Question
I injured myself on the job about 15 weeks ago and was in extreme pain. I decided on a D.C. over an M.D. because I thought that my pain would go away after a few adjustments. I had an M.R.I. and discovered that I have a herniated disk. My D.C. put me on this d.r.s. machine that actually made me feel worse at times but over a few weeks my pain actually subsided. At this point I do home exercises everyday and get an adjustment and some physical therapy 1x a week. My back still hurts all the time and with increased exertion it hurts so much that I have to lay on my side and can't do much else. My left leg also bothers me. The sensations have gone from a cold feeling to an itchy feeling to now when it just goes numb at times. I will feel the numbness beginning and if I don't stop what I'm doing then it goes down to the bottom of my foot. It is not the whole leg but the outside only and only the bottom middle part of my foot. This is a workman's comp case and I have been through an I.M.E., this was 2 wks ago and I still don't know the outcome.I am so frustrated because my life has changed so much due to this pain. I can only do about half of what I used to do and cannot even function at my job without discomfort.I keep my complaints to myself because I don't want anyone to feel sorry for me and when I express my fears to my D.C. he tells me to stop being negative and says he may try something different but doesn't and I feel like I'm a whiner when I tell him I still have pain. He says this is going on too long. If he doesn't want to treat me, why wouldn't he say so? Do my symptoms sound "normal" for a herniated disk? I've never had any medical problems before and I'm not very comfortable around DR's. Please give me some advice on what I could do next.

Answer
Marie,

I'm sorry you're having such difficulty.  What you're experiencing is common, as evidenced by the volume of patients in the offices of physiatrists,neurologists, and others.  First, if your DC fails to do something different, then that is an error on his/her part.  The human body is still a mystery, and sometimes it takes the care of different providers and/or different techniques to change someone's condition.  Forget about the MRI.  Current research seems to indicate that disc herniations don't predict outcomes.  In other words, some people have disc herniations and have no pain or get well fast, and some people have no herniations and fail to respond to a treatment.   You cannot catastrophize over what the MRI says.  If you are not obtaining expert soft tissue treatment and good quality exercise training, then your at a disadvantage.  These two things alone can make the difference between getting better and not.  Acupuncture may be very helpful.  There may be nutritional and behavioral influences (I don't know your entire history) to your pain.  For example, diabetics don't heal well, and obesity or heavy smoking can play a role.  Injuries sometimes lead to a conditon known as Complex Regional Pain Syndrome (CRPS).  CRPS is difficult to treat, and you may do well to seek an MD Physiatrist or other pain management doctor.  You're DC should have flagged your lack of response in the first few weeks of treatment, and if you were no better he/she should have addressed it and made the appropriate changes.  Some people are slow to heal and do take a long time, especially those who are traumatized, but you're talking four months.  Are you any better?  Have you been periodically filling out questionnaires to measure your progress (e.g. Oswestry Low Back questionnaire, or the Functional Rating Index questionnaire)?  Lastly, I hope you find a doctor you can feel comfortable with. They're out there...   

I hope this was helpful.  Good luck.

Dr. G
www.drgillman.com