Advice on back issues (not mine)

[janinegirly]

My sister has started suffering some pretty major back issues out of the blue. Sharp throbbing pain in upper back region. It came out of nowhere, she is young (20''s) and is active but not overly so. The dr. referred her to a physical therapist, but this seems kind of backwards and isn''t helping either.

Just thought I''d ask here in case anyone had been trhough something similar and had advice. Is there a type of specialist that focuses on these sorts of issues?

 

[Hudson_Hawk]

I''ve had a lot of back pain in my life. Is it located near the spine or over near a shoulder? Sometimes when people have bad posture the position they sit in pulls their scapula (shoulder blades) out of alignment which can affect the position of your ribs. It can really hurt a lot and sometimes there''s also pectoral involvement. When the pectoral is involved it''ll feel like the worst bronchitis ever. Every breath is agonizing. These specific back problems can also trigger headaches and neck pain.

I think going to a physical therapist is a good idea, but she might need something a little more direct, like a deep tissue massage or chiropractic evaluation. I ended up doing a combo of both, the chiro used ultrasonic waves to loosen the knots in my upper pectoral (near the collar bone) and then re-aligned my rib and shoulder blade. I would see him after having a deep tissue massage.

I''m assuming her doctor screened her for major issues such as heart stuff, right?

 

[janinegirly]

Thanks HH. She did not have screening and they are dong soft tissue massage so as to not further irritate the issue. The pain is more in the neck and upper shoulder area. I will suggest she think about a chiropractor or get a 2nd opinion from a general practitioner.

PS Congratulations by the way

 

[soocool]

I would be adverse to someone giving me deep tissue massage without being completely evaluated, meaning an MRI of the neck/cervical area. If she has a herniated disk in this region, the deep tissue massage or manipulation by a chiropracter could make things worse.

If the gp doesn't have a clue, an orthopedist may be who she wants to see.

 

[Porridge]

Date: 1/11/2010 4:08:59 PM
Author: soocool
I would be adverse to someone giving me deep tissue massage without being completely evaluated, meaning an MRI of the neck/cervical area. If she has a herniated disk in this region, the deep tissue massage or manipulation by a chiropracter could make things worse.

This times 100!!

"Deep tissue massages" cause more damage than I care to think about - I have seen so many patients with irreversible damage due to this being carried out by people who are not properly trained.

Usually these things take time to heal and be put right unfortunately. Although it seems like a sudden onset, they are often the result, as HH said, of years of incorrect posture. So there is rarely a quick fix. Unless your sister can remember doing something specific to hurt herself, a bad twist or trying to reach for something heavy?

Soft tissue massage would definitely be the safe option right now. It will probably take a number of weeks for the irritation to subside, and there may be exercises to correct and maintain good posture (if that is the problem).

The specialists that focus on these types of issues would be orthopedic consultants and physiotherapists. At least, here anyway...I think maybe chiropractors and doctors of osteopathic medicine, if you are in the states? I don't know how chiropractors are over there...I think it means something different there than on this side of the pond? Here, they are not registered medical professionals, in that they do not complete a university degree recognised by a governing body (but do graduate from a third level institution), the doctor cannot refer patients to them and they cannot work in hospitals or other public healthcare centres. So you kind of visit them at your own risk, they are officially listed under alternative treatments. But if it is different in the US then your sister could maybe ask for a referral from her GP, if the physio is not helping.

I'm sure her doc knew what he was doing. I hope she feels better soon.

 

[cnspotts]

First things first, did the doc order Xrays?

As a massage therapist specializing in structural integration, meaning realining the body through massage, I find out a pretty in depth health history before ever trying to "fix" someone''s acute problem. Yes, plenty of damage can be done but honestly it amazes my how often Doctors fail to really listen to their patients or ask pointed questions searching for possibilities of injury that may not seem obvious. I''ve been doing massage so long now that I can tell what kind of work someone does by they way their muscles feel under my hands based on the "knots" as they say.

