QuestionHi. Thank you for reading my email. I'm 30 yrs old and have had back pain since 13 off/on. 4 years ago I went to the ER for severe back pain and had an Xray that showed disk degeneration and sciatic pain. My back has been very sensitive ever since. For over a month now I have had constant pain in my whole right leg- starting from low back through the buttock all the way down to my foot. My little toe is numb, along with the right side of my foot. The pain also is in the back of my heel sometimes. I also have low back pain and have been limping every day since the pain started when I walk. The pain level increases and decreases each day off and on- I've also had muscle spasms. Not one day has gone by w/ out pain. My leg sometimes gets sharp stabbing pains, or a constant ache. The pain goes up to a level 10. I started PT recently and have had 7 sessions, and my pain is worse than when I started. Do you think I should continue PT? Any suggestions on how I can minimize the pain at home? I have taken prescription Ultram and Naproxen for pain, neither work. I also took steroids for 6 days, and I had no pain relief from that. Due to elevated liver enzymes (from fatty liver) im unable to take Tylenol right now per my Dr and im assuming that is why I have not been prescribed a narcotic.
My PCP advised me to do the PT an refered me to a specialist who is a neurosurgeon. I have made an appt to see the neurosurgeon soon. Any advice you could give me would be much appreciated, as I'm very frustrated w/ the constant pain. I have an office job and sit 40 hrs a week which isn't helping the pain. I'm worried the neurosurgeon is going to suggest surgery- a part of me is open to it, to relieve this pain, but id prefer to try whatever it takes first to see if anything else helps.
Here are the results of an MRI I had on 1/20/09.
L4-5: Mild degenerative disk disease is present with disk desiccation. A diffuse and symmetric disk bulge is present resulting in extradural deformity of the theca not resulting in spinal stenosis and no neural foramen encroachment or nerve root compression is identified.
L5-S1: A small right paracentral disk protrusion is present resulting in extradural deformity of the thecca and mild mass effect in the right S1 nerve root. No spinal stenosis is present. Lumbar alignment is anatomic without fracture or sublaxation.
Impression:
1. Right paracentral disk protrusion L5-S1 resulting in mass effect in the right S1 nerve root.
2. Bulging annulaus L4-5.
Thank you so much!
Sincerely,
Rachael
AnswerStaten Island Herniated Disk , Disk protrusion , Disk bulge , Sciatica ,
Hello Rachael,
Sorry to hear of your condition.
This is the type of problem that the Doctor of Chiropractic (DC) treats all day, every day. Often called the 'Spine Specialist', many Doctors now also have additional credentials in sports injuries (DACBSP- I hold an additional credential here), orthopedics (DACBO), radilology (DACBR), rehabilitation (DACRB), nutrition (DACBN), neurology (DACNB) and others. You can see a list of additional Chiropractic credentials at : http://www.amerchiro.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf
Your local Doctor of Chiropractic should be able to evaluate, determine if his(her) techniques are appropriate to your case, treat or refer (to another DC with different technique, or medical specialist as needed). The family DC handles problems like yours commonly, but you may feel more comfortable going to a doctor with additional credentials, such as the list I gave above.
Traditional chiropractic includes osseous adjustment, SOT technique, activator techniques. Many offices now have non-invasive non-surgical disk decompression available ( I have this equipment in my office and successfully treat many a Staten Island Disk Herniation patient through this approach). Again, your local family DC should be able to help you with this; ask around the neighborhood and get a recommendation that way.
".... I started PT recently and have had 7 sessions, and my pain is worse than when I started. Do you think I should continue PT?....",
seven sessions is probably about two- three weeks of treatment. If you are feeling worse after a couple of weeks of treatment, you should speak with the PT and alter that treatment.
Any ONE visit, any one treatment may or may not make you better or worse. One visit is not enough to judge response. All health providers are taught to MONITOR treatment response. Two or three weeks, 6- 7- 8 visits is usually enough to judge if this treatment is appropriate for this patient. You do not seem to be improving, it is time to switch treatment, or switch to a different doctor.
".....Any suggestions on how I can minimize the pain at home?...."
I am a big fan of bringing down inflammation naturally. I often recommend ICE for a home Tx. Here is an information handout I utilize in my office for my Staten Island Herniated Disk patients:
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 ??
Herniated Disk ?? Sciatica ??
