Jolie Bookspan, M.Ed, PhD, FAWMExercise and Fitness
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Cauda Equina - Result Not Cause

Jolie Bookspan, M.Ed, PhD, FAWM

Bernie, age 80, promised in December he would dance at his daughter's upcoming wedding in
Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part I.

Part II of Bernie's story looked behind the scenes of how we fixed the source of the pain, step-by-step.

The promised dance is at right.

The point of the two posts was that the key is to fix the source of pain and injury, not just have surgery, take medications, and do some exercises. The posts also showed things to do to fix the causes so that readers could do it too.

A reader wrote an opinion in the comments of Part II, that Bernie's signs and symptoms were of Cauda Equina Syndrome (CES), and felt cauda equina was important for readers to know about.

The problem is that cauda equina is not the cause of the collection of back and leg pain and numbness problems, but the result. The cauda equina is a group of nerve roots of your lower spine that go down toward your feet. The bundle of stringy nerves looks like the tail (cauda) of a horse (equina). If something hurts or presses on the area, pain and numbness can result. It is just saying something wrong has resulted in that location. The key is finding and stopping the cause of what is hurting or pressing on the area, not taking medicines or having treatments.

It is like saying someone has stomach pain, and prescribing pain medicines and support groups. The pain could be worms, a pregnancy, a lack of enough stomach acid to digest food. You need to know the cause to do the right treatment.

For example, if a herniated disc is compressing the cauda equina, you need to stop pushing your disc out of place, described in Disc Pain - Not a Mystery, Easy to Fix and use daily simple good body mechanics instead of the bad bending that gradually push discs outward - The Cause of Disc and Back Pain. Then the disc and nerves can heal and the pain will stop without drugs or back surgery.

The reader asked me to review a web site. The web site they recommended lists treatments of drugs such as narcotics and antidepressants, and epidural injections. It mentions exercise to maintaining muscle strength in leg areas that have weakness from nerves that are compressed. This is like trying to catch blood loss in a bucket instead of stopping the blood loss at the source. The web site says sufferers with foot drop can use a brace. Instead of using a brace, which can cause more atrophy, it is better to stop the cause of the foot drop, where possible.

Fitness Fixer reader Ivy from New Zealand had foot drop from nerve compression. She stopped the cause, detailed in Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier. By stopping the cause of the nerve compression, Ivy did not need the brace or cane. It is not healthy to allow nerve compression to continue. Muscles and nerves become more damaged over time. A brace or cane does not restore function. They can further cause bad gait and body mechanics.

Bernie had many injuries from the surgeries he had undergone for the purpose of relieving back pain. In addition, the back surgery deliberately resulted in some reduced movement of the spine. Many back surgeries do this on the premise that reducing movement will reduce pain. The reduced movement meant reduced function and mobility, resulting in more pain.

The cauda equina web site says, "We live with CES every day." The approach of The Fitness Fixer is not to live with an injury or take unhealthful drugs, but to find the cause and stop the cause so that you do not have to live with pain and drugs.

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Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II

Jolie Bookspan, M.Ed, PhD, FAWM
In Part I of this post on Monday, photographer Bernie tells of fixing years of pain that doctors told him only surgery would fix, even after three surgeries. Here is a look "behind the scenes."

10 March 2005, Bernie e-mailed me:
"I've had this persistent paresthesias for 4+ years. I just learned about you yesterday. Where are your back & spine classes held. Tomorrow, I'm having lumbar myelogram & CT at (top name deleted here) Hospital. Before I consider anything else, I want to learn about your methods."
I wrote back with class information. I had two classes coming up. One was the next month. The second would be in early May and only a few blocks from where he lived. I told how we work to see change in pain right in class. I asked him to let me know the test results and that I hoped to see him in class.

20 March 2005 he wrote back:
"Thanks for asking, I never expected you to keep in touch. The myelogram and CT showed moderate central spinal stenosis at L4-L5. Severe facet joint arthropy & hypertrophy of ligamentum flaxa causing compression of the lateral recesses stenosis of L5 on both sides, kinking of L5 nerve root sleeves on both sides. I have a copy of the xray, showing the "hourglass" at L4-L5

"(name deleted) is the attending, 3-B Orthopaedics. He said the next step is surgery, by ( ), at ( ) Hosp. I asked if strengthening of my upper body would help support my spine. He said "try it" so I'll be at physical therapy next week to start.

