Chiropractic VS physical therapy----NEED ANSWERS PLEASE!!

Discussion in 'The Watercooler' started by hearts and roses, Feb 7, 2012.

  1. hearts and roses

    hearts and roses Mind Reader

    I'm sorry to post another thread complaining about me, but I am going out of my mind in pain. My back is getting worse and I ran out of oxycodone so I'm stuck taking vicodin for now, which doesn't touch the pain and just makes me cry. I'm frustrated as all hell because I CANNOT do ANYTHING BY MYSELF, except pee. The bowel situation was getting fine, but now I can't seem to bear down with this low back pain so that slowly becoming an issue.

    I'm tired of feeling debilitated and useless. I am sick of being trapped at home. I am lonely and bored now. I was hoping to go back to work pt by mid february. It's been four weeks since my knee surgery and I should be much further along with my range of motion but because my back issues I can't do the PT for my knee, so that has me very concerned.

    So I saw my chiro last week for my back in the hopes of being able to return to PT for my knee, buy I decided to go to the PT yesterday after the chiro. I got a referral from my pcp so the PT could treat both the knee and the back, but the PT doesn't want, or rather, doesn't advise that I be treated by both the chiro and him. I chose him because I figured I wanted to make headway with my knee and that using him might be the best way. Today I am in absolute misery ... I just wish I was on a morphine drip or dead. I don't believe that I've ever had this level of back pain before and I cannot even wrap my head around how this is happening. I was so damned optimistic about my surgery and was looking forward to the recovery and getting my life back!! And now this bs with my back is ruining everything. I need a positive outlook again. I need patience, I need to know what to do and I can't seem to regroup.

    Should I continue with the chiro? Or should I skip her and just see the PT? Or both. Has anyone every done both he said that they each have different ways of treating my back and he felt is was best to choose one. I just want to feel better again. I've always had a relative good success with the chiro, it's just taking longer this time I think because of my gimpy knee walk. There are tears streaming down my face as I type this. I can't get comfortable. I'm considering the ER if it's still bad tonight.
     
  2. AnnieO

    AnnieO Shooting from the Hip

    Jo... I don't have any real answers. But we don't mind if you whine or vent. Being in pain is just horrid. I just wanted to tell you I'm thinking about you, and praying it begins to hurt less.
    Very, very gentle :hugs:
     
  3. InsaneCdn

    InsaneCdn Well-Known Member

    Chiro can't help your knee. And you cannot afford to mess THAT up.
    However... whether PT can help your back or not... or whether or not it can be fast enough...
    UGHHH.

    I'd be almost tempted to just GO to the ER.
    You have three competing needs, and someone has to break the cycle for you.
    - knee needs exercise
    - back needs "fixing"
    - pain needs to just plain SHRINK.

    Somehow.
    <sigh> nothin is ever easy, is it.
     
  4. DDD

    DDD Well-Known Member

    I'm not qualified to make any suggestions, H&R. If your back was the only issue and the PT wasn't helping I "might" suggest using the Chiro. on the other hand the situation is beyond my realm of knowledge. I am so hoping and praying that you get relief soon. Hugs. DDD
     
  5. ThreeShadows

    ThreeShadows Quid me anxia?

    Terry's husband is a chiro, hopefully she will see this. I'm so sorry you're in pain. Can you reach your orthopod for better medications?
     
  6. Signorina

    Signorina Guest

    Oh hun - I am so sorry you are feeling so bad.

    My h has a really bad back and has had the best success with seeing a pain specialist to treat the pain and a PT to get rid of this issues causing the pain. Epidural cortisone has always worked well for him in combo with the PT.

    And I am only writing anecdotal thru my H's experience - but he's completely thrown out his back 3 times in the 20 years or so we've been married. Excruciating, flat on his back for weeks bad. IIRC, the discs bulge and leak and then press on the nerves & the tissues and which gets inflamed and causes the muscle to spasm The first step in addressing the problem has always been to treat the muscle spasms and reduce the inflammation. A PT can't do much good unless the inflammation has gone down. Then the PT addresses whatever it is that had gone wonky to get the discs back under control. (can you tell I have no medical background?)

    H does a great job with self care - at the first sign of twinges - he starts taking the anti-inflammatory and he does the exercises he learned at PT. He is desperately trying to avoid surgery on his back. He has also had an emergency nerve block when the pain has been intense just for relief.

