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RE: PT is supposed to do what?

I had a microdiscectomy 2-22-13 on L4/L5 after nearly two years of sciatica. I did not know the longer you wait the harder it is to fix. I have had some relief w/the sciatica but the lower back pain is consistent. I have been on pain meds since surgery plus mobic and neurontin; I hurt every day. I am in week three of PT. today as the therapist touched my ack I mentioned the tingling and numbness in my right leg/buttock. She stopped for a moment then has me raise up on my elbows acing forward. Ten times she had me raise to where my tummy was off the able; it hurt my back but I dd not push and it was tolerable until near the end. She asked then if the tingling ad subsided--it had for the most part--and where the chest raises had hurt bi admitted my arms and back hurt. Her response was to say my arms should not hurt and that my back old be better if my arms were stronger and could offset the weakness/vulnerability in my back. Is she crazy? First, had I get that strengthening my core is the goal. Second, her job is to find noninvasive, medicine-free solutions to legitimate problems. And third, things are probably going to feel worse before they feel better. But I walked away feeling as if I'd been accused of being fat, lazy, weak, and a faker. Does that make sense? I don't have pain-free periods longer than three or four hours. I was on the treadmill five or so days/week before surgery. I hurt all the time and I'm sad. I know I'm hypersensitive about it. And I know I'm feeling defensive. But could she be right? Am I overreacting? Should I call my doc? I feel like tattling, you know? ;)


  • I'd give her a second chance.... but if she makes you feel uncomfortable (mentally), then I'd ask for another PT. There are lots of them. I find sometimes you just have to "get to know" the PT. My two cents, I believe one of the biggest factors of seeing success in PT is a positive attitude... and if she takes that away each time you go then you need to find someone else. Good luck, PT can be a very powerful tool in healing. I also want to make a quick comment about a line you wrote... "Second, her job is to find noninvasive, medicine-free solutions to legitimate problems." I don't agree with the medicine-free... clearly the PTs aren't allowed to prescribe since they aren't doctors, but my experience with "good" Physical Therapist is they wanted to know what drugs I was taking, when, and how often. They used this to judge some of my healing, and sometimes even asked things like.. you might want to speak with your doctor about needing _____.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • I've had issues with physical therapists before because I am a fat woman that people assume is weak & treatment noncompliant (when it comes to PT). I've learned that if they make comments that make me feel bad or they make me hurt, I let them know (sometimes I'm not in a good head space to say this right when it happens...I'm really tenderhearted, and being in pain makes it worse, so I'll tell them at the next visit). If that doesn't help, I find a new PT.

    There are other ways to strengthen the core, and many of them don't involve arm strength or doing planks (something that can be very hard post surgery. I'll also echo what AllMetal said about the medication & PT connection. My main PT is a spiney as well, so she understands that sometimes medication is necessary (and gets that, for me at 4 months out, medication is a several-times-a-day necessity still). They are supposed to get you stronger and more flexible in ways that keep you healthier for the long run so you can have the life you want to live. Sometimes that means there will be some initial pain (both physically and mentally....I've cried at PT several times just lamenting the loss of some of my old physical activity hobbies).

    I hope you find a way to make PT work for you in a way that makes you feel supported both physically and mentally.
    1/16/2013 Minimally invasive TLIF with rods, screws, and cage on L5/S1 joint to treat grade 2 spondylolysthesis, pars defect, degenerative disc disease. Dealt with chronic pain & nerve issues since at least 2007.
  • I so feel you about the fat comment. I use to be a very large woman... who finally had gastric bypass (not suggesting this, just telling my story) and although I'm now a size 14 which is the "Average" size of women in America... I still feel huge and worry about medical professionals judging me. Even as a much larger woman I was active, I was never a couch potato... So I get it.
    And yes, lots of ways to strengthen core muscles. My favorite is the Bosu Ball... but I am NOT suggesting that to anyone because it requires a lot of balance... Anyways, I hope everyone here has a great day to day... less meds (if possible) and more physical freedom. Have a great day!
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • Some PTs are harsher than others, that's their style. Some people respond better to that than others. It's all about finding the right mesh in my opinion. I've had four therapists and three were great, one was terrible. Some patients might take the "your arms should not hurt comment" and use that as motivation. For others it's an insult and not a fair way of approaching the situation. I would personally take it the same way as you if I were in your situation and feel the need to find someone else to work with. If that's an exercise that is supposed to help you I'd think the PT should have said something like "ok, well I think we should do some things to strengthen your arms so that you can more comfortably perform this exercise because it is important for your healing." Instead it seems the PT took a more attacking wording to it which would have broken me down and made me not want to return.
    Microlaminectomy and discectomy at C7-T1 on April 26th.
  • I empathize with your situation. I had a physical threapist after my first neck surgery that kept saying he needed to do cervical spine adjustments on me to help me get better. Big no no if you had fusion surgery. Each time I would tell him no and he never seemed to remember. I "fired' him when it was determined I was going back for a second surgery by my NS. The second PT I went to were great people but were unable to do anything for me. Zero help. No pain relief, no regaining of strength, and no ROM increase (which I had to explain multiple times was because I now have rods in my neck). Alas, it was a waist of the military's money to send me to PT and it was nothing but a bunch of smoke and mirrors. They even insinuated that I should lie about my outprocessing with them and say things had gotten better. I refused to do this and it annoyed them. I honestly think that a lot of the time with the more "intensive" back surgeries that PT does little to nothing for you that you can't do for yourself at home.
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