T Nation

Help with 3 Year Tissue Injury


#1

About 3 years ago I injured my back throwing a large piece of construction equipment into a van at work. I saw a workers comp lawyer who sent me to a workers comp doc. The doc did nothing, absolutely nothing. His goal was to keep me in pain to drag out the court case and land himself a bigger pay day. He said the Xray was clean and that the damage was tissue related.

1 Year later I realized this doctor was a sham. His business quickly closed down. I began bouncing from one uneducated physical therapist to another, getting the usual exercises you can print from google images. No real help or diagnosis, just a full year of bed rest and poorly performed exercises that were not monitored or supervised.

2 Years after the injury I found out I was suffering from active myofacial trigger points in my spinal erectors, upper back, rectus abdominus, and intercostal muscles. At this point I realized that bed rest was not helping. My core muscles were deactivating and any time I tried to get out of bed I would suffer extreme spasms and nerve pain. To point where suicide was a daily option.

Most doctors would not give me pain killers because of my age (mid twenties) and the fact that my tissue damage was not visible to the naked eye or on an xray. Dry needling helped but only temporarily because it would hurt so bad I would go right back to bed and my core muscles would continue to stay inactive.

3 Years after the injury I finally found a great physical therapist. Apparently I had an EXTENSION injury and I was a CHEST BREATHER with little core strength, pain was attributed to active Trigger Points. Everything in his office usually goes right. Occasional flare ups were usually do to work or other outside factors. A few times we over did it in PT and I was left with some pain to deal with.

They had a great dry needling doctor on board who did amazing things for me, one time even deflating my right lung on accident, but I didn't blame him he was the biggest help in my life. A savior. He eventually left the office and I was placed with another great doctor who knows his shit. Only issue is I get no more dry needling.

I am midway through year 3 and have suffered a recent flare up that has somewhat sent me over the edge. While lifting something very heavy at work I threw my back out and it locked up on me. PT was no help, every exercise made it worse.

My options:
Soft tissue work- Done with a PVC pipe and/or tennis ball. This is done a few times a day and after PT.

Percocet 5mgs for pain- Terrible, I lost a brother to an OD earlier this year. Not to mention opiates suppress testosterone even when used acutely. Withdrawal is also hell and can leave your pain receptors with "rebound analgesia". I can rarely take this drug for more than 2 days straight without losing myself in it.

Baclofen 20-40mgs for spasms/spacicity- Cool drug but hard to tolerate. It releases a GH pulse after you take it and it also raises LH. Problem is it has a super short half life, is very addictive, and has a nasty rebound after cessation. Also clogs my sinuses up and makes me look and act drunk. Not something I can take daily. I'm also not sure if muscle relaxers are counter-productive to activating the smaller core muscles needed to support the spine.

I have no proof but I think it's possible that while they relieve spasms they also make things worse by messing with your mind-muscle connection or activation of core muscles.

Physical therapy- A must obviously. I have to stay mobile. I have to keep working on strengthening my core. But this is difficult when I am in so much pain or an acute spams occurs. I have been with these great doctors since March-ish. I know that 3 years of damage can not be fixed in 6 months so I will continue to work with these people.

My question, or prayer, is that anyone here has any advice or ideas or strategies. Anything. I would do anything, and I mean anything, for just a little relief. Any drug, routine, stretch, supplement, or magic elixer. Any words of advice, positive thoughts, anything. Please. I was a lifelong athlete before this and it kills me every day to live like this. Anything would be appreciated. Thank you.


#2

My impression of your story is still one of vagueness.

X-rays are notoriously multi-interpretable and I’ve seen many specialists have very different opinions about lumbar spine x-rays (ranging from “you’re fine” to “big fucking prolapse” when it being the opposite) MRI’s will tell you much more in general.
An “extension injury” and a “chest breather” is not a proper diagnosis, period.
Deflating a lung when dry needling is not competent in my eyes.

In my experience, if there is no mayor diagnosable injury, then the goal should be to move out of the “physical therapy zone” as soon as possible and strengthen the whole system far beyond where you would end up with just the PT exercises (those would only be used as a carryover).

Dependence on pain medication, dry needling and other therapies that you would undergo relatively passively have a danger of taking you into the “professional patient zone”. Better, in my opinion, to strive for independence through exercise and training.

Your story is too vague for me to make an educated guess where your starting point for exercise and training would be but I’m sure there are some exercises you can do that you can then expand/build on. If you want some decent input on that from people on the forums it might help to describe your specific symptoms and your current capabilities (exercise wise)

  • Please take responsibility for your own health problems and think for yourself. The above is just my opinion and you can consider it or not. It’s up to you.

#3

The diagnosis is myofacial pain syndrome. The reason is from a work related injury, an extension injury I was told. I was also told that I was a chest breather and had terrible posture and that after so much bed rest my muscles had atrophied and deactivated.

They have me doing kettlebell work. Squats, DLs, turkish getups. Stuff like that. At home I do core work like planks and dead bugs etc.

Sorry by my vagueness. Anything else? I’m 6’4 skinny with low bodyfat but have always been an athlete, up until a few years ago.

I feel that I am moving towards what you call “professional patient”. I would like to reverse that. What is your stance on muscle relaxers? I use opiates in emergencies when my mobility is comprimised. One thing I will not do is go back to bed rest. Im not sure if muscle relaxers help or hurt. Symptom wise yeah they help but just like opiates im sure theres a dark side.


#4

Bed rest is for the flu, it’s contraindicated for cases involving musculoskeletal pain. I would consider prescribing a year of bed rest for myofascial pain syndrome as malpractice.

I would suggest googling the following: FMS/SFMA, FMS-CK, NKT, StrengthFirst, DNS, PRI, or TPI. Try to find a chiropractor, DPT, or trainer that is certified in at least one of the above. The kettlebell squats and deadlifts are good if you’re ready for them. You may have to regress to rolling and crawling patterning to reset your movement patterns. Don’t underestimate the importance of breathing. I agree with the above poster that gaining independence from health care providers should be a goal of yours.

Someone certified in dry needling should not deflate a lung, ever.


#5

Thank you developmental rolling and crawling have been used in my routine. Not sure of my PTs quals but the FMLA stuff and DNS stuff I know for sure.

I trust him when im in there. I TRY and not overtrain by doing my home exercises daily. I could use some advice there. My diet and supplement routine is borderline OCD. ive tried peptides with little results. Maybe I healed quicker from dry needling. I had my T checked and it was high 700s on the usual 300-1100ish scale so no concerns there. I try to only use meds when my mobility slows down from pain or spasm. And I alternate between pain killer and muscle relaxer to avoid addiction. They can’t be good for me. Thank you for thd advice on checking credentials.


#6

I had daily back spasms until directly working on my muscular endurance in my lower back. Very easy back extension exercises until I could handle 2x8 with bodyweight only on the hyperextension board. Build up to 2x9, 2x10, 2x11… etc, and so on. Once or twice per week.

Took about a year to build up to 3x25, twice per week. Working towards 4x25, eventually I hope three times per week… Very infrequent back pain now.


#7

they dont have a back extension set up at my rehab place. its a lot of strength work though. I assume that im headed in the right direction? I wont sacrifice anymore mobility but sometimes I can’t tell if I’m overworking an already overworked area or what. It’s very hard to determine volume its mostly done trial by error. And then I work up from there. Thanks for the advice.