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. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the pain is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Mrs T looked like the leaning tower of Pisa; she had a slipped disc at L5 making her lean towards the opposite side. It's called the postero lateral disc hernia; she's much better after two weeks of treatment and will go back to work next week, part time. Lateral discs are more difficult; both take a minimum of six weeks to heal. In my opinion, antalgic patients need what I call exercising bed rest. Sit and it won't get better.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months. He has a pincer deformity in the hip causing the groin pain, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your lower back is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her hip, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Hypermobility is more difficult that too stiff in my opinion. Chiropractic is for kids too.

8. This 65 year old lady is a serious gardener; every day is bending, lifting, digging for 2-3 hours a day; it regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

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. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

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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