Discectomy Pain

Author - discpain

Failed Back Surgery Syndrome (FBSS): What Is It?

Failed back surgery syndrome (or failed back syndrome) is a general term to describe an unsuccessful back surgery. These patients continue to feel pain after they’ve had a surgical spine procedure and can experience a wide range of symptoms which may include chronic pain in the back, neck, or legs, which could be either dull or sharp, aching, tingling, burning, or radiating. In my case, it was  a buildup of scar tissue around spinal nerve roots which caused a a considerable amount of discomfort around the surgical area.

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7 Famous People With Bad Backs

So…in a moment of self-pity, you googled ‘famous people with bad backs’ and this blog-post popped up.  It’s completely understandable. Many of us want to feel like we’re not the only ones going through this –  and in some strange way, knowing that President John F Kennedy had a horrible spine condition helps us realize that perhaps we can also accomplish great things despite days when we’re hunched over like Quasimodo.

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Total Disc Replacement Surgery

Like many people reading this blog, along with bulging discs and Spinal Stenosis, I have Degenerative Disc Disease.  It’s hard to pinpoint exactly how this contributes to my overall level of chronic pain, but generally speaking, DDD causes a lot of stiffness and instability.  I wake up with an achey lower back, and spend most of my day trying to minimize the amount of bone on bone (vertebrae – L5/S1) pounding it takes.

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Cannabis: Can It Reduce Back Pain?

To answer the question simply, yes.  In my experience when used responsibly, cannabis particularly CBD oil, can reduce back pain especially  neuropathic pain.  However, it’s extremely important to consult a physician before consuming any form of cannabis to better understand it’s unique properties.

So here’s a quick primer on two of the main active ingredients in marijuana and the affects they have on the brain and body:

THC (tetrahydrocannabinol): This chemical compound is responsible for the psychotropic effects that most people associate with marijuana use.  Apart from the ‘high’ that’s so often mentioned by recreational users, THC is reported to have several medical benefits such as treatment for depression, bi-polar disorder, anxiety and various other mental illnesses.  However, some in the medical field believe that more research is required to fully understand the overall effectiveness that THC-cannabis has on the brain, but early indications seem promising.

CBD (Cannabidiol):

Cannabidiol, is the non psychotropic chemical compound which may down regulate disordered thinking and anxiety, and seems to have some benefits with opioid addiction by blocking neurotransmitters in the brain.  Since CBD does not share any of the same psychotropic effects as THC, patients don’t feel ‘stoned’ and can continue with daily activities that require clear thinking.

CBD also acts as an anti-inflammatory and has been used to combat nausea from certain cancer treatments. The compound is already being used to treat arthritis and mood disorders, as it’s been shown to lift mood through increased serotonin levels as mentioned by Dr. Michelle Ross, here, and in this video which outlines 13 studies that link CBD to lower rates of depression.

But returning to the original question:  Has medical cannabis use helped with my back pain?

Yes, it has however…the effectiveness greatly depends on the variety and potency of the cannabis.  As cannabis becomes decriminalized in many states and countries around the world, more producers are entering the market which has created a wide variety of products.  This in turn, allows back pain sufferers who are also medical marijuana patients,  to have greater access and control over how they manage back pain through somewhat custom solutions.

For example, if you’re looking for strict pain control because of inflammation, with no psychological effects, a high in CBD/low THC oil would work best.  However, if you’re also looking to lessen the stress, and anxiety caused by chronic pain, then a more balanced CBD/THC mixture could be helpful.

Let’s have a look at this video by Dr. Rachna Patel who supports the research done on the anti-inflammatory properties of CBD:

Here’s an actual example from a registered cannabis grower, showing how medical marijuana, through careful scientific precision, allows patients to have much more control over the THC / CBD combinations.  Traditionally, strains between producers did not have this level of consistency which meant that as a consumer, you didn’t quite know what you would be consuming and how your body would react.

In this short clip, Dr. Gina Berman provides a quick breakdown of how THC and CBD work together to decrease the ill effects of the opiate withdrawal process.

As always, check with your health care expert before attempting these exercises to prevent further injury…and take care.

 

Stu McGill’s Big 3

I first heard about Stu McGill on a podcast about the rehabilitation of high-performance athletes.  He was describing how some world class performers trained to get back into top form after injury.  He was reaching peak academic nerd-speak with ‘muscle activation’ this, ‘motor pattern development’ that, when he mentioned his “Big 3” for the everyday back pain sufferer.  My ears perked up as he distilled all physio stretches into just three simple exercises.

As a professor and researcher at the university of Waterloo (Canada), McGill is an expert in the field.  At his Spine Biomechanics Laboratory, he focuses on a few core objectives involving how the back functions, how it gets hurt, and how to fix it and prevent further injury.

The four quadrants of muscles that support the spine are the rectus abdominus at the front, the obliques at the sides and the extensors at the back .  As McGill states, ‘true spine stability is achieved with a “balanced” stiffening from the entire musculature’ within the load tolerance (pain threshold) of each individual.  The “Big Three” exercises strengthen these muscle groups and help to increase endurance during lifting, pushing or pulling.

Remember to never over-exert yourself doing these movements and if pain persists, please check with your physiotherapist to ensure that proper form is being used.

