Jan 2, 2002 2:17 PM
|Does anyone know a chiropractor in the Los Angeles/Orange County area that is "cycling-specific/knowledgeable"? Thanks.|
Jan 2, 2002 6:04 PM
|I am a Chiropractor, you need to look for a chiropractor that specializes in sports injuries perhaps. depends on what your looking for, but any good chiropractor should be able to help you. I haven't heard of anyone that specializes in cycling, though I am an avid cyclist myself. good luck
Jan 2, 2002 8:16 PM
|Can I ask what your view is on using a chiro to cure sciatica caused by a bulging L4-L5 disc (i.e. appropriateness, success rates, risks, expected number of visits, etc.)? Aren't some chiros more into aggessive manipulations and others less so? Which is the more appropriate technique here?
A friend of mine has the same problem and is afraid to go to any chiro; he knows someone with that same problem again who got perhaps permanently messed up by a chiro (it's been 6 months and the person is now homebound). Of course, one must separate anecdote from likelihood. Anything you can say to illuminate things would be greatly appreciated. Thanks.
Jan 2, 2002 10:26 PM
|I am assuming you wanted my resonse ET. Unfortunately there are so many myths and misunderstandings about chiropractic I wont even get into that. should a chiro be seen for a bulging L4-L5 disc, absolutely. I can't tell you how many people have crawled into my office with that very problem and with time they were good as new. It's funny how people become afraid of chiropractors based on total ignorance, yet will happily see and trust anything that there MD recommends not having a clue that MD's kill half a million people a year from malpractice, which is equivelant to three jumbo jets crashing every 2 days, I know I wouldn't fly with those statistics, would you? and dont take my word for it, the study was done by Harvard Med School, you may have heard of it. Unfortunately there are bad in every profession, not to say that your friend of a friend saw a bad chiro, maybe he was just expecting an instant miracle, which just doesnt happen in the real world. Discs bulge because of the pressure put on them by misaligned spines, the disc isn't the problem, the spine is, and chiro is only doctor that can deal with this problem. Or you can hop on that jumbo jet and get your disc sucked out after it is totally degnerated, and they can't put it back if you dont like the results, get it? trust me, more people are unhappy with those results than you may realize. Anyways, sorry to rant. to finish your question, success very likely, unless patient waited to long and to much degeneration, risks? absolutely none, just look at the cost of malpractice insurance for a chiropractor, it is almost free, the reason is, we dont hurt anyone, now compare that to Medical doctors malpractice insurance, Yikes!!! number of visits? depending on severity could be anywhere from 30 to 100 visits over a years time. Pain relief could come within the first 4-8 weeks but total correction of spine takes much longer. good luck, glad to help.
|Thanks! Can I follow up?||ET|
Jan 3, 2002 7:13 AM
|1. What about chiro success rates, again specifically for L4-L5 sciatica? It's not 100%, as I personally know someone who went to a big name chiro for many visits, had some initial relief, and then it got even worse, and he resorted to surgery. But if the risks are minimal and the success rate reasonable, it's worth a try.
2. Where do you stand with regards to approach for L4-L5 sciatica: gentle manipulations, or aggressive cracking? I know two chiros, and each leans towards one of these.
3. Is there a typical time limit for degeneration beyond which it's unsafe to wait? A year? Five?
4. What is your view on PT (traction) for this problem?
Thank you so much. Such useful info really helps.
|ET, I'm not a doctor, but I've talked to a lot of doctors and||bill|
Jan 3, 2002 8:10 AM
|a few chiro's about this sort of stuff. |
A bulge in itself is not a significant finding. Many normal, asymptomatic adults walk around with bulges and even herniations, with extruded disc material on MRI or CT examination. Without clinical corroboration of compromised nerve function, often by EEG or by a host of other, less technical tests, which is decidedly not the same as sciatic pain, a bulge in itself is meaningless (how do you know you have a bulging disc, anyway?).
Sciatic pain is when the bundle of sciatic nerves becomes inflamed. Why does this happen? Sometimes, just because. It happens. The inflammation response of the tissues means that they swell, filling the space through which the nerves run, in turn reacting to other tissues and perpetuating the inflammation. It almost always is a local problem, often prompted by stress. Don't manipulate. Don't crack. Try Alleve. Hot and cold compresses help, too (I've had it, right in the middle of a malpractice trial, where I was representing two doctors).
