A Different Kind Of Doctor

[Fiddle-Faddle]

I don't know if I should post this here or under "Post-diagnosis and recovery."

[Rusla]

Well, depends on what it is about but give it a shot here.

[Fiddle-Faddle]

Now, that is really weird--I had this huge long post about physiatrists, and it just disappeared except for the first sentence! What's going on ? I know it posted at least once correctly, because I went back and reread the whole thing after I posted it. Anybody know what happened??????

I'll try again:

don't know if I should post this here or under "Post-diagnosis and recovery."

This is something I've only just found out while trying to learn about how to heal a torn rotator cuff without surgery, but I think it could have a lot of benefit for people on this board with joint pain, so please move this post to wherever it will do the most good!

There are actually several different kinds of doctors in our medical system who DO believe in healing and improving muscle, tendons, and joints, etc., without surgery.

1)There are physiatrists. They are MD's--they are like orthopedists, but they don't do surgery. Some of them call themselves "Doctors of Sports Medecine," and some call themselves "Rehab doctors." They either do physical therapy or oversee physical therapists.

2) There are osteopaths. (I don't know much about them but have heard that they are more sensible than regular M.D.'s)

3)There are chiropractors. Gotta be careful here--there are some that truly work miracles (I've seen one), but there are also total quacks out there (I've seen one of these, too).

I never heard of physiatrists before. I don't think orthopedists like to admit that physiatrists exist--it would probably cut into their surgical profits too much.

Anyway, the reason I mention it is that after I had my arm in a sling for a month, I couldn't move it. The orthopedist recommended surgery, of course. Turns out, this is what happens when you don't move your arm for a month, and I'm in physical therapy now, and I am improving, but it's slow progress--it's going to take a few more months to get back to normal, I think. But I got to thinking about many of you who have mentioned fibromyalgia, being in wheelchairs, etc., and I thought that maybe a physiatrist might know something helpful for you. I know the problem was caused by gluten, but going off gluten might not be enough to get your muscles and joints back.

Both the physiatrist that I talked to about my shoulder and my chiropractor have told me, for example, that orthopedists do surgery all the time on patients with carpal tunnel syndrome. Chiropractors fix this all the time simply by manipulating the ligament so that it's not hitting the nerve. Easy and painless. (I'm not clear on whether or not physiatrist and physical therapists fix this, too, or if they send people to the chiropratctor.)

And the exercises I'mdoing in physical therapy (about 90 minutes of exercises at home on my own twice a day, plus a couple of hours with tthe therapist 3 times a week) certainly are bit uncomfortable, but my pain is steadily decreasing and my range of motion and strength are just as steadily increasing.

I was just thinking that if you guys are in pain, you're probably not moving. And if you're not moving, then you're losing mobility and strength--and that leads to more pain.

Maybe a physiatrist or physical therapist could help? Or an osteopath or a chiropractor? If your Primary Care Provider doesn't want to write a referral, maybe you could say, "Look, I know you don't like dealing with me, so write the referral and then you won't have to deal with me any more!" Or maybe you could go directly to your insurance company and explain that they would save money if you could get help to get moving again, and then you wouldn't need them to pay for so many pain meds.

If you don't have insurance, if you can just get a referral to a physical therapist, they often make arrangements for greatly reduced fees on a pay-as-you-go schedule. (Depending on the state you're in, they might need the referral to start treatment.) If you can't get your doctor to do the referral, call the physical therapy office and ask them to recommend a PCP who will write a referral.

Sorry this is such a long post--I hope it helps someone!

[momandgirls]

Physiatrists are doctors (have through the same schooling/training as other MDs) who generally specialize in chronic pain issues. They don't do physical therapy themselves but do often work hand in hand with physical therapists. Osteopaths are also MDs. They have gone to schools of osteopathic medicine and have the same training/licensure as other MDs. They have specialty training in osteopathic medicine - manipulating joints, etc. - also dealing primarily in chronic pain issues. I would not say that they are more "sensible" than other MDs. Just like all doctors, there are some that are fantastic and some that aren't.

[mamaw]

Fiddle-Faddle

Did you have just therapy on your rotor cuff? If so I know several people who are using the cold laser for rotor cuff and having excellent results. I know it is a very new procedure and there is nothing painful to it. Very slick I think. I have used it for my neck pain and my hubby uses it for his knee ( he needs a replacement but is not willing to do that ) and for both of us it has been a Godsent. I only know one chiropractor who has the unit and he is in Butler but the good thing is he only charged $10.00 for a treatment. I have seen advertising in other places that it can go up $150.00 a treatment. If your interested let me know by private e-mail and i will give you more info.I can get you a quick appt also.

