QuestionHi My Name Is Jennifer My Question Is I'm In Pain Management & P.T & Also get chiropractic adjustments 3x's a week . I got an M.R.I of my neck I have bulging disc I have bad pain in my head neck shoulder upper n lower back so I asked the doctor that I see could he send me for an M.R.I of my back because I can sit stand or walk without being in a lot of pain the pain shoot from my back into my leg & then down so here is my back m.r.i L4-5 annular bulging without herniation and stenosis. mild right foraminal encroachment.L5-S1 sever disc desiccation with space narrowing and chronic endplate chages.Mild chroic appering loss of stature involing the inferior endplatesof L5.7-mmgrades 1 anterolishesis of L5 on S1. Limited evaluation for spondylosis. diffuse disc bulging abutting the the thecal sac. foraminal disc bulging with with moderate to sever formaminal stenosis and L5-nerve root impingementleygreart thst right could you help me
AnswerHello Jennifer,
I am sorry to hear of your pain, and complicated case.
Thank You for your question.
So,,, you have had two (2) injury producing accidents/ incidents. I hope you commenced care with the first injury. From a medical-legal perspective-- two incidents resulting in injury will be dificult to apportion.
Let me explain this: with cases of water falling upon you- there may be a workers compensation case or lawsuit pending here; and then a motor vehicle accident superimposed upon this first injury. If you went to doctor(s) after the first injury, and before the second injury- hopefully the doctors can separate the damage done in the two separate accidents. Maybe you are hurting 90% because of the first injury, and only 10% because of the second injury. Maybe you are hurting 90% because of the second accident, and only 10% due to the first. Hopefully the doctors and you can explain which incident caused which injuries and which injuries are the most significant. Talk to your doctors, talk to your lawyer about this- use the word 'apportion'. When we are injured, we do want to assign liability to the correct entity.
The medical-legal aspect can play upon your mind, play upon payment for treatments, and help or hinder your ultimate outcome.
On to your complaints- and I cannot/ will not determine which injury is caused by which incident.
You say; "....I'm In Pain Management & P.T & Also get chiropractic adjustments 3x's a week ....". Even with extensive injury you should feel some improvement with such a thorough approach. How long have you been getting treatment? If you have been under care for only a few days, or only a few weeks: progress may be slow, and you could be in daily and severe pain. If you have been getting treatment for 2, 3 months; I would hope that you have seen some improvement in your complaints. Just as important as all of the tests you throw at me is the question: 'How do you FEEL?'. You may not be pain free, but if you have gotten injections, PT and seen the Doctor of Chiropractic as well,,,, I would hope you are making some progress.
How do you feel?- if you are making progress, stay the course; if you are the same as last month, or the same as a week after the injuries..... maybe it is time for re-evaluation or some different approaches.
You add: "...I got an M.R.I of my neck I have bulging disc I have bad pain in my head neck shoulder upper n lower back so I asked the doctor that I see could he send me for an M.R.I of my back because I can sit stand or walk without being in a lot of pain ....". So, we have a 'bulging disc' in the cervical spine (neck)- this can certainly cause headache, neck pain, shoulder pain, even arm/ hand pain and numbness. Chiropractic is usually very effective upon this type of diagnosis. Cervical adjustments, cervical traction, interferential therapy, electrical muscle stimulation, ultrasound, infrasound, cold laser therapy are commonly utilized in the Chiropractic Doctors office- these usually help with a cervical disc complaint! Perhaps manipulation under anesthesia is indicated- talk to your Doctor of Chiropractic (DC). Perhaps nonsurgical decompression cervical traction could be used- again, talk with your DC.
On the PM (pain management) front, perhaps epidural steroid injections could be done- talk with your PM MD (medical doctor). The PT could give you some exercises, perhaps also use ultrasound or electrical muscle stimulation.
The MRI looks at structure- have you had an EMG/ncv ? this could be ordered by your MD or DC or perhaps you can be evaluated by a Neurologist.
