Back pain in women

Back pain in women

A few months ago, we came across new diagnostic and therapeutic information on Premenstrual Syndrome (PMS), discovered and applied by Dr. Jorge Lolas. We have been reanalyzing the concepts of lumbago, cervicalgia, and women’s back pain as a whole. Of course, we do not ignore the traditional concepts and our accumulated experience throughout the years. This allows us to diagnose and treat spinal conditions whenever there is a treatable pathology. But, how many women go see a doctor for lower back pain, dorsalgia, and chronic cervicalgia without an evident pathological substrate in the diagnostic tests? How many women are diagnosed with fibromyalgia when having different types of pain? Why is fibromyalgia mainly manifested in women? Why are so many women hypersensitive to the touch, so much as the touch of a sweet hug? There are also men in the same situation, but it is most common in women. It might be lesser muscle development, or higher sensitivity and tendency for women to suffer from stress due to family or work-related problems…, but we are probably not considering other pathological processes, mainly because they are still unknown.

One of the most puzzling symptoms of PMS is low back pain. It is with certainty a type of dysmenorrhea that instead of manifesting at the pelvis, is felt at the renal sinus. Patients go see their gynecologist because they relate it to premenstrual symptoms, at least at the beginning, but when the gynecologist does not find any problems (like it usually happens), patients are sent to see a spine specialist, who will not find any problems, except by chance. Unsolved case…

Another frequent symptom is chronic cervicalgia by muscle spasm, non-responsive to treatment in many occasions. Pain to the light touch of the skin is common in severe cases. It is evident, in these extreme cases, the presence of other problems besides the muscle condition. It could be interpreted as a decrease in the pain threshold, that is, a pathological increase of the skin and myofascial pain and tension receptors’ response.

Why does the pain threshold decrease? There are many reasons. The psychogenic factor is among them, and it is the most important to date, but there are many inflammatory mediators that modify this parameter. When referring to women, and considering Dr. Lolas’ theory, the causal factor for pain hypersensitivity, never taken into account before, is the increase of circulating prostaglandins. Where does so much prostaglandin come from? A swollen cervix is an amazing prostaglandin factory that produces an inflammatory and hyperalgesic state throughout the body, among other changes, such as the neuropsychological. It is interesting that there are treatments for inflammatory processes of any body parts. Why is cervicitis the only body inflammation that doctors have ignored?

Cervical inflammation is to be considered as a new possible cause for back pain (and other symptoms). Fortunately, there is a treatment.

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More about SPM

Dr. Ferrández speaks with Jamie Litrun about TDR

Dr. Ferrández speaks with Jamie Litrun about TDR

Our Spine surgeon, Dr. Ferrández, one of the most experienced Spanish surgeons on lumbar and cervical anterior approaches, has been interviewed about total disk replacement by Jamie Litrun, the director of the most quickly growing Facebook group of spine patients.

Watch the interview here and learn about the indications, advances and limitations of this restoring technique.

Jamie Litrun interviews Dr. Ferrández about Total Disc Replacement
Dr. Ferrandez implants first ApiFix in Spain

Dr. Ferrandez implants first ApiFix in Spain

A sixteen year old girl suffering from adolescent idiopathic scoliosis (AIS) was operated on September 4th by Dr. Ferrandez with the assistance of Dr. Nick Sekouris, an orthopedic surgeon from the Orthopedic Medical Center in Athens, and member of the ApiFix implantation group from the very beginning. The patient was discharged from Hospital less than 48 hours later with no discomfort. She had a 52º lumbar curve and a prominent thoracic hump which flattened immediately after lumbar surgery. The curve went down to 27º and bleeding or muscle distress were minimal during and after surgery.

ApiFix allow adolescents with flexible curves to undergo surgery with low risk, low discomfort and high postoperative mobility. The system is capable of keeping the grade of correction the patients are able to gain by themselves. Some exercises started three weeks after surgery allow the device to lengthen telescopically, increasing the initial intraoperative correction.

