Cauda Equina - Result Not Cause
Tuesday, February 19, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Bernie, age 80, promised in December he would dance at his daughter's upcoming wedding in
Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part I.
Part II of Bernie's story looked behind the scenes of how we fixed the source of the pain, step-by-step.
The promised dance is at right.
The point of the two posts was that the key is to fix the source of pain and injury, not just have surgery, take medications, and do some exercises. The posts also showed things to do to fix the causes so that readers could do it too.
A reader wrote an opinion in the comments of Part II, that Bernie's signs and symptoms were of Cauda Equina Syndrome (CES), and felt cauda equina was important for readers to know about.
The problem is that cauda equina is not the cause of the collection of back and leg pain and numbness problems, but the result. The cauda equina is a group of nerve roots of your lower spine that go down toward your feet. The bundle of stringy nerves looks like the tail (cauda) of a horse (equina). If something hurts or presses on the area, pain and numbness can result. It is just saying something wrong has resulted in that location. The key is finding and stopping the cause of what is hurting or pressing on the area, not taking medicines or having treatments.
It is like saying someone has stomach pain, and prescribing pain medicines and support groups. The pain could be worms, a pregnancy, a lack of enough stomach acid to digest food. You need to know the cause to do the right treatment.
For example, if a herniated disc is compressing the cauda equina, you need to stop pushing your disc out of place, described in Disc Pain - Not a Mystery, Easy to Fix and use daily simple good body mechanics instead of the bad bending that gradually push discs outward - The Cause of Disc and Back Pain. Then the disc and nerves can heal and the pain will stop without drugs or back surgery.
The reader asked me to review a web site. The web site they recommended lists treatments of drugs such as narcotics and antidepressants, and epidural injections. It mentions exercise to maintaining muscle strength in leg areas that have weakness from nerves that are compressed. This is like trying to catch blood loss in a bucket instead of stopping the blood loss at the source. The web site says sufferers with foot drop can use a brace. Instead of using a brace, which can cause more atrophy, it is better to stop the cause of the foot drop, where possible.
Fitness Fixer reader Ivy from New Zealand had foot drop from nerve compression. She stopped the cause, detailed in Inspirational Ivy II - Beating Foot Drop and Sciatica, and Getting Healthier. By stopping the cause of the nerve compression, Ivy did not need the brace or cane. It is not healthy to allow nerve compression to continue. Muscles and nerves become more damaged over time. A brace or cane does not restore function. They can further cause bad gait and body mechanics.
Bernie had many injuries from the surgeries he had undergone for the purpose of relieving back pain. In addition, the back surgery deliberately resulted in some reduced movement of the spine. Many back surgeries do this on the premise that reducing movement will reduce pain. The reduced movement meant reduced function and mobility, resulting in more pain.
The cauda equina web site says, "We live with CES every day." The approach of The Fitness Fixer is not to live with an injury or take unhealthful drugs, but to find the cause and stop the cause so that you do not have to live with pain and drugs.
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Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and the Fitness Fixer Index.
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See Dr. Bookspan's books and Academy.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail" (under trumpet) upper right.
See Dr. Bookspan's books and Academy.
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Photo © by Mr. Bernie Cleff
Labels: fix pain, footdrop/dropfoot, injury, lower back, practice of medicine, readers inspiring story, sciatica, surgery
6 Comments:
At Monday, February 18, 2008 3:44:00 PM,
Anonymous said…
Dr. Bookspan, I love your stuff and implement your principles while weight-lifting. It has really helped my core.
I have a quick question regarding side-bends with weights. Do you find these to be beneficial for the core and posture, or do you consider the exercises to be more harmful to posture?
At Monday, February 18, 2008 6:26:00 PM,
Anonymous said…
I've got some numbness in my thumb and forefinger, which seems to be related to some crushing at cervical vertebrae C5-C6.
What exercises do you recommend? My doctor suggested 'wait and see', but it's been over 6 months and it's not improving anymore.
At Friday, February 29, 2008 4:52:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Hello anonymous, thank you for using healthy weightlifting from this column. Sorry for delay replying. I am not the posting moderator and I just received your question. Side bends holding weights do not technically work core muscles, but the hip hikers. Semantics aside, if you want to "work" them, it doesn't matter what you call it. I do not know how this exercise can benefit posture. Strengthening core muscles does not change how you voluntarily stand (unfortunately). Plenty of muscular people stand terribly - Neutral Spine or Not?
Can side bends harm? One standard way to do side bends is to hold a weight at the side and lean so that the arm lowers along the leg. If you let the weight compress the spine downward, then you are just bashing the vertebrae against each other and narrowing the spinal canal. If you resist the lowering with muscular effort, and keep good spacing as you lower, that makes a different effect on the spine as you work the same muscles. If you let the lower back increase in arch, or hold a large inward arch in the lower back while lowering the weight, you will eventually bash up the facet joints - described in the post Prevent Back Surgery. Let us know how it works.
At Friday, February 29, 2008 5:02:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Hello Anonymous, Hand numbness from neck compression is usually easy to stop. It should not be left for so long. Nerves and muscles need their supply. As stressed in the post you replied to, it is not a matter of doing exercises, but stopping the injurious process that causes it so it can heal. Without knowing what is your cause it, I can state that one common cause is the forward head (which encourages crushing and so on). How to stop this cause of compression was covered in several posts:
- Check to make sure you do not hold your head and neck forward when you stand, move, and sit. That can press on that nerve. Check head position with the wall test.
- Then do the two stretches in Fixing Upper Back and Neck Pain and Nice Neck Stretch. Then check positioning again using the wall test to make sure you know how to make the stretches do their purpose, which is to restore resting length that you then use.
- Once you restore healthy neck positioning as above, make sure to use it when you walk away from the wall, and during all you do - not stiffly, but as a natural healthy position.
- Check head and neck position using the wall test often.
- Stop doing The Stretch You Need The Least.
- Check to see if you are Making Your Exercise Unhealthy with unhealthful upper body positioning.
- Instead of sitting on the bed first thing in the morning, lie face down, gently propped on elbows on a way that makes the neck feel better. If it is not immediately better, stop and fix it, or if you can't, then skip this one until we can talk more.
Numbness should lessen right away - as soon as you get the pressure of a forward head off the nerve. Start with these and let us know how it works.
At Wednesday, March 05, 2008 6:15:00 PM,
MIKE said…
I have some loss of sensation in the saddle area, I am concerned that it may be cauda equina symptoms. I have had this for 2 months and spine doc has put me through all kinds of test. He still says that l5-s1 and l2-l3 bulges pressing on the thecal sac is not causing numbness in this area and genitals along with anal area and constipation. I just bought your book Fix Your Own Pain and I am wondering if this will help, and I would like to get your thoughts about inversion therapy for bulging disc. More questions later
At Thursday, March 06, 2008 4:32:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Hello Mike, The book Fix Your Own Pain explains why and how discs bulge (sections of Chapter 1 on neck pain and chapter 2 on back pain), tells what specific things make them bulge, and how to stop the process so that they heal and the injuries stop. Will getting the book help? Yes, that's the idea. Inversion does not stop the cause, so you can heal the injury better and faster with other methods that I have posted throughout this column and my books. Inversion can feel nice, but then if you get off the table and go right back to causing the bulging, then it is hard for your body to heal. Use the post The Cause of Disc and Back Pain and all the links in it to see why.
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