You report that, "...an M.R.I of my back because I can sit stand or walk without being in a lot of pain the pain shoot from my back into my leg & then down so here is my back m.r.i L4-5 annular bulging without herniation and stenosis....." . You have pain from your back, into your leg- we call this 'sciatica'. In my Staten Island Chiropractic office I have MANY patients that complain of 'sciatica'. In order to help my patients, I give them an information sheet that they can read to explain the situation- perhaps this will be helpful:
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揝ciatica?
( Also Known As- neuritis, neuralgia, sciatic-radiculitis ) (pain down the leg, with or without back pain)
Sciatica can be caused by many different things. Big, BAD, catastrophic things like a tumor or a cancer can cause Sciatica (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 Sciatica (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.
Sciatica 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. Sometimes we can wake up with 憇ciatica? .... sometimes a slip, trip, fall, heavy lift, or even a motor vehicle accident can cause a 憇ciatica?
Frequently- the true c a u s e of the 憇ciatica? = pain in the lower back, buttock(s), thigh, calf and/or foot (even to toes); is a misalignment, a 慿ink?in the back- more properly termed a Vertebral Subluxation. 摂Sciatica敂 is only 1/2 a diagnosis .... what is causing the sciatica?
Vertebral Subluxation Complex (a.k.a. 憇ubluxation?
The vertebral subluxation complex is often the underlying cause of sciatica and 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 (subluxation) 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:
The VSC contributes to OsteoArthritic degeneration. 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.
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. For good health- Treat the Cause, not just the Symptoms.
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomate, American Chiropractic Board of Sport Physicians; Diplomate, 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, Selected to Colorado Springs (Olympic Training Center) to Care for USA Olympic Athletes , Chiropractor to the CHAMPIONSHIP NYPD Football Team, Chiropractor to the CHAMPION Curtis FB Team (PSAL)
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For your neck and lower back complaints- I recommend EMG/ncvs if you have not had them already. This test can help locate the level of damage in the spine AND can help determine the extent of nerve damage that you may (or may not) have. A doctor with a NEUROLOGY specialty would be best for this test and interpretation. You may get a referral to an MD neurologist, or a DC neurologist. Yes, chiropractic doctors have neurology specialists just like MDs ! For chiropractic specialties, see: http://www.acatoday.org/UserFiles/Microsoft%20Word%20-%20Approved%20Chiropractic(1).pdf
You continue with your description: ".....shoot from my back into my leg & then down so here is my back m.r.i L4-5 annular bulging without herniation and stenosis. mild right foraminal encroachment.L5-S1 sever disc desiccation with space narrowing and chronic endplate chages.Mild chroic appering loss of stature involing the inferior endplatesof L5.7-mmgrades 1 anterolishesis of L5 on S1. Limited evaluation for spondylosis. diffuse disc bulging abutting the the thecal sac. foraminal disc bulging with with moderate to sever formaminal stenosis and L5-nerve root impingement....." . Some good news, some bad news. You report NO herniation and NO stenosis- this is good news. You report MILD right foraminal encroachment- we LIKE the adjective MILD, this means there is NOT a lot of irritation of your nerve roots. These are good things.
On The other hand, you say "...L5-S1 sever disc desiccation with space narrowing and chronic endplate chages.Mild chroic appering loss of stature involing the inferior endplatesof L5...." this points to a more severe, complicated, difficult diagnosis. The Radiologist uses the word 'Chronic', so these finding may have been with you for years. Have you ever hurt your back in years past?, before these injuries?
