Question
Dear Dr. Dolan,

I am very concerned about my husband, Greg.  He has what is referred to as a "whorl" in his lower back that is very close to his spine.  I can feel this knot when I massage him.  He has been going to a chiropractor and he recently went to an accupunturist.  He said that when he received the acupunture, it felt like the knot disappeared, but the next day, he said it came back.  This know has been causing him chronic pain for several years now (I know he has been hurting from it since at least 2004).  He has had an MRI and the doctors said there was nothing unusual.  He has mentioned to me that he wished he could get surgery to remove this knot - he is scared it is going to attach to his spine.  Please let me know what your opion is.  Thank you very much.

Answer
hello Mary and Greg,

Chronic low back pain , muscle knot , "whorl" .

Sorry to hear of the pain.  So you have tried Chiropractic and Acupuncture.  Do both/ either provide any relief for an hour/ a day/ a week ?  Sometimes, regardless of the health discipline, regardless of the approach you take, sometimes it takes time.  Sometimes it takes a regimen of care.

How many times do we know someone who goes to the medical doctor and they get a pill or pills to take once a day, twice a day, three times a day; for a week, a month, sometimes a lifetime.  Well,,,, if the patient does not follow the instructions, if the patient does not comply with the regimen of care- of course the regimen of care will not work.  But, it is not the treatment that is failing if instructions are not followed,,,, it is the patient who is choosing to fail.

Chiropractic is usually very successful with 'muscle knot' type conditions.  The body develops 'habits' , and it takes time to break these habits, to correct the condition.  Ever go to the dentist for braces ? , Teeth that in a bad 'habit', teeth in the wrong position can take YEARS to move and train to hold in the proper position.  Take the braces or retainer off prematurely, and the teeth move out of the correct position, the care 'fails',,, but it was not the care that failed, it was non-compliance on the part of the patient.

Anyway, a regimen of care by the family Doctor of Chiropractic or your local Acupuncturist could defeat this muscle knot, but it could take time and treatment.

The Chiropractic treatment should of course involve Chiropractic Adjustment of the involved areas, as well as adjunctive therapy such as ultrasound and/or muscle stimulation and/or trigger point therapy through ART, NIMMO, pressure point, or electrical trigger point stim. Proteolytic enzymes, bromelain, pineapple, omega 3 efa's could be helpful.  Masssage through chiropractic devices like a thumper or G5 massager, infrasound can help break up the knot.

Analysis of the patient's activities, movement patterns, posture, job, sleep habits could all tip off why this re-occurs.

I would visit the local family Doctor of Chiropractic who utilizes adjunctive therapies, massage devices, infrasound, soft tissue like A.R.T., or nimmo; as well as the adjustment.

As always, this article is for discussion purposes only.  Information and education, not specific recommendations.  Specific evaluation, DX, RX, TX, PX can only be done in person by a treating health professional.

I wish you good luck and Good Health Naturally,

Victor Dolan, DC
http://www.GoodHealthNaturally.info
http://www.DocDolan.net
http://drvictordolan.chiroweb.com  (email newsletter)