Back Pain Questions Archive 2009 Part 5

I HATE LEGAL DISCLAIMERS, but my lawyer insists...Thanks for understanding...

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This is YOUR back pain questions and answers forum. Enjoy it, and use it to answer all your questions on back pain.

A: Hi Frank, Your MRI results indicate 6 minor disc bulges and 1 bulging disc with a rip in the outer disc wall. This last disc is touching the thecal sac, which surrounds the spinal cord and is close to the area where the S1 nerve root leaves the spine. I do not see anything here which makes me concerned. Best, Sensei Adam Rostocki

Q: Hi my name is charlie. i'm 20 years old and like you have suffered from what sounds like a very similar sort of pain to you since the age of 16. I first triggered my back doing lat pull downs in the gym and it felt a bit weird. however having had no previous back pain i ignored it and played squash the next day, were it 'went' putting me in bed for a week. From that day i have suffered horrible undiagnosed back pain which has been a constant fight. its strange it never seems to be good as its always v uncomfortable but it flairs up every so often and is unbearable. for example while at university last semester i was admitted to hospital under morphine and epidural injections for 2 weeks...yet the MRI's showed nothing. i do suffer from poor posture which is a slight kyphosis. and i find that my back pain gets worse if i stay to still of am cold which seizes the muscles up. i really don't understand as well cuz the pain moves around and will hurt on one area/side one time and another some other time. i really don't know how much more of this i can take. i was a sports fanatic and played football and golf to a high standard. i get completely that being stress free helps as when i've been most at ease and with the least stress over the last 4 years my back has been at its best (not good but alot better) however there's always things that are stress full and its hard to try to be stress free isn't it? plus stress alone isn't the underlying problem....i would do anything to know any suggestions u have for reliving muscle pain/soreness/stiffness. i find myself searching your sight tonight because i'm going traveling around Thailand with my mates in 2 days and am currently going thru a very bad stage and am petrified about what to do? i have to get rid of this pain or just get it back down to its normal level. i cant be spaced out on muscle relaxers, anti inflammatories etc etc for the whole holiday.....please help me i'm desperate for Thailand and for ever...i cant live like this. best wishes, charlie

(ps i really respect ur sight and reasons for doing it, i only regret that i have only just come across it)

A: Hi Charlie, I'm very sure that you are suffering from a chronic ischemia disorder. The cure for this is knowledge therapy, but it is not a fast fix. It will take time and effort on your part, but you will be successful if you apply yourself to the treatment. Best, Sensei Adam Rostocki

Q: Hi, I've recently started to see a physical therapist. Although I was convinced all my problems were due to TMS, and physical therapists go against the grain with respect to Dr Sarno's theories, when a friend recommended it I went along as I thought another opinion wouldn't hurt. I've been pleasantly surprised at his seemingly thorough knowledge, experience and supreme confidence that he can get me better. The reason for his confidence is that he's convinced that my problem is due to over-pronation of the feet, which (putting it very simply) puts everything out of line and subjects the lower back and pelvis to shear forces that it wasn't designed to bear, thus creating muscle tension/spasm, etc, etc. He says that his own back problems had been due to this but he hasn't had any for 10 years now. (It's worth noting by the way that this service is free because he is an occupational physical therapist at the company I work for.)

So now I'm confused - but as all I want to do is get better (whether I understand it or not) I figured I'd go along with the exercises and advice he's promising to give me in addition to keeping up the TMS program. I know this isn't strictly recommended but I'm trying to hedge my bets!

What I'd like to know - apart from any general comments or advice you might have on this approach - is whether you know anything about this over-pronation theory? I've done a bit of research on the internet and there seems to be a lot of support to it. I'm intrigued that your website seems to discuss every possible offered explanation for lower back pain except this. I would be very interested in your experience and opinion.Many thanks, Martin

A: Hi Martin, I do not subscribe to that theory or many of the other similar theories for pain. It is great that the treatment you are receiving is free and I am sure the provider is very sincere in his beliefs. Personally I think it is worth a try if you believe in it, but I stress the BELIEF part being far more important than the treatments themselves. Personally I have heard of far crazier things bringing complete resolution of incredible back pain, but once again, I defer to the placebo effect and the overall power of the mind when it comes to pain ... both cause and cure. Best, Sensei Adam Rostocki

Q: Do you know who is providing back pain treatment using the DRX9000 and VAX-D systems in Sydney. Thanks, John

A: Hi John There are provider directories on their respective official websites. I hope you can find someone! Best, Sensei Adam Rostocki

Q: I am having pinching, tingling, burning, sensation from my head to toe; can u help me understand whats happening?? Juliet

A: Hi Juliet, I recommend you go to a doctor for a medical evaluation. Once you have seen the doctor and have some additional information, I will be happy to give you my opinion on your case if you should still require it. Best, Sensei Adam Rostocki

Q: i get these shooting back and chest pains out of the blue and it lasts awhile sometimes hours and i cant get comfortable its like needles poking me, my lower back to the middle of my chest or like now it started in my lower right side of my back to my side under my right breast. i don't have insurance and i just went through a divorce a year ago and i still am dealing with it i do get sad and depressed and i try not to but it still hurts me. and i'm alone now! so i just take tylenol but it really don't help. i wish i knew what these pain were. i have had anxiety attacks and they have been really bad at times but these pains are annoying. its hard to sleep at night when i get them. my family thinks its all in my head and acts like its nothing when i tell them i'm hurting or what it feels like they just ignore me! Tina

A: Hi Tina, The pain is obviously in your body, but I am inclined to think the cause is psycho-emotional. This is the most common source of symptoms such as yours and mine. I highly recommend knowledge therapy and I am sure you will be fine if you apply yourself to the treatment. You just need to break the negative cycle. Best, Sensei Adam Rostocki

Q: Hi. I'm really just wanting to get some advice that doesn't end with "it's a chronic condition you can't do anything about".....b/c that is all I've heard and I'm so sick of the pain.I just turned 31- people say I look like I'm younger. I was active in sports most of my life but then graduate school and the real world hit me- so less time working out....which is probably my main problem.Let me back track...Diagnosed with scoliosis at age 8.. not enough to wear a brace. I have been told I have "rib humping " (a sexy term I might add), "military neck " and reversed lordosis (?) I think. I did date a chiropractic student for 4 years and was treated once a week during that time at his school....and it really did seem to help- no pain then. That was in 2005.Currently- I work too much but love my job. I have an almost CONSTANT ache in my occipital lobe region- mostly on the left side. Occipital release if done correctly is practically orgasmic for me and is THE ONLY THING THAT HAS HELPED IN YEARS! But it's a temporary fix.I'm nervous b/c there is a bump in the area that seems to always need pressing in order to relieve the pressure. I've had it checked by my doctor who laughed and said it was a "node" and is normal...that was 2 years ago- still here and still needs pressure to release the pressure I get in the back of my head and left side of my neck.Should I just go get an MRI?It has really affected my life negatively- I'm cranky, achy, distracted easily, AND IT HURTS! Please tell me what you think my next step should be....Thanks for your time - I know I wrote a lot....but it's been going on forever. Colleen

A: Hi Colleen, I believe you should get a second opinion on the bump. If diagnostic testing turns out ok, then you must get past this issue and realize that it is coincidental to the symptoms. In my opinion, I actually recommend a complete exam by a new doctor to give you a better perspective on the exact source of symptoms. Best, Sensei Adam Rostocki

Q: Hi Adam, Firstly I would like to say thank you for providing such an informative site. Secondly I would like to outline my experience with back pain since a road traffic accident and the problems i have encountered along the way.

Twenty months ago I was rear ended whilst I was stationary and subsequently myself and my partner suffered whiplash. My partner (Mrs X) suffered neck whiplash which eased as time went by and now she seems to be OK? (time will tell).I on the other hand suffered an injury to my back which caused symptoms of shooting pains in my back and down my left thigh, a dull constant ache in my gluteus medius area(on the left), intense back spasms(on the left), flash headaches(a recent addition and left sided), loss of stability on my left side, disrupted sleep...amongst other symptoms/problems.

A solicitor was assigned via my legal expenses insurers.I was examined by a consultant in order to compile a medical report. The initial prognosis was set at 6 months which, when passed, I raised issues to this fact. Nobody really seemed concerned that I was suffering and I was sent in for x-ray 5 months after the accident. The results of this were Minor degeneration at L2/L3 otherwise unremarkable.

A second consultation with the same doctor was arranged.The consultant has picked up on this and has stated that because the changes existed pre-accident, this is the reason I continue to suffer i.e. my accident related injuries will last 15 months and any suffering after that is then due to my pre existing degenerative changes.

I am finding this hard to accept due to the fact that I was completely fine with no back problems prior to the accident. I accept there is degeneration as I understand this is normal but cannot accept now that this is the reason that i suffer ongoing symptoms. I advised my solicitor that I was not happy with various statements on the legal report and then things started turning frosty.

I requested an MRI may be appropriate to identify/clarify the extent of the damage and to establish whether there was any sign of accident related injury. At this point my solicitor said that I should make amendments to the report, sign it and he would request the funding of the MRI from the third party and/or seek to arrange a consultation with an orthopaedic expert The third party would not fund this due to the degeneration(being the cause) and I would have to fund it myself or obtain one on the NHS. Thankfully after a lot of persuading my GP agreed to submit a request for MRI.

