Can chiropractors manipulate paralyzed people?
Disc problems - "How long does it take without surgery for back pain to decrease?"
During an MRI, I happened to have a slight herniated disc in my cervical spine. But I have no problems. Will I face difficulties in the future?
Patric Gross: You can often find such changes as a chance finding. As long as the typical pain (radiation in the arm) is not present, you do not need to worry. Avoid monotonous loads and do regular exercises for posture and neck muscles.
A bone splinter caused by an accident is stuck between C6 / C7. The pain increases with age. Can you improve something with targeted muscle building?
Iris Wehrle: A very targeted muscle building with therapeutic exercises can improve the functional stability of the cervical spine. This can help relieve pain.
I (40) always have problems with my neck / cervical spine. Coincidentally, in the MRI one also saw wear and tear in this area. Recently I suspected that my annoying temporary dull feeling in my ear was caused by the cervical spine. Can this be?
Martin Sailer: Good evening, the feeling in the ear does not typically come from a typical intervertebral disc. Arthritis of the cervical spine is rare and causes radiating pain in the ear. An MRI examination of the cervical spine is the first thing to do. A SPECT-CT can help as a second examination.
+++ I don't have a question, I just want to tell you that I had an operation on my spine in 1992. (L 4/5) I am glad I decided to have the operation back then. 4 of 5 doctors advised against me. Only one doctor (neurosurgeon) recommended the operation to me. I am still grateful to him for this. The cost of the operation is approx 9500 CHF. Without the operation, I would have done X cows in these 26 years and paid X times as much. +++
I (38) already had two herniated discs. I am a passionate skier, mountaineer and mountain biker. At the moment everything is ok again. Is it dangerous to continue practicing my favorite sports? I just don't see myself as a Nordic walker and back swimmer ...
Martin Sailer: No, it is quite possible to go skiing again or to climb a mountain. There is no scientific data on certain sports that are unfavorable. Anectdotally, I can add that strong rotations of the spine, for example in golf, are not optimal for the intervertebral disc.
How quickly is the "protruding" part of the intervertebral disc broken down and how? For example, swimming in physiotherapy and sports without beating? About 5mm per year? Your own assessment as a person affected: about 1mm in 4 months.
Martin Sailer: Good evening. The spontaneous degradation can be seen in the range of months. Often there is an improvement after a few weeks, around 6-10 weeks. The specialist doctor can estimate how long it will take based on the MRI image. In some cases, it is possible to predict when a herniated disc will most likely not resolve.
My friend (16 yrs) plays football and he had pain in his back and legs. Sometimes he can hardly walk, I'm really worried about his back, could you please give us a feedback
Martin Sailer: If the complaints persist for more than 3 months at a time, I recommend a consultation with your family doctor.
Good evening, I've been suffering from severe low back pain for six months. I have already carried out that examination and no improvement! Specialists said that there was evidence of atrosis and that I was not allowed to work immediately! I have a lot of charisma in my right leg! Pain and uncontrolled cold constantly invade my leg! At the moment I am cared for by a naturopath who tries to clear the nerve pathways! I don't work and it's getting worse and worse!
Martin Sailer: Since your symptoms have existed for 6 months, I recommend consulting your family doctor or a specialist such as a rheumatologist. Your description suggests carrying out a more extensive examination, e.g. a careful neurological examination, including an MRI there, depending on the findings.
The lower part of my back has been causing me a lot of problems for a good 2 1/2 years: a specialist cracked me out at first. it helped at first and then it worked again. But lately the problems are coming up again. What else can you do?
Iris Wehrle: It would certainly make sense to visit your family doctor or a rheumatologist to clarify the problem more precisely. He will decide whether there is a serious problem or whether conservative therapy can be continued. After the cracking only helped for a short time, I would try physiotherapy treatment. Besides cracking, there are many other ways to get such problems under control. It is often the case that the lower lumbar spine can be stabilized with differentiated, active exercises and thus an improvement can be achieved. Such exercises can be shown to you by a physiotherapist or a manual therapist. In addition, we always look at their everyday life and work situation with our patients with regard to ergonomic improvements.
Good evening I have suddenly had pain in my back since this morning, can hardly bend down, have now anointed my back with a pain reliever ointment, when should I go to the doctor if the pain is still there, do you recommend? Can it be that you can have a herniated disc at the age of 20? Thanks for the answer.
Patric Gross: Acute back pain is very common, luckily it usually improves quickly. Try to exercise regularly and possibly take painkillers. If the pain does not improve within 3 days or mainly radiates into a, contact your doctor. Yes, herniated discs are also possible at 20, but muscular problems are much more common.
Good evening. For a long time I have had the problem that my right leg keeps going a little numb while sitting. Even when sleeping it sometimes gets numb easily. Can that be from the intervertebral disc? Or is that more of the sciatica?
Patric Gross: That has to be examined clinically very carefully. In addition to the nerves and intervertebral discs, the gluteal muscles or other muscle groups are very often tense. This tension also very often causes numbness and radiations. Contact your family doctor or a rheumatologist.
In 2015 I had a severe herniated disc, could no longer walk at the beginning of June, was totally paralyzed in my right leg, was taken to the hospital with the ambulance, was only operated after three weeks, because of the physio, the surgeon has confirmed that, if I Had I not had an operation, I would have remained paralyzed, had an incident between the 4-5 vertebrae, now have a brace in my back, who would be responsible if I had remained paralyzed.
