Question
QUESTION: Hi Dr. Durnin,

I have read about your response to some of the people and i find it very
informative and useful and I hope you could give me some advice on my
situation as well.

Below is my MRI report:

The lumbar spine has a normal alignment. There are normal signal
characteristics arising from the lumbar vertebrae.

THe L5/S1 disc has lost its signal intensity consistent with degenerative
desiccation. It has a small posterior annular tear and shows a midline disc
protrusion indenting the thecal sac. There is increased T2W signals in the
adjacent endplates anteriorly from Modic Typle 1 degenerative changes.
Moderate facet joint hypertrophy is presenty, partially narrowing the neural
exit foramina.

THe rest of the lumbar thecal sac & cord are normal. THere are no para-
spinal masses or collections to note. The other facet joints, ligamentum
flavum and neuro-exit foramina are unremarkable.

I was given Arcxia 60mg for 2 weeks and neurogen-E for 1 month.
I still feel that my lower back and my right leg is rather weak and
strengthless. Especially if i have walked a lot on that day.

Question:
1) Is there a long term cure for my situation besides surgery? (my doctor
suggested to replace the disc!!)  Or i have to live with it for the rest of my life?
(I'm only 29 this year)
2) Does Pilates help? DO i still need to take any medication to help my
problem?
3) Is it not advisable to wear high heel shoes with my situation?
4) Does glucosamine work for me?

Please let me know your advice.

THanks a lot,
Tse


ANSWER: Hi Tse,

If you read my previous answers you may have picked up on the fact spinal surgery never works.

I believe it should be criminalized, it always turns bad secondary to scar tissue. Surgery is ONLY indicated for Cuada equina syndrome when someone looses bowel and bladder control due to disc rupture or stenosis.

There is a proven effective treatment known as F/D.

Flexion-Distraction Therapy - What is it?


Flexion-Distraction, (F/D) is a gentle, chiropractic treatment procedure utilized for back and neck pain. Flexion-Distraction is a safe alternative to back surgery for those 95% of patients whose conditions do not demand surgical intervention. The doctor is in control of the treatment movements at all times.

Flexion-Distraction is utilized for many conditions such as:

Failed Back surgical Syndromes
Disc Herniation/Ruptured Disc / Bulging Disc / Herniated Disc
Sciatica / Leg pain
"Whiplash" injuries
Stenosis
Arm Pain
Neck Pain
Failed course of Steroid Injections
Chemical Radiculitis
Spondylolisthesis
Headache
Transitional segment
Many more conditions?
How does Flexion-Distraction Work?

For Disc related conditions:

Increases the intervertebral disc height to remove annular tension on the annular fibers and nerve by making more room and improving circulation.
Allows the nucleus pulposus, the center of the disc, to assume its central position within the annular fibers and relieves irritation of the spinal nerve.
Restores vertebral joints to their physiological relationships of motion.
Improves posture and locomotion while relieving pain, improving body functions, and creating a state of well-being.
For Non-Disc related conditions:

Patients with other conditions causing back pain (facet syndrome, spondylolisthesis, sprain/strain, scoliosis, transitional vertebra, sacroiliac restrictions and misalignment, certain types of spinal stenosis), Flexion/Distraction provides all of the above benefits plus the ability to place the spinal joints into normal, painless movements so as to restore spinal motion without pain:

The posterior disc space increases in height.
F/D decreases disc protrusion and reduces stenosis.
Flexion stretches the ligamentum flavum to reduce stenosis.
Flexion opens the vertebral canal by 2 mm (16%) or 3.5 to 6mm more than extension.
Flexion increases metabolite transport into the disc.
Flexion opens the apophyseal joints and reduces posterior disc stress
The nucleus pulposus does not move on flexion. Intradiscal pressure drops under distraction to below 100mm Hg. On extension the nucleus or annulus is seen to protrude posterior into the vertebral canal.
Intervertebral foraminal openings enlarge giving patency to the nerve.

Reference: Cox JM, Feller JA, Cox-Cid JA: Topics in clinical Chiropractic 1996; 3(3):45-59


Get off your meds since they do nothing to cure the problem and get it repaired non-invasively with spinal decompression or F/D. Depending on where you live, there is a great likelihood of finding a certified D.C. in F/D that can treat you.

GS is great if you take the correct amount and certified brand. You can go to ConsumersLab.com and find products that meet proper guidelines.

500mg GS with MSM taken 3x/day twice, A.M. and P.M. for a total of 3 grams/day is the therapeutic dose. Many people make the mistake of taking too little and taking cheap brands yielding poor results. It is proven to work, you just have to get the correct stuff and take the correct amount.

You defiantly don't need surgery, any doctor that says you do is a quack.
Find a D.C./ D.O. and get a second, third or forth opinion. I am confident F/D is the answer with G.S./MSM and ultrasound treatments.

