Question
I have experience chronic back pain for the last year and a half.  I have done physical therapy, acupuncture, chiropractic, pain management, and had x rays, none of which helped or showed anything wrong.  I finally had an MRI which showed a  mm bulge in the thoracic spine, i believe the T11.  The pain management Dr said that it was not really big enough to do much except for nerve injections which would essentially shut off the nerve so i don't feel pain.  The chiropractor told me not to do the injections, because eventually i could end up with a lot of nerve damage.  I have also been taking Cymbalta and Lyrica which has slightly decreased the pain.  Is there any advice you could give me or any treatment that i may be able to ask my Dr about.  

Answer
Hi Jorge,

Yes there most certainly is. You might be seeing the wrong D.C., he may not be equipped to perform a procedure known as flexion/distraction.

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.

Forget the injections since this is only temporary and may have permanent side effects that will cause permanent pain.
In addition, it will only mask the symptoms instead of fixing the problem like F/D would.

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

This treatment is the Gold standard and your present D.C. may not be equipped to handle this.
Many D.C.'s in the US perform this, it is pain free, non-surgical, less dangerous, more effective and far more inexpensive.

If you need a referral, I'll be glad to help!

Dr. Timothy Durnin
drs.chiroweb.com