Expert: Dr. Victor Dolan, DC, DACBSP - 1/16/2009

Question
Last year I was taken to the ER with severe pain in the mid to upper section of my back.  X-rays of my back were done, and upon reading the x-ray, the ER doctor brought the film in the room for me to see.  What I saw totally flipped me out!  I have scoliosis.  I went to my regular doctor the following week and he put me on an NSAID.  It's a year later and I'm still experiencing alot of pain, and I also can feel and hear popping in my back.  From time to time the middle of my spine goes numb, and the numbness travels down my left leg.  Any ideas on what could be going on with my back?  I worry about bone cancer because my mother lost her life to multiple myeloma.  Thank you for any advice you can offer.

Answer
staten island back pain , staten island scoliosis , NSAIDS ,




Hello Lena,

Sorry to hear of your back pain.  My condolences on the loss of your Mom to multiple myeloma.

With back pain, and Mom passing due to MM, I would be concerned as well.

Q) "Any ideas on what could be going on with my back? "
   I hate to say this, but given your short description to me, it could be anything.  Given your family history, I would not panic, but I would be cautious.  I will give you some recommendations to investigate and evaluate your complaint(s).


Any Doctor that I would visit, I would be complete and communicative about my concerns and family history.  With your yearly physical, and with the evaluation you are going to get- due to this recommendation- a comprehensive blood test and Xrays will be taken.

At the end of my answer- you will see additional websites you can visit.

I have talked about being cautious- you must be, but let me try to calm you as well: your pain and >popping< could just be musculo-skeletal sprain/strain/stress.

Have you visited a Doctor of Chiropractic (DC)?   If this were me, I would.

Your DC will take a thorough history, perform Xrays, and probably send you out for the same blood test screening your family MD would.
IF your problems are musculo-skeletal, if they are related to your spine without pathology, if your problems are related to your scoliosis- the Chiropractor is a great place to be!  IF there is something going on beyond that, the Doctor will refer you to a different appropriate specialist.

Some information I hand out in my Staten Island Chiropractic practice may be helpful to you:

First, on NSAIDS and pain relievers:



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).

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 in the spine.



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).  VSC- ‘Subluxation’ – 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;   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
+++++++++++++++++++++++++++++++++++++++++++++++


That pain that you report,  you certainly need a comprehensive evaluation to determine the CAUSE, and with the cause discovered, then appropriate treatment can commence.

Treating the symptom of pain,,, covering up the pain, can be dangerous, allowing an underlying causative condition to progress.  Treating the symptom of pain with medications can have side effects and complications by the treatment itself- according to the research.

Do not just cover up the pain with a pain medication. Get to the cause if possible.

Pain in the back, pain into the leg from the back, this is often Sciatica.  Again- an information handout from my office:



“Sciatica”   

( 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  ‘sciatica’,  .... sometimes a slip, trip, fall, heavy lift, or even a motor vehicle accident can cause a ‘sciatica’.  Frequently-  the true    c a u s e   of  the ‘sciatica’,  = pain in the lower back, buttock(s), thigh, calf and/or foot (even to toes);  is a misalignment,  a  ‘kink’ in the back- more properly termed a Vertebral Subluxation.


“”Sciatica””  is only  1/2  a diagnosis  ....   what is   causing   the sciatica?

              Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)

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 describe "scoliosis" as being part of your picture.  Some information on Scoliosis:




Scoliosis

Everyone's spine has a natural front-to-back curve -- that's what produces the normal rounding of the shoulders and the sway of the lower back.

However, some people suffer from "Scoliosis" – an   abnormal  curvature of the spine, especially one characterized by  a  rotational  side-to-side  deformity.

In simple terms, what this means is that the spine is twisted side-to-side, often taking on an "S" shaped appearance and even resembling a corkscrew in some cases.

Almost three out of every 100 people have some degree of abnormal spinal curvature, and for some it never becomes a serious problem. But for many others,   the curve gets worse over time   and can cause considerable pain, frustration, and limitations on normal activities.   

Severe scoliosis can even complicate breathing and circulation.

The  current   medical   approach to scoliosis is to   react   to  symptoms  of  curve  progression,  not  to prevent potential progression. It is mainly a "wait and see" attitude - yes, you have it, but we'll just watch it for a while and when it starts to get worse, we'll do something!" However, according to the Journal of American Family Physicians, 1999, underarm thoroco-lumbar-sacral orthosis (TLSO) braces have a 74 percent success rate in     slowing   curve progression.


According to the AAOS figures, almost all cases of juvenile scoliosis (in children ages 3-10) progress.      This group accounts for 15 percent of the scoliosis cases.   Fifty  percent  of  the  cases  progress  to  a  point  of   surgical intervention.    Adolescence scoliosis (in children older than age 10) comprises 80 percent of scoliosis in children, and 5 percent to 25 percent of these cases progress. The AAOS further states that if the curve is greater than 20 degrees at 10-12 years of age, there is a 68 percent chance it will progress. The AOS also concurs that even after bone maturity, especially in curves greater than 30 degrees, some progression occurs.



