just wondering what the consultant will say regarding my MRI results

[ywedvujmiklifjefz]

Hi All

I have just an MRI scan, details below, and am impatiently waiting for the info to be translated in to plain english!! Was just wondering if anyone on this forum can shed any light on them.

Degenerative changes with dehydration of lower two lumber discs. Degenerate lower two lumbar discs. Large central lateral broad based disc herniation at L5\S1 inpinging on the right S1 nerve. L4\5 there is minor symmetrical bulging of the disc but no direct nerve root impingement. Facet joint arthropathy is demonstrated at L4/5 and L5/S1. Disc height is narrowed at L5/S1. There is loss of disc signal at L4/5 and L5/S1.

A bit of history.... I had an MRI a few years back and found that there was a small bulge at L4\5, I was lucky enough to have private health cover and and had two epidural injections which resolved the pain issue. Since then i did have the occasional occurance of back pain which was eased with a couple of physio sessions. Then in december I had the worst back pain ever with severe sciatic pain. Couldn't drive, walk, sleep - the usual stuff. Doc prescribed mild pain killer and anti inflamitries. During this time I returned to the physio and after 8 weeks I am very lucky in that pain had pretty much disappeared - well as long as i behave myself. I am left with numbness down my right leg and foot with weakness also in that side as well as cramping in hamstrings and calfs. I can walk one mile before my right side starts to struggle and my right side feels a bit like jelly. I do also occasionally feel twinges in my foot when passing a bowel movement.

Can anyone suggest any other therapies that may assist with resolvong the remaining symptoms

Many Thanks

 

[MariVi]

You've got a "slipped disc" at the base of your spine, effecting one the nerves that goes down your right leg and supplies the sole of your foot, curling onto the top around the 4th and 5th toes.
My advice for this is to see a chiropractor who offers Flexion Distraction technique. Failing that a chiropractor who offers SOT technique. Failing that any other chiropractor or osteopath should be ok. You'll only be able to find out what techniques the individual would use by phonging and asking, but remember that the receptionist is unlikely to know.
You also have a disc injury higher up the spine (by 1 level), but this is currently not hitting any nerves. The treatments above should help prevent this from becoming symptomatic.

Beyond that you also have some arthritis low down in the spine; that report makes it sound like an incidental finding, rather than being particularly severe. Again, a chiro/osteo should be able to give you advice on managing that and trying to slow its progression.

As for what a surgeon is likely to advice - he'll advice surgery, it's what they do. If you're lucky he may advice physio, which may help as your symptoms sound pretty minimal, but I'd usually start physio exercises after doing a few treatments of chiro 1st and getting things moving in the right direction.

 

[Bluey]

I'm afraid to say this doesn't look like constructive advice to me on two levels.

It's worth noting that for the most part chiropractors are not doctors nor do they have medical or orthopaedic training and almost certainly not to the level of experience consultants, whether rehab physicians or surgeons. Strayduck, suggest you evaluate all the options for yourself as thoroughly as possible; this has useful basic information about chiropractic: http://en.wikipedia.org/wiki/Chiropractic.

BIA, as for your throwaway line re surgeons - this seems just a little biased and a gross generalisation. You'll find, as a rule I suspect though there seems little data to support it much like your own statement, surgeons will do precisely the opposite and refer patient for physiotherapy or to a rehab physician and exhaust all options before surgery. To push chiropractic and write off surgeons isn't just bad advice I would say it's quite indefensible. Further, discectomy for disc herniation is routine and seldom has complications (I for instance am doing very well, having tried other options first).

I also wonder what you mean in your footer, "a man who cannot change his mind, cannot change anything" - it doesn't sound consistent with the 'advice' you've given. It seems to me you may have a conflict - promoting a chiropractic service in your footer while badmouthing surgeons... unimpressive and unprofessional.

 

[Warrior1]

Interesting.

Without wanting to side-track this thread.
I've never claimed that chiropractors are doctors (interestingly, neither are most medical doctors).
Very interesting to hear that we don't have medical or orthopaedic training; I wonder what that 5 year MSc degree included then? Maybe not to the level and experience of consultants, but then, I'm sure experienced chiros have experience.

Yes, my throw-away comment was a gross generalisation and throw-away, but still valid, a surgeon will recommend surgery earlier than a conservative practitioner, because that's what they do, and I stand by that.
It is worth noting at this point that StrayDucks symptommatology appears pretty mild, so I would expect something like 90% of surgeons to suggest conservative therapies ahead of surgery, but that's just an estimate.

As for pushing chiropractic ahead of surgery, you've just said that a decent consultant would also make very similar recommendations, so difficult to call it indefensible (I'm not writing off surgery by any means, I'm saying that it's the last option, and that more conservative methods should be tried first).
I'm well aware that discectomy (complete or partial) is pretty routine, but that doesn't make it any the less drastic, I also know that it has higher rates of complications than the consultants are aware of through under-reporting (the consultants know this too, it's just impossible for any of us to judge how much goes unreported). However, as surgery goes it's a relatively safe one; but still makes more conservative methods look comparatively risk free.

I completely fail to see what my signature has to do with anything.
I also don't feel that I have bad-mouthed surgeons, when I've given standardised medical advice.



Anyways, back on track.
I would recommend conservative care in the forms I've recommended, if those don't work, I would recommend physio &/ accupuncture to provide symptomatic relief.
In the longer term, I'd recommend pilates / physio rehab to strengthen up the core stability and minimize recurrence.
If you find that none of Chiropractic/Osteopathy, physio and acupuncture work, then it's worth looking at surgical options.

