Question
I am concerned with my doctor's quick recommendation of back surgery for the shooting pain from my low back down my left leg.  Could you check the MRI results and see if you think surgery is the only answer?

Findings:  There is no focal marrow replacement.  No compression fracture is present.  There is loss of hydration of the disc at L5-S1 with loss of intervertebral disc space height.  The conus medullaris appears in appropriate position.  On the coronal scout image there is a scoliotic curvature to the lumbar spine with convexity towards the left.

At L1-2 and L2-3 there is no canal stenosis with mild facet hypertrophy.
At L3-4 there is no canal stenosis with minimal facet hypertrophy present.
At L4-5 there is a disc bulge present diffusely without canal stenosis.  Minimal facet hypertrophy is present.  Mild foraminal narrowing is present inferiorly bilaterally.
At L5-S1 there is a left central disc extrusion which does cause mass effect on the proximal left S1 nerve root.  Left recess narrowing is present.  The neural foramina demonstrate narrowing bilaterally moderate to marked in severity.  
The visualized portion of the retroperitoneum appears unremarkable.

Impression:
1.  L5-S1 disc desiccation with disc bulge and left central disc extrusion with encroachment upon the proximal left S1 nerve root with moderate to severe bilateral foraminal stenosis.

2.  L4-5 diffuse annular disc bulge without canal stenosis with mild bilateral foraminal narrowing.  

Is there anything I should not do that might further cause damage?  I have started tonight a back exercise disc that is very light stretching, but didn't know if I could be doing more harm than good.  I tried taking Advil & semi-resting for about 3 weeks before going to my primary care doctor and could this be why surgery was recommended so quickly?  

Thank you for your help & time.  

Answer
Hi Tony,

Only 5% of disc herniations require surgery, afterward, no one is ever the same. For three decades, flexion/distraction has decompressed discs much worse than this with 80% success rate.

Here is a site that can guild you to a physician and explains what it is. It is fully researched and proven effective.

http://www.coxtechnic.com/homepage.asp



Flexion-Distraction Therapy - What is it?


Flexion-Distraction, (F/D) is a gentle, chiropractic treatment procedure utilized for back and neck pain. Flexion-Distraction is a safe alternative to back surgery for those 95% of patients whose conditions do not demand surgical intervention. The doctor is in control of the treatment movements at all times.

Flexion-Distraction is utilized for many conditions such as:

Failed back surgical Syndromes
Disc Herniation/Ruptured Disc / Bulging Disc / Herniated Disc
Sciatica / Leg pain
"Whiplash" injuries
Stenosis
Arm Pain
Neck Pain
Failed course of Steroid Injections
Chemical Radiculitis
Spondylolisthesis
Headache
Transitional segment
Many more conditions?
How does Flexion-Distraction Work?

For Disc related conditions:

Increases the intervertebral disc height to remove annular tension on the annular fibers and nerve by making more room and improving circulation.
Allows the nucleus pulposus, the center of the disc, to assume its central position within the annular fibers and relieves irritation of the spinal nerve.
Restores vertebral joints to their physiological relationships of motion.
Improves posture and locomotion while relieving pain, improving body functions, and creating a state of well-being.
For Non-Disc related conditions:

Patients with other conditions causing back pain (facet syndrome, spondylolisthesis, sprain/strain, scoliosis, transitional vertebra, sacroiliac restrictions and misalignment, certain types of spinal stenosis), Flexion/Distraction provides all of the above benefits plus the ability to place the spinal joints into normal, painless movements so as to restore spinal motion without pain:

The posterior disc space increases in height.
F/D decreases disc protrusion and reduces stenosis.
Flexion stretches the ligamentum flavum to reduce stenosis.
Flexion opens the vertebral canal by 2 mm (16%) or 3.5 to 6mm more than extension.
Flexion increases metabolite transport into the disc.
Flexion opens the apophyseal joints and reduces posterior disc stress
The nucleus pulposus does not move on flexion. Intradiscal pressure drops under distraction to below 100mm Hg. On extension the nucleus or annulus is seen to protrude posterior into the vertebral canal.
Intervertebral foraminal openings enlarge giving patency to the nerve.

Reference: Cox JM, Feller JA, Cox-Cid JA: Topics in clinical Chiropractic 1996; 3(3):45-59

Massage and epidurals won't solve the problem either, surgery should NEVER be the first option. Take a look at the spine surgery section of this site and you won't even consider it, nothing but horror stories.


Thank you for your question Tony and good Luck!

Dr. Timothy Durnin
drs.chiroweb.com