In 2015 left leg pain started. Diagnosis a year later via several MRIs was l4/l5 spondylolisthesis, disk herniation, central stenosis, pinched exiting nerves. Three surgeons sugested fusion, one suggested laminectomy. I elected the later in 2016. it did not work. Contrary, i had increased pain. i tried everying under the sun including pt, acupuncture, yoga, swiming, massage, etc. nothing worked. 7 months later, i had minimally invasive left sided latroscopy to remove pieces of disk to aim to relieve pinched nerve. It did not work. Pain increaed. Used gapapentin. It helped somewhat but could not tolerate. My state medical marijuana is legal. I stated using, it helps. I recommend everyone. Now i am facing spinal fusion surgery. Not sure it will work due to, my guess, EF is causing 24/7 pain. Doctors don’t thinks so but last mri suggested “encapsulated nerve”. Not sure about surgery. Sharing your thoughts is welcome.
Nerve pain left leg 24/7: In 2015 left leg pain... - Pain Concern
Nerve pain left leg 24/7
Do not know what EF is. Do not know what is meant by “encapsulated nerve” comment. I need a bit more explanation. You say "... nothing worked". I am not surprised. One therapy by itself will not if you need a combination of therapies.
You have a surgery option. You want to avoid this unless you have no choice. This is the difficult bit one does not know the extent of the damage and the extent of the scar tissue from the previous surgery. Scar tissue can be quite hard and unyielding. This unyielding tissue is what may be what is causing the pain.
The spondylolisthesis you mention may have been caused by muscle contraction problems. If the muscle contraction problems are still there then there is a lot of force being applied to structures that should not be.
There is something called McTimony chiropractic. It is a very gentle form of chiropractic. I would recommend that you see one with your medical records. They cannot cure, but they could take the stresses down which in turn will improve quality of life. You need to see an Alexander Teacher for body awareness training and reduction in bad muscle movement practices.
Lastly you need to find a local Buddhist group who could teach you meditation and mindfulness. The purpose is to bring more awareness of yourself, mind and body. More awareness will enable more control of events before you damage yourself and so reduce the pain and discomfort.
amaravati.org/dhamma-books/...
Meditation – A Way of Awakening by Ajahn Sucitto is one of the best books on meditation and mindfulness that I know of. It is a free download from the above web site.
For issues with my chronic pain I engage with:
T'ai Chi, Alexander Technique, McTimony CHiropractic, Meditation and Mindfulness. Any one by itself will not help. Any two will not help. I need all of them.
Hope I have been helpful.
Thank you for this information I will give meditation a go and have downloaded the book you kindly recommended.
Thank so much for sharing your thoughts.. Having two surgeries with no success and trying many things w/o succes is very discouraging. I will investigate your suggestions.
Maybe you have no clinical knowledge of degenerative lumbar spondylolisthesis pain. I have. I know it is extremely painful to even climb out of bed to the toilet in the morning, even to the extent of an accident en route. I know it is painful to move about the house to dust, vacuum and cook etc. I know it is painful to even walk 100 metres up to the village shop without leaning on something.
How can you vaguely suggest those mumbo-jumbo "remedies" as if it is something in my mind. I have seen my MRI, had a diagnosis and have been offered facet joint injections, if they work for a while then I will have rhizotomies for longer term pain control. In the meantime I have been relying on regular ibuprofen/dihydrocodeine/paracetamol to keep some mobility as I still work despite being 74. I am slim, fit and healthy in all other respects but regret my lack of mobility due to pain in my gluteus maximus/groins etc caused by nerve impingement in my lumbar spine due to degenerative lumbar spondylolisthesis. I resent being patronised by people who promote airy-fairy remedies such as "meditation, mindfulness, Buddhism, chiropracty" etc as they have been proved to be useless except to suggestible people. I am a senior medical practitioner and deplore such suggestions to people who may have less medical knowledge and might waste their time on them. I have worked in the NHS for 23 years and would not recommend paying good money to charlatans/snake-oil merchants. I wish you well if you suffer from anything bad, but recommend you stick with our world-renowned NHS and NICE guidelines before telling gullible people to spend money on charlatans.
Thank you for your reply. The first international conference on fascia was at Harvard Medical School in 2007.
The first serious papers on Medical Research Fraud started to appear in 2005. The depth of medical research fraud is very extensive.