"I have a commitment for the weekend of April 2-3 so can't attend that class, much as I'd like to. Since I live at (close to) your class at Temple CC is my best chance of attending. Cordially, Bernie Cleff"


I checked back in to make sure he was signed up for the May class and to ask what he was doing in Physical therapy. He wrote:
29March 2005
"The phys therapy that I'm getting concentrates on my core muscles. Thanks for getting in touch...very kind of you."
I wrote back saying that conventional core exercises were not the best thing. Usually they are forward bending actions that will further compress the discs, the nerves, and also do not retrain the abdominal muscles in the way they work when you go about daily life. Strengthening does not automatically support the spine. I wanted to make sure that he had my Ab Revolution book, which was then out in a training manual version. He said he had it with him for PT. (I found out two years later that they had the book, but they were not using it, and were doing traditional forward bending abdominal exercises.)

10 May 2005, the day after the Fix Your Own Back Pain workshop was held, Bernie wrote me,
"Hello, I did sign-up for your class at TUCC on Monday 5/9, but I was too tired to attend. On top of that, I am scheduled for spine surgery at ( ) on Wed 5/11/05, with ( ). After having 2 epidurals and physical therapy I decided to go for the surgery. My nerve that is pinched is in the shape of an hourglass (at L4- L5) and (the doctors told him) that no body position or exercise changes are going to help at this time. Both legs are numb and I am walking like a drunk. It is kind of you to keep in touch. I hope to meet you at your fall class."

Days later, Bernie had the surgery. He tells about it, and his next two years, in Part I of this story. The doctors all considered his surgery a "complete success." They said the surgery went completely according to plan, with no complications. His recovery was in line with expected results. The fact that his pain returned, was worse, and complicated by limited movement from his plates and screws and other surgical hardware not a factor to them. They felt the limited movement was beneficial and a goal of the surgery. The commonly held idea is to stop motion in the area to stop the pain.

In late October of 2007 arrived to teach the Fix Your Own Back and Neck Pain Workshop. I had 16 people waiting for me. One was Mr. Bernie Cleff, a funny white-haired muscular man of 80, who was in much pain.

We had a fun, energetic class. One of the students was a young man from India. He sat unsmiling as I mentioned various yoga poses that can injure discs in the neck. I tried to ease the class explaining that I am not against all yoga, and studied years to become a teacher myself. He sat unsmiling. We did three specific techniques to stop the neck pain process and a beautiful smile radiated from the young man from India. He had three herniated discs in his neck, most likely from his yoga practice of the specific moves I had mentioned, together with sitting badly at a computer for his work. He already knew those yoga moves hurt his neck. He had just been worried the pain would never stop. When it did, right there in class, he smiled.

Another of the students was a golf pro. Who I consulted with afterward to test out my work on lower back pain and golf. More on this to come.

Mr. Cleff did great in the first class. This class was done over two weeks. I gave the class things to try over the week before the second and last class.

Oct 25 2007 he wrote me:
"Today (Thursday) is my class day at The Clay Studio, working over the wheel for 5 hours. I felt good with very little noticeable pain. Usually after walking the 5 blocks from my home to the studio both my legs would tingle badly and I would stop to rest halfway. Not today. When I told my classmates about you phoning me to ask how I was doing with your exercises & stretching, they could not get over your caring. None of us had ever had a Dr. call to check-up. You are one hellova person and I'm thankful that I've met you.

"I've had my spine problems with the pinched nerves for a long time - roughly 4-5 years- and I'm slowly getting better since you came into my life. There is no other way to say it. Thanks Jolie."

He was improved in one class, and he felt that he was "slowly" getting better. I like an empowered student who does not want to dawdle to get better. The day after the second of the two sessions, Bernie wrote:

28 Oct 2007
"Last night, I walked about 7 blocks to restaurant AQUA (great value, low cost & delicious) and back home another 7 blocks.

"Upper back extension causes no pain, lower back does. I can do plank on elbows, holding for 60 seconds now, no pain.

"If you want to make photos of a geriatric doing your things, it's OK with me. as you've seen, I'm not bashful or delicate. I will work at getting better, my daughter is getting married January 5 and I want to be able to dance with her and my wife."


Bernie went back to his doctors about the small amount of pain remaining. They told him he should have more surgery, and gave him prescriptions. He wrote to ask me:
"On Nov. 2 I have a follow up with the spine surgeon (same guy) and on Nov 14 a consult with a Neurologist ( ). Do you have any suggestions about a pain med FENTANYL ,which was suggested by a doc at the V.A."
I wrote back that Fentanyl is a surgical grade narcotic. It is used "off-label" for back pain and there have been deaths. I asked him to tell me more about what hurt, and when, so we could stop it without any harmful medicine, and also what the neurologist said.

