Herniated Disc Questions and Answers Archive 2009 Part 3

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A: Hi Christina, This is exactly why I rarely endorse surgery for any back pain condition. Surgery always begets more surgery... Without insurance, it is tough, but you can not let your health suffer to save you wallet. Do you have MRI reports? If so, please send them or type them for me, so that I know exactly what you are dealing with pre and post surgery. Best, Sensei Adam Rostocki

Q: I just got did an mri that states: at c3-c4, there is a disc bulge with indentation of the ventral margin of the thecal sac. At c4-c5 there is a disc bulge with indentation of the ventral margin of the thecal sac. At C5-C6 there is a disc bulge with superimposed central posterior and right paracentral disc herniation indenting the ventral margin of the thecal sac, the cord and narrowing the neural foramina. The herniation is associated with bony spurring. at c6-c7, there is a disc bulge with narrowing of both neural foramina and indentation of the ventral margin of the thecal sac. I have bad headaches and it is painful to move my neck. any suggestions on how to relieve the pain and what to do? Dawn

A: Hi Dawn, The only disc which may be of concern in C5-C6. I do not know how much it is affecting the cord from the description. However, it does not seem that any of these discs correlate with your symptoms, so I suggest that they are most likely coincidental. If you believe them to be the source, you may consider non-surgical spinal decompression. If you are more open to the fact that they are most likely innocent, then I strongly advise knowledge therapy. Best, Sensei Adam Rostocki

Q: L3-4 has a 3mm right lateral disc bulge with facet hypertrophy resulting in moderate right neural foraminal stenosis medially. L4-5 has a 1mm diffuse disc bulge with facet hypertrophy. L5-S1 has disc desiccation and 5mm left paracentral disc protrusion with facet hypertrophy,moderate to severe left lateral recess stenosis ,moderate central canal stenosis. i have backache in the morning after getting out of bed with stiffness gradually pain decreases through out the day. do i need to undergo surgery? Jaya

A: Hi Jaya, I do not recommend surgery for your condition, nor do I think it will relieve your back pain. Best, Sensei Adam Rostocki

Q: Hi, My question is regarding my husband's injury. A year ago he slipped and fell on ice...onto the upper right part of his tailbone, at work. All of the Dr's he saw for treatment agreed it was an L5-S1 disc herniation, which was confirmed with an MRI. As this is a workman's compensation case, it has become a real nightmare. He eventually had a disc laminectomy 6 mos. after the injury because the conservative approaches just did not work, and his pain had continually progressed to unbearable and excruciating. He did NOT want surgery, and had never had any surgery before this. The surgeon stated that the disc herniation was definitely "new" because of it's appearance. Now, the workman's comp "independent" evaluation Dr. is stating that the surgeon could not have known it was new by it's appearance. He says that disc herniations could look new for years, and that my husband conjured up this injury to get $ from workman's comp. This despite the fact, at 46, he's never filed a claim in his life...that he has worked there for 10 years...that we have excellent insurance that has , and would continue to pay for all of his treatment and medication if necessary...and that he never once sought treatment from his primary care physician for any back problems. Also, our homeowner's insurance would have paid MUCH more of a settlement than he would ever get from workman's comp. if he was just trying to get money. He had seen a chiropractor maybe once or twice a year over a 10 year time period at the most for mostly carpal tunnel issues, but also stated a number of times that he had low back pain so the chiropractor would adjust his whole back and he would go on his merry way...just fine. His final prognosis is now permanent impairment, and permanent light duty. He feels devastated because he loves physical labor, and participating in sports, etc... My question is...what should be the appearance of a new disc herniation vs. an old one? And how long would it appear new? What would it look like as it "aged"? Thanks - Stephanie

A: Hi Stephanie, No 2 herniations are exactly alike. Some anatomical changes can be observed in herniations which are helpful in dating their age. First is the possibility of a ruptured and extruded disc becoming calcified, which obviously dates it as a old occurrence. Far more common is the appearance of degenerative changes in the surrounding vertebral bones, such as spurring and endplate deterioration. These can also exist with degenerative disc disease, but often correspond in specific ways to the pattern of a herniated disc. The more advanced the specific pattern of degeneration, the longer the herniation has likely existed. Best, Sensei Adam Rostocki

Q: Hello Friend. I just received my radiology report today...and non-the-less, am quite confused, do to the doctor "lingo"...I was hoping if you can tell me if I sound like surgery material?Oh, I am a 35 year old female...who has been on EXTREME...pain management for over a year now.Here is the report:

1-Left-sided T11-12 disc herniation indenting the anterior aspect of the thecal sac

2-Small central T8-9 protrusion w/out evidence of frank extrusion at this level and no other sites of thoracic disc herniation, thoracic spinal stenosis, or thoracic cord compression.

3-Chronic bilateral L5 spondylolysis w/out evidence of anterolistesis of L5 on S1.

4-Left far L-5 disc herniation projecting into the left L5-S1 neural foramen.

5-Small broad central subligamentous L4-5 disc herniation.