At this point I received an offer from the third party. Along with this offer I received a 21 day deadline in which to accept or should the matter go to court and I fail to obtain an amount higher then I would be liable for the third parties legal fees...GULP!! Hang on a minute...this can't be right. I have 100k legal cover AND I haven't even had my MRI yet!! So i go for my scan... results show

lumber discs dehydrated L2/L3 Posterior annular tear and broad based disc bulge with mild facet joint degeneration causing mild to moderate canal stenosis. No lateral recess stenosis L3/4 Broad based disc bulge and facet joint degeneration noted. No nerve root or thecal sac compression. L4/5 There is a large broad based disc bulge and a focal disc bulge with facet joint degeneration causing moderate to severe canal stenosis. the lateral recess has not been adequately evaluated, but I suspect there is at least moderate lateral recess stenosis bilaterally, worse on the left, compromising the left L5 nerve root. L5/S1 Broad based disc bulge noted. No nerve root or thecal sac compression.

Now I contact the solicitor and advise that the results are in. I am told I will be contacted to authorize the release of the scan results...two weeks pass...nothing so I call in again. I am told at this point that the solicitor dealing with my case is "out of the office, possibly indefinitely" and someone will contact me in regard to my claim.

I was contacted by the firms director and he made apologies and assured me that he would personally see my case through. "Great" i am thinking. This guy seems to be so much more helpful that the last guy. I gave my permission for my GP to pass on information as the director guy wishes to speak to him directly.

My GP has apparently stated that I would have suffered anyway at some point but I am unsure whether he made comments on the accident or injury( I wish I was there at the time). Now he has gone off on holiday for two weeks and I have to wait to see him to confirm details of that conversation because, to be fair, I do not trust this solicitor firm. Whenever I have to call them I start to get anxious,shaky and feel my heart palpitating through nerves as I do not and never have felt supported. In fact I am being made to feel like now some or all of this is my fault and my problem. The director has even stated that if I attend this consultation with this expert it is very unlikely that he will hold a different opinion to anyone else involved.This consultant, i assume, is some industry boffin who for whatever reason is not going to see my side of events. He is from the same company as the other doc who compiled my report and he has based his report on an x-ray as he has probably only just got my MRI results. The report was written months ago now.I feel like a scapegoat and feel as though I am being made victim of an industry tactic that prevents minor fender benders from going to court.

I feel as though this injury has caused my problems NOT the degeneration. Any ideas how i can achieve some peace sensei?Thanks for reading. Keep it up. Dan

A: Hi Dan, You are caught in a powerful vacuum, also known as litigation. As an insurance investigator with many years experience I know exactly what you are going through. I make it a practice not to comment on litigations, but I can tell you that focusing on the legal aspects of the case WILL absolutely prevent your recovery, I have no doubt as to this fact. I have seen it thousands of times.Basically my advice is to prioritize your life. If you want your health back, focus on that. If you are more interested in this litigation, focus on that. You can not do both. I hope this info helps you in some small way and I thank you sincerely for the kind words about my site. Please stay in touch and let me know how you are doing. Best, Sensei Adam Rostocki

Q: Hi, I was suffering from a minor back pain in my right side lower back few months ago, i did not pay much attention to it. Gradually it increased and now 6/7 months down the line, it has badly affected my legs and my thighs. Causing acute burning and pain in both my legs and lot of tingling of nerves across body.I went to a ortho surgeon and also got MRI and Xray 3 months back which did not reveal any serious injuries to my back.My MRI showed slight protrusion in L4/L5.

I have also been to a neuro surgeon and he also opines that there is simply nothing wrong and I am absolutely normal.I have been on some neuro medications since last 2 months. I met a Physiotherapist initially during my back ache and he said the pain will percolate down in your legs which has actually happened. I am just interested in knowing, what is causing the burning and pain in my legs and thighs and also tingling of nerves in my body. I have not taken any rest and have been to my work regularly since last 6 months when it started.Help me diagnose the disorder and also suggest some therapy to overcome it. I was fully fit and a regular gym hitter before I encountered this problem. I want to be back at my normal.Can i be hopeful for that in some time ? Please guide. Regards, Dwaitin

A: Hi Dwaitin, Based on the information you have provided, I am confident that the pain is ischemic, since it is anatomically illogical. You need to consider knowledge therapy, as this is the only treatment which can cure it. Best, Sensei Adam Rostocki

Q: Hi,I recently started running again after 10years(leaving the army)and whilst running i noticed a stitch-like pain in my back(right side under the rib cage),the pain is still there and gets worse when i run...could this be a trapped nerve or pulled muscle?And could it have something to do with time in between me running again... I'm 39?Thanks, Andy.

A: Hi Andy, It could be any number of things, but does not strike me as particularly troubling. I recommend going for a check up if it continues. Best, Sensei Adam Rostocki

Q: I am in real pain. I can neither stand walk sit or ly down I am fed up with it. I don't know what to do, i feel my pain specialist is going to be angry as he has just carried out an epidural, & 2, nerve blocks which only worked for 3,days. I have 3, nerve impinges L3 L4 & L5 plus spinal stenosis & sclerosis according to a my MRI scan I have been in pain since these injections but i am on morphine which thank god keeps pain to a minimum, unless i run out of the prescription & by the third it has returned. I see this pain specialist on the 31st of this month. I don't know what to say to him. Yours sincerely, Christine

A: Hi Christine, I do not see a question in your submission, but thank you for sending in your story. I hope you can fin some relief soon. Best, Sensei Adam Rostocki

Q: hi I'm 25 with two bulging discs in my lower back and a herniated in my neck. My back pain started 4 years ago after the birth of my son. Tried therapy and such but got pregnant with my daughter and had to stop all meds. Didn't have any problems with my back during the pregnancy unlike my first lots of back issues during my son's pregnancy. Well after having my daughter 19 months ago i started back up with server back pain but subsided with meds. Then started a little over a year ago with chest and arm pain. After having tests run found out i have herniated discs in my neck. Which once again have done therapy and epidurals. they all have helped. But now there is a new thing my whole spine hurts. about half way down i feel like it's bruised if touched. I'm going back to the doc tomorrow to be evaluated and possible another cervical ep. I have swelling in my hands at night and my feet tingle oh so bad when i first get up in the morning. My lower back hurts more and more now and legs are sore. my left arm is weak and sore.

When I first started with the back pain the doc said i had narrowing of the nerve canal. and when the pain doc ordered a new mri on my back after having the one on my neck showing the herniated disc the new back one showed up the two bulging discs. And now instead of it being only my left leg it now affects both legs. Last summer my left leg gave out on me and fell messing up my leg and knee with sores.

It seems to me that each year it all gets worse such a bummer with being so young and not allowed to do things because of pain or it causing pain. And not being able to lift my children cause of fear of dropping them. I missed out on lifting my daughter when she was infant cause of almost dropping her so had to stop lifting her on my own for months it seemed like. She is now able to get around on her own praise the Lord. had to put her in a big bed early too not able to put her in her crib or get her out without pain.

Well enough rambling sorry. Would be nice to have a new input on this if you have it thanks. Stacy

A: Hi Stacy, Thanks for sharing your story with us. If you would like to type up your MRI report for me, I will be happy to look it over and give you my thoughts. Best, Sensei Adam Rostocki

Q: My mother, age 71, has had spinal decompression surgery and in Feb. 2008 was diagnosed with deteriorating disc disease. and had surgery to put in 2 cages and screws plus removal of 10 bone spurs in lower back. She is still in terrible pain because according to the surgeon she did not heal properly. She was taking a lot of narcotic pain relievers before and after surgery and developed gastroparethesis.She almost died before doctors could figure out what was wrong.We got this taken care of. She takes a small dose of percoset when the pain is unbearable. Now the surgeon wants to redo the packing in the cages or put in a pain pump. She is not wanting to go through another surgery. Do you know if the small amounts of morphine that would go to her spine with the pump would cause the gastroparethesis to reoccur? Her quality of life is little to none. She is not an old 71 she loves to go places, ride motorcycles, and go dancing and she can do none of these because of the extreme pain. Please advise. Tonya

A: Hi Tonya, This is a very case specific question and I advise that she talk to her doctor about it. I send you both my best and hope that she will feel better whether or not she decides on the follow-up surgery. Sincerely, Sensei Adam Rostocki

Q: I have "mild disc bulge" in C4-5 and C5-6. What if anything can your facility do for me? Would I qualify for the fast recovery surgery? I am in pain all of the time. I was hit in an accident on April 6 this year. I then started going to a chiropractor. for the first six weeks I was on the rolling machine, heat, and electrical stimulation. Then for the last 6 weeks he started me on the traction machine which pulls my head. I have headaches just about everyday. I have in the last 4 weeks gotten deep tissue massage. It hurts big time while it is going on, then I felt like a new woman for a few hours. I don't know what more to do. Does a mild bulge mean there's nothing to be done? I just want to feel like I did before I stepped into the vehicle before the accident. Please help me answer my questions... Thanks, Aimee

