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McKenzie PT after cervical ACDF?

CMCCM Posts: 100
edited 06/11/2012 - 8:32 AM in Back Surgery and Neck Surgery
I posted this in the neck pain forum, but have received no replies. Maybe someone who reads the back/neck surgery forum has some experience with this?

I had ACDF at C5/C6 in February 2009. Now, just four months later, I once again have pain/burning in my upper back/right shoulder, and various sharp pains in my hands. My surgeon sent me to a PT for McKenzie "therapy". It involves moving my head straight back while pushing on my chin, and also bend my head backwards. I'm supposed to do 10 or 20 repetitions, ideally every hour. I would like to hear from anyone who has used this treatment method after having ACDF. Did it help you?

A cautionary tale about my physical therapy experience:

I had two young physical therapist working on me. They had both just completed McKenzie training. They both seemed very thoughtful, professional, friendly, and we developed a rapport very quickly. I felt comfortable with them and I cooperated fully. One of the things they asked me to do was sit in a chair and bend as far backwards as I could over the back of the chair. They asked me if I had any pain when I did that. I did not. I have no idea why they had me do that because I have not had any problems with my mid or lower back. The surgeon sent me to PT for a cervical spine problem. The next thing that happened is that one of the therapist placed me in some sort of grip and planted her feet in a certain way (asking her partner if she was doing it right) and then she bent me backwards over the back of the chair. I felt strain, but no sharp pain. That was last Thursday. Now for the first time ever I am experiencing intermittent sharp pains in my feet. I am really worried something in my back was damaged when they did this little exercise.

Thinking back, I ask myself, "Why didn't I just say 'Stop!'?" Why didn't I speak up at that moment? I should have listened to that gut feeling, that little voice that said, "You shouldn't be doing this." and I should have just told them STOP. But I didn't. I guess it was partly because I didn't have time to think about the possible consequences of what they were doing. Another part was that I trusted that they knew what they were doing. Why is it we (some of us) don't always immediately listen to that inner voice, especially when dealing with health professionals? I can't describe to you the regret I feel and the anger I have with myself for not stopping what I inherently knew was not healthy for me. I wish I had spoken up immediately.

I don't know yet that there is any permanent damage, but there mere thought of it scares me and makes me feel sick. I have enough problems with my neck. I don't need more spine problems.

I hope that posting my experience here will remind someone else to listen and act on their "gut feeling" when that inner voice tells them "This isn't right. I shouldn't be doing this."


  • i sure hope everything is ok.
    i've read the mckenzie book
    'treat your own back' and thought highly of it's recommendations but i dont recall seeing anything as vigorous as you experienced.
    i use the push your chin and head back a lot and think it's good for me.
    i guess it's the old story of don't ever be the FIRST patient.
    so sorry for this complication.
    keep us posted on how you are feeling,
  • Pete, thank you for replying. I am in disbelief. I just can't believe this is happening. I was already somewhat depressed before this due to the chronic pain with my neck/shoulder/hands. Now I am really depressed. I am going to call the PT place tomorrow and let them know what is going on. I hope they don't think I'm making this up or get defensive about it.
  • CM i would contact lawyer .... i'd cancel any appointments and send letter saying they hurt you and you will be represented by your lawyer. but more importantly id see your dr. to check on next step of your treatment. so sorry ....feel free to PM me if you want
  • Me personally, I refuse to do any PT that reproduces nerve pain. Also, I would not select any PT that ONLY uses one method. I think you have to tailor the treatment to the patient and use components from different ones to get what works best for the patient!

    I really don't know a lot about McKenzie, but I thought it was supposed to be for folks who have mild disease, not for fusion patients. But, like I said, I don't know that much about it. What I do know is that I love the PT's that are willing to do what works for the patient and not go by a textbook.
  • I am having a really hard time accepting this. I had an appointment with my surgeon today and told him what happened. He ordered x-rays of my neck and back. He said the fusion looked okay, but I completely forgot to ask him about the x-rays of my lower back, and I don't remember him saying anything about them. I think he offered to order and MRI, but I declined. Now I am thinking I probably should have got one. However, the surgeon did not offer to have the hospital pay for it.

    The Rehab Department where I went for PT is part of the hospital that is owned by a group of doctors, of which my surgeon is a part. My surgeon had the directory of the Rehab department come talk to me. I hardly even remember what he said. He was nice. He was professional. He was sympathetic. I think he apologize for this happening and told me that the two therapist who worked with me were very good therapist. He said he was going to talk to the PTs and have one of them call me, but I did not hear from her.

    What if I end up having a herniated disc because this? What if I end up needing surgery? What if I can't work? Should I contact an attorney? How could I even prove my back pain was caused by what happened? I'm trying not to catastrohpize this whole thing, but after having two neck surgeries (laminectomy and then fusion), and knowing my mother has a long history of back problems and that she has had multiple back surgeries, and seeing how debilitating back problems can be, I can't help but imagine the worse.

    If this had been the result of a car accident or me doing something careless (bungee cord jumping, reckless ATV driving, jumping off a roof, etc) it would be easier for me to accept, but to think a couple or professional physical therapists put me in this position makes me sick. I trusted them and they were careless - in my opinion.

    My doctor offered to refer me to someone to talk to about this. At first I declined, but later after I left I changed my mind and called his office. He was gone for the day, but his office assistant said she would give him the message. So in addition to x-rays and a doctor visit co-pay, I guess now I will have to pay for counseling too, which my insurance won't cover at all.
  • I would ask to speak to the Patient Relations department or Risk Management or Quality Assurance, whatever they call it at this facility. Explain your situation, say you really do want treatment but it is costly and you feel they aggravated/caused injury. Tell them that you would like to give them a chance to help you with this and be satisfied that you get a thorough exam and treatment. If they seem hesitant, say again that you wanted to give them chance to make this right before you report this to the Joint Commission. www.jointcommission.org You could also mention your state's department of professional regulation or department of public health(at the state level.) This should make them tighten up their sphincters and jump to make things right, hopefully at no extra cost to you.
  • ernurse, Thank you for the suggestions. I wish I had gone to a physical therapy place that was not associated with my surgeon. If it gets to the point where I have to threaten to report the incident to the Joint Commission or take legal action, then I will probably have to find a different doctor.
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