newbie with pain flare
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melissasev
- Posts: 9
- Joined: Wed Nov 03, 2010 12:36 am
newbie with pain flare
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Last edited by melissasev on Wed Mar 23, 2011 1:48 am, edited 2 times in total.
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HerMajesty
- Posts: 1134
- Joined: Sat Sep 18, 2010 12:41 am
- Location: North Las Vegas, Nevada
Re: newbie with pain flare
That is one of those great classic PT lines, "It will hurt before it helps". Don't you believe it. I am not putting down PT's, in fact I have had a lot of benefit from PT and work with a PT. But I am putting down that line. If something causes a flare, that is a warning: Back off, that method isn't working, try something else instead of hurting your patient. I don't think you will find anyone on here who saw a PT, was told "it will hurt before it helps", and then after they kept going back it really did help in the long run. Anyone whose experience has been different feel free to contradict me.
It sounds like you have had a chronic, long-term stable condition that does not like to be aggravated. I had the same for many years and my second pregnancy is what put me over the edge into a more serious pelvic condition. I would never suggest that you not try to get pregnant because that is a very personal decision and if I could do it all over again, I would gladly do it just the same to have my little girl. But realistically if fertility treatments and PT on the thighs put you into a flare, pregnancy and childbirth or c-section are probably not going to be kind to your pelvis either. You might want to do more investigating into the underlying physiologic problem and get that corrected before proceeding with a pregnancy.
I don't think a PT who puts you into a flare and then tells you it's supposed to hurt, is the person to investigate that with. Maybe consider the 3T MRI in NY? You did not mention from which direction you were driving to NH from, so I don't know how much of a trek that would be for you.
It sounds like you have had a chronic, long-term stable condition that does not like to be aggravated. I had the same for many years and my second pregnancy is what put me over the edge into a more serious pelvic condition. I would never suggest that you not try to get pregnant because that is a very personal decision and if I could do it all over again, I would gladly do it just the same to have my little girl. But realistically if fertility treatments and PT on the thighs put you into a flare, pregnancy and childbirth or c-section are probably not going to be kind to your pelvis either. You might want to do more investigating into the underlying physiologic problem and get that corrected before proceeding with a pregnancy.
I don't think a PT who puts you into a flare and then tells you it's supposed to hurt, is the person to investigate that with. Maybe consider the 3T MRI in NY? You did not mention from which direction you were driving to NH from, so I don't know how much of a trek that would be for you.
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
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pomegranate
- Posts: 157
- Joined: Sat Sep 18, 2010 3:12 am
- Location: Oklahoma
Re: newbie with pain flare
Hey Melissa,
I emailed you back just a minute ago, but I wanted to respond to your post here now that I've seen it. You say your inner thighs were painful even for her to touch. Did you mention this to the PT? I wonder what her reasoning was for that. I know some would say it's because your connective tissue was so restricted and ischemic. Hermajesty does have a lot of physical therapy knowledge, but if I were you I would probably go to this PT a couple of more times before making a decision. Especially since you've flared before from PT, and then saw improvement. But that's just my opinion!
This flare will die down, you've only had it for less than a week. Are you seeing this PT again next week? Maybe you could postpone for another week and see how you feel. I think I remember you sharing your MRI and it didn't indicate entrapments, right? I don't remember.
Hang in there! You've pulled out of flares before. By the way, Pianogal posted an encouraging study somewhere on the forum regarding the pudendal nerve and pregnancy, I'll try to find it for you.
Lauren
I emailed you back just a minute ago, but I wanted to respond to your post here now that I've seen it. You say your inner thighs were painful even for her to touch. Did you mention this to the PT? I wonder what her reasoning was for that. I know some would say it's because your connective tissue was so restricted and ischemic. Hermajesty does have a lot of physical therapy knowledge, but if I were you I would probably go to this PT a couple of more times before making a decision. Especially since you've flared before from PT, and then saw improvement. But that's just my opinion!
This flare will die down, you've only had it for less than a week. Are you seeing this PT again next week? Maybe you could postpone for another week and see how you feel. I think I remember you sharing your MRI and it didn't indicate entrapments, right? I don't remember.
Hang in there! You've pulled out of flares before. By the way, Pianogal posted an encouraging study somewhere on the forum regarding the pudendal nerve and pregnancy, I'll try to find it for you.
Lauren
2008: mild pelvic pain and PFD began
2009: true PN/PFD pain, two PN blocks, normal PNMLT
2010: PT and conservative management with moderate improvement in PN/PFD symptoms
2011: surgery for extensive endometriosis; arthroscopic hip surgery to repair labral tear and FAI (right hip)
2012: C-section delivery of first child
2014: arthroscopic hip surgery to repair labral tear and FAI (left hip); C-section delivery of second child
Ongoing physical therapy since 2010 for both pelvic floor and hips.
2009: true PN/PFD pain, two PN blocks, normal PNMLT
2010: PT and conservative management with moderate improvement in PN/PFD symptoms
2011: surgery for extensive endometriosis; arthroscopic hip surgery to repair labral tear and FAI (right hip)
2012: C-section delivery of first child
2014: arthroscopic hip surgery to repair labral tear and FAI (left hip); C-section delivery of second child
Ongoing physical therapy since 2010 for both pelvic floor and hips.
