I recently read a Q and A session on a European blog where individuals could ask a doctor about a certain situation in their personal health lives and the doc would respond.

One particular question a woman was asking about her 70-year old mother’s back pain. The response was lengthy and informative so I have taken the liberty to copy what was said and post it here for your educational reading.

“My mother has severe pain in her lower back and legs. An MRI scan showed ‘cauda equina’ compression and a slipped vertebra. She was told the only treatment is an operation but the outcome will not be that good and may even make things worse. She was given Gabapentin for the pain but it hasn’t helped, and she’s constantly crying and unable to do anything. Are there any other treatments?”

Dr Scurr says… Your mother is stuck between a rock and a hard place. But as is so often the case, communication is everything, and what is significant is that you’ve been led to believe the outcome of surgery ‘will not be that good’.

While I agree there’s a possibility an operation may not help, and under exceptional circumstances could make matters worse, the balance of probability is her pain will be reduced and she’ll be able to get back to normal life.

Hers is a common problem, so it is worth describing what’s going on. The cauda equina (or ‘horse’s tail’) are the group of nerves which travel from halfway down the back. They run through the spinal canal, a channel about the thickness of your little finger which is situated behind the vertebrae.

The scan revealed your mother has degenerative disease (often referred to as wear-and-tear arthritis), which has put pressure on those nerves. This is usually because a disc between two vertebrae is breaking up or bulging.

Sometimes the pressure is due to lack of space when new bone has formed in the spinal canal (a condition known as osteophyte formation). This is due to damage and inflammation caused by arthritis.

The medical term for this lack of space in the spinal canal is spinal stenosis. It is very common, probably affecting almost all of us to some extent as we age, though not to this degree.

All this pressure on the cauda equina causes severe back pain and some pain in the buttocks and legs, usually relieved only by lying down. It’s a disabling and miserable condition, and it usually worsens.

Your poor mother’s stenosis is being compounded by a slipped vertebra (spondylolisthesis). Imagine a pile of three cotton reels, one on top of another, then gently push the middle one; the cotton reel holes are no longer lined up, so that the bundle of nerves running down the middle are at best kinked, at worst crushed.

This slippage is caused by degeneration of the ligaments and muscles which support the vertebrae, and is the result of a sedentary lifestyle combined with natural ageing.

By the time it gets to this stage, other options, such as good physiotherapy, are very limited.

The spinal stenosis can be relieved by laminectomy, trimming the bone behind the cauda equina to open up enough space for the nerves to travel free of pressure.

To tackle the spondylolisthesis the surgeon will stabilise the vertebrae using screws, bone grafts, or both (a technique known as spinal fusion).

The combination of the two procedures constitutes major surgery, but it is routine, i.e. thousands of such operations are performed every year, and it’s the best potential route for your mother to be pain-free and mobile once again.

Gabapentin can be effective in the treatment of pain, caused by damage to nerve tissue. The dose has to be adjusted upwards, slowly, to reach a level that provides relief, although in this type of problem, which is caused by the crushing of nerves, the chances of success are limited.

You need to tackle the cause, and that means having the courage to go through with an operation.
Read more: http://www.dailymail.co.uk/health/article-1299793/Ask-doctor-Is-surgery-cure-pain.html#ixzz0vgGF8Sxy

Personally I wonder if decompression therapy would help her, or are her joints and ligaments too deteriorated? Wearing a decompression brace such as our SR 500 would certainly help relieve some of the pressure and be a good indicator as to whether decompression may work.