Friday, February 19, 2016

Physical Therapy

13 Feb 2016                              -4-

As the months dragged on with no resolution of the Sleep Number, bed position, and pillow; few comfortable nights rest; and my back and neck hurting worse; our doctor recommended a physical therapist (4 Aug 2015).

The first results were spectacular. In week 3 I was pain free. I could stand up straight with no muscle spasm causing me to bend at the hip or anywhere up and down my back. But as the days past it all returned, even during the last sessions with the therapist.

After Sunday, 18 Oct 2015, (Chart 4, Day 15) we abandoned the Sleep Number bed (red line breaks). I stopped physical therapy. Every turn or tilt of my head produced a grating sound in my neck. Every time my right foot touched the floor there was a sharp click at the base of my neck. As the weeks passed this clicking seemed more muted and to come from further down. Our doctor assures me it is not a problem.

It took two weeks (Chart 4, Days 16 – 30, no red line) to try out several combinations of sleeping position and pillows on our guest room bed. I had to sleep on my back, as my hip joints burned too much sleeping on either side. The return to the Sleep Number bed was a welcome relief (See Sleep Number Bed for details).

Charts 4 and 5 show the full set of available records for Sleep Score and Sleep IQ values. They start with the end of physical therapy on Day 2.

I have no explanation for the uniform periodicity of Sleep Score values in Chart 4 up to about Day 76. I know of no such biological rhythm.

The running five-day averages, Chart 5, present a helpful view. The lowest Sleep Scores (blue), below the Sleep IQ values (red), are associated with pain (the guest room bed). The highest Sleep Scores, above the Sleep IQ values (on the right portion of the chart after the change in patterns), are associated with reduced pain. When both sleep quality values were high (the last five days), there was little or no pain sleeping, sitting, or activities in our apartment.

Muscle spasms (that can mostly occur along my back in any order and combination) respond to physical therapy or to telling my brain to stop the pain by identifying the cause of the pain (stress, anger, fear). [Healing Back Pain, The Mind-Body Connection, by John E. Sarno, M.D., 1991]

The worst spasm is above my right knee. It feels like the tendons are being torn from bone and muscle. The scariest is a sharp jab in the left side about four inches below the arm. Over a period of 2-3 days it slowly fades away. This once occurred when my wife was in the hospital getting a stint about 10 years ago. One of the doctors asked why I was jumping periodically. That resulted in a full examination with no problem found. These are just two examples of observations that Dr. Sarno builds his mind-body connection on.

Provision Living at Columbia (MO), has a 10:00 am one-hour daily exercise period including weights, stretching, Tai Chi, and yoga. This covers both physical and mental aspects. We try to attend all of them. It also has a physical therapist and an occupational therapist who advised me to return to the therapist at Peak Performance where I had such good initial results, before I start working with them.

This recommendation is another hint that the real cause of much back pain is not understood nor is the most effective physical therapy/therapist. When you find an effective one, keep him and continue with the exercises he has taught you. Physical therapy removed the pain but not the causes: stress, anger, fear.

Physical therapy did something more interesting than remove the pain. It was started at the top of my back and then moved down a bit each day. The pain moved down until it (had no place to go?) ended. Along the way a spot that makes me belch did so. A spot for the false heart attack and one for the right knee were also visited. So now physical therapy again or "believe" to finish the pain problem while living here?

Must there be a physical connection between spot and pain or can the mind pick any site for the pain? Or, as is the case with our daughter, pain left unmanaged for several years can become a disease unto itself? Or is this another case of allergies (severe pain in Walmart, and a few other stores, after about 15 minutes, on some days)?

We have met three people who have purchased Sleep Number beds and returned them. All three had severe back pains. including one with three back surgeries and scheduled for another. We like the bed, we expected it to help, but we never expected it to cause or "cure" back pain. It has helped us to explore causes and "cures".

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