Unable to stand upright

by Anna
(Notts, UK)

I am 29 y/o, have a 'very large' disk herniation L4/L5 with sciatica for at least a year and half, Was leaning to the opposite side like tower of Pisa for long time, have radiating sciatica from my back to my foot.

But the last 2 months I've been completely unable to stand upright no matter how many tablets I take or ice packs I use. It is usual to stoop forward with a disk herniation or could there be other possible causes, if so like what?

I am due a Microdiscectomy in a few months but that's mostly to alleviate leg pain and I'm worried I'm still gonna be stooped forward and struggling to walk even with a crutch. I was advised by a neurosurgeon to avoid chiro as my herniation is so large but I just want to be able to stand up again even if I am leaning to the side and doctors don't seem to give me any answers.

I haven't read anywhere about disk herniation causing people to stoop forward, only heard about it causing a lean to the side. Hence being worried there's something else going on, plus my back pain has got a lot worse recently.

Appreciate any advice.

Hello Anna,
A prolapsed disc can not affect your posture, make you lean towards or away from the pain, or be stooped straight forward.

I'm afraid your treatment has, in my opinion at least, been extremely neglectful. In fact negligent to allow a patient to be in an antalgic posture, as it is known, for so long.

It's all very well saying avoid chiropractic manipulation, but if medicine has nothing to offer in eighteen months, then I'm flabbergasted.

Antalgic patients walk into our offices on a daily basis; there's nothing unusual or unique about it. I had just such a case this morning. Usually such a patient would be upright within a few days, though now and again it might take a week or two.

Bed rest with exercises is an important part of the chiropractic treatment in my book as there is a large hole in the disc and sitting and standing are prohibited until you are upright.

Reducing the disc with manipulation is not usually difficult but stopping long enough for the annulus fibrosis to heal is frustrating, especially as the pain subsides once the inner part of the disc, the nucleus pulposis has been repositioned.

Having said all that, every case of an antalgia causing you to be unable to stand upright is a challenge. It's a serious sign and neglected just gets worse.

After such a long time I certainly can't promise you a happy outcome with chiropractic adjustments; it will take a very skilled DC, and a particularly compliant patient to win this one.

How strongly positive the Slump test for sciatica is gives one a good indication of the severity of your case.

Perhaps surgery is the best option after all this time, Anna. If you really want to avoid it, start our lumbar disc exercises, and follow our slipped disc rules to a T.

Good luck; let me know how you get on.

By the way tell your surgeon that I personally have had a sequestered disc, it doesn't get worse, that was successfully treated with chiropractic. Read about it at Femoral nerve damage, using that same search engine.

Dr B

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Mar 23, 2016
Surgery worked for me
by: Anonymous

I'm 62 now I was 36 when the same thing happened to me; I could not stand upright; it was the most excruciating pain I've ever had.

The pain only lasted two weeks because I had surgery and it has never come back and I've never had another lower back problem. I had a laminectomy - a simple laminectomy, no fusion. They just cleaned out the disk and they said it was the largest herniation they ever seen bigger than a walnut.

Thank you for your contribution. You get good surgeons with above average results, just like chiropractors; it's a mixture of art and science.

And then you get "failed back surgery" and it's a total misery.

What's important in my book is that something be done; the lady in question is still suffering after eighteen months because nothing effective was done; unbelievable.

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 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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