Question
HI, Will cortisone shots or chiropractic spinal manipulations help with my lower back pain to heal? My PM Dr currently has me taking 300 mg of Gabapentin (after a 6 day steroid pack)and 50 mg of Topamax. He wants to do shots but I'm really just not sure about all of this. I've found most Dr.'s will only tell you the information that best suits their practice....if I went to the vet, he'd tell me I had fleas!
My injury occurred last April 2009, I have tried doing nothing, ice bags chiropractic therapy, massage therapy and ultrasound therapy to help relieve the pain in my lower backside. I have just started with the PM Dr as I am tired of having no life besides work. I sit all day, which only makes my back worse.
I do not completely understand my MRI which says: Disc protrusion noted at L4-5 central .mm L5-S1 central .mm and L5-S1 left .mm Disc Derangement w/Annular tear noted at L4-5
Can you please help me to understand this, tell me if this will heal on it's own in time or if I need to continue on the path with pain management, pills and shots (not something I am fond of)
thanks very much!

Answer

Hanna Somatic Educatio Hello, Kenny.

Cortizone is used as an anti-inflammatory -- and it has the effect of causing connecting tissue to break down, something not disclosed, commonly.  So, no, I don't think cortizone shots will help: I think they will hinder healing.

Spinal manipulations are of limited benefit, as bones (vertebrae) go where muscles and soft tissue pull them, and if they're out of place, it's because you have chronic muscular tension patterns involved.  For that, there is an effective solution (see below).

I think you've already found out the relative efficacy of ultrasound and massage therapy.

The disc protrusion usually indicates muscles in spasm, a cause of disc compression and of muscle pain.  Muscle spasm is the most common cause of back pain, and the most direct to easing it is brain-muscle training (somatic education).

A disc tear at L4/5 will heal once excessive compression forces are relieved through brain-muscle training, but discs heal rather slowly.  Sometimes, surgery is needed for that condition. I think your docs would already have recommended it, if it were indicated -- but one never knows.

However, once muscle spasms are eased, pain often decreases and mobility improves, immediately; then healing can begin.

Here are links to write-ups I have done on the subject.

http://somatics.com/back_pain.htm
http://somatics.com/chronic_back_pain.htm
http://somatics.com/back_exercises_for_lower_back_pain.htm

If you can't get to a practitioner (see write-ups), I can made a recommendation for self-care/self-treatment.

regard,
Lawrence Gold