Dr. Sekouris, based on his own experience, mentioned that correction is maintained even though the implant is removed, if it has remained implanted time enough. «This kind of device should be used in every eligible case, as the benefits clearly overcome any drawbacks, including cost», he stated.

OJOG finally releases Lolas’ master paper on PMS/PMDD

OJOG finally releases Lolas’ master paper on PMS/PMDD

Chilean Dr. Lolas' theories on the infectious origin of Premenstrual Syndrome and Premenstrual Dysphoric Disorder have been summed up in an article now published by the northamerican Open Journal of Obstetrics and Gynecology. Our team is treating PMS patients following this approach since october 2014, and has proven its success and permanent results in more than 40 women treated so far.

Download Lolas' paper here

Read more here…

iespalda.com starts helping spine patients at home

iespalda.com starts helping spine patients at home

iespalda.com is a web project cofounded by Dr. Ferrandez, one of our Spine Consultants. As exercise is being trusted more and more every day as the only real cure for spinal disorders, many Spine Centers are including personal training programs as a maynstay for better outcomes. At iespalda.com, spine patients can find and download high quality exercise protocols developed by graduates in physical activity and physiotherapists. Recovering from surgery or hopefully avoiding it highly depends on willpower, though you always have the oportunity to hire a personal trainer who "forces" you to work. At the moment this service is only in Spanish, but after the beta phase it will probably become available in english as well.

Dr. Ferrandez welcomes Dr. Akbarnia from the San Diego Center for Spinal Disorders and Marcy Rogers, CEO of SpineMark

Dr. Ferrandez welcomes Dr. Akbarnia from the San Diego Center for Spinal Disorders and Marcy Rogers, CEO of SpineMark

SpineMark, the Californian company for networking of spinal centers is trying to establish in Spain. Marcy Rogers forsees great business oportunities in the country, as northamerican regulations make it harder for medical device companies and doctors to develop new implants or techniques. Spain is an ideal environment in Europe for scientific trials, implant testing and medical tourism. Medical services meet the highest standards, local doctors are well trained and regulations allow for foreing doctors to practise under certain criteria.

Dr. Akbarnia was invited for a presentation and surgical discussion within the context of SpineMark's new venture in Spain. He talked about his recently tested magnetic growing rod for early onset scoliosis, as well as new approaches to spine deformities in elderly patients.

Our Team Helps Other Surgeons Getting Started with New Techniques

Last 16/4/2012 Dr. Ferrández was invited to Hospital San Jose (Vitoria. Spain) in order to perform a XLIF surgery with collegues from that Centre. The patient was a young male who got fusion surgery in two upper lumbar discs, being discharged 18h after the procedure with just a 4 cm wound on the left flank.

Surgical Performance in Zaragoza

Surgical Performance in Zaragoza

Dr. Ferrández was invited for a conference and surgical demonstration about XLIF in Zaragoza. Some Spanish surgeons met at the «Miguel Servet» University Hospital for a first contact with this technique. An elder patient was operated on for degenerative lumbar scoliosis, which could succesfully be corrected by using this minimally invasive approach.

Aragón es pionera en cirugía poco invasiva sobre la espina dorsal – Aragón – El Periódico de Aragón.

 

Oblique Lumbar Approach Presentation and new Implants for Osteoporotic Bone

Oblique Lumbar Approach Presentation and new Implants for Osteoporotic Bone

Dr. Ferrández presented the OLIF approach to lumbar spine (oblique lumbar approach), a less aggresive option in revision surgery for patients previously operated in the lumbar spine. After the presentation, he performed a surgical demo about the use of a new generation of cement-free pedicle screws for osteoporotic patients, by SpineNature. Surgery was broadcasted through the TVCC for a specialised audience in the Meeting Room at Clínica Vistahermosa (Alicante).

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