QuestionI was in a car accident, resulting in lower back and neck pain. An MRI showed have "noncompressive disc bulge at L3-L4 and L4-L5. Mild Retrolisthesis of L5 on S1. Thecal Sac is centric. Neuralforamina are patent" and "Broad base disc herniation C5-Ck with thecal sac indentation. Left paracentral disc herniation c6-C7 with mild thecal sac indentation no central stenosis. At C4-C5 broad based disc herniation indent thecal sac, neural foramina are patent, At c6-c7 left paracentral disc herniation mildly indents thecal sacs,facet joints are unremarkable". They sent me to Pain Mngt and I have been getting acupuncture, Trigger point injections and one SI Injection all for the lower back pain, nothing for the neck pain. I have headaches daily. Can the neck disc herniations be causing them, if so what treatment should be done? Its been 5 months and the only relief I felt was after the SI Injection but the pain is starting to return 2 weeks after injection....not sure if all of these shots are safe? Should I see an Ortho for second opinion?
AnswerMotor Vehicle Accident, Automobile accident, car crash, auto accident, car accident, staten island car accident, disc herniation, staten island automobile accident, disk herniation, whiplash, staten island disc herniation, HNP, staten island pain management, disc degeneration, degenerative joint disease, osteoarthritis, staten island motor vehicle accident
Hello Cheryl,
I am sorry to hear of your motor vehicle accident (MVA).
I am sorry to hear of your accident and the resulting aches, pains, conditions.
Well, you are in the right place! At the Chiropractic section of AllExperts.com we handle car accident patients all day, every day; we answer their questions all the time. I am sure much of my answer will concur with your own Doctor's information. Your Chiropractic Doctor (DC) probably handles many injuries resulting from a car crash, just as I have many patients from my local Staten Island Auto Accident incidents.
You state: "....I was in a car accident, resulting in lower back and neck pain.....", car accidents are common causative factors, neck and low back pain are VERY very common conditions in your local Doctor of Chiropractic's office.
Often the Doctor of Chiropractic (DC) is referred to as the 'Spine Specialist' by the public. This title is well earned- we see neck and back pain, headaches all day, and usually treat these complaints very effectively. Chiropractic is safe, non-invasive, effective and cost effective (usually much less expensive than Medical treatment).
".....An MRI showed have "noncompressive disc bulge at L3-L4 and L4-L5. Mild Retrolisthesis of L5 on S1. Thecal Sac is centric. Neuralforamina are patent" .....", I am sure your Chiropractor has reviewed and explained this to you. Disc bulges are very common to our U.S. population. These Disc Bulges may have been caused by the Motor Vehicle Accident (MVA), or may have been quietly there for years before. Disc bulges MAY be very painful, or may not. The patient response is very individual.
If these disc bulges were caused by the accident, then these disc bulges would be/ could be very painful. If these disc bulges are new, they show damage, they show a problem caused by your MVA. The discs could be said to be 'bruised', irritated, inflamed.
This inflamation could easily be the source of Low back pain, buttock/ hip/ leg/ sciatic pain; even numbness extending to your toes. If you were to have bowel or bladder control problems, those symptoms MUST be seen by a Neurologist or even an emergency room!
When we injure ourselves we set into motion a biological process known as inflamation in our bodies. Inflamation is our body's path of repairing itself, but can be very painful, and sometimes even counter-productive. Inflamation is thought to be a cause (or part) of cancer, heart attacks, strokes, indeed just about every disease process; as well as the body's response to injury. Inflamation is the reason Medical Doctors have invented and utilize Anti-Inflamatory Medications. An Anti-inflamatory LIFESTYLE is also very important in attaining and maintaining better health.
My Staten Island Pain patients get an informative handout from me on this topic of "Inflamation":
P.R.I.C.E. = P protection. R rest. I ice. C compression. E elevation.
Hurt yourself ?? injury/ trauma/ bruise/ not even sure - - a broken bone ??
You should certainly get to the Doctor or trained health professional to be examined if you think it is bad enough.
