Back pain, how to you threat it?

Preparation, Preparedness & Prevention Fitness and Nutrition
1

Looking for some other old timers methods of dealing with back injuries. I have done the various PT routines and various meds to attempt to bring down the problems, but they persist.

The problem, herniated disk at T-6/7 with a bone spur. I can reach up and touch it 24/7 to show were the problem is. Meds that allow me to function as a member of sociaty don’t touch it. Also, the prime reason I retired.

History, 20 years in the Infantry, mostly with the 10th MTN. 1 Fast Roping fall that had me recovering for a few months, and the usual grunt problems. Surgury was not recommended by either of the specialists I have seen.

I spend 8 hours a day sitting at a computer or in meetings at work, another hour on the road, then second job and chasing two very active kids. In the summer I coach soccer and my wife has recently needled me into a yoga class with her.

With that in mind I’m looking forward to some feedback on things that have worked for you.

2

I work in the field of Spine Surgery.

Having a HNP/Bone Spur combo at T6-7 is nothing to be ignored. There isn’t much PT/chiropractors/pain meds can do for impingement/cord compression in the thoracic level.

Most surgeons do not want to touch this area of the spine for multiple reasons. Being thoracic, close to the Artery of Adamkiewicz, and so on. On top of the obvious risks…

I have personally scene micro-endoscopic decompressions done at levels such as these. The surgeons you saw probably have never done them, and its probably why they didn’t recommend surgery.

Depending on the location and size of the herniation, you could be a high risk for beginning stages of Myelopathy (cord edema, paralysis, etc). Not to scare you, just throwing it out there.

I’d recommend seeing ANOTHER doctor. Ensure he/she is a Neurosurgeon, has a fellowship in Spine Surgery, and try to find one that specializes in Endoscopic Decompressions/Discectomies.

3

I use a TENS unit on my back. It helps, but I wish I could get one that ran on 120v AC, it might work better.

4

I need the 220v DC one myself, the 9v just takes the edge off.

Derek_Connor,

We only have Orthopaedic Surgery localy. Their spine specialist seems to have retired since I was last seen and I have not checked the VA in Syracuse, although they did do the disablity exam. Maybe I do need to get it relooked. It “went out” for the first time two years ago which was the last time I had it looked at. It took half the pharmacy for them to get me to a sitting position, but that was low back.

The problems have been worse for the last two months, including a period that it felt like there was swelling in that area.

5

DMR, understood.

I mean this in the most sincere way, take the time and go into a large city close to you, and try to get an appointment asap.

Being a T6-7, if you find the right doc, you will more than likely be put as priority.

MEDs have a very high success rate for immediate pain relief from what Ive seen.

If it has been progressing or the last 2 months faster than it has before, I’d venture a guess without looking at your scans, that more cord is being pinched…

6

DMR,

If you want, PM me your location, I might be able to recommend a doc, if that would help.

7

This topic has dominated my entire life for the last three years. My advice would be to take it extremely serious and see as many speciallists as you can. I would also say that regardless of what the doctors say X-rays and MRI’s are not perfect. They completely missed the fact that I had 3 vertabra that were totaly smashed. How in the HELL do you miss that? I’m 40 and they say I’ll never work again.It’s BULLSHIT!!!Any way I’m sorry to vent, but back to you,All I can say is PLEASE don’t blow this off as something that will pass. take it seriously and take care of yourself. I’m sure there are many loved ones around you that want you fit and happy. Best of luck and you are more than welcome to PM me if you want to.

8

Well said, and I add to that, don’t trust the VA, when it comes to my back they have been essentialy useless.:mad:

9

Have had back problems for 27 years, ever since getting hit by a car on my bike. I refuse to go under the knife and simply use meds as needed. Sucks but sometimes its the only way to get relief. I do as much back PT as I can endure…

10

DMR - got your PM. Will take me a business day or so to grab a reference for up-state new york…

Negligence, on either the MRI/CT Tech that took your scan, the Radiologist, and/or the surgeon? If you really had 3 fractured vertebral bodies…wow.

I dont want to come across as a cutter advocate, or surgery is the only fix. Definitely isn’t. But when you have gross abnormality in the thoracic spine, that are becoming acute over 2 months, its time to seek surgical intervention. People work and function just fine with lumbar herniations all day everyday, but thoracic cord is a whole new animal.

The probably with waiting on things like these, is the older you get, the more calcified/hardened your discs become, you lose bone density, you lose disc height, and the chances of them re-fusing you and preserving any remaining mobility decreases with age. And of course all of the internal considerations, complications with anesthesia, recovery time, etc.

I wish everyone the best…back pain truly sucks.

11

Derek Connor, I guess I’ve become a little sensitive about this subject but there is no “IF” about it. I would never put my family through the hell we’ve been through in the last 3 years. I would do any thing to be able work. I’m sorry to be so sensative about this but my family is suffering, and it’s my fault.

12

Apologies, long one, get a coffee in.