Martin Sailer: In principle, all those treating are obliged to inform you about the risks and options of therapy. Every therapist should educate you about alternatives and risks. When in doubt, it makes sense to always ask for a second opinion.
Iris Wehrle: Warmth often helps with tension. At home you can do this with a cherry stone pillow, or you can warm up one of those blue cold packs that most people have in the fridge and place it on the tense area. Basically, it also helps to exercise regularly to prevent tension.
Good evening, I have been suffering from a herniated disc in the lower lower back for several years. At first I had infiltrations on a regular basis. For over 5 years I have been doing fitness regularly and therefore have hardly any pain (I feel it as a kind of sore muscles in my back). However, if I don't go to fitness for a week, I feel the pain more. Is that possible? Do I need to try another option? Many Thanks!
Patric Gross: You are doing well! Due to the weak point in the back (wear and tear on the intervertebral disc), you should always train your muscles well and keep them in shape. This can protect you for a long time and for a long time. The training may also have to be checked in physiotherapy to see whether you are doing the right exercises at the right intensity. In the case of recurring pain in the back in the same place, targeted injections may also be used.
I have had a double herniated disk for 4 years. Now I will be operated on shortly and the question arises whether I want to be operated on from the front or from the back. (I have a stiffening in the lumbar area) Which variant can you recommend?
Martin Sailer: The procedure from behind is standard. Basically, the intervention from behind is safer. The intervention from the side or from the front may be faster. It depends on small details. If the patient is trapped in the spinal canal, i.e. at the rear, an intervention from the rear is required.
How do you rate the treatment of the herniated disc by a chiropractor?
Patric Gross: A modernly trained chiropractor can often help. It is important that, in addition to the mobilizations and manipulations, he also treats the muscles, gives you exercises or instructs you in strengthening the muscles. Depending on the course, he can also refer you to targeted injections.
In 2010 I received an artificial disc 6/7 my left arm which was pretty paralyzed how long does this disc last it is not copper many thanks for an answer
Martin Sailer: There are still no long-term results from intervertebral disc prostheses. The materials are typically chosen by the companies to be as robust as possible so that the prosthesis should last as long as possible. It also depends on the type of prosthesis. Please state the type of disc prosthesis used. I assume that a prosthesis should work for decades.
Good evening, an MRI showed a protrusion in all 5 lumbar spines. Do you need an operation? My doctor thinks more of special strength training. Thank you for your opinion.
Patric Gross: That depends extremely on your symptoms and the clinical examination. If there is back pain without clear radiation in the legs (back pain dominates), conservative therapy should certainly be tried intensively. Strength training is a very important support here. Try as much as possible before an operation in your case!
For a few years I have had my incident on the 5th and 6th cervical vertebrae well under control with osteopathy and sports etc. For two months severe pain, especially in the arm with numb fingers, etc. Pain almost unbearable. What can I still do to avoid surgery if I have already done so much conservatively? I just made an appointment with the orthopedic surgeon. I am also not in favor of operating quickly, but after a long time with severe pain you will eventually have enough.
Martin Sailer: I definitely recommend infiltration to calm the trapped nerves. This is a sedative injection under X-ray control. I also recommend shock wave therapy. On the other hand, I would rather choose an operation if you have severe pain or paralysis that lasts for at least 3 months.
In 2001, vertebrae L4 to S1 were stiffened in my case, but I still have severe pain at the operated site, "tense" as if trying to break a branch, the pain becomes unbearable when exposed to stress! What do you advise me?
Martin Sailer: The first thing you need is a specialist clarification, e.g. from a rheumatologist, also a spinal surgeon / neurosurgeon. It needs an analysis of exactly where your complaints come from. First and foremost, a precise examination, then, if necessary, a SPECT-CT examination and diagnostic infiltration helps.
Good evening, I have had an incident at the L5 / S1 level, actually without any complaints so far, now a pulsating tingling sensation in my heel for a few weeks. Can this be from the hernia?
Patric Gross: As a rule, the affected nerve would cause radiating leg pain (on the right side), extending from the buttocks into the thighs to the calves. Just pulsing without sensory disturbances, leg pain or back pain is very atypical. But there are other reasons for tingling in the heel as well.
According to the MRI, I have 2-3 herniated discs in the lumbar region. I feel this mainly in the left thigh, where numb skin often occurs. I perceive numbness differently. Sometimes more sometimes less. What do you advise me? Seeking a specialist? Physical therapy? Thank you for an answer.
Patric Gross: I advise you to discuss the results of the MRI with a specialist. With a rheumatologist, the findings and your complaints can be precisely analyzed and an optimal treatment plan can be drawn up. It is important that the imaging and clinical findings match exactly.
Mr. Sailer, for almost 2 years I have been suffering from a herniated disc in the cervical vertebrae 5 or 6 .. injections have already been made twice, physio just like that now I am in cranio sacral therapy ... Painkillers only work with co dafalgan because I am already immune am ... my neurologist (have epilepsy) does not welcome the co dafalgan, also took measurements of the nerves because hands up to elbows keep going numb ... when is an operation recommended? Or retraining allowed? Retail trade ...
Martin Sailer: You have not yet tried all therapeutic conservative measures. First of all, I recommend shock wave therapy, neural therapy is also very helpful. Surgery makes sense when your quality of life is getting worse and worse. This is especially the case with pain and disturbances of strength. Retraining is not necessary after a successful operation.