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pomegranate
- Posts: 157
- Joined: Sat Sep 18, 2010 3:12 am
- Location: Oklahoma
Re: newbie with pain flare
2008: mild pelvic pain and PFD began
2009: true PN/PFD pain, two PN blocks, normal PNMLT
2010: PT and conservative management with moderate improvement in PN/PFD symptoms
2011: surgery for extensive endometriosis; arthroscopic hip surgery to repair labral tear and FAI (right hip)
2012: C-section delivery of first child
2014: arthroscopic hip surgery to repair labral tear and FAI (left hip); C-section delivery of second child
Ongoing physical therapy since 2010 for both pelvic floor and hips.
2009: true PN/PFD pain, two PN blocks, normal PNMLT
2010: PT and conservative management with moderate improvement in PN/PFD symptoms
2011: surgery for extensive endometriosis; arthroscopic hip surgery to repair labral tear and FAI (right hip)
2012: C-section delivery of first child
2014: arthroscopic hip surgery to repair labral tear and FAI (left hip); C-section delivery of second child
Ongoing physical therapy since 2010 for both pelvic floor and hips.
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melissasev
- Posts: 9
- Joined: Wed Nov 03, 2010 12:36 am
Re: newbie with pain flare
Hi Hermajesty,
Love the name! I noticed you are in Vegas, I love Vegas. I'm actually from Boston. I agree 100% with you about the pain flare. I was hesitant to go in the first place, had just a mild flare, then once I got the therapy put me over the edge. I haven't had a flare like that for a long time. I did get the Mri from dr potter in NY. The good news is that i'm not entrapped all my pain is basically muscular. I know I did great the last time with PT, but we never worked on my thighs in the past. They actaully kill to even touch. I would think that with PT since it's muscular would make me feel better, but unfortunately it didn't turn out that way. I called her today and she said that this is normal. I work full time, so I can't take any chances with a flare like I had over the weekend. I'm going to continue doing my weekly massages which help and maybe just upping the lyrica a bit. I have an appt with my pain dr next week in NH so i will talk to him. I know what you mean about the fertility. My husband and I want a baby so bad, had a couple of miscarriages and was feeling great so that is why I figured fertility would be my next option. I really appreciate you responding. I just wanted to hear it from someone else, makes my decision much easier...Thanks again:)))
Love the name! I noticed you are in Vegas, I love Vegas. I'm actually from Boston. I agree 100% with you about the pain flare. I was hesitant to go in the first place, had just a mild flare, then once I got the therapy put me over the edge. I haven't had a flare like that for a long time. I did get the Mri from dr potter in NY. The good news is that i'm not entrapped all my pain is basically muscular. I know I did great the last time with PT, but we never worked on my thighs in the past. They actaully kill to even touch. I would think that with PT since it's muscular would make me feel better, but unfortunately it didn't turn out that way. I called her today and she said that this is normal. I work full time, so I can't take any chances with a flare like I had over the weekend. I'm going to continue doing my weekly massages which help and maybe just upping the lyrica a bit. I have an appt with my pain dr next week in NH so i will talk to him. I know what you mean about the fertility. My husband and I want a baby so bad, had a couple of miscarriages and was feeling great so that is why I figured fertility would be my next option. I really appreciate you responding. I just wanted to hear it from someone else, makes my decision much easier...Thanks again:)))
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melissasev
- Posts: 9
- Joined: Wed Nov 03, 2010 12:36 am
Re: newbie with pain flare
Hey Lauren,
Welcome Home! Thanks so much for the link. I know I get so frustrated because I was doing so great, then boom had the Pt and put me in the flare. I am doing much better today, thank god! Ice has been my life saver all weekend. The last PT i had, she never worked on my thighs. I think the new pt was trying to get at the connective tissue. I would only get the internal work done from my last pt. I told the new PT that I flared bad when my old PT once did the work rectally. She said this was part of her treatment which scares the hell out of me. My old PT knew better not to touch that area. I'm so confused. I'm scheduled for another appt on Thurs. Not sure what I should do. How are you feeling??Hopefully better....
Welcome Home! Thanks so much for the link. I know I get so frustrated because I was doing so great, then boom had the Pt and put me in the flare. I am doing much better today, thank god! Ice has been my life saver all weekend. The last PT i had, she never worked on my thighs. I think the new pt was trying to get at the connective tissue. I would only get the internal work done from my last pt. I told the new PT that I flared bad when my old PT once did the work rectally. She said this was part of her treatment which scares the hell out of me. My old PT knew better not to touch that area. I'm so confused. I'm scheduled for another appt on Thurs. Not sure what I should do. How are you feeling??Hopefully better....
