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  1. #1
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    Brief Medical History Overview

    Urgent help needed

    Physical Agents In Rehabilitation
    Hi I unfortunately have a very long story so I hope you are ready.
    I did an injury whilst on holiday in Bangkok. I was stretched by this massage therapist in a way which I can only descibe now as producing the most horrible pain. He basically stood behind me and lifted me as I was facing in the same direction. He then proceeded to stretch me to this right shoulder with my whole body being lifted to the left then backwards and then to the right and backwards. He did it with such speed that I didn't think too much to it. Then two days later I started to get an ache in my testicles and rectum area. I was also going to the loo to urinate too frequently. 4 days later I was a t a retauarant and after 2 hours sitting I started to get a burning feling in both buttocks as if I couldn't sit on them. I came back from holiday the next day but the pain in the buttocks had gone. However I was left with this ache in my testicles and rectum area that would come and go. I didn't know what it was and at that point didn't even relate it to the massage I had had. That was in May. At the end of May which was 4 weeks later I started to notice that this pain was getting worse and also strarted to feel it in my legs, like a tingly sensation as well as the burning in my buttocks. Went to see a chiro on recommendation and after his 2nd treatment about 4 days later I started to get severe spasms all around my body. They were so bad that my whole body would jerk. My GP fobbed me off saying twitching was normal! He did some standard knee,ankle jerk and straight leg testing and said that nothing was wrong and that I should see a PT. Went to the PT but his exercises only made my pain worse. By this point I was not in constant pain but when it started it was dehibiltating. It always got worse in the car to the point where I would get shhoting pains down the leg and the shaft of my ***** and the burning sensation in my buttocks. As soon as I got out of the car it would subside but still hurt just not as much. Now it was July and I ended up with a trigger point therapist but by now the spasms had gone all over. So now I had pain in the back,calf muscles,shoulder and funnily enough the pain in the testicles and rectum wasn't even noticable. He went through various points in my body and thought he had suceeded but everytime he went my pain would be back a few days later. It got to the point where now everything seemed to hurt. Fast forward August and it hit me that when I sit the pain was triggered so I stopped sitting. Within 3 days pain reduced by 90%. So I stopped sitting on August 14th altogether. My TPT (trigger point therapist) thought there might be some trigger points in my buttocks. However upon massage he found 4 tears in the gluteus maximus on September 4th on the left side. He then treated these over the next 4 weeks with two types of massage oil-one was to bind the muscles together and the 2nd was to strengthen them. So now we are in October and I had only sat on my right butock as I knew I had tears in my left one. He advised me that now I should be able to sit (4 weeks after discovery). So i did on his sofa and no problem. However after driving home (25min ride) the pain came searing back. However now it was back to the similar pain I had on holiday -burning in the buttocks, rectal area and testicles and it was also going into my legs and increased urination but only when sitting on injured buttock. Family suggested Wikipedia reference-linkMRI to rule out spinal injury and that came back fine-no herniations. So now we are in November-2 months after discovering tears and I am still sitting on right buttock. I did something really stupid two weeks ago where I squatted on the floor and heard a massive click. 5 days later massive spasms like those before and they are just about calming down now. So my symptoms are when standing and moving: Intermittent pain in testicles and rectal area, more prominent when squatting down to get something. When I sit on right glute nothing. After sitting on injured glute pain starts in glute, then into recatl area and testicles. Testicles swell up and if I sit longer can go into other buttock and then down both legs.Also the need to urinate. Once I get up pain dissipates but depending on how long I have sat (i.e 10 minutes might put me out for 4 hours on the sofa). Also the surface of the seat plays a role. On thick leather cushions the pain comes quicker, hard surface like wooden chair I hardly feel anything. Soft thin cushion is very similar. My TPT thinks it is still the torn muscles not strong enough yet. His analogy is that the tear happened in Bangkok due to extreme heat tears happen more readily. It must have tried to heal but my job of lifting,bending over and the sitting caused it to tear and tear again hence the aggravation of syptoms. He has his doubts about the reffered pain pattern into rectal,testicle area but argues that nerves are so small and as I have four tears the nerves could effectively go into that area. My question is do you feel the refered pain is possible from torn glute muscles. My feeling on this is that the torn glute muscles are affecting the sciatic nerve after it spasms and then this causes the pain and because of the size of the gluteus max it also affects other nerves gojng into rectum,testicles. Also it is know that an inflamed scaitic nerve affects the detrusor muscle which tells you when you need to urinate. I am desperate for an answer as my TPT is convinced that all I need is time to heal but shouldn't a torn muscle heal in 4-6 weeks? One final thing is when I did have the torn muscle I also felt pain in both hips at the back especially and this has all gone so surely the pain left is somthing else? I would truly appreciate your opinion. Thanyou.