Thank you SO much, I plan to see the neuro. next week- just hoping to get an idea as to what I'm looking at. Thanks, and God Bless:) Kasie

A: Hi Kasie, First off, #4 should read...Left far L5-S1 disc herniation projecting into the left L5 neural foramen.It is illogical the way it currently reads. I hope this was not on your MRI report this way...unbelievable!I do not see any serious issues here at all. There is a possibility for some symptoms in the part I quoted above, but none of the others. What exact symptoms are you having, in terms of specific location and expression? This will help me to advise you in more detail. Best, Sensei Adam Rostocki

Q: I'm a 50 year old male that tends to be anxious and somewhat obsessive. I've been treated for High BP since age 21 and am also being treated for high-cholesterol and elevated blood sugar. I could stand to lose 10 pounds but am far from overweight. I'm fairly physically active and love to ride my bike, but have been told by a doctor that it's not a good idea. I've participated in a weekly deep-water aerobic class since April that leaves me feeling pretty good when I'm done. I had arthroscopic shoulder surgery to repair right and left rotator cuff tears (11/05 & 12/07 respectively). I have severe arthritis in the right shoulder and moderate in the left. I was told that I'd probably need my right shoulder replaced 15 to 20 years out.

When I first sought medical attention for my neck, I approached my orthopedic surgeon as the symptoms exhibited themselves. It stated with the pinkie and 4th finger on my left hand tingling, followed by a tremendous amount of pain in my left bicep (That reminded me of the pain that caused me to see the ortho). The pain for fairly intense and left me physically exhausted. For about two weeks I would come home and just go to bed. I felt that this was caused by a problem with my left rotator cuff that led met back to the ortho after a period of denial. The ortho did a check of my left arm, suggested that I had a herniated disc and sent me to have an MRI, and to another doc (neurologist/pain management). I was diagnosed with the neck problems last November. I went though about 8 weeks of PT, and received facet injections, 11/08, 12/08, 01/09, 04/09, and then my pain management/neurologist left the state in June. I responded well to the PT and during PT replaced traction with inversion therapy, which I enjoyed and felt was of therapeutic value. I've found a new pain doc that I went to last week, and was given a facet shot last Saturday. He'd like to give me another facet short next week, and then from one to 3 selective nerve blocks between now and the end of the year, hoping that this will keep me happy and away for about a year.

I'm able to sleep reasonably well when I fall asleep, and for the most part felt fine from the April 09 shot until about Labor Day (09/09). Then I'd start to notice my left arm becoming increasingly sore like what happened before my diagnosis. I figured it was time for my pain shot since the pain management/neurologist that left had me scheduled to see him at the end of June and now it's late September. As these symptoms redeveloped, I observed that I had been very physically busy (planting grass seed and had been on several 20 plus mile bike rides) Before I could get into see the pain doctor, I treated my neck/upper back aggressively with heat, I'd stopped riding the bike, and my yard work and significantly tapered off and by the time I was in to see him was feeling reasonable well, almost questioning the appointment. I'm ok with getting the additional facet shot, but am wondering seriously if I should be bothering with the selective nerve blocks. Your advice here would be appreciated. I think the steroid from the nerve block might help healing, but wonder how long something lie what's going on actually takes to heal. I'd think that the steroids from the previous 4 facet injections would have mostly healed things already. I'm giving serious thought to passing on the nerve blocks, and getting an inversion board to intensify stretching on my spine. I'd also like your advice on the inversion board. I'd like to think that I'm not going to need to rely on these pain shots the rest of my life as they're expensive and I do want to remain as active as possible. These events have been mentally challenging to say the least, and have me very frustrated.

Here's what my myelogram and CT indicate (both from 11/08 indicate). Can you please let me know if there's anything physically in this list that definitely manifests itself in my pain condition? I usually describe my pain not as severe, but as constant and nagging, and it's mostly felt between my shoulder and neck. I generally feel good when I wake, and get worse towards mid-afternoon.

Cervical myelogram

No obstruction to the cephalad flow of contrast to the foramen magnum.

No lateralizing extradural deformity was seen.

Small anterior ventral extradural deformity is seen on te thecal sac at C3-4 with a larger deformity at C4-5 and C5-6 on the cross-table lateral views.

CT C-SPINE (post-Myelogram)

Anterior spurring at C4-C5

Loss of cervical lordosis observed with mild kyphosis centered @ C4-5

Disc space narrowing is present at C4-5

Posterior spurring is seen at C4-5 and C5-6

No obstruction of the cephalad flow of contrast to the level of the foramen magnum

At C2-3 small central ventral extradural deformity of the thecal sac is visible

At C3-4 a smaller central ventral extradural deformity is seen on the thecal sac

At C4-5 Anterior spurring is seen at the level of the right uncovertebral joint and centrally

At C5-6 large central spur deforms the thecal sac and spinal cord. Additional spurring is seen.

At C6 with ventral extradural deformity on the thecal sac and spinal cord.

Disc herniation is also suspected at C6-7 with broad ventral extradural deformity deforming the thecal sac and spinal cord.

I am somewhat skeptical when it comes to you knowledge approach, but am somewhat realistic that stress and anxiety and their underlying cause smay have a significant impact as to what's going on with me. I find that when I actually remove myself from the world's problems and relax a bit that I feel better, but can not seem to get over the concern that this may recur or get worse. Thanks for your consideration,Tom

A: Hi Tom, I do not like CT scans for diagnostic work, since they are very limited in their imaging compared to MRI. My first suggestion would be to get an MRI if possible. I do not recommend inversion, as it is not proven to do anything, especially for a cervical condition. It should be no surprise that the injections did not "heal" you. They are not meant to "heal" anything. The steroid is for inflammation and in my experience, there rarely is any inflammation in back and neck pain issues. They will do nothing at all to resolve a herniated disc. The only thing helping you in the anesthetic component. That is for sure, regardless if the disc is indeed the source of pain. Best, Sensei Adam Rostocki

Q: I am a competitive triathlete competing in the Olympics, 1/2 Iron Man events. Whilst training for a full Iron Man 3 months ago, I was diagnosed with a disk problem of L5 S1. This flared up for the first time with severe sciatica in my right leg, which subsided after a week and I resumed training. 3 months ago whilst running my lower back and gluteus tightened and my right leg locked up and over the next week my calf ceased for 7 days and then one night the entire leg went numb for 30min. I had an MRI with the following findings "I have a moderate siaed broad based posterocentral and right paramedian protrusion of teh L5/S1 disc impinging on the right S1 nerve root. DIsc also extends into the left lateral recess, causing compression of the left S1 nerve root. Mild retrolisthesis of L5 on S1."

