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Has anyone heard of/tried this PT???

AmandaCNAAmandaCN Posts: 51
edited 06/11/2012 - 8:40 AM in Exercise and Rehab
Hi All,

I have been lurking here for a while, though I don't post very often. I am usually content just reading posts and knowing there are others out there like me.

So, I have a question about a PT program I have been put into. Despite having tried everything to aleviate my pain over the past three years, surgeons are hesitant to operate on me because I am only 30 years old. As a last ditch effort before considering spinal fusion I have been sent to an intensive PT program where the goal is to put you in so much pain that your body turns the pain off. I am supposed to do very intense exercises that strengthen my core, legs, etc - but I am to push through until the pain is close to unbearable. I guess the goal is to get my body so sick of being in pain that it rewires my nerves not to feel it? This has been prescribed to me by a Doctor working out of one of the best hospitals in Boston. He is very well respected in the field and I have had two surgeons tell me to try out his program.

I am a little worried, though. I already work a very physical job that often puts my pain levels into the 8-9 range. I take Vicodin and occasionally use Lidoderm patches for the pain. I have been suffering through this so I can keep my insurance while seeking treatment. However, the doctor expects me to go off all pain meds while doing this PT. Needless to say, I am going to talk to my PM about taking a few weeks of disability from work.

My question is, has anybody heard of or tried this type of PT? And how long should I give it? I have done PT 3 times before and they always told me to ease off if I felt too much pain. However, part of my session on Monday will include lifting as much weight as I can. The therapist told me they will "keep piling on the weight until I cry Uncle".

I would love to hear people's thoughts on this. I know that if this doesn't work then I will be evaluated for spinal fusion - though I was told that the most they would do was one level (again, because of my age). I have included some basic history in my signature.



  • Ouch! That sounds incredible to me that they would want you to be doing stuff to the point it brings on intolerable pain. My physical therapists have always told me that if it hurts a little, keep going. But if it hurts a lot and continues hurting afterwards, don't do that exercise again.

    the thing that would concern me about this type of program is the potential for causing more damage. Piling on weights just doesn't sound good. Is it your neck or back that you are struggling with? I'd tell you to be careful when you do this, but it sounds like they don't want you to be careful. They want to torture you.

    I'd have a hard time agreeing to that program. Are they certain this won't cause more damage?
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • I have herniations in the Lumbar area from L4-S1. I am a little worried about doing more damage as well but two well-respected surgeons told me I should try what this other doctor suggested. I really feel like I have no choice in the matter. I have wondered if this doctor thought I might be exagerrating the pain due to my high activity level. In fact, I am just incredibly stubborn and have worked VERY hard at my job because I need the money and insurance...
  • Hi Amanda
    The kind of therapy that you'r doing in my personal opinion I think is kinda of danger.let me tell you that when I hurt my back I was in my earlies 30.and they didn't wanted to do surgery on me. at that time I had just 1 bad disk .doctor told me to continue to work and do my regular activities,Big mistake working and the regular activities cause me so much damage to my back .when i had my fist surgery the doctor told me why i waited so long
    forcing and pushing your back the way you are doing could be causing lots of damage in the inside becarful
  • WoW Amanda! I sit here shaking my head. I could not do this. I seriously mean it, I would fall to the floor and curl up in a ball and just die there.

    Is this Dr a nuro guy? If some Dr is talking to me about rewiring and such I would want him to be a TOP nuro.

    Please let us know what your PM thinks about this and what all happens.

    I hear you about being bull headed lol I was too BUT when I kept working I did more damage, which is also something I am sure your worried about.

    I just thought of something * Maybe call around anonymously to PT and such places and ask if they ever heard of this type of PT.

    Write their names and responses down to take with you to see your Dr in a few weeks.

    I sure hope/pray this all goes well for you (( HUGS ))

    Beth :)
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • This is not addressed in any academic research I have been reading for the last 20 years and any new idea more mythical than reality, no reasonable individual would suggest that this is preferable and maybe the concept of its provision questionable.

    Pm is about pacing and once we reach that point when the pain become intolerable and continuance after that point would seem counterproductive to encourage pain to continue at a level far beyond reasonableness.

    Most incoming PT patients have been inactive by the nature of Cp itself and the confidence of any individual have to be encouraged prior to increased activity duration of intensity. I can understand wanting to encourage people to push themselves beyond the current norm or expectation and any introduction of PT is painful and an emotional event. On the basis that a fusion may be applicable no amount of PT will reverse that clinical need if evidence supports that option, how will increasing any level of pressure reduce your condition.

