Physical Therapy and Ginger Oil

So today the physical therapist recommended by Young Doctor Kildare saw me.

Much better than the “sports therapist” outfit across the parking lot from the Walgreen’s. Instead of a gymnasium full of clients besieging a couple of trained therapists and a bunch of not-too-bright assistants, this was one guy with his own office. He did have one assistant, who seemed to know what she was doing. And yeah, he was dealing with several patients at once, but at no time did I have to sit around for 20 or 30 minutes awaiting his attention.

But in the time department, he took the time to inquire in detail after the symptoms, to do an exam, and apparently to think about what he heard.

He agreed with YDK that whatever ails me is not “muscle spasms,” and he explained why he didn’t think so.

Hmmm… I seem not to have related the recent events here.

Backstory, then: After almost a year of back pain and foot pain, and after no visible improvement in the knee that I walloped two and a half months ago, I decided I needed to talk to someone who had more than 15 minutes scheduled to speak with patients. So I traipsed back out to the Mayo to see my doc of some 35 years.

He had me X-rayed and then, reading the radiologist’s report, said the X-rays showed some disk degeneration but not enough to cause significant back pain — and so he didn’t think the cause was a pinched nerve — and the knee didn’t seem to be seriously injured. He opined that the persistent pain is caused by “a muscle spasm condition” and prescribed a muscle relaxant, which proved impossible to get through Medicare Part D. After two more attempts, he finally came up with a drug I could afford out of pocket, cyclobenzaprine.

This dulled the pain a little, caused nightmares that verged on hallucination, and did nothing to eliminate the problem.

On reflection, “a muscle spasm condition” sounded kinda fishy — what kind of “muscle spasm” goes on for ten or twelve MONTHS, and if that’s what he thinks it is, why isn’t he testing me for MS, which in fact could cause something along those lines, or for diabetes, which can cause persistent lower-body pain? So I finally decided to try again with Young Dr. Kildare, who at least accepts Medicare.

After the usual brief interview, YDK begged to differ with the august opinions of the Mayo Clinic — he thinks it is a pinched nerve and advises the prescribed treatments are as follows, in this order:

1) Intensive physical therapy.
2) If this hasn’t worked after six weeks, epidural injection.
3) If that doesn’t work, do MRIs to determine a specific cause and attempt relief with surgery.

As for the knee, he believes the issue is prepatellar bursitis resulting from the fall I took, which would make some sense. If it doesn’t resolve over time, the course of treatment is exactly the same.

YDK is just a young fella on the run from patient to patient in a medical factory. However, to my ear he made a great deal more sense than the Honored and Elder M.D. This wouldn’t be the first time the Old Man has emitted a cattywampus diagnosis — years ago, when I was a bit younger than YDK, he tried to put me on beta blockers for the rest of my life, having decided I had a mitral valve prolapse. Before committing myself to permanent medicating, I asked my father’s cardiologist about it; he said if there was a valve prolapse (which he doubted), it was so minimal as to be virtually undetectable and I should ignore it unless I had some actual symptoms.

So…while Arizona sorely lacks top-quality medical care, the truth is, I’m no more star-struck by the Mayo name, despite their excellent hospital (one of the state’s few consistently rated excellent on a national basis), than by any other cluster of M.D.s around here. The Old Man’s theory didn’t hold water, the drug he prescribed did nothing more than briefly mask the pain, its maker specifically warned against its use for the elderly, and so I was willing to seek some other advice.

Hence, today’s physical therapist, whom Young Dr. Kildare recommended.

He scoffed at the “muscle spasm” theory. He explained the pain as a manifestation of compressed vertebrae brought on by the antic I got up to a year ago, which immediately preceded the symptoms. He decided the knee pain was unrelated to the back issue, and the heel pain may or may not be related to the back pain. In any event, said he, the first order of business was to address the back.

Damned if I know what he did, but whatever it was, it seems to have worked! He pushed on the back and pulled on the back in a way that felt a lot like a deep massage and that seemed reminiscent of chiropractic manipulation. When asked what exactly his procedure would do, he said the point was to “loosen up the joints,” whatever that means.

He recommended a half-dozen exercises, none of which caused any pain, unlike the other therapist’s contortions. By the time I walked out of his office, the back pain was almost gone, and the foot pain is significantly improved.

