From: Arthur.Saus@p160.f72.n376.z1.fidonet.org (Arthur Saus)
Newsgroups: misc.handicap
Subject: Conservative treatment
Date: 21 Jul 92 15:59:21 GMT
Reply-To: Arthur.Saus@p160.f72.n376.z1.fidonet.org
Organization: FidoNet node 1:376/72.160 - Windows of the Worl, Columbia SC

Index Number: 23206

[This is from the Chronic Pain Conference]

Hello Linda!

13 Jul 92, Linda Cummings writes to Jocelyne Dever:

 >> One problem
 >> is at the L4-L5...a herniating disk causing nerve compression
 >> (surprise, surprise! <g>) and is the cause of the pain in the left
 >> leg.

 LC> Stop gloating!  This time, I'm sorry I was right.  No mention of surgery
 LC> to do a laminectomy?  Humm...

 >> The other is at the S1-S2 which he says is probably the old
 >> problem reactivated (discotomy and laminectomy in '85 at L5-
 >> S1)...how that affects the S1-S2 I am not too sure <puzzled look>
 >> and that is causing the pain in the right leg.  The other
 >> overriding problem apparently is that I have spinal stenosis or
 >> narrowing of the spinal column as the GP explained.

 LC> Well, maybe Arthur might chime in here, but it could be that the S1-S2
 LC> surgery weakened the area and now you're having problems around that area
 LC> because of the weakening.  Narrowing of the spinal column?  Hey
 LC> Arthur...is this the degenerative disk disease?

Well, that is one possible explanation, but there are others that
are equally possible if you understand the anatomy.  The L5-S1 and
S1-S2 nerves pass through the L4-L5 spinal canal before they reach
their respective levels.  It is certainly possible that a problem
at the higher L4-L5 area can affect any nerves at a lower level.

It's the same reason that neck fractures can be so dangerous, since
the nerves that go to virtually ALL the rest of the body below the
neck, first have to pass through this area.  Problems at any
specific area of the spine can affect any or all of the nerve
levels below that area.

 >> I don't mind the tens but I have had many
 >> excrutiating experiences with ultrasound in the past and will not
 >> risk it again.  The physio swears that it can't hurt but when she
 >> would rub it over parts of my legs or hips where the pain was
 >> really bad it was like chewing on a piece of tinfoil when you have
 >> a cavity in your tooth.  The pain was the worst I have ever
 >> experienced and I would have absolutely no warning when she would
 >> hit a sensitive spot.

 LC> I've never heard of anyone experiencing this.  It always felt pretty good
 LC> to me.  You're wierd!  [grin]

Other conditions such as trigger points can also cause these
symptoms.  Maybe there's more to it than just being wierd [grin]!

 >> After all this he finally got to the main recommendation of the
 >> neuro and that is that the only treatment that will really help is
 >> for me to lose weight.  That really upset me and made me quite
 >> depressed.

 LC> <snip>

 >> would probably never lose it at my age (47)!  So what do you and
 >> anyone else feel about this?  I can't be the only overweight
 >> person with  back problems but I was made to feel that I *CAUSED*
 >> it, that it is my fault.  Seems like an easy answer for them and
 >> very hard for me to defend or argue against!

I doubt this was intended to be upsetting, depressing, or what ever
other adjective you want to use to describe it.  The fact is that
additional weight appears to be associated with back pain
problems.

Look at folks you know who have back pain problems, or look at
messages on this echo about back pain.  Usually you will find it is
more likely to be a problem for folks who are overweight, although
certainly not always.  Similarly, look at thin people and you will
find it is not as likely that they will have back pain problems.

Although there is not a cause and effect relationship between back
pain and being overweight, the two do seem to be associated.
Therefore it also seems that losing weight puts someone into a
group where back pain is not as likely to be a problem.  A
recommendation to lose weight, although it may indeed be very hard
for an individual to do, becomes an important one for effective
therapy.  It's far more than just "an easy answer".

Arthur

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