Question
Hello,

I started having severe back pain in early 2002. I saw my internist, who ordered an x-ray. The x-ray showed something wrong with my L5-S1 discs, so I had an MRI done. The physiatrist I was sent to see told me that I had a "bulging" L5 disc and an annular tear in the L5-S1 discs.

He performed four or five medial branch blocks on me over 2 years, none of which lessened the pain. At the time, I was put on Percocet.

This past June, I had a supposed nerve ablation performed at a hospital with an excellent reputation on the West Coast of the US. It was a disaster. A resident performed the procedure; a needle was broken in my back, and my pulse went up to 174.

I am now on morphine and Percocet. The main symptoms I have are extreme lower back pain, which sometimes radiates down the back of my right leg, pain several discs higher, and difficulty walking, especially on stairs.

My family has found a new specialist on the East Coast. I have spoken with him this week, and he said to get a new MRI done since he felt the annular tear could not be causing such severe pain.

I'm wondering what you think. I have excellent health insurance, so it's not a problem to go somewhere else for treatment. My problem is getting the right treatment. Can an annular tear cause debilatating back pain? Or, could there be a bigger problem? I have severe osteopenia due to many years of anorexia.

Thank you for your help. I greatly appreciate it.

Answer
Hello, Kristen,

Whereas annular disc tears cause their own problems, the additional possible problem is this:  surgeries, and particularly those as problematic as yours, induce muscles to contract in a reaction known as Trauma Reflex.  It's a spontaneous common reaction to injury and pain.

When back muscles contract and stay contracted, the muscles themselves may hurt and nerves may get trapped, causing radiating pain and difficulty in movement.

Surgery can't correct that kind of problem and nerve ablations should not be done to try, as the nerve damage and loss of function are permanent and there is a better alternative that works most of the time.

Before going for a surgical fix, or even after, you must improve your control of the involved muscles to the degree of being able to relax them. The procedure is known as somatic education.  It's non-invasive and solves a host of problems.

Please see articles on back pain at somatics.com/page4.htm to understand your other option.

with regard,
Lawrence Gold