New posts (questions about how to treat individual pains) are being answered by Steve Lockhart regularly in the Private Members area. Get access now along with your self treatment program via the Ad in the right hand column.

Author Topic: August Healthletter 07 - Have you considered Surgery?  (Read 8100 times)

Steve Lockhart

  • Administrator
  • Hero Member
  • *****
  • Posts: 2249
August Healthletter 07 - Have you considered Surgery?
« on: August 06, 2007, 04:38:29 AM »
In this months healthletter I want to discuss surgery.

I want to make it clear here that I am not attempting to try and convince you that surgery is always the wrong way to go because I am realistic and agree there is a place for surgery. I do see it as a last resort if nothing else is working and I have had patients who have gone onto have surgery with my blessing when everything we tried failed to give them enough relief, from an impinged nerve.

Although most came through it well you can never be sure of the long term outcome, at least for many years because the scar tissue or a relapse can always come back to bite you later.

There are some important things to consider if you are contemplating having an operation for your back pain which I will go over after you read Geraldine’s email.

I have suffered back problems since I was eighteen when my first (of many) slipped discs occurred I experienced these on and off for many years visiting Osteopaths but in the end they could no longer help.  The upshot of all this was I was recommended for Surgery in 1988 I was undecided which path to take in the end it was so acute I couldn't carry out my job in Personnel and Recruitment so had to take the surgery option reluctantly in 1990.  I had the Lamenectomy Surgery during which my spinal cord was "nicked" and leaking fluid - I was eventually informed of this after I asked some questions.  I was left in constant pain, unable to walk or stand up, the Surgeon said he wouldn't re-operate as he was worried about the stability of my spine if he did, however attempt Epidurals under local and general anaesthetic neither of which were successful due to stenosis of my spine.  I was eventually transferred by ambulance to another Hospital when a second operation was carried out with the same result I was finally discharged three months later.  During my time in Hospital I had a XRay on my right hip because of the intense pain I was experiencing there as well as my back and legs; they thought my hip might have been fractured during surgery which proved negative.  Since then I have had several more hip Xrays, recently I was informed it was Bursitis by one Senior Houseman and had a cortisone injection which only lasted for under two weeks when I went for my next appointment I saw someone totally different and was told it was referred pain from my back and they couldn't help me any further.  When I returned to the Hospital for a check-up I was in a wheelchair still in constant pain.  Another MRI Scan (to date I have had approximately seven of these) was ordered which resulted in showing all the bone growth had returned again and was told I had the spine of an eighty year old (I was forty two at the time).  After the first Op the Surgeon tried twice to give me Epidurals one under local and the other under general anaesthetic but the stenosis in my spine was too far gone to get the needle in. Following on from all the above I have been "through the mill" having seen two Pain Specialists neither of whom could help me.  I have had subcutaneous injections, combined anaesthetic and painkilling injections, hydrotherapy, acupuncture, Physio was tried but was always too acute for any treatment to be tried, Epileptic drugs to try and interfere with the pain receptors, opiates, Arthritis medication the list goes on and on.  I was recently prescribed some very heavy drugs which I had an extreme reaction to, since then I have stopped taking any medication as looking back nothing actually took the pain away and I want to feel like a human being again.  I also have sciatica but am pleased to say that I am now able to walk with crutches but on occasions have to revert to the wheelchair.
 
I feel very sorry for this lady because in all probability if she had the right help as a teenager it’s likely none of this would have happened. Instead she has ended up a real victim of a surgeon’s carelessness because of the inability of conventional therapists to deal with her problem properly. If you are under the illusion that you can confidently put you pain in the hands of conventional doctors or therapists and everything will be find, think again.

Geraldine may well have had an fairly successful and uneventful operation if the nerve wasn’t ‘nicked’ but as a result, the flow on effects to her body from the drugs and inactivity have left her in a state which will be very difficult to come back from. Talk about a twist of fate that can change the course of someone’s life so dramatically.

One point I think really needs to be made is that, for people who have decided to go for surgery, or even if you have already had it, don’t think that is the end of the story, even if you no longer feel pain. The nerve impingement or chronic back pain is only the symptom of a bigger problem that exists.

This is the point I try to make strongly in my books and articles and it is something doctors never cover. A disc doesn’t bulge or a joint doesn’t ache for no reason, there is always some form of muscle imbalance causing pressure to build up and set up the problem.

A muscle imbalance is present when a key structural muscle on one side of the body has a different tension level, length or strength to the same muscle on the other side. When the muscles are switched on during exertion this causes the pelvis to twist or tilt.
 
To explain it another way, gravity pushing the body into the ground causes the muscles to be under pressure. If the body is balanced the muscles all share the load or weight evenly. If the muscles are unbalanced the pressure is intensified onto a small area in the centre of the body. The lower back.  Over time this pressure can cause a disc to bulge, herniate or rupture or just a joint to be out of alignment, but either way it always ends up causing some degree of pain.