The Professional Standards Authority Accredited Register who oversee the GMC ect have a register of professional health bodies.
professionalstandards.org.u...
I have a bit more to say which I can do in another reply
healthunlocked.com/painconc...
describes what a stress breakdown point is.
I have no idea what "degenerative lumbar spondylolisthesis pain" as I have no personal experience of it. I do know a lot about things that the NHS tends to totally ignore. I know from attending conferences that to change an approach in the NHS requires trials costing millions of pounds. This is why many physical treatments that work never get into the NHS repertoire. There is no money available for the trial.
There was a small trial of Alexander Technique versus physiotherapy. The Alexander Technique proved effective. The cohort was too small so a grant of a million was applied for to repeat the trial with a larger cohort the grant was refused.
You say: "I resent being patronised by people who promote airy-fairy remedies such as "meditation, mindfulness, Buddhism, chiropracty" etc as they have been proved to be useless except to suggestible people." This demonstrates you lack of understanding of what some of these things are. It is not surprising as some of the trials done on them by medical people totally ignore what they are about.
Jon Kabat-Zinn is an American professor emeritus of medicine and the creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. His work showed that meditation and mindfulness has a part to play in pain control issues.
I use meditation and mindfulness in handling my health disability issues. It is not a cure it just helps me be more aware of my activity that could cause me greater pain and discomfort. What I do is not airy-fairy it is very practical and works. However, it is not a cure for my problem it just helps. I would never consider it a remedy.
Doctors spend a lot of time dissecting dead bodies and learning the name of things in their education. A dead body is not the same a a living body which is an engineering system. Engineering systems interact with each other and have feedback mechanisms. Engineering systems break down when the stress goes above the stress breakdown point. Stress breakdown point and feedback mechanisms are not in the doctors education. So does not enter in their treatment regime.
Alexander Technique works on sound engineering principles it helps a person change the way they do things so that they provide less stress on the body's engineering systems. It is not a cure. It is not a remedy. It is a way to re-educate oneself to do things more efficiently and effectively. It understands spinal reflexes. It understands that a heavy head needs to be balanced on top of the spine rather than be held up by tight muscle which in turn pulls on all sorts of structures which do not like be continuously pulled.
One of the first things that doctors tend to forget after they leave medical school and work in the real world is that muscles are strongest at their longest length. The more contracted a muscle is the weaker it gets. It is also known that muscles have nerve inputs to contract a muscle and no nerve inputs to uncontract a muscle. It relies on other muscles to uncontract a muscle as well as the springiness of the fascia and ligaments. If a muscle gets over contracted then the muscle can remain over contracted until it is manually uncontracted. This is not in the doctors training. It is in a sports therapist training and in massage therapist training. Over contracted muscle can be very painful and take a long time to uncontract effectively. There is a belief that pain killers and drugs can magically uncontract over contracted muscle. A false belief which injures many patients.
As a senior medical practitioner you would have learnt many things which are now proven to be false. You will have forgotten that the brain controls how muscle behaves and that to change muscle behaviour you need to work on enabling the brain to do things differently. It has also been established that the brain has an influence on the immune system. The brain has methods for sampling various infections via the blood inputs. This would run counter to what you have been taught when you were in medical school.
I get McTimony chiropractic on the NHS and have been since 1994. McTimony chiropractic is not a cure or remedy for the impingement on nerve roots that I have. It does help me not to impinge on nerve roots more than I do. I also engage in Alexander Technique. I have 40 years experience of this. It is not a cure for my condition nor is it a remedy for my condition. It does enable me to function better and reduces the effect that my long term health disability has on me.
Many people on this forum would feel insulted on the suggestion that the various treatments they engage in work due to suggestion. Many GPs have given evidence to NICE about the effectiveness of chiropractors in managing their painful conditions. NICE recommends chiropractic treatment for various conditions.
As you say you are a senior medical practitioner. You do not have any engineering training. You unlikely to understand the human body as an engineering system with feedback mechanisms. Fascia is not something you would know much about as all the evidence and knowledge of it is relatively recent.
Reflexology in the medical model you learnt at medical school is deemed not to be able to work. There are engineering models that show that reflexology can help in reducing body stress and as such take the stress below the stress breakdown point and thus enable an engineering system that was failing to work again.
