Is there hope for degenerative disk disease?

[Deleted member 43589]

SB-01 is a synthetic 7-amino acid peptide that binds to and induces down regulation of Transforming Growth Factor Beta 1 (TGFβ1), which is often highly expressed in the degenerated discs of patients with lower back pain. Abnormal TGFβ1 signaling is associated with the degradation of extracellular matrix components that maintain the structural integrity of healthy spinal discs. TGFβ1 is also reported to stimulate the expression of nerve growth factor leading to an increase in sensory neurons and discogenic pain. Intradiscal injection of SB-01 in patients with degenerative disc disease was developed as a first-in-class approach to potentially treating chronic back pain and disability, possibly preventing progression of disc degeneration through TGFβ1 modulation.

Anabolic Effects of Peniel 2000, a Peptide That Regulates... : Spine

in extracellular matrix and in vitro and in vivo effects of the peptide on IVD. Summary of Background Data. Transforming growth factor-β (TGF-β) has a functional versatility on the metabolism of IVD cells, suggesting that the regulation of TGF-β signaling is important in IVD degeneration. P2K...

journals.lww.com

https://www.thespinejournalonline.com/article/S1529-9430(15)00772-X/fulltext

If you are interested in participating in Phase III clinical trials of SB-01 the contact information is here:

ClinicalTrials.gov

clinicaltrials.gov

Study Contact
Name: Pamela Zicker, NP
Phone Number:831-239-4115
Email: [email protected]

They do have multiple locations in quite a few spots.

 

[Deleted member 43589]

I did the initial phone screen today and passed and have been admitted for testing. I have an appointment Tuesday to get thsi started.

 

[t_spacemonkey]

good luck. I too have what they call 'DDD' (l5/s1). clearly visible on MRI. don't want to pull this thread too much away, but I was told that this was the reason for my chronic back/sciatic pain. turns out not. i posted this in couple places, but after doing extensive research and following dr Sarno's work, I am completely pain free for at least 1 year with virtually zero physical approaches. in fact I do workout harder (including back) then before. DDD is nothing more then aging, the reduced disc space does not cause any pain. I highly recommend listening to dr Ray Ozenich book here

https://www.audible.com/pd/Back-Pain-Permanent-Healing-Understanding-the-Myths-Lies-and-Confusion-Audiobook/B0744YMSRM?action_code=ASSGB149080119000H&share_location=pdp

i can provide more for those who are open minded.

 

[Nelson Vergel]

Thanks @BigTex

I got my L2-L5 laminectomy 10 days ago and waiting for inflammation to go down to determine if my symptoms will get better.

Good luck!

I would not qualify due to several exclusions:

Exclusion Criteria:

To qualify for enrollment in this study, patients must meet none of the exclusion criteria as follows.

Prior epidural, sacroiliac joint, or facet injections at any lumbosacral level within the past 4 weeks (e.g., transforaminal, interlaminar, caudal)
Prior interventional procedures of other types at any lumbosacral level at any time (e.g., intradiscal injection, basivertebral nerve ablation, biacuplasty; radiofrequency (RF) ablation, spinal cord stimulator, others)
Prior spine surgery at any lumbosacral level at any time (e.g., discectomy, decompression, instrumentation, fusion, fracture treatment, others)
Prior fracture at any lumbar level
Significant neurologic symptoms:

Grade 3/5 or lower strength in any lumbar myotome
Sensory deficit in a clearly radicular or sensory dermatome
MRI evidence of disc height loss > 2/3 of adjacent disc at any level to be injected, determined by the independent radiologic central lab
MRI evidence of other disc degeneration: Pfirrmann Grade 3-5 at any level not to be injected, determined by the independent radiologic central lab
MRI evidence of disc herniation with neural compression at any level, determined by the independent radiologic central lab
MRI evidence of significant stenosis of the central canal at any level, determined by the independent radiologic central lab
MRI evidence of foraminal stenosis with neural compression at any level, determined by the independent radiologic central lab
MRI evidence of moderate-to-severe facet arthrosis with edema at any level, determined by the independent radiologic central lab
Spondylolisthesis (antero or retrolisthesis) > 25% at any level, determined by the independent radiologic central lab
Lumbar coronal deformity, determined by the independent radiologic central lab:

