Question
I'm a 16 year old girl who is not completely unhealthy but i wouldn't say I'm healthy either.  Around June in 2008 my back started to spasm, it would force my back forwards and backwards into positions only trained people should reach, my back often gets locked and takes a lot of strength from whoever is with me to force it back into place(often pulling and pushing me or digging fingers into my back).  Most of the time i cannot unlock it myself, it causes me great pain and discomfort, i cannot use stairs, cannot walk for long, cannot carry anything and have to be lifted out the bath and have struggles standing up and sitting down and i am putting on weight as it hurts to exercise.  Around May i had the shingles so when i finally seen a doctor in January 2009 he said it was due to that.  Since then i have been to numerous doctors who all say a different thing, recently i have been told it's multiple slipped discs, but i do not trust his decision as he said it was something else before. He said he will refer me to a Chiropractor and a Physiotherapist but i was wondering if you have any idea what it might be as i need a second opinion.  I cannot work because of my back and need to know what it is to see if i can claim disability living allowance.

Answer
Dear Jade,

First of all, I highly doubt that you have any disc pathology.  It is possible to have a disc bulge, however this is rare at your age and I would only expect this with a trauma.  There are specific orthopedic tests utilized to determine the likelihood of disc pathology and if these were found to be positive by the doctor, he should have ordered and MRI to confirm the diagnosis and to quantify the magnitude.

Your pain description is also not due to shingles.  Shingles is a viral infection (Herpes Zoster) of the neurological tissue which lies dormant in the body until your stress levels are increased due to injury, sickness, or daily stress.  It is a direct cousin of the chicken pox infection.  Increased mental or physical stress allows the infection to create the symptoms of shingles because the immune system is not functioning as normal.  The characteristic eruptions on the skin (itchy and burning vesicles) will follow the neurological route of the nerve in which the infection lies.  Most commonly found around the torso or on the face.  Although this can be extremely painful, it does not result in large muscle spasms and contraction.

If you have problems with movements due to spasm, the spasms have got to be severe.  This could be due to movement dysfunction, deconditioned posture/contracted muscle tissue and loss of flexibility, or a physiological problem.  

Is it possible that you have had a puncture wound recently, or a dirty cut.  Tetanus, also called lockjaw, is a medical condition characterized by a prolonged contraction of skeletal muscle fibers, which can be severe.  It can progress to severe jaw muscle contractions and is caused by a bacterium called Clostridium tetani.
This is easily treated with an immunization/injection.

All of these things should be explored with functional examination and blood tests.  You should get the examination from a chiropractor who performs thorough examinations with orthopedic and neurologic tests.  Low back x-rays would be a good idea as well to look for underlying pathology or congenital defects (abnormal skeletal presentation during fetal growth).

Concerning disability.  This will not be a possibility until an accurate diagnosis has been made, and until you have tried care options to eliminate the problems.  If there is a residual problem that cannot be helped, then you will need to discuss the disability option with your treating doctor at that time.

Hope this helps Jade.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net