Question
i am in constant high level of pain my doc says i have degenerated disks and i dont really kno if that alone could cause this much pain? every time i lift anything im screwed for weeks no mobility, pain even higher. the main pain is lower back! none upper and it travels down into bum/hip are speacially on 1 side sometimes also even rarer it shoots down to my foot 1 side as well.i have had some peeing problems lately too up 3 times in night to pee and constant peeing in day thought mabye conected?i think im getting arthritis too hip and joints hurt aswell now 3-4 years after back started.back really got bad when i had a hard impact botteming out on atv felt like my spine compresed when it happened.plus i have been a grunt worker my whole life lifting heavy stuff for work.i cant do anything without massive pain besides lay down, for instance washing the dishes is extreme agony.i also have chrons deasease but pain from that under control from pain meds minus mabye 1 bad epasiode per month.but thought that might be relevent to back pain? im scarred to ask for dissability cause i feel like i should be working and not sure my doc would support it but in reality i cant work!i lost my wife recently aswell cause i didnt want to make love anymore due to pain.exrays and scans and everyting jus seem to reveal degrading disks.im persribed oxycontin and perecet but its not enough and its hard to get more from my doc,he doesnt want to give me more,cpl days a week im fully active minus work that is other than that im in to much pain to do anything .id like to go on and on but scared its too long already?plz help

Answer
Dear Sam,

Degenerative disks can absolutely be debilitating, especially if there is arthritic changes in the joint spaces or encroachment of the spinal nerve roots.  The fact that pain can radiate down to the foot corroborated the suspicion of nerve root encroachment and inflammation.

Chiropractic care is a great option for you to try though.  I know of many individual patients with disk disease and arthritic changes that get significant pain relief from chiropractic care.  As a matter of fact reduction of low back pain from chiropractic treatment has been the focus of many government reports, and the efficacy has been reported.  See below!!

The Manga Report:
The Ontario Ministry of Health commissioned Manga Report represents the largest analysis of scientific literature on the most effective and cost effective treatments for low back pain. After reviewing all of the international evidence on the management of low back pain, lead investigator Pran Manga, Ph.D., found the treatments provided by Doctors of Chiropractic were exceptionally safe - much safer than for standard medical treatments of similar conditions.

"There is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic (doctor-induced) complications for low back pain patients. Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low back pain."

"Indeed, several existing medical therapies of low back pain are generally contraindicated on the basis of the existing clinical trials. There is also some evidence in the literature to suggest that spinal manipulations are less safe and less effective when performed by non-chiropractic professionals."

"Chiropractic manipulation is safer than medical management of low back pain. Chiropractic management is greatly superior to medical management in terms of scientific validity, safety, cost-effectiveness and patient satisfaction."

The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) - University of Ottawa, Canada.

The Agency on Health Care Policy and Research Study
On December 8, 1994, the Agency for Health Care Policy and Research (AHCPR) of the US Department of Health and Human Services released Clinical Practice Guidelines for the management of acute low back pain. Their guidelines were developed after extensive study of diagnostic and treatment methods for acute low back pain.

The guidelines were created by the AHCPR panel to provide primary care clinicians with information and recommended strategies for the assessment and treatment of acute low back problems. The AHCPR panel was made up of 23 members consisting of medical doctors, chiropractic physicians, nurses, experts in spinal research, physical therapists, an occupational therapist, a psychologist, and a consumer representative.

Their findings included:
The risk of serious complications from lumbar spinal manipulation is rare.
Conservative treatment such as spinal manipulation should be pursued in most cases before considering surgical intervention.
Prescription drugs such as oral steroids, antidepressant medications and colchicines are not recommended for acute low back problems.
Acute Low Back Problems in Adults. Clinical Practice Guidelines. Bigos S, et al. Agency for Health Care Policy and Research Publication No. 950642 (1994) - U.S. Department of Health and Human Services.

The New Zealand Commission Report:
The government of New Zealand published a 377 page report which assessed the efficacy and safety of chiropractic care. The report was a result of almost 2 years of conducted hearings from recognized health care experts.

Principal findings:
"Chiropractors are the only health practitioners who are necessarily equipped by their education and training to carry out spinal manual therapy (spinal adjustments)."
"Chiropractors carry out spinal diagnosis and therapy at a sophisticated and refined level."
"Spinal manual therapy in the hands of a registered chiropractor is safe."
"The duration and training of a registered chiropractor is sufficient to enable him/her to determine whether there are contraindications to spinal manual therapy in a particular case, and whether that patient should have medical care instead of, or as well as, chiropractic care."

The U.S. Agency for Health Care Policy and Research:
In 1994, The United States Agency for Health Care Policy and Research reviewed the many different care options for acute low-back pain. The research panel was looking at what would produce functional improvements as well as symptomatic improvements. They looked at over 100 studies that related to spinal manipulation, which is the non-specific, medical term used for Chiropractic adjustments. The Agency concluded Chiropractic Care was very helpful for people suffering from acute low-back pain. Chiropractic was the only option studied found to provide both symptomatic improvement and restoration of functional stability. The research panel included medical doctors, osteopaths, nurses and physical therapists. There were no chiropractors included on the panel.

Low Back Pain:
In 1997 The British Journal of Bone and Joint Surgery found that a single chiropractic adjustment caused immediate significant changes in the reflexes of patients with disk herniation. The authors reported that "It may be concluded that spinal [adjustments] may promote relief from [abnormal nerve function] by the offending disk herniation."

The May 15, 1997 issue of Spine reports on a study that shows nearly 1 in 5 fourteen-sixteen year-olds have back pain and many of them report that the pain is chronic. 18 percent of the 14-16 year olds reported back pain that interfered with school work or leisure activities during the previous 12 months. 26 percent of the boys and 33 percent of the girls reported that the pain was recurrent or chronic. It should be noted that as the children got older, the incidents of pain increased. The authors concluded that a significant part of the low back pain children report is recurrent or chronic by the time they are 14. Chiropractic Physicians have always encouraged early detection and correction of spinal problems before they become chronic.

This study shows that spinal problems do indeed start early in life and if they go uncorrected, they get worse.  Having said that, I would suggest that you find a good local chiropractic physician and have your low back checked out.  

Listen, chiropractic care is only one step though.  With the multiple problems you have listed, it is obvious that there are numerous biochemical issues you are presently dealing with, and they need to be addressed.  I have patients just like you Sam in my office, and we can almost always help improve their quality of life, while reducing the need for drugs when we do functional metabolic testing. in your case, I would recommend the basic functional metabolic test (Priva Test), and additional tests for gut ecology and immunity (digest test), and your endocrine carbohydrate response (fit test). These tests are easily done at home with the correct test kits, and are inexpensive.  After processing at the lab, custom supplementation is created to target your individual needs.  It is a brilliant system, and easy for the patient. Myself, my partner, and many of my medical doctor friends use this testing everyday with wonderful results. If you would like more information on this, e-mail me through my website below, I and will get you whatever you need. Good Luck Sam!

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net