QuestionI am 32 years old. When I was 27 I took a bad fall down some concrete steps and most of the impact was on the L4 area of my back. I was in bed for 7 days. I have always believed this was the start of my back problems but sadly I never went to the Dr. or anything. I only had problems when I did too much lifting or siiting for long periods of time or standing for long periods of time. This last time I helped to put up a truckload of goods for the grocery store. I litterally crawled out of the bed the next day (worst episode since I fell) and went to the ER. My Dr. finally ordered the MRI. I have no prior xrays or MRI'S because I thought it would go away and didn't take care of myself. I had an xray at the chiropractor a few weeks ago and my L4 looks like its dangling on one side. (He took the xray because I was in a rollover accident). He also said it looked like it was dangling and asked for the MRI from July. I agree that I need another MRI. Thanks for all your help.
Answerlow back pain , Limbus Bone L4 ,,,,, Herniated disc
Hello Shauney,
Your comments came through as another question, so I just want to wish you luck, and maybe pass on a little more info.
I think you could just about treat your Limbus Bone similar to a herniated disc.
Some people have terrible symptoms from the disc herniation (similar to your Limbus), some people have no symptoms at all (and some people with a limbus have little or no symptoms).
As I suggested previously, I do recommend conservative care first, see how that works, and then if necessary move on to more invasive procedures (ie surgery).
Since I draw an analogy to the herniated disc for your limbus bone; and I do have a handout sheet for disc herniation (but not the limbus bone), I would like to print the information I give my Staten Island Herniated Disc patients for you:
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
+++++++++++++++++++++++++++++++++++++++++++++++
....... Actually, I just reviewed the previous answer (see attachment- end of this discussion).
It seems that you have a very physical lifestyle, and exacerbate your problem frequently. I would like to include another info handout sheet I sue in my Staten Island Chiropractic office on treating injuries/ exacerbations/ inflammation:
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
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
++++++++++++++++++++++++++++++++++++++++++++++++
If you would like, do not hesitate to re-contact me here at AllExperts.com @
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm
Again, I wish you Good Luck,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com
http://www.SIWorkComp.com
http://www.SIAutoAccident.com
(((((((((((((((((((((((((((((((((((((((
Previous Answer :
Subject: lower back pain/limbus at l4
Question: I have chronic lower back pain and have had on and off for 3 years. In
July 2008 I had a MRI because the pain did not go away. I have a limbus at l4.
The report actually said a developmental anomaly on the anterior of l4 vetebrae.
I went to two Dr.s who pretty much scratched their head and said there was not
anything that could be done. I have numbness on the outside of my right leg from
my upper hip to feet and my right leg is weaker than my left. My doctor also
said I have toe drop on my right foot. Anyhow I went to a chiropractor who
actually looked at my MRI and bot just the report and he said I have a limbus
and my L4 is slightly bulging. He also said there is nothing I can do to correct
this problem. I am discouraged because I don't want to live my life around
painkillers. Is there really nothing that can be done to help my pain?
Answer: lower back pain,
Hello Shauney,
Sorry to hear of your Limbus bone.
You have had pain for three years, what happened three years ago?
I have some questions for you; How old are you, have you had trauma (ie- three
years ago), what treatments have you tried, do you have Lumbar Xrays from years
ago-- before the pain started ? What do you do that aggravates the pain, what
do you do to relieve the pain?
At the end of my answer, you will see some additional websites to visit.
I hate to sound like a doctor, but,,,,,,
This limbus bone may have been there your whole life, and may not be the cause
of your pain.
This limbus bone could be something new, recent (ie- three years ago- trauma ??
), and can mimic a herniated disc.
That is why I ask your age, previous Xray studies, prior history, history of
trauma.
This could have been with you 'forever'. If you have prior Lumbar Xrays, we can
see if this is a new development. If this has been with you 'forever'- if it is
visible - in the past - and you did not have pain back then,,, well this may not
be the cause of your pain. If you have prior Xrays (or MRI or CT scan) and this
Limbus is not there, and now it is, and now you have pain,,,, then the limbus
could be a factor in your pain.
Your MRI should, of course, be viewed by a Radiologist. There are excellent
Radiologists out there- whether MD or DC (DACBR = Doctor of Chiropractic,
radiology specialist). Often the radiologist can date the 'injury'- new/ old/
developmental/ fracture. You may need to do another MRI or CT scan- to look at
changes over the last 7 months.
The MRI or CT scan should of course evaluate for herniated disc and other
pathology.
If this were me, I would try to get a definitive diagnosis; have the films
viewed by other radiologist(s). Perhaps have a new study taken (MR or CT).
If this were me, I would try a course of conservative care; physical therapy
modalities, acupuncture, chiropractic, even anti-inflammatory nutrition would be
avenues I would consider. Chiropractic would, of course, be my selection.
Conservative chiropractic: SOT technique, activator, adjunctive physiotherapy,
and anti-inflammatory diet and supplements would be my starting point of
treatment (after the old and new MR CT were viewed).
If the 'toe drop' continues through conservative care, or progresses towards
'foot drop', I would seek neurosurgical evaluation.
I am surprised that the Doctor of Chiropractic that you visited said 'nothing
could be done'. If you were to come to my Staten Island Chiropractic office- I
would either recommend conservative care (chiropractic, acupuncture, physical
therapy, nutrition), OR I would recommend visiting an orthopedic or
neurosurgeon.
The nerve finding(s) (toe drop), require monitoring and treatment.
I would not 'do nothing'. I would seek treatment.
Think of your history. This may all be coming from the 'disc bulge', may be
coming from the 'limbus bone', or may be from a combination.
Review the questions I have asked.
If you would like, do not hesitate to re-contact me here at AllExperts.com @
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm
I hope this helps.
Sorry to sound 'Doctorish'.
Good Luck,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com
Additional info:
http://www.chiroweb.com/archives/17/12/10.html
https://rad.usuhs.edu/medpix/tf_case.html?&imageid=38975&pt_id=11390&topic_id=0&
quiz=no#treatment
http://www.wheelessonline.com/ortho/slipped_vertebral_apophysis
http://www.nature.com/sc/journal/v42/n2/full/3101506a.html
)))))))))))))))))))))))))))))))))))))))))))))))))))))))))
