Question
Hi, for almost 5 years now I have been experiencing different types of symptoms including lower back pain, pins and needles in the buttocks and down my Left leg. I have had numerous nerve conduction studies which confirm that there are issues present. The symptoms however are mostly aggravated during walking or prolonged sitting and standing. I recently had an MRI which resulted in the following:

There is early degenerative change in the L4/5 disc with slight signal loss. At this level, a small focal left foraminal disc protrusion has occurred, associated with displacement of the L4 nerve root as it exits.

L5/S1 disc also shows evidence of dehydration with a mild posterior narrowing. Disk contours remain smooth.

Firstly is this something that can be fixed without any surgery and is this the cause of my discomfort and symptoms.

Thanks for your time it is most certainly appreciated.

Answer
Hi Michael,

Surgery is rarely indicated for small herniations like this. There is an effective and proven conservative treatment for most mechanical low back pain causes. There is no doubt that the lower extremity symptoms you have are directly related.
You need to find a physician in your area that has flexion/distraction tables and begin a short course of treatment. This will usually result in a 2-3 weeks of care that will eliminate the pain. This means you are half way there since the disc will probably still be displaced but not enough to cause pain. Total correction is the goal and follow up visits are usually needed to fully decompress the nerve. On average, total repair is achieved in 6 weeks, with pain being absent by the 2nd or 3rd week.

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

Here is a site that you cab use to better understand the process and locate certified physicians that may be in your area.

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

Here are some hints to help you along until you begin treatment.

Lay on your back and bend your knees by grabbing them with both hands pulling each leg one at a time to your chest. Do this each side 10X then with both knees 10x/3X/day before you get out of bed and before you get into bed and in the middle of the day.

Use ice instead of heat, this minimizes inflammation that is a result of nerve root irritation without causing the area to become more red, hot, swollen, irritated and inflamed.

Prevent further weakening of the disc integrity by taking an OTC supplement known as glucosamine sulfate with MSM. Take at least 3000mg/day. This is shown to aid and speed up repair of connective tissue.

If you need help finding a competent physician, feel free to contact me and I will personally find you one.

Thank you for inquiring,

Dr. Timothy Durnin
drs.chiroweb.com