Dr Louw Venter Spinale Pyn Kliniek

09/10/2025

I apologise if I cannot respond to all messages. Here are some answers to frequently asked questions: We are located at 1349 Breyer Avenue, Waverley Pretoria. Cellphone no: 0691477957 for appointments or queries. Talk to Hannelie. Services include: Full history, full examination including neurological examination taking 30 to 40 minutes. Light manipulation, nerve blocks, identifying and injecting trigger points, demonstrating home program including exercises to prevent relapse of spinal pain, tension headaches, shoulder pain, etc. Excision of skin lesions/tumors for histology when necessary. Please rather phone Hannelie or me for more info.

06/10/2025

After forty year's experience I am sure that by far the most headaches come from tension and muscle spasm.
Neck- ,shoulder- and muscles around the tempero-mandibular joints go into spasm and irritate the neurovascular bundles of the Greater Occipital and Pre- Auricular nerves, leading to progressive headache and tenderness of muscles.( Over the arrachment of the posterior neck muscles to the occiput and the TM joint in front of the ear).
This is aggravated by posture while driving, working on computers or even with microscopic medical posedures like retinal surgery, etc.
As the headaches often start on the one side, then move initially to behind one eye, people often suspect and might be treated for migraine..
Mostly the headache responds very well to gentle mobilisation of the paravertabral joints and the palpation and injection of triggerpoints in the neck-, scapular-, and/ or masseter and Temporal muscles.
This relief may wane after a while if not followed by 3 regular easy exercises of the neck and shoulder muscles,which take 3 minutes of your time two or three times a day and can be done while lying, sitting or standing.
A MRI, followed by a servical fusion or fusions for purely degenerative changes are in the majority of cases not necessary or effective, though it is regularly done.
Worrying synptoms and neurological signs; that do not clear up with treatment, warrant scans to exclude other causes like rare vascular abnormalities, intra-cranial tumors or infections.
These tension-related/muscle spasm associated headaches are more common in female patients. Perhaps because they must multi-task between household- motherhood and professional duties. It is natural to worry about such a headache, but please get second or third opinions before having neck surgery and if the first one does not help the chances of repeat opererations being succesfull is very low.

13/09/2025

As 'n mens 'n leuen genoeg vertel of hoor glo jyself en ander mense later dit is die enigste waarheid. Ook as jy sekere feite ignoreer of nie uitlig vir ander nie kom dit op dieselfde neer.

Dit is waar op baie terreine o.a. ook ongelukkig op mediese terrein wat betref sekere medikasies, ingrepe, effektiwiteit van ondersoekmetodes, ens.
Goeie studies wat bewys dat konserwatiewe behandelingsmetodes net so goed of beter as duur chirurgiese prosedures is word geignoreer en die gebreke of vals gevolgtrekkings wat ondersoeke kan uitwys (soos bv. MRI skanderings vir degeneratiewe werwelprobleme wat afwykings wys in tot 70% plus van simptoomlose mense oor 60 jaar en selfs jonger).
Ook die voordele en nadele van chirurgie vir spinale diskusverwante degeneratiewe probleme en beplande chirurgiese verlossings by normale swangerskappe voor die normale duur van 'n swangerskap word nie altyd in ag geneem en volledig bespreek met pasiënte nie.
Die moontlike akute en permanente gevolge vir al die betrokke pasiënte, ook babas,is veelvuldig Dit kan en moet op Google nageslaan word en dokters moet uitgevra word daaromtrent voor op chirurgie besluit word.
Later meer hieroor.

15/08/2025

Ek is in Duitsland tot 11 September by my kinders en klein Louwtjie tydens sy skoolvakansie.
Sal DV 12 September weer pasiënte kan sien.

13/03/2025

Pynbeheer, versterking van boud-, maag-en rugspiere, verduideliking van die oorsake van pyn, wat meesal van "normale" degenerasie van gewrigte en interwerwel diskusse af kom, is in in 85 tot 90 persent van gevalle al wat nodig is om binne 'n paar weke die pyn te genees.
Enige verbetering is 'n teenaanduiding vir chirurgie.
MRI ondersoeke kan met veiligheid uitgestel word vir 'n paar weke in dié gevalle na 'n deeglike kliniese ondersoek en geskiedenisneming.
Onstabiele frakture, tumore, infeksies en cauda equinasindroom (o.a. dooie gevoel om die anus-area), is die belangrikste redes vir vinnige chirurgie maar is baie skaars.
Pynbeheer kan insluit pynblok- inspuitings, ligte manipulasie, spuit van snellerpunte en spasme in spiere en medikasie.
Spesifieke versterkingsoefeninge wat spierkwyning voorkom en stabiliteit verbeter moet van die begin gedoen word. Plus minus dieselfde as wat na chirurgie ook gedoen moet word.
In meeste gevalle is net een of twee konsultasies nodig en bedrus moet slegs in erge gevalle gebeur want spiere kwyn binne dae weg en vertraag genesing baie.
Wys asb die skrywe aan u dokter.

01/03/2025

I want to share a few facts on the relevance of MRI-studies for spinal pain caused by degenerative disc-associated causes. 1. The information you get from this expensive procedure is not important or necessary for the treatment of more than 95% of these cases.
2.The only indications for MRI and urgent surgery are rare other causes like unstable fractures; tumors, possible infections like Tuberculosis bacterial or fungal infections and those can usually be picked up by a good hisrory and clinical examination
MRI abnormalties are common in all of us as we get older and do not aways correctly show the real cause of the pain.
3.Many symptomless people have shown impressive, dangerous-looking disc-associated lesions in more than few studies and would have been operated on if they had any back pain from.other sources.
4. MRI can be safely postponed for weeks if active conservative treatment is prescribed withou any danger to the patient.
5. Please do not go for surgery without a good clinical examination and a written explanation of why it is necassary. You can ask for a second opinion and a4 to 6 weeks conservative without any danger. 90 persent of MRI's and surgey can be prevented.