A muscle relaxer is not going to fix anything, it will however make it hurt less. Fix no. Fixing comes with hard work if it''s soft tissue related. Stretch, stretch, stretch.
Pain medicine is not going to fix anything but it will mask the problem 4-12 hours a day. Again it takes some work on part of the person to "work" through an issue related to muscle.

I''m sure if I had a conversation with your sister I could get to the bottom of her problem. Once there is a problem and it''s not addressed then future problems only compound the matter more until finally there is so much pain that the body says "okay, enough, we hurt, time to fix this mess and do something different".

The great thing about muscle pain is that is can be easily fixed in a relatively short time but it takes physical manipulation and some work part of the patient. After a couple of massages if they''re not seeing the results that would otherwise be normal for their situation then I refer them out to someone that can investigate further. There are things to consider within the structure of the skeleton, the organs when it goes beyond massage and muscle. So if it''s not disease then it''s probably just muscular and habits on her part. Tell her to take a really good look at what she''s doing with her body since we tend to take it for granted and she might see some kind of pattern.

I also love those giant foam rollers that you can get at the sporting goods store. GREAT self massage! Totally keeps my body feeling well adjusted when I''m working to hard "fixing" everyone else. Best of luck to her.

So this are some of the questions I ask

How old?
Injuries as a child? (car, horse, bike, broken bones, scoliosis, surgeries)
Is she in school?
Does she carry a book bag? Over one shoulder all the time? (this one gets a lot of kids and they have no idea that it makes them painfully lopsided)
Does she work?
What kind of job? (looking for repetetive motions here, lots of damage eventually)
Sports? Same thing, what kind, what is she doing?
sexually active (did you ever do it on the stairs? hummmmmmm???????)
Shoes? heels, barefoot (actually very good), hard soles lacking flexibility ~ bad
normal weight, overweight, underweight?
nutrition?
sleep?
what does she sleep on?


Getting the idea? It all adds up. I get lots of teens that come to see me, and their parents eventually.

 

[iheartscience]

I have a back issue right now and I also got referred straight to a physical therapist who has so far done nothing to help the situation. She keeps giving me core strengthening exercises which is great and all, but the back issue is much lower than the core area-it''s really right above my butt so I''m not getting how the core strengthening exercises are going to fix anything. I''m going to have to follow the advice in this thread and get an MRI done at the very least!

Sorry-I obviously have no real advice but I hope your sister gets help soon and gets better-it SUCKS to have a seemingly random back injury!

 

[Porridge]

Thing, you could ask her to examine your SI joint. Obviously have no real info to go on, just from the little you described I find it most commonly to be an SI joint irritation. It''s a very tricky joint.

 

[iheartscience]

Date: 1/12/2010 9:53:29 AM
Author: Porridge
Thing, you could ask her to examine your SI joint. Obviously have no real info to go on, just from the little you described I find it most commonly to be an SI joint irritation. It''s a very tricky joint.

Thank you Porridge! I''ll let her know at my next PT appt. if I don''t cancel it. I just looked up what the SI joint is and that may very well be the issue-it describes a lot of my symptoms. I actually made an appointment today with an orthopedist so hopefully I''ll get some insight.

Sorry for the threadjack, janine-this thread spurred me to do something else about my back, so thank you!

 

[Porridge]

Date: 1/12/2010 12:00:36 PM
Author: thing2of2

Date: 1/12/2010 9:53:29 AM
Author: Porridge
Thing, you could ask her to examine your SI joint. Obviously have no real info to go on, just from the little you described I find it most commonly to be an SI joint irritation. It's a very tricky joint.

Thank you Porridge! I'll let her know at my next PT appt. if I don't cancel it. I just looked up what the SI joint is and that may very well be the issue-it describes a lot of my symptoms. I actually made an appointment today with an orthopedist so hopefully I'll get some insight.

Sorry for the threadjack, janine-this thread spurred me to do something else about my back, so thank you!

