Hi there! I’m 30 years old but currently feel more like 80 to be honest. Over the years of cardio and resistance training, little aches turned into chronic pain all over my body. I always trained for wellbeing and health and tried to modify my activities accordingly. The intensity of the pain is on the low-moderate end, but the multitude of painful areas (ankle, knees, hips, back, shoulder) is slowly driving me to just give up and be sedentary. My current ankle pain, that came out of seemingly nowhere like most of my pain, is making even walking hurt.
A few years ago my knee was the biggest problem. I saw my general physician and he referred me to an orthopedic doctor and did an MRI. Knee looks healthy, I haven’t received a strategy to improve pain. I saw a physical therapist who enthusiastically gave me her “passive treatment” making up some bogus biomechanics along the way.
I also deal with anxiety, which I got properly diagnosed and did a lot of therapeutic interventions on. I tend to fixate on my body sensations and overly worry about it. My perception then warps and becomes maladaptive (somatic symptom disorder). This clearly affects my pain too and I actively do therapy for it, but my situation is still worsening.
How does rehabilitation work if:
a) managing it via pain is difficult because my perception of it can be misleading
b) rehabilitation training itself can have the paradoxical effect of worsening my situation by increasing my focus on the pain and the involved body parts (this actually happend to me while doing vocal therapy, had a hoarse painful throat for years and it only improved by not doing exercises for it and totally ignoring/accepting the pain)
Should a knowledgeable physical therapist be able to address this problem? Should I visit a neurologist? Thanks for reading and you guys rock!
Unfortunately this is a situation that’s probably too complex for us to have straightforward answers for via the forum. For example, it’s not clear whether you’ve had an adequate medical evaluation for things like rheumatologic/inflammatory conditions. I do not have enough information about your situation to say whether a neurologist would be helpful here. These kinds of things are best addressed via a thorough consultation.
Regarding your questions, yes: a skilled/experienced physical therapist should be able to navigate the other issues you describe, assuming there is not an underling/unaddressed medical cause/contributor to these issues. Our rehab team would be happy to consult with you and provide an opinion on your situation.
Thanks for your answer, Dr. Baraki. In the meantime, I consulted a new orthopedic doctor. We decided to first rule out any structural problems and did a lot of imaging on multiple joints (MRI and x-ray). He initially said that I may need physical therapy and orthopedic insoles.
But after getting the MRI results, which looked perfectly fine, he said I don’t need anything except to exercise more, reduce anxiety, and test my physical limits. After that final consultation, my pain in the scanned areas started to subside and shift to other areas. This confirmed to me that my experience is mostly a result of the way I think about pain/discomfort combined with a prominent pain/anxiety/worry state of my brain. Which are both things I can improve.
My doctor also gave me a referral to check my blood for rheumatologic markers, just to be safe. I haven’t done the test yet, but since I have no other rheumatic symptoms, I play with the idea of ending my testing/overdiagnosing spiral here and just “shoot the shit” at the gym without worry. If something new comes up I will be happy to contact your rehab team.