases. Like anything else though, the quality of the therapist is going to matter, and your individual situation is your individual situation. You may have a case that is less likely to improve with PT. I would not just do exercises on your own unless you know what you are looking for. You probably know the drill, but you can exacerbate issues by doing the wrong exercises, particularly with something like disc issues. edited to add: how often are you going? I agree that a home program is crucial. One, two, or even three days a week may not be enough to address your specific situation. What a patient does at home can make a huge difference. Have you talked to your PT about your progress and what you are feeling? That you don't feel you are seeing a marked improvement? I would be honest and let them know what you are thinking. Are they giving you concrete info based on evals or re-evals about what they are seeing? If insurance is still paying, I would think they are justifying by showing some sort of improvement. Is that not the case? Quote Link to comment Share on other sites More sharing options...
Swimtaxi234 Posted February 4, 2013 Share Posted February 4, 2013 I have been trying to send the PM, but I keep getting error messages. Will you try to send me a PM? Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 I would not just do exercises on your own unless you know what you are looking for. You probably know the drill, but you can exacerbate issues by doing the wrong exercises, particularly with something like disc issues. edited to add: how often are you going? I agree that a home program is crucial. One, two, or even three days a week may not be enough to address your specific situation. What a patient does at home can make a huge difference. Have you talked to your PT about your progress and what you are feeling? That you don't feel you are seeing a marked improvement? I would be honest and let them know what you are thinking. Are they giving you concrete info based on evals or re-evals about what they are seeing? If insurance is still paying, I would think they are justifying by showing some sort of improvement. Is that not the case? i was going one or two days a week which is what the prescription from my doctor called for. and it was for "up to 12 sessions". so at this point, i'm half way there i guess. every time, she asks me how i'm feeling/how i've been feeling and every time it's the same. there were two visits where i also had this excruciating left groin/hip pain. she attributed it to some kind of nerve pain related to the back issue. it went away on it's own after a couple of days. every time it seems that there's something that continues to be out of whack in my pelvis (?) because when i bend forward, something she's measuring on my back pelvis is off and then when i lie down, one leg is longer. so we go thru all these different things and finally, she seems satisfied that there's some improvement and it's pretty much over and i get up and hobble out just like i hobbled in. and life goes on the same way as it was before. :( Quote Link to comment Share on other sites More sharing options...
Momof3littles Posted February 4, 2013 Share Posted February 4, 2013 Are you having sacroiliac joint issues? If so, are they teaching you things to do on your own to work on getting it back into place when it goes out on you? It can take time to build up enough core strength to get things stable. And then you want to be able to work on keeping things stable while you do dynamic movements. That takes time. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 Are you having sacroiliac joint issues? If so, are they teaching you things to do on your own to work on getting it back into place when it goes out on you? It can take time to build up enough core strength to get things stable. And then you want to be able to work on keeping things stable while you do dynamic movements. That takes time. yes, and last time she mentioned trying a SI belt. no, there is nothing i've been instructed to do to get it into place because i think it actually stays out. i mean, when she's done doing what she does, i feel no different. right now, the only thing i work on is core strengthening and that's the only thing the other PT ever taught me to do. so right now, the line up is this 10 reps of 10 abdominal braces with a kegel 15 reps swaying knees side to side while lying on back 15 reps hip abductors and adductors (using a rubberband or a bouncy ball) 15 reps "marching" - lying on back, knees bent, barely lifting feet off the ground. to me, it feels like it's designed for an elderly person. i just want to pick up the pace or something. so to answer your last point, i think i'm doing my dynamic movements, but i don't know how stable i am. and it doesn't seem to be something that's being fully addressed. Quote Link to comment Share on other sites More sharing options...
Momof3littles Posted February 4, 2013 Share Posted February 4, 2013 I think you might need to see if you can find any alternatives in your area. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 I think you might need to see if you can find any alternatives in your area. might i ask specifically why you think that? :) Quote Link to comment Share on other sites More sharing options...