a. L1-S1 regional deformity > 25 degrees

Spondylolysis at any level
Lumbar inflammatory spondylitis
Recent history (previous six months) of chemical or alcohol dependence
Chronic narcotic use for more than defined as a daily dose of greater than 40 Morphine Equivalent Units (MEUs)
Depression or Somatization defined through the Distress and Risk Assessment Method (DRAM) scoring with Zung score > 33 or Zung > 17 and the Modified Somatic Perception Questionnaire (MSPQ) score > 12
Extreme obesity, defined by NIH Clinical Guidelines Body Mass Index (BMI > 40)
A QT duration corrected for heart rate by Fridericia's formula (QTcF) > 470 millisecond (msec)
Active systemic infection
Infection at the site of procedure pre-operatively
Cauda equina syndrome or neurogenic bowel/bladder dysfunction
Any terminal, systemic, or autoimmune disease including fibromyalgia, which may, in the opinion of the Principal Investigator compromise a subject's ability to comply with study procedures, and/or confound data
Metabolic bone disease (e.g., osteoporosis/osteopenia, gout, osteomalacia, Paget's disease)
Any disease, condition or surgery which might impair healing, such as:

Active malignancy
History of metastatic malignancy
Currently experiencing an episode of major mental illness (psychosis, major affective disorder, or schizophrenia), or manifesting physical symptoms without a diagnosable medical condition to account for the symptoms, which may indicate symptoms of psychological rather than physical origin
Any planned surgical procedure within the subject participation period (screening through the 12 Month Visit)
Any clinically relevant laboratory result on the screening visit Chem-12, hematology, or coagulation panels
Pregnancy at the time of screening, randomization, or planning to become pregnant during the first 3 months of follow-up
Currently a prisoner
Participation in any other investigational drug, biologic, or medical device study within the last 6 months prior to study procedure
Receiving Work Compensation benefits or engaged in personal spinal injury medical/legal litigation
Patient cannot be currently using the prohibited medications listed in the protocol

 

[Nelson Vergel]

fter doing extensive research and following dr Sarno's work, I am completely pain free for at least 1 year with virtually zero physical approaches. i

I have not read the book. Please tell us more!!

 

[t_spacemonkey]

I have not read the book. Please tell us more!!

the tldr is that a lot of chronic pain has psychosomatic causes. that doesn't mean that the pain isn't real. it is physical in nature, and is due what Sarno calls localized ischemia. this ischemia is caused by our brains. it is a response to subconscious anger/rage. as the brain perceives those subconscious emotions as threatening, it does create a distraction tactic by suppressing blood flow to certain regions in the body, the lower back being a common one, but there is many others. the root causes of this anger can be very diverse. anything from childhood trauma to work stress can cause this. the fix is to move those subconscious emotions to the consciousness "feel them". they become less threatening and the ischemia and pain subsides. Sarno says that many surgeries work initially, but this is purely a placebo effect, and the pain often returns, sometimes in different areas.
He wrote 4 books, and they are all on audible, but I would recommend Ozenich' book first, which is a very pleasant listen if you like audiobooks.
I personally went through countless PT sessions (which according to Sarno are a waste of time as well) and eventually the spine specialist told me to get steroid injections which I never did.
the entire subject is fairly controversial, but there is countless success stories. best of luck to you all no matter the route, and I think even with past treatments/surgeries you can still find value in this information.

 

[Nelson Vergel]

the root causes of this anger can be very diverse. anything from childhood trauma to work stress can cause this. the fix is to move those subconscious emotions to the consciousness "feel them". they become less threatening and the ischemia and pain subsides.

Thanks. I do not dispute this at all. There is a strong mind-body connection related to back and other pains.

I have explored many psychedelic therapies to get deep into all the trauma I have accumulated through losing so many friends and two sisters and trying to survive three life-threatening health challenges. I think I am at peace with all that, but I am open-minded enough to know there may be more buried deep inside my psyche. We will see.

At 65, I would hate having chronic pain limit my last few years of "functional" mental and physical capacity. Fortunately, I keep exploring and am grateful that I have the means to do so.

