View Full Version : Functional Restoration Programme (pain management)
9th November 2009, 04:26 PM
I thought I would start this thread for anyone who gets offered one of these courses and wants to know more about it, or anyone who might have the opportunity to ask to go on one.
It was my first day of the course today, it will run for 3 days a week for 3 weeks. Well the first part of the day we met and learnt a bit about each other (not our conditions, just us as people) there were 8 of us, 1 chap and 7 ladies (although the chap walked out saying it was stupid when he couldn't find his pelvic floor). We talked about what sort of things we would cover on the course and did a beep test - we walked between 2 cones until we were either tired, or didn't reach the next cone before the beep. We were timed going up and down some stairs to see how many flights we could manage at the end of the week. These will be repeated at the end of the course.
We had a break for coffee and then went for hydrotherapy, where we tried different things, walking up and down a slope for a minute, waving some paddles back and forth through the water for a minute, twisting with a float for a minute, and walking up and down a step for a minute, then we just floated for a bit to relax, afterwards we went for lunch. After lunch we discussed muscles, joints, tendons, and ligaments. After our discussions we did some stretches and had a video taken of us walking between cones, sitting on a chair, and laying on to the floor and getting up again.
We were then let home for the day, but not before I was taken to one side and told I now have to use 2 crutches instead of 1 as I use them differently to how a physio would teach you to use one. (because of the degree and rotation although this didn't seem to matter to them).
I am really tired and aching now but met some lovely people, found out I have some degree of hypermobility. I still don't know how much this can help me but still trying to keep an open mind about it.
Will try and update again after tomorrows session.
9th November 2009, 07:55 PM
It sounds positive so far so I hope it does help!! :squeeze:xx
9th November 2009, 10:13 PM
Well that sound like a positive start :)
Do you mind if I move this to the 'Non Surgical' forum, as it would be a great account for people to read there?
9th November 2009, 10:23 PM
That's a very useful piece of info :) I always wondered what happened, look forward to reading more episodes!
Hope it helps you, sounds like you've got through quite a lot already :) xx
9th November 2009, 10:36 PM
Sounds good Claire :) I hope you get something out of it, I really do - I hate that you're in so much pain all the time :squeeze:
Keep us updated on your progress :)
10th November 2009, 05:19 PM
Feel free to move the thread mods, I realised after I posted it that I should have put it in non surgical - I am such an airhead sometimes.
Todays session (day 2)
We started the morning straight away with some feedback from the day before, where I felt like a bit of a whinger as I was the only one who felt any pain from the previous day. We followed this with some stretches that we had learnt the previous day. We then had a discussion on understanding pacing yourself, tolerances and our diaries that we kept for the week before the programme started - in our diaries we noted what time we did any activity, when we rested, took medication, how many times we woke at night etc. We had a rather healthy debate on where we could possibly make/create time to schedule in a rest in our days with dependants to look after, work, housework etc.
We had a break and went back to face the gym. They had set up stations where we had to carry out the activity to as long or as many repetitions as we thought we could manage. We had bicep curls, press ups against the wall, sitting on the gym ball, step ups, and a bicycle. From this we could decide where our base line or starting point was for each activity, then so we don't over work our muscles and to break the pain cycle, we had to take 20% of of each of the figures (either time or number of reps) which is what we would work from over the next few weeks. I actually got quite upset as where I appear to have suddenly dropped on the left side I couldn't lift my leg enough to ride the bike, although they said I would do it by the end of the three weeks, I felt they didn't understand that it's not muscle related, its structural - I can't shift my bones in the next 3 weeks to stop my hip and ribs grinding.
We missed out on hydro today as someone didn't put the heater on overnight in the pool and it was only 30 degrees, not warm enough for therapy. so instead we discussed muscle groups to try and give us a better understanding of what we are trying to do.
After lunch, we were told we were going to do a relaxation exercise. We lay down (I made sure I got a bed so I didn't have to struggle getting up off the floor) and we listened and followed the instructions from a cd - to be honest the mans voice was so boring and there were builders outside the room drilling so I wasn't at all relaxed but apparently I will learn this skill too. We did some more stretching and were then allowed home early today.
I felt today that I might have been better at this if I either hadn't had any prior surgery, or was post re-correction surgery. I can see where it would benefit, but not sure if now is the right time for me. Still I will stick it out and maybe things will improve.
