Expert: Dr. Victor Dolan, DC, DACBSP - 2/15/2009

Question
I am 28 years old and have been experiencing low back pain since the 3rd trimester of my last pregnancy, almost 4 years ago. I sought out a chiropractor and got relief, but it was always temporary. Soon after treatment, I would be back to square one.Eventually I looked for a new chiropractor and she was great. She noticed right away that my body leaned to the left and had x-rays taken. She said they showed I had a tilted pelvis. She gave me a heel lift and I saw her for several adjustments. Unfortunately, her daughter became ill and she chose to retire early. Upon a referral form her I saw a new chiropractor. The first appointment was great.They preformed a nerve function test and also took x-rays. They said I was a mess. About a week after my second adjustment, 2 in a week, I stared to experience back spasms. They were so bad I was unable to get off of my floor on several occasions. I chose not to go back to the chiropractor. I ended up in the ER eventually due to spasms. Soon after I started to experience sciatica in my right leg. When I went to my follow up for the spasm with my medical office, I brought this up. The doctor said I was fine because I had reflexes and no severe numbness. He sent me on my way with Flexeril. A week later I was miserable. Frustrated, I saw a different doctor at my primary care office. After several questions and evaluation he set me up for PT. The PT specialist had me do the same funny exercise as everyone before. But he noticed when I would do the tip toe walk, my right ankle would give out easily. I said I hadn't noticed , but that I was tripping a lot with that foot. After, he did the big toe exercise and I was able to resist with the left toe, but when we did the right, I couldn't believe I was trying so hard to resist but my toe had no strength. He said he wanted to talk to the doctor before any more visits. The office called and said the doctor wanted to seem as soon as possible. At the appointment he had me do the exercise and toe test. He also noticed I did not have reflexes in my right ankle. No change. He suggested an MRI to be sure this wasn't a bulging disc. The MRI did show a bulging disc as he suspected. It was the L4-5.I saw a neurosurgeon and she gave me options including surgery. I opted for a trial of a Prednisone taper. I did see improvement after a week and felt like it worked. However, about a week after the taper was said and done symptoms returned. I went back to neurosurgeons and said I was fed up. She offered another taper and this time it did nothing. I ended up having surgery to remove the bulge, but the bulge was not as severe as it had appeared on the MRI. I had the decompression July 31st 2008 and have not had any problems with the sciatica since. However, I am having a lot of hip pain again with the low back pain. I even have begun to notice I have been getting headaches a lot. I do seem to have a huge knot on the left shoulder region. I am afraid to see a chiropractor again and I don't want temporary fixes. I need this tilt fixed. I am hoping you can point me in  a direction or help me with which doctor I should start with first.

Answer
Rochelle Uren,

Hello Rochelle.  Sorry to hear of your ongoing problem.

Since you do not want to see any Doctor of Chiropractic, I guess the best suggestion for you would be to return to your original surgeon.
Since the surgery fixed your first problem, and you have faith in this doctor, I recommend a return to him(her).

The first surgery alters the structure/ architecture/ biomechanics of your spine.  Perhaps your surgery caused compensations elsewhere in your spine.  The best person to see, given your history and preferences would be a return to your neurosurgeon.

Even the headaches and muscle knot in the shoulder can be compensatory to the alteration of biomechanics by the first surgery. Spinal surgery often also results in adhesions (scar tissue formation) as a result of the surgery.  Sometimes a second or third surgery is needed to continue the correction started by the first procedure.

Given your success with the first surgery, I would return to the neurosurgeon for a new evaluation. Perhaps another surgery is necessary.

My recommendation:
Return to your first neurosurgeon he(she) knows your spine, knows the procedure performed, can compare your prior MRIs, EMGs, clinical findings to your current status.  Perhaps there is a surgery to correct this 'tilt'.

Good Luck, and I wish you Good Health, Naturally!


Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com      (Email Newsletter)





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pain after surgery:  http://en.allexperts.com/q/Chiropractors-965/2008/9/pain-following-surgery.htm

http://en.allexperts.com/q/Chiropractors-965/2009/2/Bad-Sciatica-low-pain.htm

http://en.allexperts.com/q/Chiropractors-965/2009/2/Pain-runs-leg.htm

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