3 months down the track with constant core and physio work I can walk for hours, swim but still not tried cycling and feel I could run but scared of doing permanent damage? Will this, can this get better on its own? Is there a solution apart from surgery, I have heard so many horror stories... Thanks, S

A: Ok S, The symptoms are far too wide spread to come from a single level compressive neuropathy. S1 might explain numbness in the pinky toe and parts of the back lower leg, but never the entire leg. If you subscribe to the structural theory of pain, then you might try non-surgical spinal decompression. If you are more open minded to understanding why the symptoms do not match the expectations, then I advise knowledge therapy. Best, Sensei Adam Rostocki

Q: I have severe problems with my discs in my neck and throughout my back. Was diagnosed with DDS and spinal stenosis, with many bulging discs and some nerve impingement in my neck. My question is, can severe exposure to Carbon Monoxide cause this condition to worsen? I was exposed to Carbon Monoxide for 5 years, with levels found to be very high. I'm 49 years old. Thank You, Betty

A: Hi Betty, Exposure to CO is a major health hazard and has been linked to degenerative disc disease in smokers. I hope this info helps. Best, Sensei Adam Rostocki

Q: MRI conclusion reads: bulging annulus fibrosus C5-C6 impinging upon the thecal sac - what does this mean? Kim

A: Hi Kim, You have a minor herniated disc in your lower neck, which is touching the protective sheath which surrounds the spinal cord. This is nothing at al to fear and is completely common at this location. I do not see this herniation responsible for any symptoms. Best, Sensei Adam Rostocki

Q: I've been diagnosed with a herniated disc in C4. It came on suddenly and I thought I was having a heart attack. After trip to ER, the ER doc said I should see my Neuro dr. I had an ACDF for C4,5,6 18 mos ago. So evidently this is between C3,4. Weird thing is, it's on the right side, but all my pain is on the left with only ring and pinky finger pain on the right. Is this normal? Glenda

A: Hi Glenda, I am not 100% of the specifics of your question. I can tell you that the pinky and ring fingers are the C8 spinal nerve root. Additionally, if the herniation is suspected of causing foraminal stenosis on the right, but pain is on the left, the diagnosis is illogical. Seems like this applies all around in your case. Best, Sensei Adam Rostocki

Q: Hi. I have always wanted an active and exciting lifestyle, but many of my chronic joint problems have held me back. I'm already convinced that I could never be a police officer or soldier with my DDD, knee pain, carpel tunnel, etc. (It's too important to have a perfect athletic frame, and I don't want to explain why someone died because I threw my back in the middle of a flaming building.)

However, up until recently I have been hopeful about a career as a helicopter pilot. My coordination is good, I am pretty smart, and most of my weak joints would be at rest in a cockpit. However, I recently found out that many helicopter pilots suffer back problems such as herniated discs. There are many theories as to why, including the use of heavy headgear, rough take offs and landings, constant cockpit vibrations, and poor posture.

I know it's a long shot to ask you about something so specific, but my question is: If I already have DDD (mostly upper back around shoulder blades), would I be more vulnerable in a career where back problems are common? Do I stand to risk my health more than someone without DDD? Joseph

A: Hi Joseph, Find me someone without DDD, first... It is universal and we all have it, although not typically in the location you do. I think you should pursue with goals in life without fear, since fear will hold you back in everything you attempt. Use common sense to determine the best path for you and go for it without worry! Best, Sensei Adam Rostocki

Q: Hi. I am Badrun, 42 years old and a teacher. About 10 years ago, I was diagnosed to have Cervical Spondylosis. I had some physio therapy and felt better. about 5/6 years ago, I started to have pain in both the knees. The doctor said that my bones have started decaying, may be osteoporosis and told me to take calcium. i was not very regular in taking calcium. from 1 year I am having severe pain in left knee, the right one is not disturbing that much. I also have low backache. I cannot bend, move freely. I also have obesity. I am 5 feet 4 inches and I am 74 kg. The problem that I am facing most for around 4/5 months, i am having spasms in both my legs, but mostly in the left. It usually occurs at night or when I am at rest. It is so disturbing, I also have a kind of very uneasy sensation that time. I consulted an orthopaedics physician. He suggested me to have some X-rays and MRI. The report of the MRI is 1) loss of Lumber lordosis. 2) L5-S1: Central and both paracentral disc extrusion is noted. the extruded disc material indenting ventral thecal sac and compressing traversing S1 nerve root of both sides. 3) L1-2, L2-3, L3-4. L4-5: unremarkable.The X-ray for the left knee says: minimal OA changes noted in the knee joint.I cannot go to the doc now as I cannot take leave for the next month. But I am having much problem. Again I am afraid of wrong diagnosis. Can you pls help me with this? Who should I consult, a neurosurgeon or an orthopaedic surgeon. I am at a loss. After reading the reports, what do you think about my disease. please help.

