Need A Second Opinion

Discussions relating to Lower Back Pain.

Need A Second Opinion

Postby JMichael » Wed Oct 12, 2005 8:42 am

First, a bit of history ...

Two years ago this month I injured my lower back and had to be laid up in bed for three days. I couldn't stand, I couldn't sit up, and I could barely even change position in bed. My doctor put me on NSAIDs and muscle relaxers, and within a few weeks the pain eventually went away.

One year ago this month, the problem started returning slowly. I was feeling a familiar dull ache in my lower back, and while it never got as bad as it did the year before, I was still nervous about the fact that it came back at all. I took more NSAIDs and muscle relaxers, and again the pain went away.

Now here we are, in October again, and the pain is back with a vengeance. It started slowly, again, and this time I decided that I had a recurring problem that needed to be dealt with - it wasn't just a fluke. I started going to a chiropractor and had about two weeks' worth of treatments, but it wasn't getting any better.

I would feel ok after my adjustments, but the pain would be back within anywhere from a few hours to the next day.

Then, one morning I tweaked it just right - I slipped while getting out of the car, caught myself mid-fall, and jarred my back in the process. The pain immediately shot down my entire right leg and down to the sole of my right foot.

After three days of rest and more NSAIDs, I was feeling good enough to start moving around, but with a disturbing numbness in my foot.

I went in for an MRI, and while I was waiting for the results to come back, I found Dean's book online while I was doing some research on my condition. I have been doing the exercises in the book for about a week, and have noticed some drastic improvements.

I hardly have any back pain; my right foot is still somewhat numb, but the area covered by the numbness seems to be shrinking. The only thing that bothers me is my sacroiliac joint on the right side - it hurts first thing in the morning, but as I go throughout the day doing my stretches, back bends, etc., it goes away.

And now for the twist: the doctor just called me with the results of the MRI. They say I have a disc fragment in the spinal canal, around L4-L5, and I need to go see a specialist - probably for surgery.

I abhor the thought of surgery. I don't have enough disability insurance to cover being laid up for 4-6 weeks while I recover. And none of this makes sense to me now ...

If I have a fragment floating around, why am I getting better?

How accurate are these MRI things?

Is it just coincidence that I started doing Dean's exercises right when my back started feeling better?

Could it be that the exercises had little to do with it, and maybe the disc just happened to relocate itself to an area where it's barely touching any nerves?

It still sends shooting pain down my leg when I sneeze or cough ... maybe that's because I'm not thoroughly healed yet, or maybe that's because I really do have a fragment resting on a nerve somewhere.

If I do have a fragment, and they remove it, can Dean's exercises still heal the disc?

In cases where we're dealing with a disc fragment, does that mean a piece of the disc is actually broken away completely, or does it mean that a piece of the disc is just dangling in there - but still connected?

If I can avoid the surgery at all, I want to do so ... but now I'm afraid that maybe my relief is only temporary, just waiting for that fragment to relocate and start causing me serious pain again.

Thoughts?
JMichael
 
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re. second opinion

Postby Steven » Wed Oct 12, 2005 1:17 pm

Hi JMichael,

Welcome to the group. Glad to hear that the pain is improving whatever the reason.

As I'm sure you already know, no one can really say for certain whether the exercises were the reason for your improvement or not. It could have been just coincidence. I know the exercises worked for me and since the improvement coincided with you starting on the program, I would tend to think that it was the exercises doing what they are supposed to do.

Just my opinion, of course.

As far as the disc fragment is concerned, it usually means that a piece of the disc has detached completely. Your doctor can better answer that question.

Discuss all of your options with your surgeon. The good ones don't try to rush you into surgery that you don't need. They have enough real surgery cases to keep them busy and they often recommend trying conservative treatment first.

Let him know that you've been doing the rebuild your back program and so far you seem to be improving. Let him know you want to continue trying rehabilitation first to see if that won't solve the problem. He may want to send you to a physical therapist. Some of them are good and some of them are not.