A: Hi Aimee, I do not maintain a facility or offer any treatments or surgery. I would be happy to offer you my opinion on your case if you would care to type for me your MRI results. From what you describe so far, I highly doubt that your pain has anything at all to do with your minor herniations. Best, Sensei Adam Rostocki

Q: my dad (64yrs.) is suffering from 100% stiff backbone since 25 yrs. to till date. though the process was slow but now it is 100% stiff, due to that now he is loosing control over his both legs & now it is very difficult for him to make progress on his own . will u pls. suggest me something effective treatment for him. pls. tell me about message therapy.he is continuous on pain killer. my mother is also suffering from severe arthritis she is also 'ving stiff joints in the morning & after some exercise & hot water treatment she becomes normal pls. also suggest me something my mom too.with thanks. prabhat

A: Hi Prabhat, I will be happy to provide my opinion on both cases, but you need to send me detailed diagnostic information. In essence, I need to know in doctor's words, exactly what is wrong in both their spines. Best, Sensei Adam Rostocki

Q: I have a 2-3 mm disc bulge at L3L4 and L4L5. can a disc bulge ever go back to normal 0mm? if so what do I need to do? I have little pain when sitting or standing but extreme at after sleeping on my back or sides at night after sleeping for about 3-4 hours . I wake up from the pain and cannot go back to sleep unless I sleep sitting down. Pleas email me back I want to know can the disc bulge go back to normal. This all started when I did some sit ups and leg lifts to flatten my stomach. Lida

A: Hi Lida, Yes, bulges can and do return to normal. However, I highly doubt that this herniation has anything to do with your pain. It is tiny and in a common location. If you would like to type up your MRI report, I will be happy to take a look at it for you. Best, Sensei Adam Rostocki

Q: my back hurts all over and i know i don't have scoliosis or anything severe...yet...but i've tried reading your stuff but i'm only a 9th grader, it's summer break, and i have a short attention span. can you recommend (in simple, short terms) what might help my pains? i've already tried a heating pad-it only helped a little bit when i was immobile but i'm too busy to do that every time i have back pains. i've also tried pain killers-they don't help at all. Reanna

A: Hi Reanna, Without a diagnosis, it is difficult to suggest anything. Have you been to a doctor for the pain? If not, this is a good place to start. Best, Sensei Adam Rostocki

Q: I had radiation on my pelvic bone (5 wks) in 1997. Was told I had 18 months to live. Am still here, but the last few weeks I've been feeling a burning feeling in the same area where my tumor was growing in 97'. I don't have insurance. So going for a scan would be a big expense. Is the burning more than likely emotional? I've been under a lot of stress. Do tumors feel 'warm'? I appreciate the danger of e-mail advise but wonder if you've ever heard of the feeling of heat associated w cancer. I was told more than likely the cancer would come back as a brain/liver/lungs thing. Thanks for your feedback, Sandra

A: Hi Sandra, The email you provided did not work, so I hope you get this response...

Hi Sandra, The pain could well be emotional or even non-serious anatomical. However, we both know hat it may be something far worse and I do advise getting checked out. I hope all goes well. Best, Sensei Adam Rostocki

Q: Hello,I hurt my lower left back 2 yrs ago. My back has been bothering me off and on ever since.The last 2 an a half weeks the pain has been steady and not lessened extremely painful 3 doctors later and waiting for x-rays.I feel like I'm not taken seriously or like a number they all give me the same meds more or less and it hasn't helped at all.What do I do???? Very Frustrated!!! Sean

A: Hi Sean, Yeah, I know exactly what you are going through. All you can do at this point is wait. X-rays are not likely to provide much insight, so an MRI would be a better diagnostic choice if at all possible. Keep in touch an let me know what happens. Best, Sensei Adam Rostocki

Q: I have a herniated disc in my C5/C6 area of my neck. I have been on pain meds for a few years and have recent;y taken a fall riding my bicycle. Since falling the pain and numbness has doubled. I saw my spinal specialist and they want to remove the disc and fuse the vertebrae. To me being 40 years old with two young boys ages 2 & 5 feel that I should not proceed with the surgery. I do have pain in my left shoulder, numbness down my left arm to my thumb, index and middle finger. Please give me some type of direction as I am not certain which direction to go. Thanks for your help. Frank

A: Hi Frank, If you are ok with the pain, then avoiding surgery is best. I always advise surgery as a final option, never before. There are plenty of other treatments you can try, such as non-surgical spinal decompression. Time alone may completely resolve your condition. Thee is also the alternative treatment of knowledge therapy which is effective for many. I send you my best, Sensei Adam Rostocki

Q: I had an Anterior/Posterior lumbar interbody fusion done on 2/12/09. Two weeks later, my pain management doctor discovered that there was something wrong and sent me for a new MRI. Sure enough, the L5 nerve was being impinged by the cage itself. On 3/4/09, the second surgery was performed. They only went through the back this time and called it a "decompression surgery." It helped a little bit in that it made me walk a bit better, but all of the pain I had before even the first surgery was there plus more! I never had pain down my leg prior to surgery, but now I do!!! It's now been 5 months since my first surgery and 5 months that this nerve has been squished!

It gets worse. I've gone to two more different surgeons for their opinions. The first one says the cage needs to come out as it is sitting on the L5 nerve, but it would be too risky for me to have the surgery, especially since the cage is sitting on the L5 nerve and because the vascular surgeon had trouble moving my vessels far enough over the first time (that's why my cage is in crooked and sitting on my L5 nerve.) He said, I should learn to live with the pain or get a Spinal Cord Stimulator. He said I could end up with more leg pain, paralyzed, or dead.

The second surgeon says that he could go in the anterior way again, and break the cage into pieces in order to take it out. He said not to worry about my vessels during this surgery that he wants to do as he and his very good vascular surgeon that he works with can do this with no problem. He did say that nerve and scar tissue look a lot alike so he could end up tearing the L5 nerve which he says would cause me to have a dropped foot, but no pain. The other surgeon told me that would cause partial paralyzing of my left leg. He gave me these numbers to think about. 60% chance that he can help me; 40% chance I would remain the same and 5% chance that I would be worse. I asked "What do you mean by worse?" He said, "dropped foot."

I'm too afraid to take these risks. If I really knew I would come out at worse case, with a drop foot, but my pain would be gone, I would go ahead and have the surgery, but there are never any guarantees.

The second surgeon told me I should not be on hard drugs for my pain as they won't help me and you'll just need to keep taking higher dosages. He said I should be on anti-inflamatories and/or steroids. He said "Pain will not kill you, but the pain meds will!"

I'm between a rock and a hard spot. I'm wondering if someone could just go in and deaden that nerve which is impinged? What would my symptoms be after that? I'm afraid of more surgery, but I really don't think I can get off of these pain meds unless the pain diminishes a whole lot. If I have to stay on the pain meds, how long can one live on those drugs?

Thank you for any advice or encouragement you can give me. Carol

A: Hi Carol, Your story is sad indeed and I am so sorry to hear it. However, I am not surprised by it at all, since I get so many virtually identical... This is precisely why I tell patients DO NOT HAVE SURGERY if at all possible. At this time, all you can do is work to resolve these issues...

The L5 nerve is involved in far more than dropped foot.

L5 serves much of the lower body, beginning on the rear outer aspect of the hip and tracing a diagonal line over the rear outer aspect of the thigh, to the outside of the knee and calf to the outer side and front of the shin to the top center of the foot, middle 3 toes and frontal bottom aspect of the foot under those same 3 middle toes.

I think the cage should be removed if at all possible, but you should be very careful about how and who does it. I wish I had an easy answer for you and I do wish you well. Please stay touch to let me know how you are doing. Best, Sensei Adam Rostocki

Q: I am a 24 year old woman and 2 days back I had a small accident inside my house where I fell in a chair and hit my tailbone. The next day I consulted a doctor and had an x-ray. He said that I have a hairline fracture in my tailbone. What medicines should I take and how do I recover faster? Also what are the do's and don'ts during this time like exercise or carrying things? Gaj

A: Hi Gaj, There is nothing which can be done to speed the healing of a hairline fracture. Just eat right, including enough calcium, magnesium and vitamin D and do not stress the area to avoid pain. Common sense applies. Best, Sensei Adam Rostocki

Q: I'm a 59 year old male who has suffered with back pain for 20+ years. About 2 years ago I began experiencing leg problems, numbness, loss of feeling and loss of stability, etc. Ultimately the doctor recommended a laminectomy which involved L2, L3, L4 & L5. Just prior to surgery he changed plans and decided against fusion at L3 /L4. The reasoning was that I was already bone on bone at that level and fusion would possibly have caused more problems than it would solve. I am now 6 days post op and have had improvement in my legs. I still have the numbness and some discomfort but it is reduced.

