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About Dr Ron Grassi,DC.,MS.,ACFEI.
Expertise
Medical questions as they relate to the Diagnosis & Treatment of Orthopedic; Neuro-Musculo-Skeletal pain and injury. As a Board Qualified Chiropractic Orthopedist & Court Expert Forensic Witness of 23 yrs., I am qualified to answer questions as they relate to treatment & mamagement of personal injury. I can answer questions about Manipulation Under Anesthesia (MUA). I enjoy treating Sports and Performing Artist injuries. In addition to my Doctorate in Chiropractic Medicine, I have a Master's, MS. Degree in Biomechanical Trauma and hold Certificates from the National & Florida Boards of Chiropractic Examiner's. Fellow of The American College of Forensic Examiner's. I Research, Publish & Lecture. I founded www.Physicians4Musicians.com www.DrGrassi.com

Experience
23 yrs.Clinical Practice,Jupiter,Florida.USA.Editorial Review Board's; "The Forensic Examiner".www.ACFEI.com & www.SpineUniverse.com

Organizations
American Board of Forensic Medicine,American College of Forensic Examiners.Florida Chiropractic Society. Rotary Club International (Paul Harris Fellow).

Publications
Editorial Review Boards: The Forensic Examiner www.ACFEI.com & www.SpineUniverse.com Master's Thesis "Manipulation Under Anesthesia".

Education/Credentials
University of Miami,BS. Biology/Chemistry/Nuclear Medicine (1979).National Chiropractic College. Chicago,Ill. BS,Human Biology,DC,Doctor of Chiropractic Medicine (1984).Lynn University,Boca Raton,Fl. Master's Degree,MS. Biomechanical Trauma,(Summa Cum Laude) (1996).Board Qualified: Chiropractic Orthopedics,(1996).Certified,Manipulation Under Anesthesia (MUA) & Sports Medicine.

Awards and Honors
Univ. of Miami, Dean's List, President's Honor Roll.Graduated Summa Cum Laude,Lynn University,Boca Raton,Fl.Master's Degree, MS., Bio-Mechanical Trauma.

Past/Present Clients
Private Clinical Practice Patient's, Expert Consultant for Attornies and Insurance Companies.

You are here: Experts > Health/Fitness > Back and Neck Injury/Chronic Pain > Chiropractors > Herniated Disk

Chiropractors - Herniated Disk

Expert: Dr Ron Grassi,DC.,MS.,ACFEI. - 10/27/2009

Question
QUESTION: Hi Dr. Grassi,
My Mom (a young age 74) has been in pain for nearly 6 months-mainly showing up as sciatic left leg pain. She has very little loss of strength and no numbness. She is hunched over when walking and cannot stay upright for more than a few minutes at a time. She hates taking medications but is forced to by the pain. Her MRI indicates a bulge at L5 S1 with only slight stenosis and sciatic nerve impingement. In the last few weeks her bladder %26 bowels are also irritated. She was offered steroid injections and was tempted to try them but she is allergic to the contrast material needed to perform the procedure. She wants to avoid surgery(including the laser types-like foraminotomy)if possible.
We are now exploring the possibility of spinal decompression therapy but will have to drive approximately 1 hr.each way to get the treatments. I would appreciate your opinion regarding this treatment. I'm aware of the DRX 9000 computerized table and the cox table- do you have any thoughts about either or both of these, or other treatments that may work?
Thanks in advance for your help.
Julie

ANSWER: Hi Julie: Has your Mom had an EMG Nerve Test by a Neurologist,MD.? If not, she needs to get one. The MRI shows anatomy. The EMG shows physiology. I'm concerned about Bladder/Bowel (Cauda Equina Syndrome) involvement. That does not add up because of minimal findings of Spinal Stenosis. That is probably a coincidence. I would go with the IDDD. But, only AFTER clearance from Neurologist. You DO NOT want to make anything worse. Cox method is great. Much less expensive but time consuming. You will know if IDDD is working in 3 to 6 sessions. If no significant improvement. At least 20-30%. It's NOT for her. Combine IDDD with Acupuncture, Biofeedback & Physical Rehab. YOU MUST strengthen the Multifidi and Psoas Muscles. Long term goal. Get her into Yoga/Palates. Groups of Seniors at the Y water aerobics. Consider getting her a home Inversion Traction Device. You can pick one up cheap at a Sports Consignment Store. Only OK too after clearance from Neuro. Get a Neuro. that's open minded. Most of them are not. Once she proceeds past the IDDD she should start Chiro. Adjustments to maintain her at MMI or Maximum Medical Improvement. Yes, there is much hope for her. Julie, please read this a few times and follow through. She will improve. You need to keep in touch with me to let me know if she is making any progress so I can determine if she is on the right path. Later....Dr Ron Grassi,Jupiter,Florida.DC.,MS. www.DrGrassi.com
IMAGE: A view from paradise.

---------- FOLLOW-UP ----------

QUESTION: Hi Dr. Grassi,
Thanks so much for your reply. No, she hasn't had an EMG nor was it ever suggested. It sounds like this is a pretty important diagnostic piece to our puzzle. We only have 2 neurologists in our town so I will find out whatever I can about them and look in a neighboring town as well. Could you help me understand how the results of the EMG will guide us in the next steps of this process? What should we be listening for?

Could you please clarify your statement: " I would go with the IDDD." I'm guessing that you are referring to decompression therapy- is that correct?

Mom wasn't very comfortable with the Doctor who had the Cox machine and is now considering another Doc who uses the DRX9000(assuming decompression is the right direction to go). Do you think it is as effective as the Cox table?
Your advice is more valued than you know. Thank you.
Julie

Answer

My favorite Guitar

Hi Julie: IDDD=Intra Discal Disc Decompression. Remember my suggestion about hanging upside down at home IF Mom's into it. Mine was not. I AM. The EMG ( Electromyography ) Is like checking a wire, Only in this case the wire is the Nerve. The combination of the MRI findings & EMG. will unequivocally tell you the nerve root level involved. The bladder bowel issue is a red flag to get this test anyway. The Cox has it's applications. The IDDD is Cox on steroids. None of this though till EMG results. Do you know any Attorneys.? They can usually suggest good Doc's. They have good knowledge of mostly everyone. Julie, you are a good Daughter!. Dr Ron....

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