10th November 2009, 09:55 PM
Feel free to move the thread mods, I realised after I posted it that I should have put it in non surgical - I am such an airhead sometimes.
No probs, I've moved it now :D
11th November 2009, 01:24 AM
Thank you for giving us so much detail of what an FRP looks like. It sounds like they are doing a good job in making everyone understand body mechanics and I always find that useful.
I really hope you feel some kind of benefit soon.
11th November 2009, 05:25 PM
Do you know what other problems/conditions the others in the group have? x
12th November 2009, 10:52 AM
I forgot to post yesterdays session, so will do so in a minute, I am the only person in the group with scoliosis, there is a 17 year old with unexplained back pain, and area's or hyper flexibility. We have 2 retired people, 1 with shoulder pain and 1 with a problem knee after having some previous surgery. There is a mother about my age who has pain in her pelvis and lower lumbar spine after 2 problem pregnancies, 1 lady mid 40's who is experiencing back pain after having a broken spine, and 1 lady late 40's who has back pain from her job. A real mix of people and we are all getting on well.
Wednesdays session DAY 3
We started off with some feedback, and a reflection on the previous day, then started our stretches and some circuit exercises (I missed the exercises as I had to go to my consultant appointment). After a break for coffee, we discussed setting goals for ourselves, just simple things nothing what we do now, what stops us doing them, and what we would like to do as a short term goal i.e making a meal for the family, have difficulty bending to put things in oven, and to over come would like to build thigh muscles to improve stability when properly bending.
We followed this with a short hydrotherapy session and some floating for relaxation. After this we had lunch.
After lunch we had a chat to a local chap who works with the employment agency, and gained some really useful information on returning to work, how to get help to make work comfortable, benefits we may be entitled to. I also found out that the official classification of being disabled is a person who has had a condition for over 1 year. Anyone in this position could possibly be entitled to disability living allowance for the rest of their life, also if you are a pensioner, you may be entitled to pension credits as a top up yo your pension although this is means tested. I also found out that with access to work, if you move jobs, you are entitled to take any changes with you such as chairs and footrests. Once the discussion was over, we talked about setting goals for the following week. We did our stretches again, followed by a relaxation session with the cd, and finally finished the day with an understanding medication session.
These first 3 days have allowed me to make up my mind about the programme, now I would recommend them as I can see where this will benefit me even after any potential surgery. I really understand the point of the programme and am going to continue to enjoy it for the next 2 weeks, next report should be monday, I am off to do my stretches and exercises.
12th November 2009, 01:59 PM
I am so glad that you feel there is a benefit to this Claire. It sounds really interesting and packed with information that so many could benefit from.
This is such a great review of the programme. Thank you!
12th November 2009, 02:18 PM
I feel bad for not writing a report of the Functional Restoration Programme I did back in 2005......Oswestry seemed to be under the impression that theirs was the only programme of its type in the UK though, so I didn't think it would be useful to anyone else! I soon found out that they were mistaken as I started to hear about people going on similar courses at other hospitals. Dee was offered the chance to do one at Stanmore but she didn't take it up.
12th November 2009, 02:30 PM
Yes - thanks very much Claire. Makes for interesting reading. Sounds like it will be useful, with the info, exercise, relaxation and body know how. I wonder if the different courses in different places have much the same content? Is it to do with the British Pain Association?
(I agreed last year, to do the Stanmore in-patient course, but nothing ever happened.)
12th November 2009, 04:28 PM
The physio's that run the course said that they follow some NHS set standardised guidelines but are allowed to make the course theirs as long as they use certain content. Based on this I would assume the programmes at other hospitals would follow a similar pattern. I really thought about cancelling before the course but now I am glad I didn't, some of the hand exercises/stretches I have already taught to my family who use computers as it is supposed to delay or reduce the effects of arthritis in the fingers which is apparently on the increase with the computer work we all do now.
12th November 2009, 04:42 PM
Is the course residential Claire? The Oswestry one is - you stay all week and just go home at the weekends, and food and accomodation are provided. Maybe that's why they think theirs is unique, though I'm sure Dee mentioned that the Stanmore one was residential too.
12th November 2009, 04:48 PM
You can stay in a bed and breakfast for the 3 days each week - its a nice one close to the hospital and paid for by the nhs, but I have been commuting as have the other mums on the programme. The person who lives furthest away is from gloucestershire I think although my geography is not great.
12th November 2009, 05:26 PM
What hospital are you at?