BUT
in the meantime, some simple steps may help.
PRICE.
The PRICE protocol will usually help just about any musculoskeletal injury.
P = Protection; protect the area from further injury- stop what you are doing, can you
pad or bandage the area ? Tape the area? Do something to protect the area !
R = Rest; rest the area as much as possible, if a part is damaged, give the body time to
repair the area
I = Ice; ice is a potent anti-inflammatory; it will slow swelling, help with pain control
(ice is analgesic), place ice over cloth over the injured area for 5, 10 minutes, off the
injured area for 30 minutes; then back on again ( please do NOT use heat, heat adds to edema->
heat feels good while it is on,,,, and often makes the condition WORSE after you take heat off )
C = Compression; to help prevent swelling compression may be helpful- for example
if it is an ankle, wrap the ankle with an ace bandage and ice the area. Many body
parts may not be applicable to compression.
E = Elevation; again to fight swelling and pain, raising the injured body part above the
heart may be helpful- ie raise an ankle or knee, you lay down, raise the injured part
PRICE may help : Sprains, Strains, musculo-skeletal injury, bruise, contusion
Sometimes a slip, trip, fall, heavy lift, athletic injury, or a motor vehicle accident can cause a bump or bruise, sprain or strain. Sometimes also involved with the injury is a vertebral subluxation (or other joint subluxation) (subluxation is a mechanical problem- of any joint- and requires a mechanical correction). In the spine, a sprain/strain is a misalignment, a 慿ink?in the joint, a stretch of the muscles, tendons and/ or ligaments:- more properly termed a Vertebral Subluxation. Sometimes symptoms can come immediately, sometimes days, weeks or even months later!- Well after the actual trauma !!!
Spinal = Vertebral Subluxation Complex (a.k.a. 憇ubluxation? ; ( subluxation COULD be any joint )
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
This is a serious condition identified by its five parts:
Spinal Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
Histopathology:
A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
Pathophysiology:
Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment. For good health- Treat the Cause, not just the Symptoms. Sprain/ strain/ bump/ bruise?= may result in subluxation of the nearby joint. CORRECT the subluxation !!!!
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomate, American Chiropractic Board of Sport Physicians; Diplomate, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine
I know it is to late for the 'PRICE Protocol' to applied in your case, but if you get injured again, OR if you aggravate these very same areas-> do the PRICE steps,,, especially ICE.
".....Mild Retrolisthesis of L5 on S1. Thecal Sac is centric. Neuralforamina are patent".....", again, just as with Disc Bulges, this 'retrolisthesis' may pre-date your accident, or may have been caused by your car accident. If you never had symptoms before, then these conditions found by the MRI were probably caused by the MVA.
"Retrolisthesis" is one bone slipping backwards over another, see images: http://www.dynamicchiropractic.com/content/images/eggleston_figures_19266_1_1_65... ,
http://www.headbacktohealth.com/Retrolisthesis%20of%20L5.jpg ,
http://www.google.com/imgres?imgurl=http://www.headbacktohealth.com/Retrolisthes... ,
This misalignment could have been there before your MVA, could have been caused by the MVA, could have been aggravated by the MVA.
"......Thecal Sac is centric. Neuralforamina are patent" .......", this is good stuff, these are normal findings, good findings. Your spinal cord, spinal nerves (Thecal Sac) are central in your spinal canal; and the neuroforamina- the holes that nerves go through are patent (good).
Now we move on up to the neck (cervical spine) MRI results: "....."Broad base disc herniation C5-Ck with thecal sac indentation. Left paracentral disc herniation c6-C7 with mild thecal sac indentation no central stenosis. At C4-C5 broad based disc herniation indent thecal sac, neural foramina are patent, At c6-c7 left paracentral disc herniation mildly indents thecal sacs,facet joints are unremarkable"....."
