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Is PT really worth it?

Has PT ever really worked for you? After 20 years of chronic back pain and what my new neurosurgeon is calling a failed level 1, L4-L5 fusion from 5 years ago, he wanted me to try PT for 3 months before we talked about another surgery.

PT at the very best seems to be just another way to convince the insurance company that you tried other things before surgery. Maybe PT worked for some people, but it not only didn’t help me but at times seemed to do more harm than good.

After the first visit for an “evaluation” I was given some “homework” to do at home. Some warming up and stretching. What happens during each visit is just a waste of time. By the way this is a very reputable PT business. When you first get there you are put into area (light out and certain closed) and moist heat is applied to your back for approx 20 minutes. Then the therapist comes in and tells you do all of the exercisers and stretching that you were already doing at home for the next 20 minutes. She then goes around to at least 3 other patients that she is working on. Now 40 minutes of “my” 1 hour session has gone by. She then shows me a couple of “new” things to do that have no bearing on my back issue. One hour is over.

So the bottom line is that mine and the other 3 patients insurance companies all paid for a 1 hour session with the same person. Is this the cost of doing business? We all had co-pays and it wasn’t being done for nothing. Matter of fact my co-pay stinks and its $ 40.00 per visit. Besides all of this, is it any wonder that it did not do a thing to help my back. What happened to the one on one therapy that I was paying for?

Has anyone else ever had a better outcome of “real” benefit from PT?
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1

Comments

  • Not saying that PT doesn't work for some people. I think its a waste of time. I tried it before I had my first discectomy and i thought I was going to die. I got nothing out of it but more pain, so bad that I couldn't sit up to put my clothes on, let alone walk. My copay was 60 dollars a visit. Like you I were there for an hour but so where four other people. So I actually got very little time with the therapist. I finally just went to the doctor and complained. He ordered an MRI and I had a huge herniated disc. I believe it just made me worse. I have had two fusions and I haven't went to PT for either of them. My NS just told me to walk. He said that is cheapest therapy I can get. It worked. I built up strength in my legs in no time.

    Jennifer
    Discectomies 05/08 and 04/11, fusions L4-5 Feb 9,2012 and L3-L4 June 28,2012, Staph infection washout 3/2/2012, Bulged L5-S1. SCS trial on January 17th, 2014, which was a success! Permanent SCS on February 20th.
  • I think PT is very helpful after a surgery. But, before, I have never had it help me. And like you say, the one PT Tech is working on 3,4 or 5 people at the same time and doing nothing that you haven't already done at home.
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  • Davey16DDavey16 Posts: 31
    edited 01/02/2013 - 9:18 AM
    The Ones I have been with made me feel worse, and i stopped going my Doctor agreed, There are certain thing they can do to help with a little flexibility,But they seem to lose interest in you and it just seems once you have signed in for them to get paid, they leave you to your own devices,There are some good ones out there but finding them is the key, I hate to be considered a gravy train.
    I have not been post op ,I may now benefit from a bit of P.T and massage because the back sure does stiffen up towards the end of the day. See what my Dr thinks
  • If your already messed up, the disc is already compressing the nerve, things like that PT I dont think will help much. But post-op for me PT has been amazing. I am not very self motivated to exercise so I def needed help in that area. Massage & muscle stim helped me alot. I was prescribed PT for 4 weeks but have been going well beyond that like 14 weeks now. I am about done but plan on going back for a week or2 in the spring to get ready for summer. I really feel I would be in alot worse shape without PT.

    Remember though everyone is different.
    L5S1 REMOVED herniation. Years of pain & compression. Microdiscectomy complete!! Trying to be super smart & safe with recovery!
  • Hi Bob.

    I also think PT is invaluable post-op, but I got nothing from it pre-op. I think it was an insurance thing too. The post-op PT was always one-on-one, helped strengthen my muscles and they taught me things to do and not to do in the future. My surgeon even had the PT show me, and have me practice, a new golf swing that I could do with my new hardware and limitations.

    So I believe it has its value, just depending on what it's for and when it's done.

    Good luck and keep us posted.
    Cathie
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  • I found physical therapy very valuable both before and after surgery. Now -- this is all going to depend on where you go and what methods they use. Trapped nerves can cause some amazingly knotted muscles. I went to see several people and finally ended up with a guy who used Graston Technique. I like to say that it hurts so good. It is done with curved metal tools and ointment/oil, to get the knots out of your muscles and free up the nerve pathways. I had knots in my lower/mid back and butt and up in my shoulders and neck from trying to hold myself rigid so I would not hurt myself. When the tools start gliding over your muscles it can feel like metal on a stiff old washboard, but eventually, it all smooths out. The Graston, coupled with TENS therapy, ultrasound, heat/ice, and strengthening techniques, was key in my recovery. I did, and still do, a lot of pilates for keeping my core strength. I would have turned into a blob of jelly without PT.