Runningmom80 Posted February 4, 2013 Share Posted February 4, 2013 No. I went for 6 months when my twins were infants. The multiples pregnancy destroyed my back. The exercises didn't help until I worked my abs. But for me it was more of a weak core issue, not a disc issue. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 No. I went for 6 months when my twins were infants. The multiples pregnancy destroyed my back. The exercises didn't help until I worked my abs. But for me it was more of a weak core issue, not a disc issue. well what i've been told (by both PTs) is that yes, i have disc problems, but that they won't go away/improve until i strengthen my core. did you do it on your own or with PT direction? Quote Link to comment Share on other sites More sharing options...
Momof3littles Posted February 4, 2013 Share Posted February 4, 2013 Is this person doing any manual therapy on you? Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 Is this person doing any manual therapy on you? manually pulling my leg/traction (when i had the groin pain) having me resist her pulling/pushing pulling my upper body left while forcefully pushing my right hip (kinda felt chiropractorish) Quote Link to comment Share on other sites More sharing options...
TravelingChris Posted February 4, 2013 Share Posted February 4, 2013 Narcotics don't get the majority of patients hooked. I believe the percentage is something like only 3%. One way to know if you will have a problem is do you have a problem with any other addiction, be it alcohol, cigarettes, etc. ? If not, you are very unlikely to have a problem with narcotics. But that may not even be what they would prescribe for you. Over here, we have a wonderful pain clinic that I am just getting started with. They don't just shove medicines. They have a multi-disciplinary approach with medical, behavioral, and physical therapy. I think their PT will work better for me than the regular type because they know that they are dealing with improving function and decreasing pain, but not curing a condition. The behavioral is teaching non medical techniques to lower pain and also to have people who also have chronic pain to relate with since it becomes very lonely being usually the only person with constant pain in a situation. Then the medical people do prescribe medication but one of the things they do which would probably help a person like you is put in pain pumps that act on the specific area. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 4, 2013 Author Share Posted February 4, 2013 it becomes very lonely being usually the only person with constant pain in a situation. oh my yes. this totally. i don't have an addiction to anything but chocolate, but alcohol and cigarette addictions are in my genes, so it does concern me. i'm just done with this. the adds for cymbalta are calling my name (the ones that focus on chronic pain). Quote Link to comment Share on other sites More sharing options...
Jann in TX Posted February 4, 2013 Share Posted February 4, 2013 A herniated disk is like a tire tube that has a weak spot-- it buldges. The buldge puts pressure on your nerves (spinal cord) and the result is pain. Your ab muscles help to support your spine-- so having good strong ab muscles will help to aleviate the pressure from the buldge-- but it WILL NOT FIX THE HERNIATED DISK-- and a herniated disk rarely, if ever, heals itself. (a tire tube will NOT go back to normal once it has a weak spot). If your herniated disk ends up leaking the disk will deteriorate. Now your spine is not balanced (vertebrae are crooked and the result is more pain due to inflamation). The disk will NOT regerate. This is permanent. Again, having strong ab muscles ( reason for PT) will help support your spine and may help with the pain-- but if the disk degenerates-- it (PT) most likely will NOT help. Can you live like this with pain management-- sure--but it is NOT fun (not life threatening but still unbearable at times). A chiropractor can help with buldging/herniated disks-- again keeping the spine in line and helping to reduce pressure on the bad disk(s). It will be a temporary fix- combined with PT it can, however, have long lasting results. (but you may have frequent visits to chiro). If a disk has herniated your spine can slip out of alignmnet as soon as you leave the office! I herniated a disk in college. I lived through it and working out (my own PT) helped. I thought nothing of it for many years-- until after my 3rd child was born and I bent over to pick up a baby blanket (twist/bend)... I blew the disk! The pain was horrid! I went to PT for several months-- no relief. I ended up 'dealing with the pain' and suffered for several years-- mainly because I heard that back surgery was a bad solution. I was a grumpy mom and generally a depressed person... chronic pain is yucky! ( I decided to edit the bad work out!) Well-- I got to the point a few years later when PT and pain management were no longer helping. I chose surgery. I regret having waited so long. My surgery had a 2 week painful recovery (they went in through my abs --kind of like a C section) but as soon as I woke from surgery my back was not hurting-- I could feel my hips and legs--- no fire moving down my legs! I wore a back brace for a few months-- but it was worth it. I still feel like I have a weak back-- (I have other disks that have some herniation but have not started degenerating yet). PT and /or regular exercise will help that. I love my Orthopedic surgeon-- he never pressured me (he was the one who wrote the script for PT in the first place)-- and he had me get second and third opinions before I had the surgery. Quote Link to comment Share on other sites More sharing options...
