Spinal Stenosis-What has Worked or not Worked for our Viewers- Part III of a III Part Article on Stenosis

(12/29/08)- We at therubins recently received the following e-mail from one of our viewers, Jack Rubens, who by the way is not related to any of us. If any of you have had a similar experience, we would appreciate either your e-mailing that experience on to us, and we will forward it on to Mr. Rubens, or to e-mail it directly to him.

Since I have suffered from this illness, there are many unanswered questions that some of you, our viewers may know the answers. Here are but a few of the questions that I have concerning this disease:

• The first spinal steroidal cortisone shot that I received was in July 2 002, and it lasted til July 2004. I received the 2^nd shot in July 2004 and it stayed effective til July 2007. It is now 1 1/2 years since my last shot. Why the difference in timing in regards to how long the shot will stay effective? How come the shot is effective only about 50% of the time, but once it has helped you, it means that subsequent shots will also help you?
• It is said that you should only get 3 shots within a 6-month period of time. My pain management doctor said, that is because Medicare or Medicaid will only pay for 3 shots within a 6-month timeframe, and that your body will not be negatively effected by receiving more than 3 shots in the 6-month timeframe. Which answer is correct?
• How damaging to the body is the steroidal cortisone shot?
• Is stenosis a genetically inherited dispostition? Incidentally, my brother Harold has never suffered from this problem.
• Are men more predisposed to get the disease than are women? Does race or religion enter into the equation?
• We at therubins receive the most e-mail in regards to stenosis, and the e-mails are from young as well as older individuals. Is age a factor in the disease?
• Are people who do more physical activity more predisposed to getting the disease than are less active people? Does a physical injury when a person is younger have a cause in the disease's development?
• In Mr. Rubens case he states that the injection done under the older method, meaning between the space, rather than directly into the nerves works better. In my case, the injection went between the spaces. Is that truly the better way for it to be given?
• When I got the shot in 2004 another doctor was present while my doctor administered the shot. He explained the steps to the other doctor and I overheard all of what he was saying to him. One of the things he said that has stayed with me to this day was that he "left the needle in" for a few seconds longer than most other doctors leave it in for. Is this significant? He also told the other doctor that the mixture (he mentioned what was in the concoction, but I sure don't remember what it was) varies with the particular patient. Does this truly have a material effect on how and if the shot will work? Incidentally, the shot does not hurt at all, and all I "felt" was the fluid from the shot going into my body, since the shot takes a while to administer.
• Does diet have an effect in the whole process of the development of the disease?
• How important is the pain-management doctor who administers the shot? I will give my answer to this one- Yes he or she is critically important as to how effective the shot will be. In my case, even though all the doctors have x-rays and MRIs to work with, he probed for quite a while before determining exactly where the needle to administer the shot went.
• Does exercise and/or stretching help prevent or even mitigate a stenosis attack?

These are the questions that I have and below is the e-mail that Mr. Rubens sent us. This article is strictly devoted to any answers, or even additional questions that you our viewers may have. We will gladly post these responses on this site, and if you don't want to have your name used, we will omit your name.

"Original Message -----

From: JackRub@aol.com

To: hrubin12@nyc.rr.com

Sent: Wednesday, December 24, 2008 1:55 PM

Subject: Spinal stenosis

I was wondering if you could post this on your blog as I'm trying to find out if anybody has had the experience I have had.

My spinal stenosis had been under excellent control through the use of narcotics and an occasional epidural. Some epidurals helped and some didn't. In my particular case, the newer technique of doing the injection directly into the foramen (cluster of nerves), did not help and actually made things work. The older style of injecting into the narrow space worked better for me.

I was doing quite well but in July, 2008 I took a bad fall. The injuries cleared up within a month but the impact of the fall brought back my spinal stenosis. I had an epidural and it helped. I had pretty much recovered from it. About 3 weeks later, I was lying on my back very still in bed. My right foot, the foot that gets the pain from the stenosis, was gently lodged against the left foot. Suddenly, I felt like what I thought was a cramp coming on. The pain was excruciating. I had no choice but to scream loudly while at the same time jumping up. In around 10 or 15 seconds it was over. After that, there was a feeling of tightness in my ankle and moving up to around the calf. I was unable to walk without the help of a cane. In around 48 hours, the pain went away. I asked my doctor whether the epidural had anything to do with what happened and he said that it might have because the nerve can do strange things.

