PT student with serious back injury

[april3333]

Hi

I am a second year PT student with a back serious injury sustained a couple of months ago in February. I actually went to ER due to bladder issues, bilateral radiculopathy and back pain. I got the MRI and it said I have two central disc herniation at L3/4 and L4/5 with mild and moderate stenosis at those two levels respectively. The doctors put me on methylprednisone and naproxen. I missed a couple weeks of classes, and took no practicals. I actually tried to finish up the spring semester but couldn't. I went for physical therapy but they just did some massage, E stim and ultrasound and showed me exercises I already knew, so I stopped going. I just did some transversus abdominis and multifidus exercises on my own. I felt better in a couple of months but still have some pain at back and legs. I tried to practice for my practicals. I was practicing lumbar and thoracic mobilizations and PIVMTs for a couple of hours and that completely flared me up. I was in alot of pain for days and couldn't sleep. Now, two weeks before the end of classes, I ended up withdrawing from all my classes and taking a medical leave. I don't know what's next for me. Should I go back to PT school next year or consider a new career path? I know how physically demanding the job is and I still have 3 more clinical to finish before I can graduate. I am only 23 years old and I don't how long I can last as a PT with this type of injury. I still have some moderate back and leg pain right now. Is it reasonable for me to stay in this profession because I know how hard it is on the back even in those with no serious back issues. Good body mechanics and strengthening can only help so much. I been a clinical last summer where I did do a lot of lifting and transfer on a daily basis. I can't imagine doing this for the rest of my life. I know once I become a PT I don't have to work at that setting. But I do have clinicals where I am required to work in settings that involves me to lift and be active. Is there any PT practicing with a serious back issue like mine? So far, I haven't met any physical therapist practicing with a serious back issue. My PT GPA is pretty good so far at 3.86. I am seriously considering other career options at this point. What is your advice?

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[Fiveoboy11]

Hi

I am a second year PT student with a back serious injury sustained a couple of months ago in February. I actually went to ER due to bladder issues, bilateral radiculopathy and back pain. I got the MRI and it said I have two central disc herniation at L3/4 and L4/5 with mild and moderate stenosis at those two levels respectively. The doctors put me on methylprednisone and naproxen. I missed a couple weeks of classes, and took no practicals. I actually tried to finish up the spring semester but couldn't. I went for physical therapy but they just did some massage, E stim and ultrasound and showed me exercises I already knew, so I stopped going. I just did some transversus abdominis and multifidus exercises on my own. I felt better in a couple of months but still have some pain at back and legs. I tried to practice for my practicals. I was practicing lumbar and thoracic mobilizations and PIVMTs for a couple of hours and that completely flared me up. I was in alot of pain for days and couldn't sleep. Now, two weeks before the end of classes, I ended up withdrawing from all my classes and taking a medical leave. I don't know what's next for me. Should I go back to PT school next year or consider a new career path? I know how physically demanding the job is and I still have 3 more clinical to finish before I can graduate. I am only 23 years old and I don't how long I can last as a PT with this type of injury. I still have some moderate back and leg pain right now. Is it reasonable for me to stay in this profession because I know how hard it is on the back even in those with no serious back issues. Good body mechanics and strengthening can only help so much. I been a clinical last summer where I did do a lot of lifting and transfer on a daily basis. I can't imagine doing this for the rest of my life. I know once I become a PT I don't have to work at that setting. But I do have clinicals where I am required to work in settings that involves me to lift and be active. Is there any PT practicing with a serious back issue like mine? So far, I haven't met any physical therapist practicing with a serious back issue. My PT GPA is pretty good so far at 3.86. I am seriously considering other career options at this point. What is your advice?

Don't worry about PT school right now. Ask one of your former ortho professors who is a good PT in town (who does evidence informed practice). Don't waste your time working with a BSPT ***** who does the garbage you mentioned above.

 

[jesspt]

Don't worry about PT school right now. Ask one of your former ortho professors who is a good PT in town (who does evidence informed practice). Don't waste your time working with a BSPT ***** who does the garbage you mentioned above.

Yup. I'm sure that it's their degree which makes them a "*****." If we find out later that the OP's PT has a Master's, or God forbid, a DPT, what can we blame then?

I've been the CI for Master's and DPT students and can't say that I've seen significant differences in performance between the two.

april,

I'd consider finding a PT who uses more ative treatment interventions, and make sure you're under the care of a good physician who can help manage your situation medically as well. You mention methylprednisone. Have you considered an epidural steroid injection, and if so, have you discussed this with your physician?

Also,

I know of several PTs with lumbar and cervical disc herniations with intermittent history of radicular symptoms, all of whom are still practicing in the outpatietn orthopaedic setting.