Stu McGill’s ‘Big 3’ Exercises 

1.  Modified Curl-Up
Laying on  your back, one knee is bent and one knee straight. Your hands are placed under the arch of your lower back and begin by bracing your abdominal muscles and bearing down through your belly. While keeping this brace, breath in and a breath out. With your spine in your neck and back joined together, pick a spot on the ceiling and focus your gaze there, lift your shoulder blades about 30° off the floor and slowly return to the start position.

2.  Side Bridge
Laying on your side, prop yourself up on your elbow with your elbow directly under your shoulder to avoid straining.  With your legs straight, place your top foot on the ground in front of your bottom foot. Place your top hand on your bottom shoulder – be sure that your upper body does not twist or lean forward, brace abdomen, squeeze through your butt muscles, and lift hips up off the ground. Hold for 8-10 seconds, repeat 3 times. As the exercise becomes easier, increase the number of repetitions as opposed to the length of time.

3.  Stirring the Pot
This exercise starts on your hands and knees,  with your hands shoulder width apart directly under your shoulders, and knees hip width apart directly under your hips. Brace through your abdomen and squeeze your gluteals. Ensure you can maintain this while you take a breath in and out. Lift your right arm in front until it’s level with your shoulder, squeezing the muscles between your shoulder blades as you do so. At the same time, extend your left leg straight back until it is level with your hips, squeezing your gluteals, and keeping your hips square to the floor. Return to the starting position in a slow and controlled manner, and perform the same action with the left arm and right leg. That is one repetition. Perform 3 sets of 8-10 repetitions.

 

 

McGill also advises full-time desk jockey’s like me, who have a ‘flexion intolerant back’ to not focus on range of motion with back exercises.   His Big 3 have just as much to do with which exercises you shouldn’t do, than with what you should do.  McGill makes us keenly aware “that the spine discs only have so many numbers of bends before they damage”.  In a nutshell, he bluntly states that it’s better to do less of the thing that’s hurting you, flexion in many cases, rather than take medications to treat a strained back, or worse, protruding discs.

As always, check with your health care expert before attempting these exercises to prevent further injury…and take care.

 

Firefly 2

Before I launch into the review of the Firefly 2, let’s begin with a basic question: why would anyone with backpain want to vape in the first place…?  Isn’t taking CBD oil enough to relieve inflammation and chronic nerve pain caused by degenerative, herniated discs?  One of the biggest reasons to vape is that it is the quickest way for cannabis to enter your system allowing for almost immediate pain relief from a more concentrated dosage.

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Pain After Discectomy Surgery

The most commonly searched term on this blog is “pain after discectomy”.  So I’ve decided I would dedicate a post to this topic based on my personal experience and some recently published articles and videos.  This is by no means an exhaustive search for all that ails us after a discectomy, but I’ll do my best to provide relevant information that can answer the most common concerns regarding the types of pain some of us experience after undergoing this procedure, and possible treatments.

A discectomy is the surgical removal of the whole or part of an intervertebral disc that is often pressing on a nerve root or the spinal cord.     The procedure is most often performed by a qualified  orthopaedic surgeon or neurosurgeon.

Inflammation: 

One of the most common issues after surgery is inflammation especially at the incision point. Even minimally invasive, arthroscopic surgery will irritate some tissues and nerves and during this process inflammation can persist.  Most physicians will suggest over-the-counter medication to control and reduce inflammation.  I was sore for about a week and as you can see here, there was still a bit of puffiness around the 1″ incision.

Epidural Fibrosis (Scar Tissue): 

Sometimes after a discectomy, scar tissue forms near the nerve root and can cause extreme burning or nerve pain even if the surgery was successful in relieving the initial pain.  This type of postoperative pain is commonly called failed back surgery syndrome because you’ve swapped out one type of pain for another.

As Spine Health points out “Scar tissue formation is part of the normal healing process after a spine surgery. While scar tissue can be a cause of back pain or leg pain, in and of itself the scar tissue is rarely painful since the tissue contains no nerve endings. Scar tissue is generally thought to be the potential cause of the patient’s pain if it binds the lumbar nerve root with fibrous adhesions.”

Numbness:

After my last surgery (discectomy at L4/L5), I experienced some tingling and general numbness in the areas where my Sciatic pain was the most intense (bottom tibia/ankle and toes).  Months later a EMG revealed that I had permenent nerve damage caused not by the surgery but by the constant ‘zapping’ of the Sciatic nerve, pre-surgery.  Those who have had Sciatica know the feeling of this type of excruciating nerve pain which most likely deadened some areas on my leg and foot.  Here’s several accounts of other patients going through similar foot/leg numbness.

Aches / Spasms: 

Post L4/L5 discectomy, as the nerves began to heal I had a mild ache in my leg around the site of the sciatic nerve shocks.  I was told by my surgeon that this wasn’t uncommon and was caused by the nerve trying to repair itself.  Massage therapy can help with the aches as muscles can sometimes tighten from being inactive and without any type of stretching may lead to issues such as piroformis syndrome.

Re-herniation:

Current research suggest that there is a 2-18% chance of re-herniation dependent upon the size of disc defect as well as other factors such as disc height, pre-surgery.  It is most likely to occur in the first few weeks after surgery, and it’s strongly discouraged to lift anything heavier than 3-5 pounds during this period.  As this research concludes, there are no hard and set rules that make it more likely for re-herniation, however my personal suggestion would be to not strain yourself within the first 2-3 weeks and when ease into a work schedule rather than full-time duties with no easing in preparation.  Post surgery is also a good time to re-examine your sitting posture and to explore other options for working at a desk.

 As always, consult a doctor if you are experiencing discomfort and take care.

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