14 Nov 2007 he wrote:
"I had an office visit with the neurologist at ( ), he said my twisted nerve at L5 will never get better and I will always have pain."
They told him to have another spine surgery and take the Fentanyl. (Then why did they put him though all that surgery?)

He wrote:
"Hello, I still have some tingling in both knees...but much better than 2 weeks ago! There has always been pain in my left flank between spine & hip, never told you because the knees were my greatest problem… The lower back pain persists, but only left side. When I do the trap stretch leaning to left--puts much pressure on that pain. Leaning to the right feels like a good stretch. Any additional suggestions?"

I found that that he was still doing "their" exercises. Conventional exercises of bending forward to stretch the hamstrings are often prescribed for back pain. The assumption is that tight hamstrings have (something) to do with back pain. However, bending forward is one major contributor of this kind of back pain. I changed how he stretched his hamstrings to one of the ways we did in class.

He was also continuing to overarch his lower back when walking, which was a large source of the tingling pain. When he used the Trapezius stretch, he was also overarching, which makes pain when bending to that side. This kind of pain is often confused for spinal stenosis. One classic sign of stenosis is pain when bending toward one side. But the narrowing is not true stenosis, but just overarching which narrows and pinches the area. For someone who has stenosis, not pinching the area further with overarching is frequently enough to stop pain.

What was complicating everything was his surgeries. They were considered "completely successful." The two knee replacements were "completely rehabbed" meaning he could bend his knees enough to sit in a chair. He could no longer stretch the front of his hip enough to prevent the kind of tightness that encourages standing and moving in overarched position. The back surgery put a plate in his back to prevent much movement. That meant that even small overarching movements were enough to pressure the newly immovable area. The back hurt, and the tight back and hip were compressing nerves going down both legs.

He wrote two mails:
"Jolie You hit on the spot. I will keep at it gently."
and
"Jolie, a quick note to tell you today I walked 12 blocks, stopping to stretch hamstrings.. often on steps or fireplug....as you suggested...also lunge stretch. I will dance at my daughter's wedding. Much thanks.

"There will not ever be more surgery on my body."


For the flank pain, he had been for many tests, and was even scheduled for a kidney evaluation. The muscles in the area were so tight, that I biked over to his home to do a sports medicine technique to stretch it out for him, and checked his other stretches. I went over how to stretch the front of the hip without overarching his lower back. His sweet funny wife made me lunch. We got some fun photos of things as gifts for you, of fun stretches and activities.

He wrote
"I've had x-rays, MRI, bloodwork, surgery, injections, no Dr. had any solution.
YOU HAD THE ANSWER. No wonder so many people have thanked you."


He did the work and gave me the credit. That's a good man.

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Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part I

Jolie Bookspan, M.Ed, PhD, FAWM
In this post, Bernie, an 80 year old retired photographer tells how he was signed up to take my "fix your back pain" workshop in 2005, but was convinced by his doctors that nothing but surgery would help. After "completely successful" surgery, his pain returned and worsened. He returned two years later to me. December 2007, Bernie wrote:

"I was a professional photographer for over 53 years-freelance-meaning go any place, any where- for many varied clients and I am now 80 years old and retired from photography.

"Much of the time I carried a 40-pound camera bag on my shoulder when climbing a 75 ft radio tower, walking on railroad construction sites or climbing The Great Wall in China.

"When I was at my vacation home, I climbed ladders to paint, replace cedar shingles and install new windows.

"Both my knee joints were replaced (5/93 & 6/01). Sometime in 2003 I was aware of tingling in both of my lower limbs from the knees downward. That started my medical testing with EMG’s, MRI, CT Scan and X-rays. The diagnosis was spinal stenosis caused by age-related changes in my spine. Physical therapy was started and I had an epidural, which helped for about a year. Then a second epidural lasted for only 3 months.

"I had been volunteering in an E.R. for 7 years helping patients and I had to stop as it was impossible to walk or stand on my feet because of the strong tingling in both limbs. Then I was told that spine surgery was the answer, but continue P.T. with some changes of the therapy. So, two years later, with some relief… but not enough to continue, I stopped the P.T., had an MRI scan which showed further degeneration of L4 & L5 with kinking of nerve roots. All along there was a pain in my left flank, but that was overshadowed by the strong tingling in the knees. There had been suspicion of kidney stones or liver function but x-rays & all blood work proved negative. I was hurting more in both knees.

