Yesterday I had my back and neck injected by Dr. Pitts. This is something I do a few times a year, not because I’m disabled but because I want to be able to be active as I age. I also want to treat small problems while they’re small and not let them spin out of control. Let me explain.
My Neck and Back
My neck is a mess. Why? My best guess is that it’s because I have a big head to carry around. In fact, when one of my sons was born, my wife asked our pediatrician about his head size and he asked to see Dad. I was located, and as soon as I walked into the room, the doctor took one look at my big noggin and said, “No need for any tests here.”
My back issues are traumatic. When I was a resident, I stupidly didn’t wear a seat belt and got cut off and turned hard enough to flip my jeep. I became like a sneaker in a big washing machine, tumbling inside the rolling vehicle. That accident broke three transverse processes (parts of the backbones), which have forever altered the biomechanics of my back.
A few years back, I had my first severe flare due to cervical stenosis. This is a condition where there isn’t enough room for the spinal cord and nerves as they pass through the neck bones. I had miserable 9/10 left shoulder pain for about a week, believing I had a shoulder problem. It wasn’t until Dr. Schultz injected our advanced platelet lysate around my irritated neck nerves that I began to feel normal again. As for my low back, it’s usually easily managed by platelet lysate epidurals as well. See my video below for more on stenosis:
It’s amazing to me that we as doctors teach patients that they should ignore what’s happening to them. There isn’t a day or a week that goes by that I don’t have some symptom that I know is related to my neck or back. For example, my right thumb will get tingly (C6 nerve in my neck) or my left shoulder blade will ache (C6 nerve in my neck on the other side). In addition, I often get coldness or a sweating sensation in my calves (S1 nerve in my back) or have weakness in my shin muscles (L5 nerve in my back). More recently, I find that I can’t sit in seats that don’t have good lumbar support (lax supraspinous/interspinous/iliolumbar liagments). Or my neck will crack (lax supraspinous/interspinous).
However, none of the above is disabling in any way. I still work out hard six days a week with two days of heavy weights. I can hike long distances. But I know enough to recognize when this stuff is beginning to get ramped up. To catch it before it goes thermonuclear, which is why I was injected yesterday. I wrote a whole book on this idea, below:
Taking Your Own Medicine?
First, some blog readers may not know that I get injected by our doctors. I lay down on an X-ray table just like everyone else and have Drs. Pitts, Schultz, Markle, Hyzy, Silva, and Azuike place needles within millimeters of important structures. I have that confidence in these physicians because of a few things most people don’t realize.
First, it’s hard to get a job at our clinic. Meaning, many have inquired and everyone, so far, has been turned away. The skill level required is not widely available, and there is no current training program that we would accept (other than IOF). Hence, everyone who works there had fantastic skills when they first walked in the door but was required to do at least an additional year in fellowship training in our clinic. Hence, when I lie down on that table, I know that the doctor who will be guiding needles with ultrasound and/or fluoroscopy is an expert’s expert.
What Did Dr. Pitts Inject?
For my neck stenosis, Dr. Pitts injected the bilateral C5–C6 facet joints with the point of letting those leak around the nerves. The goal here was to have our fourth-generation platelet lysate improve the blood supply and nerve health. He also injected my ligaments to reduce the sloppy movement that would further beat up nerves, and then he injected the muscles that help stabilize the area.
In my low back, he noticed that I’m beginning to get a small amount of forward slippage of the L5 vertebra (my fault for not getting in often enough for more aggressive ligament injections that could have prevented that issue), so we hit my low back ligaments hard, using fluoroscopy to guide those injections. He also injected epidural at L5–S1 for the same reasons as the neck. Finally, he used ultrasound imaging and injected platelet-poor plasma to help my multifidus muscle stabilize my spine.
The Amazing Connected Body
One of the amazing things from yesterday was that my hip was fixed with a neck and back injection. It had been bothering me with clicking and grinding. I was pretty sure it was likely an inflamed ITB moving over the greater trochanter portion of the femur bone. It could have also been the labrum. However, within hours of getting these injections, it was all gone, despite the fact that Dr. Pitts never went near my hip. How?
The gluteal muscles insert into the ITB, and the low back nerves power those muscles. Hence, irritated low back nerves mean less gluteal muscle firing, and the ITB gets loose, sloppy, and irritated. Fix the nerve, fix the muscle, fix the ITB. In addition, the additional swelling from the injections also help to stabilize my L5–S1, which is the CORE base of support for the hips.
The upshot? Every doctor on earth needs to take his own medicine. First, it shows confidence in what he or she recommends. Second, there’s nothing like being a patient to help you learn how you can be a better doctor! Finally, I’d like to thank the doctors in our Colorado HQ who give of their time to treat this aging body!
Post-procedure updates: On Friday (injection day) I was able to do a 30-minute high-intensity bike ride at the gym. I had some soreness in my back and slight tightness in my neck on Friday night. Put Tylenol by my bedside, but never took it. On Saturday, I had no issues with (and felt great) riding a 6-mile single track, technical mountain biking loop in the mountains. On Sunday I went for a 3-mile hike in the mountains and had some low back and left hip soreness afterward, so called off my planned bike ride and instead did 30 minutes on the bike at the gym. Finally, as I write this on Monday morning, I’m a little sore in the back with bending, but no other issues.