My question is this: with the degeneration of disc material does spinal fusion take place naturally? Would fusion surgery have resulted in greater problems. The fusion was being considered to repair a curve in the spine to prevent the need to go back in for a second surgery. This all sounded reasonable to me and I liked the idea of not needing the fusion.Thanks. Mike

A: Hi Mike, Without intimate knowledge of your case and diagnostic testing, it is difficult to answer this excellent, but highly specific question. Fusion may take place naturally, but almost never as firmly as a surgical fusion should provide (although often does not...) Your surgeon made the call based on what they thought was right and it is done. All you can do is hope for the best. The fact that you are feeling relief already is good and I hope that trend continues. It would surely be nice to hear that SOMEONE has enjoyed a good surgical experience for a change. I send you my best, Sensei Adam Rostocki

Q: It's 4 a.m., I have tears in my eyes. I've had all the lower back surgeries; decompression, L5/S1 hemilaminectomy w/discectomy, fusion at the L5/S1, and for what it is worth, a spinal electrical implant that is two months old.

I have never been so miserable. The amount of drugs I take and the virtual unlawful way of obtaining half of them is the only way I have been able to cope with the PAIN. They say my scar tissue is the problem, encasing my nerve roots, along with everything else an MRI might say. The doctor I'm with now does believe in the pain, and she does help me with caudel injections monthly.

But as with all doctors, they draw a line in what they will and can do for you. In Florida, the legal system doesn't protect them as it should, coupled with the fact there are more dope heads abusing the system which makes it hard for back sufferers. DRUGS HAVE BEEN MY ONLY RELIEF UNTIL I READ YOUR WEBSITE.

After reading your website, it makes sense. I fit the profile. I'm sure my mind and back are intertwined. It's the first darn thing that makes sense I'll keep reading but it's quite intense. Richard

A: Hi Richard, I will be happy to correspond with your by email and answer any specific questions you have. If you are open minded to the idea of knowledge therapy, then I highly recommend you begin right away. I am sure it will help you tremendously. Best, Sensei Adam Rostocki

Q: Hello, I have been suffering now for 7 months with an extremely hypermobile t7 or t6 (I have to manually manipulate it probably every 5-10 minutes due to the pain), along with this I have very bad neck pain and what almost feels like a winging right scapula but according to chiropractors, doctors and specialists is not. I have had numerous adjustments by chiropractors and 3 months of physical therapy with no improvement besides added pain and fatigue. X-rays and MRI's are normal, any clue what is going on in my back? I pulled my body with my right arm in thick powder while snow skiing.Thanks, Adam

A: Hi Adam, Your symptoms obviously do not correspond to T7 or T6. I am not sure I understand how you "manually manipulate" it, but to me the entire condition sounds like TMS with a heavy doses of behavioral conditioning, especially since there are no abnormalities on your tests. I recommend knowledge therapy and losing the chiropractors. Best, Sensei Adam Rostocki

Q: Hi, Your website largely focuses on back pain and the material it contains is undoubtedly interesting and very thought-provoking. However, with regard to sufferers of Chronic Fatigue Syndrome who do not have any back pain, but do have musculo-skeletal head and neck pain, and crushing fatigue, what would you advise? i.e. how should such individuals seek to heal themselves? Salman

A: Hi Salman, Most cases of CTS are idiopathic, therefore the diagnosis. Doctors do not know what causes it. Of course, sometimes, there can be a physical cause which has not been discovered in some patients. In my personal experience, the overwhelming majority of CTS, especially when accompanied by musculo-skeletal pain, is related to the mindbody process and should be treated with knowledge therapy. Many patients are resistant to this idea, but there is no denying the countless sufferers who have been cured using this method. I wish you the best, Sensei Adam Rostocki

Q: Hi I am here telling you my story and how my last year and a half of my life have been horrible due to my back pain. It all started after my freshman year of high school, I was a star player for my high school football and wrestling team but right after the school year ended I felt horrible pain in my mid and lower back. I just thought it was like pain I have had in the past, so I went to the chiropractor and iced it like your supposed to do but weeks went by and the pain was not getting better at all. I was give every type of drug possible for the pain and nothing helped. I did chiropractor and physical therapy for that entire summer and nothing changed at all. I had to quit sports entirely and end what I loved the most. I was an emotional wreck now as well, I felt like I had lost a piece of me. It was so bad that I just wanted to end my life everyday. My grades and everything just started to go down and the year before i was a straight A student, possibly the happiest kid my friends knew but no longer was I. I got epidural shots in my back and that seemed like the first thing to ever help even a little bit, I thought my pain would be gone so I decided to join back in football, my passion. I was lifting weights again and still felt a little pain but it was able to stand. But about a month later it was back to horrible pain so I had to quit once again. That was about this past April. Now were in July, and yet my pain is still here and have caused me depression that is so bad i don't even want to get out of bed, I just wanna sleep and not do anything. I'm almost 17 and don't understand why I have this pain and why its still here almost a year and a half later, so i'm here asking for help. Lucas

A: HI Lucas, Thanks for sending in your story. What did the doctor diagnose you with? They were treating you for something, what was it? Best, Sensei Adam Rostocki

Q: hi there, whilst working on a conservation project in S Africa last April (27th April) I had a fall down a waterfall about 15 ft down, Immediately i could not move my legs, as i'm sure you appreciate. i cannot remember much of the fall or thereabouts just after, but the only way i can describe my pain was that without my feeling and noticing my heel on my foot had basically come off via the impact of the fall, an i did not feel it due to my back pain. Anyway i was made to walk back over rocky terrain and actually climb back up what i had just fallen down, refusing to go to hospital. I went to sleep with strong pain killers for 2 days, still in a ridiculous amount of pain i asked to go the hospital where they x-rayed the wrong part of my back (I know now) and sent me away with strong pain killers and said i would be fine! i did feel an improvement over the next week or two, so i just left it, then i moved to a different part of South Africa and asked to go to another doctor where they x-rayed and found 2 fractured vertebra, they said nothing could be done as i was flying back to the UK the next week and was sent away again with medication. I went through an MRI scan over here, finding fractured vertebrae and bulging disk, physio didn't work, i was still in pain, acupuncture didn't work, i was still in pain, now i have been going to a chiropractor for a few months with small amounts of improvements, but now i am getting pain down my right leg and in my right hip? basically i was just wondering if you could suggest any other therapy or help for me, its just that its been over a year now and i am still in pain, not daily but a good amount of the time, and when my back goes it really gives my agony. thanks for taking the time to read this long message. thank you Kat

A: Hi Kat, The body is designed to heal and obviously yours has not or your pain is from a different source altogether. I would like to see your MRI report. If you can send it along, I will take a look and give you my opinion. Best, Sensei Adam Rostocki

Q: Hello Sir, I am writing to send my thanks for our helpful website. It really helped me to get through a particularly bad episode of pain recently. I feel much better and have spread the word about your site. Thanks, Rachel

A: Hi Rachel, Thanks for the nice words and thank you for helping to get the word out. I am happy you are feeling better! Sincerely, Sensei Adam Rostocki

Q: I have been treated for back pain since October 2008. The initial MRI showed some disc bulging, mild stenosis, degenerative disc disease and something about sciatica. I have been taking Avinza to control the pain. Since March 2009, the Avinza no longer controls the pain AT ALL. I tried 2 epidurals which each lasted approximately 3 weeks with mild break through pain. I had an MRI in late June 2009. The report is long so I will enter the overall impression and if that is not enough information, let me know and I will type the entire report out. The overall impression listed is as follows: 1. At L2-3 to L4-5 there is disc bulging and facet degeneration with moderate spinal stenosis at L4-5.

2. At L2-3, there is a central disc protrusion indenting the ventral aspect of the thecal sac.

3. At L3-4, there is a central annular tear.

I need help as the pain has significantly impacted the quality of my life. Are these findings enough to warrant surgery to relieve me of at least some of the pain? Cynthia

A: Hi Cynthia, From the information you have provided, I do not see any obvious reason for your pain. I do not know how old you are, but the MRI report is typical for any adult and your spine is not in bad condition at all. I certainly do not recommend surgery. In fact, I recommend knowledge therapy, since I do not believe the disc abnormalities to be the source of your pain. If you want to send the entire MRI report, I might get a better insight, but these are my thoughts as of now. Best, Sensei Adam Rostocki

Q: I have had back pain starting in R buttock moving to leg and now hip since 2007. I went on endep and panadiene forte recently and it seemed to work now I am back to where I started the leg numbness and pins and needles are worse can medication do this or do I need to revisit the doctor? Jane

A: Hi Jane, You should always report any changes in symptoms to your doctor for advice. Best, Sensei Adam Rostocki

Q: I have 2 herniated discs in my back as a result of a car accident, as well as 2 in my neck. I have never had an injury in my life, i work out, eat right, and I'm in good shape. I've seen numerous doc's and the only treatment left for me is surgery. I'm not a fan of being cut open and i'm refusing to have it done despite the advice of docs and lawyers. What can you. offer me in terms of treatment that does not require surgery. What did you do? Thank you, Mike

A: Hi Mike, I used knowledge therapy to cure my pain. I will be happy to make recommendations for you if you can send me your MRI report, so that I know what you are dealing with exactly. Best, Sensei Adam Rostocki

Q: Fibromyalgia IS NOT all in one's mind. It has to do with pressure points on your body, that get painful, especially when they are touched. If it was "all in ones's mind" I'm sure everyone of us with it, would wish it away. Since it can be horridly painful. I wish it was easy to "tell myself" I feel GREAT! You need to catch up with the times, because many Doctors know that the pain is REAL, and not in our heads!!! Cynthia

