Dear Dr. Sood,
I doubt whether removing the hook will cure his pain either. And,
I understand your frustration at the fact that other surgeons have
almost made it impossible for you not to.
I have a question to all list members, and yourself, regarding the
work of Dr John E Sarno, an American author of the book
"Healing Back Pain - The Mind Body connection".
This guy discusses the concept of repression of emotions and
conditioning to believe that some activity may cause back pain
usually will. Does anyone know his work and have any comments?
What I am wondering is what is this patients emotional life like?
His childhood? Marriage? Job?
Herein may lie a perpetuator of his painful cycle. Unlike Dr Sarno I
don't believe that it is the sole cause of the pain, but how often
does the medical profession delve into this? We look too much at
a physical cause, and attempt (often poorly) to explain why it might
cause the pain, but we're not really sure if it does.
Just a thought.
Scott Epsley
Physiotherapist.
--
On Sun, 28 Nov 1999 20:15:10 Sood wrote:
>Dear Friends,
> Among wide spectrum of cases of back pain we come across some are so peculiar ,that one is always tempted to share the experience, one of such case is as follows
>
> A 50 yrs old male shopkeeper developed sudden onset back pain in 1988 upon getting down from a bicycle ,the pain was localized to lumbar region only ,Corsets,tractions rest,NSAIDS etc did not offer lasting relief from this pain ,In 1992 someone opened his lumbar spine and put a Herringbones rod, inspite of trying my best I could not find the reason for doing this surgery as X-ray taken at that time has nothing which should require surgery of this magnitude. However he was asymptomatic for 3 months after which he develpoed severe Jaundice for which he was in hospital for a long time.After 18 months of first operation the second surgery was done to remove the Herringbones rod, for some resaon the lower hook was left in the L3.
>At present he is in severe back pain ,which is migrating to his both legs,above knees,ROM is markedly decreased in spine ,pain is static,constant .
>DR knee and ankle are decreased on both sides.No sensory ,bladder /bowl symptoms.SLR+ve20*/bilaterally.pain increasing on coughing .
>MRI; No evidence of disc herniation.
>Metallic hook of removed Herringbones rod in right pedicle of L3 causing mild
>indentation of theca.
>Morale of story is left over Hook can cause problems
>Questions ;
>1.What could be cause/source of pain ?
>2.Shall I attempt to remove hook ,will the removal of hook cause pain relief ?
>3.Fibrosis & adhesions and scar formation caused by two surgeries may be the causing the pain.Mck evaluation for the spine could not be done as there is no possible pain free movement.
>4.So many surgeons have put it in his mind that removing the hook will relieve pain and restore movements that he is insisting and requesting me to operate and remove the hook .But I do have my reservations ,I think the indentation is only mild and we can help him by physio and exercises.
>Dr.Sarveshwar Sood
>Orthopaedic Surgeon & Head Department of Physical
>Medicine & Rehabilitation,
>Member American Academy Of Pain Management.
>S.B.L.S.Hospital
>812/1,Housing Board Colony
>Model Town,Jalandhar city
>Punjab State.India
>E-mail [log in to unmask]
>http:/Personal.vsnl.com/sarvesh
>
>
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