Sorry for all the questions. We can strip out your important posts and sticky them once you've finished the programme though :)
12th November 2009, 06:30 PM
I was thinking this would make a very useful sticky too Toni :) Thanks for taking the time to write it all up and for your honesty Claire, this will be really useful to others embarking on programmes like this :)
12th November 2009, 07:09 PM
I'm at Nuffield Orthopaedic in Oxford Toni, I don't mind questions, I have a memory like a goldfish so I ask things a million times before I remember
16th November 2009, 08:46 PM
Day 4 today, and it started well, we had a chat about what we had managed to achieve over the weekend and then started with some stretching followed by some exercises in the gym (walking on a treadmill, cycling on a bike, bicep curls with weights, walking up and down stairs that kind of thing) After the gym we headed for a coffee break, and after that we had a discussion about sleep and tiredness, suitable sleeping positions, matresses, how long is a normal nights sleep, and what disturbs sleep and the effect that has on us. Everyones favourite part followed - Hydrotherapy and then lunch.
When we got back from lunch we did our stretches again and then had our relaxation session with the CD (I couldn't stop giggling as the lady next to me fell asleep and was snoring so loud I couldn't hear the cd then claimed it was a rubbish cd because the blokes voice was monotone - it obviously worked though). We then began a discussion session on posture and gait with different chairs for us to try out. We looked at where we all naturally stood and where our centre of gravity was, then went to the gym and watched each other walking where I was the only person who walked naturally as you apparently should do, even though i'm the only one on crutches so I felt quite good about that. Unfortunately I am suffering a lot tonight on one side but I think a lot of that is due to my structural change rather than the exercises.
All in all I had a good laugh today and achieved quite a lot, I am really tired and in need of a good nights sleep.
16th November 2009, 08:48 PM
I really enjoyed reading your post Claire, you sem to not just be getting out of it but having a good old chuckle on the way, great news, i hope the rest of the course is such a hoot
17th November 2009, 07:22 PM
Wow they weren't kidding when they said this week would be the toughest of the 3, I am really exhausted now. So today was day 5, and once again we had a review of how we felt last night and I was honest and said that I thought I needed to lower some reps of the exercises as I was in a lot of pain last night. Everyone else was putting their reps up so I felt a bit down generally today - this was not helped by my GP not sending my repeat prescription to the pharmacy in time so I didn't have enough tramadol to see me through and they were closed so I had to improvise with lower dose so I had some in my system. After our discussion we did our stretches and then went into the gym for some exercises which I finished way before everyone else and had to sit watching. We took a coffee break and went back to a group talk on pain, and the difference between causing damage without pain, and having pain without damage covering what type of things were acceptable and how this fit into the pain cycle. I can really see how we get into this cycle of pain and how we become stuck - the initial physical pain comes from a damaged area of the body, that pain is remembered by the body rather than the brain and we continue to feel it, this causes us emotional pain, feeling frustrated, moody, tired, depressed etc. and all these things lead us back up to feeling more pain then we are stuck. The problem now is finding a way to break that cycle. Hydro was next, a circuit of activities and then a float followed by a well deserved lunch break. After lunch we had a relaxation session followed by our stretches and then we were allowed home so today was a short day.
I am starting to feel a little apprehensive about the programme finishing now, I will miss the people that I have met and friends I have made on the programme and I am a little unsure how I will find the daily time and energy to do exercises once a day, and stretches twice a day on top of work and looking after my daughter. Perhaps i'm just having an off day.
19th November 2009, 09:11 PM
We started out in our now regular routine of stretches and exercise, coffee break, and then our morning talk was about friends and family. We had a bit of an insight as to how they feel with the situation and how they feel about living with someone in pain, and their natural human reactions, and how we react to them. It was really useful to see how this tied in with the pain cycle. We followed this with hydrotherapy, and then lunch break. After lunch we had our relaxation session and stretches and then had our afternoon discussion on how we feel about pain, our frustrations, how useless we feel, and how we don't know what to do for the best, feeling lost etc. We also had an opportunity to discuss returning to work, and help we can have at work with a disability work advisor - the information we got, and questions we could ask were absolutely amazing, it was so useful to have access to this kind of resource. The man also gave us contacts and numbers of advisors in our local area. Following this we planned weekend goals and were then able to go home.
I really feel that the information and help has been fantastic, the stretches and exercises will be great long term, but unfortunately with the change in my spine it looks like I will need surgery, but will definately continue with what I have learnt after the programme ends.
