Dangers of Epidural Spinal Injections

[BruceMC]

I know that posting this is going to elicit a firestorm of commentary, but this list of bogus back pain treatments piqued my curiosity:

http://americannewsreport.com/nationalpainreport/five-back-pain-treatments-avoid-8821957.html

His over 20 ESIs did not help Terri Anderson very much it would seem:

“'The multitude of risks attributed to epidural steroid injections outweighs the transient benefits. Risks include arachnoiditis, meningitis, stroke, paralysis and death to name a few,' says Terri Anderson, who had over 20 spinal injections to treat a ruptured lumbar disc and now suffers from arachnoiditis."

It seems their dangers far outweigh any dubious benefits they may provide.

 

[cirrusnarea]

Wow, with all the anti-chiropractic sentiments you think the more traditional medical treatments would come under equal fire for their risks. Not that I'm into chiropractic anymore, but fair is fair.

 

[BruceMC]

Yes, cirrusarea, it seems to me that this study shows just how much traditional medicine is grasping at straws in their efforts to identify and treat a physical cause for back pain. At least, chiropractors do use a "healing touch", which, as Steve Ozanich points out, can sooth a patient while distracting him or her from the pain symptoms he or she is obsessing over.

Here's a Wiki definition of arachnoiditis:

http://en.wikipedia.org/wiki/Arachnoiditis

Of course, I'm not an M.D., but arachnoiditis sure sounds like it could result from needles being poked into your spinal canal, doesn't it? But it also sounds like it could result from TMS.

 

[Steve Ozanich]

Bruce this post brought back some deeply buried memories in me. That term "arachnoid" became my nightmare in the 1980s, and was one reason I latched onto Dr. Sarno and TMS so tightly.

More precisely, it was "sub-arachnoid." It was the space from within my ex-wife's spine that she became paraplegic. I don't know what everyone else was doing in the 1980s but I was in court battling incompetent physicians, for years, as the lawyers and neurosurgeons kept using that phrase, "sub-arachnoid space." I was in my mid 20s and I was learning all about the spine, nerves, and the spinal chord, in ways that I never wanted to hear about.

So, for me, it wasn't that difficult a decision to avoid surgery, and to trust the good doctor. That arachnoid space was something that I wanted to avoid like the porta-potty line on free beer night. But I still see people who would rather try an injection than TMS-healing.

It's what we haven't seen that makes us unaware. And so tragedy enlightens us to the suffering of others.

Steve

 

[Pandagirl]

I had an epidural during childbirth that didn't touch my TMS pain. I had been looking forward to it actually, fantasizing about having a couple of hours where my back and legs would be numb. Instead, the heightened state of stress only increased my pain.

SteveO - I might not have had an epidural if I had read your book back then. How terrifying! I was actually given too much because the needle went in crooked and only worked on one side of my body. So one side was really, really numb. I couldn't feel my leg for another 12 hours and was initially terrified that they had done irreversible damage with the needle. At midnight I was pushing the baby's bassinet, making laps around the nurse's station, dragging my right leg behind me trying to metabolize the drug and get the feeling back in my legs. No more babies for me, but no one is coming near my spine with a needle!

 

[BruceMC]

I had no idea that my posting would touch so closely on your personal biography and your wife's paralysis, Steve. Sorry if it brought back unpleasant memories. But what was interesting to me was that so many physical and structural remedies for back pain practiced by modern clinical medicine are no more effective than mumbo jumbo and in fact often, if you look at them closely, do downright harm to the patient. It all gets back to what Dr Sarno says about the proliferation of essentially useless treatments based on a mis-diagnosis of the real psychological causes of most cases of back pain. It seems like the reason they sometimes work is mostly due to the placebo effect that we discussed in our chat group meeting two weeks ago on Chapter 7: "Placebo Yo-Yos and Nocebo No-Nos" of your Great Pain Deception book. The article doesn't elaborate, but you have to wonder what sort of negative side-effects have occurred when morphogenetic protein (a compound that stimulates bone formation) was introduced into a patient's spine during fusion surgery? Sounds like a real adventure in forensic medicine!

 

[Steve Ozanich]

No problem Bruce, I've given up most of my attachment to that event, although I still feel sorry for the ex wife. She deserved better. But I hadn't consciously thought about those days in a while. It was a time of tremendous stress and sadness and anxiety, as she was crippled, and many loved ones began to die around us that year. The 1980s was a blur to me, much like life has been to Keith Richards.

Pandababe, remember, there is a big difference between an epidural, like you had, and a spinal block. Yours was very safe and didn't get near the dangerous nerves. But several women have emailed to say the story freaked them out while they were pregnant. It was such a rare tragedy that I didn't link our story to what others might fear. I should have known that catastrophizers would latch onto it. I don't blame them. It was one of the main reasons I wanted to believe that Dr. Sarno was right. I didn't want a needle near my spine. Now we see 64 people died from meningitis who probably never needed any injections, likely TMS in most of them. Tragic, and senseless.