High heels are bad for obvious reasons, if you have to wear them, get a waiver from your doctor or it will take twice as long to correct your problem.
Avoid doing exercises, stretching is O.K. Your D.C. will tell you what you should and shouldn't do.

If you need a referral, I would be happy to give you one. Let me know where you live and I can readily find a competent physician to treat you.

There is no concrete cure for your problem, you can make it much better but it is like going to the dentist, you will always need monthly visits to stay on top of it.

Let me know if you need any more help,

Good Luck!

Call me if you need anything,
Dr. Timothy Durnin
drs.chiroweb.com
708-466-9994

---------- FOLLOW-UP ----------

QUESTION: THanks for the quick response Dr. Durnin.

1) Roughly how many F/D treatments would be needed for my case?
2) WIll the problem come back afterwards?
3) Thanks for your offering of a referral letter, but I don't live in the State.
I live in Singapore and I'm wondering if you know any physician here or if
your referral letter works for me.
In fact a referral letter from a doctor would be great because my insurance
will pay only if there's a referral letter. Otherewise, i have to pay for all the
treatments, that's why i want to know how many treatments are needed.
( No doctor here is willing to give me a referral letter to see a physician or
what they called "alternate medicine")


ANSWER: Hi Tse,

In 3-6 treatments you should be 50% better. I will write or call anyone you need me too. It is imperative you see a D.C. and get this fixed before it deteriorates further. I am sad to hear that where you live, prejudice still exists with M.D.'s.
In the states and many other countless countries, Chiropractic is not only recognized, but embraced.

We are in all entitlement programs such as Medicare and Medicaid, VA hospitals for our military. I am the team physician for the Chicago Bulls, which is a big reason they won the championship 4 yrs in a row. I am in several hospitals and guest lecture at many medical schools.

We are considered mainstream in America. I don't understand why it isn't the same everywhere, we have unequivocal proof of hundreds of studies showing efficacy and superior economic feasibility with managed care.

Why spend Tens of Thousands on a treatment that fails 99% of the time when there is a proven alternative costing 1/10 the price? Sounds crazy over there!

Will my letter from the states carry any weight over there?

I am also aligned with dozens of top spine surgeons and can get them to write a letter as well. I think it is a shame your country is a hundred years behind in spinal care.

I think in 8 wks at 3X/week, you will be new person for the better. You will feel great in a couple weeks but that doesn't mean you will be fixed.

Are there licensed D.C.'s in your country? If so, go anyway if you can find one. You don't need insurance to fix this. It will cost less than 2K in the USA, probably much less in your country. Check around and get me the phone #'s of D.C.'s in your area and I will call them and pre-screen them for you. I will make sure you get the best possible care available, no surgery is needed, it will only worsen your condition once the scar tissue sets in.

Gravity never stops wearing down the spine, so yes, you will have to come in once/month to maintain what the doctor achieved.


Chiropractic is not referred to as "alternative" medicine. It is the gold standard for spine conditions and has been for decades.

I think you can afford a payment plan with a D.C. spreading the payments out so it's manageable.

How can you put a price on peace of mind knowing you can get your life back without risk of infection and death?

Not all D.C.'s utilize F/D or spinal decompression, I think it is because it takes more training and study along with great expense, for the equipment. If I can get an M.D./D.O. and a D.C. that says you need this, how can they argue?

I will do everything in my power to see this through, it will take both of us to get it done. First I need to know if they exist in Singapore, second I need to know if they have F/D, third I need to know where to send the prescription.

This is a condition you need to stay on top off, it only worsens with time if nothing is done. It will be irreversibly damaged once they do surgery, whatever you do, don't get surgery!

Get out of the country and have it done somewhere else if necessary. It would be worth every dime, it's your life we are talking about, the quality of your life!

You didn't work your whole life to make some greedy surgeon rich at the expense of your future, body and quality of life, so do whatever it takes to see the best, the best being someone that spends a year longer in medical school than M.D.'s. Plus, we concentrate on your specific condition, there is nobody on earth that can help you more than a competent D.C.

The trick is, like any Dr., finding one.

As I said earlier, I am here to volunteer and help all the people I can by giving them professional guidance. Don't feel like a burden, I live to help people that can't help themselves, even if it means I have to give away my services, it's not about the money for me, it's about sleeping at night knowing I changed someone life for the better, I pray I can do the same for you.

All I ask is that you rate me and give me a yes, this affirmation is all we get and all we need to feel appreciated, thank you for your last rating, I do appreciate it!

Don't give up and get surgery, I guarantee you will regret it. Just ask anyone that had it after 5 yrs. In that time, scar tissue invades the spinal canal creating pressure on the spinal nerves, this is bad and inevitable!

I can and will help you,
Keep in touch and we'll get through this together, keep a positive attitude, ice it down when it hurts (at your low back) and do stretching exercises bringing your knee to your chest while laying on your back before you get out of bed and before you get into bed, both legs 10X each with 2 reps, then do it again grabbing both knees and pulling them to your chest.

