For years, when describing my back issues, I mixed up the terms bulging disc with herniated disc and vice versa. It wasn’t until a neurosurgeon corrected me that I learned that though both conditions deal with disc impingements, each was a separate problem with separate solutions.
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.
With the rise of podcasts as a platform for free-flowing dialogue and discussion, Here’s some of the most informative and enlightening conversations with doctors and medical professionals about the various types of back pain ( conditions / injuries), treatments and new medical advances in spinal care.
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.
In a previous post I listed the seven most famous professional athletes to undergo back surgery, and as a followed up I’d like to shine a spotlight on the struggles of Tiger Woods, and his recovery from the crippling backpain that has sidelined his illustrious career.
Here’s a timeline of the spine procedures he has undergone:
April 2014 — Back surgery No. 1: Woods undergoes his first back microdiscectomy to repair a pinched nerve that forces him to miss the 2014 Masters.
September 2015 — Back surgery No. 2: After playing in the Wyndham Championship, Woods undergoes his second microdiscectomy to remove a disc fragment that was pinching his nerve. “I’ve been told I can make a full recovery, and I have no doubt that I will.” Woods is forced to miss the Frys.com Open, Bridgestone America’s Golf Cup and his own Hero World Challenge.
October 2015 — Back surgery No. 3: Woods has a follow up surgery to his September microdiscectomy. From all accounts the minor procedure is a success.
April 2017 — Back surgery No. 4: Woods withdraws from the Dubai Desert Classic in February and announces that he will undergo spinal fusion surgery in April leaving doubts he will compete in the 2017 Masters. The surgery involved removing the damaged disc and re-elevating the collapsed disc space to normal levels. This allows the one vertebrae to heal to the other. The goal is to relieve the pressure on the nerve and to give the nerve the best chance of healing.
May 2017: Woods is arrested in Jupiter, Fla., on suspicion of driving under the influence. In a statement, Woods says alcohol was not involved and he had “an unexpected reaction to prescribed medications.” It’s reported that Woods had 5 active drugs in his system upon his arrest. “The report, prepared by the Palm Beach County Sheriff’s Office, says Woods, 41, had THC, the active ingredient for marijuana; as well as the painkillers Vicodin and Dilaudid; the anxiety and sleep drug Xanax; and the anti-insomnia drug Ambien in his system when he was arrested at 2 a.m. on May 29 about 15 miles from his home in Jupiter”.
The stiff, aching and often burning sensation in my lower spine started in my late twenties and ten years later, when I had my first MRI, it was clear that Degenerative Disc Disease was one of the root causes of my lower back pain.
It’s said that as many as 80% of healthy adults experience some sort of back pain between the ages of 30 and 50, however Degenerative Disc, the loss of fluid in the discs between each vertebrae are padding for the spinal column, and without them every step can send shockwaves through the spine, making healthy living a real challenge. Age, poor posture, and injury can weaken discs between vertebrae, causing tearing along the disc walls.
To treat DDD, many medical specialists first recommend conservative, non-surgical treatments such as physical therapy or chiropractic treatment in an effort to stretch the space between discs and relieve the pressure on surrounding nerves. Manual manipulations on a decompression table can lift and separate discs to ease the strain on the lower back and some doctors may also recommend non steroidal anti-inflammatory drugs to reduce the burning sensation that often builds up when there’s no separation between vertebrae caused by collapsed discs.
Surgical options to reduce the pain of DDD include:
Discectomy: the surgical removal of herniated disc material that presses on a nerve root or the spinal cord. The procedure involves removing the central portion of an intervertebral disc, the nucleus pulposus, which causes pain by stressing the spinal cord or radiating nerves.
Laminectomy: surgery that creates space by removing the lamina — the back part of the vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.
Spinal fusion: a neurosurgical or orthopedic surgical technique that joins two or more vertebrae. This procedure can be performed at any level in the spine (cervical, thoracic, or lumbar) and prevents any movement between the fused vertebrae.
Lumbar Total Disc Replacement: With artificial disc replacement, pain relief is brought about by removal of the painful disc and motion is maintained with the use of a prosthetic implant made of metal (with or without a plastic bearing surface). This is more similar in theory to the artificial hip, knee, and shoulder joints that orthopedic surgeons have been using for more that 35 years to maintain motion and relieve the pain of arthritic extremity joints. However, there is a significant difference in that only one of the three joints that are present at each vertebral level is being replaced, whereas a hip or knee joint the total joint is replaced.
In recent months, restorative types of treatment have emerged to repair damaged vertebrae discs.
Mesoblast Cell Therapy: All therapies for progressive, severe and debilitating pain due to degenerating intervertebral discs treat the symptoms of the disease, but are not disease-modifying and thus do not address the underlying cause of the disease. This type of treatment involves a single intra-discal injection of 6 million MPCs resulted in meaningful improvements in both pain and function that were durable for at least 36 month. For more information regarding this new therapy, please check out this link.
Platelet-Rich Plasma Therapy: A clinical study of 49 patients who underwent intradiscal platelet-rich plasma (PRP) injections for low back pain found significant improvements in pain and function through two years of follow-up. Dr. Gregory Lutz, Founder and Medical Director of the Regenerative SportsCare Institute, and Physiatrist-in-Chief Emeritus, Hospital for Special Surgery, presented the two-year results at the Interventional Orthopedics Foundation’s Annual Conference in Broomfield, Colorado last month.
It’s also worth mentioning that a recent publication in the New England Journal of Medicine revealed that ‘patients with degenerative spondylolisthesis and spinal stenosis treated surgically showed substantially greater improvement in pain and function during a period of 2 years than patients treated nonsurgically’.
For simple, home-use products, Dr. Dan Perez outlines a few options and the advantages / disadvantages of each:
Here’s a video describing What Degenerative Disc Disease Is, Causes, Symptoms, Treatments
Other Resources:
In May of 2015, the Sciatic pain down my left leg was so intense that I couldn’t get out of bed for three weeks. I had surgery for a herniated disc (the root cause of Sciatica) at L4/L5 in June of 2015, and here’s an update a year and a half later.
As spine treatment centres pop up in my city, I’ve noticed that many of these facilities (usually run by chiropractors), offer Spinal Decompression Therapy to relieve pressure on herniated or degenerative discs.
The basic premise of SDT involves laying on some sort of traction table, hooked up to a computer with electronic pulses stimulating certain muscle groups. By taking pressure off the disks, which function like gel cushions between the bones in your spine, the bulging or herniated disks can retract, taking pressure off nerves. With less pressure, the spine can move more freely increasing the movement of water, oxygen, and nutrient-rich fluids which promotes healing.