"...."Broad base disc herniation C5-Ck with thecal sac indentation...."- this is not a happy finding, this disc herniation is at a place usually found with a 'Whiplash' type injury (cervical acceleration deceleration injury; cervical hyperflexion/ hyperextension injury, cervical aprain/strain). This is good evidence of injury caused by MVA. This may cause neck pain, pain into your shoulders, even pain into your chest, and could cause your headaches.
".....Left paracentral disc herniation c6-C7 with mild thecal sac indentation no central stenosis.....", Left C6/C7 HNP (disc herniation) with thecal sac indentation (pressure on the protective covering of the spinal cord) could cause shoulder/ arm/ hand pain/ numbness- usually left sided.
"....At C4-C5 broad based disc herniation indent thecal sac, neural foramina are patent, At c6-c7 left paracentral disc herniation mildly indents thecal sacs,facet joints are unremarkable.....", These are good evidences of injury sustained in this MVA. These may cause neck pain, pain into your shoulders, even pain into your chest, and could cause your headaches.
Your Lumbar AND Cervical MRIs show damage, damage probably caused directly by your MVA, damage well handled by your local Doctor of Chiropractic. You will probably see good progress in the right direction with your regimen of Chiropractic. Your local Doctor may already be a specialist, or may even refer you to a specialist within Chiropractic; see----> http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf a chiropractic radiologist may review your films, a chiropractic neurologist may prescribe certain maneuvers or exercises, a chiropractic nutritionist may recommend an anti-inflamatory diet!
".....They sent me to Pain Mngt and I have been getting acupuncture, Trigger point injections and one SI Injection all for the lower back pain....", these chemical (pain management) and energy (acupuncture) techniques should be helpful with your pain. Your MRIs show mechanical problems in you spine (neck and low back), and these should respond especially well to chiropractic treatment. In fact, these mechanical problems NEED a mechanical answer.
In my Staten Island Chiropractic office I hand out the following information:
PAIN
Pain is a 憆ed light on the dashboard? RED LIGHT = Trouble !!
Pain is your body telling you that something is wrong. Think you should listen??
That RED LIGHT on the dashboard of your car-
-- do you ignore it until the car breaks down,
or do you get it checked and correct the problem?
Pain,
pain in your body-
-- do you ignore it until your body breaks down,
or do you get it checked and correct the problem?
Pain,
do you cover up the pain by taking a painkiller?
Take a painkiller,
mask the pain,
and allow a problem to progress in your body?
Pain Killing medication??? = 16,000 deaths ( probably under-reported )
DEATH ! ? ! ? better watch out on those medications!!!
NOTICE ON PAIN RELIEVERS:
Label changes ORDERED by FDA; the FDA announced proposed label changes for OTC over-the-counter pain relievers to include the potential for stomach bleeding and liver damage (FDA news 206- 207; 12-9-06) ;
SIXTEEN THOUSAND DEATHS: "Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective medications for the treatment of many chronically painful medical conditions. However, it is estimated that 25% of all serious adverse drug reactions involve NSAIDs, with more than 100,000 hospitalizations and 16,000 deaths occurring annually due to NSAID-induced gastrointestinal (GI) events."----- http://hhc.sagepub.com/cgi/content/abstract/13/6/468 Home Health Care Management & Practice, Vol. 13, No. 6, 468-475 (2001) Motrin, Advil = NSAIDS
The American Heart Association issued a scientific statement recommending medical doctors change the way they prescribe OTC pain relievers from a first choice to an alternate of recommending non-pharmacologic treatment (AHA statement 2-26-07).
NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people take NSAIDS for the pain of Arthritis, not realizing these drugs may make the underlying condition worse. These medications cover up the pain, and cause the problem to worsen.
http://rinf.com/alt-news/business-news/prescription-drugs-kill-300-percent-more-...
= An analysis of 168,900 autopsies conducted in Florida in 2007 found that three times as many people were killed by legal drugs as by cocaine, heroin and all methamphetamines put together. BE CAREFUL WITH THAT MEDICATION !!!