I feel for you and appreciate what you are going thru. I have a herniated cervical disc (skydiving, bad opening) and a herniated lumbar disc (rucksack marches). I hate the idea of being a porker so I still work thru the pain and keep running and cycling the pain is a moderate to medium ache most of the time and I can live with that - most of the time, sometimes I am Mr Grumpy head.

If it gets bad I go for 400mg - 600mg Ibuprofen.

When I got diagnosed I happened to be starting as a student nurse. So I approached the problem with the attitude of “Ok, so if I was the Queen of England or POTUS my minions would have something that could fix me…so what is it and where is it”? And then I spent days in the University Medical Library reading up on the physiology, causes, symptons and treatments for this shit.

My Doc calls back surgery “Salami surgery”, rightfully so in 99% of cases. To fix the spine most surgeons use techniques that are a posterior approach - attacking good and healthy tissue, muscle and bone. So what you need is an anterior (frontal) approach that makes an incision, pushes organs to the side and then has access to the affected disc … now, you’d think why don’t they do that?

The med library I used was english language containing all the published British and American journals and texts - so that was all I could read about.

Well, one day I am on the Net looking at something in German, I speak German fluently, and I decide to Google my disc problem in German. I get some hits and start reading expecting the same old salami surgery solutions. Fuck me was I surprised with what I read.

In the 80’s the Charite Institute in Berlin, Germany, developed and inserted its first artificial disc … the recipient is still alive and well and playing tennis.

What if I told you that a patient with multiple Thoracic disc replacements took up skydiving AFTER the surgery.

There are lots of Americans that go to Germany for the surgery - including Dr’s, nurses and cops. I do not know how it works in the US but from what I have been told the FDA has allowed trials of thew disc but not actually approved it yet.

I intend to get my cervical disc replaced later this year at the Stenum Clinic, nr. Bremen Germany - come and keep me company. The Stenum is one of the top 2 clinics for doing disc replacement … the surgeon there has done around 2500 + replacements, so for him it is a routine operation.

The procedure is:

  1. You send them an MRI and they assess what they can do for you - FOR FREE.
  2. If you get the GO; you arrive, get checked out and ok’d for the operation.
  3. Next day you have the op.
  4. The day after the op the sadist - sorry, the Physio gets to abuse you and make you walk. Remeber they have only made an incision they have not cut away tissue.
  5. You spend up to a week in the clinic so they can keep an eye on you.
  6. You get released from the clinic and stay in the Marriot in Bremen for a further week. Here you play tourist for a week. The fee for the procedure includes accomodation for 2 at the Marriot so your good lady can join you for a week if you want.
  7. Two weeks after the procedure you get cleared and go home.
  8. You send peiodic x-rays of the replaced disc for a couple of years so they can make sure there is no slippage of the implant. There was a miniscule chance of movement in earlier discs but the newer designs have removed that problem.

I understand that there is a way you MIGHT get a US insurance provider to pay for the op - but being UK I don’t know how it works. So call the Stenum people. If the insurance provider will not play, well…I asked myself the question “Is my quality of life worth Euros 23,000”. 'kin right it is.

Look at these mate, then ask away:):

http://www.stenumhospital.com/about/lang.asp

http://www.youtube.com/watch?v=zJ1nEcQiwo4

http://www.globalpatientnetwork.com/blog/0805-sas8/

http://www.para-concepts.com/kirk/

13

The #1 Spine Fellowship in North America is St. John’s Spine Institute in Santa Monica, CA.

http://espineinstitute.com/handler.cfm?event=practice,main&nid=4223

I dealt with USC Neurosurgery, Cedar Sinai, & others and the top experimental surgeon in CONUS is Rick Delamarter at St. Johns.

These guys saved my live, literally. Broke my back in 2 places and blew 2 discs and no one could help me. Bedridden for 4 YEARS! I won an IDPA State Championship one year after surgery. Shoot 3 Gun now and am an avid ice climber. It took me searching for the right guy. Some body can fix you.

I’ll be praying for you!

14

No apologies needed by you Trapper.

15

The problem with this is if you do not have 40k+ in your pocket, you are not able to afford to go over seas.

That, and who wants to recover from back surgery in a foreign hospital?

On top of that, a thoracic artificial discs may or may not be contraindicated due to the OP having a bone spur at that level?

Cervical Disc replacements are just now starting to be approved in the US depending on your insurance. Lumbar is as well, but more insurance companies are still waiting for research to stamp off if they will pay or not.

I will admit, i’ve never seen a thoracic disc replacement stateside.

16

Everyone has priorities. I’m a boring git, don’t drink, don’t smoke and as I’m married I don’t pay for booty so I don’t have any pointless expenses. To me if I had a level a high level of pain it would be worth having the op.

I have little pain with my own cervical disc but I had a check up a week back and was told I have partial loss of shoulder abduction and loss of right bicep reflex … thats the slide to having loss of right arm movement in some years to come - for my lifestyle that is not an option, I want to be the despatcher for my boy when he gets his wings in 9 years when I will be 60. So I will be talking with Mr. Visa if I need to.

Read the Stenum Clinic website. They have groups of Americans going over for the Op…so no one is alone. Like I said, the second week of recovery is in a Marriot where you can have company in the bed, it is their way of ensuring you are in the real world but close at hand. And, believe it or not, the natives are friendly in Germany and they have McBurger there.

