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pars defect
9/26 8:50:59

Question
Dr. Nolan,  In February of this year, I was involved in a car accident and as a result have low back pain on the left side.  Initially, I saw my family physician who did x-rays and sent me to physical therapy.  I did PT for 12 weeks and had no pain relief.  I had an MRI and it showed I have a degenerative disk (L4/L5) and was sent to see a neurosurgeon.  She did not believe that the pain was from the degenerative disk and diagnosed me with sacroiliitis.  She sent me to have an SI joint injection which made the pain worse.  I went back in to get a lumbar injection at the L4/L5 disk to see if that helped relieve the pain and that also did not work.  The neurosurgeon then said that I must've bruised the bone in my back on the left side and there was nothing else she could do for me.  I have seen a chiropractor for 6 weeks, had deep tissue massage and acupuncture with no results.  I had requested to see another dr. for a 2nd opinion.  He repeated my x-rays and immediately diagnosed me with a pars defect.  He did a bi-lateral pars injection to confirm the diagnosis and had finally received some pain relief.  They repeated the pars injection only on the left side and I had about 4 weeks of no pain and it is now returning again.  Now having a diagnosis, can chiropractic help with this or am I only left with getting the pars injections to relieve the pain?  The only thing my current dr. offered for relief was to take ibuprofen and do stretches and if it inflammed again to get another injection.  I currently do stretches, use heat/ice and also have a TENS unit.  I'm just looking for anything else to help relieve the pain.

Thank you for your time.

Answer
low back pain, pars defect, anterolisthesis, spondylolisthesis, pars interarticularis, spondylolysis, spondylo

Hello Val,

Sorry to hear of your condition.  I hope this info helps.

".....Can chiropractic help with this or am I only left with getting the pars injections to relieve the pain? ...." , yes, chiropractic can help.

Physical therapy, pain injections, TENS, medications- all may help in the short run, but I think the Doctor of Chiropractic (often called the 'spine specialist') is an avenue you should consider.

The Doctor of Chiropractic (DC) will probably work with his(her) hands or devices to 'manipulate' your back, your spinal bones and joints; this will help your movement, posture.  The DC will probably work with nutrition to reduce inflammation (hence pain).  The DC will probably work with physiotherapy in the office to bring down nerve pain, muscle spasm, irritation and inflammation.

The DC can work concurrently with your medical doctor.  If you have found some of the medical things helpful, you can continue them as well as have chiropractic evaluation and treatment if found appropriate.  It does sound like chiropractic examination will find you a good candidate for chiropractic treatment.

My Staten Island low back pain patients usually get excellent results through chiropractic treatment.  In my office I utilize gentle chiropractic adjustment, nutrition, adjunctive physiotherapy, nutrition to help as many aspects of the problem as possible.  I also hand out informational sheets- such as this:


Lower  Back  Pain  (LBP):

         Low  Back  Pain  can be caused by many different things.

 Big, BAD, catastrophic things like a tumor or a cancer can cause low back pain (only a proper exam by a licensed doctor, like your Doctor of Chiropractic, or your family Doctor of Medicine, can evaluate your signs and symptoms, and perhaps refer for testing).

 Big, bad things like a Herniated Disc, sciatica, possible fracture or dislocation can cause LBP (again, best evaluated by your DC or MD, and perhaps referral).

Bad things, like  - Sprains, Strains, contusion, or Vertebral Subluxation Complex (all very efficiently diagnosed and treated by your Doctor Of Chiropractic.  

LBP can come from a motor vehicle accident, sport injury, slip, trip, fall, arthritis, lifting improperly, or even bad posture in standing, sitting or sleeping.  All of these things often have a Lumbar (Low Back) Vertebral Subluxation involved.

              Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?

The vertebral subluxation complex is the underlying cause of many healthcare problems. A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

This is a serious condition identified by its five parts:

    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

    Pathophysiology:
         Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.




ONLY a Doctor of Chiropractic will evaluate for Vertebral Subluxation, as well as evaluate for other pathology.



         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical-  problem requires a mechanical   correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  Only a Doctor of Chiropractic will evaluate you for VSC- as well as the other possible pathologies.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
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Certainly pain medication is necessary.  Only the patient themselves can really tell how much pain they are in.  But appropriate use of painkiller drugs is important- I use this handout in my Staten Island Chiropractic office:


PAIN     

Pain  is a  憆ed light on the dashboard?

Pain is your body telling you that something is wrong.

That RED LIGHT on the dashboard of your car- -- do you ignore it until the car breaks down, or do you get it checked and correct the problem?

 Pain, pain in your body- -- do you ignore it until your body breaks down, or do you get it checked and correct the problem?

  Pain,  do you cover up the pain by taking a painkiller?  Take a painkiller, mask the pain, and allow a problem to progress in your body?

    NOTICE  ON  PAIN  RELIEVERS:
 
Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06) ;

The  American Heart Association issued a scientific statement recommending medical doctors change the way they prescribe OTC pain relievers from a first choice to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people take NSAIDS for the pain of Arthritis, not realizing these drugs may make the underlying condition worse.  These medications cover up the pain, and cause the problem to worsen.


Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.

Vertebral  Subluxation           (  慥SC?,    憇ubluxation?  )
Vertebral Subluxation  is  actually  a  quite  common  condition.   Doctors of Chiropractic look for pathological conditions which may require referral to other specialties,   and also look for 慡ubluxation? Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system  (the master control system- ALL health disciplines learn this).  VSC- 慡ubluxation??can be the cause of many symptoms and conditions.



Only  a  Doctor of Chiropractic  will  evaluate  and  treat  for  VSC,   as  well  as  other  pathology.



The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.
       Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,         best  performed  with  the  chiropractic  adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine

++++++++++++++++++++++++++++++++++

That pars defect will probably lead to the components of the VSC, and perhaps the subluxation itself.  Chiropractic will help mitigate this condition.

I recommend a local Doctor of Chiropractic.

I hope this information helps.


If you need to re-contact me, please do so: ALLEXPERTS.com
( http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm )

Thanks for the question, Good Luck, and I wish you-
Good Health, Naturally,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (email newsletter)
http://www.SIworkcomp.com
http://www.SIautoaccident.com  

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