Where do you get your PT? My daughter works at the Zelienople PT......

mamaw

[Fiddle-Faddle]

Physiatrists are doctors (have through the same schooling/training as other MDs) who generally specialize in chronic pain issues. They don't do physical therapy themselves but do often work hand in hand with physical therapists. Osteopaths are also MDs. They have gone to schools of osteopathic medicine and have the same training/licensure as other MDs. They have specialty training in osteopathic medicine - manipulating joints, etc. - also dealing primarily in chronic pain issues. I would not say that they are more "sensible" than other MDs. Just like all doctors, there are some that are fantastic and some that aren't.

I'm sure you're right and I shouldn't have said that they're more sensible than MD's. I've just been SO frustrated with SO many MD's!!!!!!

Thanks for the more thorough information!

[Rusla]

We all have been frustrated with MD's.

[Ursa Major]

Fiddle-Faddle, I've had fibromyalgia pains (in my joints and muscles, lower back etc.) from the age of 5 at least (I think I was even younger). Now I know they were ALL caused by food intolerances, including gluten. And exercise (no matter which kind I tried) would inevitably put me into MORE pain, rather than help relieve it. Still, as a child I seriously thought everybody felt like me, and so I was determined to do what everybody else did. I got LOADS of exercise as a kid, and was in constant pain anyway.

Now that I have stopped eating the things I am intolerant to, my pain has gone down so much that I am off all pain meds (including codeine 24 hours a day), and NOW I am able to exercise to gain back the strength in my muscles.

In the five months since starting the gluten-free (and many-other-things free) diet, I've lost 28 pounds, and I finally dared being seen in a bathing suit again. Today I went lane swimming with my 20-year-old daughter for an hour, and it felt good! Mind you, I am aching now. But I hope it is just normal muscle pain from doing something I haven't done in a long time. We are going every Tuesday now, and I will go with her every other Friday as well. The other Friday I will go back to playing table tennis with my table tennis club again (I had been too sick to go for nearly two years). I am also walking a little (that's hard, because I have a bad ankle), and when it gets warmer, I'll be riding my bike around town a lot.

It has been shown that for SOME people with fibro exercise is helpful, while for others it makes things worse. I think that is because it is not always caused by the same thing. Really, fibro is another catch-all, like IBS. If the doctor can't figure out why somebody is in constant pain, fatigued all the time, can't think straight half the time etc., they'll call it fibromyalgia. Mind you, when they tested to see if I have any of the trigger points, I had all 18 (11 are required for a diagnosis of fibro). Pushing on them just about made me scream, and it would ache for an hour.

I still have those. Maybe I need to go to somebody who knows how to release them. The massage therapist at my chiropractor's office says she does it all the time. I think I'll get a referral from my doctor (so my insurance will pay for it) and try it.

[ravenwoodglass]

Fiddle-Faddle, I've had fibromyalgia pains (in my joints and muscles, lower back etc.) from the age of 5 at least (I think I was even younger). Now I know they were ALL caused by food intolerances, including gluten. And exercise (no matter which kind I tried) would inevitably put me into MORE pain, rather than help relieve it. Still, as a child I seriously thought everybody felt like me, and so I was determined to do what everybody else did. I got LOADS of exercise as a kid, and was in constant pain anyway.

Now that I have stopped eating the things I am intolerant to, my pain has gone down so much that I am off all pain meds (including codeine 24 hours a day), and NOW I am able to exercise to gain back the strength in my muscles.

In the five months since starting the gluten-free (and many-other-things free) diet, I've lost 28 pounds, and I finally dared being seen in a bathing suit again. Today I went lane swimming with my 20-year-old daughter for an hour, and it felt good! Mind you, I am aching now. But I hope it is just normal muscle pain from doing something I haven't done in a long time. We are going every Tuesday now, and I will go with her every other Friday as well. The other Friday I will go back to playing table tennis with my table tennis club again (I had been too sick to go for nearly two years). I am also walking a little (that's hard, because I have a bad ankle), and when it gets warmer, I'll be riding my bike around town a lot.

It has been shown that for SOME people with fibro exercise is helpful, while for others it makes things worse. I think that is because it is not always caused by the same thing. Really, fibro is another catch-all, like IBS. If the doctor can't figure out why somebody is in constant pain, fatigued all the time, can't think straight half the time etc., they'll call it fibromyalgia. Mind you, when they tested to see if I have any of the trigger points, I had all 18 (11 are required for a diagnosis of fibro). Pushing on them just about made me scream, and it would ache for an hour.

I still have those. Maybe I need to go to somebody who knows how to release them. The massage therapist at my chiropractor's office says she does it all the time. I think I'll get a referral from my doctor (so my insurance will pay for it) and try it.

I agree completely with your post, in fact I could have written it. Any long lost relatives in the US ?

Anyway, have you ever tried Acupuncture? Even pregluten free it would give me at least a few days relief from the fibro pain. I know what you mean about the pressure points, I always wondered how people could possibly find any kind of massage relaxing. The pain was excrutiating and I also thought everyone felt that way. You may want to consider giving the acupuncture a try, it might help.