It was reported in 2000, that 700,000 U.S. citizens die as a result from medical causes (iatrogenics). Of course, other records and statistics had the number above the one million mark. Whether 700,000 or one million people, that's a lot of innocent people dying from visiting a hospital and trusting a medical doctor.= http://www.dherbs.com/articles/iatrogenics-99.html
Pain can often be the result of the Vertebral Subluxation Complex.
Vertebral Subluxation is actually a quite common condition. Doctors of Chiropractic look for pathological conditions which may require referral to other specialties, and also look for 慡ubluxation? Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system (the master control system- ALL health disciplines learn this). VSC- 慡ubluxation??can be the cause of many symptoms and conditions.
Only a Doctor of Chiropractic will evaluate and treat for VSC, as well as other pathology.
The course of VSC is highly variable. Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights. Some patients immediately develop symptoms related to the VSC, some patients take years to develop symptoms. Some people suffer for only a few days with pain and symptoms, some people suffer for months. Some people recover in days, some take months or years, depending upon severity of the condition.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position. When subluxated, joints are in a stressed, vulnerable, compromised condition. Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment.
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomate, American Chiropractic Board of Sport Physicians; Diplomate, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine , Invited to Colorado Springs (Olympic Training Center) to Care for USA Olympic Athletes 2010 , Chiropractor to the Championship NYPD Football Team, and the PSAL High School Football Champions (Curtis)
I think the above information helps my Staten Island Motor Vehicle pain patients, I hope it helps you understand your problems.
".....nothing for the neck pain. I have headaches daily.....", I do not understand why they are not treating your neck as well as your low back. Have you asked your Chiropractor why not???
".....I have headaches daily. Can the neck disc herniations be causing them, if so what treatment should be done? ....", With FIVE (5) months of treatment and little or no progress I recommend a new, different doctor. Have you spoken with your chiropractor and asked why the slow progress? --> Communicate, talk with your doctor.
Your Doctor (of Chiropractic) could certainly change techniques, try a different protocol, or send you to a different DC who uses one of the other approaches to care.
YES, your headaches could well be caused by the neck complaints listed above. Your headaches should be progressing in the correct direction with your regimen of chiropractic care.
".....I have headaches daily. Can the neck disc herniations be causing them, if so what treatment should be done?....", perhaps it is time for a different chiropractor.
"....Its been 5 months and the only relief I felt was after the SI Injection but the pain is starting to return 2 weeks after injection....not sure if all of these shots are safe?....", I would recommend talking to a Medical Doctor for comments on the chemical (medical) approach. But often these shots are only temporary fixes- se above the information an pain medications.
".....Should I see an Ortho for second opinion?.....", the Chiropractor managing your case probably works with several different Orthopedic Medical Doctors. Ask your DC for a referral to another MD if you are not happy with your progress/ treatment to date.
If you are not content with your progress, if you are not getting good answers to your questions, then it may be time to change doctors for a new different approach.
One final information handout; my Staten Island Whiplash patients receive this information:
揥hiplash? ( Also Known As- Cervical Sprain/ Strain, CAD= Cervical Acceleration/ Deceleration Injury)
Sometimes a slip, trip, fall, heavy lift, or a motor vehicle accident can cause a 慦hiplash Injury? This can result in ligament sprain, muscle strain, and 憄inched nerves?
Often - the c a u s e of the neck stiffness and pain; a cause of stretched ligaments and muscle strain is a misalignment, a 慿ink?in the neck- more properly termed a Vertebral Subluxation. Sometimes 慦hiplash?symptoms can come immediately, sometimes days, weeks or even months after the actual trauma !
Vertebral Subluxation Complex (a.k.a. 憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
This is a serious condition identified by its five parts:
Spinal Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
Histopathology:
A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
Pathophysiology:
Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment. For good health- Treat the Cause, not just the Symptoms.
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians;Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine , Selected to provide care to USA OLYMPIANS, Colorado Springs Olympic Training Center
Well, I hope this information helps you. If you need further, do not hesitate to RE-contact your Staten Island Chiropractic Expert here at http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm
Thank you for the question,
I wish you good luck in returning to good health,
Dr. Victor Dolan, DC
