Is physical therapy effective for Functional Neurological Disorder?

[sgaetna2013]

Personally, I have found physical therapy to be quite ineffective as a treatment for my FND, which centers on gait and balance. I'd like to find out what other people have experienced. Has PT helped you a great deal, somewhat, or not at all?

Thanks for your input.

[VR053]

Hi, I have had the same experience as you. Physical therapy wasn't very effective for me with balance and I also had some muscle and nerve issues in my legs and they tried to do acupuncture and balancing and running but it all made it worse for me and didn't help me at all it just caused more pain and then I had more PT for a different issue I have with my heels that also did balance and strength but that also made things worse for me and didn't help much so I honestly don't recommend it for FND cause it'll be a waste of money and time unless it actually helps you. Thank you for posting this. I wish you the best.

[Misstea]

I apparently have cervical and thoracic spondylosis developing so PT has helped relieve that pain some.

[Hraefn]

Hello,

Physical Therapy hasn't helped with the pain or the weakness. However, I think working with my occupational therapist has helped keep muscle wastage to a minimum which is a good thing.

[rphike]

My experience with physical therapy for the last two months Hasn’t helped improve my walking balance or gait but I do think it’s just helped me maintain not better not worse, the therapist tells me I’m making progress but I don’t see it they tell me to be patient. My speech therapist tells me the same, slurring when talking but says my breathing has changed since FND and practice breathing focusing on my diaphragm. I also have gone through acupuncture no results.

[BuntyP]

I have had two lots of very unhelpful physiotherapy including 1 whilst in hospital when I had been recently diagnosed and couldn't make my legs work. Both focused on telling me to walk and basically dragging or pushing me until I virtually passed out and then looking angrily at me. A retired nurse in the bed opposite described it as torture not physiotherapy. 1 which didn't really help but the physio was very kind and did cheer me up and then a 4 week in-patient stay at Queen's Square where they identified that I often 'hardly breathe at all' during a physio session. At Queen's Square they taught me techniques including rhythm and counting and breathing which I use every day especially in the morning as when I wake up I can't walk. Also techniques to reduce the involuntary movements and CBT which really helped with coming to terms with my new life learning not to panic when my legs wouldn't work or my arm was waving about over my head. I first had symptoms in January 2010 and got treatment in May 2019.

[sgaetna2013 in reply to BuntyP]

Thanks so much for your input. Can you or anyone else in the U.K. let me know how easy or difficult it is to get a 4-week (or longer) inpatient stay for FMD/FND treatment. I am in the U.S., and it is not possible here to get an inpatient stay (of any length) for FMD/FND treatment.

[Fighter_B in reply to sgaetna2013]

I was hoping there was a long term rehab place we could go for intense treatment too.

[Riley-Roo]

I have been going to PT for five years for spine issues, after being diagnosed with FND I sometimes questioned the effectiveness of PT so I discontinued it for six weeks. In those six weeks I lost so much more function of my legs and balance that I went back, I have realized for me that I may not regain much function I don’t lose more either. At this time I would like to maintain as much of what I have so I continue to go to PT.

[Brokendeer]

Hi Neuro Physical Therapy is what is needed for FND which has its grounding in helping people recover from other Neuro conditions like Stroke, Parkinsons, Multiple Sclerosis and I suspect probably now Long Covid. Standard Physical Therapy I found useless for FND as setting exercises to be repeated multiple times is not helpful when your FND cannot repeat any action on demand often not even twice let alone multiple times!

The Neuro Physio has more emphasis on what you need to achieve in your everyday life and how to work around any obvious obstacles to meet those self-made goals. ForExample: in order for me to do some sink washing up we discovered I needed to change position frequently, wash, dry and put away each item not stand at the sink tryng to repeat identical actions this stopped my neck and shoulders from seizing up and causing nerve stress/signal loss.

I found being shown a movement less effective as them actually moving my leg into the right position, for say walking stage sequences. So think more Physio combined with Occupational Therapy. Even then, depending on the Therapist you can feel that you are not being listened too or understood - remember no one can understand FND like an FND Sufferer, so just get out the sessions what you need and try not to accept ludicrous goals set by them i.e do not set yourself up to fail! Note: If you are in the UK, you can request Neuro Physio via your GP and hope your Local Hospital has a qualified Therapist covering this specialist Physio.

UK NHS Inpatient Multi-Disciplinary Rehab (4 week course) is incredibly difficult to get a placement, you have to meet a `Complex' FND category, have to get Regional Medical Funding and then have to get a Neuro Hospital with a bed available! UK does offer some Outpatient sessions too. After all that, you discover that actually the majority of the Rehab in UK focuses on Cognitive Behavioural Therapy (CBT). Changing your thought processes and perceptions about FND is their priority and system to cope and manage the daily symptoms - less about physically changing anything, finding a root cause or getting back to normal.

There is a book you can buy (got mine off Amazon) which covers all the elements in the UK Rehab, including personal worksheet sections without going to Rehab itself.

Obviously the Neuro Physio cannot be covered, but that is the only bit missing really.

Overcoming Functional Neurological Symptoms: A Five Areas Approach: 5 Paperback – 26 Aug. 2011

by Chris Williams (Author)

I personally found this other cheaper book more helpful for my Motor FND, as focuses on the Physical outcomes and coping mechanisms of various other conditions (do not let the title put you off!)

Living with Physical Disability and Amputation Paperback – 1 Sept. 2009

by Keren Fisher

Good luck

Look for the calm in the Storm!