Question
Hello. I have had three back surgeries at L5-S1. The first a discectomy, the other a lumbar fusion, and then the final an insertion of pedicle screws. The last surgery was Dec of 03. During that surgery, one of the screws severely damaged a nerve that affected my right leg, causing diminished sensitivity. I have recently suffered began suffering a great deal of pain in the localized area of my lower back, with some shooting pains down the right side. However I am more concerned about the fact that I have had increased spasms centralizing in my right calf, which last for anywhere to 30 seconds to 3 minutes. During these spasms, my right foot inverts and cannot be straightened until the spasm releases.

An MRI taken 27 July 06 basically indicates broad base disk protrusion at L4-5, and mild central protrusion at L3-4, both with mild facet arthropathy, but no neural foraminal narrowing or spinal stenosis, so nothing that shows any nerve impingement. My EMG is not scheduled for a few weeks. What could possibly be the cause of the actual back pain since there's no herniation? And, why might I be having these sudden spasms?

Answer
Dear Sheryl,

Your inquiry reveals the basic flaws in surgery as an approach to back pain.  There are two.

1)  Surgery does nothing to correct the underlying causes of disc problems, which is conditioned muscular contractions that pull neighboring vertebrae too closely together.  The "sandwiched" discs get compressed and protrude, sometimes impinging on nerves, as in your case, with symptoms that affect the extremities.

2)  All wounds (including surgical wounds) trigger a reflexive reaction to pain known as Trauma Reflex, in which muscles related to the area affected contract.  With back problems, that reaction can make the condition addresed by the surgery worse, involving previously uninvolved, neighboring areas.

After any corrective surgery, you should embark on a program of somatic education to gain enough control over the involved muscles to relax them.  Stretching won't do it.

With common back pain, the pain is the soreness of muscle fatigue in the back muscles.

Please see the articles on back pain at somatics.com/page4.htm.

with regard,
Lawrence Gold