W00t!

[purpletigron]

Despite being in considerable discomfort, Mater made it to her physio appointment.

And I think we may have a breakthrough!

We saw a new physiotherapist, as the staff cycle sites three times per year. This physio gave us something specific for the first time - scar tissue in the muscles around the sacro-iliac joint causing sciatica-like symptoms. One exercise that the original physio suggested for strengthening Mater's back had been aggrevating the s-i, hence the renewed pain. So that's off the list - and we have three new exercises to target the scar tissue. Apparently, it's possible to 'break up' the scar mass. Mater's bad leg was perceptibly 'shortened' by the knots in her hip!

The physio is confident that Mater will soon be able to cope with car journeys again, thanks to the new exercises - one of which can be done whilst sat in a car seat to keep things loose. She'll just need a break every hour to stretch.

So we might yet be able to go on holiday at the end of May after all :-)

Mater felt drained immediate after the appointment, but as we gently puttered home (it's a 15 min walk), her mood improved, and she's very happy and feeling quite chuffed now.

Go Mater!!!

Comments

[purplecthulhu.livejournal.com]

That sounds really good, and explains a lot of her recent discomfort.

Not impressed that one of her exercises was being counter productive, but at least that's off the menu now. Yay for the new physio! And for M!

[purpletigron.livejournal.com]

Well, the physio clarified that the exercise is still useful, and that M needs to balance between the good it does her back, and the aggrevation to her hip. A variation on the old joke, "Doctor, Doctor ... it hurts when I do [FX: This!]"...

[hobbitblue.livejournal.com]

That's what my mum has.. she doens't find exercises useful but walking about a lot and swaying if she stands still helps, plus a mix of resting and moving (we're on timers here right now, an hour down, 2 hours up, it used to be just an hour up so she's improving). Hope the new informatin and the stretching prove beneficial - my mum also had cortisone injections into the scar tissue which helped her keep working for a while, don't know if that's something your physio might consider recommending, it varies in effectiveness from person to person.

Questions!

[purpletigron.livejournal.com]

OK, may I ask a screed of questions now?

How long has your Mum had this? Mine probably developed the problem 11 years ago, yet it has only really affected her seriously since she injured her back in January.

How does your Mum rest - in what postures?

Can we work out what the two sets of exercises are ... perhaps I can find a site on the Web with explanations, so we can compare notes? Meanwhile, some confusing descriptions of Mater's three:

(1) lie on back, bend bad knee up to chest whilst clasping it with arms
(2) sit with legs straight, cross bad leg over good, putting bad foot outside good knee to bend bad knee, put good-side arm to cross bad leg, and use outside of good-side elbow to push on outside of bad knee to increase leg cross, whilst supporting upper body with bad-side arm (hand flat on floor) and twisting upper body toward bad side and looking over bad-side shoulder
(3) Lay on good side with legs straight, allow bad knee to bend and bad leg to move forward onto floor/bed, then lift bad ankle to produce stretch in bad sacroiliac area.

What exactly do the cortisone injections aim to achieve? What does your Mum think they achieve?

Thanks! And best to your Mum with this...

Re: Questions!

[hobbitblue.livejournal.com]

Sorry for delay on responding to this, was checking with mum and then didn't get round to replying, oops.

Mums had back trouble from 1976 until 1980 when she had surgery for spondililosthesis, after which she was much better and able to work part time then full time for many years, her back went bad again in 1996 and after that it was a struggle to keep working, this time it was diagnosed as inflammation of the sacro-iliac joints, likely caused by scar tissue from previous procedures, though it was "set off" by a bad bout of shingles we think..

Resting is mainly done flat on her back on her tummy, or with legs up, she doesn't use a pillow, and has some of that memory foam on the bed to provide a more stable surface. She's been sleeping downstairs since 2002, has her bedroom in our dining room and avoids stairs and doens't go out as too much walking is a problem, until recently she couldn't sit at all and while still working spent most of her time kneeling or standing or lying (had a couch in work) - recently she's at least been able to sit on the end of her bed to eat meals which is a huge step forward.

Exercise wise most of the standard ones make her back worse, the ones you describe she couldn't begin to attempt, for her the main thing is a mixture of resting and movement in general, it used to be she could spend 20 minutes up and about doing gentle housework and then lie down for a couple of hours, she's currently on 2 hours up and 1 hour resting, though has to be careful not to strain or stretch or carry heavy things or bend too much.