How mature are intervertebral disc prostheses today?
Martin Sailer: You are so mature that I would immediately have one inserted in the cervical area myself. So far, there are promising candidates in the lumbar region, but not yet an excellent model. The long-term results, e.g. after 50 years, are not known. But that wouldn't stop me from having one of my own.
I had a herniated disc in April. The pain is over now, but I have no feeling in my heel and sometimes down to my toes. I do gymnastics exercises that the physio showed me. So far there are no improvements. Can you recommend any other therapy or what would you do if you were me?
Iris Wehrle: The nerve is a structure that reacts very slowly. That is why the symptoms caused by the nerve, such as tingling or numbness, often last much longer than the pain itself. There are physiotherapeutic options for treating the nerve. However, these are often only used by therapists trained in manual therapy. You can find a list of therapists with OMT, i.e. additional training in manual therapy, on the homepage of the manual therapy association SVOMP. The symptoms that the nerve always causes need one thing: a lot of patience
I (36 y.) Have a pronounced protrusion LW5 / S1. Was injected with depot cortisone 100 days ago. Now the pain is only sporadic and I do physiotherapy. To what extent do I have to "take it easy" with lifting, bending, carrying, etc.? MERCI!
Patric Gross: Your back and leg pain have gotten better. It is now important not only to take it easy on yourself and not do anything for your back, it is very important to carefully build up the load, possibly with physiotherapy and medical training therapy. So, as long as the right muscles are functional again, you can put weight on your back again!
For almost a year now I've been suffering from lower back pain, sometimes more and sometimes less. Bending over in particular is often problematic. I am 75 years old and have always done a lot of sports. Currently still up to 3 hours a day, alternating between swimming, cycling and running. In addition, one hour of stretching, strength exercises and balance exercises every day. So otherwise in top shape. These back pains are less (or even get better with cycling. This gets worse with running. Your advice?
Martin Sailer: First of all, I recommend contacting your general practitioner and having him conduct a thorough examination. Basically, if you have repeated or even permanent symptoms for 3 months, you should consult a doctor. In most cases, an easy cause can be identified. It is also helpful to have a diagnosis at all. There are now many successful therapies for back pain.
How long is the incapacity to work in the office job after an operation on L4 L5
Patric Gross: You often have to reckon with 4-6 weeks, as you often sit in the office in a place without movement. It is important to have an ergonomic workplace, i.e. a height-adjustable table, the possibility of standing in between, walking short distances and doing the exercises you have learned.
Good evening. I've had back pain for years, which is probably also caused by a large bust. Now I had to go to the MRI for another evaluation where the whole back was scanned. It has now been determined that I have three herniated discs. Two lighter ones, and in the case of the incident in the lumbar region, the capsule has already torn.I have had more lumbar pain for a week now and have been taking Olfen duo 75mg for five days. How next?
Patric Gross: Based on the pictures, you can't decide whether your back pain is really something to do with the herniated disc. You have to study it carefully. Often there is simply an imbalance between the muscles, the loads and the posture. Targeted muscle training can help, but it takes some time to feel the effects. In the meantime, you can take short-term pain relievers like Olfen.
Good evening, I'm 29 years old and have been suffering from slipped discs since I was 15..Have 3 pieces in the lumbar spine where they are "worn out "..I went to a specialist because I'm getting tired of taking such strong medication where against the pain doesn't heal that much in an incident anyway .. My question would be, what else can I do? I also have psychotherapy, try to eat healthily and do sports as well as possible ..
Martin Sailer: I also look after professional athletes from various national teams. They seem to be very active as well. There are several very effective therapies for your situation. Important: there is a possible genetic cause of disc problems: a change in the vitamin D3 receptor. Maybe this plays a role for you. Regular intake of vitamin D would help there - however, prior clarification is necessary.
I have had shoulder pain for almost 3 months and have already been to the family doctor who sent me to therapy for 9 times. I've been there 8 times, but it didn't get any better. Should I go to the specialist after the nine times? And 2 ask where can it come from that I have pain every month when I struggle, only painkillers help or let's say the Saridon 400 I look forward to your answer
Iris Wehrle: If a problem did not get better after 8 treatments, I would speak to your therapist first and ask her how she assesses the problem and what she would suggest as a further course of action. Then I would also report back to your family doctor that not much has changed in your symptoms and discuss with him whether further clarifications are necessary or whether this problem simply needs more time or another therapy.
Since my herniated disc 5 years ago, my lower left leg has been numb and I often have cramps in that leg. Can that be alright again? Thank you for your reponse.
Martin Sailer: Basically, the regeneration of a previously pinched nerve takes a lot of time. The regeneration is estimated at 1mm / day. That means it can take years. I know patients who have improved after 14 years. The vitamin B complex is generally recommended. A detailed neurological examination by a spinal specialist is useful for you.
Good evening, I've had back problems for about a year. They were always bearable. Two weeks ago I had an incident with terrible pain in my leg. It was like a cramp was choking everything off. I was then given a cortisone injection. I got the diagnosis: segment collapse with broad-based disc herniation in osteochondrosis with inflammatory activity. LWK 4/5. An operation was recommended to me. Is there an alternative solution for me?
Patric Gross: If the cortisone injection has worked, you can wait well and possibly repeat it later. Often there are also different syringes which can "attack" the problem from different places. If the back pain is in the foreground and no paralysis occurs, I would recommend intensive physiotherapy, possibly an examination by a rheumatologist, before agreeing to an operation. You can always ask for a second opinion.