 

[Deleted member 43589]

My back has been bad for years. It has gradually gotten worse and the pain has increased. The last x-ray I had done my doctor said it has gotten quite a bit worse since He 1st x-rayed it in 2016. I do have some bone spurs as well. But it is a mess and I have been dealing with this pain for quite a long time. I would love to be able to stand up and not be in so much pain and love to go into the gym and not have this pain. As it is now, I am legally disabled. So I understand Nelson. Yes my mental and physical capacity are definitely effected. Sometimes it is hard to even be in a good mood when you hurt. Good luck to you Nelson and I hope we all find some solutions in our life.

 

[Nelson Vergel]

As it is now, I am legally disabled.

I am so sorry to hear!!!!

I saw 7 doctors (orthopedic surgeons) in Houston. This one has the most experience:

Best Surgeon in Houston, TX - Stephen Esses MD

Do I need Back Surgery? Dr. Esses is a recognized expert who has developed several new surgical techniques for the treatment of spinal.

www.stephenessesmd.com

Read his reviews on Google:

Stephen Esses, MD - Google Search

I hope you get some relief. It's not a way to live.

 

[Deleted member 43589]

I am so sorry to hear!!!!

I saw 7 doctors (orthopedic surgeons) in Houston. This one has the most experience:

Best Surgeon in Houston, TX - Stephen Esses MD

Do I need Back Surgery? Dr. Esses is a recognized expert who has developed several new surgical techniques for the treatment of spinal.

www.stephenessesmd.com

Read his reviews on Google:

Stephen Esses, MD - Google Search

I hope you get some relief. It's not a way to live.

Thanks for that reference Nelson. If this doesn't do the trick am going to have to considered doing surgery. They say now they can do more minimally evasive things going in from the side, instead of abdominal area. I have talked to 2 spine surgeons with UT and did not care for either. My doctor was going to refer me to a neuro surgeon. Hey, here are the qualification for handicapped parking

• Mobility problems that substantially impair a person's ability to move around; these problems can be caused by:
  • Paralysis
  • Lung disease
  • Cardiac deficiency
  • Wheelchair confinement
  • Arthritis
  • Foot disorder
  • Other medical condition causing a person to use a brace, cane, crutch or other assistive device

I have two issues, arthritis and foot problems. Morton's neuroma. I think the qualification was being able to comfortably walk 100 yards. No way I can do that.

 

[Deleted member 43589]

Well, I got dropped from the trial. They feel because I take Eliquis, it would be very risky for me to come off long enough to do a spinal injection. I kind of figured that might come up. So back to the drawing board.

 

[FunkOdyssey]

Peter Attia just released a podcast with Stuart McGill that has a ton of great information related to spinal health and back pain. If you have a back, it's worth checking out.

#287 ‒ Lower back pain: causes, treatment, and prevention of lower back injuries and pain | Stuart McGill, Ph.D. - Peter Attia

“All I did was learn from the best weightlifters in the world, people who know how to move load, learn what the efficiency was and turn it into a hack to change a person's life.” —Stuart McGill

peterattiamd.com

 

[Weasel]

I’ve been dealing with DDD for close to 20 years now. I was told by the VA that “it’s just part of getting old” at 19 years old.

 

[Deleted member 43589]

@Weasel apparently there is something called endoscopic surgery. This is a minimal invasive surgery that can be done to fix this issue. All I have to do is find someone who does it and my insurance will cover them. Nelson suggested someone who looks great but my insurance does not have him on their list.

 

[t_spacemonkey]

i'll be sounding like a broken record a bit. this is not directly on Sarno's methods, but i remember (before i learned about Sarno) watching a lot of podcasts of various experts (md's, surgeons etc) virtually saying the same. you do not operate on chronic back pain, especially sciatic pain. they have an extremely low success rate. I too considered surgery at some point, but after browsing to a couple of forums and FB groups about outcomes...i figured i will never go under a knife. there is only misery out there.
A personal friend of mine had a fusion done. thats how all them eventually end. symptoms were (really bad) sciatic pain. I met him a year later how he is doing. what he said matched exactly what I read in Sarno's books. when he first got off the operating table (once the inflammation went away) - he was virtually pain free. 'I did the right thing' was his obvious reaction. recovery took close to a year or so, and he stopped doing many activities he enjoyed for good. especially biking. however as time past his pain returned. now has chronic back pain. not sure what to do next. he has more herniations. the cycle never ends. Sarno explains this as the symptoms imperative where symptoms become worse or switch location. here is some resources/success stories:

https://www.youtube.com/results?search_query=tms+success+story

here is also a good forum to start, dedicated to TMS. TMS Forum (The Mindbody Syndrome)
there is specialist doctors who can do consults and help diagnose if this is TMS. i think dr Ozenich is in culver city, ca

