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Question: Pain upon bowing head forward...
| hollnbrand
- Fri Feb 02, 2007 5:05 pm |
Female, age 31
Dx 1 year ago with herniated L4/L5 & degenerative disc disease.
After I had twins in 2004, I developed lordosis so bad that MRI shows tailbone sticking straight out. I had an epideral for the c-section and ever since I cannot bow my head down without severe pain and weakness in my lower back: the same sensation I felt when they missed with the needle in the first attempt. I saw the chiropractor for over 2 months and felt worse each time I got adjusted. Is this a neurological concern or ortho? How can this be treated, by whom? And what in the world is it?
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| Dr. Safaa Mahmoud
- Fri Feb 02, 2007 8:35 pm |
 Hello,
Degeneration of the disc tissue makes the disc more susceptible to herniation (rapture).
Each disc is formed of a central gel-like inside (nucleus pulposus), surrounded by an outer ring (annulus fibrosus).
When this softer component ruptures (herniates) through the outer ring it press directly on nerve roots and irritate adjacent nervous tissue.
These conditions can be treated in the majority of cases with medical and conservative treatment (non surgical).
Non surgical treatment includes, physical therapy, certain exercises, weight reduction, epidural steroid injections, non-steroidal Anti-inflammatory medications, and decreased daily activities. The pain usually improves faster than the numbness and the weakness if present.
Associated, Muscle spasm alone can cause this pain.
In cases of pain due to muscle spasm, self care and avoiding the precipitating cause (proper posture) will lead to a gradual but clear improvement in the pain. Home treatment includes the use of Analgesics, cold or hot therapy.
Surgery for disc herniation is only considered if symptoms are not controlled after at least one month (6 weeks) of regular medical and conservative treatment, or in very complicated cases with serious symptoms.
A spinal physician is the one able to determine if surgery is the best treatment for the patient.
Hope you find this information useful.
Best regards,
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