Your description in this paragraph includes: "7-mmgrades 1 anterolishesis of L5 on S1. Limited evaluation for spondylosis. diffuse disc bulging abutting the the thecal sac. foraminal disc bulging with with moderate to sever formaminal stenosis and L5-nerve root impingement....." . That anterolisthesis may have been there before your latest injuries, or may have been initiated by these injuries. The anterolisthesis can give you a lot of pain. There are chiropractic maneuvers to help with the anterolisthesis- I am sure your doctor is using these approaches. Disc bulging abutting the thecal sac is another bad finding- this can be irritating the nerves in your back, nerves to your buttocks, nerves down your legs- the anterolisthesis and these disc bulges pressing on the thecal sac- I would think this is the cause of your complaints. Severe forminal stenosis talks about the exit holes that nerve roots use- this foraminal stenosis can pinch and irritate the nerves. These last findings could be due to your recent injuries, and the cause of your current condition.
Usually thes complaints will respond to a regimen of Chiropractic and/ or Physical Therapy. Give it time. Follow your doctors advice. Use ice.
Again, in my Staten Island chiropractic office I utilize an informational handout sheet that may be helpful to you:
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P.R.I.C.E. = P protection. R rest. I ice. C compression. E elevation.
Hurt yourself ??
injury/ trauma/ bruise/ not even sure - - a broken bone ??
You should certainly get to the Doctor or trained health professional to be examined if you think it is bad enough.
BUT in the meantime, some simple steps may help.
PRICE.
The PRICE protocol will usually help just about any musculoskeletal injury.
P = Protection; protect the area from further injury- stop what you are doing, can you
pad or bandage the area ? Tape the area? Do something to protect the area !
R = Rest; rest the area as much as possible, if a part is damaged, give the body time to
repair the area
I = Ice; ice is a potent anti-inflammatory; it will slow swelling, help with pain control
(ice is analgesic), place ice over cloth over the injured area for 5, 10 minutes, off the
injured area for 30 minutes; then back on again ( please do NOT use heat, heat adds to edema->
heat feels good while it is on,,,, and often makes the condition WORSE after you take heat off )
C = Compression; to help prevent swelling compression may be helpful- for example
if it is an ankle, wrap the ankle with an ace bandage and ice the area. Many body
parts may not be applicable to compression.
E = Elevation; again to fight swelling and pain, raising the injured body part above the
heart may be helpful- ie raise an ankle or knee, you lay down, raise the injured part
PRICE may help : Sprains, Strains, musculo-skeletal injury, bruise, contusion
Sometimes a slip, trip, fall, heavy lift, athletic injury, or a motor vehicle accident can cause a bump or bruise, sprain or strain. Sometimes also involved with the injury is a vertebral subluxation (or other joint subluxation) (subluxation is a mechanical problem- of any joint- and requires a mechanical correction). In the spine, a sprain/strain is a misalignment, a 慿ink?in the joint, a stretch of the muscles, tendons and/ or ligaments:- more properly termed a Vertebral Subluxation. Sometimes symptoms can come immediately, sometimes days, weeks or even months later!- Well after the actual trauma !!!
Spinal = Vertebral Subluxation Complex (a.k.a. 憇ubluxation? ; ( subluxation COULD be any joint )
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.
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. For good health- Treat the Cause, not just the Symptoms. Sprain/ strain/ bump/ bruise?= may result in subluxation of the nearby joint. CORRECT the subluxation !!!!
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomate, American Chiropractic Board of Sport Physicians; Diplomate, 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 , Invited to care for USA Olympians @ Olympic Training Center , Chiropractor to the CHAMPIONSHIP NYPD Football Team, and PSAL Champion Curtis Football Team
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Looking at your description, you certainly have some damage. Some of the damage is probably older- predating your incidents. Some of the damage may be new- caused by your recent incidents. You do not say how long ago you were injured. You do not say haow long you have been under care. Pain management, physical therapy, chiropractic are usually pretty successful with findings such as yours. Give it time. Take care of yourself at home. Take it easy at work. Use the 'price' protocol above.
If you have any further questions, do not hesitate to REcontact me here at allexperts.com : http://www.allexperts.com/ep/965-100794/Chiropractors/Dr-Victor-Dolan-DC.htm
Your Staten Island Chiropractic Expert,
Dr. Vic Dolan, DC, DACBSP
