Physical Therapy with or without pain medication?

Posted by bushy @bushy, Mar 12, 2020

I medicated last week before my TKR Physical therapy session, and I found I was better with all manipulations/flexion, etc. Thoughts?

Interested in more discussions like this? Go to the Bones, Joints & Muscles Support Group.

@colleenyoung

Good point, @jip499.
@kaptainkat @karenann01 and others in this discussion. Use caution when taking multiple prescriptions and CBD or medical marijuana and supplements. Don't be fooled by thinking CBD and supplements are "natural".

A number of over-the-counter and prescription drugs may be associated with serotonin syndrome, especially antidepressants. Illicit drugs and dietary supplements also may be associated with the condition. Read more from Mayo Clinic here:
- Serotonin syndrome https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758

If you have questions about drug, prescription and supplement interactions, don't forget that a pharmacist is a really useful member of your health team. They can provide more information about possible interactions.

Jump to this post

Thank you for the response and concern.

I don't use CBD per se, I inhale burning 'flower' via water pipe.

'We' built up to 90mg of Cymbalta over a several month period, carefully watching for changes.

ALL of my 'health care team' - GP, cardiologist, pulmonary specialist, pain specialist, psychiatrist, internist (hernias), AND physical therapist OUGHT be aware that I am in the state's Medical Marijuana program, as I am not shy about it when we discuss my formulae, aches, or pains.

It has been a few months since my last blood workup, but with no issue apparent, there isn't really a need.

I have a dietary disorder that also keeps me on my toes about the 'big picture'. I am on the dietary list here at the Mayo for issues from repair of an 'esophageal stricture' and extreme GERD.

I either cannot or will not eat, 'we' are not sure which. See that thread for those issues.

Three of my meds list 'dizziness' as a 'possible side effect'.

Insomnia and agitation are more influenced by my pain level at the moment. When 'Spike' bites, 'polite' gets lost.

And I do have some 'motor' and dexterity issues, but I blame that on the neuropathy, neuralgia or radiculopathy from the damage in my neck.

I can't really say I experience any of the other symptoms on the list. But I will be diligent in being alert.

Once again, thank you for the heads up.
KK

REPLY
@cindiwass

Thanks for the comments. I just had hip replacement, 6 days ago, and am experiencing a lot of pain, but have resisted taking narcotic pain meds, however, want more info or suggestions from people that have been through it. I don't want to be sleepy/drowsy if possible. And especially not stomach sick. I was nauseated after the surgery and vomited a couple of times. I'd like to avoid the harsh side effects of narcotics. I was prescribed oxycodin for one, and extra strength tylenol, but have resisted taking the oxycodin because I'm afraid of the side effects BUT the pain is very difficult to deal with. So not sure what to do. My health care practitioner knows I'm a crazy person and tries to work with me kindly. He wants me to take the pain meds. I DON'T KNOW WHAT TO DO, in other words, if taking the pain meds (strong ones) will help me heal faster. I gotta heal. Thanks.

Jump to this post

Take the pain meds, smallest effective dose as prescribed. The workouts will be more effective, even though not completely pain-free. Most worthwhile goals involve at least a little pain, but too much pain can cause you to avoid effective exercises and other therapies. How much pain or pain meds is too much? Your physical therapist can help you figure that out.

REPLY
@emil

Take the pain meds, smallest effective dose as prescribed. The workouts will be more effective, even though not completely pain-free. Most worthwhile goals involve at least a little pain, but too much pain can cause you to avoid effective exercises and other therapies. How much pain or pain meds is too much? Your physical therapist can help you figure that out.

Jump to this post

Ok but how about swelling. My knee is all swollen, the hip is too. How long does that take to go down? I know we're all different but in general what about the swelling.

REPLY

Ice packs wrapped in a towel? A bag of frozen peas works nicely.

I assume you’re seeing your clinic to rule out infection?

REPLY

I have a serious T12 Fracture and they tell me it is healed but I can not pick up any weight over 5 lbs but now I can not do any PT they tell me my back is in spazams any excursive I try works for 1 month then I go in severe pain with my BACK I don't know how the correct the spazams any one had this problem?? (very serious in feel like I'm am fading away)

REPLY
@etartaglione

I have a serious T12 Fracture and they tell me it is healed but I can not pick up any weight over 5 lbs but now I can not do any PT they tell me my back is in spazams any excursive I try works for 1 month then I go in severe pain with my BACK I don't know how the correct the spazams any one had this problem?? (very serious in feel like I'm am fading away)

Jump to this post

I have a T12 fracture that occurred in 2006, as the result of a traumatic fall. Since then I also have not been able to lift much weight. At first I could not lift a glass of water but it did improve from that!

At this point I have 7 fractures total. T4, T6, T11, T12, L1, L2 and L5. Three are non-traumatic and from osteoporosis and one unwise movement a year and a half ago.

I have tried PT a few times and it makes things worse for me. I recenlty withdrew- again. Capsaicin patches help the muscle spasms and I take a non-steroidal anti-inflammatory called flurbiprofen. Tai chi helps me.

Things DO get better. Try to stay active if you can.

REPLY
@windyshores

I have a T12 fracture that occurred in 2006, as the result of a traumatic fall. Since then I also have not been able to lift much weight. At first I could not lift a glass of water but it did improve from that!

At this point I have 7 fractures total. T4, T6, T11, T12, L1, L2 and L5. Three are non-traumatic and from osteoporosis and one unwise movement a year and a half ago.

I have tried PT a few times and it makes things worse for me. I recenlty withdrew- again. Capsaicin patches help the muscle spasms and I take a non-steroidal anti-inflammatory called flurbiprofen. Tai chi helps me.

Things DO get better. Try to stay active if you can.

Jump to this post

Sorry I just got your response ty it was in my spam i will look into your advice are you still having pain?

REPLY
@etartaglione

Sorry I just got your response ty it was in my spam i will look into your advice are you still having pain?

Jump to this post

Yes but I can function, take walks, am better able to lift a little, and generally tolerate it. Sometimes I make mistakes with movement or with lifting and suffer for it but so far it is for a few days.

REPLY

Hi, for me, I prefer to have PT after taking pain meds.

REPLY

After all my assorted surgeries (2 shoulder repairs, 1 knee scope, 1 TKR), I never took pain medications before or after PT. Ice, yes. While I dread pain, my thinking was that I have a better way to judge progress when I compare the pain level at PT with the pain level of the same exercises done at home. Hopefully, and usually, the pain decreased some with each session, so I could see progress, without being shocked or surprised when the exercises at home hurt much more than during the PT hour. Plus, I wanted to be clear-headed to drive myself - both to PT, and generally being self-sufficient and mobile.

I want to add that I had an excellent PT person, who was aware of my abilities, pain tolerance, and compliance, so he pushed, but did not force me beyond what was necessary for quick progress.

REPLY
Please sign in or register to post a reply.