Question about physio

[fisho mcspaz]

I went to the physio the other day because my neck was stuffed and she massaged it a bit and pressed on the facet joints and told me some exercises to do for my neck. Two days later and I am in a LOT of discomfort, aches all over the shop. I've taken two Nurofen Plus and they are not doing the trick. I just want to know if this is normal - do you feel worse before you feel better? I do not have much experience with this sort of thing, this is only the second time I've been to the physio.

[mighty_tiger_79]

cant give any advice as ive never been

but it doesnt sound normal to me

I wouldve thought there was some discomfort during the process of being fixed up, not afterwards

[CK]

This can happen. If you haven't visited a physio before, entirely probable they will work hard on trying to find the spots that are causing discomfort and be a little "rougher" (not the right word,, but hopefully you know what I mean) to work things clearer.

The first few times can be a bit painful, but from there, the body should slip into more of a routine with it and be looser.

[Drop Bear]

If it's still painful after 3-4 days I'd ring them up and let them know.

[Psyber]

One of the problems is that after an injury or chronic illness you find that muscles have shrunken and shortened through reduced use, and need to be remobilised and stretched.
This involves a process of microscopic tearing and healing over time to regain the lost bulk and, particularly, length.
The process generates pain.
On the other hand the shrunken muscles cause posture alterations that cause chronic pain too.

My knowledge here is not just theoretical.
Many years ago I had a fall and tore a muscle in my left shoulder slightly.
It hurt to do much with my left arm and I am very dominantly right handed so I fell into the trap of just not using the left much.
Three months down the track I had a "frozen" left shoulder, able to be moved only a few inches in any direction without pain.
I went through months of severe pain, gaining a few millimetres extra movement in each direction every day though carefully planned exercises.
I eventually regained full movement.

Before embarking on anything like this it is important to make sure there is no underlying unresolved injury that needs fixing first.
Usually there isn't - most chronic pain is caused by such muscle atrophy and posture changes.
The place to start is with a good Rehabilitation Physician who can supervise Physiotherapy management.
If you haven't had this work up yet, I'd recommend Dr Colin Mills, based at Hindmarsh Hospital if he hasn't retired yet.
I did a lot of work with him over common patients when I was seeing a lot of work injury patients.
[He was still there last year.]

[JK]

I regularly get the same treatment as you FilletO, and whilst I feel tender when I leave, there's immediate relief in my head and neck .. Ive NEVER felt any discomfort the next day or the following week for that matter.

I'd follow DB's advice and if it still hurts tomorrow I'd probably get it checked it because it doesn't sound right to me (although Im obviously no Physio)

[Barto]

Sometimes it hurts more straight after but should settle down in a day or two. Depends on the injury.

Back up the "if it still hurts in 3 days, go back"

[gadj1976]

I went to the physio the other day because my neck was stuffed and she massaged it a bit and pressed on the facet joints and told me some exercises to do for my neck. Two days later and I am in a LOT of discomfort, aches all over the shop. I've taken two Nurofen Plus and they are not doing the trick. I just want to know if this is normal - do you feel worse before you feel better? I do not have much experience with this sort of thing, this is only the second time I've been to the physio.

Depends Fisho..... If you haven't been to the physio for a while, and you needed a bit of work, then there is a good chance that you'll be sore. That should dissipate after another day or so. The concerning part is that the physio didn't tell you to expect the soreness?!?!

[Ian]

If you haven't had this work up yet, I'd recommend Dr Colin Mills, based at Hindmarsh Hospital if he hasn't retired yet.

Wow!! is he still going?

When I worked down the Port (finished there 17 years ago) he was our resident work injury doctor and used to visit our site every Wed morning.
He sorted out a back/shoulder problem that my GP was getting no where with in a matter of a couple of weeks, I would highly recomend him as well!!

[Psyber]

If you haven't had this work up yet, I'd recommend Dr Colin Mills, based at Hindmarsh Hospital if he hasn't retired yet.

Wow!! is he still going?

When I worked down the Port (finished there 17 years ago) he was our resident work injury doctor and used to visit our site every Wed morning.
He sorted out a back/shoulder problem that my GP was getting no where with in a matter of a couple of weeks, I would highly recommend him as well!!

He was in early to middle 2009 when I dropped in to say "Hello", but he is 74 and thinking about retiring.
He and his wife were just off to a holiday in Mexico then.
I met him when my wife was in a lot of trouble with her back and being given the run around by Orthopaedic Surgeons and an insurance company.
Later he and I had a lot of WorkCover patients in common and met regularly at case conferences.

And he and a lawyer I knew well both bred Simmentaler cattle.

[Footy Chick]

Simmentals - good breed.

I used to dabble in Limousins myself ( the cows, not the cars..ok, well those too. A good friend of mine had part ownership in Krystal Koach )

I really love Charolais though, they're so big, white and squishy


But I digress...

Pain appears on the surface and muscles contract painfully because they are trying to protect a skeletal structure that's not right underneath. A physio can prod and massage all he likes but unless you get to the bottom of what's causing it , you're just wasting your money.

[Psyber]

Pain appears on the surface and muscles contract painfully because they are trying to protect a skeletal structure that's not right underneath. A physio can prod and massage all he likes but unless you get to the bottom of what's causing it , you're just wasting your money.

That's right initially FC, but the problem is that if it goes on long enough the muscles actually shrink and atrophy through not being mobilised.
Then they brace the body in the abnormal posture and resist mobilisation even after the underlying condition has resolved.
Management then depends on what stage things are at - that's why a thorough assessment and periodic reassessment is needed.

To the sufferer it all seems the same so they tend to assume the underlying injury has not resolved, and so are afraid to do the necessary painful exercises in the later stage.
In an ideal world we would be able to determine early whether an injury is soft tissue only or whether there is underlying bone or disk damage.
The optimum management of the two conditions is more or less the opposite of each other - continued use/early mobilisation is best if only soft tissues are involved..
MRI is the best tool we have to determine this, though it is not perfect, but last time I checked Medicare would still not fund early MRI.