Momof3littles Posted February 4, 2013 Share Posted February 4, 2013 THere are numerous studies about outcomes for disc herniation with PT. PTs often use more gentle mobilizations than chiros to line up the spine (high velocity movements are often unnecessary), they can use traction, etc. Surgery is definitely a good option in some cases, but there are quite a few studies showing PT has better outcomes long term for many people, or similar results to surgery over the long term with lower risk of complications. Obviously, this is going to vary depending on what exactly is going on with a particular patient. Several studies have indicated surgery often provides quicker relief, but not necessarily a significantly different outcome than conservative management long term. Again, this is going to vary depending on what exactly an individual is dealing with and in certain situations one vs. the other may be more appropriate. Comprehensive PT for back issues like a herniated disc does not just encompass strengthening the muscles. There are many more tools in a good PT's toolbox than that. edited to add: Jackson'smama these may or may not apply to you. Ask your therapist what they think about long term outcomes in your situation. Ask for studies, etc. if you are curious, ask how they might apply to what has happened with you to date with conservative management. http://www.ncbi.nlm....les/PMC3025225/ http://www.ncbi.nlm....pubmed/20949289 http://www.ncbi.nlm....pubmed/17538084 http://jama.jamanetw...rticleid=204281 http://www.ncbi.nlm....pubmed/18312085 http://www.ncbi.nlm....d/20203381 by the way does your pain centralize at all while you are at PT or after? Even if you are having some pain, having it centralize during or after therapy would be a positive sign) http://www.ncbi.nlm....pubmed/18841731 http://www.npr.org/t...storyId=5240537 http://www.npr.org/t...toryId=15807449 http://www.npr.org/t...oryId=125627307 http://www.npr.org/t...storyId=6519896 OP, have you had any imaging done more recently? Quote Link to comment Share on other sites More sharing options...
Heartsjoy Posted February 6, 2013 Share Posted February 6, 2013 McKenzie trained PT train you with exercises to continue at home that help push the discs back in place over time. Centralizing of pain is a beginning goal like a pp said. Quote Link to comment Share on other sites More sharing options...
dhudson Posted February 6, 2013 Share Posted February 6, 2013 2 herniated discs here and one had to be fixed by surgery. I then lost 25lbs and started doing Pilates 4-5 days a week. This has greatly helped in managing the pain. PT and Chiro only seemed to exacerbate it. The best thing we've done since is to buy a cheaper brand of the Tempurpedic mattress with a motorized base so that I can sleep with my feet and head slightly raised and cradles my back. First time in 10+ years I have woken up with no pain. It was miraculous and made me a much happier wife and mom. Quote Link to comment Share on other sites More sharing options...
