QuestionHello Doc,
I took awhile for me to decide whom to ask my questions too. In advance, thank you for your time. I was injured at the beginning of December. I have had chiropractic treatment since the 1st of December (3 times a week). By mid December I had pain radiating down my left leg to my knee as well as in my lower back. I finaaly requested a MRI the results were....
L4-5 there is a mild central and left lateral disk protrusion with a fairly large left lateral tear. This results in flattening of the anterior thecal sac and borderline central stenosis, as well as moderate left neural foramina stenosis.
L5-S1 There is a mild right paracentral focal disk protrusion which results in mild mass effect along the right anterolateral thecal sac and S1 nerve root. The neural foramina appear within normal limits.
I work as an estimator and sit 6 plus hours per day, my pain sitting down is extreme and worsens the longer I sit. This injury was at work. Should I be working and what type of treatment do you suggest? Is there another option other than surgery for my injury? Is this an injury that you would have your patient working without limitations?
Sincerely,
D
I am taking norco, naproxin, ambien, and norflex
Answerdisk protrusion, disk herniation
Hello Dustin,
Sorry to hear of your pain and condition.
I have an information handout sheet that I give to my Staten Island Herniated Disk patients that I think will help explain what you are going through:
Disk Herniation
Low Back Pain can be caused by many different things.
Big, BAD, catastrophic things like a tumor or a cancer can cause low back pain (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 LBP (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.
Sometimes LBP is caused by a Herniated disc: Herniated disk is actually a quite common condition. However, the course of the condition is highly variable. Some patients with a herniated disk literally cannot walk, yet other patients with similar MRI findings may be able to run marathons or lift heavy weights.
Some people suffer for only a few days with pain and symptoms, some people suffer for months. Although the course is highly variable, there are certain steps that are always helpful to follow: Ice the area when painful- 10/ 15minutes on, 30/ 45 minutes off; avoid certain postures and movements; bend the knees when coughing or sneezing; bend the knees when lifting anything; do not extend legs straight out when sitting, laying down, lifting, or driving.
Avoiding certain movements and postures will prevent aggravation of the condition. Practicing good postures and movement patterns will help the condition heal and be less painful. Disk Herniation is often caused by, or often concurrent with the Vertebral Subluxation Complex.
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.
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. 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
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Another sheet I utilize talks about pain medications:
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
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".... work as an estimator and sit 6 plus hours per day, my pain sitting down is extreme and worsens the longer I sit...." - VARY your posture. Do not sit, stand, or maintain any particular posture too long. Every 15 minutes get up and go for a 1 minute walk!, Every 15 minutes CHANGE posture, change movement patterns.
The MRI was certainly the RIGHT test to take. What has your Doctor of Chiropractic said about the findings and treatment?
Chiropractic is usually very helpful in cases like these. Conservative, non-invasive, safe, effective, cost-effective treatment may take time and require patience, but give proper treatment TIME.
A large component is INFLAMMATION. Give the inflammed disc time and proper treatment and the inflammation will resolve, and so will the symptoms.
The Vertebral Subluxation Complex (herniated disk)describes what happens when spinal bones lose their normal movement patterns and position. When subluxated, joints are in a stressed, vulnerable, compromised condition. When Subluxated, the area becomes INFLAMMED. Inflammation is a body response governed by 慚other Nature?or biological law. That INFLAMMATION is similar to a -Bruise- or a contusion, or even a cut on your skin.
Inflammation: A basic way in which the body reacts to infection, irritation or other injury, the key features being redness, warmth, swelling, loss of function and pain.
Have you ever had a Bruise ?? Did it disappear as soon as you looked at it and wished it away?
Or did it Disappear OVER TIME? Did it come back if you injured / irritated the same body part again?
Did you ever have a cut ?? Did it disappear as soon as you looked at it and wished it away ?
Or did it take time to heal? And if you scraped it, irritated it,,, did it take even longer to heal ?