Right after my wife was paralyzed we were sent to rehab to begin the long grueling battle of learning how to live again from a wheelchair. There was a woman in her room who was telling us that her spinal block went the wrong way during her baby's delivery and it paralyzed her from the waste up, instead of going down to her legs.

I had seen enough horror in my life, so God showed me Dr. Sarno.

See you Tuesday. Who is bringing the beer?

 

[BruceMC]

The 1980s was a blur to me, much like life has been to Keith Richards.

I thought that was the case too, Steve, until I read Keef's autobiography last year. After he met his wife, Patti Hansen, in 1982, Keith gave up heroin completely. Has been clean for 30 years. His autobiography is extremely interesting not as a record of debauchery because of all the insider information he gives about open G and D tuning using a capo to get the unique Stones sound on various songs. He was real monogamous too. Not nearly as decadent as the publicists would suggest. But it's the hype and the mystique that sells records, isn't it?

I'll bring the pretzels if you bring along the metaphorical suds!

But I can certainly see how the 80s must have been a blur for you. I remember my late father's wrongful death law suit while I was supporting my mother with dementia and working at the same time in the Professional Services Division at Fujitsu Ltd. It was not so much a blurr as a series of isolated vignettes. Disconnected images and discontinuous, broken narratives.

 

[njoy]

I agree with cirrusarea that "fair is fair". I did the chiropractic thing for years and got some relief until my final treatment gave me horrifying TMJ (pain in the jaw area). But, and this is important, it was pure TMS! So, when I hear people, especially doctors, dissing chiropractic I think "what makes you so much better?" No doctor, and I saw several, offered any help and the dentist wanted a thousand dollars for a device that made the problem worse.

Once, a doctor told me (based on my age, no tests), "You have arthritis in your spine and it can only get worse." Can you imagine? Luckily, I was a Sarno fan by that time and was unimpressed. Twenty years later I have no back pain beyond an occasional twinge which doesn't stick around.

Give me placebo over nocebo any old time!

 

[BruceMC]

Once, a doctor told me (based on my age, no tests), "You have arthritis in your spine and it can only get worse."

Now there's an example of a classic 'nocebo', yet you weren't affected by his diagnosis-prognosis because you were equipped with knowledge about the true cause of your condition from having read Dr Sarno. That says a lot.

 

[njoy]

Well, Bruce, reading Dr. Sarno did help but I also had some useful information from my family background. I was taught early on to mistrust doctors and have never found any reason to discard this notion. Almost every single member of my family has been harmed through doctor's mistakes or lack of knowledge. Seriously, I could write a book! A few have actually died and many have sustained life long damage. Even my husband's nephew who is a smart, sincere, well-trained medical specialist has extraordinarily narrow views. I would never consult him about anything medical without balancing his recommendations with those from other sources before making MY decision about MY health.

Apparently, doctor error (mostly medication errors) is the 3rd or 4th most important cause of death in the US and, no doubt, elsewhere in the world. In the situation I described above, I already knew that a bit of arthritis in the spine is common in older folks. Big deal. That's natural and certainly not some kind of morbid curse that life as we knew it has ended and it's all downhill from here. Maybe he didn't really mean that but his words implied it.

I totally understand the advice to see a doctor to "eliminate a physical cause" for our pain but we all know that's not what usually happens. Usually, the doctor comes up with a physical cause de jour or (worse) implies "it's all in your head" without any useful ideas about what to do about that.

Actually, I have quite a bit of respect for doctors. I just don't trust 'em with my health!

 

[BruceMC]

I think a diagnosis of "arthritis of the spine" is a convenient catchall to explain any kind of back pain that develops after, say, your 40th birthday. Just an easy way out for a doctor confronted with pain symptoms he/she can't really explain. Behind it is the plain old fashioned bugbear of "spinal degeneration" that we're all supposed to be suffering from ad nauseum after 40. Very good way, too, to get you to sign up for a year of chiropractic procedures to avoid "being paralyzed for life" as a hunchback! I've just known scads of people who've been told they are suffering from "arthritis of the spine" who never "degenerate" into paralysis, but instead have aches and pains in the lower lumbar region that go up and down for no real obvious reason; that is, unless you accept Dr Sarno's explanation that this has to do with emotions rising, falling and attempting to break out from the patient's unconscious mind. If lower lumbar pain was caused by so-called "spinal degeneration", the pain would be steady and slowly increase in severity over many years time. Never seen it happen that way. "Arthritis of the spine" just seems to be a convenient way for the doctor to tell a problem patient to get the heck out of my office.