Dunno, I’m not a surgeon. But it is worth talking to the clinic to see what is possible … MRI or X-Ray review along with a treatment plan is free.

And ask yourself why they will not sign it off. A disc kit for an Op costs $5000 and from the test study reports I have read surgeons expect the Op to run at $100,000 in the States.

Germany is the acknowledged leader in spine surgery and disc replacement. They kicked it off in the 80’s and have only got better.

Funnily enough, the M6 disc they use at the Stenum Clinic is made by an American Company in America.

Hardly surprising if they are only just kicking off with Lumbar and Cervical replacement.

We have two Docs in the UK that do the procedure. I would not use either of them because they have done the Op on less than 100 people each.

I read an article a while back on spinal surgery and the FDA time requirements for the approval of disc replacement surgery. One of the disc manufacturers ahd run 2000 training courses and sold juct over 2000 kits to surgeons … would you trust your spine to a surgeon that has the experience of one (1) whole procedure. I would rather go to Germany and see a guy who has done the procedure 2500+ times and was involved in the development of the procedure.

I spoke with a Doc in Germany and he told me that nowadays with disc problems they will invariably send the patient for a replacement as a standard treatment. The results are invariably better for the patient and cheaper fr the insurer as they do not need to pa for continual Physio or other care issues.

http://spinerevolution.com/documents/CharitePosterMedina..pdf

http://nymag.com/nymetro/health/bestdoctors/2005/11964/

17

It still doesn’t negate the fact that the average american household income in '05 was $45,000. You are in UK, we are over here across the Pond. Expense are quite different…

For a one level surgery it is $24,500 euros which is $35,000 american dollars. This does not include per the website:


Not included; your flight (destination is Bremen (BRE)), lodging for early arrival prior to admission to hospital, lodging for family members while you are in the hospital, and meals while at the hotel in Bremen.

Over seas ticket, 2 weeks of dining out, lodging for 2 weeks for family? - CONSERVATIVE estimate would be another $3000.

So I’d venture a guess those rolling over to Stenum are more than likely in the top 1% of society here in the US…

I have little pain with my own cervical disc but I had a check up a week back and was told I have partial loss of shoulder abduction and loss of right bicep reflex … thats the slide to having loss of right arm movement in some years to come - for my lifestyle that is not an option, I want to be the despatcher for my boy when he gets his wings in 9 years when I will be 60. So I will be talking with Mr. Visa if I need to.

Im sorry to hear about your deficits.

The loss of shoulder abduction (C5 Nerve root palsy) is a risk in ANY anterior cervical procedure unfortunately. The C5 nerve root is extremely short compared to its others in the brachial plexus, and stands to be injured quite frequently.

Rarely is 100% total loss of arm movement seen.

Read the Stenum Clinic website. They have groups of Americans going over for the Op…so no one is alone. Like I said, the second week of recovery is in a Marriot where you can have company in the bed, it is their way of ensuring you are in the real world but close at hand. And, believe it or not, the natives are friendly in Germany and they have McBurger there.

Im aware of the Stenum Clinic and what it offers.

And ask yourself why they will not sign it off. A disc kit for an Op costs $5000 and from the test study reports I have read surgeons expect the Op to run at $100,000 in the States.

Germany is the acknowledged leader in spine surgery and disc replacement. They kicked it off in the 80’s and have only got better.

Funnily enough, the M6 disc they use at the Stenum Clinic is made by an American Company in America.

No argument there. The FDA and insurance companies are doing what they do best, dragging their damn feet.

18

Derek, Deficit, LOL. First time I’ve heard it called that.

To be honest I have not noticed a difference which is why I get the expert to check me over every couple of years. Mine’s at C6/C7 and I don’t want to lose any more movement than I need to.

We ain’t all millionaires this side of the pond you know. Just hard working folk trying to make a living and provide for our families as best we can. But at the end DMR, like myself, has to decide what he wants to do in the way of treatment.

It does’nt cost that much to visit “The old country” especially if you watch out for airline offers and the like. But I give you that it would probably cost around $40K total.

The Stenum site has some info about American Insurance providers and I know that more than a few have actually parted with the money for the procedure. You need to build a decent cost benefit analysis model for them to show them how much cheaper it would be to be able to have the treatment than not. Yes, yes I know it sounds simplistic but if you complicate things they tend to get even more complicated.

Your insurers are like our wonderful National Health Service:rolleyes:, as long as it is cheap it is provided. The disc replacement was signed off in Germany back in the 80’s, France and Belgium in the 90’s and here in the UK around 2 years ago. They have all been thru the same crap that the FDA is putting the discs thru at the moment. Interestingly, I said above, that here we have two doctors that can do the procedure … thats it, two that our glorious Health Service have paid for to be trained … train too many then where would we be, people would want the operation and that would cost money.

DMR, mate, all I can say is … if you can swing it, do it.

19

do Yoga. :smiley:

20

The right exercise(s) is the key. See a physical therapist.