When you have a spinal subluxation, the surrounding area becomes 態ruised? irritated, INFLAMMED. This inflammation takes time to heal. This inflammation is easily re-inflammed, re- started.
The subluxation is NOT JUST a 慴one out of place?easily 憄ut back into place? TIME and proper TREATMENT are partners in correcting your health problem.
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Some nutritional advice:
揚inched Nerve? ( Also Known As- neuritis, neuralgia, brachial-neuritis, sciatica )
As the 損inch??the MECHANICAL component of the problem, the CAUSE of the problem is being taken care of through Chiropractic treatment, perhaps additional help would speed your return to health:
Nerve Health Support:
-----B complex containing thiamine, folic acid, B-12 and niacin is highly suggested for nerve support. High dose
B-vitamins should only be taken at the advice of a licensed healthcare professional.
-----B-6 is lower in patients with neuropathy. Vitamin B-6 reduces the glycosylation that can cause nerve damage. Amounts greater than 200mg/day can cause neuropathy symptoms.
-----Calcium and magnesium are important for nerve conduction and as muscle relaxants.
-----A multi-vitamin/mineral supplement is suggested for comprehensive support.
-----Essential fatty acids are necessary for nerve health. Essential fatty acids include omega-3 fatty acids (fish and flax oil) and omega-6 fatty acids (black currant seed oil, borage oil and evening primrose oil).
-----Proteolytic enzymes may be beneficial in neuritis for the inflammation.
-----Lecithin aids in nerve support.
-----Natural herbal remedies including passion flower, valerian, chamomile, scullcap and white willow bark may be helpful.
-----Eat a healthy diet. Avoid foods that stimulate the nervous system such as caffeine, chocolate, refined sugars, soda pop and cigarettes.
-----Drink plenty of filtered water.
-----Chiropractic care is imperative to remove nerve irritation.
Joint Support:
-----Glucosamine sulfate helps strengthen joint integrity. Glucosamine is effective in relieving joint pain associated with osteoarthritis. Glucosamine's pain-relieving effects may be due to its cartilage-rebuilding properties. These disease-modifying effects are not seen with simple analgesics and are of particular benefit.
-----MSM is known for its pain-relieving properties in such conditions as fibromyalgia, osteoarthritis, bursitis, tendonitis, back pain and muscle soreness. Not many clinical trials have been done using MSM, but clinical observations support the theory that MSM is beneficial in pain managment.
-----White willow is an antiinflammatory and analgesic agent. White willow was used as far back as the Middle Ages to reduce pain and fevers. The salicylates found in the white willow bark are responsible for the anti-inflammatory and anti-fever effects. Acetylsalicylic acid, otherwise known as aspirin, is chemically similar to the salicylates.
-----Boswellia and turmeric (curcumin) are potent antiinflammatory herbs. Curcumin may have similar action to aspirin.
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Standard in-office Chiropractic treatment should be able to reduce your symptoms and get you back in shape.
If standard, traditional adjustment and adjunctive physiotherapy do not clear the problem, talk with your DC about non-invasive spinal disk decompression; many chiropractic offices now have that as a treatment option. My office utilizes disk decompression on tough cases.
Another option would be spinal manipulation under anesthesia. This is another safe, effective, cost effective treatment approach available through your Doctor of Chiropractic.
There are many options available to you. Even with proper treatment- words of caution: #1) be patient, even with proper treatment, it will take TIME to get back in shape; #2) do not re-injure the area,,, what caused this in the first place; do not tempt fate and re-injure the area.
If the natural, conservative, non-invasive chiropractic treatments fail ( give it time and patience, they should work effectively) or do not appeal to you, pain management would be an option. Again, your Doctor of Chiropractic could probably refer you to a pain management specialist for injections or medical management.
Finally, after conservative treatment methods have failed, then and only then should you consider any surgical intervention.
I hope I have given you some good information. If you need further, 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,
your Staten Island Chiropractic friend signing off,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (Email NewsLetter)
http://www.SIworkComp.com
