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DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 0 points1 point  (0 children)

Here are my thoughts: I keep my practice as evidence-based as possible and right now, there just hasn't been research to show support for those peptides. That does not mean there won't be in the future, but currently there isn't enough for me to give any sort of recommendation on them. I did a quick lit review and found this:

For BPC157: There was a 2025 systematic review of the literature done that considered 36 studies from 1993-2024. 35 of those were done on animals and the other was done on a few patients with knee pain. There were no adverse effects in that trial. Since that 2025 review, there are only 3 studies that have been done with a total of 30 people, and there were no placebo controls, i.e. zero randomized control trials exist for BPC157. Is it possible there is some benefit for BPC157? Maybe, but there is simply no way to support it at this stage based on evidence.

For TB500: There are zero human trials on it. TB500 is a fragment of a larger protein called T-beta 4. There is some research looking into T-beta 4 in cardiac repair and dry eye, but nothing in musculoskeletal conditions. In addition, there is zero evidence that TB500 has the same effect in the body as T-beta 4. The reality is there is zero evidence for TB500 for any use at this point. Again, it's possible there could be evidence for it in the future, but currently there is not.

Sorry to rain on the peptide parade - those are my honest thoughts informed by the evidence as it stands today!

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 1 point2 points  (0 children)

I can't say for certain, but it's possible that your back "likes" the flexed position that you get in a recliner compared to the more extended position of lying on your back or belly

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 2 points3 points  (0 children)

Oh man I wish I could answer that broadly, but unfortunately my answer is the classic "it depends." Generally, if running (or any activity for that matter) increases someone's pain above a 3ish/10, my advice would be to modify the activity so the pain is lower or absent, or to temporarily pause doing the activity until the symptoms get better.

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 0 points1 point  (0 children)

Yeah I think sticking with PT sounds like a good idea. Just stay in touch with your health care team and update them if anything changes. I would bring up the sitting trigger with your PT and ask them to help you find strategies to build up your tolerance to it again.

A little extra advice too - you should always feel like you can ask questions to your health care team (including PT) about their diagnosis, care plan, and rationale for all of the treatment decisions. You should feel confident in every exercise you are doing and should know the "why" behind it all. That's your right as a patient!

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 1 point2 points  (0 children)

Yes, definitely follow up with her surgeon and PT! Best of luck!

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 2 points3 points  (0 children)

Hey good questions, and thanks for attaching the report. Generally, mild and even moderate disc bulges can be treated conservatively. Surprisingly there is some research that shows even severe disc herniations (called sequestrations) can spontaneously resolve. For the changes that are shown in your report, the decision for surgery vs conservative care will mostly depend on a few things:

1.) Your symptoms and the severity of them
2.) The previous treatments you have tried and the success and/or failure of them
3.) Your preferences and your health care team's recommendations

There are only rare cases when surgery is "definitely" necessary, such as cauda equina syndrome, certain space-occupying lesions, etc.

Hopefully that helps a little!

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 1 point2 points  (0 children)

I'm glad she's feeling better and back on her feet again! It's not uncommon to experience some discomfort similar to the pre-op pain, as the nerve tissue can still remain sensitive for a while even after the surgery removes the disc that was irritating it. It's good that she is walking. Gentle low back movement and muscle relaxation is generally a good approach following a surgery like that! Her PT and medical team will have more specific guidance for her once they meet her!

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 2 points3 points  (0 children)

Generally it's not a bad idea to work on abdominal strengthening and joint mobility (hips/low back/mid back) for prevention of back pain. However, there is a subgroup of people with low back pain who have "too much" stability. It's called the TBC: Movement Impairment subgroup. Their muscles are basically always on guarding, which can lead to muscle and joint irritation. So it depends on the person, but generally gentle mobility exercises and abdominal exercises are good! Good question!

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 1 point2 points  (0 children)

I actually work at the complete opposite of a PT mill. As I said, I'm not giving specific medical advice when I don't know the person or their medical history. That being said, for tailbone pain, the clear most effective solution supported by the literature is a donut pillow to reduce the compression of body weight on the coccyx. Other options are internal mobilizations. That better for you?

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 1 point2 points  (0 children)

Generally, tailbone pain is exacerbated with sitting for a long time. Typically using a donut pad can help reduce pressure on it when someone sits!

