What follows is a letter from a potential patient and my advice to that patient.
From Mr. Smith (submitted via e-mail): In July 2001 I had back surgery for a ruptured L5 disc. In the surgery, my L5 vertebra was fused to my sacrum. Even though the pain was reduced about 20-25 percent, I'm having worse pain above the original area. The surgeon told me there was a chance that it might happen; he's right - it did. This new pain is starting out the way my previous pain started out before I had surgery. Now, I am told that the disc above L5 is ruptured, and the surgeon wants to fuse the L4 to the L5 vertebra.
Having run more than 45 miles per week for the past 10-12 years, my running has recently had to take a back seat to back pain surgery. This week, I tried to run, but the pain in my back began to intensify. Many of my running friends have recommended you, and I have also seen you at hundreds of races for as long as I can remember. I am hopeful that you can help me. I don't want to have any more surgeries for my back. Any suggestions?
Dr. Batchelor: I had a patient similar to you a few months ago who had surgery of the L5 disc. The L5 vertebra was fused to the sacrum; after six months, he began to have pain one level higher in his spine, at the L4 disc area. His surgeon wanted to fuse the last two vertebra in his lower back. The patient opted out for the second surgery and came to my clinic for nonsurgical intervention. We used a special traction device, a Cox-McMannis flexion/distraction table, along with physiotherapy and chiropractic. He responded well, and is now training for a half-marathon. We placed him on a program that enhances and maintains structural alignment of the lumbar vertebra above the fused L5 vertebra. As long as he is faithful in sticking to his rehabilitation program, I see no reason why he should have to limit himself, except for specific motions involving lifting.
I understand your frustrations. Many people, after having surgery that might have been avoided, are hesitant to repeat it. I suggest that three doctors be consulted before making any informed decisions regarding invasive treatment of any back-related condition: a chiropractor, an orthopedist and a neurologist.
Each case is unique, and it would be impossible to diagnosis your specific condition without examining the area of your complaint. If you have x-rays or an MRI, bring them in. Plan to spend about an hour in our clinic. Also, bring your old running shoes in, along with your present running shoes.
Daniel Batchelor,DC
Roswell, Georgia
Editor's note: When not treating patients, Dr. Batchelor runs and cycles. He was the number-one-ranked mountain bike duathlete in Atlanta from 1996-2000. He has been a consultant for Runners World; Running in Georgia; Running Journal; Georgia Runner; and Run and See Georgia magazines. He has won over 350 road races, run over 60,000 miles and treated over 100,000 patients for a variety of conditions. He was recently interviewed on national CNN Headline News as an expert on athletic injury and back pain.
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