From terrible pain to complete recovery
People living in the grip of pain day by day consider it inconceivable to regain their physical activity and health.
The story of our patient may be inspiring for those whose everyday life is determined by spinal pain. This edifying example shows us that it is worth seeing the doctor since specialists, with the help of today’s modern diagnostic tools, may determine with high certainty what type of therapy is required for the recovery.
The case of István also demonstrates that fast and efficient surgical techniques are available today that—after proper rehabilitation—may result in achieving complete recovery and, following the surgery, patients may live a symptom-free, active life, and may even return to their hobby that involves hard physical activity.
We hope that this story will be a source of strength for many people and they will fight for a complete recovery with similar tenacity.
When did it become obvious that you need to see a doctor because of your pain?
After spending the last 8 months of my disease lying or sitting virtually immobile because of my terrible pains, I realized that it could not go on any longer... The drugs, the osteopath and the physiotherapy no longer helped, and I asked for an injection almost every day to be able to walk... It was this time when I saw Dr. Gábor Jakab at the National Center for Spinal Disorders.
How was your treatment continued after the examination?
Doctor Jakab performed a stabilization surgery on my spine on 29 February 2012 (leap day). After the procedure, my spinal pain was gone without a trace and forever. I spent one night in the observation room, and then I could return to my room the next morning. The physiotherapist (also from the Center) came almost at once and I did exercises in the bed. In the afternoon, I got up and I was walking, and in the evening, I could wash my body independently, with caution. The day after the surgery, I did not ask for the help of nurses, and did not use a gurney or the elevator to go to the follow-up examinations: I climbed the stairs between the floors.
How were the first few weeks after the surgery?
I could return home on the 6th postoperative day. First weeks: lots of walking, increasing the distance slowly. I had recorded the prescribed exercises with a voice recorder in the hospital, drew them at home, and I did the exercises this way. I had to do exercises for 3 months, 3 times a week. Each exercise lasted for 40 to 45 minutes. (Back, trunk, abdomen and lots of stretching.) Doctor Jakab and the physiotherapist told me unanimously that the key factors for my complete recovery were patience and perseverance during the rehabilitation and, therefore, I decided to use an exercise bike for another month after the prescribed 3 months of exercise. (It was, naturally, discussed with both of them.) I rode the exercise bike at a moderate level for an extra 1 month, increasing the distance from the initial 15 km to 20, 25, and then 30 km over the 4 weeks.
How is your everyday life?
I am healed. :) I still exercise and, in addition, I ride the bike. At least once a week, I ride 30 to 40 km on flat ground between Budapest and Szentendre. If my schedule allows, I do it more times. I have no complaints whatsoever since the surgery: I can work, do sports whenever I feel like, walk, go on excursions, and travel with my family. I can do my hobby: I participate in excavations from time to time, and I have no complaints even after this heavy physical activity. I live a healthy and complete life. I cannot describe how lucky I am that I was treated at the National Center for Spinal Disorders and by Doctor Jakab, and I cannot thank them enough for healing me. I was extremely satisfied with the services of the institution, the environment and the facilities, as well as the work and kindness of the doctors, physiotherapists, nurses and administrators—in short, with everything—, during both the preparation for the surgery and the follow-up care. I wish to express my thankfulness and gratitude to every employee of the center here as well.
Through the eyes of the doctor
Answers by Dr. Gábor Jakab, Head Physician
What was the diagnosis of the patient after the examinations performed at the National Center for Spinal Disorders?
Our patient presented with the typical symptoms of lumbar disc degeneration: he had recurrent lumbar spine pain with a history of several years, which had first shown good response to decreased physical activity and conservative treatment, but then pain had occurred more and more frequently and lasted for more and more time, making the everyday life of the patient more and more difficult.
What examinations were required to make the accurate diagnosis?
The important thing in these cases is to clarify the morphology and function. We need to determine which segment or segments of the spine is/are impaired and to what extent. To this end, we use standing radiograms and magnetic resonance imaging (MRI) scans. Although the latter are performed in lying position, that is, without load, they show the details, the degree of degeneration, the involvement of the bone next to the end plates, any inflammatory changes, and nerve compression. However, conventional radiograms are also indispensable since the structure of the spine, the posture assumed under load, the position of the weight line, the shape of the curvatures and congenital anomalies—to mention just a few—are best seen on these images.
How common is degenerative disc disease? What are the most characteristic symptoms?
Wear or degeneration of the intervertebral discs is a very common condition. Most often, the lumbar spine is affected, followed by the cervical spine. With regard to symptoms caused, changes on the thoracic segment are the least common. The causes of degeneration include the unusual load on this structure due to standing on two legs, but genetic polymorphism, injuries and overuse also have a role. The most common symptom is the lumbar spine pain that is increased by load and occurs more and more often, and which may be band-like and may also radiate towards the buttocks and the back surface of the thigh. This pain may be decreased by using a proper mattress, optimizing our physical environment, avoiding stress and maintaining strong trunk muscles. Provoking factors, such as unusual physical strain in an improper position, excessive temperature variation and not having enough sleep, must also be avoided.
Is the surgical solution recommended in every case?
The fundamental treatment for this condition is conservative. A surgical intervention is required only if the stability of the motion segment cannot be restored by further strengthening the muscles and if nature does not solve the problem with the restabilization process (forming a secondary rigid connection between the adjacent vertebral bodies). It is also important to compare the current quality of life with the expected quality of life.
Could the disease have been prevented?
First, the incidence of the disease could certainly be decreased because, although the genetic factors cannot be changed, the effect of environmental factors can be minimized with caution and conscious prevention. If you live a sporty, active life without overexertion, you certainly have a higher chance to prevent the occurrence of intervertebral disc degeneration. It is known, however, how different the quality of life can be with morphologically similar disorders. Therefore, even if the disease is developed, we may decrease its negative effects—pain and disability—with a conscious lifestyle.