This evening when Cassie dragged me out the door to tromp around the block in search of cats, I was walking pretty much normally, something that hasn’t been so for months.

So what about the ginger snake oil I cooked up the other day?

Well, it did have a slight analgesic effect, so slight as probably to be wishful thinking. This evening I used some of it to stir-fry some shrimp with piles of onions, garlic, and Napa cabbage. Mighty good!

Probably the highest and best use of the stuff. ;-)

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frugalscholar February 15, 2013 at 7:55 am

My poor husband has suffered with chronic back pain for many years. As did his mother. His mother had surgery, which–years later–caused other more severe problems and worse pain.

I would try to avoid surgery at all costs. Mr FS manages the pain with TINY amounts of pain killers. He also hates muscle relaxants and won’t take them.

funny February 15, 2013 at 8:54 am

Yes, I feel the same way. One of our neighbors downtown had chronic back pain for years and years. She finally threw in the towel and had the surgery, which helped for about six months. Then scar tissue grew around the injured vertebrae and she ended up with exactly the same pain as she had before. Literally nothing helped.

SDXB is starting to get crippled from his condition. He’s in constant pain that affects his legs, to the point where he can barely walk and can’t hike anymore.

He’s found a surgeon who claims to do minimally invasive procedures using lasers. It worries me. The neurologist who sent him to this guy, and who he thinks is just great, was censured for misdiagnosing a case of status epilepticus (the patient died) and is roundly hated by patients who have left comments on the Web about him. And the Mayo’s website inveighs against laser surgery for the back.

However, pretty consistently, reports say that endoscopic surgery for spinal stenosis is effective in about 85% of patients. Apparently, though, it’s not a permanent fix.

He’s almost 73, though, so with any luck whatever good it does him will last for the relatively few years he has left.

jestjack February 15, 2013 at 9:22 am

Glad to hear you got some relief. Sadly just like there are good auto mechanics and bad…the same holds true for Docs. What I worry about with the older doctors is some….not all….don’t stay current on new treatments and findings in their specialty and tend to too readily prescribe drugs to mask symptoms rather than deal with the cause. DW just switched doctors because of the behavior you describe. And with good results…she loves her new doctor. As for your pain, though I have no medical background,I’m betting on “disc compression” in the back which in turn can cause irritation and problems with transmissions thru nerves causing pain. Don’t know if I would allow any type of injections in the spine…just not a fan. Glad you got some relief and sorry to hear of SDXB .

funny February 16, 2013 at 6:25 am

@jestjack: Thanks. Glad to hear the wife found a doctor that seems to fit…hope things work out for her.

My sense is that doctors are a) trained to use drugs as the first line of defense against most ailments; b) strongly encouraged to do so by powerful marketing programs emanating from Big Pharma; and c) so overworked that they don’t have time to keep up with these drugs and so take pharmaceutical company sales reps’ word for what they’ll do. Honestly, I believe many doctors have no idea what side effects some drugs have and may not be very sensitive to the fact that older people tend to experience more negative side effects, simply because our bodies don’t metabolize things as fast as they once did.

Agreed about the spinal injections. No doubt they’d be effective if we had some assurance that the chemicals were being manufactured under safe and sanitary conditions, but obviously we don’t. I told YDK I’m not interested in an epidural until such time as we know compounding pharmacies are being regulated and inspected. He didn’t try to gainsay that.

Revanche February 16, 2013 at 5:32 pm

Oof, the options we have for spine pain and treatment just aren’t that good, are they? It’s sort of amazing how, in comparison, the same procedure for pinched nerves/disc compression can actually be effective for dogs, but so much less so for humans. It’s a shame.
My fingers are crossed that the exercises work well!

Sandra Becker June 30, 2013 at 7:15 am

I keep my ginger root fresh for long periods by keeping it in white wine. Since I don’t drink, I buy a 4 pack of individual bottles which is a good vintage for the ginger root. The wine also gets the ginger flavor so you can use it in cooking, and just add more wine to cover the root.

funny June 30, 2013 at 8:03 am

Wow! That’s an extremely interesting idea. You could put some of the gingered wine into a little bowl of tamari or soy sauce for dipping sushi & the like. And I suppose you could drink it…uhm…I wonder what it would taste like. (Like wine with ginger in it…ya think?) You could use it to make a sangria…mixed with some fruit juice it could be awesome.

Thanks for sharing this. :-)

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