Who suffers from scoliosis?

The most common form of scoliosis is called idiopathic scoliosis, which basically means that the cause is unknown. Anyone can suffer from scoliosis; the condition usually begins in childhood, although too often it is not identified until the teenage years or later.
Scoliosis tends to run in families, and it affects many more girls than boys. In fact, research indicates that girls are nearly eight times more likely than boys to have scoliosis and five times more likely to require some form of treatment for their condition than boys, and the curvature of their spine is more likely to worsen over time, especially if left unattended.


What are some of the symptoms of scoliosis?

Sometimes curvature of the spine is visible (the body tilts to the left or the right, or one shoulder blade is raised higher than the other. Some of the actual physical symptoms of scoliosis can include back pain, fatigue (especially postural fatigue -- feeling tired when standing, sitting, etc.), and in more severe cases, problems with circulation and breathing.


What can chiropractic do?

Doctors of chiropractic are trained to identify and manage problems relating to the spine and the back. An initial visit to the chiropractor will include a thorough physical and diagnostic examination (including range-of-motion tests and spinal x-rays) to identify any problems you may be having, including whether you or your children may be suffering from abnormal or dangerous curvature of the spine.

If you do show signs of scoliosis, your chiropractor can provide a variety of techniques to help your condition, including spinal adjustments to increase movement and biomechanical function, and advice on posture and exercise to help prevent further increase in the problem.+++++++++++++++++++++++++++++++++++++++++++

Scoliosis and the Chiropractic Approach     http://www.planetc1.com/chiropractic-articles/scoliosis-chiropractic.html
By Matthew Trull

Analysis of Findings

Scoliosis can be very serious. If detected early, the chances for stabilization and reduction of the curves are very good. In my family alone, we have two examples. My sister’s Scoliosis was diagnosed when both her curves had already progressed to 45 degrees. She had Spinal Fusion surgery in Atlanta at Scottish Rites Children’s Hospital. The surgery was successful; her curves were reduced to 20 degrees each. However, it was very dangerous, painful, expensive, and changed her life dramatically. My Scoliosis was diagnosed early, while I had only one curve that was 21 degrees. Following six months of Chiropractic care, I have been completely cured of Scoliosis. The approach was painless, inexpensive, and did not alter my life in any way. I believe Chiropractic care should be the first-line approach for all patients diagnosed with Scoliosis. My research has proven it has a very high success rate: 70% achieving stabilization and reduction, and 15% obtaining total correction!


Typical  Treatment  Options

Bracing: For curves 30-degrees or less, a Milwaukee brace is typically worn. It is a rigid brace that exerts pressure against the spine, in hopes of achieving stabilization. The brace is uncomfortable, unsightly, and is usually worn 20-24 hours per day, until the patient stops growing. It offers no correction, and is only marginally effective for stabilization. Surgery: An orthopedic surgeon performs Spinal Fusion surgery. The patient is placed on a spinal cord monitor to prevent paralysis. After performing an incision, the surgeon manually reduces the curves as much as possible, and inserts metal rods on each side of the spine, attaching them with special hardware. Bone splinters (either removed from the hip area, or donor bone) are applied between the vertebrae. Over time, these fragments grow together to create a solid bone. Surgery is very expensive, painful, dangerous, and requires the patient to alter their lifestyle forever. Surgery is very effective for reducing curves. Surgery should be considered a last resort.


Signs of Scoliosis

Most obvious signs of Scoliosis are: shoulders of unequal height, a ‘rib hump’, which is caused by the ribcage on the back protruding more on one side than the other, and hips that appear unequal in height. Scoliosis clinics are conducted free of charge by health Departments and Chiropractors. A school or Health Department nurse or Physical Education teacher routinely screens students during the middle school years. It is extremely important to diagnosis and treat Scoliosis as early as possible.


Special Thank-You

I want to thank Dr. Marc Schnobrich, of Rincon Chiropractic, for all the many ways he has helped my family and me. He diagnosed my Scoliosis while treating me for an elbow injury. During the following months, he treated me weekly, always explaining what he was going to do. He provided excellent chiropractic care in many other areas, as well. Dr. Marc checked my spine often for progress. After six months of care, I was completely cured!


Dr. Marc has always been very kind, caring and helpful. He has been my friend as well as my doctor! During my research for this project, he loaned me books and other research materials. He patiently answered questions, and was never too busy to talk to me on the telephone between visits. He also answered my emails promptly and accurately. Thanks to Dr. Marc’s care, I will be able to continue my normal lifestyle, which includes baseball and many other physical activities.

Thank you, Dr. Marc!