No problem Thing! It really is tricky though. There's a lot of debate on it. Some clinicians believe it doesn't move at all, some believe it moves slightly and can go "out of alignment" as they say, some believe only the ligaments are the source of irritation...the debate rages on, but it does usually mean non-uniform treatment for patients unfortunately! If you're not happy with your PT, you should certainly ask to be transferred to one who is specialised in low back pain. No PT worth his/her salt would continue with treatments that aren't working IMHO, but I'm v opinionated on this

There are bad PT's out there, just as there are bad docs/nurses/jewellers!

ETA hope the MPH application is going well! I'm in the midst of mine.

Sorry JanineGirly, threadjack over, promise!!

 

[Pandora II]

I'd say a physio is a good first step referral. Personally I don't let osteopaths or chiropractors near my back - and certainly wouldn't without having a complete set of x-rays and MRI scans first.

Things I have discovered over the years (I have spinal stenosis plus herniated discs and have had a load of spinal surgery so have rather BTDT

)

Analgesia - It is vital that you take adequate painkillers. Being a martyr or 'not being someone who takes meds' can make a small problem into a much bigger one. When a part of the body hurts, you will compensate to protect the area. This can result in muscle spasm and set up a vicious circle of pain leading to more pain. Taking proper pain relief means that you will continue to use muscles appropriately and prevent this happening.

Acupuncture - Brilliant on muscle spasm and has been very helpful for me.

The vast majority of back pain resolves in 6-12 weeks anyway so conservative care initially is good - rushing in can make things far worse. I think in the UK they reckon that of all those who visit their GP with lower backpain only 1 in 10,000 is actually a candidate for surgery. I was amazed when I was told that statistic.

ETA: I see a spinal neuro-surgeon for my back. I did the rounds with the orthopaedic surgeons and I wouldn't go back!

 

[soocool]

Date: 1/11/2010 9:25:18 PM
Author: cnspotts

I also love those giant foam rollers that you can get at the sporting goods store. GREAT self massage! Totally keeps my body feeling well adjusted when I''m working to hard ''fixing'' everyone else.

Ditto, these foam rollers. I use it for my IT band and have had no issues for over 4 years.

 

[Haven]

Date: 1/12/2010 2:11:40 PM
Author: Pandora II
Things I have discovered over the years (I have spinal stenosis plus herniated discs and have had a load of spinal surgery so have rather BTDT

)

Pandora--My DH has severe cervical spinal stenosis (C3 to C7). He was diagnosed a little over six years ago. He was initially told to get surgery ASAP, went to see the "best" surgeons for his particular condition, and decided to back out of the surgery at the last minute.

He ultimately found a Muscle Activation Techniques Specialist (MAT) through some professional references, as he was an occupational therapist at the time. The MAT worked so dramatically well that he left OT to become an MAT Specialist, himself, which is what he's been doing professionally ever since.

Since he's been getting regular treatments he no longer has the severe symptoms that he was suffering from the cervical stenosis, and he's been weight lifting and doing all of his old regular activities with full range of motion in his neck. It's unbelievable. The surgeon who did his last MRI said "I can't believe you're walking around and feeling fine." But he was, and is!

 

[Pandora II]

Date: 1/12/2010 10:35:09 PM
Author: Haven

Date: 1/12/2010 2:11:40 PM
Author: Pandora II
Things I have discovered over the years (I have spinal stenosis plus herniated discs and have had a load of spinal surgery so have rather BTDT

)

Pandora--My DH has severe cervical spinal stenosis (C3 to C7). He was diagnosed a little over six years ago. He was initially told to get surgery ASAP, went to see the ''best'' surgeons for his particular condition, and decided to back out of the surgery at the last minute.

He ultimately found a Muscle Activation Techniques Specialist (MAT) through some professional references, as he was an occupational therapist at the time. The MAT worked so dramatically well that he left OT to become an MAT Specialist, himself, which is what he''s been doing professionally ever since.