"The spring passed at my vacation home near Barnegat Bay with much pain and with me looking at my kayak that had remained in storage. I called for surgery to be scheduled.

"The lumbar myelogram & CT was done at Pennsylvania Hospital and surgery date was set.

"On March 10,2005 I found the website of Jolie Bookspan and e-mailed her with my “story” of pain. Her class to fix back pain was going to be held soon a few blocks from where I lived. She asked me to try the class first, (it was being held a week before the schedule surgery) but I told her that both legs are numb and I am walking like a drunk, the doctors said no amount of exercise or body mechanics would fix such structural problems, and am going thru with the surgery on May 11, 2005.

"Post-op recovery was hell. The summer was hell with pain killers and sleeping pills. At the follow-up exams, I was told “the surgery went well, no infection, you’ll be better in 6 to 8 months”. The laminectomy used a metal plate & 4 screws and a bone graft from my hip for the fusion of L4 & L5. The pain in my left flank remained throughout 77 physical therapy treatments. The surgeon prescribed Elavil and when I took it, I felt like a zombie. After I told him, I was told to try a half tablet. That made me feel like a half-zombie.

"No doctor had a solution except “try Tylenol, Advil, Fentanyl, and more”…a consult with a neurologist said that my twisted nerve would never get better. (So why all the surgery?) The pain in my left flank remained.

"Then I took Jolie's class on October 20, 2007 and she had the answer. My left flank pain was not a medical condition (I was put through every test including kidney function), but a muscle in spasm. I was doing the wrong exercises that I had learned in PT and they were making it worse. She taught me to do the exercises the correct way as shown in her books and articles in her websites.

"Five days later I reported to Jolie that I had been working at The Clay Studio, throwing clay on a wheel making pottery for 4 hours and felt good. Usually after walking the 5 blocks from my home to the studio both legs would tingle badly and I had to stop halfway to rest. Not today. When I told my classmates about you phoning me to ask how I was doing with your exercises & stretching, they could not get over your caring. None of us had ever had a Dr. call to checkup. You are one hellova person and I’m thankful that I’ve met you.

"I’ve had my back problems with the muscle spasm and damaged nerve for a long time…roughly 4-5 years…and I’m getting better since you came into my life. There is no other way to say it. Thanks Dr. Jolie for your passion for helping others.

"On your questionnaire in the first class I wrote that I wanted to be able to dance with my daughter at her wedding in January 2008. You have made it happen for me.

"I will dance."


Next - Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II - a look behind the scenes.

Follow-up Note - the wedding on the 4th of January was great and Bernie danced and danced. Here is a photo.

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Prevent Back Surgery

Jolie Bookspan, M.Ed, PhD, FAWM
I received an invitation to take a course to learn a new back surgery for damage to the facets. Facets are the joints at the back of each vertebrae (spine bone). The surgery was advertised as a good revenue producer.

In the surgery, the facet joint is cut off and replaced by "lumbar position preservation hardware" rigidly attached so that the area can no longer bend or arch backward. At right is an X-ray of the lower spine with surgically implanted hardware. The person is standing sideways facing to the right. Surgical facet rigid fixation surgery is considered innovative because it replaces the more drastic spine fusion. It also replaces repeated injections into the painful area. The seminar would teach me the surgery with a cocktail reception following.

Why does the surgery want to prevent arching the lower spine? The facets are in the back of the vertebrae. Chronically letting your spine arch (too much inward curve) squashes the facets in back. According to work I've done over years in the lab, the overarching, called hyperlordosis (or slouching backward), is a chief factor in damage and pain to the facets and surrounding soft tissue. That means that you can stop this yourself without the surgery.

Notice if you allow overarching when carrying things in back (left) and in front (right). It is not the normal curve of the spine. It is too much:
The left photo above is from the post Healthier Backpack Carrying to Get Better Exercise and Stop Back Pain. You do not need to allow the pack to pull your upper body backward. Right photo is from Healthier Carrying - Get Free Ab Exercise and Stop Pain. You do not need to lean back to offset weight carried. In both examples, the hip tilts forward in front, instead of holding vertically.
Two examples above show allowing the spine to arch too much when reaching overhead. Left photo is from Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain. The drawing at right is from Back Pain in Pregnancy - and Why Men Can Get It. Imagine lifting your baby overhead (or any weight) and allowing your spine to pinch backward on the facet joints instead of standing upright and holding neutral spine.
Two examples above are from Aren't You Supposed To Stick Your Behind Out to Sit Down or Do Squats? (left) and Overlooked Ab Muscles in Overhead Lifts (right).