Jan 3, 2002 8:56 AM
|Confirms bulging L4-L5 pressing on sciatic nerve. Report might have used the word "herniated"; I can check. Very comfortable with diagnosis (although there's more to my medical history which I won't go into now); that's not the problem here. It's what to do about it that's unclear. (BTW, no trouble cycling.) I've had it now for a year and a half; it's wearing me down over time and perhaps getting worse. I can feel it running down from lower back and down leg. It's the worse in hamstring and butt especially while sitting. I've been to a neuro, who of course has a low opinion of chiro and PT. He told me to take Alleve and bear it as long as I can (since it might go away by itself) and when I can't bear it, come back for surgery. The neuro is chief of this and chief of that (the only thing missing is a wigwam :-)). Claims 99% success, (beating the industry average of 90%); he may be right, but I've had foot surgery with high stated %s with less than spectacular results, making me more receptive of nonsurgical alternatives than I was before) with a 15-20% recurrence rate (the industry standard, and apparently due to a decrepit back, not the surgeon). Alleve does give some partial temporary relief, but there are a few side effects on stomach; don't want to live on that stuff forever either.
What to do next? Some claim success with chiros (who often overinflate expectations), some have horror stories. Same with PT. Some claim they were totally cured by Sarno's book ("it's all in your mind"). Just want a plan, a rational order of what to try first before progressing towards surgery.
|My .02........||Len J|
Jan 3, 2002 9:14 AM
|is always to start with the least invasive therapy and only do invasive when I have exausted all others. Especially if I have something that I am able to function with. It sounds like you are functional (with some discomfort). If you try the Chiro and he doesn't work you are only out some time & money, if you try the surgeon, and it doesn't work, then what?
I always try to ask myself: "What is the worst that could happen?" If I can live with that, that I'll do it, if not, than drag me kicking & screaming.
|the chiro here...||ET|
Jan 3, 2002 9:18 AM
|makes it sound like waiting is a risk too.|
Jan 3, 2002 10:17 AM
I have (had) the same symptoms as you and I was riding asleast 200 miles per week. The riding didn't bother my back much. I tried the chiro for 3 weeks, 3 times a week and the problem got worse. Maybe the guy I was going to didn't know what he was doing I don't know.
The next thing I did was talk to an orthopedic surgeon and after the MRI, he sugested that we try Cortosone. I did and it did help for a while. He also said for me to bear with the pain as long as possible and only consider surgery as a last resort. And like you are experiencing now, the pain becomes too great.
I had a surgery for L4-L5 bulge on the 13th of December. The surgeon removed the bulge, which by this time was large. I went into surgery at 7:30am and home by 3:30pm, mind you I wasn't jumping around. Before surgery I had severe pain in my hamstring area, calve and butt. The pain now is gone but I still have pain in my back, however I am still recovering and at work.
It's not all in your mind!!
Just my 2 cents.
Jan 3, 2002 11:06 AM
I had the same symptoms as you, pain in my calve, hamstring and buttocks. I was still riding 200 miles a week. Not wanting to be cut on I went to a chiropractor, which took an x-ray and took out a ruler and said that I was miss-aligned. He suggested that we start cracking and we did. After 3 weeks, 3 times a week the symptoms got worse, actually from taking Alleve to hydrocodone.
I went to an orthopedic surgeon and he suggested that we try cortisone. I had 2 cortisone shots, which help for a while. The surgeon told me to deal with the pain as long as possible and to consider surgery as a last resort. As you are finding out now, you can only deal with the pain for so long.
I had surgery on the 13th of December 2001 to remove the bulge, which was quite large. I went into surgery at 7:30 am and was home in bed by 3:30pm. I was able to walk by the next day, (like the old man on the Carol Burnett show). I do not have the pain running down my leg but I do have some discomfort in my back, but I am told that is from the surgery and it should go away. I am at work and getting around I plan on getting on my bike next weekend if the Doc gives the ok.
|Hey, boy, go easy on the medication.||bill|
Jan 3, 2002 11:52 AM
|You've posted almost, but not quite, the same message twice. Take er easy, big fella.|
|Hey, boy, go easy on the medication.||ghoss|
Jan 3, 2002 11:58 AM
|That was the hydocodone!!! :^) |
Sorry about that!
|The danger of going to a chiropractor is not so much that you'll||bill|
Jan 3, 2002 7:29 AM
|get hurt but that you'll pay $200 a visit, three times per week, for no help. With no personal disrespect to my cycling colleague, the statistic about MD malpractice is misleading. Sure, MD malpractice is going to cause a lot more physical harm than chiropractor malpractice. It is also going to cause a lot more physical harm than accountant malpractice. MD's are licensed to use tools such as scalpels and medicines, which can hurt you. Rubbing your back is (probably) not going to hurt you (yeh, yeh, I know, you do a lot more than rub backs; but, is what you do any better than rubbing a back? I simply have never been convinced about that). |
In some cases, chiropractors, by omission, can cause serious harm, because they can miss serious problems that a competent MD can diagnose. Then, when the victim tries to blame the chiropractor, they get to say, hey, we're not MD's. You can't hold us to that standard of care. How was I supposed to know?
This is a bit harsh, because I believe that there are competent, responsible chiropractors who know their limitations (we shouldn't trust our MD's blindly, either). I just have seen far too many instances where chiro's promise you health and wealth and then rub your back and rub your back and rub your back some more and charge you a fortune. You may even start to feel better, but you may have started to feel better anyway.
