Stenosis and herniated disk L4/L5 36 years old part 2
Hello Dr B,
Firstly, I must thank you wholeheartedly for your willingness to, not only reply but, offer insightful and helpful information. For me, your information and website are the cream of the crop!!
Just to clarify a few points: My 65 year old father has never suffered from any kind of back problems (beyond normal muscle injuiries, etc). The same goes for my mother and all of my siblings (of which there are 9).
General health is above standard, non smoker, very occasional wine drinker, prior to the injury I was extremely active - running app 50km a week, swimming, football once a week, 3 visits to the gym a week. There wasn't much I couldn't do!!
The slump 2 test results are as follows: right (good) leg straightens out well and doesn't cause any pain whatsoever. The left leg will only straighten to about 80% percent and causes a sharp, stabbing, pain around the back of my left hip. Basically it mimics the pain I presently feel when walking.
Jan - May 2011, I started feeling low back pain, but the pain never raditated down my leg and didn't really hinder me. I now summise that I possibly had a bulging disc or light stenosis.
In May 2011 during a game of football, I felt a 'click' in my lower back, nothing painful but a very strange feeling. My movement became lethargic, but I just passed this off as a strain. During the following week I discovered that I couldn't walk more than 50 meters without having to sit down for 3 minutes to recover. Over the next 18 months the pain turned to nerve pain down to my foot. Since that time I have tried many different therapies, injections, acupuncture, exercise, (but never a chiropractor) with little to no success.
The first success I achieved, was following your advice about absolutely not sitting down (I am standing as I type this) and, of course, I followed your exercises. Within 3 weeks, the nerve pain had all but disappeared and now I am trying to deal primarily with hip, backside and sometimes thigh pain (all brought on by walking and light exercise). There is a curiosity in that, I can sometimes run at a slowish pace (7kmh) without pain, but the moment I stop, I am in near agony. This only appears to subside once I have slept for at least 8 hours.
I realise there are so many factors involved and that no 2 cases are the same. Different doctors will interpret MRI's, pain, movement in their own way. Although, it seems, once they see a herniation, they stop searching for other causes.
If there is a possiblity of viewing a few selected images of my MRI, I would love for a 4th opinion. I certainly don't mind making a donation towards the running of your fantastic website.
Best regards Scott
Dear Scott, I'm not a qualified radiologist, but I do look at Xrays and scans every day and have done for 35 years. You obviously have a fairly large prolapsed disc at L4-L5, protruding into the foramen, and also compressing the thecal sac.
That Slump test shows that stretching the sciatic nerve is restricted, it's tethered in the foramen. Good that it doesn't produce leg symptoms.
Scott, my opinion is that you have to do something now. From a very active lifestyle, you've become quite disabled.
It's great that the not sitting, exercising regimen has made such a difference but I would give it a defined period, perhaps a month, to see if that improvement continues. If not, I would either go and see an experienced chiropractor, to see if the fragment can be reduced with manipulation, or have the surgery.
Both in skilled hands could improve it quite quickly, both could make it worse. Follow your gut feel. But my feeling is you can't go on like this indefinitely.
Was this scan taken recently, or at the time of the injury?
Can you raise your big toe off the ground?
Start talking to friends and family, your GP, and get the name of a good, thorough local chiro.
No payment needed, but it would make my day if you bought one of my books! My nom de plume is Bernard-Preston.com
Let me know how you get on. Please keep to the same thread.
1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort 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. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree.
Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.
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 stabs in the groin, 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 spine is just as important as the pain.
7. My own granddaughter, only 7 is hypermobile giving her pelvic, 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. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.
8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 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.
Greetings, Dr B. You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.
Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.
You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.
The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.
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