As long as your not in any real danger, I would try to put off the surgery if I could. That disc fragment may never give you any more trouble. And I seem to have read somewhere that the body can actually dissolve it over time. (I may be mistaken.)

On the other hand, surgery is permanent. You can't undo it.

Hope this helps,
Steven
Steven
 
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Joined: Sun Jun 05, 2005 10:00 pm

Re: re. second opinion

Postby JMichael » Wed Oct 12, 2005 7:20 pm

Steven wrote:As long as your not in any real danger, I would try to put off the surgery if I could. That disc fragment may never give you any more trouble. And I seem to have read somewhere that the body can actually dissolve it over time. (I may be mistaken.)


Thanks for the remarks, Steven. I would love to know more about this possibility of the body dissolving the fragment over time ...

One more question, though: let's say this fragment is not a problem, for whatever reason - maybe the body dissolves it, maybe I have a surgeon remove it - what I would like to know is if my back can heal itself with a disc that's missing a fragment?

Put another way: does this condition mean I have to have my vertebrae fused? Or will I be able to "pump up" (as Dean says) the disc so that it remains healthy, despite missing a fragment?

--Jacob
JMichael
 
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Joined: Wed Oct 12, 2005 8:25 am

No to surgery!

Postby PeteD » Thu Oct 13, 2005 6:25 am

Say no to surgey at leas for now!

Theres a lot of good research being carried out at NY uni?!! looks at the mind body connection. if you wanna know more email me

Peterdocker@hotmail.com
PeteD
 
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Joined: Mon Aug 15, 2005 5:42 am

Postby Steven » Thu Oct 13, 2005 12:01 pm

What determines whether your disc can "pump itself up" or rehydrate is the condition of the nucleus. It's the nucleus that attracts or controls the moisture content of the disc. If the nucleus is still present and healthy (something that should show on your MRI) then there is a good chance that the disc can recover to some extent.

The extent that the disc can recover is hard to say. It's going to do what it's going to do. All you can do is help it by giving it the movement that it needs to get the moisture into it.

As far as fusion is concerned, even if the disc were to totally disintegrate, that would not necessarily mean you need to fuse the vertebrae. Many people are walking around totally pain free with discs that are totally gone.

Hope this helps,
Steven
Steven
 
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Joined: Sun Jun 05, 2005 10:00 pm

Update

Postby JMichael » Wed Nov 02, 2005 11:27 am

Just a quick update and a few questions.

I saw my specialist, and he said a few different things:

1) He's not sure if my "fragment" is detached or not; said there's no way to tell that apart from actually getting inside and looking at it

2) Surgery may take care of the numbness in my foot; but it also might not. The damage might be permanent.

3) Physical Therapy might also cure the numbness; but it also might not.

4) The sooner I have surgery, the better the chances are of healing the foot

He recommended that I see a "McKenzie" Therapist. Does anyone have any experience with McKenzie? How does it compare with the therapy/exercise program that Dean's book outlines?
JMichael
 
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Joined: Wed Oct 12, 2005 8:25 am

Postby Steven » Wed Nov 02, 2005 7:35 pm

Hi JMichael,

Sounds like your surgeon is pushing quite hard to do exploratory surgery on you. I would definitely get a second opinion before agreeing to go ahead with the procedure.

At least he's being honest about the possible outcomes. If it were me, I'd stick with the rebuilding since you were making progress with that. You can always have the surgery later.

McKenzie (and Williams) type physical therapy is very good at relieving back pain, but the problem is, it doesn't go far enough. It doesn't do much to actually improve your back.

One of the things that I like about Dean's program is that it does everything that McKenzie does (and Williams, too), but Dean takes it to the next level by actually having you rebuild your back.

Steven
Steven
 
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Re: Need A Second Opinion

Postby Kevin » Fri Aug 18, 2006 3:18 pm

[quote="JMichael"]First, a bit of history ...