You can stop overarching, thereby preventing crushing force on the facets, and distribute the weight through the core muscles instead. It is a simple positional adjustment that takes seconds (shown below). An alternative is to have surgery.

Following rigid fixation surgery, you will no longer be able to stretch your lower spine as far backward, even when you want to stretch for range of motion and better disc health. You will still be able to slouch your body weight backward - onto the implants. They may eventually wear, along with adjacent bone, from the chronic crushing. Because the surgically fixed area can no longer overarch, increased forces occur on the joints above and below which have to bend more. If you thought the spine in the x-ray above still looked overly arched, not neutral, you are right. The areas above and below the implanted devices are over-arching backward, and the backside is tilting out in back (hip axis is tilted anteriorly). After years, those facets may be next to break down. It is no surprise "when the pain comes back." The cause of the pain was never removed.

Instead of allowing your spine to be pulled into damaging position, use your muscles to hold neutral spine. Here is one easy way to learn to feel it:
  1. Stand with your back against a wall. Touch heels, backside, shoulders, and head. Do you feel a large arch in the lower back making a large space?
  2. Put your hands on your hips. Thumbs in back. Fingers in front.
  3. Roll your hip so that thumbs roll down in back.
The large space between lower back and wall becomes a smaller space. Do not flatten against the wall or round your back. Just feel the strain come off the lower back. Use the new neutral for daily positioning. Simple. Check the photo at right (spine positioning is shown standing sideways, not with back to wall). Left is arching. Right is neutral. A small inward curve remains with neutral spine (right). Neutral spine does not mean rounding the back (which pressures the discs). Make the belt line level, not tilting down in front. The photo is from the post Using Abdominal Muscles is Not Tightening or Pressing Navel to Spine. Click for additional ideas.

The muscles used to maintain neutral spine are your abdominal and core muscles. It is not strengthening ab muscles that stops pain or teaches you neutral spine. It is using them to prevent damaging spine position. You get free, built-in core muscle exercise just by avoiding back surgery.


Xray by ryortho.
Photo credits for three arching composites appear in the original posts
Drawing of hyperlordosis when lifting overhead and last photo of tilting to neutral spine copyright by Jolie from the book The Ab Revolution

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Fix Disc Pain Without Surgery

Healthline

I received a phone call from a physician who said he had three successful disc surgeries and had slipped another disc. He wanted a consult with me before his fourth surgery. I told him it was like having three successful tonsillectomies. That is not a successful surgery. He had never stopped the reason he was pushing his discs out of place, one after the next.

Surgery for back pain and sciatica is considered by some as a solution, but an alarming number of people have pain that continues after surgery, or their pain stops initially while on pain medications and rehab following surgery, but then returns. The reason is that, except for unusual situations like bullet wounds or tumors, surgery does not stop the root cause of back pain. Because the cause continues, you continue doing harm to your back until it hurts again.

Degenerating or slipping discs are not from aging, or fate, or heredity, or a disease. The term "degenerative disc disease" is a misnomer. It is not a disease process, or a germ, or inherent factor or weakness that makes discs unhealthy. There are external factors, like smoking cigarettes, which contributes to disc degeneration. However, the majority of damage to discs and the soft tissue of the back and neck is usually chronic forward bending that physically pushes the disc outward until it presses on nearby soft tissue and nerves.

Disc damage occurs daily from avoidable bad bending in daily life, unhealthy sitting position, and many common exercises and stretches. Just as not all food is healthy, not all exercises and stretches are healthy, even some of the most common ones in gyms and yoga and fitness studios. The daily harm to your back is usually painless and something you are not aware of doing, until it accumulates, like smoking for years, until one day you get symptoms. The pain may come on suddenly, but was developing over years.

The physician who had the three surgeries, and three discs already removed, had gone back to all his bad bending, lifting, and sitting, and pushed out another disc. If he had stopped the injurious mechanics, he could have let the disc heal. Pain can often stop within days using this method. He probably never needed the first three surgeries. Having a fourth disc surgery will not stop him from going back to the injurious habits that caused the discs to break down and push out of place.

