DISCOVERING & TREATING THE FACET SYNDROME: CASE STUDIES FOR 12 MEDICAL SPECIALTIES

Headaches, dental pain, trigeminal neuralgia, instability and dizziness, ear noises, eye problems, urology problems like testicle pain and neurogenic bladder, abdominal pain, perplexing general surgeons and gynecologists, cardiac and respiratory manifestations, obscure neurological entities like spastic paraparesis, peritrochanteric and knee pain, Sudeck syndromes, certain types of sciatica and a lot of other morbid manifestations whose etiology still remains obscure, are some of the symptoms that current medical practice, more often than not, fails to treat due to incorrect diagnosis of the root problem.

Our autonomous nervous system, authorized to protect us even from ourselves, in an attempt to attract our attention, will often inflict pain in other parts of our body when we do not seem to take notice of strain in the real problem area. One such simple example is chronic headaches as a result of strain on our neck or back, due to bad work or reading posture.

This book shines light into cause and effect relationships that span across 12 medical specialties, as treated successfully for thousands of patients, by Orthopedic Surgeon Nikolaos Giantsios, over a 45 year career. It also challenges the single-sided examination of patients by an increasingly specialized body of medical practitioners that yields significant patient, social, productivity and healthcare costs, unnecessarily.

Nikolaos (Nikos) Giantsios was born in Thessaloniki in 1932 and was brought up in Kozani, the home town of his parents.

He received his degree from the Medical School of Thessaloniki University. His postgraduate training as an Orthopaedic Surgeon lasted a total of six and a half years; eighteen months in Athens (Children Orthopaedic Hospital of Penteli)and five years through six hospitals in the United Kingdom including Royal National Orthopedic Hospital, Chesterfield Royal Hospital, War Memorial Hospital (Rhyl, North Whales), Oswestry Hospital, South Mead & Cossham Memorial Hospitals (Bristol) and Burnsley Hospital.

He has been practicing Orthopaedics in Thessaloniki since 1967. During this period he held appointments as a Consulting Orthopaedic Surgeon at the 1st Surgical University Clinic in AHEPA hospital from 1967 to 1976 and later at the Theagenio Cancer Hospital from 1979 to 1986. From that time onwards, he was confined strictly to private practice.

Hello, I am Nikos Giantsios, an orthopaedic surgeon whose career started in UK in 1962 and ended in Greece 45 years later. Quite early in my career and while serving as an SHO, I was asked to take over the Injection Clinic. This happened suddenly, when the Registrar in charge had to move to theater work and I was the one left to take over and learn quickly how to treat the spinal pain. This took place at the Royal Hospital of Chesterfield, a small town of Derbyshire in UK. It was a most fascinating period which lasted seven months till the end of my appointment, during which I had to learn how to approach with a needle blindly, almost every single joint. I had the opportunity to apply and widen this skill, while continuing training in the rest of the UK Hospitals, especially the last one where, being in charge  of an Outpatient Orthopaedic Clinic, I started applying on my patients what I had earlier learned.

The spinal pain at that time, was a subject not very popular among orthopaedic surgeons, who having been tired of hearing their patients’ complaints and feeling unable to help them effectively, felt happy seeing someone else willing to deal with them. The paravertebral injections (PVI), the treatment technic which I had to learn in order to treat the spinal pain, although widely known was not equally widely applied. Applying this, I realized gradually that these injections apart from relieving the spinal pain, could help disorders of other systems too, irrelevant to the locomotor system. What connected these systems with the spine were the facet joints, the small posterior intervertebral articulations, which host in their capsules, apart from the pain sensors some other sensors too known as proprioceptors, which provide to the balance center information about stance and gravity. Systems collaborating with the balance center are sharing this information and consequently are vulnerable to distress signals launched by proprioceptors of suffering facet joints. It is their vasomotor centers those which are finally triggered to react leading to morbid conditions in their domains.

Tracing and injecting these  joints resulted to improvement of quite a number of medical disorders which are described in this book as facet syndromes. It is the result of treatment which has founded this concept and not any sophisticated research plan. Since the treatment results are facts, there should be an explanation why injecting facet joints, morbid conditions of the nervous, ophthalmic, auditory and musculoskeletal systems were improving. This need is what dictated my own myth. It was the need to understand them. Since the ancient times, myths were created to explain facts which people could not understand, only to be later abandoned when a better myth appeared to give a more logical explanation. No doubt, a proper scientific research will soon take care of this in my case.  

Dealing with accidental findings at the start it grew gradually to a systematic search for cases of this kind. What it demanded was good clinical estimation and equally good focusing ability to locate the suffering facet joints and then to reach them. The blind approach at that time was the only one which could practically be applied. This approach was later tried on the cervical spine when I felt confident enough to attempt it. This led to the discovery of the majority of syndromes described in my book. My strong belief is that there is still a wide field left open for doctors to discover themselves the nature of some obscure clinical entities in their domains. It will not be an easy task but is worth trying. I am wishing to them good luck

Although spine surgery, total joint replacements and trauma were my favorite fields of action in practice, facet syndromes pushed them all  aside gradually. I turned to be a second opinion doctor for those who wanted to know if spine surgery which was proposed to them was the right one or could be avoided  Having the luxury to be familiar with both surgical and conservative treatment this has helped to be honest and useful to them. The spinal pain turned to be the major part of my practice. This has certainly helped to a deeper  understanding of spine problems.