Learn about sciatica

[mdmrcog]

I found this book on www.ebook.com and www.amazon.com titled "Say Goodbye to Back Pain" by Dr. V. Ranjan. It is easy to read and gives a wealth of info. More importantly, you can avoid treatments that will worsen the condition and know exactly when surgery is required. My back pain has disappeared without surgery after reading this book.

[admin]

Hi mdmrcog,

welcome to the back pain forums.

Please could you give some examples of the sorts of information that the book provides.

Thanks

[mdmrcog]

Back pain does not mean surgery

Just because you see your physician or orthopod does not mean surgery. Even if you have severe back pain it does not mean that you need surgery. Surgery has been found to be helpful in only 1 in 100 cases of low back problems. Patients with acute low back pain alone rarely benefit from a surgical procedure. If the only symptom is back pain, surgery may do more harm than good.
This is why we need some sort of indicators for surgery. These indicators are known as “Red Flags” and tell us that surgery must definitely be done if permanent damage is to be avoided and that the benefits of surgery far outweigh the complications that may arise due to the procedure.
Let us find out more about what these “Red Flags” are.

Red Flags
Findings on the history and physical examination that raise suspicion of serious underlying spinal conditions that may require surgery are known as red flags.

Basically we are looking for evidence of nerve irritation or compression that is causing one or more of the following:

1. Difficulty in urination or loss of bladder and/ or bowel control
2. Saddle anesthesia – numbness around the genital area and buttocks
3. Numbness/ tingling in one or both feet/ toes
4. Difficulty in moving the ankle upward or downward or raising the great toe
5. Gait disturbance – difficulty in walking
6. Changes in reflexes in the legs (this can be detected by the physician).

If you have one or more of the above symptoms you definitely have a pathological cause that may need surgery. The timing of surgery will depend on how severe the symptoms are.
Conditions that can cause severe nerve compression and damage producing one or more of the above symptoms are:

1. Spinal stenosis caused by severe osteoarthritis, osteoporosis, spondylolisthesis, inflammation, or a herniated disc which decreases available space for the spinal cord, thus pinching and irritating nerves from the spinal cord
2. Cauda Equina syndrome
3. Spondylolisthesis caused by stress fracture of vertebrae
4. Vertebral compression fracture due to osteoporosis
5. Severe sciatica caused by:
a. Prolapsed lumbar intervertebral disc
b. Osteoarthritis of the spine
c. Spondylolisthesis – lumbar or isthmic spondylolisthesis
d. Tuberculosis of the spine
e. Piriformis syndrome
f. Tumors of the spinal column – including secondary malignant deposits
g. Tumors of the spinal cord or cauda equina
h. Tumors of the sacrum or ilium
i. Pelvic tumors

The opposite is also true. IF THERE ARE NO RED FLAGS, SURGERY IS NOT REQUIRED.
Do not be impressed by an orthopod who says that you have a major disc prolapse or that your osteoarthritis is in a late stage. As long as you do not have any of the symptoms listed above, surgery is ruled out. You then come under the category of “Pathological cause but no Red Flag” for which conservative measures are sufficient. We shall discuss these measures in a later chapter.

Summary – Red Flags

If this is your first episode of severe back pain, YOU NEED TO SEE YOUR DOCTOR FIRST to find out if you have a pathological cause for your pain. Your doctor or orthopod should be able to assess from your medical history and clinical examination whether any investigations are necessary to identify a pathological cause. Watch out for “RED FLAGS” as these indicate nerve compression that may require surgery. You, and not your doctor, are the best person to identify Red Flags since almost all of them are symptoms that you may experience. We shall consider in the next chapter the appropriate surgical treatments for the different conditions listed above when red flags are present.

Extract from "Say Goodbye to Back Pain" by Dr. V. Ranjan.

[Back Pain Doctor]

I also have a free back pain remedy handbook here that you can download at: http://free.backpainsupport.org/. Try to visit this site.