Tap Posted February 6, 2013 Share Posted February 6, 2013 3 of the PTs I went to were not helpful. These all worked at a top rehab center in our area with prestigious professional athletes as clients. ....the last one at a small private PT office.. was a God send. She took an entirely different approach. Instead of leg swings and traditional exercises, she concentrated on rebuilding my core muscles starting with my pelvic floor. She worked with me on every part of my day. From standing, to sitting, to laying down. She changed my posture an inch at a time. She showed me small exercises to do throughout my day to continue strengthening my core and triggering muscles that I wasn't using properly to support my body. She looked at my whole body as one unit, and treated my blown disks as weak spots that needed to be rebuilt and worked around, but my back was not the center of every therapy session. She took me from seriously considering surgery (despite the low 50/50 chance of sucess), to being off of all meds and no surgery in 6 months of weekly sessions. I will always hurt. I am not saying she cured me in anyway. She absolutely change my life and the way I look at my injury. I have blown L4, L5 and they are pretty much inoperable since the 4 neurosurgeons I consulted all think I will end up worse after surgery than before (conjoined nerve overlaying the disks). The head of neurosurgery at a top teaching hospital told me that if I was his wife, he wouldn't let anyone cut on me. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 6, 2013 Author Share Posted February 6, 2013 by the way does your pain centralize at all while you are at PT or after? Even if you are having some pain, having it centralize during or after therapy would be a positive sign) OP, have you had any imaging done more recently? no , my most recent mri was over a year ago. there has been no change in my pain, so the doctor didn't feel the need to repeat it. i declined the mri until after the first round of PT. that PT felt that my problems were all core weakness-related and possibly not even disc herniation. mri showed L4 and L5 herniation and "some involvement at S1". also some facet hypertrophy. McKenzie trained PT train you with exercises to continue at home that help push the discs back in place over time. Centralizing of pain is a beginning goal like a pp said. what does "centralizing of pain" mean? generally what i find is that i struggle getting out of the car, kinda hobble on and as i walk it improves, i sit in the waiting room and then have difficulty rising from my chair and beginning to walk (difficult as in painful). then forward bending really hurts as does lying flat on my back. the specific exercises that i do do not cause pain. the last time i was put in some type of machine that involved being strapped in with carseat-type belts across my upper thighs, pelvis and lower abdomen. the goal was to brace my pelvis so that forward bending was not painful. i was ratcheted in so tightly that my abdomen hurt but it continued to be painful when i tried to forward bend???? i called yesterday to try to get an appointment. i have been unable to get one for two weeks due to scheduling conflicts. i mean, i work two days, homeschool, and have three children that can't be home alone or go along with me. i can't just go any day or any time. still couldn't be seen until next tuesday and i am "not allowed" to be seen by anyone else in the practice until i'm reevaluated by the current pt since i haven't been in two weeks. two co-workers recommended a different therapist and i have an appointment for friday. hopefully there won't be some insurance issue with switching to a new PT. this stinks. Quote Link to comment Share on other sites More sharing options...
2boysmom Posted February 6, 2013 Share Posted February 6, 2013 I also had disc surgery when I was 30. I'm so glad I did. I have to be careful for sure to protect my back from now on, but I'm 43 now, and don't even think about it. I could not live with chronic pain myself. My Dr. also said, this problem cannot be "cured." You can prevent, or work on exercises following surgery to increase strength. But, once it's gone. It's gone. I would highly reccomend re-thinking having surgery done. I have never, ever, regretted it. Quote Link to comment Share on other sites More sharing options...
gingersmom Posted February 6, 2013 Share Posted February 6, 2013 I also had disc surgery when I was 30. I'm so glad I did. I have to be careful for sure to protect my back from now on, but I'm 43 now, and don't even think about it. I could not live with chronic pain myself. My Dr. also said, this problem cannot be "cured." You can prevent, or work on exercises following surgery to increase strength. But, once it's gone. It's gone. I would highly reccomend re-thinking having surgery done. I have never, ever, regretted it. I agree. I had surgery at 34 and it was the best thing I ever did (L3 and L4). I actually had no choice but it was still the best thing I ever did. I had been dealing with back pain since I was 10 years old. And yes I had been through too many PT appointments to count. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 6, 2013 Author Share Posted February 6, 2013 I also had disc surgery when I was 30. I'm so glad I did. I have to be careful for sure to protect my back from now on, but I'm 43 now, and don't even think about it. I could not live with chronic pain myself. My Dr. also said, this problem cannot be "cured." You can prevent, or work on exercises following surgery to increase strength. But, once it's gone. It's gone. I would highly reccomend re-thinking having surgery done. I have never, ever, regretted it. I agree. I had surgery at 34 and it was the best thing I ever did (L3 and L4). I actually had no choice but it was still the best thing I ever did. I had been dealing with back pain since I was 10 years old. And yes I had been through too many PT appointments to count. i'm glad you both had such wonderful results. i guess i've always had this fear that what if i'm the statistic that becomes paralyzed from surgery? i'm a worrier like that. i'm glad i experienced natural childbirth just for the experience itself. but even if i had not really wanted natural childbirth, i'd have done it to avoid the epidural. internally messing with my spine totally scares me. it's the same reason i've declined steroid injections. so surgery is just off the charts terrifying at this point. i've always felt that i'd have to be basically debilitated to the point that paralysis would not be such a negative alternative. i'm sure that sounds ridiculous to some, but it's kinda where i am at the moment. Quote Link to comment Share on other sites More sharing options...