20th November 2009, 12:42 PM
I am sorry to hear change in your spine require surgery, but sound have great, interesting and meet new people. Jo xx
23rd November 2009, 09:14 PM
Well its the start of the last week, and to be honest I am actually a bit worried about how I am going to keep it up at home without the support network around me, I have to find a way because I have to go back for a review in 3 months so they will know if I have been slacking.
Today started with stretches, and exercise in the gym followed by coffee and a chat about diagnosis of pain and understanding it, and accepting it if your diagnosis is simply chronic pain syndrome. We had hydro after and tried out some new stuff whilst trying not to drown - it's so hard to balance on a noodle and lift your arm up :D
We had luch afterwards and then a relaxation session followed by stretches and a chat about understanding when you need to take a step back and how to manage it which was really useful especially as the natural reaction is to say i'm not going backwards, then making things worse.
Sorry it's not a positive post today, the day was good and I had more energy today but I also got some bad news which put a bit of a dampner on the day - not at all linked to the programme.
23rd November 2009, 09:17 PM
Hope you're OK Claire? :squeeze:
24th November 2009, 07:00 PM
The penultimate day today. We started with feedback, stretches and exercises in the gym followed by a much needed coffee break. After coffee we had a discussion on ergonomics and lifting techniques and then our hydro session, where after our exercises we had a real giggle with the noodles floating around the pool, and riding them like a bike:D
We then had our lunch and the usual relaxation session followed by stretches. We then had to work our brains with a think about setting some realistic goals that we aim to achieve by our 3 month group review which we will have on 22nd feb. I am not alone in feeling nervous about losing the support so as a group we have set up a facebook forum so we can all still talk to and support eachother. Last day tomorrow - I kind of wish it was like groundhog day, repeated so I don't lose out and have to face the reality of going back to work. I have to admit I really think it has been worthwhile - I am almost ready to put down my crutches and walk without as my legs have gotten so much stronger in just 3 weeks and its amazing I look as though I am standing holding myself straighter.
24th November 2009, 07:11 PM
Wow! well done Claire :) Sounds a really positive programme, keeping it up will be harder, but I reckon with the group support you've set up that should help. Plus to feel as good as you do after 3 weeks it has to be worth it! Fantastic news! xx :)
Oh and thanks so much for posting your experiences each day, I've enjoyed reading them and learning a bit about what happens on these programmes.
24th November 2009, 07:13 PM
well done Cherry, we all proud of you and you have all for support to. xxxxx:ghug:
24th November 2009, 09:26 PM
Fantastic news that you feel so much stronger and great that your group can keep in contact on Facebook as you will be able to chivvy each other on :)
24th November 2009, 11:34 PM
Ah that's really good to hear Claire :D I really hope you manage to keep hold of the techniques you've learned, because although you know you need surgery, i'm sure it will help you pre and post op.
25th November 2009, 01:25 PM
I'm really pleased for you Claire. It all sounds like it's helped you out and made you feel more positive. It's great that you can still keep in touch with the others and I hope you manage to keep it all up :squeeze: xx
25th November 2009, 04:52 PM
Thank you so much Claire for posting this and all the info, I really enjoyed reading this. I would love to try the hydro pool but the swimming pool near me is tool cold for me to use. I tried to go swimming there but after a few mins my feet went numb with the cold and all the areas where I have nerve damage pinched with pain. I hope you will benefit greatly from your course.
25th November 2009, 08:11 PM
Last day today and I have to say I was actually very sad. I can't believe the change in my attitude from before the programme to now. I thought about cancelling so many times before hand as I knew I would end up having surgery, but now I would definately say if you get the opportunity then go for it. Today we started off with feedback from the previous day and then stretches. We then were filmed with some walking, sitting and laying down ready for review later on comparing it to our video at the start of the programme. After this we repeated the tests we did at the start of the programme (walking between cones - beep test, walking up and down stairs, and sit to stand from a chair without using arms to hold on to). We followed this with a tea break, then a questionnaire about our attitudes to the programme followed by hydrotherapy which as usual was followed by lunch. We went back to our room after lunch and went over our results and watched our films. My before film looked like I was moving very slowly, painfully and holding myself really stiffly, in my 2nd film I could clearly see how much more stable, relaxed and in control I was moving - I had tears in my eyes as I couldn't believe the difference, first film I used my left leg like a stick that would barely bend, and in my 2nd film it was like I had a whole new leg, bending my knee and having a lot more power in my thigh. If I ever needed a reason to keep going this was it. From my walking beep test, at the start of the programme I walked 70meters, and today it was 150meters, the stairs at the start was 4 flights and 13 steps, and today 6 flights and 9 steps, and finally at the start of the programme, my thigh was so weak I could not do a sit to stand from the chair (17 inches high) today I managed 3 a whole 300% improvement. We get a review in february to see how much more we have improved and also to see if we have been continuing so there is no time for slacking off or I will get caught out. This has really been worthwhile and eye opening, I only wish I could have gone sooner. I should be able to get back to this level of fitness sooner after surgery with the information I have learnt, and the skills I have gained. All I can say is WOW!!!!