    I think PT is probably your best shot since you need it for your knee as well and hopefully they will work in conjunction with your dr to get you the right medications in combo with the PT. My H likes the mega rx (800mg?) ibuprofen to relieve the inflammation as well as some pain - but he will take the heavy duty pain medications in the acute phase. Between those and the anti-spasmodic he is pretty loopy. He prefers to go straight to the epidural cortisone rather than do l/t RX therapy. But that's just him. We have teens in the house, so we don't like having those medications around.

    Also want to add that the first time his back got really bad, he was having hip problems as well. When he couldn't take it anymore (Typical 30 yo man) he finally went to the ortho. Turned out he had a hip imbalance because he had been favoring his back while ambulating which threw out his hip. So - I think your instinct about your knee causing the back pain is right on.

    I hope you get some relief soon. {{{hugs}}}
     
  7. Hound dog

    Hound dog Nana's are Beautiful

    I would contact the ortho and let him know you're having some serious pain issues that are going to hamper your progress with PT. Someone in that level of pain is simply not going to be able to stick with the program. Know what I mean?? Then, while you're at it, talk to them about the chiro situation and see what they think is best.

    I'm sorry your pain levels are so high. (hugs) I know my mom nearly quit PT several times after hip surgery because she wouldn't let doctor know about the pain levels until my sis really pushed her to do it, once that was under control, she was able to do better.
     
  8. hearts and roses

    hearts and roses Mind Reader

    H is picking up my refill for the oxycodone, which has been helpful for the knee pain. However, I do think that the knee pain is not bad enough for the oxy and it's not really effective for the back pain. I'm on robaxin (for muscle pain from the surgery) but I don't know that it is that effective for the low back pain I'm experiencing. Usually I take flexeril for the low back muscles and a lot of advil and that, combined with the chiro and tens unit and ice do the trick.

    This time around it is all new territory. I am keeping my appointment with both the chiro in the morning and the PT in the afternoon. I'll let them both know so they don't overelap treatments.
     
  9. hearts and roses

    hearts and roses Mind Reader

    So H is super peaved because he has to stay home and drive me to my appts tomorrow. I get it, if he doesn't work, he doesn't get paid, but I can't drive myself and I've already tapped out difficult child, E and easy child. What else can I do?
     
  10. tiredmommy

    tiredmommy Site Moderator

    H&R~ Icing my back makes a huge difference, it may help you. Also, I think I look at this differently than you: you won't be able to do your PT for the knee properly until your back is realigned, right? So I would go to the chiro so I could get past this and move forward in my PT.
     
  11. witzend

    witzend Well-Known Member

    Your PT can probably help with your back, depending upon what it is that is wrong with it. I had PT that my Physiatrist called "Shake and Bake". It was a combination of massage therapy, sonogram treatments, and a tens unit. It was very helpful. This was combined with regular stretching and swim therapy. That's because my problems were musculo-skeletal rather than disc related.

    If I were you, I'd check with a Physiatrist and see what they recommend. Not a lot of people have heard of them, so here's a link.

    What is a Physiatrist?
     
  12. susiestar

    susiestar Roll With It

    Have you had any xrays or mri's of your back done since this got so bad? You MUST get the ortho and/or your reg doctor to look at your back and figure out what is going on. Just treating the spasm is NOT the best thing. Unless you know that there is not some type of damage or problem causing the pain, the chiro and/or PT treatments could make things a LOT worse.

    You NEED pain medications and muscle relaxers and an anti-inflammatory. PLEASE get your reg doctor to get you in to see a pain specialist asap. You may not need them forever, but they could be a HUGE help right now. Get them to rule out spinal/disc issues and then work on treating the symptoms and strengthening the muscles.

    Robaxin is usually more effective than the flexeril (I have taken every muscle relaxer they make according to my docs), but you may need something stronger like baclofen or zanaflex (tizanidine). If you are not sleeping, any movement while sleeping has you waking up in pain, etc..., then I would ask the doctor about zanaflex. It is available in generic and is what the football and basketball teams at the university here use when needed. Chances are it will knock you out the first few weeks you are taking it. I used to take that at night and a different muscle relaxer during the day.

    Both chiro and PT can be helpful if you have a good chiro and PT. You may want to explore trigger point therapy. There is an awesome book on it, and it was one of the most helpful things I have used with back problems. If you don't have a theracane, get one. It is a hook like thing that you use to massage areas you can't reach. This amazon search will show you some different versions. I have the one at the top. Amazon.com: theracane massage tool I also use it to put muscle rub on places that hurt. I put a clean pantyliner on the ball on the end and put the muscle rub on that, then I can put it where I need it.