06/02/2025

I regularly see patients who have undergone two or more (up to five+) spinal operations before the age of forty. By the same or different surgeons. This saddens me because the chances of each new operation to be succesfull gets lower and lower every time.

What is however more shocking is that a high percentage of these patients are surprised to have a clinical back- and neurological examination. They say that the surgeon just discussed the MRI, showed them the " dangerous abnormalities" and booked the surgery that will save them from "becoming paralised if they stumble".

This breaks my hart for mainly two reasons:

Firstly it has been widely known for years, proved and published in different studies, that a high percentage of MRI "abnormalities" can be seen in random, asymptomatic individuals. From the age of twenty, (getting higher in each age group),these individuals showed disc protrusions, narrowed and ruptured discs as well as degenerative changes of bone and joints - which is now seen as normal signs of the aging process. Few healthy, people over fifty have "normal" MRI's.

Secondly it is also well-published that permanent paralysis from degenerative, disc- related spinal problems is highly unlikely in conservatively-managed patients and occur much less than complications during and after surgery. This becomes more and obvious in higher age-groups.

Unfortunately doctors are not trained pre-and post-graduately how to do active conservative treatment of disc-associated spinal pain. It becomes the easier way out (for the doctors) not to do a time-consuming clinical examination, explanation of the normal healing time, exercises and pain control measures but to do a expensive MRI and operation.
The financial costs of these procedures and time off from work etc. in South Africa and the unnecessary damage to patients has enormous consequences. Good for the hospital industry and service providers and bad for patients and medical aid premiums.
Medical schemes pay for more than 85% of spinal surgery for disc-associated degenerative spinal pain in our country. This is done to the less than 10% of the populace that can afford medical aids.
During their studies spinal surgeons get experience in training hospitals mostly in surgery for indications like unstable fractures, spinal infections like Tuberculosis, tumors of the spine or spinal cord, congenital defects, etc. Surgery for degenerative conditions is done much more seldom. These patients usually get better by themselves, being as active as possible, in one to three month's time. To keep on working is recomended. (Unused muscles get weak within days and delay healing).
In private practice these operations usually are the main source of income for spinal surgeons.

Please do not have surgery done to you or your loved ones by a doctor who just looked at the MRI and did not examine you clinically. It is your back and your life. Get a second opinion.

The facts stated here is supported by studies that I have at my disposal. You can visit: pubmed.ncb.nim.nih.gov/11568190/

Be well.

06/02/2025

The findings on magnetic resonance scans were not predictive of the development or duration of low-back pain. Individuals with the longest duration of low-back pain did not have the greatest degree of anatomical abnormality on the original, 1989 scans. Clinical correlation is essential to determine....

21/01/2025

Vandag voel ek hartseer oor twee bejaarde pasiënte wat na herhaalde rugoperasies nou huistoe gestuur word deur die dokters met `n voorskrif vir pynpille en raad om dalk `n fisio en `n biokinetikus te raadpleeg nadat nog `n duur MRI gedoen is wat bevestig "dat die operasie100% lyk".
Dit nadat die een pasiënt direk na die eerste operasie met `n "drop foot" wakker geword het, wat gelei het to vier operasie aan die enkel en voet om dit styf te maak.

Die fisioterapie en biokinetiese hulp moes die eerste operasie voorgeskryf gewees het met die inligting dat in meer as 90% van gevalle met degeneratiewe diskusverwante rugpyn net oefeninge en pynbeheer nodig is en binne 4 weke to 3maande self sal opklaar, sonder gevaar van verlammings of ernstige komplikasies.

Die verligting en hoop wat `n verduideliking, eenvoudige ingrepe en instruksies,oor wat die pasiënt self kan doen om die toestand te hanteer en verbeter is van langtermyn waarde.

15/11/2024

Velkankers is baie algemeen en kan lewensbedreigend wees. Dit kan grootliks voorkom word deur faktor 50+ sonbeskermende room te gebruik en voorloperletsels vroeg te behandel.

Moet asseblief nie wag totdat dit te ver gevorder is nie (sien meegaande foto's waar die gevorderde velkanker al 'n deel van die oor vernietig het - gelukkig kon die volledige kanker in ons kamers onder lokale verdowing verwyder word en die oor herstel word sodat hy nog 'n sy bril kan dra). Laat u vel gereeld ondersoek. Boererate werk gewoonlik nie, soos die meegaande foto's bewys.

Maak asseblief 'n afspraak as u enige moesies of gewassies het wat onreëlmatige rande het, meer as twee kleure in dieslfde letsel het of onlangs van kleur of vorm verander het sodat dit ondersoek en vroegtydig behandel kan word.

04/10/2024

Konserwatiewe behandeling van nek- rug- en hoofpyn asook behandeling van velletsels en fibromialgie

17/09/2024

Lees gerus die "abstract"van die studie wat bewys dat 90% van operasies vir rugpyn (wat veroorsaak word deur degenerasie en diskusletsels), vermy kan word deur gestruktureerde konserwatiewe behandeling en pynbeheer.

Konserwatiewe behandeling van nek- rug- en hoofpyn asook behandeling van velletsels en fibromialgie