Re: newbie with pain flare
I completely agree. I was told that it would hurt before it gets better many times by PTs who used myofascial treatment and I persevered with this type of PT for years and changed therapist several times. Unfortunately it just hurt and it did not work for me. I stress the term myofascial PT as I have not tried the type of PT that HM was helped by.HerMajesty wrote:That is one of those great classic PT lines, "It will hurt before it helps". Don't you believe it. I am not putting down PT's, in fact I have had a lot of benefit from PT and work with a PT. But I am putting down that line. If something causes a flare, that is a warning: Back off, that method isn't working, try something else instead of hurting your patient. I don't think you will find anyone on here who saw a PT, was told "it will hurt before it helps", and then after they kept going back it really did help in the long run. Anyone whose experience has been different feel free to contradict me.
Going to a PT and being told by them that they can get you better if you just stick with it can be incredibly reassuring but in my opinion if you are not noticing sustained improvement ( not just a day or few hours after treatment) after several sessions change therapist or look at other treatments. Going to see someone once or twice a week who reassures you that you will recover is bound to have a slight placebo response.
PT may work for some but be aware that there is not a single study that can show myofascial PT resolves pelvic pain. The latest study on IC patients showed that it did not have a significantly greater effect on pain scores ( on a scale of 1-10) than a regular full body massage.
That is not to say it does not work. There are success stories with PT on the net and you will also find people on this forum who have been helped by PT. However there are no studies that can show it is a reliable treatment. I think people deserve to know that before they spend a lot of money on it. Myofascial PT for pelvic pain is an alternative therapy.
Many on this forum will disagree with me but I would be more inclined to try nerve blocks before PT.
Last edited by Charlie on Tue Mar 22, 2011 10:11 am, edited 1 time in total.
Tried numerous medications as well as a long period of myofascial physical therapy combined with meditation/relaxation. My pelvic floor muscles are now normal and relaxed on exam ( confirmed by many Pelvic floor PTs) yet my pain remains the same. Also have intense leg pain. Deciding on next treatment.
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HerMajesty
- Posts: 1134
- Joined: Sat Sep 18, 2010 12:41 am
- Location: North Las Vegas, Nevada
Re: newbie with pain flare
For the record, mellissasev, regarding Charlie's reference to myofascial PT vs. the kind of PT I am involved in - I work with a PT Manual Therapist who works solely on correcting joint dysfunction.
Pelvic joint dysfunction was my underlying problem and correcting it did a lot for me, although I do have secondary damage as it went uncorrected for 25 years.
I have no idea if that is also your underlying problem, but it is worth investigating since the MRI shows you are not entrapped however you have myofascial restrictions: SOMETHING is underlying this, and joint dysfunction will rarely show up on imaging tests as it is a problem of movement and imaging tests take still pictures.
I am delighted you live in Boston. April 2 & 3 we are doing a sold - out seminar there (actually in Somerville) and will be training 40 PT's in Hesch Method Manual Therapy of the pelvic joints. If you PM me after that weekend, I will have a very good idea of who you should be seeing in your area to be screened for pelvic joint dysfunction. Assessment is a one visit deal, treatment a couple visits more, and it is painless.
Pelvic joint dysfunction was my underlying problem and correcting it did a lot for me, although I do have secondary damage as it went uncorrected for 25 years.
I have no idea if that is also your underlying problem, but it is worth investigating since the MRI shows you are not entrapped however you have myofascial restrictions: SOMETHING is underlying this, and joint dysfunction will rarely show up on imaging tests as it is a problem of movement and imaging tests take still pictures.
I am delighted you live in Boston. April 2 & 3 we are doing a sold - out seminar there (actually in Somerville) and will be training 40 PT's in Hesch Method Manual Therapy of the pelvic joints. If you PM me after that weekend, I will have a very good idea of who you should be seeing in your area to be screened for pelvic joint dysfunction. Assessment is a one visit deal, treatment a couple visits more, and it is painless.
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
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melissasev
- Posts: 9
- Joined: Wed Nov 03, 2010 12:36 am
Re: newbie with pain flare
Thanks so much Charlie. I gets so frustrating and confusing. She did say that she was trying to break up some of the connective tissue then we would be doing internal work within the next couple of visits. Hermajesty-What type of treatment does your PT do on you. My pain flare is so much better this evening. My next appt is Thurs so I will see how I am feeling on Wed before I make any decisions. I have tried nerve blocks in the past. I had a total of about 5 of them. The first 3 helped alot, then the pain came back, and the last 2 put me in a flare. I have had a MRi with Dr Potter and there is definitely something muscular going on. This condition is just a roller coaster..Some treatments work for some, then others get into a major flare.
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melissasev
- Posts: 9
- Joined: Wed Nov 03, 2010 12:36 am
Re: newbie with pain flare
Hermajesty,
That is awesome. I will defintely Pm you after the seminar. I live about 10 mins from Somerville right outside of Boston, about 10 mins from the city. I would love to hear who you would recommend. This is something I would definitely explore. I know my body is so out of aligment. One leg a bit longer, etc. Can't wait to hear..Thanks so much!
That is awesome. I will defintely Pm you after the seminar. I live about 10 mins from Somerville right outside of Boston, about 10 mins from the city. I would love to hear who you would recommend. This is something I would definitely explore. I know my body is so out of aligment. One leg a bit longer, etc. Can't wait to hear..Thanks so much!