A: Yes, Cynthia, the pain is in the body, just as all my writing clearly details. I never said it is in the head, since it is not. Research has shown that fibromyalgia is caused by oxygen deprivation of the soft tissues in the body and nothing else. This is due to ischemia, the same process which causes TMS, TMJ, carpal tunnel syndrome and many other conditions. The source of this issue lies in the subconscious mind, which controls the autonomic system. Knowledge therapy has cured thousands with fibromyalgia, while medical treatments have cured almost zero... Unfortunately you really missed the point of my fibromyalgia section. As I write many times before, you can fight the flow or accept the truth. I send you my best, Sensei Adam Rostocki

Q: can you, would you link me to doctors practicing spinal decompression in 1)northwest NJ area, 2)Tulsa, OK area, 3)Houston TX area, 4)St. Louis, MO area, 5)eastern PA area near Easton/ Bethlehem. Thank you, sincerely, Joe

A: Hi Joe, I do not maintain a database of doctors in all these areas. I recommend you search the care provider directory available on all the official sites for the decompression systems. Best,. Sensei Adam Rostocki

Q: Good afternoon. I have read your answers & am really hoping you can help me. I was in a car accident in February and suffered a posterior disc protrusion at L5-S1 impinging on the anterior aspect of the spinal canal, and posterior disc herniations at C4-5, C5-6, and at C6-7 abutting the anterior aspect of the spinal cord at C4-5 and at C6-7 and compressing the anterior aspect of the spinal cord at C5-6. I recently completed a round of epidural injections of Depo Mederol (three in the cervical, three in the lumbar). They did help and the pain decreased but then I began to suffer occasional terrible bouts of sciatica with the pain running down my legs and being worse in my knees and sometimes my feet. I take Skelaxin or Cyclobenzaprine (depending on the time of day since Skelaxin doesn't knock me out) and it helps. I also have prescription strength Ibuprofen which helps when the pain is not too severe. My issue now is, since I completed the injections 2 weeks ago, the muscles in my rear have been tightening up and feeling extremely hard, and I've been experiencing intermittent coccyx pain. Is this just my body adjusting to not having the steroid injections, or is it some brand new side effect I have to worry about? (I say that because the steroids caused me to gain 20lbs in 4wks - I'm 37 but I've always been btwn 110 and 113lbs - and the weight put additional pressure on my back and knees, and, since my appetite also increased I was eating much more frequently, which, combined with the fact that I'm a teeth grinder, has resulted in me developing TMJ so it's been a pretty stressful 5 mos. I'm hoping things will get better so I hope this new pain in my tailbone and the hardness of my glutes are just some sort of steroid withdrawal and not another new issue. Any assistance you can provide would be appreciated more than you know. Ayanna

A: Hi Ayanna, I do not think the tight muscles are caused by the injections. As you have read my site, I am sure you know that I rarely even subscribe to the theory that pain is caused by most herniations. Being that you have a history of TMJ and now chronic muscle tightness and shifting symptoms in response to seemingly appropriate treatment, I would advise you to consider the idea that your pain may be completely ischemic. Best, Sensei Adam Rostocki

Q: Hi, I am 25 yrs old I have never had any serious injury to my back. Last yr I notice a rather large indentation on the lower right side of my back. At first I thought it was a back dimple but then it started to hurt. Every so often I will experience a pain that starts from the indentation through my thigh and down to my knee. I have never had a Kenlog injection either. I am not really sure what it is from but my doctor says it was probably a reaction to some injection I had there. I am a little worried. I would like to think that an injection would not cause pain to run from my back down to my knee. The indentation is about the size of a golf ball. If you have any information as to what this might be please forward it to me. Thank You, Allie

A: Hi Allie, I wish I did. This is beyond the scope of my experience and qualifies more as a general medical issue than a specific back pain issue. I would go for a second opinion... I send you my best, Sensei Adam Rostocki

Q: Will Medicare pay if the Doctor says it will help ...... ME and My husband Both Have Back pain And we just need some help with it and I think we are sleeping on the wrong kind of bed to ok please contact me please. Sharon

A: Hi Sharon, I do not know about Medicare, since every doctor has a different policy about accepting it. You will have to contact a specific doctor and ask them. As far as bedding goes, I do not know what you are sleeping on now, but mattress type rarely causes back pain, except in unusual circumstances. Best, Sensei Adam Rostocki

Q: 2years ago i fall from 1st floor during dahi handi since from that back problem started till now it is their pls help me to cure it Prasad

A: Hi Prasad, Have you been to a doctor? If so, what was the diagnosis? Best, Sensei Adam Rostocki

Q: I would like to ask if you have any experience of my particular pain story, its a long one but I'll try to be brief:

Jan 2008 - on waking sharp pain felt upper left side but only for a second and went with getting up. Initially once a week, increasing to nearly everyday by around april 2008.

June 2008 - felt as though I was 'coming down' with something, feverish so went to bed early. In the middle of the night woke with stabbing pain in my left side like a knife through my ribs. Went to hospital, nothing wrong with my heart, hospital diagnosed chest infection (though I could breath well and in fact deep breaths eased the pain).

June-Dec - The following months and the pain increased in severity and area, i can only describe it as though I had a javelin through me (front to back) and several small knives sticking in me, all in upper left side. I have been mis-diagnosed (and treated) for pulmonary embolism, then referred from Dr Radcliffe chest dept to Rhuematology, had 2 MRI (thoracic & cervical) which were normal.

Dec 08 - On 2 hourly morphine & unable to lay down.

Jan 09 - Closed my saddlery shop because of my pain

Feb 09 - Spent all month shouting at my GP for a referral to the Hospital Pain Clinic

Mar 09 - Prescribe Duloxetine from the pain clinic & within 24 hours 'javelin' had been removed and I could lay down, i just couldn't believe it, the beginning of the end.

Mar - May and I continue to improve, I start riding my horse again and all my friends say how well I look.

Jun - Just as begin to think its all over the pain rears its ugly head again, luckily I have follow up appointment at pain clinic, a different doctor pin points the source to T4, T5, T6, & T7 and suggests facet joint injections.

July 5th 09 - almost a week since my injections and I'm desperate, the pain is back to its almost very worse, I am once again sleeping sitting in a chair, I did this for 9 months before and I'm not doing it again, does any of my pain suggest anything to you? Can you help? Regards, Elaine

A: Hi Elaine, Given the barrage of testing you had, I theorize that the pain, like most chronic concerns, is ischemic. I advise trying knowledge therapy as an alternative approach. Best, Sensei Adam Rostocki

Q: i have degenerative disc disease, two protruding disc,and two fused together grinding away. should I have any problem getting disability? all of these problems are documented. Andrew

A: Hi Andrew, There is no way to know for sure. Disability is a funny thing and is not evenly applied to all cases. I wish you well. Best, Sensei Adam Rostocki

Q: Hi Adam, I hope all is well with you. Like many others, i have been plagued with back pain for over 24 years. In my twenty's an orthopedic said i had to have surgery for 2 herniated discs some spinal stenosis or i'd be paralyzed. so at age 24 i had a laminectomy and fusion at l4-s1. The only thing the surgery did was take away the left leg sciatica. I struggled with doing all the core exercises and going for years of physical therapy three times a week, missing work, and bed rest. I have tried all the modalities and in my 20s i was a patient of Dr. Sarno's and attended his classes every week for months. Even though I believed in his ideas and books, I did not get much relief. I altered my life and walked three times a day etc. Two years ago the sciatica pain returned but do not get relief when i lie down. I went to a notable psychiatrist who has been talking about epidural injections. On Monday i just received two cortisone injections into my coccyx area because that has been in pain since October. everything was fine until about six hours later, I experienced the worst sciatica, along with hip and back and coccyx pain and double vision. I believe all side effects from the injection but the doctor doesn't and wants me to have an epidural on Monday. I went to see a new physical therapist today who seemed to take a bad attitude towards me when he read how long Ive had back pain as if to say it is all in my head. I feel very depressed and losing hope. I want to purchase your book and was wondering if there was a store i could purchase it from instead of the e-book on line?Also I was wondering if you knew the side effects from cortisone? I also wonder why i didn't get back relief after being Dr. Sarno's patient and taking full part in his treatment plan. Thank you so much, Irene

A: Hi Irene, Let me answer all your questions, one at a time. First off, I do not print and ship hardcover books anymore, as it is prohibitively expensive. I only sell mine as e-books now. This helps put the book in the hands of people who need it, the fastest and cheapest. Next, cortisone injections are very bad for the joints, causing damage to cartilage, ligaments and other tissues, especially with repeated rounds. There are other rare but extremely dire potential side effects, as well, including tissue necrosis. I do not know why you did not enjoy relief from Dr. Sarno's program, but I have met many who did not. However, some of these same people DID eventually find relief from another form of knowledge therapy. I think some people just do not respond to his approach. I wish you well and hope you can find some lasting relief. Best, Sensei Adam Rostocki

Q: Hello Sir, I wanted to say thank you for your site and your book. It is a God send for me. Warmly, Monty

A: Hi Monty, You are welcome! Best, Sensei Adam Rostocki

Q: I have lower back pain on both sides and in the middle with throbbing in the rectum. I need help and nobody cares. I need help. TY, Penny

A: Hi Penny, I think you need to see a qualified physician for a complete exam. Let me know what the doctor says and I will do my best to advise you. Sensei Adam Rostocki

Q: Hello,I am writing you as i was impressed with the questions posted and the informative feedback you provided for others on your site. My story is a unique case as i am not your typical person who trusts doctors and falls for the "take a pill to cure you" philosophy.