Two years ago this month I injured my lower back and had to be laid up in bed for three days. I couldn't stand, I couldn't sit up, and I could barely even change position in bed. My doctor put me on NSAIDs and muscle relaxers, and within a few weeks the pain eventually went away.

One year ago this month, the problem started returning slowly. I was feeling a familiar dull ache in my lower back, and while it never got as bad as it did the year before, I was still nervous about the fact that it came back at all. I took more NSAIDs and muscle relaxers, and again the pain went away.

Now here we are, in October again, and the pain is back with a vengeance. It started slowly, again, and this time I decided that I had a recurring problem that needed to be dealt with - it wasn't just a fluke. I started going to a chiropractor and had about two weeks' worth of treatments, but it wasn't getting any better.

I would feel ok after my adjustments, but the pain would be back within anywhere from a few hours to the next day.

Then, one morning I tweaked it just right - I slipped while getting out of the car, caught myself mid-fall, and jarred my back in the process. The pain immediately shot down my entire right leg and down to the sole of my right foot.

After three days of rest and more NSAIDs, I was feeling good enough to start moving around, but with a disturbing numbness in my foot.

I went in for an MRI, and while I was waiting for the results to come back, I found Dean's book online while I was doing some research on my condition. I have been doing the exercises in the book for about a week, and have noticed some drastic improvements.

I hardly have any back pain; my right foot is still somewhat numb, but the area covered by the numbness seems to be shrinking. The only thing that bothers me is my sacroiliac joint on the right side - it hurts first thing in the morning, but as I go throughout the day doing my stretches, back bends, etc., it goes away.

And now for the twist: the doctor just called me with the results of the MRI. They say I have a disc fragment in the spinal canal, around L4-L5, and I need to go see a specialist - probably for surgery.

I abhor the thought of surgery. I don't have enough disability insurance to cover being laid up for 4-6 weeks while I recover. And none of this makes sense to me now ...

If I have a fragment floating around, why am I getting better?

How accurate are these MRI things?

Is it just coincidence that I started doing Dean's exercises right when my back started feeling better?

Could it be that the exercises had little to do with it, and maybe the disc just happened to relocate itself to an area where it's barely touching any nerves?

It still sends shooting pain down my leg when I sneeze or cough ... maybe that's because I'm not thoroughly healed yet, or maybe that's because I really do have a fragment resting on a nerve somewhere.

If I do have a fragment, and they remove it, can Dean's exercises still heal the disc?

In cases where we're dealing with a disc fragment, does that mean a piece of the disc is actually broken away completely, or does it mean that a piece of the disc is just dangling in there - but still connected?

If I can avoid the surgery at all, I want to do so ... but now I'm afraid that maybe my relief is only temporary, just waiting for that fragment to relocate and start causing me serious pain again.

Thoughts?[/quote]

16 years ago after MRI and other tests, my surgeon diaganosed a disc fragment that they believed was causing me problems. They believed it lodged, then relocated and then located back to a nerve position. This was well before I found this site which was only a week ago. I would trust this site now but let me tell you what my experience was. The surgeon diagnosed me and basically said, "See ya" I said what do you mean? He said when you are readly for the surgery you will call me. Kidding I said well "Forget" you and left determined to ride it out. About three weeks later I begged for the operation. He took the piece out and carved out another 80% of the disc to let it refill with scar tissue. He said that experience showed that when 80% was taken out to refill with scar tissue, 80% of the patients did not return for surgery. The surgery went fine and even though they discovered two other bulging discs, I have been fine (statying loyal to the stretching exercises given to me then) until recently when I developed what I think is sciatica. I found this site and am really encouraged by it as people are always finding new ways. So if you have to have surgery, ask around for a well recommended surgeon ( I usually ask the surgical nurses or neurologists). Find someone who believes in cutting only if you need it, not just because he does this for a reason. Good luck. Until then, I found the advice and knowledge in this forum to be excellent so far, even though no one has yet responded to my questions (which are very recent I might add). Best wishes.
Kevin
 
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