A: Hi Badrun, The cervical spondylosis is universal and no cause for concern, same for the arthritis in your knees. The extruded disc may be the source of your pain, since the leg symptoms correlate to some degree, however, the lower back symptoms may or may not. You may be suffering from this herniation as the main source of pain, in which case I recommend you seek out a neurologist for additional testing. There is also the chance that the herniation is coincidental and the pain is ischemic. In this case, I recommend knowledge therapy. Please stay in ouch and let me know how you are doing. Best, Sensei Adam Rostocki

Q: Hi! I fell in on my left side 6/09 had some back/neck pain that subsided in a couple weeks. Then I had no feeling/numbness in my right hand. I was sent for a nerve conduction test for possible carpal tunnel in 9/09. During the test, the dr poked my left side of my shoulder/neck area which caused ecruciating pain. He immediately applied pressure & said I was going to hate him for that. Since then, the pain has not stopped. (nerve conduction showed C7 radicualphty) Now I continue to have major pain in my neck that goes up my jaw behind my left ear. It goes into my head along the back. My left side of my face swells. I feel pressure in my head & experience pressure popping in my ears as if I'm changing altitude. I also have burning in my left shoulder. I also get a choking sensation as if someone is pressing on the front of my throat. I have been on vicoden & motrin because I am allergic to steroids. When the pain meds wear off, the pain is unbearable & it's been almost 8 weeks with no relief. I had an MRI that shows 1mm central posterior disk protrusion at C4-C5 & at C6-C7 & 1.5mm at C5-C6, all indenting the anterior aspect of the thecal sac. There is also a straightening of normal lordotic curvature. My question is, prior to the needle poke I only had right hand numbness, so is it possible the condition of the discs is causing the symptoms or is it more likely there was some nerve lesions from the nerve conduction test? If there is a nerve lesion, can that be repaired? I appreciate any insight towards my search for some relief!! Thank you!! Heather

A: Hi Heather, I can tell you for sure that those disc issues are completely asymptomatic for sure. 2 tiny herniations at very common places. Nothing to fear there. All the symptoms in your head and face do not even remotely correspond to the area affected and are obviously unrelated. Additionally, the loss of lordosis is consistent with muscular tension. I think the entire condition is regional ischemia of the neck, cervical plexus and brachial plexus, which would explain the incredible and illogical diversity of symptoms you are having. I advise knowledge therapy. Best, Sensei Adam Rostocki

Q: I have been seen by drs for about 3 years now and haven't worked since Oct 2007 due to severe pain. My very first MRI reads: Impressions: Disk bulging at L2-3, L3&4 and L5&S1 Left posterolateral disk herniation at L4&5 much neural encroachment at several areas (too many to list) and I have had the hardest time trying to get fixed. I did much research on my condition and from everything I read from Drs it is the hardest to find and treat. Most MRIs don't even pick this type herniation up, but I have severe numbness and pain in my left leg to the knee only and it has worsened with time, and I am in a charity type training type hospital in Dallas that started out great and now my dr thinks I am a head case because they can't find any logical reason for my severe constant pain and I explained how for 14 months I was on Roxycodone(oxy as generic) and it did great for months and then the pain out grew my meds and no one would up it. I was on about 300 mgs per day all together and diazapam to help rest. When I moved to Dallas from Florida, I decided it would be best to get clean 100% and I did and went through hell with DTs and wasn't taking anything for about 2 weeks.

well places I never knew I had started hurting so bad I would cry out loud and I am 37 male, 340 now because I quit eating and don't move too much as I fall alot, but I was 250 when it began. One day I couldn't take the pain any longer because I was drug free 100% I fell and told my wife to call 911 and went to a local hospital. They didn't touch me other than vitals. The Dr came in and said we aren't going to treat you here because you aren't an emergency but we will help the pain for now and give you a script until you get to what is Parkland, where I go now. They are on the cutting edge here although it's free so you have to put up with mess but 5 huge schools send their kids here to learn and become drs and pharmacists and I haven't pd a dime for 10's of thousands of dollars worth of tests or meds, but my Dr started out on the right foot and ordered every kind of test I needed for years in 1 day.

EMG was normal but when they stuck the needle in my back I screamed so loud and cried like a baby it hurt like a knife stab I can imagine. Everything was normal so I didn't want permanant nerve damage. NOW my meds... Even after I told my Dr what I was on and showed him I was clean and had no desire for the meds physically, he still classified me as a drug addict and took my diazapam and gave me 3 psych meds instead that make me sick and won't give me percocet 10/325 and is making me take Hydrocodone 10/650 even though I told him tylenol makes me very ill. Anything I tell him doesn't work he adds 2 more to try rather than just giving me a very light dose of what I need and works for me. They say this type is the hardest to diagnose so any ideas how to approach my new Dr I am getting to get proper treatment as well as testing to see where I am hurt. I mean everything is classic symptoms. I even lost the use of my manhood lets say and haven't had my wife in a very long time, and I pee in my pants now, but he tells me it's a head problem and wants me to see a behavioral person to "get off the drugs" that I am no longer addicted to, it's just that hydro with tylenol 4 to 5 times a day NEVER helped and I know it, just like Diazapam never gave me vivid nightmares like trazadone does, but he wants me taking it. SO any help would be great! Thanks, Tony

A: Hi Tony, Your story is alot to take in, but the parts which would assist me in helping out are the very parts you omitted. I really need to see the actual MRI report, not just 1 sentence of it. The rest of the details do not provide me with too much to go on, besides to say that you are obviously not being treated very well, which is a classic symptom of our ridiculous medical system in many cases... This is especially true in low and no income patients, such as yourself.Best, Sensei Adam Rostocki

Q: I got a MRI that was never explained to me, I have severe pain in my lower back and one doctor said he does not think it is from where I think it is from, I still have radiating pain and pain shooting down my left leg and pains that shoot scross the top of my butt as well as a deep ache. Here is what the MRI says.

