Compression Fracture with metal rod/titanium cage

by J.Jansen
(Pocahontas, AR)

Compression Fracture

Five and a half years ago, I was in a severe car accident that shattered my L1 vertebrae. I had surgery, where the pieces were removed and built with a titanium cage.

I also have a steel rod down my spine with four finger-size screws holding it in place. I've had severe pain since the accident, but recently, it seems to be worse.

On top of the injury, I've been having shoulder problems, which I think could be from a pinched nerve. SO my question is, with all of the metal in my back and the cage around my L1, is it safe for me to see a Chiropractor???

Hello Jessie,
How nice to have someone who takes the trouble to write in decent English! Zijn jullie Nederlanderen of Afrikaans? Or is Jansen just part of the great American melting pot?

Yes, it certainly is safe to see a chiropractor, but I would take care to find someone who is experienced, methodical and thorough, and who will give your case the time it deserves. Talk to friends and neighbours and perhaps your doctor.

L1 is the area where the Femoral nerve originates, passing down through the groin to the side and front of your leg. If you start to get groin pain, think L1 first. Type "Femoral nerve" into the Search this Site at C-h, you'll find quite a lot of material.

It's also the area that can set up a "Maignes syndrome", a facet syndrome from T12/L1.

Chiropractors have a number of gentle techniques that can be used in the treatment of old fractures. Heavy manipulation of L1 would obviouly be inadvisable, but it may well be that your pain is coming from elsewhere, say L4, in which very specific manipulation would not be unsafe.

Many shoulder problems we see in the practice come from an old injury of the neck. In a bad MVA it is not unlikely that your neck was affected.

You might start with "Maignes syndrome exercises" and "Frozen shoulder exercises" (again use the Search facillity at C-H), though the usual advice is examination first, diagnosis, and only then treatment. But they are quite gentle, done sensibly are unlikely to aggravate your problem.

Good luck, let me know in a few months how you get on.

Dr B

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Interesting challenges of the day

1. Mrs D, a 78 year old woman has very severe sacroiliac joint pain, and even more severe cramps in her right leg. There are two problems; she is on two diuretics but no slow K. Taking her temporarily off one diuretic and adjusting the SIJ brought 50 percent relief within four days. 

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has  two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

13. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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