    This is the book I was talking about: Amazon.com: The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, Second Edition (9781572243750): Clair Davies, Amber Davies, David G. Simons: Books It was written by a man who tuned pianos and learned all he could about muscles and trigger points etc.... after his daughter was injured. I have a cousin who is a PT who says it is the BEST book out there for professionals and lay people alike. It can help you figure out how to help these muscle problems. The theracane lets you do what the book shows you.

    Along the list of things that might help are hot and cold packs. If hot helps, consider using a muscle rub with capsaicin in it. That is the stuff that makes peppers so hot. If you have a muscle rub with capsaicin on, you will feel the warmth and if it cools or the warm sensation goes away, you can re-activate it by leaning on something warm or taking a hot shower/bath. For days when I have to be out and about this works a LOT better than a heating pad or rice bag. Just be careful when you put something warm on the area so that you don't leave it there or fall asleep with it on the area with the muscle rub. Wear gloves when you put the rub on too.

    Do you have lidoderm patches? They are 4"x6" patches of lidocaine that you can wear for up to 12 hours out of 24. They are incredible. Many docs don't seem to know about them or to remember them, but they are a big help. I often end up putting spanx or vet wrap or an ace bandage over the area with the patch (depending on where it is) because they don't stick well on me. They are not cheap, but insurance should pay for them. At least we never had a problem until we had medicaid.

    I hope something I suggested helps. PLEASE, if NOTHING else, get your back seen by the ortho and get an mri done. If there is damage, the chiro and PT need to know because they could make things worse.

    (((((hugs))))) I am SOOOO Sorry that you are in such pain.
     
  13. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I was going to also suggest you get into a pain specialist at this point. You have been on pain medications long enough to qualify. Flexeril is just about useless in my book. Robaxin is a bit better but not a whole lot. At this point you most likely need something along the lines of zanaflex. As far as the NSAID itself, I would actually go with Voltaren Gel because it wont go through your stomach and innards. It is a gel that you apply straight to the areas that are bothering you and it helps immensely. Trust me on that one. One less pill to swallow is also good. However I also take ketoprofen along with it but the docs arent thrilled with that. I really shouldnt take two NSAIDS at the same time but I am in enough pain to choke a horse so I am somewhat pushy.

    If you can manage the MRI, then I think I would do it for your lower back. You may have very well thrown out a disc walking or favoring that one leg that had surgery done on. I know that my right knee got a lot worse because I favored my left one for so long. Or your disc's were going anyway and this just gave them the push they needed to show up. It is not uncommon for people with degenerative joint disease to also have degenerative disc disease. Your ortho can give you a mild steroid shot in the dimples on your butt and you will feel so much better in a day or two. It doesnt hurt at all. Its a small shot like a flu shot. Not a huge needle. I get them every 3 months or so.

    However if you go to a pain management place you could probably actually get put on morphine pills. That might actually help you some. They would be long acting and you would have breakthrough pain pills for anything that happened between times.

    Just a suggestion.
     
  14. SRL

    SRL Active Member

    I'd go for a multidisciplinary approach as each discipline has different tools at their disposal.

    I've known several people--and have read reports of others online--whose back pain has been helped by accupuncture when nothing else works.

    If your current chiro has run out of ideas find another one. I mention this because there are two chiros in the office I go to with very different styles. One helps me a great deal and I'm usually in more pain when the other one adjusts me (although some patients really like him).
     
  15. susiestar

    susiestar Roll With It

    The voltaren gel that Janet mentioned IS great but it is also about $200 a tube if insurance won't cover it. I am not sure it is the best option because you likely have inflammation in your knee and in your back and with the gel you put it on one or the other. While it DOES get into your system when used as the gel, it isn't as effective on areas you don't apply it to.

    PLEASE remember to take a medication like prilosec also. The LAST thing you really need to add are stomach problems or esophageal problems (esophageal problems are common esp if you don't drink enough liquids when you take your medications - you NEED six oz at least to be sure they get all the way to your stomach.) The doctor I had as a teen completely ignored the possible stomach problems and I will always have to be very careful because of the damage that was done then. Prilosec is still available as a prescription at twice the strength of the OTC version and it is very safe to take long term. If they don't prescribe any NSAID medications for you, naproxen is much stronger than ibuprofen, so you may be able to get more help from that. It also last longer, which means that it won't wear off if you are able to sleep for more than 4-6 hrs.