Focal mild central bulging L3-4Broad based with left lateral bulging L4-5 with some narrowing of the left neural foramina. DIsc dehydration at L3-4, L4-5 and L5-S1 with disc space narrowing at L5-S1, and Mild bony degenerative changes. I am only 32. I also have some straightening of the cervical spine with some mild reversed lordosis.Please help explain the pain.Thank you, Jeanette

A: Hi Jeanette, I agree with your doctor that the structural issues are not at all likely to be the source of your symptoms and commend this doctor for their honesty. The pain is likely to be ischemic, so I recommend knowledge therapy as the best treatment with the least risk. Let me know how you do with the therapy. Best, Sensei Adam Rostocki

Q: I had a car accident over a year ago. Before the accident I was very active and had no pain or problems. Now I have severe neck and back pain. After 7 months of physical therapy the back pain was mostly gone but the neck pain was still severe. One month later an MRI showed disc herniations at C3-C4 and C4-C5 both with mild flattening of the spinal cord. C5-C6 showed a mild disc osteophyte complex. I still have daily pain, pain in my right shoulder, limited neck motion turning to the right and limited shoulder motion. The pain is sharp in places and in others is a pulling sensation like a muscle cramp along with burning and tingling. If the herniation itself is not painful, what is causing the pain? And how can I make it stop? Rheana

A: Hi Rheana, There are many possible explanations for your pain. If you would like to send me your MRI report, I will be happy to take a look and do my best to advise you. Sincerely, Sensei Adam Rostocki

Q: i'm 32...very active runner and avid golfer, i started to have bad lower back pain....never went to get it checked until just recently...herniated L4 and bulging S1?? can i still be active with sports? also how does the inversion therapy work for herniation? thanks, Glenn

A: Hi Glenn, I do not have your MRI report, so I do not know the extent of the condition. If you would like to send it, I will be happy to take a look and provide my thoughts on your prognosis. I do not recommend inversion as a back pain treatment. Best, Sensei Adam Rostocki

Q: I had a car accident in May of this yr. which resulted in a herniated disc, and has caused me to lose my job. My question is...If I feel I can handle working, do I actually need the Dr.s confirmation? (I've also hired an Atty.) I've been in treatment since September, my back feels fine, I so need to find a means of income. I cannot collect Unemployment Ins. because,(according to their rules), I'm not "able, and willing" to work.Any advice would be appreciated. Linda

A: Hi Linda, This is out of my field of expertise. My thought is that if you want to work, then work. I do not see how they can stop you. But, the situation may be more complicated than I understand. Since you have an attorney already, use them. Talk to them and see what they say. Best, Sensei Adam Rostocki

Q: Hi, My cousin, Male, aged 38, has right arm pain right from spinal chord through out the right arm. He's feeling numbness & pain in fingers. The following is the diagnosis:1) Loss of cervical Lordosis is noted Impression:Posterion Bulge with postero - right lateral herniation and minimal Inferior extrusion of C6-7 Disc indenting the Thescal Sac, Impinging on right C7 nerve root and compromising the right neural foramen

One of the doctor has suggested for surgery immediately.Second opinion doctor suggested, this problem can be corrected using medicine, over period of time, though, pain killers would be necessary to defer the pain during such period. Please suggest, if a surgery is mandatory for such issues. - Is there a chance of re-occurency of this issue even after the surgery - Any major/minor risk / side effect if opted for surgeryThanks, Shiv

A: Hi Shiv, C7 is very specific and does not represent the nerve which is causing such wide spread symptoms. C7 is for the middle finger. Additionally, loss of lordosis is consistent for muscular spasm in the neck which is usually a sign of regional ischemia. This is my theory, as the symptoms are too diverse to be accounted for from C7 compression. I certainly do not recommend surgery in any case. I do recommend knowledge therapy as the best course of action. Best, Sensei Adam Rostocki

Q: I have a herniated disc in the L5 it is pressing on my spine, I have pain in my right leg, and some pain in my left leg, and in both my hips and tail bone , Just was wanting what type of work can you do with a herniated disc? It also hurts if I go to bend over. Thanks Phyllis

A: Hi Phyllis, People do all sorts of work with herniated discs, considering the majority of the adult population has one or more in their spines. For example, I have 9 that I know of and I write, teach martial arts, work in real estate and also in investigation. I know people in every field with herniations. Most disc issues are not the real source of pain. Best, Sensei Adam Rostocki

Q: Do you know of any psychotherapist in the New York City area who treats patients based on Dr, Sarno's knowledge-based principles? Thank you. Richard

A: Hi Richard, Contact Dr. Olga Protomastro. 19 West 34th St, NY, NY. I do not have a phone #, but she can be reached through Dr. Sarno's office. She is in charge of intake at Sarno's official therapy program. Best, Sensei Adam Rostocki

