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Determining a course of treatment for chronic pain

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2 of my doctors (spine and physical medicine) and my physical therapist do not think my herniated disk in L4-L5 or the piriformis muscle is causing my pain. My spine doctor and gynocologist have said the fibroids or retroverted uterus could be the cause. Is this possible? I'm trying to decide whether to have a hysterectomy but I don't want to have an unnecessary surgery. The pain is very hard to live with and I definitely want to find the cause of it.

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replied February 2nd, 2009
Back Pain Answer A5625
Your question involves the pain going down your legs and whether or not your fibroids or retroverted uterus could be at the root cause.

Generally speaking, internal organ dysfunction can be the root cause of chronic pain. Diagnosing this accurately can be extremely challenging. In the way you have described your pain, it is suggestive of nerve root pathology, particularly of disc origin.

Many times, as pain patterns persist, additional imbalances may be brought forth in the muscular system, such as chronic ischemia, nerve entrapment, and/or trigger points. These need to be handled with good soft-tissue manipulation such as rolfing, neuromuscular therapy, and movement-based programs.

Underlying metabolic changes must be dealt with as well. B-12 deficiency is well known to cause pain in the extremities, and is frequently found deficient in individuals with chronic pain, possibly due to gut dysfunction caused by long term use of pharmaceuticals for pain relief. Other nutrients to evaluate may include 25-Hydroxy Vitamin D, Omega-3 fatty acid status, as well as Omega 6, and total digestive function.

As you can see, pain is a complex web of interactions between structural aspects and biochemistry. Exact diagnosis in cases such as yours is very challenging. You may wish to speak with your doctor regarding the above recommendations prior to, or in conjunction with your next course of treatment.

Sam Visnic NMT

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