“Types” of Post-Polio Sequelae
Question: I can't help but wonder if, since polio entered our bodies and affected our spinal cords, if spinal arthritis causing lower back pain another late effect of polio? I have a follow-up visit after my last epidural with my orthopedic doctor and he wants to talk to me about a possible Radio Frequency Ablation. Is that a good idea?
Dr. Bruno’s Response: Arthritis isn’t caused by the poliovirus but it is related to polio’s effects.
I separate PPS symptoms into two groups:
DIRECT: symptoms caused by the poliovirus (e.g., muscle weakness)
INDIRECT: symptoms caused by problems due to poliovirus damage (e.g., arthritis)
For example, muscle weakness (see below) is obviously a DIRECT PPS symptom, directly related to overworked, poliovirus-damaged neurons. But, muscle weakness can cause INDIRECT symptoms, among them arthritis (in joints and the back), joint pain, deformities and pinched nerves (spine, wrists and elbows) and muscle pain.
While DIRECT PPS symptoms are often unique to polio survivors, INDIRECT symptoms (like spinal arthritis) can occur in anyone and often can be treated by doctors knowing nothing about PPS. In picking a treatment for back pain, you need to find out if the pain is due to the pinching of nerves as they exit the spine (radiculopathy) or central stenosis (pressure on the spinal cord).
Facet joint injections often help treat radiculopathy and epidurals help central stenosis. Radio Frequency Ablation should only be considered if injections fail and on the basis of what nerves are being pinched and where. A second opinion from another physician is always in order.