The grant system has recognised that much research needs to be interdisciplinary. This is very different than the research that took place when you were in medical school. There is a recognition that research on two variables in a silo has led to many a wrong answer which has caused people injury.
Your first paragraph leaves me in despair - have you reached 2019 yet in medical research/knowlege - or are you stuck in the 1960s? My medical training and 40 years of experience in the NHS (with frequent re-training and access to the latest trials in the BMJ etc) has led me to acute awareness that in certain suggestible subjects "mindfulness, meditation" etc and whoever calls himself Jon Kabat-Zinn (does he drive a Rolls-Royce by any chance?) pain relief might work, rather like the placebo effect. However:
I do have extensive knowledge of orthopaedics, neurology, psychology etc and of course I know the meaning of "fascia" (did you know it also lies just under your forehead as well, beneath the skin and before the bone of your skull?) - it is all part of our ongoing clinical development path which takes place every year. I am sure you are convinced about the Alexander Technique, which is just one of many physiotherapic practices like Pilates or Yoga and purely existential "reflexology" (That was Not Taught as it is not deemed a clinical treatment) etc. However, did you know that, due to degenerative spinal arthritis (which can occur at any age but mainly in later life), the nerves in the lumbar spine can become compressed (ie pinched) so that any movement can cause any one of these nerves to cause pain in various areas of distribution, ie buttocks, groin, thighs or even whole leg? This condition CANNOT be cured by simple exercises, however straight you hold yourself (I have done all that and have excellent deportment as taught at public school, back never touches chair-back etc) or physio. It can only be alleviated by deadening the pain impulses from the nerves which are pinched by narrowing of the foramen, either by facet joint injection or actually killing those nerve endings. Other than this, if all else fails, an operation is perfomed to open up the foramen to allow those nerves to become un-pinched.
Please do not patronise a medical practitioner by quoting chapter and verse about the gospel of a random pseudo-"engineering" physio exercise. We do know all about it. Thank you.
PS - You say I "don't know about engineering"? Your text assumes far too much, which I say was patronising. My father was a famous design engineer who collaborated with Sir Frank Whittle on the first jet engine and designed high pressure valves for nuclear power stations (eg Trawsfynnyd etc) in the past and I stood next to him at his drawing board, so I know a lot about engineering/loads and balances etc. So don't tell your grandma how to suck eggs. Just stick to clinical evidence-based research (worldwide if you don't care for the NHS), read Google Scholarly Articles and educate yourself, so to prevent you conning people into paying money to be convinced by your specific narrow "beliefs". Try actually working In the NHS and see how dedicated people are there, on very low pay but with firm clinical hands-on skills. What job would you be able to do? Kitchen porter?
Thank you for your reply. There are things which need certain interventions as you describe them as that is the only option that can be available. There are many who are damaged by them.
Your fields of medical endeavour requires a lot of learning. It also requires a lot of unlearning. Sometimes it is very difficult to unlearn data that is wrong. It is much easier to continue doing the same thing as it is automatic.
You say: "(I have done all that and have excellent deportment as taught at public school, back never touches chair-back etc" . This is not good posture. Good posture balances the spine on the pelvis with the head balanced on top of the spine. This requires very little muscular effort. It does require mental effort to learn however.
You say: "It can only be alleviated by deadening the pain impulses from the nerves which are pinched by narrowing of the foramen, either by facet joint injection or actually killing those nerve endings." This demonstrates ignorance. There is a spectrum of spread of how much the gap is closed. You can by reducing the muscle stress reduce the pressure and stress on the nerves. This is not simple exercise. There are difficult issues of muscle control to learn. This is why it is not in the medical curriculum. It takes time to learn and understand. This is not conducive to the ten minute consultation. It is not conducive to the NHS physio where one size fits all. Wolfes law states bone grows where there is stress. Where stress is removed bone can reduce in strength and be removed.
Go for an Alexander Lesson and find out for yourself. There are things which are not able to be put in books. There is a great deal written and researched into how muscles behave which is ignored by many medical practitioners who operate in their own individual silos. This is why there are pressures to get interdisciplinary research rather than research in a discipline which only looks at two variables.
You say: " I know a lot about engineering/loads and balances etc.". There is a difference between static loads, cyclic loads, temperature cycling and loads above and below stress breakdown points. There is hookes law and its effect on muscle behaviour. There are also the way muscles actually work in the human body system. Which I know from experience many orthopaedic and neurologists do not know.
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