BMH: What a pain! One patient's adventures with sciatica, part 2

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Recap: In a previous column the author discussed their initial impressions of beginning a course of physical therapy at Brattleboro Memorial Hospital to treat a recently-diagnosed case of sciatica. The author's conclusion thus far is that PT is not for the faint of heart, but the gains are worth it.

As predicted, my symptoms over the next few weeks of therapy follow a very non-linear trajectory. There are days when I bound out of bed, ready to tackle whatever is tossed my way, and other days when I feel frustrated by what seems to be regression. My therapy sessions become a good reality check – in spite of some days that feel like setbacks, my therapist, Kim has actual measurements and data to show that I am steadily increasing my core strength and the flexibility and extension of my spine.

The environment in the BMH Rehab Services Department is upbeat and optimistic, and this makes a huge difference in my willingness to go there, even on days I don't particularly want to. I'm on a parallel schedule with a number of other folks I've begun to recognize in the waiting room – some high school athletes recovering from injuries, some people who have recently had knees or hips replaced, and quite a few folks working on their fine motor skills with the Occupational Therapy team. It's encouraging to see others making progress with whatever they may be struggling through, and it's always humbling to reflect on how the human body is both a fragile and resilient instrument.

Of course everyone's experience of physical therapy will be different, but I do think a few things hold true for most people:

• It is a marathon and not a sprint, so don't be surprised if you have moments of feeling discouraged or stuck in the same place.

• PT is not something someone does to you or for you. You have to commit to being a full participant in the program laid out for you.

• Simple as it may sound, you have to do your exercises. On the schedule prescribed. Don't do more than instructed, and certainly don't do less. Trust that your therapist knows what you're capable of.

• Your therapist can help you most effectively if you are honest with them. Tell them what hurts, how it hurts, which exercises are so boring you can't stand to do them anymore, when you're feeling discouraged, or if you develop new symptoms. You might be surprised at how creative and resourceful they can be in keeping your sessions motivating and productive.

So after 6 weeks of PT am I magically cured? Well, nothing is magical, so no, BUT there has been good progress. My leg pain has indeed "centralized" to a very specific point in my lower spine, so I am no longer experiencing the random lightning bolts of shooting pain down the back of my leg. This is a relief since people tend to look at you strangely when you suddenly emit the yelp of a stabbed rat for no apparent reason. I am taking over-the-counter pain medication far less frequently, but most importantly, I now have a repertoire of exercises, stretches, and positions I can use to reduce the pain, confident that I am helping, not hurting, the underlying condition.

It's possible that I may need more significant medical intervention in the future, but being better-informed and equipped to deal with this spine condition has been a huge step forward in learning to live with the realities of an aging body.

So my final words of wisdom (because of course a few months of physical therapy has made me an expert on virtually everything related to the human spine!):

• Don't ignore pain if it's impacting your daily life. Denial just serves to extend your misery and there's nothing inherently noble about suffering if you don't have to.

• Even if you'd prefer a quick fix to whatever is ailing you (wouldn't we all!), be open to investing yourself in a longer-term process for healing.

• Don't be shy about asking for encouragement when you need it. Your therapist has a documented record of your progress, so on days when you feel like you're taking steps backwards instead of forward, and ask them to review the gains you've made since beginning therapy. You may be pleasantly surprised.

Yes, it is true that many spinal problems can be prevented by establishing and maintaining healthy habits early in life – exercising regularly, maintaining a healthy weight etc. etc. – but you already know that. No amount of lecturing or "woulda, shoulda, coulda" thinking can erase whatever sins we may have committed against our own bodies, and frankly I don't think it's all that useful to beat ourselves up. I think it's in all of our natures to believe ourselves invincible when we are younger, with a remarkable ability to bounce back from whatever ails us. Unless we are blessed with extraordinary good luck or remarkable genes, most of us find that we are less resilient as we age, but that doesn't mean that we must resign ourselves to lives of nagging pain and discomfort. There are many pathways to feeling better, and if you find yourself faced with back pain that limits your joy and productivity, physical therapy may be helpful. What's the worst that could happen? You might end up with six pack abs and the ability to do fifty one-armed pushups, which, I should be clear, is NOT what has happened in my case, but I can now successfully tie my own shoes. We must celebrate our victories wherever we find them!

At Brattleboro Memorial Hospital Rehabilitation Services you'll find a staff of physical, occupational and speech therapists ready to offer their expertise to help you get your life back on track. The spacious, fully equipped outpatient facility offers the largest rehab facility and the largest rehab staff in the area. You'll get one on one care, attention during your treatments and as a hospital based clinic we can provide comprehensive care for all of your rehab needs in one convenient location. Call 802-257-8255 or visit bmhvt.org for more information.


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