Good evening, according to the MRI, I have slight herniated discs in my cervical and lumbar spine. Every now and then I have a tingling sensation in my right hand. Last year it was very bad for a while. 18x physiotherapy did not help. It only got better after 6x chiropractic therapy. Now my question: How can I prevent that I do not have to operate? Are there physical exercises or should I see an osteopath from time to time? Thank you very much for your answer!
Iris Wehrle: Chiropractors and osteopaths mostly work with passive interventions, such as manipulations, etc. If you want to have a problem under your own control over the long term, you usually have to work actively, i.e. with special exercises. If the previous physiotherapy has not helped you, I would recommend a physiotherapist who is trained in muscle balance or manual therapy training (OMT, SVOMP, see list on the homepage: www.svomp.ch, link opens in one new window).
Good evening, within about 2 years I received 3 cortisone injections in the back. After each injection, I am fine for a few months. . I noticed that nobody mentioned syringes. How do you rate this treatment? Thank you for your reponse!
Patric Gross: Treatment with injections (infiltration) is an important element of conservative therapy. The inflammation around the nerve often succeeds in reducing the pain for a long time and clearly. It is always important to combine it with physiotherapy and training. The injections are usually simple and can easily be repeated (max. 3-4 times a year in the same place).
According to Emeri, I have slipped vertebrae (between the 4th and 5th lumbar vertebrae). Severe pain / radiation in the right leg. No paralysis or numbness so far. The vertebra presses on the nerve canal. This was shown by an x-ray while bending forward and backward. A spinal specialist and surgeon told me I was walking into a paralysis. I should operate (screw). Should I get a second opinion or is the case possibly clear? With a rheumatologist. Thank you very much.
Martin Sailer: In general, it makes sense to get a second opinion before an operation. If there is no paralysis, you have plenty of time to get a second opinion. Contact either a rheumatologist, neurologist, or spine surgeon. With a sliding vertebra, the pain often worsens over the long term. Often times, stabilization / stiffening is actually the therapy chosen successfully when the other therapies do not work.
At the end of June, I suffered my third herniated disc with severe pain. The pain subsided after about 3 hours. However, I still have a numb feeling with a tingling sensation in my foot. At first I had to limp while walking, now not anymore. Sometimes the tingling sensation is so strong that I can barely sleep at night. Does this numbness and tingling sensation go away conservatively?
Martin Sailer: The numbness can be a sign of a severe disorder / severe damage to a nerve. In my experience, however, there is still an improvement after years. I definitely recommend vitamin tablets with the vitamin B complex. The tingling sensation can be interpreted as a sign of regeneration as well as an ongoing entrapment of a nerve. Here I recommend getting a second opinion from a specialist.
I was born on August 9th and 16th After 9 months of conservative treatment (painkillers, physiotherapy) the lumbar vertebrae were operated twice (spinal canal narrowing, herniated disc. The first operation was unsuccessful, on the day of the operation, the pain was the same when the first time I got up and in the same place the pain gone. According to the surgeon, a cyst in the spinal canal was "complicit" for the pressure on / or the nerves. After discharge from the hospital, I was pain-free for three or four days, then b
Patric Gross: I hope you are well again now. With a narrowing of the spinal canal, it often takes a while until you are able to bear weight again after an operation. Intensive follow-up treatment is important as soon as your surgeon allows it. The muscles have to be strengthened, physiotherapy or rehabilitation is necessary.
Herniated disc for 3 years, injected twice after annual CT scans. Slight pain in the lower back remained, especially the massive radiation in the legs and feet, as well as slight paralysis in the left foot. Should I get a physiotherapy prescription from the rheumatologist right away?
Martin Sailer: If you continue to experience similar radiation of pain for more than 3 months, I recommend consulting a specialist, e.g. a rheumatologist. Therapy first requires a diagnosis. It is important to get an accurate diagnosis on you. There may be some therapy that is more effective for you than physical therapy. In most cases, correct, so-called isometric physiotherapy for the back is optimal and essential.
Good evening, a week ago I was diagnosed with a "voluminous" discus hernia, lws5 / s1, the pain radiates to the sole of the foot, but this has improved for two days because I do exercises by "walter packi" (pain therapy), tomorrow I'm going to the physio for the first time. My question; I have been taking the medis (ipuprofen 600mg + dafalgan) for a good three weeks ... I also take gastric acid blockers). Can I still take this? The pain is mainly from sitting to getting up. Walking is good
Patric Gross: If you are otherwise healthy and can take the medication well, you can take it for a little longer. If the symptoms have decreased during the therapy, you can gradually reduce the painkillers (first ibuprofen, then Dafalgan). Other treatments, such as local heat or exercise, can also help relieve pain. Try it!
Are movements or stretching exercises forwards or backwards better to restore the intervertebral disc to its original shape? for me c6 / 7
Martin Sailer: No, extreme movements of the intervertebral discs put more strain on them than they are useful. Disc herniations tend to occur in the first place during rotation and flexion. On the other hand, if you sleep on your back, it is better to use a flat pillow.
Despite therapy, I haven't been pain-free for the last 5 months. It's okay in the morning, but in the evening my upright walking deteriorates. My head is lowered further and can only look ahead for a short time. Is that normal? What role do the back muscles play? Does it make sense to start advanced training?