Q: I have a herniated disk L5 s1 , I work on assembly line I have been off work 9 weeks gone thru physical therapy on pain meds . I was feeling better , I was hoping to go back to work soon then I bent over and it was like I hurt my back all over again. I'm so confused on what to do i need to get back to work asap . I go see my doc next week , should i have surgery so i can get back to work ? I need i speedy recovery. Thanks, Candy

A: Hi Candy, I do not typically recommend surgery for any disc concerns. If you would like to send a copy of your MRI report, I will be happy to look it over and provide my opinion.Best, Sensei Adam Rostocki

Q: Hi Sensei,I am 45 and experienced T7-9 Retro disc herniations 1988-1991. Multiple symptoms over the years. However during past few years and more recent (10-12 weeks), Being treated for Diverticulai. Colonoscopy revealed no diverticulitis lesions, but rather a loose sphincter with poor tone. I have always had some degree of radicular pain left chest/side area, but recent identified with swollen liver, (High Cholest 7.3 - Now Crestor), Elevated Blood sugar, 6.6-7.6 12-14hour fast. Pain in left side abdom through to back/sharp constant. Wanting to know if Thoracic and symptoms all inter-related? Please note very strict with diet/training all my life. No alcohol/smoking ever. Tks Larry

A: Hi Larry, The symptoms could be related. Do you have an MRI available? If so, it may provide some insight. Best, Sensei Adam Rostocki

Q: Hello, Thanks for maintaining this website.. Well I was injured in a car accient in 02/2009 and they did a MRI of my CERVICAL SPINE on 4/09.. TO summarized my MRI showedC2-3 normalc3-4-broad based bulging of disc abutting the ventral thecal sac.. Server stenosis of right neural foramina due to uncovertebral osteophytes and facet joint hypertrophyc4-5-broad based bulging of disc abutting the ventral tecal sac-no stenosis c5-6 - SAME AS C3-4 c6-7 SAME AS C3-4C7-T1-- no issues So as u can see its NOT good, but it could be worse..

Well in 08/2009 I started working out and eating right.. My neck pain felt 100% better (before I was stiff and driving a car from 02/09-07/09 was a bit painful).. All my doctors SAID the MRI info from 4/2009 was done in the PAST and the accident DID NOT cause it.. I was like WOW that's nuts because my neck and shoulders were never this bad.. I had ONE simple shoulder stinger in HIGH SCHOOL football.. THE NEURO said most of you issues are DEGENERATED, but he SAID the MRI was not the good quality.. In any event I went on with lift...

Then on 09/20 I did some stuff in my back yard (nothing crazy, moving stuff and raking leaves). 2 days later horrible neck pain and left shoulder pain at 2am... The pain was HORRIBLE for 3 weeks, then everything seem to get better except at night the left arm tends to tighten.... Well now I am i my 5th week since the NEW incident and I feel about 80%.. The doctor want to give me INJECTIONS, but i told him the pain is livable without meds..

Well he had me do another MRI on 10/09 which should about the SAME INFO as the 04/09 MRI EXCEPT NOW IT SHOWS C5-6 WITH disc desiccations with disc space narrowing and anterior endplate spurring. There is broad annular bulging with a superimposed left central/left posterior LATERAL DISC HERNIATION which impresses on the ventral aspect of the cord asymmetrically toward the left . The cord is slightly displaced, but normal in signal INTENSITY. This is left foraminal encroachment . The left c6 root is obscured and right is demonstrated..

Anyways..... As u can see I am upset account I READ IF U HAVE SEVERE STENOSIS along with herniated DISC this NORMALLY MEANS Surgery..... I have yet review this NEW MRI with the NEURO account my appoint is not till Oct,21.. I guess if this was LIFE THREATENING he would have told me to come in.. is assistant called me to say "The doctor said u got 2 herniated discs and he will give u injections on Oct 21".. I said the PAIN is better , but I want more info on what we happen to me..

Do u have any good exercises i can do? or have any info on my condition?? Are all HERNIATED DISC THE SAME? I thought since the pain was 90% gone in 3-4 weeks that may be a good sign?

Thanks for all your time.. I am so sorry I have JUMPED AROUND.. Hopefully u can understand 1/2 of what i wrote.. Thanks, Don

A: Hi Don, It is clear that all the arthritic issues are old, as are some of the disc concerns. I do not see anything which worries me from your MRI and most of your symptoms are not even consistent with the structural issues demonstrated. Injections are like aspirin. Symptomatic treatment, regardless of diagnosis. If you want them, that's fine, but they WILL NOT cure anything. In my opinion, there is nothing to cure. I would continue to live as normal and not obsess over the MRI results. Best, Sensei Adam Rostocki

Q: c/o rt leg pain (heavy with prickly feeling to foot, some muscle weakness, and pain; after standing, sitting or walking) MRI: grade 1 anterolisthesis of L5 on S1 with a broad based disk protrusion with extends from neural foramen to neural foramen producing a mild stenosis of the left neural foramen and a mod. to severe stenosis of the right neural foramen (no significant effect upon the spinal canal or the lateral recesses) My rt buttock and rt leg hurt all the time, tried PT but that seemed to aggravate it. I take NSAIDS daily. I was very athletic until 6 months ago when my rt leg started to hurt when I ran. Now no matter what I do I can not shack it! I want to run again, I am a nurse so I am on my feet all day. Please tell me what I can do so that I can run again (I have gained 12 pounds). Charlotte

