Physical Therapy/Pain following
 

In preparation for my fusion in February my neurosurgeon has asked that I do physical therapy to work my core so I can stabilize my back better after surgery. I am to do it 2-3 times a week. I started on Monday and my first visit was an evaluation and they did some heat/stim pads on my back. It felt awesome and Tuesday I felt the best I have felt in a loooooonnngggg time.
Tonight I went in and it was a new therapist. I started the session with heat and doing the stim therapy (electrical therapy). After that she massaged on my lower back/hip areas. It was the most painful thing I have EVER experienced. I told her it hurt several times and that seemed to lighten her up and then she was back to it. She kept rubbing right where the disk is slipped (L5 over S1) and my goodness it was awful. I did the exercises afterward which weren't bad at all and then finished with ice. I was slow to get up and slow when walking afterwards but when I got in my car I COULD NOT sit back in my car seat because my lower back was swollen. I am now home and have taken 2 Ultrams and 2 tylenol with no relief. My back is starting to bruise and is still visibly swollen.
My questions are, how much is too much with physical therapy? Should it be this painful? Is this a no pain, no gain kind of thing and I just need to suck it up? Or I am right that this was over the top and I need to request another PT?

Some therapies may involve some pain, but in this case I think the therapist was over the top; some minor swelling/redness - maybe - but there shouldn't have been any bruising.

Sounds like the therapist got a little too enthusiastic. I think it's worth reporting and proceed from there. Your feedback should be as constant as is necessary. If she kept things up or went back to being too rough, you need to be adamant. If necessary, ask for another therapist right then & there.

Doc

I'd take a picture of it.... and show the doctor too.

Bruising should NEVER happen... this is a sign of damage of some kind. Also if you have an undiagnosed issue with bleeding your doctor needs to know before surgery! Do you take SSRI drugs? (antidepressants for pain, like Cymbalta)... they can cause bleeding.

So do please call him up ASAP!

I was unsure if I was just being a whiner with how much it hurt and since I have never been to physical therapy so I didn't know what it should be like. I am going to request another therapist for when I go back on Tuesday. It is even more bruised this morning and I now have pain running down my right leg when I never had that before. Ugh.

I only take Ultram and tylenol right now. I am chubby so I do bruise easier but I couldn't even sleep on my back last night due to the swelling and it just hurt soooo bad.

Candlegirl, so sorry you got a bad therapist. After many, many PT sessions cervically over a period of years, I learned that as in any profession, there are good therapists and then those who should find another line of work. Never ever be afraid to speak up during your sessions! If it hurts, tell them to stop. And be sure to inform your doctor. At one time, I was given such bad PT and such inappropriate exercises that I changed PT clinics altogether. A good therapist will not cause pain, nor insist that you continue in pain.

I am going to give her a chance tomorrow and explain to her that it was way to painful and if she can't be easy then I will switch to another PT. I still have bruises on my lower back so I am going to ensure she understands that she really hurt me. Thanks for letting me know I am not nuts and that it was too much!!!

Candlegirl,

What Seahorse said. ;)

Unfortunately, a lot (too many) of patients have bad initial experiences with PT, and it puts them off it for life (if not longer). The real shame is that PT (often the firstline therapy for a lot of things) can resolve many pain issues without medication, surgery, or other more severe (and more expensive) therapies.

Another unfortunate circumstance is that insurance companies will often only foot the bill for one course of PT sessions, so that if a patient has a bad experience (which further underlines the importance of speaking up early), or even if they have a good one and additional PT would prove even more beneficial, the patient must pay for any further sessions out of their own pocket. So milk those therapists for all the information, advice, suggestions, etc. you can while you've got them on the line (so to speak ;) )!

Fortunately we can continue the therapy on our own by continuing the exercises, or obtaining our own (TENS, traction, etc.) equipment.

Doc

Re: over the top
 

The pain you are experiencing is over the top. Your PT may get uncomfortable, but that kind of pain you are experiencing isn't usually what should happen. My son is a PT. If the therapy hurts, he lets up, engages in a lighter massage, around the area of inflamation. If there is this much pain, call your physician and relate the information to him. Adjustments need to be considered in the kind of therapy you are receiving. I have had alot of PT on my spine, both before and after my fusion. I never had this kind of pain that you are experiencing regarding the therapy I received. Ache yes, knee dropping kind no. I hope you will call your psysician, maybe he will even want to see you. I will be keeping you in my thoughts today. I certainly hope your pain level goes down soon. ginnie

right to say stop
 

Just one more thing candle girl, always say stop, and insist on it, if it causes you that much pain. don't be afraid of hurting their feelings...You are the patient in need, and should be listened to immediately. ginnie

Hey Candlegirl - I thought of something else...
A dr. gave me this bit of advice. Since my PT appointments were coming out of pocket, he advised me to ask the physical therapist to make copies of the exercises they were giving me to do in case I couldn't remember them when I got home (they keep binders with illustrations of exercises for different problems, different areas of the body). The dr. also told me not to tell the PT that was in order to save some money as my or your repeated trips to the clinic are they're bread & butter - but we can only do so much with the moola we have - and those trips add up fast.