 

[Fiveoboy11]

Yup. I'm sure that it's their degree which makes them a "*****." If we find out later that the OP's PT has a Master's, or God forbid, a DPT, what can we blame then?

I've been the CI for Master's and DPT students and can't say that I've seen significant differences in performance between the two.

april,

I'd consider finding a PT who uses more ative treatment interventions, and make sure you're under the care of a good physician who can help manage your situation medically as well. You mention methylprednisone. Have you considered an epidural steroid injection, and if so, have you discussed this with your physician?

Also,

I know of several PTs with lumbar and cervical disc herniations with intermittent history of radicular symptoms, all of whom are still practicing in the outpatietn orthopaedic setting.

I highly doubt the person has a Master's or DPT. I've worked in numerous settings and with varying levels of baseline PT educated PT's and on average there is obvious difference between BSPT and MPT/DPT. I've been a CI too, and currently I am one for a DPT student in his last clinical. I have much more respect for him at this point as a clinician (and when he first started this clinical) than I have for many PT's I've worked with who have a BS.

 

[april3333]

Thanks for the replies :] I thought about steroid injections and I am planning to speak to my physician about it. From what I read online, it doesn't always work. I am a lot better than I was a couple of months ago. Bladder symptoms went away after a couple of weeks and now I just have back and leg symptoms. The PT I worked was specialized in sports Orthopedics so I am sure he knew what he was doing. yeah he had BS in PT but at least he showed me some core stabilization exercises lol. To jesspt, wow you know some dedicated PTs out there. It must be tough working with lumbar or cervical herniation.

 

[Litlwarrior08]

April, also try radiofrequency ablation - "nerve burning" usually insured after a series of injections. should help w/ the leg pain, you'll always need to do the strengthening exercises. Good luck with your decision.

 

[fozzy40]

April, also try radiofrequency ablation - "nerve burning" usually insured after a series of injections. should help w/ the leg pain, you'll always need to do the strengthening exercises. Good luck with your decision.

Radiofrequency ablation or neurotomy is not indicated and will not work for radicular symptoms. It's typically for facet mediated pain.

 

[Coach Hoski]

Radiofrequency ablation or neurotomy is not indicated and will not work for radicular symptoms. It's typically for facet mediated pain.

I am a third year 2 months from graduating, out on my last rotation. I had severe herniations of L5/S1 and L4/L5 with radicular sx back in 2007, I even have mild residual sensory/motor loss in the distribution of L5/S1. I'm 27 and have made it through PT school thus far with only a few problems. My physiatrist tried to talk me out of PT school as I had my back injury prior to starting but I ignored him. I had my first clinical rotation in a clinic that specialized in LBP treatment and I learned a ton from that CI (btw he had a BSPT and OCS, I don't think we need to be bashing veteran PTs with 'lower' degrees and more experience than any DPT here). Essentially I actually learned how to use my core musculature during functional day-to-day activities rather than performing exercises and not putting them into application. As someone with a similar predicament, I would give this advice: know your directional preference and SERIOUSLY use it to your advantage. For me, it was studying prone on my floor to stay in extension instead of sitting which gave me absolute hell. Stand up in the back of the classroom for 10 minutes every hour, your professors should understand better than anyone. When you have LBP/sciatic tension, do sciatic dural glides exactly like you would prescribe them for a patient. Use modalities, you are a PT student and you should have access to traction/ice maybe a portable TENS.
You're going to have flare ups but you need to learn how to control them and manage your symptoms. I had to give up golf (temporarily at least) because I am thus far unable to modify my swing enough to prevent recurrent LBP. It sucks, but my career takes priority and personally learning how to manage a relatively serious and potentially debilitating injury has made me a better PT student.

 

[jesspt]

Radiofrequency ablation or neurotomy is not indicated and will not work for radicular symptoms. It's typically for facet mediated pain.

Thanks for the input Fozzy. Nice to get a medical perspective here as well.

 

[truthseeker]

i'm with Jess on this one five0boy. Its the student, not the program or the degree. you really seem to have a lot of bees in your bonnett.

 

[Fiveoboy11]

i'm with Jess on this one five0boy. Its the student, not the program or the degree. you really seem to have a lot of bees in your bonnett.

Just going off what I've seen. I definitely think the best PT's in the world, including US have a baseline bachelor's education. It is tough to generalize because as you said it's an individual issue, but a difference is still apparent at least to me. Baseline education for many PT's who graduated in a BSPT program is antiquated, and if they haven't done extra work besides some lame weekend course here and there, they way they practice is likely antiquated as well.