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09-23-2009, 06:39 PM

That's where physiotherapy gets useful. I should have made that caveat. Physio that involves the therapist doing alot of different manipulations tends to feel good while they are doing it, but has no longevity. The only physio that ever works long term are those elements that involve "YOU" doing the work. Thus, it comes back to exercise, exercise, exercise.

And, once again, medications create the window of opportunity.

Consider an NSAID (diclofenac, high dose advil, naproxen), add in an opioid starting at tylenol#3 and ramp up through percocets and settle at oxycontins. Take a break from the meds every two weeks or so (for about 1-2 weeks rest, at least the NSAIDS, to protect your stomach), consider a PPI like losec/pantoloc to help avoid the stomach toxicity of the NSAID. Consider maintaining access to muscle relaxants for when it might be needed.

Then, consider augmenting/replacing with gabapentin (neurontin). Consider an SSRI (anti-depressant) to help increase your coping capacity for pain.

Then, aggressively maintain pain control and holidays from the drugs too. Then addopt the attitude that your exercise is a part-time job. You wouldn't call in sick to a part time job you really needed just because you are in pain right? That was the attitude I had to adopt. It was the only way to keep myself getting up at 05:00AM to hit the gym. "Gotta get up and go to work....boss will fire me if I don't show up....future is in jeapardy without this second job." Soon, I found that I was addicted.

As a further benefit, sustained aerobic exercise demonstrates as good a mood improvement success rate as do the anti-depressants....once you have it established.

Another idea I came up with was the "5 healthy things a day". Going to the gym counts as one, having a properly portioned meal counts as a point, going for a walk later in the day (as long as I have already gone to the gym) counts, not having a snack while everyone else has one counts as a point. If I can attain 5 points a day, I am proud of myself.

And then, you have to commit to 2 years. But, once those 2 years are up, you will be a different person.

09-23-2009, 06:39 PM	#12
Cyanide Guest Posts: n/a	Re: Anyone have sciatica? That's where physiotherapy gets useful. I should have made that caveat. Physio that involves the therapist doing alot of different manipulations tends to feel good while they are doing it, but has no longevity. The only physio that ever works long term are those elements that involve "YOU" doing the work. Thus, it comes back to exercise, exercise, exercise. And, once again, medications create the window of opportunity. Consider an NSAID (diclofenac, high dose advil, naproxen), add in an opioid starting at tylenol#3 and ramp up through percocets and settle at oxycontins. Take a break from the meds every two weeks or so (for about 1-2 weeks rest, at least the NSAIDS, to protect your stomach), consider a PPI like losec/pantoloc to help avoid the stomach toxicity of the NSAID. Consider maintaining access to muscle relaxants for when it might be needed. Then, consider augmenting/replacing with gabapentin (neurontin). Consider an SSRI (anti-depressant) to help increase your coping capacity for pain. Then, aggressively maintain pain control and holidays from the drugs too. Then addopt the attitude that your exercise is a part-time job. You wouldn't call in sick to a part time job you really needed just because you are in pain right? That was the attitude I had to adopt. It was the only way to keep myself getting up at 05:00AM to hit the gym. "Gotta get up and go to work....boss will fire me if I don't show up....future is in jeapardy without this second job." Soon, I found that I was addicted. As a further benefit, sustained aerobic exercise demonstrates as good a mood improvement success rate as do the anti-depressants....once you have it established. Another idea I came up with was the "5 healthy things a day". Going to the gym counts as one, having a properly portioned meal counts as a point, going for a walk later in the day (as long as I have already gone to the gym) counts, not having a snack while everyone else has one counts as a point. If I can attain 5 points a day, I am proud of myself. And then, you have to commit to 2 years. But, once those 2 years are up, you will be a different person.