About two years ago, my wife and I joined my cousin and his wife on a driving vacation from Phoenix to Big Sur and Las Vegas and back. My cousin did most of the driving. I sat in the backseat and drifted in and out of naps.
While asleep, my noggin rolled like a bobblehead. As a result, I found my neck and upper back felt like they were on fire. I saw a massage therapist when we returned to Phoenix. That helped temporarily as did Tiger Balm, Biofreeze, and other remedies.
I continued to ache. My muscles, especially my left trapezius muscle and right levator scapulae muscle, were tight with hard knots. I experienced excruciating pain -- like an 11 on a 10-point scale -- when I attempted to look behind me to check my rearview mirror while driving, A bass player could pluck my trap like a thick string.
But this pain wasn't new. I have been dealing with it for more than 50 years, ever since I had a whiplash injury at age 20 while out for New Year's Eve. I stopped in a large intersection in Chicago as the light was changing, and another driver rear-ended me.
The pain comes and goes. Poor posture and constant hunching over a typewriter and then a computer over decades only made things worse.
I turned to my general internist. He had ordered a plain X-ray a couple years ago. No surprises. It showed I had moderate arthritis, the sort of thing that happens as we age.
I told him that 15-20 years earlier I had significant relief of neck and shoulder pain from physical therapy. But he wasn't a believer. Two years ago, I experienced my first lower back pain. I suggested to the GP that I see a PT. He refused.
He told me a story. He said he referred some patients to PT at a local hospital. He said they had to wait seven weeks to get in. By the time their appointments came, their back pains had disappeared.
He viewed PT as a time- and money-waster. He had a blindspot for PT. Instead, he prescribed a heavy dose of ibuprofen, the nonsteroidal anti-inflammatory drug. The therapy tore up my gut. I had traded neck pain relief for a burning sensation and cramping in my stomach. Not worth the trouble.
A friend of mine who sees the same internist needed help with a muscle weakness problem, but our doctor again refused to order PT. Instead, my friend got a referral from a radiation oncologist who had treated his prostate cancer.
I am covered by traditional Medicare. That meant I could have an evaluation by a physical therapist. But to get coverage of the actual therapy, I needed a physician's referral, and approval of a treatment plan.
So I returned to the GP. This time the doctor handed me a sheet of paper with some exercises. That was it. Not good.
I was suffering and needed help. I got CBD (Kentucky hemp) cream with menthol and camphor, which stinks but it reduced the pain. I used a heating pad and ice. Everything I tried helped a little.
I called an old friend, who is one of Chicago's top neurosurgeons, and asked his advice: PT and yoga and pilates. He said he used to think he could solve any problem with a knife. Not anymore.
I decided to take more drastic measures and figure out how to get an order for PT.
Earlier this year, my wife underwent PT. She has a different GP. She was happy with the therapist, Phil. I asked Phil if he thought he could help me. He did an unofficial evaluation and concluded I was a candidate for PT.
I told Phil that my MD would never refer me for PT. So I did an end-run. I asked the PT for an MD referral. He sent me to a sports medicine specialist, who gave me a prescription for diclofenac sodium topical gel 1% to reduce pain while bypassing the gut, and gave me the PT referral I wanted. Finally I could see Phil with Medicare paying.
He came up with a plan that I followed for two months with exercises to strengthen those back and neck muscles. I lifted light weights, rotated my head, stretched with bands and made other small moves designed to strengthen muscles and relieve this pain.
In a matter of weeks, I felt better than I have for years. The pain for the most part was gone. I gained 30 degrees of movement in my ability to look up -- important if you photograph the birds and sky as I do. I made lesser gains in other directions. My posture improved.
I was angry with myself with accepting my MD's closed mind about PTs and his willingness to let me endure pain for no reason.
I shared my story with a physician-friend, who has a family practice near Chicago's lakefront. She had another partial solution to the pain in my neck. "Fire your doctor," she said.
I did. My friend helped me find a new one. I see my new primary-care doctor next month. I understand that he makes referrals, if needed, to PTs.
Howard Wolinsky is a medical journalist based in the Chicago area. He has been blogging for 鶹ý about his experiences with active surveillance for low-risk prostate cancer since February 2016. Read more of his posts here.