I am a 23 year old male and have actively played football and baseball my entire youth along with collegiant baseball. I now am working in my career and not playing professional or collegiant sports, however i am extremely active and healthy. I work out a minimum of 5 days a week, run and play rec sports for fun. I eat very healthy and have been pretty lucky not to have any serious injuries to my back.

Recently i started having lower back pain, nothing excruciating just annoying and sensitive to certain movements. Then suddenly after playing in my flag football rec game i had a sudden tightening of my back that increasingly got worse over a 24 hour period- but not caused by any standout plays or movements, just tightening quickly and suddenly. The next day i could barely move and went to the doctor (which i hate doing- especially Kaiser). The doctor gave me meds (which i didn't take) and sent me to have a radiology examination. The radiology examination report said:

Real disk space narrowing is present posteriorly at L5-S1. Mild endplate spurring is present from L3-4 through L5-S1. Surgical clips are seen at the right hemipelvis.

Before i go back to my doctor i would like to get your take/feedback on what that report means? I have no clue what this indicates and what to do to cure it. I would rather have feedback from you before meeting with my doctor-it is better to be your own advocate if you know what i mean.

To sum things up, it has been 2 months and my back pain has been steady/constant and painful as well as causing numbness to my limbs. However, i REFUSE to take medication- heck i don't even take advil. I assume bear the pain and deal with it as i have always lived with minor injuries during my sports days and am use to it. My only problem is that i tend to try and ignore injuries and this one seems to be not going away and is constantly throbbing. I am the last person in this world to physiologically think something is wrong or nurse pain, but this is real and not going away. There has got to be a way to cure my pain and take away the constant symptom that is limiting my physical activity in running and playing rec sports.This is very unfortunate to me and is upsetting because of how active i am. I have taken ZERO meds and need an answer before seeing the doc and getting typical treatment and them trying to shove meds down my mouth- i refuse to do it.

Any advice would be MUCH appreciated and well considered. Best, Brandon

A: Hi Brandon, The report simply says that your have degenerative disc disease at l5/s1 (which is universal in the population) and some minor arthritis in the lumber spine (extremely common, virtually universal). I do not see either of these as the source of your pain. However, I do get a good sense for your personality from your letter and feel this pain is surely psychosomatic. You are an achiever, a perfectionist and someone who CAN NOT back down. This puts tremendous pressure on yourself and is most likely the source of the ischemic you are suffering. I advise knowledge therapy. I send you my best, Sensei Adam Rostocki

Q: Hi there,I have had persistent back pain for a year now and nothing I've done (acupuncture, physiotherapy, chiropractor, massage, structural integration) has brought any last relief. I am currently undergoing a course of intramuscular stimulation for the second time, even though it is possibly the most painful treatment I have ever experienced. I am intrigued by your recommendation of "Knowledge Therapy" and think I could really benefit from something like that. Do you know anyone in Vancouver, BC, Canada who practices this? Thanks for your info,Laura

A: Hi Laura, Successful knowledge therapy rarely requires a professional. In most cases, a patient can cure themselves using the recommended sources. If you have need any help, you can write to me at any time. Just for the record, the nearest doctor I know to you is:
David Clarke, MD
Clinical Assistant Professor of Gastroenterology
Oregon Health & Science University
Portland, OR 97239
Best, Sensei Adam Rostocki

Q: Dear Sir, I fully accept the diagnosis of TMS - I've had lower back problems for 14 years and I fit the model perfectly. In fact I believe it even more after I've recently had an MRI scan showing a prolapsed disc. I had the scan during a particularly bad acute flare-up - the worst I've ever had - which I'm still recovering from several weeks later.

However, I have trouble accepting that in TMS there is no interaction with the purely physical. This is something that is not discussed at all in Dr Sarno's books and DVD. For example, if TMS causes tight muscles, tendons or ligaments, does that make you more susceptible to injury (even though Dr Sarno seems to imply that it's almost impossible to physically injure your back). Or can it have a physical knock-on effect or even a positive feedback effect - e.g. tight muscles cause joints to become tight or apply pressure on nerves, which cause pain in themselves and also cause the muscles to be even tighter, and so on, eventually going into spasm? One good example of a seemingly physical effect that I experience is that it hurts when I sneeze - it feels as though it's jarring the whole of my spine. It also hurts when I do certain stretches or bend down. Could these effects be purely physical - albeit caused by the physical state created by the mild oxygen deprivation dictated by the unconscious mind?

I don't see how these effects can be purely mental. And I don't see that they could be caused by conditioning either (although I do accept and understand the concept of conditioning, especially with actions such as sitting). Speaking of sitting - why do I seize up after sitting down for a while? I can even be sitting comfortably, but often when I try to stand up I've become incredibly stiff and sore, which prevents me from standing and walking properly until I've loosened up. This loosening up takes quite a few minutes of trying to stand/walk (although it can also be achieved by lying down for a few minutes). Nobody has been able to explain what is happening here. The best explanation I've had so far is that the ligaments shorten when they're not being used - and then on standing up they pull on tender tissue. But if this were true then surely it would also happen with lying down (which it doesn't - it improves it)? It should be noted that I only ever have this problem when I'm having (or recovering from) an acute flare-up with significant muscle spasm.

Dr Sarno also only ever attributes the short-term success of certain treatments (e.g. chiropractic and massage) to a placebo effect. Is there really never any benefit due to the temporary relief of the physiological conditions caused by the mind in TMS - e.g. muscle spasm/tightness?

Please could you clarify any such physical involvement and interactions? It's important to me that I understand what is going on as much as possible. I've been trying so hard with my program - for several weeks now - but I don't seem to be improving. In fact I'd already started the program when the recent particularly bad flare-up happened. Many thanks, Martin

A: Hi Martin, I do not agree 100% with all of Dr. Sarno's theories either, but most of them. There are countless symptomatic expressions, some very common, like yours, and others absolutely bizarre. No one, including Dr. S, is sure of the physical mechanism behind all of these, but it is safe to say that they are TMS in most cases. I have suffered many illogical ones myself.

Do not dwell on the "WHY" anything happens. That is self defeating. Just move forward and ignore it, regardless of the symptomatic expression. This has almost always worked, even if it takes a long time to do so. I am not sure exactly what you are asking as far as the "purely physical" but I can tell you that the body definitely reacts to physical activities, although it is not the activities themselves which cause the reaction in most cases. It is conditioning or simple fear. Sometimes, there is no explanation, it simply happens.

My best advice to you, from someone who has been there, and continues to be, is to do what Sarno says on one main point, which you are obviously not doing... Stop asking WHY when it comes to the physical. Simply concentrate on the fact that the reason for any of the pain is irreverent. The fact that you had a bad flare up when starting his treatment is a good sign. It is the mechanism fighting to preserve it own life, as it normally does. Keep working, take the timeline off yourself and you will be fine. Best, Sensei Adam Rostocki

Q: After a fall 5yrs ago & 2 car accidents, & another car accident, last year were i was nearly dragged under the car wheels plus i tore my cartilages in my knee which i am waiting for an operation on. After the first fall & two car accidents I have gone through sheer hell starting with physio, who told me my back was too far gone to work on me. I was even sent to pain management classes were they lay mattresses on the floor, there where a number of other people that went there with me. We were all told to lay on these mattresses the only difference was everybody else could manage to get up off them from the floor but me. I needed a crouch to raise myself up. The pain specialist was not content with that he sent me to see an Orthopaedic Specialist after examining me, he told me i had disks pressing on nerves & recommended Epidurals started. I underwent a further examination with the Pain management Specialist,who told me i had a very weak spine & his staff nurse said i had a trapped nerve. i have had epidurals for the last 4-5yrs till this Pain Specialist told me he wasn't doing anymore on me he told me he was moving to another department in the Hospital. I was then put under another German Pain Specialist who told me the reason why he was worried about doing them is because it was becoming to risky, what he meant was his hand was getting to shaky!. Being told this i immediately asked for a MRI scan it revealed to the Pain Specialists horror. I had Spinal Steno sis, Nerve impinges of L3 L4& L5 with Scoliosis of the spine I had another Epidural & 2 Nerve Blocks 2 wks ago. The Pain Specialist also told me prior to doing these injections as he said these injections were only a quick fix i needed to see a spine specialist & a Neurologist. I have just come back with the shopping & just lifting the shopping bags from the trolley to the car i am in agony again with this damn Sciatica I have been on Morphine patches for the last 6 mths. The Pain Specialist wanted me to stop them because i was allergic to the plaster I had big red marks after taking these patches off. I know you just can't stop Morphine I stopped them for 3days after the injections I woke up at 2am in the middle of the night with severe knotting like pain in my leg with the Sciatica trying to break through but being blocked at the top of the leg. Then my leg just went floppy with a spongy sensation again just like it used to be when i had the Sciatica before on the run up to an Epidural. I have tried stopping the Morphine again since for 1day but the pain returned straight away. Again over the last 3days i have stopped it but since as i say i have been shopping it has come back with a vengeance. I don't know what is causing this whether it is the injections that are not working or just coming off the Morphine. I have got to go back & see this Pain Specialist in 4weeks time. Please can you help me i could literally climb the walls with this damn pain.Yours sincerely, Christine