    They can do a LOT for back problems and Janet is right about the degenerative thing. Many people have more than one area/type of joint that degenerates. So get the pain doctor if at all possible. They do more than just give pain medications. They are able to manage pain using a lot of other things. My pain doctor does a lot of nerve blocks, uses a lot of non-traditional therapies, etc... to get the pain to a manageable level. He hasn't been able to get an accupuncturist because no insurance will pay for it around here. It can be helpful though.
     
  16. hearts and roses

    hearts and roses Mind Reader

    Thanks for all this great info and input. Here is the list of medications I'm currently taking in combination for the knee, the back and the surgery: robaxin (muscle relaxer for surgery, but is helping with back *I think*), oxycodone (for pain post surgery, but it's helping with the back as well), Tylenol for post surgery (also helping with general pains), celebrex (NSAID). I can't use the volterin as I'm taking the celebrex. I've used it in the past and it wasn't all that effective. I think that once I'm all healed and good to go, it will be a nice alternative.

    When my back goes out, it is generally because I'm extremely stressed out (check), my knee is out of whack and throwing off my gait (check), I'm premenstrual (check), or all three, which is this case. I have HAD issues with bulging and slipped discs, but my chiro has been able to get me back to normal.

    After the pain of yesterday, I decided to take back my own care and advocate for myself. I chose to go back to my ride and true chiro. She is awesome. She uses accupressure as well as gentle manipulation, stimulant, moist heat and ice, exercise and massage to get me straight again. I will get my back in order and then focus on the knee, in the meantime, there are modified movements I can do with the PT that will not strain my back.

    I'm telling you, vicodin is the devil. I've said it before, I just cannot tolerate that stuff but because the surgeons office messed up my oxycodone script, I had no choice as it works for the pain somewhat, it just also happens to mess with my psyche. Is wish I knew why, but the **** makes a mess out of me. H and E were able to get me my new script for the oxycodone so I switched back last night. I feel much better mentally and emotionally today than I did yesterday. I feel capable of being in charge of my health again and I'm optimistic that my chiro will get my back in order and everything will work out with my knee.

    I was so freaked out and stressed about my knee becoming stuck and never regaining it's range of motion, and of my house that is slowly (rapidly) going to pot, of everything being upside down, my disability being denied, etc., that all that stress goes right to my back. I need to practice some relaxation techniques while I'm floundering away.

    Anyway, thank you for the support...again...and if I don't improve, I will definitely ask about seeing a pain dr or physicist (sp) like Witz suggested. Also, srl, I searched for an acupuncture dr last night on my insurance and there is one in the town next over. I will keep that info handy as well. And my insurance covers it!
     
  17. susiestar

    susiestar Roll With It

    Sounds like you have it all covered!! Good for you! The right chiro can do amazing things. I am often amused by MDs when they say that a certain area "cannot" be causing a certain problem because the structure of the body means it can't. In my experience, if the chiro is good and says it can help/fix/end/prevent some structural problem, the chiro is right and the MD is just wrong. I used to think that MD's had this huge amt of knowledge about how the muscles and bones and nerves etc... worked, but a cousin who is a PT ended that notion. PTs and chiros take a LOT mroe classes in the structure of the body than MDs do. At least this was true when my PT cousin went through school. I had three neuros SWEAR that my vertigo had to be an inner ear problem or a psychological one. The ENT and psychiatrist disagreed. The chiro read my headache journal (I also recorded vertigo, muscle spasms, etc... because several diff docs wanted diff things tracked) and saw that teh dizziness hit when the muscles in my neck/shoulders/head were all spasmed. By working on those muscles, we were able to stop the dizziness (or vertigo - diff people called it diff things). The chiro said that the blood vessels run through and between the muscles and the spasms were restricting blood flow to my brain and the dizziness was the first sign.

    Doctors still think I am nuts when I say this. They don't think it is possible for a muscle to spasm and swell and create restricted blood flow. The proof is in the lack of vertigo - I only get the vertigo wehn the muscles are a mess.

    So go with the doctor who has helped in the past - the CHIRO. I think PT would help, but if the PT isn't willing to work with you if you see the chiro, either don't tell him or don't see him (him being PT). Ask the chiro for help with getting the range of motion in your knee back.