Removing discs, even part of them, means that the cushion and shock absorption between your vertebrae is reduced. This predisposes to early arthritis. A worse situation follows fusion surgery. It is a belief that stopping motion in a joint via fusion surgery will stop pain. But it also stops function. If you want an active life, it is setting you up for more problems. Even if you do not value being active, because fused back bones cannot move when you bend and sit and move, the vertebrae above and below the fused site must move more than usual, squeezing the discs and bones more than they are designed for. Fusion surgery is often a predisposing factor to forcing people into future back surgeries.

I sent the physician my free articles showing, step-by-step, how to stop disc pain. I sent him several of my books for his own use and for his waiting room. I called to follow-up on several occasions, urging him to simply stop the cause of disc injury so that he would not need the surgery. He told me he was not interested and had decided to go for his fourth back surgery. I hope his luck in avoiding surgical complications holds out as well as his good insurance.

The post Common Exercises Teach Bad Bending will get you started understanding common exercises that harm. There are far better exercises to do instead that give you fun, healthy movement without harm to discs. I am not in favor of doing less to avoid pain. I want my patients to have their life back and more. You can do this in fun ways and without surgery.


Photo by subscription to clipart.com

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Studies Say Back Surgery Not Needed

Healthline

Many back pain patients who come to me say the same thing; that they have gone for several opinions and were told each time that surgery was the only answer. However back pain, even chronic pain, sciatica and disc pain, are simple to stop with quick and non-surgical methods.

News articles are now reporting that back surgery is not more effective than non-surgical methods.

Patients are often told that if they don't have the surgery, they might become paralyzed. A recent New York Times article stated, "Many surgeons had long feared that waiting would cause severe harm, but those fears were proved unfounded." The Times article quoted Dr. Steven R. Garfin, chairman of the department of orthopedic surgery at the University of California, San Diego, "I think this will have an impact. It says you don't have to rush in for surgery."

More important to your health is what is not being reported. The Times article said, "No one who waited had serious consequences, and no one who had surgery had a disastrous result." It is important to know what is meant by, "no one who had surgery had a disastrous result." It is not considered "a disastrous result" if you go through the pain and fear of surgery and still have back pain, or are worse after surgery. It is not considered "a disastrous result" if you lose your job because of the time lost to surgery and recovery, and your family won't talk to you because they think you're a complainer. It is not considered a "disastrous result" if the medicines given during and after surgery cause problems you didn't have before, or worsen existing problems, and then you are given more medicines to counteract the first ones, each with their small (or large) health drawbacks. It is not considered a "disastrous result" if you get far more out of shape and gain large amounts of weight because you could do less after your surgery, and your overall health declines from it.

There is no national database where people who have the same or worse pain after surgery are counted. There is no clearinghouse where people who get new problems because of the surgery are counted or helped. Often, there is no way for surgeons to know that their patients still have pain years later.

Patients may be referred to physical therapy but as their pain, disability, and misery grow, they "are lost to follow-up." I hear these things every day because these patients show up in my office and e-mail me everyday saying they have no money left and will I please help them. They are at the end of what they can endure.

Exercise programs for back pain often fail because they do not stop the cause of pain. Personal trainers and Pilates instructors come to me all the time as patients with herniated discs because they do unhealthy bending and stretches for their exercise. There are far better exercises and stretches you can do instead. Some of my patients are doctors. Their own doctors said there is nothing else to do but live with pain. People often tell me, "You don't understand, I *HAD* to have the surgery, because of the pain." I do understand, and you can stop the pain without surgery, often better and faster.

My posts The Cause of Disc and Back Pain and Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch show you how easy it is to avoid and fix pain from bad discs and sciatica, and give better exercises to do instead. Understand how to stop the root causes of pain in the posts Breasts Causing Upper Back Pain is a Myth and Disc Pain - Not a Mystery, Easy to Fix. Learn why it is not a matter of just strengthening abdominal muscles and realize what abs really do to help your back in What Abdominal Muscles Don't Do - The Missing Link and Change Common Exercises to Get Better Ab Exercise and Stop Back Pain.

Use this free blog every day to change your idea of exercise from a bunch of artificial moves, to real health that is built-in to your daily life. You don't have to have back pain, and you can be stronger and healthier than before - without surgery.


Photo by akeg.
Read real stories of exactly how my patients fixed pain without surgery.
Fix your back pain by Christmas - read Fix Your Own Pain Without Drugs or Surgery

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