Expert: Dr. Victor Dolan, DC, DACBSP - 10/1/2008

Question
Hi I am a 38 year old woman who had fusion in my neck about 9 yrs ago. I have an Orion plate and screws there now. My questions is...I began having terrible lower back pain from sitting or standing for too long. About 7 months ago I noticed a bony growth on my sacrum. I went to a chiropractor who tld me my sacrum is horizontal and my tailbone is in 3 different pieces. I fell about 3 yrs ago on my bottom but didnt go to the doctor due to no insurance. Now my regular doctor has me going to PT 3 times a week. My therapist said my sacrum is rotated and the bony growth is most likely due to my fall but my spine is also slightly curving to the right. So my question is, is there really anything they will be able to do to help me with this? My cervical spine has degeneration and narrowing along with bone spurs growing around the 4 bulging discs above and below the fused area. They tell me in 20 yrs I will be crippled. Is this true or just a bad guess? Thanks for all your help because I am beginging to get scared.

Answer
herniated disc, low back pain, neck fusion, spinal curvature, disc degeneration, bulging disc, spurring,

Hello Alice,

Sorry to hear of your pain and tough health history.

Cervical (neck) spinal fusion nine years ago; I am sorry to hear that non-invasive conservative chiropractic care did not help you.  Surgery is always the last resort (as I am sure you know).  Many Orthopedists and Neurologists usually recommend months of medication, months of physical therapy, months of conservative care before resorting to spinal surgery.  

Of course, as a Doctor of Chiropractic, I will admit my bias immediately towards the conservative treatment route.  In my Staten Island Chiropractic office I have seen many surgical failures, so my perspective on surgery is skewed by treating the failures.

Spinal surgery is a major invasive step.  IF you had surgery, I am sure you had a dire diagnosis, tried conservative care, and had to proceed to the fusion.  Certainly you asked questions and were informed as to the immediate risks of the procedure, and of the complications even years down the road from having the surgical procedure.  Fusion- does exactly as it's name implies: fusing segments together, limiting motion, stabilizing the affected area.
The neck, the mid-back, the low back all have a certain number of segments; with a range of motion inherent to each segment and each section of the spine.  Fusion prevents the motion of certain segments and usually causes the body to compensate in the neighboring segments.  Often one spinal surgery  will be followed years later by a second and perhaps third surgery as the spine compensates and degenerates from the altered segmental motion.

The spine is one organ.  To illustrate- the old song- the toe bone connected to the foot bone- to the heel bone- to the ankle bone- to the leg bone- to the knee bone- to the thigh bone- etc etc- is true. Everything is connected and everything is INTERDEPENDENT.  When one part is not functioning properly, other parts compensate.  Your cervical fusion could actually be affecting your thoracic (midback) and lumbar (low back) function.

Without a doubt, the fall you suffered did damage to you. 'Rotated sacrum', spine slightly curving, bulging discs, ALL of these things show spinal motion changes and spinal misalignment.  Instead of the physical therapy,,, I am inclined to recommend the Doctor of Chiropractic who works on spines everyday, all day. The Doctor of Chiropractic works on spinal misalignment all the time.

I have informational handouts I utilize in my Staten Island Chiropractic office that may be helpful for you:
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Disk   Herniation

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.  ‘subluxation’)
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.


Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, 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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PAIN     Pain  is a  ‘red 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).

Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.

Vertebral  Subluxation           (  ‘VSC’ ,    ‘subluxation’   )

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 ‘Subluxation’. 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).   Only a Doctor of Chiropractic will evaluate and treat for VSC.   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.
         Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)
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.

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Why  so  many  treatment visits ?,   Why so many different  therapies ??
Many people do not come to the Doctor of Chiropractic first.  Many people take an over the counter medication (OTC) (covers up the pain, does not treat the cause of the pain),  see a medical doctor for a prescription medication  (covers up the pain, does not treat the cause of the pain, stronger then OTC drugs, increased possibility of side effects and complications), or just wait and hope the pain goes away.
                        Then, after the pain continues, FINALLY they go to the Doctor of Chiropractic.  Studies show that while Chiropractic is often the last Doctor people will go see, they expect immediate results- i.e.; a couple of weeks of treatments are expected to cure the problem.  It is a paradox that people WAIT to go to the Doctor of Chiropractic, but expect immediate results, on conditions that have been building for months or years; yet when they go to a medical doctor- they accept invasive surgeries  and/ or a long treatment protocol of physical therapy- weeks, often months.
                         Spinal pain, like many other conditions, often builds for years and years until the pain becomes strong enough to send someone for treatment.  It is well known that heart conditions build for years and years, yet  in  40% of cases, the first pain someone feels with their heart,,,, is the last pain someone feels with their heart (a fatal heart attack in ‘asymptomatic’ patients).  Sad that they waited for pain to be a gauge of health.  Pain is the LAST thing that comes in a problem, and often the FIRST symptom to go away.  If there is a problem, isn’t it better to treat BEFORE the pain, or if pain has started, isn’t it better to take care of the problem, prevent future pain and progression of the condition?
                         Why so many treatment visits to start?,  Well the problem, the condition, has momentum on it’s side.  Irritation, inflammation and damage has taken place and then the pain comes.  Pain is the last thing that comes in the condition, and Pain is the first thing that disappears during treatment;  but the underlying irritation, inflammation and damage has to be repaired. Initial treatment schedules, depending upon the severity of the complaint could be as often as twice per day, or once per day for two- three weeks, followed by a gradual reduction in treatment visits.   This is similar to surgery!  When a patient has an invasive surgery, often there is followup rehab treatment of daily, then every other day, then weekly visits for a prolonged period (i.e.; shoulders- up to a year of treatment AFTER invasive surgery).
                         Chiropractic works with your body.  Chiropractic helps your body to heal itself. Chiropractic restores Homeostasis, balance in the body.  Chiropractic  corrects  the  Vertebral  Subluxation  Complex.  You  cannot be ‘healthy’ if you have a Subluxation.  You MAY feel it, with a pain, stiffness, or a ‘kink’ in your neck/ back.  You may NOT  even feel it-  just as people often do not feel the cavity growing in their tooth,,,, until it hits the nerve; or you may not feel it at all, like people do not feel high blood pressure or diabetes until AFTER damage has been done!!  The vertebral subluxation complex can be 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  (Subluxation)  is a serious condition identified by its five parts:    Spinal Kinesiopathology,     Neuropathophysiology,     Myopathology,  
Histopathology,    Pathophysiology.    Chiropractic corrects this ‘silent’ condition, works WITH your body, and like other health approaches requires a certain treatment regimen.
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"....They tell me in 20 yrs I will be crippled. Is this true or just a bad guess?....";  no one can tell us anything about 20 years from now.

