Expert: Dr. Victor Dolan, DC, DACBSP - 6/6/2009

Question
I have had neck pain ever since I had my thyroid surgery 2 mo. ago.  I have recovered from the surgery but the day of surgery I asked the surgeon why the back of my neck hurt so bad and he said, "It is probably from the torque I had to put on your neck to get you in position for surgery." I am currently gettin PT which is amazing, but feel I need it more often than 1x/week. The X-ray, according to my GP and radiologist showed a fusion of C2 and C3, slight retrolisthesis C4/C5 and C5/C6. C5/C6 has moderately severe narrowing on the right. Also marked disc space narrowing. Mild diffuse disc bulge with associated hypertrophic spur. C6/C7Moderate disc space narrowing. Small-medium sized diffuse posterior disc protusion. This causes a ventral extradural devect, but no impingment on spinal cord.T2/T3 Small diffuse posterior disc protrusion.  T3/T4 Minimal diffuse disc bulge with associated hyptertrophic spur.
My GP gave me the feeling that something was seriously wrong on my xray. therefore ordered the MRI. When I got the MRI I had the feeling through thier questioning that something was wrong as well.  However, when I FINALLY was seen by the neurologist he told me there was nothing he could do and I just have some arthritis!  Could my doctor and radiologist not see that? Why Am I getting the runaround? Is it so I don't sue the surgeon for an injury? Is my MRI normal?

Answer
Staten Island Neck Pain, Staten Island Chiropractor, Staten Island Manipulation Under Anesthesia, MUA





Hello Deb,


I am sorry to hear of your neck pain.


".....I have recovered from the surgery but the day of surgery I asked the surgeon why the back of my neck hurt so bad and he said, "It is probably from the torque I had to put on your neck to get you in position for surgery.".....", I have performed many Chiropractic Spinal Manipulation Under Anesthesia procedures.  Among the first Doctors to perform, even to bring this procedure to New York State, New York City, I have seen Hospital and Ambulatory staff procedures in the Operating Room.  I must admit, at times I have been surprised with the gentleness of the staff.  I must admit, there were times when I was surprised at the roughness of the staff.

When we have procedures performed upon us in the Operating Room, we are generally sedated- either totally asleep, very 'drunk', or even just slightly 'woozy'.  Regardless of the state of anesthesia or sedation,,,, we often need assistance to move.  Sometimes the staff can be pretty rough.

My Chiropractic staff was/is  ALWAYS very gentle.  People were undergoing spinal MUA because of neuro-musculo-skeletal conditions.  We do not want to bruise/ contuse/ sprain/ strain/ initiate a new problem.

Sometimes, if we are not quick enough, the medical staff is rougher then us.  When people are 'out of it' and 'floppy', perhaps major injuries do not occur, but- as a Chiropractor- I respect the body and fear for even subtle injury.

I once had a little girl patient who had a stiff neck.  She was only 8- 9 years old.  She had to come to me for several months.  The initiation of her problem?  A tonsillectomy.  Here head/ neck were in an odd position for a time, while under anesthesia, and resulted in Vertebral subluxation of her C-spine.  Ultimately she fully recovered, but it was the surgery position that caused her problem.


"...I am currently gettin PT which is amazing, but feel I need it more often than 1x/week.....", depending upon your findings and progress, I agree, you may need to be adjusted more often then that to get to the CAUSE of the problem- the mechanical misalignment.



".....The X-ray, according to my GP and radiologist showed a fusion of C2 and C3, slight retrolisthesis C4/C5 and C5/C6. C5/C6 has moderately severe narrowing on the right. Also marked disc space narrowing. Mild diffuse disc bulge with associated hypertrophic spur. C6/C7Moderate disc space narrowing. Small-medium sized diffuse posterior disc protusion. This causes a ventral extradural devect, but no impingment on spinal cord.T2/T3 Small diffuse posterior disc protrusion.  T3/T4 Minimal diffuse disc bulge with associated hyptertrophic spur......"  - FUSION?- is this from birth, or did you suffer a trauma years ago to this area- resulting in degenerative osteoarthritis resulting in fusion?  What does your Doctor of Chiropractic (DC) say?

Retrolisthesis- again haw much trauma have you done to your cervical spine- motor vehicle accidents/ slips/ trips/ falls?  Certain Chiropractic Maneuvers may help this- C5 toggle, Peirce Stillwagon, Pettibon, ask your Doctor if these are the chiropractic techniques he(she) can utilize.

Narrowing, disc bulge, disc protrusion; you are going to ned a chiropractic regimen for quite a while with this much damage going on.

Hypertrophic spurs- what have you done to yourself?  This sign of OsteoArthritic degeneration shows trauma- whether habitual poor posture. poor lifting habits, or traumatic injury- you must be going to the Doctor of Chiropractic for years to battle these problems.


"....Is my MRI normal?...."= "Mild diffuse disc bulge with associated hypertrophic spur. C6/C7Moderate disc space narrowing. Small-medium sized diffuse posterior disc protusion. This causes a ventral extradural devect, but no impingment on spinal cord.T2/T3 Small diffuse posterior disc protrusion.  T3/T4 Minimal diffuse disc bulge with associated hyptertrophic spur...."= no this is not normal.
This shows a neck with longstanding problems.

Is your Xray normal?= "....The X-ray, according to my GP and radiologist showed a fusion of C2 and C3, slight retrolisthesis C4/C5 and C5/C6. C5/C6 has moderately severe narrowing on the right. Also marked disc space narrowing....."= no this is not normal. This is an Xray of longstanding deterioration, degeneration.

I do not particularly see any NEW injury.  I do see a neck that has had problems for years.  Stiff necks, poor postures, possibly injuries treated with painkillers that 'killed the pain', but did not get to the CAUSE of the problem and the neck deteriorated over time: narrowing, spurring.

I utilize a couple of handouts in my Staten Island Chiropractor office that may be helpful to you:




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).



ACCELERATION  OF  ARTHRITIS:

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.


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



Another information sheet:





OSTEO-ARTHRITIS
Degenerative    Disk     Disease


DDD = Degenerative Disc Disease;  

OsteoArthritis-

THE most common Arthritis-  the ‘wear and tear disease’ .                         DJD = Degenerative Joint Disease; = similar/ same OsteoArthritis.


Degenerative Disc Disease  (old term =  DJD) is  actually  a  quite  common  condition.   However,  the course of the condition   is  highly variable.   Some patients with DJD literally cannot walk, yet other patients with similar X-ray/ 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.  DDD, DJD,  OsteoArthritis, -  deteriorating discs (disk)   is/ are  often caused by,  or often  concurrent with the Vertebral Subluxation Complex.  


VSC is a misalignment which hastens deterioration of the joints involved.    

Misalignment/  improper motion patterns  CAUSE/ HASTEN  OsteoArthritic degeneration.


         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 joints, and can cause 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) 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.  Subluxation may cause 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.

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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I hope that information helps you.

If you need further,,, do not hesitate to REcontact me here at
AllExperts.
http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm



Wishing you Good Luck, Good Health and a quick recovery,
your Internet Chiropractic Staten Island Expert,


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