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
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; 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
To hit the high points of the above, use ICE where the root of the pain is--- ICE the lower back, through cloth, never on bare skin. The sciatica, or leg pain, or leg numbness is a symptom. You do NOT put ice on the symptom, put ice at the cause, the root of the problem, the lower back. Bring down the inflammation there, and the leg will feel better.
".... I have taken prescription Ultram and Naproxen for pain, neither work.....", Chemical painkillers, chemical artificial anti-inflammatories sometimes have severe side- efects and complications.
Again, in my Staten Island Chiropractic office I utilize an information handout on pain meds:
PAIN
Pain is a 憆ed light on the dashboard?
Pain is your body telling you that something is wrong.
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?
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) ;
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.
Pain can often be the result of the Vertebral Subluxation Complex.
Vertebral Subluxation ( 慥SC?, 憇ubluxation? )
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; 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
As you can see from the FDA, AHA, and medical research journals, medications can cause complications and should be used only when absolutely necessary.
".....Due to elevated liver enzymes (from fatty liver) im unable to take Tylenol right now per my Dr and im assuming that is why I have not been prescribed a narcotic....." , the liver detoxifies and processes the chemicals we put into our body. Many medications require that the MD monitor the liver. Liver damage is shown by elevated enzymes found in the monitoring bloood tests.
"....I'm worried the neurosurgeon is going to suggest surgery- a part of me is open to it, to relieve this pain, but id prefer to try whatever it takes first to see if anything else helps.....", surgery may be an option for you. Before progressing to invasive surgical intervention, most people want to exhaust the alternative options. That is why I have recommended your local Doctor of Chiropractic for evaluation and possible treatment.
".....L5-S1: A small right paracentral disk protrusion is present resulting in extradural deformity of the thecca and mild mass effect in the right S1 nerve root. No spinal stenosis is present. Lumbar alignment is anatomic without fracture or sublaxation....".
The report reads: small right paracentral disk protrusion ; this should respond to conservative, non-invasive chiropractic care.
Your report states: Lumbar alignment is anatomic without fracture or sublaxation.
The Chiropractic term 'subluxation' is not identical to the medical definition of 'subluxation'. Please see a local DC.
My Staten Island Sciatica patients are aware that 'Sciatica' is only 1/2 a diagnosis. The sciatic nerve, when inflammed gives us symptoms we diagnose as 'Sciatica'. Here, some additional information:
揝ciatica?
( Also Known As- neuritis, neuralgia, sciatic-radiculitis )
(pain down the leg, with or without
back pain)
Sciatica can be caused by many different things.
Big, BAD, catastrophic things like a tumor or a cancer can cause
Sciatica (only a proper exam by a licensed doctor, like your Doctor of Chiropractic, or your family Doctor of Medicine, can evaluate
your signs and symptoms, and perhaps refer for testing).
Big, bad things like a Herniated Disc, sciatica, possible fracture or dislocation can cause Sciatica (again, best evaluated by your DC or MD, and perhaps referral).
Bad things, like - Sprains, Strains, contusion, or Vertebral Subluxation Complex (all very efficiently diagnosed and treated by your Doctor Of Chiropractic.
Sciatica can come from a motor vehicle accident, sport injury, slip, trip, fall, arthritis, lifting improperly, or even bad posture in standing, sitting or sleeping. All of these things often have a Lumbar (Low Back) Vertebral Subluxation involved. Sometimes we can wake up with 憇ciatica? .... sometimes a slip, trip, fall, heavy lift, or even a motor vehicle accident can cause a 憇ciatica?
Frequently- a true c a u s e of the 憇ciatica? = pain in the lower back, buttock(s), thigh, calf and/or foot (even to toes); is a misalignment, a 慿ink?in the back- more properly termed a Vertebral Subluxation. 摂Sciatica敂 is only 1/2 a diagnosis ....
QUES: what is causing the sciatica?
ANS: Vertebral Subluxation Complex
(a.k.a. 憇ubluxation?
The vertebral subluxation complex is often the underlying cause of sciatica and 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 (subluxation) 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:
The VSC contributes to OsteoArthritic degeneration. 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.
Rachael, I hope all of this information helps you. My recommendation boils down to seeing a Doctor of Chiropractic, preferably with an additional credential (see above) and with non-invasive, non-surgical spinal decompression available in the office. I think this conservative, non-invasive treatment could help you a great deal.
Good Luck, I wish you Good Health Naturally!
Further questions? do not hesitate to re-contact me here at allexperts.com
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm
Thank you,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (Email newsletter)
