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as someone dealing with it currently.... the last thing you want to do is have someone "refill" your disc with the gelatinous synovial fluid (as the therapy promises to do), because
it will just leak out where your herniation is, and that bathes the area in cytokines.
The real problems come when you either delay or heal up in some fashion, and then compensate in a way that aggravates other discs.
That doesn't mean I advocate running under the knife -- there are plenty of procedures,
such as the epidurals, that if applicable, might relieve the situation.
Not all disc material is compressing a nerve. Some herniations are central, and press
upon the ligament that surrounds the nerve trunk. In that case, no nerve damage is
imminent, but it still hurts like hell, regardless - especially when it is aggitated.
I can't imagine any reputable orthopedic surgeon not wanting to stabilize the area
first, via a combo of epidural and oral meds (prednisolone) and then discussing with
you the various types of surgery that exist.
As for IDENTIFYING the real problem.... you can have herniated discs that cause you
no pain. What happens is idiots operate on the wrong one. Such as the example above
about not seeing it on an xray.
Discograms are among the most painful things you can endure, because they are
injecting iodine into discs to find the one that is hurting... THAT inflates the disc, and
you'll be a cripple until it all leaks out - and the pressure is AGAIN reduced. Sometimes
2-3 weeks. Expect to be in severe pain after an epidural too.
Get the MRI, but if you have no issues with Gadolinium, request it. If you can manage to
find a 3 Tesla MRI local, those records will do you a great deal of good. I have stacks of
literature - one where MDs themselves, with problems, missed it on their own MRIs, but the more powerful, closed (tunnel) unit and contrast, showed a tiny tear that was leaking
and inflaming the area non-stop.
Anyone who doesn't say "let me put steroids in there and your mouth.... and you stay flat/curved/hanging from ceiling/in traction" or whatever, is rushing you, especially if you don't have a WITH contrast MRI to be very VERY specific.
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sorry if I repeated this thread. The pain is so bad right now and the thinking is rather fuzzy....
As far as me, 42, 5'11", 190lbs.
Had an MRI and the L5 disc is bulging on the nerve.
The surgeon didn't over alternatives, just surgery.
Have had this pain since January of 2007. The doctor originally told me it was just back spasms and I treated it with a dose of prescribe exercises, aleve, and I lost 20 pounds.
I went to a different doctor last month when things really got worse--as a result, the mri, surgeon, so on.
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Studies continue to show similar outcomes in treating back pain with surgery vs without. Roughly the same amount get better in the same time frame with either surgical or nonsurgical treatments.
As to the original question about the decompression therapy, it has not been shown to be any more effective than traditional treatments that are less expensive and ARE covered by your insurance (and I include in that group manipulative therapy, accupuncture, etc.). It is basically a fancy new snake oil/tonic/miracle cure. There are no good studies that support the DRX decompression therapy. But it is highly advertised. The manufacturer usually provides a deal where they help the chiropractor with advertising costs and materials while they provide access to and use of the machine for a set lease fee and term (usually reduced fee the first 1-3 months). When people quit paying for the treatments, the machines become too expensive to keep and are removed from the offices (therefore the lack of current advertising on the above-mentioned website).
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I have been dealing with herniated disks in my neck for decades. I have been to a lot of professionals and this is from experience:
1. Beware of Chiropractors. They can often bring temporary pain relief but at the cost of wasting your money and most importantly the time that could be putting you on the road to better results. Many are the stories of Chiropractors treating pain when the underlying cause was cancer or a tumor.
2. Beware of Orthopedic Surgeons. My experience has shown me that these guys were trained that surgery is the answer for everything. The honest ones will tell you outright that for disc disease surgery is a low percentage absolutely last chance alternative.
3. Beware of Physical Therapists that do not target your therapy and only put you in traction (commonly called spinal decompression). Decompression is a good thing but be wary if they want to put you in traction every visit and skip the exercises and stretches that need to be done by you at home.
I have had the best luck with a physical therapist that is a certified McKenzie Therapist. After three previous therapists this one finally diagnosed the correct way that the disks had to be moved and helped me to relieve my pain and control my symptoms with proper self treatment. Good Luck.
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Grumpy,
I've been there, and am better now. I guess I'm lucky and never required surgery. What cured me was prescription strength pain killers and muscle relaxants (at the same time) and a heating pad on my back. Over the past few years I've made some changes:
1. Get good walking shoes - don't skimp and get Walmart specials. I prefer Rockport walking shoes - but buy whatever fits.
2. Don't drive with your wallet in your back pocket. Might not seem like a big deal - but it made a big difference for me.
3. I switched from a Mustang with a 100 lb clutch pedal (OK - maybe that's a slight exaggeration), to an SUV with an automatic that I can step into without bending over.
Good luck.
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[quote Blurb]Studies continue to show similar outcomes in treating back pain with surgery vs without. Roughly the same amount get better in the same time frame with either surgical or nonsurgical treatments.
As to the original question about the decompression therapy, it has not been shown to be any more effective than traditional treatments that are less expensive and ARE covered by your insurance (and I include in that group manipulative therapy, accupuncture, etc.). It is basically a fancy new snake oil/tonic/miracle cure. There are no good studies that support the DRX decompression therapy. But it is highly advertised. The manufacturer usually provides a deal where they help the chiropractor with advertising costs and materials while they provide access to and use of the machine for a set lease fee and term (usually reduced fee the first 1-3 months). When people quit paying for the treatments, the machines become too expensive to keep and are removed from the offices (therefore the lack of current advertising on the above-mentioned website).
Good post.
To clarify on the first part-- the one "big" study thats often cited says that the surgery group is more likely to report improvement short term (1-2 years) but then everyone comes back together somewhere down the road.
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[quote Grumpyguy]sorry if I repeated this thread. The pain is so bad right now and the thinking is rather fuzzy....
As far as me, 42, 5'11", 190lbs.
Had an MRI and the L5 disc is bulging on the nerve.
The surgeon didn't over alternatives, just surgery.
Have had this pain since January of 2007. The doctor originally told me it was just back spasms and I treated it with a dose of prescribe exercises, aleve, and I lost 20 pounds.
I went to a different doctor last month when things really got worse--as a result, the mri, surgeon, so on.
Based on the additional info, surgery might not be so bad- but what exactly is being proposed?
Severe. long-lasting pain like you describe is often treated with laminectomy and fusion. At this point the risk is that the extruded material may be calcified and difficult to seperate from the nerve root.
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A bulge and disc herniation are as different as a broken bone and a compound fracture that protrudes through the skin. Bulges often retreat. Herniations are ruptures of the side-wall of the disc and do NOT retreat back into the disc.
There may be some drying, over time, which lessens the pain, because the ejecta is not as gelatinous as it was originally, but its there, and something can always set it off, including compression that pumps more disc "innards" into the herniated projection.
If you have options to see multiple "Mayo" types in your area, do it. I'm game for whatever relieves the pain, but ultimately, if it interferes with what I do at some level, and it does, it has to be addressed. Over time, even if you go with the epidurals and oral corticoids, you'll come to the same conclusion.
I know more people NOW (as opposed to historically and/or even 20 years ago) who have had great success, even with local surgeons - not something I would do, but am amazed at the people who have had success at a local level.
If you can get by with a micro-discectomy, which is more like arthroscopic surgery, trimming away the offending herniation and cauterizing the disc so it can't leak there,
consider yourself EXCEEDINGLY FORTUNATE, and seriously consider doing it.
I wish that was an option for me.... I'd have been there a long time ago.
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