A: Hi Christine, It is obvious that you have to get off the morphine. All the treatments you have attempted are symptomatic, so none will cure anything. If you need help with your condition, please send me the MRI report so that I know what you are dealing with. Best, Sensei Adam Rostocki

Q: I have pain which is disabling due to schuermans disease and ddd. I would love to send an xray for someone to view. Tom

A: Thomas, How bad is the scheuermann's disease? Have you received a specific diagnosis for the pain your are having? How about an MRI? I would be happy to look at the radiological report from your x-ray, but do not need the film. Best, Sensei Adam Rostocki

Q: how do I find a DRX qualified person in NW Pennsylvania? Judie

A: Hi Judie, The DRX9000 official site has a provider directory. Look there and best of luck to you. Sensei Adam Rostocki

Q: Hey well i'm in high school, and after my surgery when i was in the fourth grade became different. I have questions but the main question is what is a good college to go to become an orthopedic surgeons. I ask my family members and they said MUSC college of Charleston.But i always wanted to leave state but i don't know what to do. So i what is a good college to go to? Taylor

A: Hi Taylor, The email your provided did not work, so I hope you see this... To answer this question, I recommend contacting the orthopedic department at your local hospital and asking several of the doctors for their opinions. I wish you well with your education! Best, Sensei Adam Rostocki

Q: I have recently been diagnosed with FMS but I also have had 4 knee surgeries (rt knee) & several years ago, I fell on ice and ended up sitting on my ankle. For a while now, my lower back hurts so severely even if I am just brushing my teeth, sitting in a chair, walking up/down stairs. But lately, the more sever the lower back pain, my hands and feet get swollen & will start to tingle & go numb. I used to see a PM&R but he has told me he can't help me anymore so should I go see a Pain Mngmnt DR? Also, what could be causing this pain? I have already had a hysterectomy & my gall bladder out, so I know it is not related to either of these two things. Kim

A: Hi Kim, You can go see an orthopedist or neurologist for an evaluation. In my experience, FMS is just a severe form of TMS and that is the way I recommend treating it. Best, Sensei Adam Rostocki

Q: Hi, I just wanted to say thanks for your site and your book. I had read Dr. Sarno before , but the treatment did not work for me. I was frustrates, but got your book anyway. After reading yours, I made some new breakthroughs and its amazing. My back feels so much better. I am not even concerned about my herniated disc anymore. Thanks, Mike

A: HI Mike, You are welcome and I am happy that you are feeling better. Sincerely, Sensei Adam Rostocki

Q: i had back surgery on april 9, 09 i had a herniated disk in L5 and S1 i had the micro disketomy. the first 6 weeks i felt awesome, hadn't felt that great in 10 years. i was like a kid again, but on about my 7th week the pain that forced me to have the surgery was back in my right leg and continues to get worse, i went back to my surgeon he said its inflammation and to start taking the naprosyn antiflammatory and vicondin. i don't believe he is telling me the truth, can you give me some advice, oh yeah i was not able to walk, sit, drive or do anything but lie down a month and a half before my surgery, i still would say i have improved 60% from the surgery. my name is Kim.

A: Hi Kim, This is extremely common and one of the many reasons I typically advise patients against surgery. At least you got some relief, which is more than most who often wake up with terrible pain immediately after the procedure. In my experience, surgery is rarely indicated and often acts as a placebo, which explains its short term benefits. I hope in your case that I am wrong, but I fear not. Best, Sensei Adam Rostocki

Q: I am desperate and needed to find somewhere to ask about my back pain. I have intense burning where my neck meets my shoulders. I crack my neck at a minimum of 15 times a day to alleviate the pain even a little bit, but it never stays pain free for more than a minute. When my husband rubs my shoulders and neck if he hits this area it feels like a red hot poker being shoved into the base of my neck and he has to stop. This is what leads me to believe this is nerve issues, not knots in my back. I've been in car accidents when I was a teen...but this has been going on for a good 10 years and only gets worse and worse. I've considered paying big bucks to see a back surgeon, get MRI's...I need something fixed, not put on medication for it. Please...do you have any advice? Jennifer

A: Hi Jennifer, Yes, my advice is to follow you own advice. Get to a doctor and get a diagnosis. Without this, you are merely guessing at the cause and have no hope for a cure. Let me know what the doctor says. Best, Sensei Adam Rostocki

Q: I have been 8 years suffering from daily pain. I have mild retro-listhesis and a mild herniated disc in 2/3L and 4/5L in addition where I have this trouble I have 2 nerve impingements. I have spent so much money on pain relief but nothing seems to work. Now my side muscles started hurting me and the strength in my legs isn't too good. I am 62,I feel OK but I am going berserk with this pain. I now simply don't know how to cure it as it's driving me up the wall. What happens when a person is driven up the wall??? Eileen

A: Hi Eileen, That is a good question. In my case, after 18 years of suffering, I thought about surgery, suicide and almost any possible option. Luckily, the desperation led me to my cure. I hope it does the same for you. Best, Sensei Adam Rostocki

Q: My thoracic MRI report says there is a small synovial cyst in the right neural foramen at T6-7. Also a hemangioma in the T5 vertebral body. I've had chronic pain in my upper left back that radiates over to my left shoulder and back of left arm. My neck on the left side is stiff and sore..all xrays and blood work appear normal. I've been to doctors, beurologists, acupuncturist..have used all kids of back relief contraptions and potions..new mattress but still wake up every 3-4 hours in pain. Next step is a cervical MRI. Other than this I am healthy, 51 years old, female, and not overweight. Marty

A: Ok Marty, Thanks for sending in that information. Let me know how you do after the MRI. Best, Sensei Adam Rostocki

Q: I have a large herniation at C6-7 from 2 rear end collisions that occurred 2 weeks apart. My herniation is compressing the cord and pain is not high...but head, ear pressure, headaches really bad and numbness in ankles, and hands, double vision. Knees sometimes wobble. All the Drs Ive seen say surgery before there in neurological damage. The pain has gone down since the accident but I am still left in a bad state. Cant walk on the ground too long (grassland) only smooth surfaces, can walk well in the house. Have to wear a neck brace at night to keep neck straight so that the numbness doesn't set in. Neck position causes numbness. Cant stand it any more. Morning starts off ok....then the pressure begins and by nightfall I just cant bear it. I have tried everything....now its been 1 1/2 year. I tried even decompression DXR9000....is there anything else? They say I need the surgery to stabilize my spine in case I fall etc... Cathy

A: Hi Cathy, I have heard all this before. Surgery or else... The problem is sometimes they are right, but mostly it is a load of nonsense. I do not have your MRI report, so I can not advise you specifically, but I can tell you that there is more than one explanation for your pain. Make you decisions carefully. Best, Sensei Adam Rostocki

Q: I have suffered with CLBP for about 15yrs. It is now starting to get worse with PC working from low doses of Narcs and moderate exercise. It does however flare up more and more where it puts me flat out. My MRI showed; Multi Level Disc Dessication with moderate loss of Disc Space. Rudimentary Disc Level S1-S2. Anterior spurring present on multiple levels. Moderate to Severe narrowing of the left & right neural forament. Mild to Moderate Facet Arthropathy all levels. Hypertrophied Facets L5 S1.

I have constant pain when I sit, stand and lie down. The only relief I seem to get is when I lie on the floor with my legs up on the couch. I'm not a back expert but I would say that my pain is probably well deserved given what appears to be wrong. My question is; Is this a screwed up back? What good are back exercises for something like this? Thanks, James

A: Hi James, I have a few more questions for you and then I will do my best to advise. How old are you? Where is your pain exactly, as specific as possible? Is this the exact wording of your MRI report or paraphrased? Best, Sensei Adam Rostocki

Q: Dear you! 34, female, alive and very much kicking- till Aug, 2008. I unfortunately over exercised and was diagnosed with exhaustion and periodic paralysis. For the following 7 months I was on a combination of bed rest and severely restricted movement. All tests showed up normal! But I could not walk, talk, laugh at my usual pace. It was comically slow! I could not make a grip, felt oxygen deprived in my lungs. The only thing which helped was "Neurotherapy" and "Breathing exercises" - yoga.

Currently I am usually short of breath (although much better) - when i exert the shortness is pronounced. And instantly my entire spine will tingle . I'm afraid for the health of my spine...please advise what i can do .... should i exercise gently for my spine should i not .... how can i heal my lungs without effecting my spine. How can i protect my spine from any ill effects of this apparent oxygen deprivation....

How do i know if it is psychosomatic.....if so what is the best way out ? Wheph!!! A handful of questions!.... Thanx so much for your time..Warm regards, n.