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  2. #2
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    Re: Urgent help needed

    Thats a really hard one to comment on - you've had a Wikipedia reference-linkMRI of the back so that does generally rule that out... however I wouldn't rule out the back as a cause of symptoms - your symptoms seem to peripheralise and centralise which is very characteristic of a discogenic problem.
    I'm not sure about your gluteal tears - I'd look into an ultrasound of the area to rule those things out.
    Maybe someone else will have something a bit better than that... but I think you need to bully your doctors into more scans. even MRI's won't give you the right answer first time and they find things on repeat. I'll read it again later and see if i can think of anything else but my patient just showed up so i better go.


  3. #3
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    Re: Urgent help needed

    Hi jobo147

    This is complex so any opinion should be given and taken with caution

    Best to try to find one tissue that can explain all the symptoms. That is because it is much more likely that in an injury one tissue gets injured

    Muscle tears can’t explain all your symptoms. (eg increased frequency to urinate). The gluteal muscles are also the some of the most robust muscles in the body and it takes extreme forces to damage them. A masseur would be unlikely to generate such forces even with the ghastly manipulation he performed.

    The increased frequency to urinate, pain in the testicles and rectum are more likely to be due to involvement of the sacral nerves at the cauda equina, sacral outlet or at the sacral nerve plexus. Dramatic symptoms are much more likely neural in nature, and neural tissue is much more vulnerable than muscle. The long time to settle can also be explained by neural involvement. The burning pain in the buttocks are typical symptoms of dural pain – that is the protective tissue surrounding the sacral nerve may be involved.

    Why the symptoms took two days to develop is a bit harder to explain by a direct nerve injury It may suggest that something impinged or adversely affected the tension on the nerve rather than a direct blow to the nerve.

    This has gone on a long time. Neural tissue can take a long time to repair and settle down. Are the symptoms slowly improving or are they staying the same? If the symptoms are slowly improving (eg less intense, less extensive, or less easily stirred up) then this may suggest just giving it time might be fine.

    Have you sought an opinion from a neurologist? I think it is worth trying to get it properly diagnosed. From a therapy point of view I would go and see a specialist manipulative physiotherapist – a therapist that has extra training in such problems. Muscle tissue therapy may give you some symptomatic relief but probably isn’t doing much.


  4. #4
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    Re: Urgent help needed

    Aircast Airselect Short Boot
    im experiencing something similar, you nee to get this checked out as much as possible it sounds like muscle damage gone wrong not that i am an expert.

    but nerve pain you KNOW about, muscle pain is localised.

    look for any kind of tenders spots on your thighs ands lower back, the chances are the muscles are compensating and beocoming knackered

    this iswhat i think happended to meand i am unable to walk and im in a serious condition if you look up my previous posts you can see how i can walk.

    i also have a very tender spot on my buttock which is where i think a muscle healed andtrapped a nerve in it, its almost like abutton the minute i push it, pain factor = 100.

    your doctors will fob you off and tell you its in your head, they just dont want to deal with you this is the problem i had an in the end it caused me t lose my ability to walk until i was taken seriously.

    when going to the doctors take a parent or a gf etc just so you have some sort of witness this tends to put them on a back foot,

    see a neurologist to rule out any nerve disfunction, have a massage round the area your self and see if you can find any tender spots.

    also give you thighs, hams, lowerback, IT band and if you can glutes a good stretch again seeing if anything comes up.

    this is something your going to have to solve on your own, but dont leave it to late and dont give up as it will only get worse



 
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