Discussions on Radiculopathy

 

 

 

 

 

 

Sciatica-Radicular Pain-MRI

Radicular pain is described as deep and usually constant. It follows the nerve down the leg and is often accompanied by numbness or tingling and muscle weakness.

Discussions on Radiculopathy from our Radio Show:

Lower Back Pain

Caller: I have had an injury in my lower back since 1985, surgery has been recommended and strong medications have been recommended. I have been told that I needed spinal fusion. My MRI indicated I had a slippage in the vertebrae (Spondylolisthesis).

Dr. Darrow: That doesn’t necessarily mean you need surgery.

Caller: They found an arthritic condition.

Dr. Darrow: That doesn’t necessarily mean you need surgery.

Caller: And they found that I had Bulging Discs.

Dr. Darrow: That doesn’t necessarily mean you need surgery. Do you have pain down your legs?

Caller: Yes, radiating down both legs.

Dr. Darrow: Okay, that is an indication that a surgery may help you although I am not telling you to have a surgery or not. Here is the confusing part.

Pain that radiates down the legs is called a radiculopathy, pain that is referred down your legs by a nerve being pressed on by a bulging or herniated disc. Often I find that the radiating pain is not because of radiculopathy or pinched nerve but because of a ligament that is loose or injured because ligaments refer pain the same way. Before surgery explore conservative methods including Prolotherapy to see if its the ligaments.

Car Accident

Caller: I was in a car accident, a roll over car accident on the freeway that resulted in Bulging Discs in my spine and a herniated disc in my neck. They cause me a great deal of pain.

Dr. Darrow: Do you have any pain that goes down your arms or legs?

Caller: Down my arms especially on one side, the left side

Dr. Darrow: (If it is a nerve problem) One of the first things I would try (even before Prolotherapy) is spinal decompression therapy. Spinal decompression therapy is like traction except it pulls you in different directions. What it does is pull on the spine and open up the foramen which are the holes in the spinal cord which the nerves pass through that go down the arm and very often with a series of decompressions, you can aleviate the problem by in essence, giving the nerve more room to breath.

The other thing is that there are trigger points often that can cause these radiating pains down the limbs and even though you say you a herniated disc, that doesn’t mean that that is causing your pain or the pain radiation, because there are trigger points that can create the referral pain patterns just as well as what we call radiculopathy or pinched nerve, so you need to go to someone who understands these different mechanisms and just doesn’t follow the allopathic medical model of “herniated disc – go to surgery.”

We find that most of the people that have these problems with radiating pain is that the radiating pain actually goes away by itself, even without doctors over a period of time, now it can be cyclical thing and come back but often times I have had patients who have fought me and gone to surgery and not only winding up with pain in one limb, but pain going down the other limb as well probably because of scar tissue that forms. Return to Radiculopathy main page

Football Injury

Caller: I have been suffering with lower back pain due to playing football for such a long time. The pain runs from my lower back down into the right side of my leg. Chiropractors worked on me for years but they say that basically there is nothing they can do for me with the discs as compressed as they are. I played in the NFL for 18 months.

Dr. Darrow: There are two things that run through my mind immediately when someone has leg pain, either it is a radiculopathy which means that there is some bone that is overgrown in the vertebrae that closes off the holes where the nerves come out or there is a piece of the disc that cushions the vertebrae that has broken loose or has become a herniated disc. If that is the case, then Prolotherapy sometimes can help because it stabilizes the vertebrae so there is not much shifting of the bones so it is not irritating the nerve.

We are differentiating between a referral pattern from a ligament in the low back or a radiculopathy which is an inflammation or a pinching around the nerve that comes out of the spinal cord that comes out of the vertebrae and goes down the leg. And unless we are able to put our thumbs in your back and check you out, we would not know for sure what is going on but we will be careful NOT to use an MRI to make our diagnosis for us because more than half the people with no back pain at all, if they get put in an MRI machine, half of them would have disc problems ON FILM, but no back pain.

Most of the surgeries that are done, in my opinion, is to cure the MRI than to cure the person. Our clinic is filled with these people who had the surgeries that have failed.

There is hope, even when people do have these flares of leg pain like you do, most of them go away on their own.

Caller: That is exactly right, I have been dealing with this for 20 years. It comes and goes.

Dr. Darrow: Back exercises can be a good idea. MedX is a big frame machine built by Arthur Jones who built Nautalis Equipment. This machine can strengthen up the muscles in the low back, which can be a good idea with someone with this type of problem. There is a lot of hope that you can deal with this without surgery. But if you have progressive neurological deficits like you can’t go to the bathroom, you can’t lift your leg, your leg is shrinking in size, things like that you need a surgical consult.