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in reply to: antalgic scoliosis, can it become permanent? #9639
Hi,
This discussion has been most stimulating and I am sure it will help other sufferers who are looking for information relating to antalgic scoliosis and heeniated discs. I would like to thank Dr Corenman for his insights and opinons and the person who opened this thread.
I agree with Dr Corenman that if motor weakness appears then surgery should be considered. I was afraid that I may cause myself significant nerve damage if I did not have surgery. The two surgeons I saw were very experienced and had an excellent track record, so when I asked them they both looked at me, my MRI, and the time I had already been suffering. I think I just wanted something to resolve my problem. I was terribly depressed. My whole life had shrivelled away, and I just didn’t like the idea of waiting it out. I had already waited for nearly a year and I did not see an improvement so I was not convinced I would improve. What if I did not? I had a child and I was unable to stay unemployed and put my life on hold. The banks, the sympathizer’s and eveyone else are hardly patient. People want you on your feet. No one cares or is sympathetic about your problems. I just couldn’t see how I could live a stress free life while waiting to recover because the timeframe I was givem by all the professionals was 2-5 years. By that point my body would have become crippled. I already had some other health problems with my knees. I even started to put on weight because I was unable to walk or do much else, and as the pounds piled on, I knew it was only a matter of time before my problem got worse. I admire the OP for his fortitude and positive attitude. Your belief in your body’s healing power is remarkable and I am happy that your outcome was a good one. Both our stories may help other people make their choice.
I have one final question for Dr Corenman. I had the surgery and my physio and surgeon have said that even if it takes several more months my body will realign. After it does, the achea and pains I have at present will subside. Once the process is complete, my fear would be reherniation. I was told the possibility of the disc reherniating are quite slim as long as one is sensible and does not do anything that unduly causes stress to the spine. Howevee, it seems to me, being in my mid-30s, that I have a long time to live and with half of l4/l5 gone, this problem will rear its head again. Even with precations wouldn’t the body just wear down#? If reherniation is rare, why is this? Is the disc much stronger than we think? Even after surgery, does it still have enough strength to keep going? Most of the doctors and physios I have seen say that a person who has disc surgery, even if they are ratively young, they will ot necessarily have disc related problems if they keep thwor back strong and do not do anything that is known to cause damage to the discs (slouching, bending, lifting something heavy, etc). They also told me that a reherniation would be the result of wear and tear or one very traumatic event but I often fear day to day movements because I wonder how they will cause stress to my back. The last thing I want is the antalgia to return because it is so hard to straighten out after it, especially if you already have other health problems thac may cause a potential setback.
In thw UK you can either go to the hospital in an emergency (where they may operate on you if they consider your condition bad enough), or you have to wait to see a consultant. Health care is free but there is a downside. Everyone uses the health service and waitinf lists to see consultants can be long (and tests cans add more time – they are rarely done on the day). If you are deemed fit for surgery often there is a waiting list for that too, and in my case it took several months from the point I first saw a doctor to the point I had surgery.
This means if I ever have this problem again I will have to wait a long time for diagnosis ans treatment and I just want to avoid a reherniation. Anyway sorry for an unfocussed post. I hope those that have already been here and those that will see this thread in the future are freed of their pain and disability one way or the other. Please be strong and have faith that if nature cannot restore your function, doctors can do a grand job of restoring your health. Dr Corenman here has provided some terrific information about disc herniations and the different types of problems they can cause. I hope these forums also help sufferers and enhance their understanding of particular problems such as antalgic scoliosis.
I hope to post again when I see further improvements, but if I do not I hope my story has helped extend this discussion in a useful way. For now, bye bye everyone.in reply to: antalgic scoliosis, can it become permanent? #9516Hi,
I am sure everyone here will agree that the OP has provided an excellent accoint of his experience. I wish you all the best and hope you remain pain free.