    Have you ever used guided meditation to help with stress? If you are interested, I can get some names and some free mp3s for you. husband has a lot and they can be a HUGE help. Biofeedback is also helpful.
     
  18. TerryJ2

    TerryJ2 Well-Known Member

    Oh, Jo, you poor thing.
    Sorry I'm so late to see this but I see you've moved on with-your decision.
    I was going to say get your back in shape first and then focus on the knee, because you really can't do anything with-your back like that.
    I'm glad that you like and trust your chiro and that she is going a good job. Ice, ice, ice! I can't say it enough. I got to bed with-an ice pack more often than not.
    Have you asked your chiro anything about the knee? The only thing I would caution you about is not to overdo the PT with-your knee ... a good PT will push you but not past your limits. You don't want to make it worse.
    Some chiros do all body parts, some don't. I have no idea what your chiro's training consists of so I can't help you there.

    by the way, typically, just because it's a somewhat competitive issue, the chiro will say do chiro and the PT will say PT, because some of the things they do are similar. So don't expect them to refer to one another. ;)

    I, too, tend to throw out my back when I'm stressed out. And pms-ing. I'm wondering if you have considered not using the Vicodin or oxy and just using naproxen sodium? It's an anti-inflammatory, and if you take 3, they are prescription strength. They will make you sleepy so don't drive while using them.

    If you've been diagnosed with-a bulging disc you'll have to continue with-the chiro for awhile. Do you have a decreased disc space there, too? It could be something genetic, and you just have to be extra careful in general.

    Remind me ... when did you do your knee replacement? If it was recent, I'd do the PT asap because you don't want that little window after surgery to pass you by. So I wouldn't wait more than a wk or so. It shouldn't take your back that long to relax, I would hope.
     
  19. hearts and roses

    hearts and roses Mind Reader

    Susie, I am interested in those tapes-very much! I used to have a couple, but I've lost them.

    Terry, the usual treatment when my back goes out is either four advil or two aleve and icing. I am calling my reg dr tomorrow to go over how I should be managing the pain at this point, but I want to give my back another day or two to improve.

    My chiro cannot treat the knee, we've discussed it. However when I spoke with the PT this morning and explained to him my plan, he said it was fine to continue with my chiro and he will just use modified PT on my knee until my back heals. He seems to be very good and sensible. So I am *hoping* between the two of them that www can get me up and moving again!

    Oh yeah, Terry, it is definitely genetic. My loco sister is currently getting second and third opinions for her back issues. Two years ago, two of her discs burst and she had to have emergency surgery. And now her troubles have returned and the doctors are telling her that without the surgery she will definitely become paralyzed. With the surgery she has a 50/50 chance of either ending up paralyzed or coming out great. She has stenosis of her spine and all of us have some level of degenerative bone disease. It's ugly. For now, my chiro is who I trust. Thanks!
     
  20. susiestar

    susiestar Roll With It

    Terry, I will get him to send me a list of some of his fave free ones. When we met my only experience with meditation was from my cousin who had the Buddhist wedding and lived in a commune. husband used cassettes of guided meditations and he loved them. He convinced me to try some and while I never really bought into their version of everything, I did get help from them esp in handling stress and with migraines. Before that happened, I had gone about 15 years with-o ever having a holiday or family celebration where I didn't have a migraine. Our wedding was the FIRST family gathering since I was a little kid where I wasn't hiding a migraine. (Of course husband said it was a sign from the universe that we were soul mates :loveforever::morethanchocolate:) Back then there was no imitrex and meditation was the first thing that meant i didn't have to just endure until it was over.

    He really likes Jonathan Parker's line - we still have lots of audio cassettes of his meditations, etc.... My favorite, esp when I was hurting a lot, was and is Super Still. It is something I can focus on, helps relax my entire body and mind, and I find his voice soothing. It is a beginner's program but it works for me.

    Parker also had what he called Audible Subliminals. They drove me nuts. You hear people talking to you but it is hard to hear what they are saying. husband thought they were awesome and I wanted to go Rambo after about 30 seconds. I don't know if they still make them.

    I will find other guided meditation programs from husband and send links to them.

    I just hope you feel better soon. If you take the naproxen at the rx strength (rx can range from 500 to 1000 mgs, or it used too when I was a teen. Recently Jess was on 1000 mgs of naproxen - NOT a good thing.), please make sure you are taking prilosec to protect your digestive tract from it.
     
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