A: Hi N, Being that you were thoroughly evaluated medically and cleared and that your symptoms are illogical for any structural causation, there is a very good chance that your problems are indeed psychosomatic. I advise trying knowledge therapy, since there is no risk here at all. Nothing bad can happen to you, only full healing and a new life. Let me know how you make out with the treatment. Best, Sensei Adam Rostocki

Q: I am 31 and have ruptured 2 discs in my neck. I have been in alot of pain though it is gradually easing. I have lost feeling in 3 fingers on my left hand. Doc recommending surgery on Friday. How long does it usually take for these symptoms to clear up on their own? I really don't want to do surgery...but my arm/shoulder hurts so bad... HELP!! Thanks Susi

A: Hi Susi, There are many explanations for the symptoms you are having, and they may or may not be linked to the disc condition. I can not comment without seeing your MRI report. As far as how long... Most disc concerns resolve in 6 to 8 weeks, although some take longer. Surgery is rarely necessary and often makes the matter much worse. Be careful how you proceed. If the symptoms are improving, I do not know why any surgeon would advise surgery. If you want more detailed advice, please send the MRI report. Best, Sensei Adam Rostocki

Q: I am looking for others that have a similar problems. After 15 years of back pain, I am finally getting to the point of having surgery. However, I am fighting tooth and nail NOT to.Bad news..I have very little disc left at L5/S1. Good news, the ones above it are fine. Bad news..I've ruptured that disc 4 times in 15 years. It's dry, britle, and flaking apart.

My hamstrings are very tight, as are all the muscles that connect to the lower back. My hips get "cocked" when my back wants to "go out". It seems like my problem is more muscular, but neurosurgeons say that is a symptom of the problem. I'm 40 years old, and the episodes are getting more frequent and more severe. I have had many epidural steroid shots over years. I have done physical therapy, massage, yoga, seen three surgeons, blah blah blah. I am currently doing pilates 5 days a week since the last episode. That is helping at the time I am working and stretching, but it seems like I go back to zero after I make strides.

A local neurosurgeon, whom I really like says that fusion is the only procedure that will help me. And that I could see "some" relief. What do you guys think? Any thoughts would be appreciated. Regards, Adam

A: Hi Adam, First off, I am admittedly anti-surgery, due to its abysmal results, especially in the long term. Secondly, fusion creates more problems than it solves, as degeneration spreads like the plague to neighboring vertebral levels. Thirdly, DDD can be treated surgically with disc replacement, not just fusion. I can not tell you what the best path for you is, but I do highly recommend you confront this surgeon with these facts before making your decision. I wish you the very best, Sensei Adam Rostocki

Q: I have had low back pain off and on for a long time depending on my activity. I recently went to a NUCCA Chiropractor and he said I have a curve in my spine and my 6 & 7th vertebrae are phase 3 degenerate. What can I do to restore this? Mike

A: HI Mike, Vertebral degeneration is common and universal. You can not reverse it. As far as curvature, I do not know the type or extent, so it is difficult to comment on it. I recommend you talk to this doctor about what THEY think should be done or send me more detailed diagnostic info. Best, Sensei Adam Rostocki

Q: My husband jon used to play golf professionally, ten years on he has started to play again for fun but recently has suffered with sever burning pain in his back, we would appreciate an response to this e. mail so we can get back to normalcy. Elizabeth

A: Hi Elizabeth, Did he go to a doctor for an evaluation? If not, this is my recommendation as a starting point.Best, Sensei Adam Rostocki

Q: Hi, Thanks for this website. I quickly looked through it but did not see anything pertaining to vitamin D. Chronic muscle tension and pain can be caused by a vitamin D deficiency. Despite recent research supporting this, many doctors still fail to diagnose this. I have experienced this myself, as it took me 3 years and numerous doctor visits to figure out what was wrong with me. For me, the main symptoms were chronic tension in the neck, shoulders, back and hamstrings. It took me three years before I figured out what was wrong. I had tried physical therapy, chiropractic care, had x-rays and MRIs done, but no conclusive diagnosis had been made until I took a vitamin D test which turned out low. After I started taking an ultra high (50,000 IU/week) prescription dose of vitamin D (D3 to be exact) the symptoms gradually went away over the course of a few weeks. I hope you can add something regarding vitamin D to your website! Thanks, Kika

A: Hi Kika, It has been there for years. I am thrilled to hear that your fix was simple and non-medical.Here is an article for you.
http://www.cure-back-pain.org/vitamins-for-back-pain.html
Best, Sensei Adam Rostocki

Q: I was just reading the article regarding the tense back muscles. I do have a very similar pattern. I do have a normal healthy life but have back pain since I was 16. At that time one my leg being longer then the other was the assumed issue. After going to chiropractor and having to put things in my shoes seemed to resolve the problem from what I can remember. Now being 31 and having back problems since more then 8 years I am getting really worried. Have been to loads of different physios and recently osteopath we can't bring a solution to the problem. 8 years ago a very strong pain in my lower back always was the main problem. Physio did help to solve the very acute pain but never a long time relieve. So a daily pain is normal. Meanwhile my upper back (mainly between my shoulders) and neck is as worrying as my lower back. Especially the word tense fits regarding my upper back and I feel I can't relax, even though I try. I do live in London. Any advice or help would be appreciated. Thanks in advance, Marc

A: Hi Marc, As the article suggests, the main source of ongoing tension in the muscles is chronic ischemia. If you have checked out physically, I advise knowledge therapy as the best course of action. It worked for me ( and millions like me) I am sure it will work for you , as well. Let me know how you make out. Best, Sensei Adam Rostocki

Q: I have a herniated disc at the L4-L5 level. An MRI has confirmed this. I have no back pain at all. I just have numbness below my knee and this has weakened by ability to walk forward, except with a limp. I can walk backwards normally and if i turn my foot in, i can walk better. Will this go away? Please advise. one of my doctors says just to wait and it will eventually go away. the other says to do back surgery. thanks in advance for your time. ted

A: Hi Ted, I would like to know the wording detailed on your MRI report concerning the effects of the herniation. If you could type or send the report, it would help me to advise you greatly. Best, Sensei Adam Rostocki

Follow up: Hi Ted, I reviewed the material your sent. In your cases, I do believe that the herniation could be responsible for the symptoms you describe. It is not certain, since there are other possibilities, it is definitely probable. That being said, I advise avoiding surgery if at all possible. Surgery often makes these matters worse, as the epidemic occurrence of failed back surgery syndrome proves. You can wait it out and it might resolve on its own or at least improve, or you can consider a non-surgical choice, such as spinal decompression. There is far less risk here.... Let me know how you make out and I wish you the best! S.A.R.

Q: I am a 41 year old female and have not had problems with my neck or back until I was rear ended a year and 4 months ago. My xrays look fine and I have done about 6 months of chronic pain classes as well as medications with little to no relief. I recently had an MRI and they say a little arthritis in my spine. How can this be so painful after this accident and not at all before? I am trying to understand how this is not from this accident but from arthritis. Theresa

A: Hi Theresa, It does not sound like the pain is in any way structural, based on your testing. I theorize that the accident acted as a back pain trigger to begin an ischemic pain syndrome. I advise knowledge therapy and I am sure this approach will work FAR better than any chronic pain classes. Let me know how you make out. Best, Sensei Adam Rostocki

Q: What is your opinion on the possible cause of pain concentrated on my right side from the top of my head to my toes. At night I wrap my right knee, ankle, wrist and elbow with neoprene wraps, and the pressure seems to lessen the pain. Thank you. Steve

A: Hi Steve, You mean to say that your entire right side hurts? Head to toe? I can not make a diagnostic opinion based on this information, but it seems anatomically illogical to me. What have the doctor's said? Have you considered a psychosomatic causation? Best, Sensei Adam Rostocki

Q: Sir, I m facing acute upper back and chest pain for last 8 years. In initial days the pain was only in my chest. I went for several tests for my chest pain but found nothing. Even doctors did my angiography for a possible heart diseases but found nothing. Lastly Doctors advised me to go for Spinal MRI and found that I have a partial spinal fusion in my D4 and D5 disc. But Doctors said it is since my birth and does not require any treatment. But i m living my life like a hail all the 365 days 24 hour I feel a acute back pain and some times it passes to my chest. No medicine no exercise works. I am in great depression now. Sir, suggest me the right treatment please. SHYAM

A: HI SHYAM, If the doctors have not found anything which is causing the pain structurally, I feel confident advising you to try knowledge therapy. There is no risk here and the result might just provide you complete relief. I wish you well and hope that you can finally end your pain. Best, Sensei Adam Rostocki

Q: Hello Sir, when i told u about my problem you told "Hi Abhijeet, If you have been cleared of all structural possibilities, then the pain is most likely ischemic. I recommend knowledge therapy for this type of pain and I am sure you will do well with the treatment".........SIR COULD YOU PLEASE ELOBRATE IT A BIT MORE....LIKE WHAT IS 'ISCHEMIC'I WOULD BE VERY THANKFUL TO YOU.

A: Hi Abhijeet, All the information is found on my site:
http://www.cure-back-pain.org/oxygen-deprivation-back-pain.html
http://www.cure-back-pain.org/ischemia.html
Best, S.A.R.

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