#backpainblog, #BACKPAINBLOGUK, #fibro, #fibromyallgia symptoms, BACK PAIN, CHRONIC PAIN, discogram, DISCPGRAPHY, pain

LUMBER DISCOGRAPHY FOR BACK PAIN DIAGNOSIS…

A discogram is an investigation which will help your surgeon to see which level of your spine may require surgery. It is usually performed only on patients who the surgeon feels may need or benefit from spinal surgery for maybe a spinal fusion or an IDET treatment.

Discogram or diagnostic discography is an X-ray procedure that can help to determine the source of your lower back or leg pain. This procedure is used to determine if a degenerative or worn out disc is the cause of your back pain. They enable the surgeon to determine the level of the fusion required or to confirm disc degeneration which is unclear on MRI scans. A discogram is hardly ever used to diagnose the cause of back pain.

If you have been suffering from severe back or leg pain, this may be due to a worn-out disc but it is not always very easy to tell which part of your spine is causing you this pain. You may have already had an MRI or CT scan but because these investigations have not determined for definite where your pain is coming from, your doctor has asked us to try to find
out which part of your back is affected.

At the time of injection, there is usually some pain which may be similar to or different to your usual pain, so you will be awake in order for you to experience the sort of pain you are in. I’ve had this done twice and although it is obviously quite uncomfortable it helps the surgeons decide on possibly some very import surgery. You are mildly sedated so you soon forget how bad it was.

It is done as a day case and you lie flat face down and a local anaesthetic (lignocaine) is put on your skin. Under X-ray control, the needle is advanced into the disc space in question and they dye (which is visible on Xray) is then injected during which you will be asked whether this causes the type of pain you are suffering. The procedure is then repeated at another level if necessary.

This procedure can aggravate the pain for a few hours after the procedure or in my case a few days but I just increased my pain killers. The pain disappeared gradually. If the disc is the source of your back, spine, extremity and/or leg pain the injection will temporarily reproduce your symptoms, thus resulting in a positive discogram. If the disc is not the source of your pain the injection will not reproduce your symptoms or cause any discomfort, thus resulting in a negative discogram.

You can find out more information about this procedure on Spine Universe and Spire Healthcare.

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THE FIRST PILL FOR MULTIPLE SCLEROSIS…

Great news for MS sufferers after the first ever pill for multiple sclerosis is expected to be launched in the next few months according to the Daily Mail today.

Its called ‘Gilenya’ (and also known as fingolimod) and has been developed for relapsing-remitting MS. It has already been approved in the US and is just awaiting licence approval in Britain.

The other drug for MS had to be given in injection form three times a week so this pill will be a blessing in disguise for many MS sufferers.

Trials have shown that the new pill halves the number of relapses by blocking the actions of white blood cells which play a big part in the destruction of myelin, the protective coating around the nerves, this damage causes the symptoms of MS, including numbness, incontinence and difficulty moving.

Head of medical research at the MS Society, Dr Doug Brown said that ‘a licensed tablet would be a huge step forward’.

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THE IDET MINIMALLY INVASIVE SURGERY FOR LOW BACK PAIN…

The IDET ( Intradiscal Electrothermal Annuloplasty) provides and alternative to other surgical procedures for people suffering from back pain caused by certain types of disc problems.

It’s a fairly advanced procedure now and is made possible by the development of eletrothermal catheters that allow for careful and accurate temperature control. It is thought to decrease pain by cauterizing the nerve endings within the disc wall to help block the pain signals. Although no guarantee was made to me that this would be successful they felt it appropriate at the time to try and help ease some of my pain.

The actual procedure only takes about an hour to complete and is performed with a local anaesthetic and mild intravenous sedation. A needle is inserted into the painful lumber disc space using a portable xray machine and a heating wire is then passed through the needle and positioned along the back inner wall of the disc. The catheter tip is then slowly heated up to 90 degrees Celsius for minutes and then the heat contracts and thickens the collagen fibers promoting closure of the tears and cracks. Nerve tears are burned which makes then less sensitive. The needles is then removed and after a short stay the patient then goes home.

I then had to wear a lumber support corset for 6 – 8 weeks with quite an in-depth guideline for activity. Returning to work could take up to six months depending on what type of job you had, i.e. heavy work had to be avoided for 5 to 6 months but after 14 days you could resume sedentary work.

You had to lie rather than sit after the surgery and gradually increase your sitting as the weeks went by and bending was to be avoided at all costs. Unfortunately for me the procedure did not work but it was a chance I took with it being such a minimally invasive technique. However some people have had great success especially if they have not had any other type of spinal surgery before.