5 months went by and last week I played a fairly strenuous game of tennis. Upon leaving the court, I felt a slight pain in my ankle. I know from experience that this is referred pain from the stenosis. That night, I went to be and got another attack like the first one. Again, I was lying completely still. Again, the pain caused me to scream involuntarily. Again, I had to use a cane afterwards and then everything cleared up.

I would like to know whether anybody who reads your materials has ever had this kind of experience from spinal stenosis. Because both times I was lying completely still when the attack came, I do have a theory. After playing tennis, there is an inflammation that takes place due to arthritis. When the inflammation finally causes the nerve to touch something, the attack takes place. This would explain the attack but wouldn't explain why the attack is over in 10 seconds or so.

Any help would be appreciated.

Jack Rubens "

(10/20/06)- We at therubins received the following email from one of our viewers:

"how come on the articles with regard to spinal stenosis not a word mentioned about healthy eating, supplements, minerals etc. t.s."

Stenosis is a horrible disease that alters the afflicted individual's quality of life. You will try anything to alleviate the pain. As the article pointed out, I tried everything from acupuncture to painkillers, etc, In my case the spinal steroidal injection has alleviated the bulk of my pain. I do my stretching exercises, and so far it is under control.

In the email cited above, the viewer asks about eating right, dietary supplements, minerals, etc. We would appreciate anyone who has had experience with any of these items to email and tell us about your experience with it. We will withhold naming you, or even putting in your initials if so requested.

If you have any other possible suggestions as to a treatment that either helped or didn't help please let us know about it.

(10/23/06)- "At the age of 41 I was diagnosed with spinal stenosis.I have the same diagnosis and have had very good results after going thru physical therapist after therapist. One I have been with for two years has me do 20 minutes of traction(works well for me takes the tingling feeling out of my right foot), stiff has hell for a a couple of minutes after getting off the table. Then we do I believe they are called the "thomas"stretches on a stiff padded bed type equipment. Then a cybex rotary torso machine 3 sets of 10 on setting plate #4(extremely light weight)(however the machine is not used as it is normally intended to. I stand instead of sitting, lock the two pads in all the way to the left side then grab both of them while I am standing up almost perfectly straight, push on the one closest to me with my left hand and pull the other pad with my right hand, again very low weight 3 sets of 10. Eventually do a roman chair at about 45 degrees, put my hands on my chest and remain in that position for 30 seconds, rest then do do again, eventually work up to 60 seconds etc. Then a cybex mutlipositional hip machine. Has a pad that goes right above the knee, lift up tyowards the chest say 10 if you can on very low weight, then the other, eventually more sets. Also they have me seated on a office stool with wheels facing some kind of cybex adjustable pulley machine, in this situation the pulley is positioned about paralell with the chest. All I do is pull the "t" bar handle back towards my chest with both hands while trying to keep th rest of my body quiet. The purpose of the wheels is that it forces you to use your stomach muscles. Then on the same machine they put me seated on a exercise ball sideways to the machine and have me use one arm at a time, pulling across my chest. then the other side. Ball forces you to keep balance and work the abs. I am looking to eliminate this tingling in my foot all together. I was thinking of trying Chinese herbs in combination with the exercise program. I have great confidence in the pt center I attend. Geez just the other day I threw out a question to my therapist about my pal having a sacroiliac strain and by God the info he gave me I called my bud in Utica NY and asked him what the treatment program was that helped him for the first time in 6 months and you would have thought my pt guy was treating him. " TS

Please also see: Tips on How to Keep Your Back Healthy
Low Back Pain" Does Treatment Help

Spinal Stenosis- A Personal Chronicle - Part I
Spinal Stenosis-Clinical Trials- Part II

FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "Selecting a Nursing Home"

updated December 29, 2008

http://www.therubins.com

e-mail: hrubin12@nyc.rr.com or rubin@brainlink.com

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