Question
I am currently being treated for a twisted coccyx and forward leaning pelvis for the past 4 months. My physical therapist typically has to "straighten" me back out each week due to my muscles refusing to cooperate and stay unknotted. As a result of an MRI, it was recently discovered that I also have a bulging disc between the L5 and S1 region of my spine. I am also seeing a spine specialist, which I am not entirely happy about. He has taken an X-Ray of my spine and shows the disc is bulging in, causing my bones to practically touch on the outside. I have undergone two cortisone shots in my spine, neither of which seemed to give me much relief. The main area of my pain is my right hip joint and tail bone. I have some pain around the bulging disc area, but not much. I am pretty much at the point where I want to simply give up. Nothing is helping me to relieve this pain. I am tired of having to take Vicodin each night just to get some type of rest due to the amount of pain I am in when I try to lay down. My job requires me to sit for an extensive amount of time without the ability for much movement.  I feel this is hindering my healing...but what could be causing my muscles to constantly stay tense and not respond to physical therapy or anything else for that matter? What do I do at this point? I'm about at the end of my rope and I don't want surgery, because I don't think that's the problem. Should I consult with an internist or rheumatologist to see if there is something else going on?

Answer
Dear Corey,

I am sorry for your pain.  Let me help you to at least understand some of the issues.  First of all, it sounds like you have a bulging and degenerating disc.  It is wearing out. when it wears out and bulges, it touches up against the spinal cord (nerve tissue), the nerve roots (again, nerve tissue), or the dura, which is a very sensitive tissue that surrounds the cord and nerve roots... or perhaps any combination of all three.

There is NOTHING that will make your disc grow back to normal. Like the human eye, it just doesn't regenerate very well.

When nerve tissues or the dura are irritated, the nerves not only transmit a pain signal to the brain, but they also send a signal to the muscles along the spine telling them to contract, and as a result, to splint the lumbar spine region.  This is why the muscles continue to spasm.

As far as the epidural injections... like anything else, sometimes they work to reduce pain, and sometimes they don't.  The good news is that your doctor is trying non-surgical methods first.  Have you considered any of the following?

Physical Therapy, Chiropractic Care, Acupuncture, massage, trigger point injections, spinal exercises, spinal decompression therapy,...

Nothing, again, nothing is going to make the disc grow back to normal, so now it is time to finds ways to help reduce the pain and then maintain the condition.  If you find that something like chiropractic care works, then ask the doctor to help you to learn exercises... and then CONTINUE to seek regular adjustments and CONTINUE to do your back exercises.  If you lay off the care, It is very likely that your symptoms will return, possibly with a vengence.

I wish that I could give you a new back. Don't give up. Keep seeking alternatives for help. Don't run to the surgeon. All that a reumatologist or internest could do for you is to prescribe additional pain medications or muscle relaxants... do you want that?  It sounds like you don't.  So, your best approach is to find NON-INVASIVE help, such as the things that I listed earlier.

Oh... one last thing. Make sure that your physicians have taken a look at your true hip joint to make sure that it is not the cause of your pain.  It might also be beneficial to take a look at your knees to see if they are contributing.

Good luck,

Keith Biggs, DC
http://www.eastmesachiropractor.com