QuestionHi there. I am currently living in Georgia (the country) and I'm a bit frustrated because I can't seem to get concise answers from the doctors here, so, I was hoping that you could help me.
In 2003 I had emergency surgery for CES. For the 8 months prior to my surgery, I had intense pain in my left leg right behind the knee cap. It got progressively worse, but every time I went to my doctor he kept telling me that it's just a muscle and to walk it out. I was 16 at the time, so it never dawned on me that it could have been something else. One day, while at school, I bent down to reach a book and my back locked. The surgery was successful, there was absolutely no pain afterward, and for 6 years I felt great.
I recently moved to Georgia for a few years and soon after getting here, my back started feeling really week and I had similar symptoms of pain as 6 years ago. I went to a doctor here, he told me it's nothing to worry about. I went and got an MRI done myself, and then went to another doctor who told me that I had a bulging disc at L4/L5. So, the same disc that was operated on 6 years ago. I read in someone's answer on this site that once you have surgery, the chances of your bulging disc/herniated disc to heal become far greater. Is this true?
The doctor that I saw suggested PT, but he kept telling me that the resources are very limited here and they have no equipment. So, I opted to not have PT, especially after the horror stories I've read. I was wondering if you would be able to suggest some exercises that I can do myself. The pain I have from the disc is not bad. I do have the feel of pins and needles in my legs and sometimes I have some sharp pains as well, but it is tolerable. The muscle spasms however seem to be increasing. Plus, I have been experiencing some spasms in my left eye as well. Can this be related?
One more question - I am experiencing some sharp pains shooting down into the pelvic area as well. Can this be caused by the disc, or perhaps another disc?
I would really appreciate some help/insight on this. Not speaking the language in this country and the health care system being less than stellar is a problem. Even though I've found doctors that speak English, they always seem a bit confused by what I tell them. Makes me feel like people in Georgia have wonderful backs and no one knows how to really deal with a back issue.
Thank you,
Karina
Would it be helpful if I sent you my MRI?
Answernational healthcare, socialized healthcare, cauda equina syndrome, 'pulled muscle', MRI, Herniated Disc, bulging disc, sciatica, staten island socialized medicine, staten island herniated disc
Hello Karina,
I am sorry to hear that you you are in pain.
You have had a back surgery, and sorry to say, usually once you have a back surgery, your back is '...never the same...' and usually requires repeat surgery down the road. Your similar symptoms returning is certainly no surprise.
When you initially injured your back 6- 7 years ago, what did your Doctor of Chiropractic have to say? What treatment did the doctor provide?- spinal adjustment manipulation, manipulation under anesthesia, noninvasive spinal disc decompression, SOT Blocking, applied kinesiology, activator, inversion, what type of treatments were initiated at your Chiropractors office?
These conservative treatments did not help your condition? Even though they did not help in the past, perhaps they could help now. I am not familiar with the country of Georgia, but when I went to Palmer College of Chiropractic in Davenport Iowa- we had students LITERALLY from around the world with many many countries represented. I just attended a fraternal reunion with Chiropractic Doctor Brothers from Europe, Africa, England, Australia, France. Perhaps there are Chiropractic Doctors you could try in Georgia?
I would certainly recommend conservative evaluation, and conservative treatment for your spinal problem. There is much controversy over the safety and efficacy of invasive spinal surgery.
Most herniated discs heal conservatively, sometimes taking a year to heal, but with 'time and treatment', HNP (herniated nucleus pulposis = herniated discs) do heal.
Be very careful of surgery, as often one surgical intervention requires another and another due to the biomechanical changes that surgery forces upon the body.
Robert G. Schneider, MD writes: "....For many patients back surgery is a disaster, leaving them worse off than before. At best, chronic recurrent back pain hovers like a specter over the rest of their lives, their work, their play. At worst, complications such as radiculitis (inflammation of the spinal nerve roots) produces intractable pain and irreversible crippling. This is especially true in patients who have been subjected to two, three or four back operations in misguided attempts to "fix it". ........ Back surgery opens a Pandora's box of crippling [ain and recurring disability...."- Scneider, MD: ""WHEN TO SAY NO TO SURGERY"" .
Another Medical Doctor: Hubert Rosomoff, MD reported in the Journal : "GERIATRICS" ;
"..... Add another operation to the ranks of unnecessary surgery. According to a noted neurosurgeon and pain specialist, many of the operations performed each year to relieve herniated disc pain are actually unnecessary.....".
Your surgery was not to just relieve pain, you report having cauda equina syndrome (CES). True Cauda Equina Syndrome has loss of sensation of the leg(s), loss of control of the legs, loss of control of the bowel and bladder ( defecating and urinating without any control). This Cauda Equina Syndrome is a true emergency, and needs surgery to decompress the spinal nerves and prevent permanent nerve damage.
Pain alone is not a good indicator for surgery, especially since failure rates are so high, as well as the development of post-op infection and the development of adhesions over the surgical area.
".....Compression or inflammation of the nerve roots can cause symptoms of pain, altered reflexes, decreased strength, and decreased sensation. Although these symptoms can become severe, and in some cases disabling, most are self-limiting and respond to conservative care.