One interesting thing you mention is that you started to feel better at around the six month mark. Now I am not going to say I felt better, but I had a feeling thatvmaybe things were starting to settle down. The antalgia was still there, but I wonder if the exercises I did after the op would have helped then. After the surgery, my body was in the wrong position and Ibthen had to do the physio. Once the exercises started to work I started to realign. The question I keep asking myself is whether exercise could have helped at the time. I will jever know now. I do think doctors often push people into having surgery, but here in the UK you don’t pay for the health service (the health service is paid for via taxes), so individual surgeons have nothing to gain by suggesting surgery when it is not necessary. I saw two very reputable surgeons and they both suggested surgery. They did so in part because I was unable to cope living the way I was. I was unable to work. I was unable to study or go out. The disc herniation was so large it could have gotten worse, causing nerve damage. If you had what I had you are a brave person to have waited it out. My life had effectively ended. I was not a happy bunny. I just couldn’t have waited so long to recover. I do agree, however, that natural recovery is probably much smoother. The herniation gradually decreases in size and youbslowly start to realign as much as your body allows. With surgery, you wake up, and problem is gone, and now your body has to deal with straightening out immediately. Naturally it would have been slow because as the herniation decreased, the alignment would have followed. With the prolapse gone, the body reacts by trying to move normally all of a sudden but all the shrunken muscles etc are bot ready yet.
I am happy for the thread starter and his recovery, but I also hope, now that I have had surgery, I continue to recover. I think even without surgery it would have been harder. I also think since I had to do a lot of work to straighten out, natural recovery would have been similar. Before surgery I had a lot of back pain because walking caused a lot of stress to joints and muscles on the lower back. I don’t know if surgery was the answer but I can tell you there has been a significant change. Maybe this change would have occurred naturally but I was disabled. I wqs unable to go out. I was unable to do most things. The baby requires so much attention and care. Everyday there are medical appointments, errands to run, and things come up out of the blue. I was stuck at home. The idea of getting on a train and going to a London park seemed out of the question. I just wasn’t mobile enough. After surgery, my walking jas improved. I have not really gone out but I know soon I will be able to.
I would like to ask Nikaulaus whether he did any exercises to get rid of the antalgia? My rib cage is still a little crushed because I had been leaning to one side for so long.
I would also like to ask the good Doctor Corenman to offer his thoughts on long term health damage if antalgia is not addressed. For instance, if someone chooses not to have surgery and is not seeing natural recovery, is there a chance that sich a person will develop other health problems. I also had neck and knee pain. I do wonder if things did not improve and the postural changes that were causing the problem were not correcte, could things like long term knee misalignment cause permanent damage to the knee? If that is the case, then perhaps antalgia without sciatica is still a good reason to have surgery especially if it is bot showing signs of improvement within a year or so.
I think my decision was based on the fear it could get worse and I iust couldn’t live the way I was living. I was an active person with responsibilities and my whole life ahead of me. Without any certainty of natural improvement (which my surgeons said had no real chance of improving without surgery), I felt I had no choice. Almost everyone I spoke to said it was a good idea. I knew it will not be an instant fix. The body doesn’t just swing back. Even the OP here has suggested that it took him a very long time to heal. I would like to ask him what hos life was like at the time, whether he expected to improve, and how he was able to afford to consider a long term recovery without knowing if he will ever get better, be able to work and live a normal life? I never felt any real improvement and as such I did not have faith I will get better.in reply to: antalgic scoliosis, can it become permanent? #9513One more thing. I would appreciate it if the original poster can write and describe how he got over the antalgia. Even with hree months of targetted exercises I am not 100% straight. I am in my early 30, not overweight and generally healthy. I actually had to make an effort to correct my posture. I don’t think it just goes away. I guess we all have a limp or something when we have pain but real antalgia doesn’t disappear without some effort so I hope the poster can describe his journey because before I had my operation there was almost no infrmation on the internet as to how antalgoa goes away and what the process is. Everyone kind of says, it goes away. I think people who have had this for a long time and need some reassurance can do with so e more information.