Since he''s been getting regular treatments he no longer has the severe symptoms that he was suffering from the cervical stenosis, and he''s been weight lifting and doing all of his old regular activities with full range of motion in his neck. It''s unbelievable. The surgeon who did his last MRI said ''I can''t believe you''re walking around and feeling fine.'' But he was, and is!

Glad to hear that it''s working well for your DH! (My mother is an OT btw

)

I have lumbar spine stenosis and it was badly affecting my ability to walk - the surgeons took away a load of bone from some of the vertebrae to open up the space which helped hugely. Sadly I had been messed about for so long by the orthopaedic surgeon who misdiagnosed me that I have some permanent nerve damage in my legs...

When I get pain in my actual back I know it''s because I''ve sent some muscles into spasm and I use PT techniques and accupuncture to fix it.

Weirdly enough with discs and backs, if you MRI''d a hundred people you will find some with major abnormal pathology and no pain, some with no pathology at all and a huge amount of pain and everything in between.

 

[soocool]

Date: 1/12/2010 10:35:09 PM
Author: Haven

Date: 1/12/2010 2:11:40 PM
Author: Pandora II
Things I have discovered over the years (I have spinal stenosis plus herniated discs and have had a load of spinal surgery so have rather BTDT

)

Pandora--My DH has severe cervical spinal stenosis (C3 to C7). He was diagnosed a little over six years ago. He was initially told to get surgery ASAP, went to see the ''best'' surgeons for his particular condition, and decided to back out of the surgery at the last minute.

He ultimately found a Muscle Activation Techniques Specialist (MAT) through some professional references, as he was an occupational therapist at the time. The MAT worked so dramatically well that he left OT to become an MAT Specialist, himself, which is what he''s been doing professionally ever since.

Since he''s been getting regular treatments he no longer has the severe symptoms that he was suffering from the cervical stenosis, and he''s been weight lifting and doing all of his old regular activities with full range of motion in his neck. It''s unbelievable. The surgeon who did his last MRI said ''I can''t believe you''re walking around and feeling fine.'' But he was, and is!

Haven, This info about MAT is great. I checked it out on Youtube (there was an interview with the founder of MAT). Afew years ago I had severe nerve pain that began in both my knees (outside) and radiated down to my toes. I saw several doctors and went to PT and when that didn''t help I saw a neurologist who actaully told me what the problem was and luckily the nerve damage was reversible. I apparently had extremely tight IT bands in both legs. I went back to PT and we integrated some additional exercises and stretches that helped (plus the foam roller), but it was interesting to hear that you have to find what causes the IT band to become tight. In my case it was overuse of the stairstepper which caused the problem. I am so interested in learning more about MAT! Thanks for sharing this info.

 

[Hudson_Hawk]

I''ve used the foam rollers to assist in stretching at the gym and they''re fantastic!!!!

 

[Haven]

Date: 1/13/2010 11:50:17 AM
Author: Pandora II
I have lumbar spine stenosis and it was badly affecting my ability to walk - the surgeons took away a load of bone from some of the vertebrae to open up the space which helped hugely. Sadly I had been messed about for so long by the orthopaedic surgeon who misdiagnosed me that I have some permanent nerve damage in my legs...

I''m sorry to hear that you were misdiagnosed, Pandora. I can only imagine how frustrating that is when you are in severe pain the entire time.

 

[janinegirly]

just a quck note to thank you all for the information (threadjacks included...that's where most of the interesting info is)! I'm lurking but reading it all and passing along info to my sister. Back issues are widespread but can be so complicated to diagnose! I hope everyone who is struggling with it finds relief soon.

My sister is on week 3 of the pain and feeling slightly better (with PT only so far), so hoping it's on it's way out.