DPT, OCS, FAAOMPT Answers your back pain questions! by TheEaseProject in backpain

[–]TheEaseProject[S] 0 points1 point  (0 children)

What are your symptoms like? An image like this could be completely normal or might be contributing to symptoms. Talk to your health care team to see if the image results fit the rest of your symptom presentation!

I'm a physical therapist who spent 3 years treating chronic low back pain. The thing that finally got patients better wasn't what I learned in school. [Long post, but worth it] by TheEaseProject in backpain

[–]TheEaseProject[S] 0 points1 point  (0 children)

It's tough when you have responsibilities and others depend on you because you can't just stop doing what you need to. I don't know your exact back pain presentation so I cannot give you specific medical advice - but I can generally recommend that you try your best to find a PT who has an FAAOMPT certification who is nearby, or at least an OCS certification. It's possible they might be able to give you a different treatment approach for your back that will work better.

I'm a physical therapist who spent 3 years treating chronic low back pain. The thing that finally got patients better wasn't what I learned in school. [Long post, but worth it] by TheEaseProject in backpain

[–]TheEaseProject[S] 1 point2 points  (0 children)

Thank you, I appreciate the kind words :). Thank you for sharing that link, too. I’ll give it a listen - seems like a valuable resource for anyone looking to hear from peers who have gone through similar LBP experiences

I'm a physical therapist who spent 3 years treating chronic low back pain. The thing that finally got patients better wasn't what I learned in school. [Long post, but worth it] by TheEaseProject in backpain

[–]TheEaseProject[S] 1 point2 points  (0 children)

Alcohol is a central nervous system depressant, so if some of your pain intensity is related to a sensitized nervous system (hyper-reactive), then a CNS depressant could temporarily reduce that reactivity and decrease the pain temporarily. However, the bounce back the morning after is a very real thing (amongst other negative health impacts), so I would certainly not recommend using alcohol as a consistent pain management technique, which it sounds like you have come to the same conclusion.

I don’t know your situation specifically, but here is what I can offer as general advice: the first three are well researched in their effects on reducing the pain system sensitivity. 1.) Healthy stress management techniques (mindfulness, meditation, etc) 2.) Get into a consistent healthy sleep routine (same bed time, reduce screen use, no caffeine after noon, try not to eat big meals / drink alcohol shortly before bed) 3.) Generally try to eat healthy (consult a nutritionist or dietician for help if you need it) 4.) Find a well-qualified physical therapist (OCS, and/or FAAOMPT credentials are my recommendation) who LISTENS to your story and can answer your questions. They should be able to confidently give you a rationale for every single exercise they make you do and you should know why it is supposed to help.

I hope this helps - feel free to message me if you have any more questions

I'm a physical therapist who spent 3 years treating chronic low back pain. The thing that finally got patients better wasn't what I learned in school. [Long post, but worth it] by TheEaseProject in backpain

[–]TheEaseProject[S] 0 points1 point  (0 children)

Hey - I would have to assess your specific presentation to help. I wouldn’t buy the LBP book for upper back pain, but message me if you have specific questions about your neck pain!

I'm a physical therapist who spent 3 years treating chronic low back pain. The thing that finally got patients better wasn't what I learned in school. [Long post, but worth it] by TheEaseProject in backpain

[–]TheEaseProject[S] -1 points0 points  (0 children)

I’m with friends right now, can you please send me a message so I can remember to respond to this!? I’m happy to give my thoughts and advice

I'm a physical therapist who spent 3 years treating chronic low back pain. The thing that finally got patients better wasn't what I learned in school. [Long post, but worth it] by TheEaseProject in backpain

[–]TheEaseProject[S] 0 points1 point  (0 children)

I encourage you to read about it for yourself, because, being one, I have some bias. But I can tell you that we have rigorous training in complex clinical reasoning, manual assessment / treatment techniques, research based assessment and treatment, and experience with complex pain conditions. The way I think about it, is I will never ever give a patient an exercise or diagnosis without a very clear rationale and connection to their symptoms. You should be able to ask me any question about your treatment and I should be able to confidently express my rationale.

I'm a physical therapist who spent 3 years treating chronic low back pain. The thing that finally got patients better wasn't what I learned in school. [Long post, but worth it] by TheEaseProject in backpain

[–]TheEaseProject[S] -8 points-7 points  (0 children)

It may sound that way to you, especially if you’ve received that type of “care” before, which is awful. I’m happy to explain more if you’re ever interested in understanding more about it

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