In the December 2017 edition of the medical journal Spine, doctors from the University of Pittsburgh and University Toronto reported these observations in patients seeking non-surgical treatments for lumbar spinal stenosis.
- Three themes related to medical treatment and symptom management arose from analyses –
- (1) an emotional response (depression, anxiety) to lumbar spinal stenosis;
- (2) a desire for education about lumbar spinal stenosis and motivation to pursue education from any available source; and
- (3) a desire for individualized care based on self-management techniques and lifestyle changes.
- Emotional responses were more evident in individuals receiving medical care, while the other two themes were consistent across all 3 treatment groups.
Many times a patient will come into our office with a nondescript diagnosis of back pain and/or accompanying hip pain. Despite numerous treatments which may include epidural steroid or cortisone injection, the patient still has pain and now has been recommended to a spinal procedure because something has shown up an an MRI. But is it in fact the disc problems on MRI causing the pain? Medical investigators are asking, “maybe we should look at the spinal ligaments?”
We receive many emails from patients who have undergone numerous spinal procedures. The question they all ask is: “Can you help?” Because of the complexities of spinal surgery, especially in patients with numerous procedures, this question must be answered following a physical examination and consultation where realistic healing options can be discussed.
Doctors in Australia wanted a better understanding of what goes through a patient’s mind when they have chronic back pain, specifically what they think their chances are for a recovery.
I am going to get to that research later in this article. First I want to help describe what is going through our patient’s minds when they first reach out to us about bone marrow derived stem cells and platelet plasma rich treatments and their potential for healing. (more…)
Epidural steroid injection is the most frequently performed pain procedure. It is becoming clear that epidural steroid injections for various spinal conditions are best used for a patient who is in pain and waiting for back surgery. If you have decided that you are getting a spinal surgery, then an epidural may be the procedure you want prior to surgery.
Let’s look at two studies, five years apart, from the same learning institute. The research concerns pain and fear of movement following spinal surgery.
From 2011: Patients with back pain have many concerns and fears when it comes to being able to move pain-free. Surgery is supposed to take care of this fear. Researchers from the University of Gothenburg, Sweden followed 97 patients after their spinal disc surgery looking for a post-surgical occurrence of kinesiophobia “fear of movement,” a tell-tale sign of unsuccessful back surgery. What they found was surprising.
- Half of the patients suffered from kinesiophobia 10-34 months after surgery for disc herniation.
- Prior to surgery these patients were already classified as more disabled, had more pain, more catastrophizing thoughts, more symptoms of depression, lower self-efficacy, and poorer health-related quality of life than patients.”1