    Perhaps you could ask the therapist to show you that crying technique before you have a go and most of my peer group CP patient would not even attempt anything close to this level of inability. I think you may be confused, reducing those signals of pain will not be reduced in increasing intensity, I do understand that for some, thinking of pain continuously or excessively will increase the notion of pain to become increased, if we stay clam the concept of the pain intensity may reduce, irrespective that the underlying and origin of the pain stays the same. CBT attempts us to think of the pain less by reducing and managing our traits of behaviour and how we react, they would never say in thinking of the pain more it will go away. !

    Ask them to tell or show you the evidence and what research suggested this is a good idea.


    Good luck and take care, Sternbach et al never mentioned this…........good job.

  • I come from the Boston area and know how the hospitals are famous there for new and innovative approaches to medicine, but what you are talking about sounds very unreasonable. If you go for this approach, please keep us posted on how you are doing. Has this doctor given you references from his patients as to how they made out with this program? I would definitely want to speak to one of them.

    Best wishes,

  • I have read about and seen this used. I did volunteer work in 2 large Physical Therapy Clinics (run by and for the military) and picked up quite a bit over the course of 3 years there.

    Basically the thought process is as you were told, "to change the perception" of the pain you are feeling. In other words, to create new pain filters in your brain so that the pain you feel gets run through a new set of filters.

    Take for example the use of "white noise". I used to work mid shift and the only way I could sleep during the day was to run a fan in my room to block out the noise around me. My brain learned to not focus on the fan but to use it as a filter. That same fan, if I focused on it, could be an annoying source of noise if I were trying to listen to music or the TV.

    Pain is dealt with much in the same manner. How many times have you heard people refer to the fact that they have been in pain so long, that they didn't realize how much, until it was taken away via meds or a procedure. Over time their brain had begun to filter out certain pain reception so that it could process new and different signals.

    Think about other things that your brain can and does filter out on a daily basis. Like the way your clothes press on you, or a watch or a ring. Your brain files that away so that it can sense new and more important stimuli. Take for example wearing a bra. (sorry guys) For the most part women get so used to it, that they don't notice the pressure and restriction of it during the day or normal activities. However there are times when it seems like the most uncomfortable piece of clothing ever designed and you can't get comfortable until it is removed.

    So there are clinics that do prescribe to the thought process that you can retrain the brain while strengthening the body to fight against the source of the pain.

    I hope this makes sense, it is a difficult concept to get across in words.

  • dilaurodilauro ConnecticutPosts: 9,859
    but for most Physical Therapy I have seen or discussed regarding Spinal problems, I have never come across that method.
    In fact, some of the problems with Physical Therapy is they may push you too far and you wind up with additional discomfort.

    In terms of your doctor not wanting to do surgery because you are 30, trust me there are 1,000's of spinal surgeries that are done on people much much
    younger than you. That should never been used as an excuse.

    I do however believe to try all the conservative treatments that are available, if not once then twice before you decide to have surgery
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Thank you all for your input and kind words. I really appreciate that you took the time to respond.

    payo - I agree with you on "over-working" oneself. This will be my last ditch effort before surgery. If this doesn't work I will be DONE with PT.

    Beth - The Doctor is a physiatrist but he does work with neuros and orthopedic surgeons. That is a good idea about conducting research - maybe I will try that.

    John - I think I would be more confident in thei type of PT if I had tried it early on. It is strange to me that they want to put me in more pain. As for "crying Uncle", that is just a phrase the therapist used to describe what they were going to do. What he meant is that they are going to keep putting weight on my back until I am in too much pain to continue. I am really nervous about that part...

    Marianne - Unfortunately, I did not get any references from other patients - just doctors. Though, one of the surgeons did tell me that it seemed unreasonable to put me in this program AND expect me to go off all pain meds.

    hagalndc - I am so happy to know that someone has heard of this. It does make sense in a warped sort of way. The problem is I am hardly a sedentary type and I have to push through physical labor at my job. I worry that this theory is based on the fact that people do not push themselves enough. At any rate, it make me feel a LOT better to know that someone has actually heard of it!

    I will let you all know how it works out. It will be interesting to see how I feel on Monday after my first session.
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