a27mom Posted February 6, 2013 Share Posted February 6, 2013 I am a PT, though I dont specialize in backs, but I definitely think you should switch PT's. glad you have a new appointment. There are a lot of different approaches to treating back pain. For discs I generally prefer a Mackenzie approach, which is not what your current PT is doing. (Mackenzie in your case would involve something lying on your stomach.) If you have herniated discs that don't respond, surgery can really help. Your therapist should be giving you work to do at home, and modify that regimen most visits. they should explain the changes you should be feeling (ie. centralizing pain) They should instruct you on body mechanics and posture as well. It takes time to recover completely, but after 6visits, they/you should be able to identify some improvement Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 6, 2013 Author Share Posted February 6, 2013 I am a PT, though I dont specialize in backs, but I definitely think you should switch PT's. glad you have a new appointment. There are a lot of different approaches to treating back pain. For discs I generally prefer a Mackenzie approach, which is not what your current PT is doing. (Mackenzie in your case would involve something lying on your stomach.) If you have herniated discs that don't respond, surgery can really help. Your therapist should be giving you work to do at home, and modify that regimen most visits. they should explain the changes you should be feeling (ie. centralizing pain) They should instruct you on body mechanics and posture as well. It takes time to recover completely, but after 6visits, they/you should be able to identify some improvement thank you for giving your perspective on this. while i am not happy about it, i am glad to hear that i should be seeing something change by this time. i kept thinking i should but wasn't sure. i have been doing exercises at home but not much, in my opinion. and have been given no instruction on modifying anything about my posture, lifestyle, starting an overall workout regimen, etc....all things i've asked about but just feel like they're being postponed or something. again, what is centralized pain mean? Quote Link to comment Share on other sites More sharing options...
gingersmom Posted February 6, 2013 Share Posted February 6, 2013 i'm glad you both had such wonderful results. i guess i've always had this fear that what if i'm the statistic that becomes paralyzed from surgery? i'm a worrier like that. i'm glad i experienced natural childbirth just for the experience itself. but even if i had not really wanted natural childbirth, i'd have done it to avoid the epidural. internally messing with my spine totally scares me. it's the same reason i've declined steroid injections. so surgery is just off the charts terrifying at this point. i've always felt that i'd have to be basically debilitated to the point that paralysis would not be such a negative alternative. i'm sure that sounds ridiculous to some, but it's kinda where i am at the moment. I felt exactly the same way. Thats how I landed having emergency surgery. I was unconscious for 5 days (in the hospital) before they even could do the surgery (the swelling was so bad and some other complications). I was also paralyzed on my right side. In hindsight I regret letting things get so bad. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 6, 2013 Author Share Posted February 6, 2013 I felt exactly the same way. Thats how I landed having emergency surgery. I was unconscious for 5 days (in the hospital) before they even could do the surgery (the swelling was so bad and some other complications). I was also paralyzed on my right side. In hindsight I regret letting things get so bad. wow...so sorry you had that experience. Quote Link to comment Share on other sites More sharing options...
jackson'smama Posted February 9, 2013 Author Share Posted February 9, 2013 went to a new PT today and i am not kidding when i say i feel better. i cannot believe it. it's definitely not over...not even close. but i feel like there was an improvement today. not only that, but she is very holistic in her approach and was focused on all of me, and especially all of my back - not just the herniated disc area (which is a new experience in this drama). i don't know what she did (she talked about it and it sounded like an old college class with words like neuron and ganglion and such!) but i feel some promise here. and that's huge right now. thanks to all of you for chiming in and offering support and advice. Quote Link to comment Share on other sites More sharing options...
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