Iris Wehrle: I think it would make sense for you to try to find out with your therapist and the treating doctor why the symptoms keep increasing so much during the day. For example, have you talked to your therapist about your work posture or the stress at work and looked at what you could possibly improve? If your discomfort is so severe that you can no longer look straight ahead, you must first get that pain under control before you can exercise.
+++ I don't have a question but a comment. What I missed about today's broadcast is the reference to the danger of chronic pain. I didn't have the operation too quickly and tried to get my pain under control with injections, physio and complementary medicine. The result: 2 operations, the 2nd with "stiffening", nevertheless chronic pain with daily medication with Targin and Lyrica! This danger should have been mentioned! +++
Since 2011 I have been diagnosed with a slipped disc S1 / L5, initially with radiation to the leg and at that time symptoms of paralysis. With a special therapy (MedX device) and physio, I had it more or less under control and an operation could be avoided. But I always had pain in my buttocks and legs (when walking and standing). Now after 5 years it has got worse again ... Is an operation really that risky and a last option? Are there any statistics about it?
Patric Gross: It depends a lot on whether the situation is still the same as in 2011 (pinched nerve in a herniated disc) or whether new changes have occurred. Intervertebral disc surgery is good for leg pain but hardly anything for back pain. There are certainly other options, have the situation re-clarified and reassessed (rheumatologist or spinal specialist / surgeon).
hello i have had a ban disc for 2 weeks. i take irfen 400mg twice a day i only have pain while walking. how long do i have to limp on my left leg? does it go away by itself? does moving, so running (without walking) is good? what can I contribute to the healing.how long does such a healing time take.I'm 61 and unfortunately 95 kg since I stopped smoking.was training, but has now stopped.tampoline and walking.it no longer pulls up to the leg.but have less strength in the left
Martin Sailer: Quiet is usually best. Too much activity, especially bending and twisting the back, is unfavorable and can aggravate a herniated disc. It is important to lie down (sleep) at least 8 hours per night. The intervertebral disc regenerates mainly at night. If you have the following symptoms, you should consult a doctor immediately: paralysis in the leg / foot; You cannot dissolve more water or lose urine without your wanting to do so; strong pain. The strength in the leg increases faster with vitamin B and targeted physiotherapy.
About 15 years ago I had an acute herniated disc, inc. CT, I was trained in stages over a long period of time by the chiropractor Dr. Daniel Mühlemann treated. With long-term success. Why is this chiropractic method not mentioned? very inexpensive and usually a surgical procedure can be prevented.
Patric Gross: Chiropractic belongs to the conservative therapy. in combination with exercise and muscle training, this is often a very efficient form of therapy.
I have a segment collapse with a broad-based disc herniation in the LWK 4/5. An operation was recommended to me. I was given a cortisone injection for excruciating pain that went into my leg. Is there an alternative treatment for me?
Martin Sailer: A broad-based disc herniation is not mandatory for an operation. There is always alternative treatment. Often, however, severe paralysis must not be missed / overlooked. In the case of bladder disorders, an operation is mandatory. There are e.g. shock wave therapy, also neural therapy.
Good evening. In February the pain started in my leg. In April I had an MRI and they found a herniated disc. I had physiotherapy and had an infiltration done at the end of May, with moderate success. Since the beginning of September I have had massive pain in my leg again. I am 36 years old, the mother of 2 children and I am employed. The pain is always more intense and grueling. Would you advise me to have an operation, or rather more conservative? Thank you for your reply.
Patric Gross: If you have the same pain in your leg again and have had repeated targeted therapies for months, including muscle building training and possibly multiple injections, I would seek advice on the operation. After more than 6 months of intensive conservative therapy, surgery can be discussed. But it is a decision that also depends on you, especially on your patience. Another alternative is intensive treatment with inpatient rehabilitation.
Goodnight. I was diagnosed with a moderately discreet erosive osteochendrosis L5 / S1 with evidence of a small, somewhat paramedian dorosal shift with emphasis on the left and slight compression of S1 on the left as well as discrete discopathy also L4 / 5 with evidence of a small median disc protrusion without contact to neutral structures (MRI) . Radiance in the left leg, partly to the heel, it's my turn physio what other alternatives do I have? Obs is not an issue for me so far
Martin Sailer: Please try neural therapy once. Osteopathic stretching therapy is also recommended. Please contact a specialist for a second opinion.
Dear Ladies and Gentlemen. I had an operation on my back 4 years ago. Diagnosis by the doctor after the operation: status after decompression and interbody fusion L5 / S1 with foraminal root compression L5 left. or more satisfactory progress in terms of pain. Now I have pain again, especially in my right ankle. A new MRI was done on October 25th this year. Diagnosis: Clear critical spinal stenosis on levels L2-L3, L3-L4 and slight to moderate narrowing on L1
Patric Gross: If the pain is not only in the ankle, but rather in the whole leg and is provoked by walking or standing, there may be a connection with the back. However, spinal stenosis can be treated conservatively (also with special injections in the back) as long as there is no paralysis.
Since mid-September I have had back pain that radiates down to my ankle on my right leg. Physio brought little relief. That's why my family doctor arranged an MRI. I quote from the report: Severe bilateral facet joint arthrosis and disc herniation LW5 / SW1 ... Subtotal obliteration of the spinal canal LW4 / 5 ... Spinal canal stenosis with compression of the cauda equina LW3 / 4 ... My doctor recommends an operation. Is a second opinion advisable? How should I proceed? Thanks!
