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Dear Dr. Borigini, I had L5-S1 microdiskectomy surgery at the beginning of June. The pain going down my leg was excruciating for months, and after injections and meds, I chose surgery. The surgery was successful as far as I was concerned, but I still have pain in the back of my right leg. It's not radiating like it was pre-surgery, but sometimes it's almost as painful. My doctor had no explanation for me. I mentioned this to a coworker who had the same operation—he said that he had the same pain and it went away. Well, mine isn't going away and it's been 6 months. He said something about the nerves having to repair themselves. Is this the case? If so, how long does it take to go away? I think it's getting better, then it comes back full force. An MRI of my back revealed no connection. Any help or suggestions would be greatly appreciated! As you know from conversations with your coworker, individuals respond differently to the same surgery. I have seen many patien...
Last month, the American Pain Society added to its recommendations to health care providers regarding the diagnosis and treatment of low back pain .
In addition, the Society decided to discuss openly procedures that could be risky to sufferers of low back pain, including recommendations on surgery and other invasive therapies.
Unfortunately, there is not a significant body of good evidence to justify unquestioningly embracing these new recommendations. It is difficult to find well-done clinical studies which support the use of a number of the more invasive treatments used for chronic low back pain.
The initial set of guidelines for the management of chronic low back pain were published in "Annals of Internal Medicine" last October. However, these recommendations dealt more with the initial evaluation of a low back pain patient, and included thoughts on what type of x-rays to order in addition to more conservative treatments such as massage/manipulation and exerci...
Q. I definitely want to avoid lymphedema. Is there anything I can do to ward it off, or is lymphedema totally random? A. The very best thing you can do to help prevent lymphedema is to make sure you get full range of motion back in your arm, whether after surgery or radiation. Favoring the arm on your affected side, hunching your shoulder protectively, being too stiff to stretch your arm up over your head and around towards your back–these are all things that will make it easier for lymphedema to gain a foothold. I have a friend who’s a physical therapist specializing in lymphedema treatment. In fact, we became close as she gave me daily massages to relieve my own swollen arm. (Just as getting a tummy tuck is the silver lining of a tram flap reconstruction, a daily massage is the big plus of having lymphedema!) This friend says that women who’ve had surgery, particularly a mastectomy with lymph node removal (even if just a single node) need physical thera...
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