A: Hi Charlotte, If you think that the disc is enacting nerve compression, you might consider non-surgical spinal decompression. This may be the best medical treatment for you. Best, Sensei Adam Rostocki

Q: i had a herniated disc since the age of 17 (now 33)i windsurf in a pro level since 14 and had my first surgery at 29 because it became huge and never had any pain after that until 1month ago i went to my doctor and told me i have a new herniated disc at the same disc i had surgery and i have to wait and see how things develop with physio and swimming. What do you suggest will i be able to windsurf at this demanding level (i want to go to surgery but doctor says that i will need implant and wants to leave it as last option) Konstantinos

A: Hi Konstantinos, Most herniated discs are not painful and are misdiagnosed as the source of pain. I do not have your MRI report, so it is difficult to determine if yours is symptomatic or not. As far as windsurfing, I advise you talk to your doctor, since they are knowledgeable bout your specific condition. Best, Sensei Adam Rostocki

Q: Hi - I have been diagnosed (as per the MRI report) by a right posterolateral herniation of the L4/5 invertebral disc impinging upon the right L4 nerve root and causing moderate stenosis of the lateral aspect of the right neural foramen. I am not be asked to see a neurologist and a neurosurgeon. Do you think this requires surgery ? What are the risks for this kind of surgery ?Gayatri

A: Hi Gayatri, Most herniated discs do not require surgery, nor do I recommend surgery for any patient unless there is extenuating circumstances. Risks depend on the specific procedure used, but all surgeries have inherent and implied risks which should be discussed with your doctor prior to undergoing the operation. Best, Sensei Adam Rostocki

Q: Hi, I just read your story. Please forgive me if you already commented on this but did you try acupuncture? Did that help? I can't sit too long so that's why I can't go through your entire website which looks fabulous! I was just diagnosed with a rather large herniated disc l5,S1 (just like yourself!) and really bad sciatica which landed me in the ER... oh I am 46 and an avid mt. biker! thanks again for your website! Wendy

A: Hi Wendy, Acupuncture is symptomatic treatment, akin to taking a pain pill, but without the health risks. It will not cure you, but may provide relief. Best, Sensei Adam Rostocki

Q: I have been diagnosed L5-S1 herniated disc.It is almost 7 weeks now. I can not walk and stand without help of walker. If I move or move while walking, pain comes. My Left leg has weakness. the only occasionally numbness is on the smallest toe of my left leg sometimes. I am afraid and worried the passage of time. if it continues without any treatment.Should I have operation? Best Regard, Belikkiz

A: Hi Belikkiz, How were you diagnosed? MRI? If so, please send the report so that I can give you my opinion. Best, Sensei Adam Rostocki

Q: I had a serious Herniated disc problem. My EMR result is:L3-L4 small localized and central disc herniation.L4-L5 discrete localized posterior central disc herniation. There is presence of a high signal intensity focus at the margin of the disc posteriorly and centrally which likely represents an annual tear.L5-S1 Significant localized left posterolateral disc herniation. The thecal sac at this level is deviated to the right and is compressed. The S1 nerve root which is descending from within the canal appears to be compressed.Thre are no neural foraminal stenosis in all cases.It is almost 7 weeks now. I can not walk and stand without help. If I move or walk, pain comes after a while. My Left leg has weakness at some degree. the only occasionally numbness is on the smallest toe of my left leg. I fell I am improved in my strength but not my disc pain.Should I have an operation?Your answers will be highly appreciated! Best Regards! Ablajan

A: Hi Ablajan, I do not recommend surgery. I would try more conservative means, such as physical therapy and non-surgical spinal decompression. Save surgery as a very last resort. The pain is likely to fade with time. Best, Sensei Adam Rostocki

Q: I had a surgery for 2 herniated discs 3 and 4 on April 1st and after that I did my physical therapy for five months then a final evaluation describes that my condition is good to do light duty work but I'm still feeling pain in my right leg.My question is that is correct going back to work with that pain which is a heavy? Andres

A: Hi Andres, I can not advise you on the correct time to return to work, since I am not at all familiar with your case. This is a matter to discuss with your doctor, but if you feel it is premature, you should make your opinion known and documented. Best, Sensei Adam Rostocki

Q: Hi. I'm hoping you can help me. I was in a car accident seven days ago and my MRI report just came back. I don't understand all fo this, I only know that I'm in terrible pain. Below are the findings:

Superconducting Open Magnetic Resonance of the Thoracic Spine:

There is anterior disc bulging and osteophyte formation at T5-T6 and T6-T7. At T7-T8 and T8-T9, there are anterior disc herniations present with anterior osteophytes to the left of midline. No prevertabralor paravertabralmasses or fluid collections are identified.

Conclusions:1) There are changes of spndylosis present in the thoracic spine as described.2) At T5-T6 and T6-T7, there is anterior disc bulging with anterior osteophyte formation.3) At T7-T8 and T8-T9, there are left sided anterior disc HERNIATIONS present.

Superconducting Open Magnetic Resonance of Cervical Spine:

Findings - The posterior fossa structures are normal. The cervical cord structures are normal. The lordotic curvation is preserved. No prevertebral or paravertebral masses or fluid collections are identified.

