QuestionQUESTION: Hi. I had a microdiscectomy and decompression 10 weeks ago following a protruding L5/S1 disc and 8 months of sciatica. I am pleased with the results and the main sciatica has gone. I have some very persistant back pain around the spinal nerves and above the wound. When the surgery was done my surgeon found I have 2 spinal nerves on 1 side which he said would take longer to heal. I have good mobility and feel strong but this pain is very draining. I am an aerobics instructor so am exercising daily without the impact as i'm a bit scared of re-herniation. My leg is still stiff but is improving. Can you give me some advice on what is causing this pain and should I worry or is this normal? I ice daily but am having to take pain killers again which I wanted to stop. I have considered acupuncture, do you think this would help? I really would be very grateful for any advice you could give me. Many thanks.
ANSWER: post op pain, microdiscectomy, surgical decompression, L5/S1 disc protrusion, herniated disc, HNP, sciatica, persistent back pain, re-herniation, taking pain killers again,
Hello Carol Hartley,
Sorry to hear of your continuing pain. It seems some of your pain is gone, yet it seems some of your pain has continued for eight months post surgery, and it seems you are now stepping up the medication again.
Sorry to hear that you are (probably) not doing as well as expected. Back SURGERY is always a BIG deal and utilized ONLY on the most difficult of cases. In Twenty-five years in practice I have had three patients that had to progress on to surgery. The last patient I forwarded on for surgery two years ago, a 30 year old man, is now experiencing the same symptoms he had prior to surgery. Surgery is sometimes definitely necessary, but is a last resort.
Most people who have surgery cannot return to as active and strenuous a life as they had prior to injury and surgery.
Exhausting all of the conservative, non-invasive approaches to back pain and sciatica, is a recommendation to everyone- even the conservative surgeons usually like a trial of conservative care.
Often once one surgery is performed, years later a second and sometimes even a third surgery is necessary. Surgery changes the whole ballgame and alters the biomechanics of the spine. Surgery alters the techniques and treatments available to the Doctor of Chiropractic and other conservative approaches to health.
First, I would recommend you stay in close touch with your surgeon. He/she knows what was done, what alterations were made, and the compensatory changes the spine will make in adapting to those changes. Also MRI could be performed to see if scar tissue (adhesions) are building and causing your increasing need for pain medications. Most people are unable to return to full strenuous activity after back surgery, perhaps you have exceeded your new limitations and aggravated the healing back. In any event, I would have re-evaluation by the surgeon and referring doctors as to your progress.
You may want to return to the Doctor of Chiropractic who treated you conservatively before resorting to surgery. Perhaps an alteration in technique could be applied and help your increasing pain.
Nutritionally, I would try to LIVE an anti-inflammatory lifestyle: obviously no smoking, alcohol, recreational drugs, processed foods, soda pop, fast foods. Obviously- as much as possible: fresh, raw, organic, whole foods; fruits, vegetables, bake broil boil organic fish and chicken. Big nutritional supplementation: Glucosamine Sulfate, Chondroitin, MSM, SAMe = all for joint repair, Omega 3 essential fatty acids, proteolytic enzymes, Vitamin C, Calcium/ magnesium/ vitamin D. All of the aforementioned will prevent inflammation and help you heal. Your Doctor of Chiropractic can no doubt help with nutritional evaluation and recommendation.
Would I try acupuncture? Sure. It will not hurt and could help. Chiropractic?, absolutely, even after the surgery- surgery limits the approaches available, but treatment can be modified.
Some information I utilize in my Staten Island Chiropractic office:
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on medical/ surgical approaches:
(from: """""Death by Medicine
By Gary Null, PhD; Carolyn Dean MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD
Something is wrong when regulatory agencies pretend that vitamins are dangerous, yet ignore published statistics showing that government-sanctioned medicine is the real hazard.
Until now, Life Extension could cite only isolated statistics to make its case about the dangers of conventional medicine. No one had ever analyzed and combined ALL of the published literature dealing with injuries and deaths caused by government-protected medicine. That has now changed.
A group of researchers meticulously reviewed the statistical evidence and their findings are absolutely shocking.4 These researchers have authored a paper titled "Death by Medicine" that presents compelling evidence that today's system frequently causes more harm than good.