25th November 2009, 08:45 PM
:clap: Fantastic news Claire :clap:
I wish we could all get the chance to do something like this, what a difference it could make :)
25th November 2009, 08:52 PM
I would recommend asking for it, it doesn't matter whether you have had surgery or not, but it seems better than just straight physio as it help you understand what to do for yourself when you have a flare up of pain or a setback. Anyone who suffers with chronic pain can do the programme and its only exercise that is proven to reduce the number of occasions you get a flare up, and how long it lasts for so can help you get off pain meds too.
6th December 2009, 06:00 PM
I have a few copies of the exercise sheets and notes from the programme if anyone wants a copy just pm me your address and I will post.
29th January 2010, 01:04 PM
Since building up the stretches and exercises I can now manage round the office without my sticks although I still take one with me when I walk in open spaces kind of like a comforter. I have also been building up 1/2 an hour a week on to my work time although some days I have had to drop back down, but now I am back up to my normal 5 1/2 hour day. Something that I really got out of the programme was the ability to recognise that I do sometimes need to drop back on doing some things, and to recognise when to do this, and how to build it back up. I was really stuck in a vicious pain cycle with no way out, and now I have the tools to manage the easy days, and just about cope with the bad days. It hasn't 'fixed' me but then I do need surgery, what is important is that after I have had my surgery I know how to get myself back on track and rule my own life without the pain ruling me.
29th January 2010, 01:53 PM
Well done Claire sound you're doing great.
29th January 2010, 04:31 PM
That's great!! :niceone:So pleased for you. Well done :squeeze: xx
29th January 2010, 11:50 PM
That's great!! :niceone:So pleased for you. Well done :squeeze: xx
Me too, it sounds like you have really learned a lot
I hope it helps i really do
22nd February 2010, 03:32 PM
Well I now have proof that this programme really works. Wehn I went in and did my walking between cones test at the start of the programme, I managed 70meters with 2 crutches. At the end of the programme I did 150meters with 2 crutches, and today 3 months on I managed 190meters with no crutches. That is not my only proof, we did sit to stand from a 17inch chair in 1 minute, first day 0, end of programme 3, and today 20. Then lastly walking up and down stairs over a timed period, to start with 4 flights 13 steps, end of programme 6 flights and 9 steps, and today 2 steps short of 10 flights. I will be honest and admit that I have not been doing the exercises as much as I should, but have tried to keep on top of the stretches as they seem to make the difference. Yesterday I actually managed to walk for 40mins without my crutches, and am back to my usual work times after a phased return to work. I still have an awful amount of pain, but I have now become more mobile with it which will set me on a great road to recovery from surgery, as some of you have read on another thread that I have been put on the surgery waiting list. I truly now believe that anyone with back pain should try this sort of pain management treatment - the only drawback is that you need to be referred from a consultant which I only found out today, so maybe save the question in your notepad to ask consultants at visits.
22nd February 2010, 03:47 PM
That is excellent Claire. I completely agree with you, I felt brilliant after I completed the FRP in Oswestry. I was referred to that one by the consultant at the Pain Clinic that I attended.
22nd February 2010, 05:11 PM
I'm thrilled that you are becoming more mobile :). Great news! I hope that now that you are moving more the pain level with start to decrease.
Take care and again, I'm so chuffed for you.
22nd February 2010, 05:29 PM
Well done Claire ... am made up for you . let it contiune xx
22nd February 2010, 07:43 PM
That's great news Claire :) What a worthwhile few weeks that was. Hope it continues and your pain decreases. xx :)
23rd February 2010, 05:45 PM
Wow Claire, you certainly have come a long way, you should be well proud of yourself :)
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