Expert: Dr. J. Shawn Leatherman - 3/15/2007

Question
Can you assist with a decision?  Would MUA or Epidural injection help me and if so what which would the preference?  MRI shows straightening of the cervical spine, torticollis convex to the right, anterior protrusion at C5-6, no bone bruise or fracture, C5-6 has central herniation indenting the spinal cord.  L1-2 is a right, para-central herniation indenting the thecal sac, L2 nerve root radiculopathy, L2-3 central herniation indenting the thecal sac, L3-4 & L4-5 bulge indenting thecal sac. L5-S1 bulge tangent with thecal sac with bilateral neural foraminal narrowing.  All due to car accident, rear end collision.  Too many opinions right now are clouding my decision as doctors and specialists point to the other's recommendation as no good.  How is a lay person supposed to know what's best?

Answer
Dear Alice,  

Sorry to hear about all this, I know that all the opinions can be confusing, and rear impact collisions can cause significant injuries.    

Well my initial opinion would be that you should try the MUA first as an epidural injection is not treating anything, only covering up the pain.  

Let me qualify that though:  MUA is a procedure that should be reserved for someone in chronic pain who has tried conservative management of pain and disability first.  This means that you should have initially been treated with chiropractic care,  massage, traction, physical therapy and minor pain prescriptions first.  If you have tried these options for more than 6 weeks and are not seeing any results, then you are definitely a candidate for MUA.  

Epidural injections should have a significant impact on the pain, but they will not change anything at the sites of injury other than some reduction of inflammation. They will do absolutely nothing for the bulging disks! Injections work by deadening the transmission of pain from the nerves and spinal cord to the brain.  If the brain does not receive the pain message then it also cannot interpret the pain, therefore you are not affected by it.  

Injections of all kinds can work, but many people do not get any benefit.  Epidural injections can also cause significant headache pain if the dural sac of the spinal cord is punctured or nicked.  This should be explained to you by the doctor who wants to perform this procedure.

Other options to look into:  Intervertebral disk decompression.  This treatment has had some controversy due to the high prices some doctors charge for it, and the fact that there needs to be more research, but I have seen disk patients get great results after treatment.  you should explore this option and get more information about it.  Do an Internet search about "DRX 9000", "Spinal Aid Centers", and "Accuspina".  These are the top machines on the market in my opinion.

Additionally, I would recommend that you read over, www.srisd.com.  This website will supply ample amounts of researched information about rear-impact vectored collisions that you can trust.

If you have any further comments or questions Alice, feel free to write back.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net