Martin Sailer: Yes, a second opinion is generally recommended, especially if a serious diagnosis and an operation are up for discussion. Don't forget that there are often alternative therapies that can avoid surgery. Ask your family doctor to register for a second opinion.
For more than 3 years, I have had severe pain in the lower vertebrae (in the buttocks), especially at night. The pain is less during the day. Does this indicate a herniated disc or rather a narrowing. What is the difference. I'll be 70 next year, otherwise I'm healthy.
Patric Gross: That has to be examined carefully. In addition to the frequent problems such as muscle tension, wear and tear or problems with the bend disc, there are also less common causes such as inflammation in the spinal area than a disease of its own. Night pain in the back should be carefully examined. See your family doctor or a rheumatologist.
Good day. Just like in the example mentioned in the show, a doctor asked me about the risk of wear and tear on the cervical spine after an MRI. Do exercises help? If yes, which? Or can you not really influence the course?
Iris Wehrle: It seems important to me that you take care of your cervical spine. This certainly includes the most ergonomic load possible in everyday life (i.e. at work, but also in leisure time). What exactly is meant by this in your case, you would have to take a close look at with a physiotherapist who is familiar with your everyday stress. So that the muscles are efficient and enduring enough to carry us through life in the best possible posture, there are individual therapeutic exercises.
Good evening, almost exactly 1 year ago I had an operation on my intervertebral disc. After 3 weeks everything was back to normal, the radiation was back and on the MRI you could see that there was another incident on the same intervertebral disc. An infiltration did not work, a new operation was not recommended because of the existing scarring and now I was an implanted device is recommended as one of the last options, which is supposed to replace the pain sensation with an electrical impulse!
Martin Sailer: Good evening. If you clearly still have a pinched nerve, the first thing that should be eliminated is this major cause of your discomfort. It is not beneficial to choose symptom treatment if the cause of your pain has not been addressed. Scarring is generally more difficult to operate, but it is definitely operable. Depending on the exact findings, the risk of a dural leak could be increased.
Good evening, I suffered my second herniated disc three weeks ago. In the same place the lower lumbar vertebra L5. The first operation went very well. I don't know whether I should follow the advice of my family doctor to have a second operation. What alternative is there that can help in the long term? How do you get the troubled nerve free again? What happens to the defective intervertebral disc without surgery?
Patric Gross: I would wait after the first operation and continue conservative therapy. This includes intensive physiotherapy including active strengthening exercises, possibly targeted infiltration and possibly inpatient rehabilitation treatment. The operation should only be carried out soon in the event of paralysis.
Infiltration made 10 days ago, still no pain relief in the leg. Is that normal? Diagnosis DH L5Si
Martin Sailer: If you have had a root infiltration, the best thing to do is to do a sacral block now. Of course, all the details are always important. Caution: if you are paralyzed and / or in very severe pain, it is essential to ask your family doctor and / or specialist.
Since my LSW4 operation 1 year ago I have suffered from muscle cramps in my right calf. Always in the morning when I stretch in bed, sometimes in the middle of the night and during the day. It is the leg in which I also had severe pain, including symptoms of paralysis. I've been in the gym twice a week since January to specifically build up my muscles and go for a walk on the weekends. What else can I do about it?
Martin Sailer: In the case of muscle spasms, a careful work-up is required first: a neurological examination, probably a current MRI examination with gadolinium to search for scars. Depending on the cause, drugs with a vitamin B complex can help. It is important to discover the cause, then choose a therapy. Could the nerve still be partially pinched?
I have had pain in my lower back for some time, radiating to both legs and calves. It feels like sore muscles. I am 90 years old and walk about 4 km every day, but I have had physio without real success. I do it every day Exercises to strengthen the back muscles. The pain is not so strong that I would have to take painkillers. My question: would massage or special physio or swimming possibly use underwater massage, can you massage the back with Blackroll? thanks
Patric Gross: You can definitely try to use the Blackroll, of course, targeted physiotherapy would also be helpful. If this is unsuccessful, however, a spinal stenosis must be sought / excluded, here again other therapies including special injections are possible.
Two and a half years ago I had an acute herniated disc in the cervical area. The pain almost went away with tablets, diclofenac injections, physiotherapy. The feeling in the fingers never quite returned. Is there any hope that the feeling will return completely over time or is that only possible with an operation? Depending on the activity, pain in the vertebral area occurs sporadically, but until now there have hardly been any need for pain medication.
Patric Gross: If the severe arm pain no longer occurs, an operation is certainly not helpful. The nerves grow back extremely slowly and falling asleep can improve even after years. But there are also other reasons for fingers falling asleep on the hands, which of course must be ruled out (family doctor, possibly neurologist)
Good evening. With certain movements and while sitting, I have stabbing pains and a constant pull in the rather right lumbar / pelvic area that radiates over the buttocks and into the back extensors. How much pain should you endure? When is there a suspicion of a herniated disc? For professional reasons, it is not possible for me to take it easy physically. Should you take it easy at all, or does it help if you do exercises? Thanks for the answer.
Martin Sailer: In general, I recommend keeping your back very straight and not bending and turning for another 6 weeks if you have pain that lasts longer than 6 weeks. I recommend contacting your general practitioner if you experience pain that affects your quality of life. A herniated disc consists of pain that, for example, radiates from the buttocks over the hips into the groin. Yes, protection is important for a damaged intervertebral disc. Min. 8 hours of sleep or love per night helps the intervertebral disc to recover.