Conclusion:1) At C6-C7, there is a central disk HERNIATION which is causing anterior impression on the thecal sac and mildly stenosis the spinal canal. The focal convexity in the posterior border of the disc is the herniation.2) At C5-C6, there is a central disc HERNIATION with tear in the annulus which mildly stenosis the center of the spinal canal. 3) At C4-C5, there is a right foraminal disc HERNIATION with disc bulging which is causing anterior impression on the thecal sac and moderately encroaches the right neural foramen.4) At C3-C4, there is disc bulging which is causing anterior impression on the thecal sac.

Superconducting Open Magnetic Resonance of the Lumbar Spine:

Conclusions:1) At L4-L5, there is a central posterior disc HERNIATION which causes anterior impression on the thecal sac and mildly stenosis the spinal canal and the bilateral foramina. 2) At L5-S1, there is disc bulging which is causing anterior impression on the thecal sac.

I've had a headache since the accident, tingling in both feet and hands and terrible pain in my neck and back. I need help understanding what all of this means in laymen's terms! Thank you in advance for your much needed help! Rodney

A: Hi Rodney, I do not see any serious issues with your MRI results. Being that your accident is recent, the pain could be from any number of concerns, including general trauma. I do not know the exact symptoms you are having, besides headaches, but see no clear reasons for any in your results. Best, Sensei Adam Rostocki

Q: Hi Sensei, great website, great to read your story. i guess i am stuck on what to do/where to go in direction of my back/leg pain. for the past 2+ yrs i have been suffering from leg pain--sciatic and severe lower leg/ankle joint pain... i recently got an MRI and the results are:L4-L5: "narrowing and desiccation of the disc. posterior central and paracentral annular tear, associated with a 4 mm left paracentral disc protrusion. flattening of the left ventral thecal sac and displacement of the origin of the L5 root. lateral recesses and foramina are unremarkable with no impingement on the existing L4 nerve roots." my doc is suggesting to try a steroid shot in the back, which i will do. i am also going to start seeing an acupuncturist (tried that which helped some, but don'[t think my guy was experienced enough, so going to different one this week). do you think i should be seeing a chiropractor? the sciatic pain is horrid and i am taking about 60mg of norco a day (it is the only thing that will bring some pain relief). any help would be appreciated. thanks! Phaedra

A: Hi Phaedra, I do not think the symptoms are from this herniation. I would recommend knowledge therapy. If you do thoroughly believe in the structural diagnosis, then you may want to consider spinal decompression. I do not think you will see any lasting relief from the injection or any of the other modalities you mention. Best, Sensei Adam Rostocki

Q: I fell off a ladder flat on my back on concrete in my garage 7 mo. ago. The MRI showed herniated t7-t8 disk, flattening the ventral aspect of the cord. Advised against surgery. My shoulders click when i swim free style, and back dull ache. I'm hoping the disc reabsorbs.Also 2mm anteriolithesis L5 on S1, and small herniation c6-c7 npt touching cord. Any advice. Thoracic herniation scares me, and depresses me. No more running Liz

A: Hi Liz, I would like to see the MRI report before advising you. Best, Sensei Adam Rostocki

Q: My MRI Report is :-Findings :-Saggittal T1 and T2 weighted scans of the lumber spine were studies and correlated with axial scans at L1 to S1 vertebral level. Diffuse posterior disc herniation at L4-5 causing indentation of spinal theca, narrowing of neural foramina (left>right) compression of exiting nerve roots, secondary canal stenosis and lateral recess stenosis.Lumber canal measurements (in MM) at various levelsL1-L2 (IV disc):17L2-3(IV disc):15L3-4(IV disc):15L4-5 (IV disc):13L5-S1(IV disc):15The conus medullaris and nerve roots of cauda equina and CSF sub arachnoid spaces are normal. Lumber lordosis is maintained.The study reveals normal morphology and aligment of rest of the vertebral bodies, pedicles, laminae and spinous processes.No osteophytes are present. No facetal arthropathy is seen.No ligamentum flavum hypertrophy is present. There is no abnormal pre or paraspinal soft tissue. MR Myelogram confirms above findings. IMPRESSION :- MR Study reveals -Diffuse posterior disc herniantion at L4-5 Level.My Question is :- I am suffering from back ache that hurts like a pin-prick. What type of treatment should I opt for in these circumstances. Ranjeet

A: Hi Ranjeet, Where exactly are your symptoms, as specific as possible? Best, Sensei Adam Rostocki

Q: My mri shows 5 mm broad-based and central disc protrusions are present posteriorly at the levels of l4-5 and l5-s1, without appreciable neural compromise.There is facet arthropathy at l3-4 without narrowing of the neural foraminaModerate degenerative disc disease at l5-s1no evidence of central spinal canal stenosis. I had two of the steroid injections about 10 months ago and felt pretty good. The pain is back, had an injection a week ago but have not felt any relief. I was just looking for some answers on-line or possibly find out any options that could be available. Thanks! Kathy

A: Hi Kathy, I can tell you for sure that the chance of these spinal issues being the real sources of pain is slim to none. I do not see anything on your MRI which makes me concerned in the least. I advise reconsidering the diagnosis, as I believe it to be completely incorrect. Best, Sensei Adam Rostocki

Q: my mom is suffering from acute pain near the tail bone x-rays show degenerative disease, I do not know the solution,I cant take her to the dr for she has no insurance. plus she cannot sit for long time only 1 hr at the most then she has to lie down.pls help THANKS. Indy

A: Hi Indy, DDD is almost never the source of pain as your describe, and is universal in the lower spinal region. I can basically tell you that it is unrelated to the pain. You might tell her to try knowledge therapy, since the treatment is free... Best, Sensei Adam Rostocki

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