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  • hydrojohn
    Member
    Post count: 3

    I am a 59 year old male who has lead an active lifestyle. 25 years ago I had surgery for a herniated L4/L5 disc. For years afterward I was pretty good, occasionally suffering back spasms but generally within a week I was back to normal. Two years ago I had a significant reoccurrance with sciatica. Had several MRI and other tests. I have been told that I have a couple of bulging discs in my lumbar and the disc has completely eroding away at the L4/L5. In the last month I wake up in the morning with significant joint pain in my hips and my hamstrings feel like I have really strained them without actually doing anything. It tends to feel better after I move around a bit. Standing on hard surfaces really makes my back tighten up. I met with a surgeon recently who recommended I have a ALIF proceedure. Is the hip and hamstring pain related to the degenerative disc and will the operation fix it. I am not too excited about surgery and was wondering about alternative treatments. Medication or injections. Maybe I should get a second opinion.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    The first thing you need to do is to get into a good rehabilitation program and have proper conservative measures like medications and epidural injections. Consider chiropractic care. Only after you fail these measures should you consider surgical intervention.

    The symptoms; “In the last month I wake up in the morning with significant joint pain in my hips and my hamstrings feel like I have really strained them without actually doing anything” may or may not be related to the L4-5 disc. It depends upon what the other discs look like and the results of any compression of the nerve roots or spinal canal noted on the MRI.

    Most likely, you might have IDR (isolated disc resorption-see website) at the old L4-5 surgical level and that condition could cause these symptoms. In my opinion, if you have failed all the conservative measures and your pain is impairing, you could be a candidate for a fusion surgery. Assuming that the MRI and examination would confirm this, I would have a patient in your situation undergo a discogram of at least the assumed L4-5 painful level. A positive conformation (reproduction of your typical pain including the hip and thigh pain) would indicate the candidacy for a fusion.

    There are many types of fusion of which ALIF is one. You can read the section regarding lumbar fusion to understand the types of fusion and the risks/benefits of each one.

    Dr. Corenman

    hydrojohn
    Member
    Post count: 3

    Thankyou Dr. Corenman for reponding to my question. I followed up on your reply by reading more about conditions on your excellent website. I failed to mention that during my last examination based upon an xray the surgeon said one of my vertebra where the disc is gone is displaced 8 mm. I did see a chiropracter on several occasions during the last two years, but it did not help and I have myself convinced the manipulation did more harm than good. Maybe I need to try again. What qualifications or skills should I be looking for in a chiropracter to help with my condition?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    If you have tried chiropractic treatment with no positive results, it is unlikely that further treatment in this speciality will give you relief.

    Displacement of a vertebra could mean many things but more likely, this condition could be a degenerative or isthmic spondylolisthesis. There are sections on each disorder on the website.

    Dr. Corenman

    hydrojohn
    Member
    Post count: 3

    I have an appt at your clinic in 3 1/2 weeks to get another MRI and consultation with you about treatment options for a degenerative disc in my lumbar. I have now develope severe pain in my shoulders (approaching 3 weeks)and a stiff neck. Symptoms are worse first thing in the morning and at the end of the day. Can these be related to my spine condition in the lumbar. Seems unlikely to me and so I am wondering if I should seek medical attention or just hold out until I see you?

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