This fully referenced report shows the number of people having in-hospital, adverse reactions to prescribed drugs to be 2.2 million per year. The number of unnecessary antibiotics prescribed annually for viral infections is 20 million per year. The number of unnecessary medical and surgical procedures performed annually is 7.5 million per year.
The number of people exposed to unnecessary hospitalization annually is 8.9 million per year.
The most stunning statistic, however, is that the total number of deaths caused by conventional medicine is an astounding 783,936 per year.
It is now evident that the American medical system is the leading cause of death and injury in the US. (By contrast, the number of deaths attributable to heart disease in 2001 was 699,697, while the number of deaths attributable to cancer was 553,251.5)
We placed this article on our website to memorialize the failure of the American medical system. By exposing these gruesome statistics in painstaking detail, we provide a basis for competent and compassionate medical professionals to recognize the inadequacies of today's system and at least attempt to institute
meaningful reforms. """""""
Estimated Annual Mortality and Economic Cost of Medical Intervention
Condition Deaths Cost Author
Adverse Drug Rxns 106,000 $12 billion Lazarou, Suh
Medical error 98,000 $2 billion IOM
Bedsores 115,000 $55 billion Xakellis
Infection 88,000 $5 billion Weinstein, MMWR
Malnutrition 108,800 ----------- Nurses Coalition
Outpatients 199,000 $77 billion Starfield Weingart
Unnecessary Procedures 37,136 $122 billion HCUP
Surgery-Related 32,000 $9 billion AHRQ
Total 783,936 deaths/ year $282 billion / year
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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). Only a Doctor of Chiropractic will evaluate and treat for VSC. 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.
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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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).
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). Only a Doctor of Chiropractic will evaluate and treat for VSC. 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.
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I hope this all helps. You should actively approach your problems with a good diet, good lifestyle, appropriate activity, and nutritional supplementation along with natural approaches such as chiropractic and acupuncture.
I wish you Good Luck, and Good Health Naturally, your Staten Island Chiropractic advisor signing off,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (email newsletter)
http://www.GoodHealthNaturally.info
http://www.DocDolan.net
---------- FOLLOW-UP ----------
QUESTION: Thanks for your reply lots of really useful advice there. Just to confirm my surgery was only 10 weeks ago not 8 months. I had sciatica for 8 months before the surgery was done. Had tried all conservative treatments and 2 nerve blocks before deciding to go ahead with the op. I am seeing the same chiropractor I was prior to surgery. He is doing Active Release Technique and small manipulations where he can. He has said I have subluxations but not sure which ones. I may have over done the exercise but was given the all clear by my surgeon at 6 weeks to return but with care. I take Zinc, VitC, Glucosamine and am a vegetarian so do eat well. As I said your reply was very helpful but just wanted to confirm that my surgery was done 10 weeks ago.
Many thanks for you time and help.
AnswerHello Carol,
Thank you for continued conversation. I certainly wish you well.
I am sorry I misread the time lengths!
Ten weeks is NOT a long time ago,,,, BE PATIENT !!!
Continue your good lifestyle, fruits, vegetables, fresh, raw, organic, an occasional fast,,, it is the way to go- keep it up.
Exercise--- remember you cannot start where you were prior to your problems,,, you have to build gradually!!! BE PATIENT !!!
Always, do not hesitate to communicate with your surgeon or the physicians assistant or nurse practitioner in the surgeons office.
I think the ART the active release technique is excellent, also low force techniques like S.O.T. blocking and/ or Activator Chiropractic technique could be helpful.
Anti-inflammatory supplements could be helpful:
Glucosamine/ chondroitin/ MSM/ SAME for the joints. Calcium (best at night to help you sleep), magnesium, Vit D for the bones. Vitamin C for connective tissue, Bcomplex for the nerves. I like proteolytic enzymes and Omega 3 Essential Fatty acids as anti-inflammatory nutrients-- ask your DC about them, they should help and not hurt.
Good Luck. I hope I have been of help or encouragement. I HOPE I READ YOUR QUESTION CORRECTLY this time !! I wish you Good Health Naturally, your Staten Island Chiropractor friend signing off,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (email newsletter)
http://www.DocDolan.net
http://www.GoodHealthNaturally.info
