[legitster]

So, other medical systems around the world are cheaper, but that doesn't make them magic. Chronic pain - especially back pain - is often an unsolvable quagmire for most doctors.

Not a doctor, but several family members have had to go through something similar. So here is my advice:

- Get imaging tests (Xray, MRI). And screen out the any of the worst case scenarios (like tumor or etc). But if there is nothing inherently obvious and doctors are sending you down obscure test panels, cut bait early - they're out fishing and you shouldn't expect anything worthwhile.

- For back pain, there is almost no medical solution other than surgery. If surgery is optional, don't take it. The recovery from a back surgery is brutal and long and can come with unintended consequences.

- Talk to a fitness instructor. Especially one with a formal education. This is the most underrated option - these are the true experts on kinesthesiology and recovery. You'll be surprised how much good advice they can give you in a single session - identifying which sets of muscles can be developed to take strain off your back, giving you targeted workouts to try, pain management techniques, etc.

- Patience. My father-in-law spent a year recovering from back problems. Despite trying every medical intervention under the sun, his recovery ended up taking exactly as long as his original doctor said it would. But the important thing was lifestyle interventions to prevent reaggravating the problem.

[orev]

By “Fitness Instructor” I think you mean “Physical Therapist” (and definitely not a Chiropractor). In the US, a fitness instructor can be literally anyone who runs an aerobics class, while a physical therapist actually has medical training.

[legitster]

No, I mean a fitness instructor. Or perhaps a "personal trainer". There are certain certifications that exist (And some people are both trainers and physical therapists).

In my (limited) experience, physical therapists tend to have much broader recommendations. Like a PT might tell you to walk an hour a day, but a trainer might recommend a specific kind of crunch that targets the actual muscles in question.

And to OP's point, PTs are very much ingrained in the US medical system and consuming their services can be a pain in itself.

But the guys who get professional athletes back on the field every week are for the most part just personal trainers with a master's level education in sports science. THOSE are the guys you want to help your back recover.

[Moto7451]

Boosting this comment, you want to talk to someone with a Masters or Doctorate in Kinesiology. Some Physical Therapists will have this or equivalent training. Some other specialists will fit the bill as well but not all.

My wife had back pain due to a disfigured vertebrae. That’s something they do not want to operate in until every other option is exhausted. Much of her pain and numbness is caused by imbalanced muscle development from a lifetime of incorrect posture and movements that compensated for the defective vertebrae. She’s worked with both a Physical Therapist and a Trainer to improve her strength and how she moves to the point that she is pain free 90% of the time. Both were referred to her by her doctors. They’re not part of a PT chain or gym.

[ianai]

50/50. The problem with going to fitness/sports people is they may get "distracted" with other concerns of theirs and ignore your central complaint. So if that fitness instructor is incredibly informed and clearly taking your priorities straight then, sure, go there. But if they seem to have a chronic case of "jock brain" and seem to be only concerned with your physical appearance then go elsewhere.

[Moto7451]

These aren’t fitness instructors. The trainer in this medical setting is someone that has you perform exercises to restore mobility rather than for general fitness. There’s certainly a link between the two but that’s not why you go to a hospital to work out.

Kinesiology is the study of how the body moves. While the largest target audience for that is going to be people looking for a standard gym fitness trainer, the higher degrees are wasted on that sort of thing and are better used to restore the range of motion of an elbow after a car accident.

[mtalantikite]

It really depends. I know plenty of people that are "fitness instructors" (mainly yoga and Pilates teachers) and I'd recommend them over regular PT in most situations. They know a ton about anatomy, how to read body imbalances, and can work with you to train your body back from injury.

Personally, I had a debilitating shoulder injury, couldn't put any weight on my right arm at all, and one of my yoga teachers put me on the path of fixing it up. Same with a low back injury, I couldn't even sit at one point and she helped fix me.

I'd 100% recommend someone with back pain visit a highly trained yoga or Pilates teacher. Some Pilates studios even take health insurance, since some are considered PT.

[sizzle]

I would be careful with shoulder injuries, your body simply can’t repair certain things like rotator cup injuries if I recall correctly.

[mtalantikite]

Absolutely, some things we actually need surgery for. But most of the time it's not necessary and really the only solution is to fix poor movement patterns and to strengthen the body. A lot of back pain comes down to strength and flexibility issues.

For my shoulder the main thing that worked was getting into the habit of doing pull-ups and stretching out my pec minor. Anytime I neglect pull-ups for a while the discomfort will creep back in. I probably should also buy a split keyboard.

[pokeymcsnatch]

So, you're definitely right- go to someone with actual medical training first. But a physical therapist's job is to get people back to basic functioning. From there, a good fitness instructor can help a person with stretching, light exercise and strength training, and stuff like posture/positioning and meal planning to maintain and improve on the initial work put in with the PT. A fitness instructor/coach is a fraction of the cost of a PT, and if you maintain a good relationship, you can just kind if drop in for guidance as needed vs going to weekly dedicated sessions.

But yeah, they can be literally anyone. A good one understands simple (bio)machines and pays close attention to how a body moves AND is a good teacher.

Edit: "A PT will get you to functional, a fitness instructor will get you to capable"

[shiftpgdn]

It's worth keeping in mind that the quality of Xray and MRI machines vary greatly and the facility doing the scans typically won't be upfront with what machines they're using. You are the only person who is ever going to advocate for the treatment you get so you'll need to be very firm but polite to get this information.

[giantg2]

"and the facility doing the scans typically won't be upfront with what machines they're using."

All one has to do is ask. I've even had scheduling assistants ask me what power of machine the doctor wanted.

[okr]

How i would i be able to differentiate the quality of the machines?

[giantg2]

Depends on the type of machine/imaging to be done. For MRIs, you typically want higher Tesla values for better detail. There are also other types of imaging tech too like DTI or functional MRIs depending on what you want to look at.

[flemhans]

In Eastern Europe they often advertise the make and model (and some weird specs like Teslas) on their web site, if it's a good one

[giantg2]

Teslas aren't really a weird spec. In general they correspond to a better level of detail, which could be necessary for certain imaging/conditions.

[bowsamic]

Yeah, a physiotherapy course is the standard treatment for "weird body pain with no visible problem on MRI" here in Germany. I'm surprised to hear if that isn't the case in your country.

[shigawire]

It generally is in my personal experience... But people don't like having to do work and want a quick surgical or medical fix.

[ggeorgovassilis]

> Talk to a fitness instructor.

I strongly agree out of personal experience. FIs have fixed all and every sedentary-job-induced ailment I've had so far. I highly recommend watching the athlean-x YT channel. Adding to that: also ask older, fit people you meet in the gym. They are full of good advice how to avoid injuries and, once you have one, getting over it.

[giardini]

legitster says >"- For back pain, there is almost no medical solution other than surgery. If surgery is optional, don't take it. The recovery from a back surgery is brutal and long and can come with unintended consequences."<

I have two friends who had almost identical spinal & neck issues: both got no relief until they had surgeries. Both say "Why prolong the suffering? Do the surgery!" One of them did have to wear a neck brace for months, but that was because his surgeon found the old neck vertebra was too delicate to keep, and so cut a chunk of bone out of his patient's hip, hand-carved it to the shape of a healthy vertebra and inserted it into his patient's neck. When the patient awoke he complained about the pain in his hip (his neck was fine).

Now that's the kind of surgeon I want!