in reply to: antalgic scoliosis, can it become permanent? #9512Also, the body can get used to that position and the muscles you do not use shrink. There are lots of muacles involved and all of them hurt as they readjusted. I am talking about hips, thoighs, abomen, lower and upper back. You won’t even believe the muscles you use to stay upright and how much work you have to do to stay correctly aligned. After the surgery, I did not see a physio for six weeks. Here in the UK they recommend that you do some basic exercises for the first 6 weeks and then you start a programme of physiotherapy. For the first six weeks I mainly walked. I would get fatigued. Several days went like this. The muscles that come back into use do not have strength. They take time to get strong and carry your weight. My body still has spme of that list left and I certainly do not feel comfortable. My physio has dealt with many people with thia list. He says the pain and discomfort os related to the muscles readjusting and it disappears after the body relaigns. It gradually disappears but he said the list can remain for around one year. People who just have sciatic pain, they have the surgery and 90% of the time they are back to normal. I recovered from the surgery in aroind four weeks. I think with thia kind of postural problem you really have to work hard to get back into the correct posture. It doesn’t just go away. I was physically unable to stand straight. The side where the disc had prolapsed was in a huge spasm.
After the surgery, that went away, and though it has been hard at least now there is some chance I will recover. Maybe not 100% but even if I can get out and about and do normal things. I think anyone who has this antalgia should consider the surgery.in reply to: antalgic scoliosis, can it become permanent? #9511Hi,
Thabks for the reply. I appreciate the comment from the original poster. My antalgic position produced back pain since the twisted pelvis made me use muscles and joints that were not designed for the purposes I was using them for. My sciatica was mild or nonexistent. I am a young person, with one baby. I was studying, I was working. I was very depressed, and severely disabled. I looker pretty bad too and people often commented on the shape pf my body. I saw two very experienced surgeons and surgery was indicated because the disc prolapse was massive. The prospects of it improving naturally were quite slim because most people see improvement within three months. I did not and walking in that odd posture may have caused other health problems. I started to have knee pain. I appreciate the original poster improving naturally but I think leaning to one side is one kind of antalgia. My body had a dpuble twist. My pelvis was going right, and my chest was going left. The scoatica was no a non-issue but when I had my surgery, it had been almost a year that I had been in that position. The surgeon who operated on me was very skilled, experienced. He does many operations like this per week. I am in the UK and I had the operation done under the national health service. The NHS has many patients and this surgery is routine. I was out of the hospital within two days but even before surgery no one told me how soon my body will realign. If I had left the op too late I may have had more damage. The disc can always prolapse further.
in reply to: antalgic scoliosis, can it become permanent? #9507Dear Doctor,
I am posting on this thread because I would like to add something important. It is true that part of antalgic scoliosis is caused by habit after your muscles get used to the posture, but the muscles also shorten (atrophy) and lose strength. I had antalgic scoliosis and mild sxiatica due to a very large prolapsed disc at the l4/l5 level. This was confirmed by MRI and after several months of no improvement, I was told surgery was my only option. I was unable to stand up straight and joints/muscles adjacent to my spine were in pain. I was unable to walk.
I was in agony. My husband was very supportive but we were unable to do most of the thongs we enjoyed doing together. With him being at work, I spent most of my day trying various exercises, or putting faith in natural recovery, but that just wasn’t happening.
I had the discectomy in May last year. The mild sciatica I had improved but the postural problem remained. Immediately afterwards some muscles started getting streched naturally. My pelvis had tilted right and my chest was leaning left. Initially the pelvis had to be moved back to the left. I walked with my pelvis slightly tilted left. This felt more comfortable. All my back muscles were tender and felt tired. The muscles do not have enough strength to begin with and many of them had already shrunk. It takes time for the pelvis to get in the correct position. My physiotherapist started me on some exercises that were designed to assist natural recovery. As mentioned before my chest was leaning left and my midline on that side was caved in. This took an extremely long time to straighten. I think straightening involves stretching, inevitable muscle fatigue (that can make you feel and look worse), and evetual strengthening. While the muscles initially stretch they do not have strength so you keep reverting back to the antalgic posture and that can be frustrating and confusing.
I think this list requires a lot of physical effort on your part to correct. Postural problems are not just habitual. With this condition you just can’t stand straight until the muscle imbalances are corrected. That in itself is a painful and fatiguong and, for me, even four months into the recovery, I was still suffering. I think the information on this site is good. -
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