What does this all mean ........extra info to previous letter

I have found my MRI scan results and wondered if you could ellaberate on some of the points.

Some straightening of the normal cerical lordosis
Degenerative discal changes and osteophyte formation of moderate severity seen at c5-c6. The lower neck is particularly vulnerable after a whiplash type injury. If a ligament called the PLL is stretched or torn it allows a change in the posture of the neck: straightening of the lordosis.

What simultaneously frequently happens is loss of movement (in chiropractic jargon a "fixation" or subluxation. This loss of movement results in "immobilisation arthritis": osteophyte formation. Because the disc is also in part hyaline cartilage, dependent on movement for its normal nutrition, that fixation also results in degeneration of the cartilage: Degenerative discal changes.

Slight encroachment on the exit foramina of the c6 roots bilaterally slightly more so on the left than the right. (please explain) The nerve roots escape from the spinal canal via a "foramen". Those osteophytes mentioned above can encroach the foramen and threaten the nerve. It's a not uncommon finding after a neck injury. The net result is tingling and sometimes pain in the arms.

This is due to degenerative disk bulging and osteophyte formation. (why has this happenend) sometimes from the injury itself, but more usually as a result of the immobilisation the disc cartilage slowly degenerates.

There is a focal right sided disc prolapse at the c6-7 level which is effacing the right c7 root to the exit foramen. Over and above the narrowing of the foramen due to the osteophytes, you also have a bulging disc that is encroaching the nerve that supplies the middle finger.

Now that you have more details of my problem is there still a possibility that i can be helped through the work of a chiropractor. It's a problem we deal with every day, Alison. It probably won't be easy though and you will have to be patient and work with your chiropractor. I personally think that cervical traction (a home unit) also helps in conjunction with chiropractic, though the research suggests there is no benefit.

I have enquired at one place near my home town, but am wondering if i can be helped as my physio did say that there was nothing else he could do for me. I would give it 4-6 weeks before submitting to surgery. Good luck! Let us know in a month or so how your are doing. Take all your scans with you. And this letter.
Thanks Alison

Comments for What does this all mean ........extra info to previous letter

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Sep 08, 2011
More of my progress or not!
by: Alison

Hi, been having two treatments a week with my chiropractor. When she first started to treat me the pain moved down to the lower part of my back, then back up, then back down and now it has gone back to it's usually place. At the moment i am in a middle of a flare up. This flare up has lasted well over 7 days and is STRONGER than any flare ups that i have had before. I am in tears with the pain and the intense headaches and just cannot get on with everyday life. Everything i do is agony although i do do things just to keep going. I have noticed that my pain seems to be alot worse when the weather is colder is this typical? My chiropractor said to go and see you before an appoitment is made if pain is worse however these treatments do not come cheap and i am not working. Would you know if i can get a chiropractor on the NHS and what would i have to do for this? Alison

Gosh, Alison, it's really hard for me to comment. It's about style...

With a neck problem, I personally start with the neck, unless there are very strong reasons to look at the lower back first, or simultaneously. However, many chiros do things differently.

How about if you ask her to leave your lower back alone for the moment.

Have you had any exercises?

When there is lots of pain after the treatment, I like to schedule a longer period between visits. Obviously because of the degenerative change, the treatment itself is working on painful tissue.

So, perhaps ask her if you can now go once in 10 days perhaps. How many treatments have you had altogether? Or even longer if you've had 10 or more treatments.

Obviously I have to be careful of interfering - your relationship is with your chiropractor, not me, I'm only here as someone for you to throw questions and ideas to.

If your gut sense is that these treatments are really not helping, then another chiro might be an idea. We all work differently. I had a new patient this morning who wasn't satisfied with the progress under her other chiropractor.

Good luck, hope this has contributed. Discuss what you have told me openly with your chiro, it is important that as two adults you can talk freely. Old style doctors don't like it, of course. "I'm the doctor, you're the patient, do what you're told, and don't ask any questions." But that's very out of date today.

Dr b

Jul 28, 2011
My Progress
by: Anonymous

Have booked appoitments with a chiropractor. The first appointment that i had didnt feel too bad the day after. Had a bit of discomfort but nothing i felt i couldn't handle.

The second appoitment was a different story. Pain in my lower back like i have never felt before, and a lot of pain in my right arm and in my right shoulder blade. The chiropractor said that i had tennis elbow and golfer's elbow in my right arm.

She did alot of cracking on my back from which she suggested that is where the problem started? My muscles are extremely tight and knotted. I have another two appoitments with her and she said that she would refer me back to my doctor if she felt she couldnt help me any further. I will let u know how i get on.

Hello Alison,
With a long a difficult history like you have, don't expect miracles. It's going to take hard work, and extra care on your part.

Often the pain increases with chronic conditions in the short term, don't be put off by that. Ice is your best friend for the treatment of after-treatment pain.

Ask for exercises and stretches, and whatever else you can do to help yourself.

Keep at it! Rome wasn't built in a day...

Dr B

Jul 20, 2011
Tingling in arms and hands
by: Alison

Tingling in arms and hands

You mention in your reply that my neck injury could be due to a whiplash type injury. I havn't had any type of injury of whiplash or anything like it. Is it possible that this could happen through getting older? By that i mean wear and tear or is it more severe than that?

Is this something that will always be with me and just get to a stage that it can be managed and more comfortable?
Regards Alison

Hello Alison,
You have almost certainly (in fact, I would say CERTAINLY) had a whiplash type injury, but that doesn't only happen in car accidents. A fall off a horse, down the stairs, diving into shallow water... there are many possibilities.

And it was definitely a long time ago. How long is difficult to say, but a long time. I would guess more than ten years, and it could be fifty. And it could be several smaller events. It's not just 'aging'. It's injury PLUS aging. It's exactly why we believe EVERY whiplash needs to be seen by a chiropractor, to prevent exactly what you have.

Yes, I'm afraid this is not going to go away completely whether you see a chiropractor, go for surgery, take pills... I would start with a chiropractor if I was you. Look for someone with experience, and a reputation for being thorough and careful. Talk to your doctor, friends and family.

Let me know in a month or two 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 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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