Global cooling (according to the 1970's- 1980's) is inevitable.
Global warming  (according to the 2000's) is inevitable.
The Yankees will definitely win the World Series.
The Mets will definitely win the world series.

WHO KNOWS.

Health and disease are highly variable.  This does NOT mean we should stand by idly and let things happen.  We can work towards disease: smoking, drinking, recreational drugs, over-eating, under-exercising, etc.  We can work towards health: do not smoke, do not drink alcohol, no drugs, eat fresh, raw, organic, maintain good weight, exercise sensibly.  In large part- YOU control your health.  Do the right things, and you will probably be fine.  Do the wrong things, and you definitely will not be fine (you sound like you have many musculo-skeletal problems).

DO:  Maintain a normal weight.  Increased weight means increased joint deterioration, increased arthritis, and increased risks of heart disease and cancer.  DO: supplement with joint support formulas-
glucosamine, chondroitin (see: "the arthritis cure", theosadakis, MD),
SAMe, MSM, calcium, magnesium, vitamin D.  DO: moderate exercise as you can, walk, swim, stay active to stay loose. DO: see your local Doctor of Chiropractic, not only for restorative Chiropractic, but preventive chiropractic  (see this handout:  

What ? ! ,  I have to brush my teeth!?,,, after EVERY meal ! ? ,,, For the REST of my life ! ? ! ...  I don’t  want  to.  period.  I won’t.  To heck with it !  If I get a hole (cavity),  THEN  I’ll take care of  it.   Maybe I won’t get any cavities anyway…..
              It  took  the  American Dental Association YEARS to educate people that they should brush frequently to avoid dental disease.  It has taken YEARS to educate patients that visits to the Dentist for hygiene, cleanings, flossing, coatings, etc.  are  necessary to PREVENT  dental problems.  Some people still do not floss after every meal, some do not even brush often enough  (yyyuuukkkk),  so some people still have severe dental problems  despite  all  the  knowledge  about   PREVENTION   and  dental  health maintenance  that  is  out   there.     Can  you  believe  it  ?? !!
              Some people have the same problem with  PREVENTATIVE  Spinal  Health
that  used to  exist with preventative dental health.  Some people come to the Doctor of Chiropractic and say, ‘...do not adjust me, just give me therapy...’;  some people say,
‘...What ? ! , I have to practice SPINAL HYGIENE !?!, (practice proper postures, proper movement patterns, and  see  the  Chiropractor  periodically !?!),  Naahh, ... I  don’t
want to. period.  I won’t.  To heck with it!  When I get PAIN,  then  I’ll take care of it.
(  pain is often the LAST symptom to appear-  whether a cavity or a heart attack !  )
              Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)
The vertebral subluxation complex can be 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  (Subluxation)  is a serious condition identified by its five parts:
      Spinal Kinesiopathology,   Neuropathophysiology,   Myopathology,  
      Histopathology,  Pathophysiology.    
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, massage, 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.
             Chiropractic  corrects  the  Vertebral  Subluxation  Complex.
You  cannot be ‘healthy’ if you have a Subluxation.  You MAY feel it, with a pain, stiffness, or a ‘kink’ in your neck/ back.  You may NOT  even feel it-
just as people often do not feel the cavity growing in their tooth,,,, until it hits the nerve; or you may not feel it at all, like people do not feel high blood pressure or diabetes until AFTER damage has been done!!  PREVENTION-  Visit the Doctor of Chiropractic REGULARLY,,, just like your dentist!  (practice spinal hygiene as you do dental hygiene  -PREVENTION!-  ).

DO:  go for massage, loosen the body, muscles, joints.  DO: look at Jack LaLanne, 95 y/o and still jumping around on television selling juicers.  Jack LaLanne did not become a HEALTHY 90+ year old by accident.  Dr. LaLanne (educated as a chiropractor in the 1930's !!) is 90+ years old and healthy BY DESIGN, not by luck.

You certainly have health issues.  I would be concerned if I were you. I would take positive action steps to heal better now and feel better in the future. I do not meant to alarm you, but as a doctor I have to be cautious and recommend the BEST avenue to you; you may comply or not.

This Staten Island Chiropractor is available to you for further information if you have further questions, do not hesitate to recontact me here at allexperts.com:  http://allexperts.com/user.cgi?m=4&expID=100794&catID=965  (Dr. Victor Dolan at allexperts.com).

I hope this is helpful, I wish you good luck and Good Halth Naturally!

Thank you for the question,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com    (email newsletter)
http://www.DocDolan.net
http://www.GoodHealthNaturally.info