I initially began to have low back pain and left leg pain at the end of January 2000 which I believe occurred after lifting some heavy suitcases. The back pain and leg pain became progressively worse over the next month. I had numerous visits to a local Medical Center Emergency Room and also the Columbia Memorial Hospital Emergency Room to try to obtain pain control. I had an MRI scan which revealed three very lateral herniated discs at levels L3-4, L4-5, and L5-S1. I was seen at the Neurosurgery Department where the initial feeling was that we should hold off on any surgery at this point. Over the next three weeks, the pain became worse and it was more and more difficult for me to work. I continued to work however, I had to lie down on the floor in between patients to try to ease the pain. Eventually the pain became excruciating. I had visited the Emergency Room earlier that day and received injections for pain control. After I was discharged home, within 20 minutes my pain became so severe that I had to go back to the Emergency Room, where I was admitted and placed on IV medication for the pain. After a week physical therapy was started in the hospital and I continued as an outpatient. Though my back pain got somewhat better, it was still quite difficult to walk. My leg pain continued and I developed a severe burning in my left lower leg that made it difficult to walk. I was unable to sleep through the night, having to get up every two hours because of the pain, and sometimes having to stay up for hours at a time before I would get some pain relief. I saw a pain management specialist who gave me an epidural steroid injection with essentially no results. At the end of April I was in a situation where I knew I would be unable to go back to work and had exhausted all conservative treatments. Physical Therapy did not seem to be helping me at this point. The epidural steroid injection had not been helpful, and at that point, I felt that my only alternative would be surgery. I began to feel some leg weakness and an EMG study revealed denervation of two of the quadriceps muscles. These were significantly denervated and I found myself having difficulty rising from a kneeling position. I then became aware of VAX-D Therapy and reviewed the literature on this. After reviewing the articles, I felt that the research was solid and the theory behind it made eminent sense. I began the treatments at the end of April and after three treatments, I was able to sleep through the night. I have received a total of 26 treatments. I found the VAX-D Treatments to be remarkably effective. At this point, I am pain free, I essentially feel the same as I did before I sustained the back injury, and I am able to sleep easily through the night. I am now back at work . I am quite sure that without VAX-D this would not have been possible. Had I not gone through VAX-D, I am quite sure that I would have needed surgery, which certainly would have been a more involved surgery given the fact that I had three very lateral herniated discs. As a physician who has experienced this ordeal of having three herniated discs and the severe pain associated with it and given the fact that it had essentially incapacitated me, I was very grateful to find a therapy which could be helpful short of surgery. As a physician who treats many patients with back pain it is quite clear to me that this is a very underutilized procedure which more physicians should know about and should be much more available to those patients suffering from low back pain who have failed conservative measures. I am putting together a talk on VAX-D and plan to present this to the physicians at the local hospital . I think that VAX-D Therapy has the potential to revolutionize the care of low back pain sufferers and avoid unnecessary surgery. VAX-D should be a mandatory part of any algorithm in the treatment of low back pain that has not responded to conservative measures In those patient’s with chronic low back pain with the diagnosis of extruded herniations, multiple herniations, single herniations, degenerative disc disease and facet joint syndrome, who are candidates for VAX-D and have no contraindications, I would certainly advocate this treatment before moving onto more invasive treatments. In fact. I would feel almost unethical not sending a patient to VAX-D prior to an invasive surgical procedure if he/she was a candidate for VAX-D and had failed other conservative treatments. Sincerely, Lance Castellana, MD
LANCE CASTELLANA, M.D.
Family Practice, Hudson, New York
Family Practice, Hudson, New York