If we have too, I can devise something that you can do at home to vastly improve your situation, we can talk about that if and when we have too.

I wish you all the best of luck!

Sincerely,

Dr. Timothy Durnin
drs.chiroweb.com

---------- FOLLOW-UP ----------

QUESTION: HI Dr. Durnin,

Yesterday i asked another question but i didn't get any receipt of question, so
here i go to ask you again. Pls ignore it if you did receive my yesterday's
question.

1) THere is an chiropractic association of Singapore and the website is
www.chiropractic.org.sg, they have a list of the clinics and a brief history of
the doctors. Some are from the State, it would be great if you can take a look
and advise or pre-screen the clinics which is suitable for my situation, many
thanks. Singapore is a very small country so i can visit any one of the clinic.

2) As per your experience and base on my report readings, is my situation
considered serious? And recently i got a lot of cracking sounds of my joint, is
this related to my slip disc or a sign of worsening situation?

3) I'm asking the Association if there is any GP can write me a referral letter, if
i couldn't get one here, I might need your help to write me a referral letter.

THank you very much.

Warmest regards,
Tse
ANSWER: Hi Tse,

I can't tell from the registry in Singapore who went to school where. All you have to do is print up our correspondence and give it to the physician you choose.

It's real simple, call each one until you find one that went to NUHS or NCC that does F/D and you found your doctor. Even if they went to LACC, Texas, Palmer, Canadian Memorial, Logan, Western States, ect, that's O.K.

Just don't go to a Life or Sherman grad!

Your biggest problem is the annular tear, this needs to heal before anything else is done.
You must take 3 grams of Glucosamine Sulfate with MSM/day and get therapeutic ultrasound over the tear before any decompression can take place. Due to the poor blood supply in the disc, tears can take months to heal with therapy and never heal without. Once it doesn't hurt to distract you on a F/D table, your good to go with the above recommendations. You may even be able to tolerate F/D with the tear, the only way to know is try.

Your condition is not life threatening, it would be if you went the surgical rout, but you're smart enough to go online and get another opinion.

The "popping" noise is nothing to worry about unless it's painful when it pops. Your Dr. will check that out in more detail. It looks like you have plenty of professional D.C.'s to choose from, just follow my advice and you will be fine.

I will write you a referral if needed.

Make some calls and settle on one or two possibilities with my criteria and get back to me. I will then decide which one is best for you. I need to know where they went to school and if they have F/D tables or spinal decompression.

Good Luck!

Dr. D

---------- FOLLOW-UP ----------

QUESTION: There are 2 doctors which I found that might be suitable.

Dr. Robert Wasserman received his chiropractic training at the Western States
Chiropractic College of Portland, Oregon, graduating with honours in 1981.
He is also a Certified Chiropractic Sports Physician (awarded in 1994 by the
NorthWestern College of Chiropractic of Minnesota) and a holder of an
International Chiropractic Sports Science Diplome.


Prior to establishing the clinic in Singapore, he practised general chiropractic
and sports medicine in the U.S.A., & held licences in five states. He is
presently a member of the American Chiropractic Association, a member of
the board of the Chiropractic Association of Singapore, and the country
representative to the Federation of International Sports Chiropractic.

Another doctor is Dr. Terence Yap and he gradudated from Palmer college of
chiropractic in Canada.

Both they do Flexion-Distraction.
I have started taking the GLucosamin SUlfate with MSM. But is there any side
effect if to be taken long term?

Thank you Dr. Durnin

Tse
ANSWER: No, there are no side effects, only if diabetic.

By far, the Dr. that went to Western States is your man!

Everything is good now, see him and you won't look back. Your problem is solved!

Dr. Tim

---------- FOLLOW-UP ----------

QUESTION: HI Dr. Durnin,

I have been seeing the chiropractor for 4-5 times. During the treatment, the
doctor used a machine called "Acutron Mentor" and put some patches around
my right buttock for 10 minute, after that he adjusts some of my back joints
with the popping sounds.  He said that is to relax my muscle and stimulate
the nerves. Can I ask you what exactly is that machine doing?
SO far i have only did 2 times of flexiion distraction. Is it too little? Am i
receiving the correct treatment.
I feel that my situation is improving but still if i walk too much i will feel the
weakness of my back and on  my right thigh.
I'm now seeing the doctor once a week and I just want to seek your advice
that am i getting the correct treatment?

Thank you so much

Answer
Hi Tse,

Glad to see you are improving. Are your legs strapped in when you lay on your stomach? Does he put his hand on your back above the painful area while the table drops down? Here is a website that shows what F/D looks like. Let me know if it is the same. You need to go 3x/week for 3 weeks to get it corrected, once/week is probably not enough.


http://www.coxtechnic.com/homepage.asp

The machine with the pads is called interferential therapy, here is a link to what it does. Basically it acts like a TENS unit, it block pain.

http://www.electrotherapy.org/electro/interferential/interferential.htm

Dr.T