An extreme version of nerve compression or inflammation is cauda equina syndrome. Cauda equina syndrome is a serious condition caused by compression of the nerves in the lower portion of the spinal canal (see Multimedia File 2). Cauda equina syndrome is considered a surgical emergency because if left untreated it can lead to permanent loss of bowel and bladder control and paralysis of the legs......." = http://www.emedicinehealth.com/cauda_equina_syndrome/article_em.htm
Your pain is your body talking to you. Listen to your body. Do something about your body complaining NOW before your body complains EVEN LOUDER.
You state: "....I read in someone's answer on this site that once you have surgery, the chances of your bulging disc/herniated disc to heal become far greater. Is this true? ...", I do not know this to be true. I do not know that having surgery allows a herniated disc to heal better.
All of the people I know that have had back surgery: cannot return to their prior level of activity, cannot return to their former job, are prone to exacerbations of their back.
Sometimes it can take years (ie: most followup studies done upon back surgery end at two years, with exacerbations and deterioration often waiting until 4, 5, 6 years post surgery) for adhesions, complications to occur.
Back pain, with or without leg pain is VERY very common in the Doctor of Chiropractic's office.
In my Staten Island Chiropractic office I give out informational handouts, I think this info may be helpful to you:
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; 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
Another information handout I utilize for my Staten Island Herniated Disc patients:
Disk Herniation
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.
Sometimes LBP is caused by a Herniated disc: Herniated disk is actually a quite common condition. However, the course of the condition is highly variable. Some patients with a herniated disk literally cannot walk, yet other patients with similar MRI findings may be able to run marathons or lift heavy weights. Some people suffer for only a few days with pain and symptoms, some people suffer for months.
Although the course is highly variable, there are certain steps that are always helpful to follow: Ice the area when painful- 10/ 15minutes on, 30/ 45 minutes off; avoid certain postures and movements; bend the knees when coughing or sneezing; bend the knees when lifting anything; do not extend legs straight out when sitting, laying down, lifting, or driving. Avoiding certain movements and postures will prevent aggravation of the condition. Practicing good postures and movement patterns will help the condition heal and be less painful.
Disk Herniation is often caused by, or often concurrent with the Vertebral Subluxation Complex.
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.
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. 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.
Along with that low back pain, Sciatica ( pain in the leg(s) ) may also occur:
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.
You may be doing something to irritate/ inflamme/ aggravate your vulnerable back---
use ICE !!! My Staten Island Pain patients get the following:
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
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
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Being in Georgia ( when I was young they called it Soviet Georgia ) must be interesting! and you are lucky! The United States is moving towards the Georgian healthcare system right now. With the socialized medicine there you should be able to get all the testing and treatment you need at no cost.
The United States is going to have the same healthcare system soon, getting rid of our old way of doing things!
You state: "...The doctor that I saw suggested PT, but he kept telling me that the resources are very limited here and they have no equipment.....", I do not understand this, we are told that America has the worst healthcare in the civilized world and we need to copy systems such as the Georgian medical style.
I would suggest PT (of course by a licensed, trained Physical therapist). I would PREFER if you were able to find a local Doctor of Chiropractic (often called the 'spine specialist' by lay people) as these complaints are what we treat all day every day- and we treat them safely, effectively and cost effectively.
"....I was wondering if you would be able to suggest some exercises that I can do myself....."; SIMPLE things like walking, swimming, yoga, pilates, inversion or chin-up 'hanging' would be good for you to do. Guidance by a DC or PT or licensed massage therapist, even a certified physical trainer would be more then helpful.
"....I have been experiencing some spasms in my left eye as well. Can this be related?..." this is not likely related to your lower back condition.
"...I have been experiencing some spasms in my left eye as well. Can this be related? ..." ABSOLUTELY this can be related. Your spine is irritating the nerves that flow/ go/ supply these areas. see: http://www.beecavechiro.com/images/AutonomicNervousSystem.jpg
http://www.contracostachiropractic.com/MericChart.jpg/MericChart-full.jpg
http://visualchiropractic.com/sitebuildercontent/sitebuilderpictures/Nerve-Chart...
"....Not speaking the language in this country and the health care system being less than stellar is a problem.....": in America we HAVE to supply translators to people of a different language, I am surprised Georgia does not do the same; health care less then stellar?= again, I am told we have a poor healthcare system here and we are going to follow a system similar to Georgia's very shortly.
My advice?
--- See any Doctor of Chiropractic that you can. Most European countries do have Doctors of Chiropractic.
--- see the PRICE information above
--- sleep upon a firm mattress
--- BEND your KNEES
--- sit/ stand/ walk properly
--- Walk, swim, stay slim, yoga, stretching, pilates - these things should be helpful.
--- take advantage of their socialized medicine, learn how it works, because you will be coming home to that type of system.
If you would like, yes- please forward your MRI report to me, If I see something that changes these recommendations, I will communicate with you.
Thank you for the question, I hope all of this information is some help to you.
Do not hesitate to RE-contact me here at ALLexperts.com:
http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm
Good luck in returning to good health,
Dr. Victor Dolan, DC
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