TheJude.com - Enbrel

The Theory

Vertebral disks are made up of a fibrous outer layer called the annulus fibrosus and a jelly-like inner layer called the nucleus pulposus. It has been suspected since 1987 and known since 2000 that the nucleus pulposus is capable of expressing an inflammatory substance called Tumor Necrosis Factor Alpha.

When a disk is fissured or ruptured, it can leak TNF-alpha into the space around the disk. TNF-alpha is highly inflammatory and can irritate the nerves and tissue surrounding the disk. This can cause profound pain and swelling and mimic all the symptoms normally associated with radiculopathy.

When examined using MRIs, a disk may show up as herniated. However, a herniated disk may be causing no symptoms if it is not leaking TNF-alpha. On the other hand, there may be pain even though there is no herniation if there is a fissure. In other words, anatomical deformities may or may not have anything to do with pain. MRIs may not be the last word in diagnostic tools.

Since my L3-L4 disk was fissured (known since 2000), no operation could ever fix me completely. Each operation fixed a particular problem but also flushed the area clear of TNF-alpha. That is why my pain always went away after each operation but then, eventually it came back within 3 weeks to 3 months. However, it ALWAYS came back. The last operation proved this. The pain returned even though there were no anatomical or biomechanical issues remaining. Therefore the pain had to be biochemical in origin.

This may also explain why doctors are having such good luck with the artificial disk. It may not be so much that it is inherently superior to fusion but rather that they must take out the herniated or fissured disk to put it in.

Finding Dr. Omoigui's book was very helpful. It not only gave a detailed explanation as to the symptoms I was experiencing but also gave case studies where people suffered in a way similar to me and showed how Enbrel could cause a complete remission of symptoms. More research and references are given in the section called Important Links. (NEXT->)