Conclusion

Spinal Fusion surgery is very painful, expensive, and will alter the lifestyle of the patient forever. Surgery should be considered the last alternative in treating Scoliosis. Wearing a Milwaukee Brace is uncomfortable, limits physical activity, offers no correction, and is mostly ineffective in stabilizing the spine. The Chiropractic approach is very effective at stabilizing the spine, preventing the curve from progressing. At least 70% of the patients achieve some degree of reduction in the size of the curves. Approximately 15% of Scoliosis patients achieve total correction, like I did! That means at least fifteen out of 100 patients will not have to face surgery, take medications, and change their lifestyle forever! All of this is done with a minimum of cost and no pain! Research and experience have proven Chiropractic care is definitely effective in the stabilization and reduction of Scoliosis! Chiropractic care should be the first-line approach for all Scoliosis patients.


Chiropractic Facts

The first Chiropractic adjustment performed on the North American Continent was in 1895, by Dr. Daniel David Palmer. His first patient experienced deafness following a back injury. Following care, the patient reported improved hearing. Dr. Palmer founded the Palmer School of Chiropractic in Davenport, Iowa, which continues to train Chiropractors today.

Spinal manipulation has been practiced since the beginning of recorded time. Over 2700 years ago the Chinese documented this form of treatment. Records indicate that ancient Japanese, Indians, Egyptians, Babylonians, Syrians, Tibetans, and Native Americans practiced a hands on approach to health.

An estimated 19.5 million Americans visit a Chiropractor each year.

There are over 50,000 licensed Chiropractors in the United States, and another 30,000 worldwide.

Chiropractic is the world's second largest health care profession. It promotes the body’s own ability to heal itself. Chiropractic uses no drugs or surgery, and is all-natural.

Evaluation of Work

I believe whole-heartedly in Chiropractic Care for Scoliosis. I am living proof that it works! I thoroughly enjoyed researching this project. I was eager to find if others had similar success. I was delighted to find that more than 2/3 of the Scoliosis patients seeking Chiropractic care had very good results. It was fascinating to speak with Chiropractors who treat Scoliosis on a regular basis. I found them to be very caring, dedicated professionals. I accompanied my sister to Atlanta for her Spinal Fusion surgery, and remember the excruciating pain she suffered. I see her daily life changed. I wish my parents had been aware of Chiropractic when my sister was diagnosed with Scoliosis. Maybe next year I’ll research why more health care professionals don’t offer Chiropractic care as an option to their Scoliosis patients. More public education is definitely needed in this area!


Scoliosis-  is an OBVIOUS  Misalignment of the spine.  The spine compensates- like dominoes - - - one falls here, and the final  domino may be far distant !,  Like the old song- the toe bones connected to the foot bone, the foot bone to the ankle bone, the ankle bone is connected to the leg bone, the leg bone is connected to the knee bone, etc etc etc. the body is all interconnected and interdependent.  A misalignment (subluxation) in the spine can cause a compensation elsewhere contributing to an abnormal curvature- known as a  SCOLIOSIS.



Scoliosis:  a  misalignment  of  the  SPINE  often  contributed  to  by:

         Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)
The vertebral subluxation complex is the underlying cause of many healthcare problems.
The kinesiopathology of the subluxation (misalignment, improper movement pattern) is often involved with scoliosis, and can sometimes be the cause of the curvature.
A subluxation interferes with the proper functioning of joints, and can cause scoliosis, osteo-arthritic degeneration, Degenerative Disk Disease, degenerative joint disease, etc.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body- i.e.: muscles) 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.   Inflammed  Discs can easily bulge,  herniate,  tear,  or  degenerate.   Other  soft tissues  may  also  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.  Vertebral  Subluxation may cause Spinal Scoliosis, Arthritis, Disk Herniation, Disk Degeneration,  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  by  Doctor  of  Chiropractic.  Scoliosis??- nothing better then the CHIROPRACTIC Adjustment.  Plus- do your at  home  exercise (ie ‘hanging’) as instructed.

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
+++++++++++++++++++++++++++++++++++++++++++++++++++++



I hope the above information helps you.

To summarize:

Do NOT jump to conclusions that your back pain is caused by some malignant pathology.  DO be concerned and Do be cautious given your family history.  DO get to the bottom of the pain, DO get to the cause of your symptoms.

A thorough evaluation to get to the cause.  This will include blood tests (see websites below) and Xrays, perhaps MR or CT scans.  Your local Doctor of Chiropractic would be competent to handle this and give treatment if your condition is musculo-skeletal.  Your local family MD sould be competent to handle this, and refer to the chiropractor if your condition is musculo-skeletal.

I am sorry to hear that you have been hurting for a year.

It is certainly time for new eyes to look at your problem.

Xrays are a must, an MRI may also be helpful.

A family MD is a good place to start, so would a family DC. Being a sports chiropractor myself, I am partial to sport DCs.

I wish you good luck and Good Health Naturally.

I hope this information helps.

If further info is needed, do not hesitate to re-contact me here at
ALLEXPERTS.com @
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

Bye,

Dr. Victor Dolan, DC, DACBSP
http://drvictordolan.chiroweb.com



further info:
http://www.multiplemyeloma.org/about_myeloma/2.05.php

http://www.wrongdiagnosis.com/m/multiple_myeloma/tests.htm