 

[Haven]

Date: 1/13/2010 3:06:48 PM
Author: soocool

Date: 1/12/2010 10:35:09 PM

Haven, This info about MAT is great. I checked it out on Youtube (there was an interview with the founder of MAT). Afew years ago I had severe nerve pain that began in both my knees (outside) and radiated down to my toes. I saw several doctors and went to PT and when that didn''t help I saw a neurologist who actaully told me what the problem was and luckily the nerve damage was reversible. I apparently had extremely tight IT bands in both legs. I went back to PT and we integrated some additional exercises and stretches that helped (plus the foam roller), but it was interesting to hear that you have to find what causes the IT band to become tight. In my case it was overuse of the stairstepper which caused the problem. I am so interested in learning more about MAT! Thanks for sharing this info.

soocool--That''s really interesting! I didn''t realize Greg Roskopf has a Youtube video out there. I guess you can find anything on the Internet, huh?
DH has had a lot of success with the MAT for his stenosis, of course, and he treated me exclusively after I broke my elbow back in May. It''s definitely worth checking out if other therapies aren''t working for you. They have a lot of PTs and massage therapists, and a handful of orthopaedic surgeons going through the MAT internship right now, so it''s interesting to hear their reflections on how different the MAT approach is to their original field of study.

I''m glad to hear your nerve damage was reversible--thank goodness!

 

[Haven]

Date: 1/13/2010 3:46:35 PM
Author: janinegirly
just a quck note to thank you all for the information (threadjacks included...that''s where most of the interesting info is)! I''m lurking but reading it all and passing along info to my sister. Back issues are widespread but can be so complicated to diagnose! I hope everyone who is struggling with it finds relief soon.

My sister is on week 3 of the pain and feeling slightly better (with PT only so far), so hoping it''s on it''s way out.

Janine--I really hope she feels better soon. Three weeks is a long time to be in pain. Big hugs to her. (And sorry for the threadjack. My husband''s experience with his spinal stenosis has been life changing for him, so I couldn''t help myself but respond to Pandora. I''m sorry!)

 

[janinegirly]

Date: 1/13/2010 3:50:30 PM
Author: Haven

Janine--I really hope she feels better soon. Three weeks is a long time to be in pain. Big hugs to her. (And sorry for the threadjack. My husband''s experience with his spinal stenosis has been life changing for him, so I couldn''t help myself but respond to Pandora. I''m sorry!)

Oh I only mentioned threadjack since someone else above kept apologizing for it was which was totally unnecessary! We need this back pain thread to share information and the more input the better. To me real life experience info is so much more helpful than a doctor''s impersonal referral sometimes.

I hope your hubby is doing better!!

 

[4ever]

Date: 1/11/2010 11:07:48 AM
Author:janinegirly
My sister has started suffering some pretty major back issues out of the blue. Sharp throbbing pain in upper back region. It came out of nowhere, she is young (20''s) and is active but not overly so. The dr. referred her to a physical therapist, but this seems kind of backwards and isn''t helping either.

Just thought I''d ask here in case anyone had been trhough something similar and had advice. Is there a type of specialist that focuses on these sorts of issues?

How is this backwards? Unless he/she was a specialist he/she can''t do much more than give drugs for the pain. I''d have her stick with the physical therapist or see a chiropractor.

 

[janinegirly]

Date: 1/14/2010 12:15:50 AM
Author: 4ever

Date: 1/11/2010 11:07:48 AM
Author:janinegirly
My sister has started suffering some pretty major back issues out of the blue. Sharp throbbing pain in upper back region. It came out of nowhere, she is young (20''s) and is active but not overly so. The dr. referred her to a physical therapist, but this seems kind of backwards and isn''t helping either.

Just thought I''d ask here in case anyone had been trhough something similar and had advice. Is there a type of specialist that focuses on these sorts of issues?

How is this backwards? Unless he/she was a specialist he/she can''t do much more than give drugs for the pain. I''d have her stick with the physical therapist or see a chiropractor.

I guess I thought it was backwards b/c she hadn''t been diagnosed by an MD before being referred. It was my impression that the PT defers to doctor''s diagnosis and works to rehab the issue, but if it''s the wrong diagnosis (or there is none at all) it could be ineffective or even harmful.

Anyway, I''m new to this which is why I was seeking others'' feedback who''ve been dealing with it for longer. For the time being the PT seems to giving relief so hoping it continues.