What radicular pain can I ignore?

by SJ

Where is the radicular pain?

Where is the radicular pain?

What pain is fine to ignore?

For example, my chiropractor says he ignores his own mild low back pain. Is intermittent radiculopathy also OK to ignore? Intermittent or transient pain that is moderate or sometimes severe? Pain that is only manifested when moving a particular way, but absent most of the time?

My chiro said the pain I am dealing with might be my "new normal," which implies there isn't much to be done about it, so I may as well get used to it and try to ignore it.

If I knew exactly what was causing my pain, and that by ignoring it I was not too likely to cause any more damage, then I suppose getting used to it or ignoring it could be viable (though unsatisfactory) options.

However, could I be ignoring symptoms that might get worse, if untreated?

A secondary question might be, how can I articulate exactly what I am feeling to my chiropractor, in words that both of us understand in the same way? I find my vocabulary is amazingly deficient when it comes to describing the location and nature of pain that I feel.

These are big and important questions, SJ. Firstly, pain is notoriously difficult to describe and quantify, so don't feel all alone.

Secondly radiating pain should always be taken more seriously than localised lower back pain.

And then a lot depends on your age and history. For example, I myself am nearly seventy and had a very serious slipped disc four years ago. A surgical job for what we call a sequestered disc in the jargon. I was saved by some very skilled chiropractic care, but I now have fairly regularly a numbness in the foot; that is fine to ignore at my age and with that history.

Likewise, a pain that you recognise and have had many times before, which has resolved with time or treatment, you'd treat a lot less seriously, and may choose to ignore.

On the other hand, if you are much younger, and this is something new, then my recommendation is that you don't ignore it; the likelihood of it progressing is relatively great.

Are you doing your part, like exercising your lower back every day, and being reasonably careful with bending, lifting and twisting?

Your chiropractor knows and understands his LBP; it's not unreasonable to ignore it. But it sounds like you don't understand yours; does he? For example, if you have a bad scoliosis, or advanced degenerative change and both you and he have an understanding of what's happening, then it might be reasonable to accept this is a new normal.

I hope this contributes; a difficult question to answer frankly. Follow your instincts.

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.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

Interesting questions from visitors

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