Dear Sirs, About 2 months ago I was diagnosed with a herniated disc with an MRI. After a CT-guided infiltration, the pain (sciatica) has largely disappeared. I have been doing physiotherapy for 2 weeks, feet are still partially numb, every morning there is "tingling" in the leg and the muscles are slowly regaining their strength. Question: when can I start fitness and jogging again? Many Thanks.
Iris Wehrle: The physiotherapist, or the therapist treating you at the moment, can judge that best, because he or she examined you thoroughly at the first consultation. Since it is important, before you start fitness training and jogging again, to make the deep stabilizing muscles efficient again with specific exercises, you should discuss this structure with the treating therapist. She will be able to tell you when the right time is ... and also then: build up the training slowly and in small steps so that you can assess how the intervertebral discs and the nerves react to it.
Good evening What experiences do you have with neurostimulators in pain therapy when operations do not help? thank you very much
Patric Gross: First of all, the exact cause of the pain has to be sought in a targeted manner. If there is no specific treatment (atypical symptoms, scarring or other reasons), a pain specialist can do tests to see whether a neurostimulator can work for you. It is one method among many ...
I have had back pain for 9 years. However, it has only radiated into the legs for about 4-6 months. Since the end of July I have had the diagnosis of a slipped disc L5 S1 with light pressure on the nerves. My therapist told me that the pain in the legs comes from the tense muscles and not from the intervertebral disc. Could it be that in addition to the intervertebral disc that presses on the nerve, the muscles also hurt?
Martin Sailer: I hear again and again that a "therapist" knows the cause without having clarified exactly. Caution: Always make a precise diagnosis first. The right therapy only comes with the right diagnosis. Pinched nerves cause electrifying, stabbing pain, which, however, is sometimes difficult to distinguish from sore muscles in the leg. It needs an examination and an MRI.
Had such an operation in april, infilge numbness could no longer walk but now with duck walk no long stretches are possible. I do swimming, physiotherapy and fitness studio, how long do I have to count on to normal, thank you
Patric Gross: Have patience, paralysis often lasts for months (or years). The missing or poor function can be improved with targeted training or special splints. Sometimes intensive rehabilitation under inpatient conditions makes sense. Talk to your GP or spine specialist.
Good evening, it's great that this topic is taken up. I only had a small herniated disc, but unfortunately major disorders in my right leg. Over the course of 3 years, people were always treated conservatively in the opinion that everything would be so good. But it wasn't. Now it is the case that my right leg wakes me up after about 1.5 to 2.5 hours of sleep, especially at night. No feeling in the foot and pain that almost drive me crazy. No chance without morphine. Unfortunately. It was then finally operated on. Unfortunately without success, no, it even got worse. Now the time has come to stiffen from S1 to LW 3. My question: Could this have been prevented with an earlier operation? That I am desperate at 63 is certainly understandable. Thank you for this broadcast.
Martin Sailer: I generally recommend a second opinion before an operation. An earlier operation can often control the symptoms earlier: if an operation is really needed, one should operate as soon as possible. In my experience, however, there are many alternative therapies. Have you tried neural therapy? The length / size of an operation is also important. The longer and bigger an operation, the more complications can arise.
How important is cortisone infiltration? When does this make sense and when should you invest more time in physio and rest?
Patric Gross: Often, targeted infiltration directly at the location of the problem on the spine can combat the local inflammation and thus also the radiating pain very well. Sometimes pain relief through infiltration can only enable more intensive physiotherapy. Just resting and waiting is unfortunately of little use, in just 2 weeks you will lose up to 30% of your muscle mass (not visible on your back)!
I've been wondering for a long time whether there are still no viable replacements for a broken intervertebral disc. What do you know about it. Many Thanks
Patric Gross: Unfortunately, there is no equivalent replacement. The aging of the intervertebral disc is a natural process that often does not cause any problems. Even a disc prosthesis can never offer the same function; unfortunately, good long-term examinations are still lacking. This often leaves only the stiffening (spondylodesis), which of course can never be a replacement for the original intervertebral disc, but brings pain relief with a good prior analysis. Well-trained supporting muscles can also help.
Two years ago I suffered a herniated disc, which I treated conventionally for over a year. This was unsuccessful, so an operation was performed. I was pain free for a year. Two months ago, however, there was again severe pain in the back and radiation to the leg. An MRI now shows that there is an even larger herniated disc L5 / S1. It can also be seen that the vertebral joint above L4 / 5 has stiffened itself. Surgery? Stiffening?
Martin Sailer: If the nerve is clearly pinched, I recommend a direct renewed surgical nerve liberation. Studies to date show that another operation is feasible. A stiffening is only useful in the case of severe movement-dependent back pain. Functional recordings of the lumbar spine help to make this decision. If the radiation in the leg is central to you, the first thing that should be relieved is the nerve alone.
Good evening I have a herniated disc plus severe osteoarthritis in three places. So also the spinal stenosis. My biggest problems at the moment are the tension in the stomach area, this leads to the fact that my asthma is getting worse and I have the feeling that a rope is constricting my core. Is it all coming from the back? I am now taking a muscle relaxer but this does not help. what does this have to do with in your experience? Thank you for your answer.
