Failed Back Surgery

From our radio show

Caller: I am 58, played a lot of sports and have some pain, mostly sciatic pain with a little tingling down my leg. I spoke to some orthopedists and I think they are a little quick to operate. Is there something I can do to make the pain a little less?

Dr. Darrow: Studies now show that four or five years after back surgery, people do not feel any better than before they had the surgery. In our clinic we find a lot of people with “Failed Back Surgery” feel worse than they did before the surgery. I never recommend back surgery unless they have such traumatic problems, like progressive neurological problems. It is not something that I would consider telling the patient to do because of the pain.

Most back pain, believe it or not, is caused by sprained ligaments. When we examine the iliolumbar ligament, the ligament that attaches the L-4 and L-5 to the pelvis we find that there is just a superficial sprain that is radiating down the leg. Prolotherapy would be a good thing, sometimes traction; spinal decompression would be a good thing to do. Sometimes it resolves by itself.
 

Epidurals

From our radio show

Caller: I have had back pain for some time, the pain radiates down my legs, I have had three epidurals and cortisone shots but without any relief, where do I go from here?

Dr. Darrow: The fact that you had three epidurals is a good sign because that means that the pain is not from an inflamed nerve. It is probably a ligament in the low back, most likely the iliolumbar or sacroiliac ligaments. These ligaments can refer pain down the legs and look a lot like a sciatica problem but is really not sciatica.

In all the new patients we see each month, I would say that 25% of them come in and say that they have been diagnosed with sciatica, most of the time it is not, but sciatica is such a common term for back pain that radiates down the leg that it gets used.

On examination we find the “sciatica” problem to be those ligaments mentioned or a bursitis or it’s the iliotibular band, the connective tissue side of the leg from the hip to the knee that gets irritated.