scoliosis from a herniated disc

by Holly
(Lombard, IL)

I was diagnosed with a herniated disc and sciatica last fall because of extreme back pain, and not being able to walk very well or sit. I had spinal injections, medications, physical therapy, etc when the pain slowly subsided.

Now, I have from time to time and achiness in my thigh from the sciatica but can do mostly anything except high impact activity.

I went to the chiropractor the other day for an exam and the xrays showed I have scoliosis. My question is this: should I leave well enough alone? or should I get chiropractic adjustments to help with the scoliosis? If my body created the scoliosis to relieve pressure off of the nerve, won't pushing the spine back in alignment put the disc pressure on the nerve again and cause the original pain? But if I don't do anything for the scoliosis, I'm worried that the herniated disc could come back too or other problems would occur. I don't know what to do and would appreciate some advice. Thank you so much!

Hello Holly,
Gosh, this brings back memories; I survived the blizzard of '79! And four long winters living and training in Roosevelt Rd. You live in the heart of the chiropractic world.

There are two kinds of scoliosis; one which is temporary, called an antalgia, and the other is permanent. When you had your slipped disc, were you standing and looking like a question mark? That's a functional scoliosis, or antalgia.

The second is permanent and is usually caused by a short leg, or a chronically subluxated sacrum, for example after slipping and falling on the ice.

And, of course, at the time of your slipped disc you may well have had both.

A permanent scoliosis is associated with a higher incidence of knee, hip and lumbar arthritis; and more back and sacroiliac joint pain.

I'm of the opinion that an orthotic in your shoe is of great value; it seeks to make your hips level and your spine much straighter. But it's not straight forward.

That could be an insert inside your shoe, either under the heel only, or sometimes the whole foot. It could be either.

If the leg is more than 10mm shorter, it should go under the shoe, but that's not common.

Then you may go for a very expensive pair of orthotics that go in both shoes, the one thicker than the other. Each chiropractor has his or her own opinions.

I personally go for the cheaper version, because the orthotics are so highly priced here and certainly not always of benefit. Making a good orthotic is an art in itself. I decide on the heel vs whole shoe, and how thick based on proprioceptive testing, but it's very subjective.

You have to work at this, Holly. Perhaps print this out and discuss it with your chiropractor. If your back is basically stable, I'd try the inserts for a month or two, trying to decide whether thicker or thinner, whole foot vs heel works best for you.

And do our lower back exercises EVERY morning before getting out of bed.

I hope this contributes.

Dr B

PS. Could you send me a digital version of your xrays, taken standing, I hope.

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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 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.

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