I will always recommend exhausting non-surgical options first though; some surgeons will, some won't.
For the arthritis, the same advice applies, but I'd recomment avoiding HVLA thrusts from chiros/osteos in that area, as much as possible (though they may be justified on occassion) as there is the risk of exaccerbating the arthritis. Stick to mobilisations as much as possible there.

Another option worth considering is a TENS machine for analgaesia, but remember that it is only analgaesia. From the sounds of things StrayDuck, your's isn't bad enough for this to be an issue.

 

[avjbuyuj]

Hi All

Welll have had my appointment and the way forward will be one epidural, if this fails then it will be surgery.

I also asked the question of trying other treatments such as chiropractor and acupuncture and was encouraged to do so. So... if anyone knows of any good chiropractors in the Bristol are can you please post the details here so that i can investigate these options further.

Many Thanks
Hayley

 

[katysoucierxtw]

Good luck dear, hope the epidural does the trick!

 

[InsageGinaIle]

Hey man, wasn't intending to pick a fight as much as stress the importance of giving balanced advice... it's all to easy for folks in a difficult situation to take a 'senior member's' advice as gospel. It's safer to give factual info and let folks use that in a way relevant to their personal context. Olly.

 

[steellloniext]

Not wishing to continue this debate in a negative light, but from my own experience Chiropractic methods did nothing for me except take a lot of my money. And they missed the point completely - the chiropractor I went to see failed to even notice my slipped disc and from a basic x-ray she diagnosed merely "wear & tear" on the disc/vertebrae. So I was treated over a few weeks for pain relief to the tightened muscles and I was told to lie down on the floor as much as possible at home. In truth the pain relief was always short-lived and I kept being told that I needed a "full-course" of 2 sessions a week for 6 weeks before the pain would fully go away. I was not prepared to spend £500 of my hard-earned money on what appeared to me to be a total con-trick. So I cancelled my appointments and spent some weeks just doing some simple Alexander Technique exercises and getting lots of rest.

It was only when the back pain stopped but the sciatica started that I went to see my GP who sent me then to a Consultant Osteopath. After the MRI scan it was the Osteopath who recommended surgery - and he was 100% convinced that neither Chiropractic nor Osteopathic methods would have made any difference at all to my condition.

I am sure that Chiropractic techniques have their place for rich people who may have muscle pain issues, but they certainly cannot compare with a full MRI scan and an Osteopath who is prepared to recommend surgery over and above his own techniques.

 

[KRISTIE]

You can search by postcode here: and it sohuld list good options based on proximity to you. As mentioned earlier though, I would be recommending Flexion Distraction technique as the treatment of choice, and you'll only find out who offers that by asking the individual clinics I'm afraid, good luck.

 

[Nicky Alien]

2 sessions a week for 6 weeks is pretty shocking, especially if that's what you were told at the start. Being told that without imaging, and being given a definite answer to being able to help ring alarm bells to my ears.

I know I've discussed your case briefly with you in the past, and I still say that the size of the disc bulge makes little difference to the prognosis; healing times are different for every patient, and no promises can be made. For disc injuries I tend to recommend a trial course of 5-6 treatments, and if there's no improvement by that time, then there's not likely to be, and it's time to try something else; if there is improvement in that time, then it's worth continuing care.
Again, having briefly discussed your case with you before, I think you got a dodgy chiropractor there. IIRC you did have distal symptoms (pain down the leg, below the knee) that in itself is enough to make me suspicious of a disc injury. I rarely bother with X-rays or MRIs initially for disc injuries and they rarely tell us anything useful at this stage; and my treatment methods (flexion distraction) is very gentle. They're nice, but rarely add to the clinical picture at that stage, and wouldn't alter my treatment plan or prognosis.

To be honest, I'd be shocked to hear any chiro or osteo who wasn't willing to discuss surgery as an option, especially if conservative treatment is failing. I've often recommended it myself, but only after discussion with the patient.


In short, I think you had a bad chiro, but please, don't tar us all with the same brush.

(Incidentally, if it's a muscular pain issue, you're better off not seeing a chiropractor, massage therapy would be far more appropriate.)

 

[XRatedMisfit]

BIA, thanks for the very frank and honest response. I guess I must apologise for the strength of my comments, and yes I am sure that Chiropractic techniques have a valuable place in the treatment of pain. I have friends who swear by it - indeed they regularly visit the same clinic that I went to - so I guess everyone responds differently to this type of treatment.

I am humbled by the way you did not immediately jump to the defence of all chiropractors, and you yourself appear to be a very open-minded person.

Any surgery is extreme, and yes I think everyone should at least consider all possible alternatives. I was one of the lucky ones I suppose - my surgery so far has been a success and now 3 weeks after my operation I am feeling very well and definitely on the mend. But I must acknowledge that it is the physiotherapist exercises and general aftercare that has enabled me to recover so quickly. The surgery was only a small part of this process - so in support of alternative therapies in general I am sure my body is now healing itself with the assistance of the right exercise, rest, stretching and positive mental thought.

 

[The Skybird]

Hello ollyhartley, and welcome to Healthypages

May I just clarify generally here with regard to your reference to 'senior member', without making any comment upon individuals.

With the exception of the additional titles accorded to Admin and Moderators, the titles that appear below members' avatars on the left of their posts relate solely to the number of posts they have made on the forums. They therefore do not reflect any status in terms of proficiency, and are not awarded to members through any special criteria.

All members are giving their opinions and quoting from their experience regardless of whether their title suggests they are New, Member, Senior or Super.

Hope that helps.

Holistic