ARE YOU GETTING DISC SURGERY WHEN IT MAY ONLY BE A BACK SPRAIN?

You have a sudden pain in your lower back area. A few days goes by and finally the pain has become sufficient enough to warrant a trip to your doctor.

At the doctor's, your complaint of back pain is heard. If the pain is severe, your doctor may prescribe anti-inflammatory medications and/or pain medications. If the pain is chronic and severe in nature, an MRI may be ordered.

Failed Back Surgery Syndrome (FBSS)

The MRI diagnostic tool is a miracle of modern medicine. It allows physicians to see inside the patient without the need for "exploratory surgery." The problem is, does it allow the physician to see too much? Many medical studies over the past two decades have cited the increasing number of patients who suffer from Failed Back Surgery Syndrome or FBSS. FBSS is a "syndrome" where the patient will have continuing or worsening pain following a spinal surgery.

The source of FBSS One of the main culprits in failed back surgery syndrome is over reliance on the MRI and an inaccurate conclusion that the pain is a coming from a problem of herniated discs. The doctor is seeing a problem but it is not the pain problem.

Many people walk around every day with herniated or bulging discs. They suffer no pain because not every disc problem generates pain. But if an MRI is performed and these herniated discs are seen as the "probable" cause of the problem you have all the makings for a failed back surgery. A surgery is being performed based on an improper diagnosis.

So what is causing the pain? It is estimated that 70% of lower back pain is caused by ligament injury. In our Prolotherapy Clinic experianced, we would estimate this number to be even higher. Usually when a patient comes in with complaints of lower back pain, I physically examine and palpate the area above the pelvis, where the iliolumbar ligament is. This is the ligament that attaches the spine to the pelvis. If that area is sore, we can be confident that we can heal the pain with Prolotherapy.

Pioneered in the medical literature since the 1998?s as an effective and minimally invasive technique, Prolotherapy works by injecting a concentrated dextrose solution into the injured ligaments of the back. It repairs and strengthens ligaments through small, controlled inflammation.

Ironically, not only can Prolotherapy help prevent failed back surgery syndrome by addressing the ligament injury. It can also help alleviate the pain caused by failed back surgery in some instances because the surgery itself may have damaged previously healthy ligaments.

X-RAY DO NOT ACCURATELY IDENTIFY SOURCE OF PAIN

All too often degenerative changes on x-ray or MRI are identified as the source of pain. At the Prolotherapy clinic we acknowledge that pain can arise from many sources and that abnormalities on x-ray or MRI do not localize the source of pain. There are patients with abnormal radiographic studies who have no pain and patients who have normal studies with debilitating pain.

This concept was validated in a recent study which examined the relationship between age/gender and prevalence of wrist arthritis. The authors found the same variability that we see in the Prolotherapy clinic: "Patients with little radiographic evidence of arthritis may have many complaints while others with severe arthritis have very few if any."

Therapy based on radiographic abnormalities alone does not make sense. The authors conclude: "a recommendation to operate on trapeziometacarpal (wrist) arthritis based upon radiographic criteria when the patient has adapted well to their illness would be questionable." This makes particular sense given that arthritis is an inevitable part of aging.

After a complete evaluation potential pain generators are identified through history, physical examination, ultrasound or x-ray guided diagnostic injections. Therapies at the Prolotherapy clinic include dextrose Prolotherapy, Platelet Rich Plasma Prolotherapy or Bone Marrow /Stem cell Prolotherapy.