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in reply to: mri ?????????? #4613
The MRI report gives an idea of the cause of the symptoms, but does not specifically identify what is causing pain. I can let you know what potential symptoms you can have from the MRI report, but without a good history and physical examination, this is conjecture.
Do you have central upper neck pain? This can occur from the C3-4 disc space. Do you have right sided neck and shoulder pain? This can occur from compression of the C4 nerve which is compressed at the foramen. The C4-5 and C5-6 levels do not sound too problematic but you have to remember that we are reading this report through the eyes of a radiologist and personal opinion can flavor the report.
The C6-7 level has foraminal stenosis on the right. This can cause arm pain and paresthesias (pins and needles) into the middle of the hand and weakness of the triceps muscle.
The way I confirm the diagnosis of a patient with this type of MRI is to have a selective nerve root block performed at the suspected level. Good temporary relief would confirm the suspicion of the diagnosis.
Treatment could range from physical therapy and injections through surgery.
Hope this helps.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.You are now coming across the great dilemma of chiropractic but at an early phase. Chiropractic has so much to offer but is also taught with much dogma. To take on the mantle of “primary health care practitioner” but not use the knowledge of physiology, immunology and medicine is doing a disservice to patients. The core philosophy of subluxations causing dis-ease is simply not supported by any research or literature.
Chiropractic is a wonderful treatment for many disorders but if your patient comes in with pelvic inflammatory disease from an infection and you are going to “take on everything that comes in your door”- to be called a primary health care practitioner, you must diagnose and treat this individual. Do you adjust this patient when they really need antibiotics? Do you adjust the patient with severe back pain from an undiagnosed osteomyelitis and cause further damage? As a chiropractor, I needed more knowledge. I thought the medical route would give me a better understanding of the disorders my patients had.
If you want to become a great healer, open you mind to the achievements made by all the specialities. Look into the philosophy of Osteopathy and you will find that Stills was very close to DD Palmer in thought as well as location. Find out about the history of Homeopathy and why in the 1900s, it was the most respected profession in the USA. Yes- above medicine. Look into acupuncture and you will find similarities to chiropractic.
Use the knowledge gained from so many great individuals such as Lister and Osler. DD and BJ Palmer made great discoveries and brought together a wonderful treatment method but it is not the only discovery that has had great outcomes.
Then look into medicine. The profession has downfalls (the egos are difficult to deal with and the politics) but if you really look with a practiced eye, you will find the most scientific but caring profession. The amount of knowledge to gain blows the mind and takes years to master. If you however, start with a chiropractic background and then learn medicine, you have a base point to make much more sense of it all. I think that chiropractors that go into medicine make great doctors. You already know how to listen to patients and take care of them on a personal level. If you just add current medical knowledge to that mix- you will give spectacular care.
I’ll compose and send you another email regarding the trials and tribulation of going from D.C. to M.D. There are some challenges!
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.in reply to: bulging disc #4607The fact that standing and walking do not aggravate your symptoms is helpful. Central spine pain with standing normally stems from instability or discogenic pain so absence of this pain makes the prognosis much better. The “central bulge” at L4-5 does not really describe how large the herniation is or if it lateralizes to one side or the other. Please send in your films.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.in reply to: bulging disc #4606It appears that you suffered a disc herniation at L4-5 when doing back extensions so many years ago. The L5 root was compressed and you developed radiculopathy. You don’t mention any foot weakness (the L5 nerve could cause foot drop, weakness of ankle inverters and a trendelenberg gait)- see web site for these conditions.
Normally with a disc herniation, the symptoms will slowly decrease over time. The tear in the back wall of the disc however does not heal. Since the process of degeneration does not stop, the nucleus (inside jelly) can disrupt and become another free fragment. A recurrent (repeat) disc herniation occurs in about 10% of patients. This is what probably happened after the bowling incident.
The comment by the neurosurgeon about one vertebra slipping on the other sounds like a spondylolysthesis. There are two types that might affect you- isthmic and degenerative. These should be obvious on x-ray and MRI. Look at the radiology report to confirm this slip.
If you have back pain and leg pain- what is the percentage of back vs. leg? This makes a difference as back pain is generally caused by the spinal column itself (instability, degenerative disc disease or spondylolysthesis) and leg pain which includes buttocks pain is caused by nerve compression.
The fact that sitting causes more pain is somewhat encouraging as this may indicate that the disc herniation is causing much of the pain. However, the percentage of back vs. leg pain will help to understand the correct diagnosis. Please feel free to send your films into the office.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.in reply to: Do i Have Lumbar Foraminal Stenosis #4602I would be happy to review your imaging studies. Please contact my nurses at 888-888-5310 (USA) for shipping instructions.
For foraminal stenosis, selective nerve blocks can be helpful for relief (see website section). These injections will not cure the compression, but will “make the nerve tougher” to tolerate the compression. See if your treating physician will consider these.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.in reply to: L5 S1 Herniated Disk #4600If you could move up your appointment or get a referral sooner, so much the better.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books. -
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