Norman Allan
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Low back pain with disc prolapse and/or herniation


O.M. writes, "I have been diagnosed with a marked protrusion of the L5-S1 ,a case of discopathy.The pain comes and goes and has been going on for nearly three months. Could you kindly put me in the right direction and advise me as to what can be done to alleviate the pain and more importantly what could be the principal cause."

The finding, on MRI or CT scan, of discal herniation or prolapse is somewhat enigmatic. "Slipped disc" may or may not be associated with Low Back Pain (LBP). Disc prolapse is as often seen in asymtomatic people as an incidental finding. Furthermore, operating on discs in symptomatic patients may or may not help with the symptoms. Where disc prolapse is associated with LBP, the prolapsed discal material can impinging upon spinal nerve roots and even upon the spine itself. Though LBP associated with disc failure can be amongst the most severe of LBP, the problem will usually prove to be "self-limiting" - it will correct itself. Prolapsed discs, or at least the associated symptoms of LBP, usually resolve, with or without treatment, over months, typically half a year.

LBP associated with disc prolapse can be associated with "hard neurological signs" such as, one, loss of sensation (in contra-distinction to the numbness and tingling known as paraesthesia, which is a "soft neurological sign" seen in many conditions), or two, profound muscle weakness (not due to pain), and
three, muscle wasting.
     With these hard neurological signs a "slipped disc" can be a medical emergency, and it is only where hard neurological signs fail to respond to conservative treatment that one should consider surgery. Low Back surgery is notoriously problematic. Patients respond positively to surgery about half the time, and half of what is left ends up worse, while the last 25 percent see no change despite undergoing the grave risks of surgery.

Medication may help one cope with the pain but will not address the problem. Long term use of anti-inflammatory pain medication is not without harm.

There are many non-invasive treatment options, several of which are available at my practice and... I am now working with Zero Gravity Clinics offering chiropractic Spinal Decompression!

"Smaller-ticket" iems include: -

Trigenics is a new soft tissue therapy that utilises the wiring of the nervous system to instantly relax over-tense and painful muscles. Trigenics is an effective treatment for many chronic pains, including TMJ, neck, back, and foot pain.

CranioSacral Therapy (CST) is a gentle hands-on technique that follows and facilitates the body's own subtle movements to release tensions and restrictions in muscles, connective tissue, the skull, and organs. I have seen gentle craniosacral "traction" alleviate pain and occasional produce dramatic miracles.

Chiropractic: "diversified" rotational adjustments are contraindicated as they may tend to exacerbate damage to the disc. However, sagittal Gonstead manipulation can reposition the problematic vertebra and take pressure off of the disc, and it is safer, the risk is less than with surgery.

So I would suggest first trigenics, and acupuncture, and CranioSacral therapy, and possibly sagittal Gonstead manipulation.


see also "Low Back Pain"