    Linda
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • KeeweeKKeewee Posts: 91
    edited 01/02/2013 - 12:07 PM
    I have had PT so many times I have lost count and generally found it to be pointless with the exception of one intense therapy I did before my fusion but for a different problem (thoracic)

    It involved the use of specific machines (which looked like gym equipment but slightly different) to build muscle deep inside.
    It absolutely done wonders for me.

    However, for my lumbar problems I found the best help in the form of Pilates and abs classes in the gym working those core muscles.

    PT really isn't a one size fits all solution and also drastically depends on who is showing you what to do.

    I am not having PT (I'm 3 weeks post op two level fusion and one level ADR) as I do not feel it will benefit me.

    Best of luck
    Keewee
    2 level Discectomy 2000 open surgery
    L4/5 Discectomy & L5/S1 Laminectomy 2005- (Cauda equina) open surgery
    5 x joint injections 2012
    Discogram Dec 2012
    Dec 2012 - 360 Lumbar Fusion L4 -S1(BMP), Disc replaced L3/4, Bilat trocanter injects
  • dilaurodilauro ConnecticutPosts: 13,244
    edited 01/03/2013 - 6:47 AM
    I had my first Physical Therapy session over 34 years ago. Since then I have been to over a dozen different Rehab Centers and have had countless number of therapists. As with any profession, there are good and there are those that are not so good.
    About 8 years ago, I started going to this one Rehab Center. I did this because of a therapist I had seen several years before.
    She knew more about my physical structure and problems than I did!

    I feel that it is very important to stick with one Rehab Center and stay with one therapists. This way, the therapist and you build up a relationship. After a while, the therapist will 'see' so many things about your problems. The way you walk, if you turn you foot in, are your shoulders hunched, etc. Then they can start working to fix those areas.

    After each of my surgeries, I had time periods with Physical Therapy that ranged from a quick 3 weeks and up to along 18 month period. For some of those, I felt PT did not help me at all and for the past 8 years or so, without PT, I would not be as good as I am today

    There comes a time when you know that additional PT will not benefit you any more. By that time you should have a set of exercises that you can do by yourself to continue your mending. Most Rehab centers have insurance guidelines. When a patient plateaus and is not showing any additional sign of progress, they will normally be discharged.

    I mentioned in my subject line about PT Limits. Much of that revolves are the particular therapist. For the most part, therapists themselves are in good shape. So, when it comes to some exercises or stretches their expectation at times as that you are going to do as good as they can. Thats the 'drill sergeants' I've learned over the years to tell those time, No, I am not going to do that and here is why

    What can become a fine line is when you first start out with Physical Therapy. In the beginning it can hurt so much that all you want to do is quit. That, is NOT the time to give up. If after a while , it is still hurting or you feel causing additional problems, you need to discuss this with both your doctor and the therapist;

    So, Is PT really worth it?

    Yes, without it, I wouldn't be here at a desk typing my response
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • Thank you all for your comments. I do agree that PT can sometimes work under the right circumstance. A lot of you have had some success, but the question still arises is that how do you find a therapist that is going to give you the full one on one that you not only need but have paid for? Even if it’s for 45 minutes and not the full hour, you and your insurance company both paid for it and you should be able to get the FULL benefit of it. Does such a therapist exist and how do I find one?

    If I was to hire a painter or a tutor to teach me something and paid them by the hour would they then go to another job while I am paying them? I don’t think so.

    I do 100% agree that you should always have the same therapist who will get to know you and help you.
  • dilaurodilauro ConnecticutPosts: 13,244
    Before the first PT Evaluation, the Center should take you around for a tour. You can look at all the facilities. Its helpful to have a frame of reference, but just looking at the equipment, condition of the general PT area and private PT rooms can tell you alot about the place.

    I also ask questions regarding the therapist. I know what orders my doctor wrote for me and I ask about the specific therapists that are qualified to work on me. I ask some more general questions about each therapist.

    Then when I go for the actual evaluation, I start my own evaluation. Questions regarding how long a therapist has been working here, how long in general, is it a practice for one therapist to follow a patient, etc. Many times, the therapist
    doing the evaluation is NOT the therapist you will be seeing. In those cases, I ask to see that therapist before I start any sessions.

    I have to say in all my years, when I was in session with any of the therapist, good or not so good, I always had 100% of their time during that session.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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