 

[Deleted member 43589]

Thanks for all the advice @t_spacemonkey. I really do appreciate it. I am lost for what to do. I know now I can not do the typical pain therapy with an epidural. I have done stretching exercises for years now, every kind of pain medication except opiates. Nothing has helped. I can't work the core muscle because I almost can't walk the next day. It just gets worse and worse. I take Gabapentin on the weekends when I don't have to work or go to the gym but all it does now is help me sleep better.

I did find a very good neurologist that specializes in minimal invasive spinal surgery. I may make an appointment and at least listen to what he has to say. He does seem to believe that everything needs to be tried before surgery. There comes a point where the pain just gets to be too much. Between the back, both shoulders, both knees and both feet its getting to be too much.

I have had a few surgeries in my life and sure would not look forward to another one. But it seems this type of surgery is one that one hour after surgery you are encouraged to get up and walk and then go home. Rehab is very fast.

 

[Weasel]

Thanks for all the advice @t_spacemonkey. I really do appreciate it. I am lost for what to do. I know now I can not do the typical pain therapy with an epidural. I have done stretching exercises for years now, every kind of pain medication except opiates. Nothing has helped. I can't work the core muscle because I almost can't walk the next day. It just gets worse and worse. I take Gabapentin on the weekends when I don't have to work or go to the gym but all it does now is help me sleep better.

I did find a very good neurologist that specializes in minimal invasive spinal surgery. I may make an appointment and at least listen to what he has to say. He does seem to believe that everything needs to be tried before surgery. There comes a point where the pain just gets to be too much. Between the back, both shoulders, both knees and both feet its getting to be too much.

I have had a few surgeries in my life and sure would not look forward to another one. But it seems this type of surgery is one that one hour after surgery you are encouraged to get up and walk and then go home. Rehab is very fast.

I very much relate to this. I’ve put off/ refused surgery for 20 years. Exercise helped for a long time and still does to some extent but more and more I find myself not working out cause of pain, which in turn causes me more pain. Vicious cycle.

Sleep is almost non existent cause of pain more often than not, which also have been proven to increase perceived pain.

Somedays it’s just difficult to exist.

 

[testiculus]

It just depends on what's driving the pain. Some things can only be resolved by surgery. Unfortunately, surgeons generally will advise that surgery is the only thing that will work in cases where that is not true. So always take what a surgeon says with a large grain of salt. If you decide to go with surgery, the best way to figure out which surgeon to choose is to talk to PTs in the area. They see which docs have good outcomes and which ones don't.

In Houston, I've heard the following are good for spine issues. No personal experience with either:

Matthew W. Wasserman | UT Physicians | Orthopedic Surgery Doctor in Houston, Texas

Dr. Matthew Wasserman, UT Physicians orthopedics, cares for adult patients in the Greater Houston area.

www.utphysicians.com

Dr. Paul Boone

 

[Deleted member 43589]

Amen. I fight going to the gym because of pain. But once I get there I am OK because the pain seems to just go away. I live off Celebrex, Ibuprofen and Tylenol. Sleep is the hard part. Not only does my back hurt but both shoulders hurt worse. I was told that I would now when it is time to get surgery.....when I could no longer tolerate the pain.

 

[t_spacemonkey]

I'm sorry for you guys, chronic pain is a life killer.
ok, so its not ozenich, its Schechter in culver city. I have not talked to him. I recommend making an APT. what can you loose?

Mind-Body Medicine - David Schechter, MD

Inspired by John Sarno's diagnosis of TMS, I have developed programs to help understand mind-body medicine, the link between mind and body.

www.schechtermd.com

also, I talked to a non-md therapist about this some time ago. very helpful

Request a Consultation - The Pain PT

www.thepainpt.com

if you are not convinced, talk to those guys, worst thing it won't do much (but less invasive)
best of luck