Iris Wehrle: Unfortunately, intervertebral disc problems together with spinal canal stenosis often cause very pronounced and extensive complaints. This can lead to radiation in the abdominal area with tension. Manual trigger point treatment, used by physical therapists, is an efficient way to release muscular tension. However, it should first be clarified by a doctor whether there is no other cause for the discomfort in the abdomen. Then, through the physiotherapeutic functional examination, you can find out whether the tension in the abdominal muscles is causing your pain, or whether it is radiation from the vertebral joints or the intervertebral discs. You can also try to influence this by manual mobilization. Experience has shown that it is not that easy with spinal stenosis, but it is worth a try.
I was operated on 1 1/2 years ago. The nerve pain in my leg has persisted to this day and significantly affects my everyday life as a mother and housewife. In the follow-up examinations and this year in rehab I was told that there is a fivty-fivty chance of a cure .the pain increases depending on the load. isn't there another way to get rid of these complaints?
Martin Sailer: Good evening. Your description speaks in favor of contacting your family doctor first, then, depending on the findings, a spinal specialist. What exactly was the operation for you? Have you already had function recordings? Could there be a new instability or nerve entrapment? Basically, there are solutions and therapies for all of these situations.
4 years ago I had a herniated disc with a pinched nerve and the pain radiated into the leg ... it was the last 3 vertebrae at the bottom where they are very worn. I got it with Chiro and Physio that the hernia went away. Now my problem is that I can not stand for long and sit for long because I get pain after 2-3 hours. I am looking for a job and it is very difficult to find something that I can only work for 2-3 hours. What do you recommend.!?????
Patric Gross: If the radiating pain is better, an attempt should be made to increase the resilience with targeted training. In general, there is not necessarily a sustained reduced resilience with intervertebral disc problems. Werner Günthör became world champion in the shot put with a spinal disc damage, his good muscles helped him. In general, light to moderately difficult activities with alternating stress and the possibility of changing positions are ideal. Of course, this depends on your education and your age. Ask your GP.
+++ I miss the mention of the FM Alexander Technique +++ in the report
Good evening, I have already received 3 cortisone injections because of back pain as a result of 3 herniated discs. After an injection, I am fine for a few months at a time. I noticed that nobody talked about this type of treatment tonight. How do you rate them? Thank you for your answer and best regards
Martin Sailer: Infiltrations are very valuable and I also missed the mention. The strength of the infiltrations is that they are done very quickly and precisely (I do infiltrations every day). They are also important for the diagnosis because they help to make the right point and a diagnosis. The weakness is that severely trapped nerves or severe osteoarthritis can rarely be cured with it in the long term.
Guete Abe In 2010, after 3 months of physical and strength training, I had to operate on an intervertebral disc fashion with a specialist. Since then I have been free of pain. I am also back skiing and cross-country skiing, bike hiking and, on the advice of the doctor, jogging on soft ground. In addition, I sometimes bend when things get worse - tired lower back core training. The tip of the iceberg is currently repaired to my satisfaction. May I continue to develop my hobby ... Thank you very much
Iris Wehrle: ... to expand hobbies, I would say that exercise usually has a positive effect. When training, it is important that you only go so far that you do not feel any complaints in the sense of back pain, stiffness in the back, etc. after training and the next morning. I would be a little careful with weight exercises that bend the back because they can put strain on the intervertebral discs. Still best wishes!
I have had pain (69) for about 5 weeks, starting from the back and down the left leg to the feet. Sometimes this pain comes when sitting or walking.My current family doctor said, without a more detailed examination, that this was the sciatic nerve and gave me pain pills and advice that only one injection, targeted during an MRI, would provide relief. Is this true and what does the sciatic nerve have in common with a herniated disc?
Patric Gross: It could be a herniated disc that presses on a nerve and causes pain in the leg ("sciatica"). But there are also other diagnoses such as tense muscles, spinal canal stenosis. A detailed examination (clinical, then possibly MRI and X-ray) is important if the pain has not improved after this long time. Talk to your family doctor or see a spine specialist for clarification.
Good evening, I have decided to stiffen my spine because I feel that the pain has become unbearable after an infiltration. My question is, the operation is carried out on the abdomen and not on the back. Is this method riskier?
Martin Sailer: Basically, surgery from behind is the standard because the spinal canal can be cleared under the microscope. The operation from the front alone is difficult because, according to medical studies, stabilization is best done when there are screws at the back. I advise against an operation in which an implant is only placed in the front.
Is constant pain in the sciatic nerve a sign of a herniated disc?
Patric Gross: The intervertebral disc is not always responsible, there are also other reasons (bony constrictions, vertebral displacement, etc.) which can cause nerve pain in the leg. But often it is not the nerves themselves, the muscles or joints can sometimes cause similar symptoms. A detailed examination is important!
Good evening, next Tuesday, November 8th, 2016, I will also have a herniated disc. I have symptoms of paralysis in my left leg which are at least limited during the day in terms of pain, but I also have problems with the water and have to go to the toilet 2 - 4 times at night. A doctor at Inselspital told me that this problem can also be related to this discussion hernia. An examination at the urologist on May 16 has found everything to be normal.
Martin Sailer: If you lose urine without your wanting to do so, you should immediately consult a doctor in an emergency. However, this situation is rare. How old are they? Men are more likely to have to go to the bathroom at night. It is true that herniated discs can impair bladder function. Frequent nocturnal watering when the prostate is enlarged, on the other hand, is not improved by surgery. The larger the disc herniation on the MRI, the greater the risk of a bladder disorder. With a small hernia, bladder disorder is very rare.
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