Question
I have been suffering from pain in my right butt cheek and excruciating pain down the side of my right leg to my ankle for 3 months.  I have been to the family doctor and was referred to an orthopedist.  They did an MRI and the orthopedic doctor called and told me that I have a herniated disc.  The family doctor called and said I have a herniated disc with a pinched nerve.  The doctors are referring me to a pain clinic for cortisone shots.  I prefer not to take meds until absolutely necessary.  I went to a chiropractor last night and when the family doctor called today I told them that and they told me since I have a pinched nerve the chiropractor could have paralyzed me.  I am tired of being in pain and living on Tylenol.  The doctor tried stronger pain meds but I had a bad reaction to them.  I've had high blood pressure since this pain started and was advised that NSAIDS would raise my blood pressure so I stayed away from them.  My questions are this:
1) Is there anything I can do at home to alleviate the pain? I have been sleeping in a recliner for months because it is the only way I can get comfortable.
2) Is there a risk of paralysis if I continue to see a chiropractor?
Any help you can give me would be much appreciated.  My life has come to a stop I can't even make it to work most days and am getting depressed.  Thanks so much for your help!!

Answer
Cindy,

Shame on your family doctor!  That was an ignorant statement.  In fact, there is a good chance that the care the chiropractor provides can reduce your pain.  This is especially so if the chiropractor can determine if you experience a "centralizing phenomenon" on exam, or can improve your leg symptoms with procedures such as "lumbar flexion-distraction."   Your physical exam should also include a "prone instability test" (PIT) that would help understand if you have instability to your spine contributing to the pain.   Chiropractors should be the first in line to evaluate, treat and triage cases like yours.   There is little the orthopedist can do unless you clearly are a surgical case and the orthopedist happens to specialize in spine surgery.  Most general ortho's don't want to deal with back pain or sciatica.   The cortisone shot that you will get from the pain management doc' is in and near your spinal canal and nerve root.  It's called an epidural steroid injection (ESI).  Did the doctor tell you that you could suffer irreversible arachnoiditis from epidural steroid injection?  It does happen but it's rare, and I have one patient that suffered such a complication.   The odds of a bad complication from the chiropractor are slim to none.   The benefits of each of these procedures outweigh the risks when you are suffering with sciatica.  If the chiropractic fails to improve your condition at all after a few weeks of care, then the ESI is a logical next step.   If you have a (+) centralization phenomenon, in other words, if you bend backwards and your sciatic pain comes out of your leg, then you must do exercises into that position.  If you have a (+) PIT, then you must do back stability exercises.   Does your family doctor know anything about this?   Doubtful.  Lastly, you can also do both.   It is fine to get the ESI and also continue with joint manipulation or flexion/distraction and any exercises you must be doing.   My web site shows flexion-distraction in the products/services tab (see: www.drgillman.com) and your DC should know what all of the above terms mean.  

'Hope this helps,

Dr. G


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