When the surgeon operates to repair the damaged disc or fuse the vertebrae they don’t do anything about the muscle imbalance which is probably more important. This is something that still needs to be addressed to ensure the surgery has every chance of lasting success.

Statistics show that around 50% of back surgeries are successful in the months following, there are no statistics that assess a person 5 or 10 years later. You can be pretty sure the 50% that are not successful are people who had significant imbalances that were not able to be held at bay by the surgery.

If the imbalance is not taken away, it keeps putting pressure on the lower back and over time that can easily cause the pain to come back either in the same area or in a joint above the one that was operated on.

The worse thing about the surgery is that it often masks the presence of the imbalance for a time, perhaps months or years, adding to the deterioration of the body so when the pain does come back the body is that much older, weaker and more difficult to fix.

Imbalances cause a body to become tight and inflexible. They cause certain muscles to become dysfunctional, the circulation to some areas to be restricted and the tissue to begin deteriorating and therefore weak. The longer it is left untreated, the more difficult it is to reverse this deterioration and get the body balanced and working properly again.

There are very few people who have had ‘successful’ back surgery who can go back to a physical lifestyle without suffering a relapse or another chronic pain somewhere else that is also coming from the same muscle imbalance.

If surgeons understood the implications of the muscle imbalances and worked in with a therapist who could fix them, not only would so many of the surgeries be unnecessary but the ones that were would be a lot more successful in the long term.

So the moral of my story is that no matter what type of back pain you have or whether you believe you need or have had surgery, you must, as part of the recovery process, have your body rebalanced by someone who knows what they are doing.

To help you find that someone or even so you can do a lot of the work yourself I have put the self treatment program together. I hope you will realise how important it is in the big picture because you only have one spine and every decision you make could mean the difference between a happy and healthy pain free future, or a lifetime of pain and expense such as Geraldine has had to endure.

Warm regards

Steve Lockhart

The self treatment is available here www.backpain.com.au/selftreat
« Last Edit: December 27, 2007, 03:37:49 AM by Steve Lockhart »

markuk

  • Private Members
  • Newbie
  • *
  • Posts: 5
Re: August Healthletter 07
« Reply #1 on: August 17, 2007, 09:34:46 AM »
Thanks for the August health letter very interesting.  I myself do believe in what you say about both surgery and muscle imbalance and agree that no matter which option you take muscle imbalance shold be addressed.  I have also witnessed via using myotherapy and shiatsu on clients how catching a imbalance early (with or without sciatica being present) can prevent injuries or imbalances becoming major problems.   However despite my knowledge experience in helping other people's backs i have found myself rather emarressingly unable this time to sort my own back out.  I have tried over the last year (almost a year to the day) various methods including yours to try and re balance my muscles.  Dont get me wrong I believe in the methods particularly yours and continue to recommend it to clients who i feel are willing to put the effort in to help themselves.   I also continue to benefit from the self massage with balls etc which i just love.   

I do though feel for people as often as with me it feels like a case of 'the chicken and the egg' which one is the cause, after a year of trying im now thinking maybe it is the disk which is causing the muscle imbalance!  The body i feel is protecting itself and some muscles particularly i feel the gluetus minimus muscle on my nleft wont relax.  As i start heading for the surgery root i just pray i am right. If it is the nerve will the imbalance re ajust?

Once had the surgery do you recommend continuing with the yoga routine - i have to say some physio's i have recently seen have strongly advised me against it often refuring it to old style physical puishment - whilst some iyenger yoga teachers have suggested they use similiar ideas.  you can really understand why people get confused i am confused!!!

Years ago im told not so long ago infact about ten years they would remove the whole disk now they apparently just remove a small part has anyone on here tried this method if so would appreciate your thoughts/comments mark

Steve Lockhart

  • Administrator
  • Hero Member
  • *****
  • Posts: 2249
Re: August Healthletter 07
« Reply #2 on: August 17, 2007, 06:29:59 PM »
Hi Mark, the pressure from the disc on the nerve has a definite affect on the whole body and makes it very difficult to get the muscle problems to respond and change. I am sure you will have more success once that is taken care of. I saw your scan remember and your case looks very pronounced and probably a classic surgery case. Once you get the nerve turned off I would take it very easy for a while and give the area a good chance to settle down and healing to take place. The SLM Yoga should only be performed gently after that healing to coax the muscle balance back in and improve the circulation. Seeing an experienced Physio would be helpful for a short time but ultimately your self treatment efforts will probably give you the most success.

Regards
Steve

 

Download a FREE copy of the latest version of my book: A Specialists Guide to Sciatica and Back Pain Treatment.

Your details will always be kept private and NEVER be shared with any third party


Free Video You Can Watch at Home For Instant Relief



youtube_ad