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-   -   Physical therapy/Sciatic nerve (https://board.crossfit.com/showthread.php?t=77743)

Michael Keller 10-01-2012 05:56 PM

Re: Physical therapy/Sciatic nerve
 
[QUOTE=Brian Strump;1096226]Yes, if money was no object, and the test's are cheap.

Even if it wasn't through WC, most insurance companies will require you go through a trial of treatment(either meds, or rehab) prior to authorizing it.

Also, most imaging is very overused. They may tell you if it's a herniation, but that's it. If you're not getting surgery, the exact location of the herniation, or whether it's herniated or not, should not matter much during the initial phases of a rehab program.

Would it be nice to have, sure.....but it will not be dictating most rehab programs.[/QUOTE]

My Physiatrist required it before spinal injections. He has to have the exact location of the herniation to get the injections into the best spot for them to work most effectively. I've been through several rounds of injections over the course of the last 12 or so years, and they have worked wonders for me. Without an MRI, he would be blindly guessing on the best location to inject.

I do agree they are often overused, but they are also often needed. I did not have to go through any rehab program because he was familiar with what I already do, and agreed the PT would not be able to do anything I wasn't already doing.

Brian Strump 10-01-2012 06:31 PM

Re: Physical therapy/Sciatic nerve
 
[QUOTE=Michael Keller;1098006]My Physiatrist required it before spinal injections. He has to have the exact location of the herniation to get the injections into the best spot for them to work most effectively. I've been through several rounds of injections over the course of the last 12 or so years, and they have worked wonders for me. Without an MRI, he would be blindly guessing on the best location to inject.

I do agree they are often overused, but they are also often needed. I did not have to go through any rehab program because he was familiar with what I already do, and agreed the PT would not be able to do anything I wasn't already doing.[/QUOTE]


For injections, of course.

I would disagree, that depending on your condition, if you've gotten "several rounds" the only wonder they work was to temporarily relieve some of your pain. Some require injections as a last resort, however that should only be used as a last resort.

David M Welton 10-02-2012 11:26 AM

Re: Physical therapy/Sciatic nerve
 
Update on my injury... I had my lower back put back into alignment by a chiropractor during my physical therapy today. It hurt pretty bad. still no mri. My xrays came back with nothing bad but I still have pain in my lower back down to my butt and left foot. Im really hoping today fixed the problem. What would the pain level be like if it was a slipped disk? My pain level now is around a 3-4 and if I do a lot of walking or sitting in the car a lot it gets up to an 8 some times. Thanks!

Brian Strump 10-02-2012 12:12 PM

Re: Physical therapy/Sciatic nerve
 
[QUOTE=David M Welton;1098171]Update on my injury... I had my lower back put back into alignment by a chiropractor during my physical therapy today. It hurt pretty bad. still no mri. My xrays came back with nothing bad but I still have pain in my lower back down to my butt and left foot. Im really hoping today fixed the problem. What would the pain level be like if it was a slipped disk? My pain level now is around a 3-4 and if I do a lot of walking or sitting in the car a lot it gets up to an 8 some times. Thanks![/QUOTE]

Everyone's pain threshold is different. If we don't see holding improvement after 3-4 visits to start, we'd consider an MRI in your case. If you had muscle weakness, we probably would have ordered it already.

Aaron Wayne Campbell 10-02-2012 02:42 PM

Re: Physical therapy/Sciatic nerve
 
David - I had very similar symptoms to yours - pain in left lower back, radiates down my butt and leg. Tingling in my left foot. Muscle spasms in my butt and obliques. My original injury was in July. Got an MRI in August - herniated disc l4-l5 with left L5 nerve root impingement. A common injury.

Found a good PT - doing "McKenzie" exercises and stretches, working on my core. Have had to adjust work outs significantly. Have made a lot of progress, now 3 months out. If I do what I'm supposed to, I do pretty well, and hope to continue improving. Haven't needed injections.

I agree to avoid surgery at all costs - only if you develop leg/foot weakness or bowel/bladder problems. I agree MRI is probably not essential, but may be helpful.

David M Welton 10-02-2012 10:26 PM

Re: Physical therapy/Sciatic nerve
 
Aaron- Did you always have pain or did it come and go? My pain comes and goes. I never know how im going to feel when I wake up. If I walk a lot or sit it hurts bad at the end of the day...I would say it hurts around 3-4 days out of the week. Other days I can deal with it talking my meds. Thanks...

Aaron Wayne Campbell 10-03-2012 09:15 AM

Re: Physical therapy/Sciatic nerve
 
David at first my pain was severe and always there. The moment it happened - during a deadlift, I actually fell to the ground and didn't get up for about 30 mins. Now the pain is up and down, and not in my leg anymore. Sitting long periods makes it worse, like long car rides. I got a lumbar pillow I use at work and in the car that helps some, keeping the curve in my lower back (lordosis). If you do have a pinched nerve from a herniated disc, the pain should move out of the leg and into the back as it is improving (and hopefully eventually go away). It ought to hurt worse when you bend at the waste - arching your back. This opens up the vertebrae and alows the disc to push backwards towards your nerve roots. Staying in lordosis (back extended) should help. That's what McKenzie is all about. Again, I recommend a good PT. Ice seems to help a lot. I wrap an ace wrap around myself or stuff it under my pants to hold it tight against my back. Staying active and doing my PT helps the most. I take motrin about twice per day and occassional tramadol. Was taking flexeril for muscle spasms but haven't needed it lately.

David M Welton 10-04-2012 03:16 PM

Re: Physical therapy/Sciatic nerve
 
Today was day two with the chiropractor during my physical therapy. PAINFUL! I felt somewhat better on weds but after today it felt like I had reinjured my back. The chiropractor told me this would happen but man it hurts! We will see what happens tomorrow at my next Doctors apt.

Megan Zetter 10-05-2012 06:33 AM

Re: Physical therapy/Sciatic nerve
 
[QUOTE=David M Welton;1098766]Today was day two with the chiropractor during my physical therapy. PAINFUL! I felt somewhat better on weds but after today it felt like I had reinjured my back. The chiropractor told me this would happen but man it hurts! We will see what happens tomorrow at my next Doctors apt.[/QUOTE]

What is the chiro doing? What is the treatment?

David M Welton 10-05-2012 09:36 AM

Re: Physical therapy/Sciatic nerve
 
[QUOTE=Megan Zetter;1098924]What is the chiro doing? What is the treatment?[/QUOTE]

He called it the "Lumbar roll" He had me lay on my side with my upper leg bent towards my chest and he pressed on my lower back causing it to pop.


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