The cortisone injections were painkilling and muscle relaxants, injected into the site of the scar tissue they killed the pain nicely for about 6 months during which time she was able to get on with things. People who could do exercises were encouraged to increase their flexibility during this time while the pain was switched off (um, sort of, still pain but not the screaming agony levels) which I htink is a good idea.. the downside is that frequent injections may likely have increased the amount of scar tissue, but at the time it was more important for mum to continue working full time and the injections allowed her to do this.

when mum was ill in 76 the medical opinion was bedrest, we now know this is lethal for back problems and a mix of movement and resting is ideal, what helps mum most is not standing still for too long, she can feel things stiffening up so she sways or moves from side to side to keep things loosened, or walks around while talking.

Um, any of that helpful? feel free to ask more... mum had her cortisone injections from Dr Wells, an eminent pain specialist working out of Rodney St here in Liverpool and went privately, not sure they're available on the NHS, and long term they're not ideal but do give a "boost" to get you up and moving enough to become more mobile. Mum takes a cocktail of medications now which help, also prozac which isn't exactly for depression but again just gives her a bit more oomph to cope with the day..

Re: Questions!

[purpletigron.livejournal.com]

Many thanks for this! Mater's finding she is getting sore patches on her buttocks (from sitting/laying), her good hip (from laying on her side) and her feet (from sitting), because of all the time spent in bed.

She's not doing the exercises whilst she's incapacitated, of course. She was getting quite good at going for moderate, gentle walks. What other kinds of movement help your Mum? We are scheduled to see the physio again on Wednesday afternoon, but I have no idea when Mater'll feel up to getting out of bed again :-(

I wonder whether deep tissue massage could achieve much of the benefits of the cortisone injections, but with the effect of decreasing rather than increasing the scar tissue?

Re: Questions!

[hobbitblue.livejournal.com]

Is she quite skinny/boney? Don't think mum's had those problems but she's well-padded.. the memory foam stuff might help with that, gives a soft but firm surface. Sorry to hear she's not managing the exercises, always harder when you just physically *can't* though... moving around and doing will help in general, mum mainly gets her exercise from pottering in the house now she's well enough to be doing the washing (sliding the baskets on waist level trolleys to our eye level positioned machines), doing the cooking (most utensils and pots stored in easy to reach places, dad puts stuff in the oven) and gentle gardening (pots and compost up on a table so she can reach).

The main problem mum had was boredom, particularly when she was stuck in bed more and feeling more ill, and because she's a workaholic and doesn't like to "give in" - does your mum have lots of stuff to distract her? My mum reads a lot, and watches old comedy stuff on television, and when she was more immobile I made sure I spent time talking to her and sharing what I was doing, if we go out, I'll come back and give her a blow by blow account so she feels like she was there too, which helps her feel less isolated I think, though she's doing better now, plus we have a former carer coming in to help out with various things once a week and thats good company as they potter around together doing things.

I would think deep tissue massage would be most effective - mum has a hand massage thing got from Argos that has heat and massage she finds useful for her legs, if that's any help? this one she gets dad to use on her (without the infrared thing, I think), and this one she can use herself at other times..One cortisone would likely be of benefit, more than that, less so, I'm thinking - when mum was having hers they didn't realise it had that effect on scar tissue.

[sammywol.livejournal.com]

Ouch! i never had scar tissue but I was having a lot of problems with my sacro-iliac joint for a while and found that deep tissue massage helped relieve the symptoms a great deal. Perhaps when you Mum is a bit stronger or that scar tissue is broken up a bit she might be able for it. It did leave me with a piebald bottom but then I bruise very easily and I was able to walk without pain after a session which was a big plus as I am sure I don't need to tell you.

Good news on the car exercises too!

[purpletigron.livejournal.com]

I suspect this might describe what the osteopath, J, was doing? J described it as 'realigning' the SI joint, which D's father (retired GP) said was rubbish. But it could be that J was actually doing was somehow loosening up the scar mass?

[sammywol.livejournal.com]

Hmm? I thought the point was that the sacro iliac was a pretty fixed feature but everything else has a tendency to get out of alignment with it. I wonder which of our alternative practitioners was talking cobblers.

In my case all the masseur was doing was easing the symptoms so the problem, which was mainly postural I think, didn't get worse. (I never really got to the bottom of it but haven't had a recurrance now for nearly four years.) The real pain was in my heel which was too painful to put any weight on - all just transfered pain.

Go with whatever works I would say, even if the theory might be a bit dodgy.

[purpletigron.livejournal.com]

D's father was indeed saying that the SI is fixed, as far as I understand.

Although it should be easier to find something that will work based on good theory, the theory isn't well enough worked out yet, is it? We might well try deep massage at some point, so thanks for the suggestion :-)

[micheinnz.livejournal.com]

Go Mater indeed, and go clued physios!