I'm a lawyer, by the way. I've never sued (or defended) a chiropractor, but I've worked with MD's and chiro's in the course of representing individuals, and I can tell you who'd I go to.
Jan 2, 2002 8:37 PM
|Basically I'm looking for a chiropractor that knows about cycling so they would completely understand my symptoms, and possible treatments.|
Jan 2, 2002 10:28 PM
|what are your symptoms mavic? I may be able to get you headed down the right path, since I myself cycle, I understand what kind of problems can arise.
Jan 3, 2002 7:27 AM
|Well, to keep a long story short, I broke my femur (cycling of course), so my left femur is 1 cm short than my right. Okay the problem is in my right shoulder blade. I feel like its twisted inward causing pain in the middle of the shoulder blade and spine. I'm thinking I'm a bit misaligned....|
Jan 3, 2002 8:34 AM
|Mavic, sounds to me like you have a basic musculoskeletal/spinal problem that any good chiropractor can deal with, you dont need a specialist. has your femur actually been measured short radiographially, or is one of your legs appearing short when you compare the two? big difference in the two. The other's here have made some decent points regarding chiropractic and yes there are other reasons that Med Doctors Insurance is higher, I agree with the post. On the other hand, Chiropractors do not hurt anybody, and I mean worse than some soreness or irritation of a current problem at worst. Most people dont realize that when a chiropractor adjusts the spine, the amount of movement out of a particular vertebrae from a single adjustment is so minute to be immeasurable. It's when you had up a series of adjustments over a period of time, you get the correction. I myself take pre and post X--rays on patients (post xrays being after atleast 30-40 adjustments) and not one of my patients would tell you they dont believe in chiropractic when we are done. Is Chiropactic 100%, no it is not, I believe the statistics show that chiropractic is successful with 80% of cases related to low back pain. Some people just dont respond, and some are to far beyond repair unfortunately. As far as the lawyers go who posted here, research is always handy. look up a document done by AHCPR on Acute low back problems in adults. This is a study done by our government showing Chiropractic to be the most affective treatment for low back pain. Unfortunately for Chiropractic, we have been put into this niche of treating back pain when that is not really what chiropractic is, funny huh?
Jan 3, 2002 9:16 AM
|I wouldn't say chiro never hurts anyone, either. I know someone personally who went to a respected chiro for this problem and was in agony after one alignment until another re-aligned it and got him back to where he was; he never went again. Another friend with the same L4-L5 sciatica (but different symptoms) has a relative with same problem who has been homebound since getting messed up. There's a lady on another forum whose SI joint was permanently injuriously displaced by an osteo; it's been 4 years, and her back problem, minimal at first and initially a result of foot problems, are now so bad from that one visit that it is now her primary problem. Not too many people on that forum in total, either. It's too many people from too small a sample for me to dismiss it as purely anecdotal.
Sure, anecdotes don't tell the whole story, and there are horror stories about surgeons too, who, as you point out, traditionally get viewed more favorably. They often are weak on nonsurgical solutions too. But the risk of chiro is not zero. What it is is very unclear.
I must support some of Bill's general thinking with regards to the study you quote. For starters, obviously you're quoting that one because it's favorable (others may show something else). And general low back pain can be the result of many things, and the fix can occur in many ways. A lot of time often passes from one's first chiro visit to one's last, and it's possible that some would have gotten better anyway or could have used another technique.
I don't want to get into a discussion of general lower back pain; that's never-ending. I want to focus specifically on a diagnosed L4-L5-induced sciatica. I'm open to chiro. Wish I had more of a handle on the risk and success rates. You've offered some info, and I'm taking it in and thinking about it. I'm still listening too. Thanks.
Jan 3, 2002 9:43 AM
It was done with x-rays with the ruler in the x-ray etc...
Didn't know the thread was going into the direction it did. Sheesh, all I wanted was a good referral =)
Jan 3, 2002 9:42 PM
|Mavic, my fault the thread got off topic, I tried to bite my tongue but couldn't help it. Everyone here has made good points, I will not fully disagree with anyone. I have no doubt in my mind that the percentage of people that actually understand chiropractic is very very small, not to say people are dumb, they just dont understand. Like I stated in my last post, Chiropractic is not even based on the treatment of back pain, but if you ask 100 people on the street what chiropractors do, 99 of them will tell you we treat back pain. Unfortunately, chiropractic is great for back pain, which has become a major headache in a way for chiropractors that actually practice chiropractic, not chiropractors that wish they had gone to med school instead. I doubt anyone that has posted here can tell me what chiropractors really do, and why we were first lisenced in the first place.
|those of you with back pain - read this book||gtx|
Jan 3, 2002 1:06 PM
|I was off the bike for over 2 years with awful back pain. WSaw lots of docs and diagnosed with herniated discs, but chiros, PTs and drugs didn't help. This book fixed me in two weeks and haven't had any pain since. Read through some of the reviews. Good luck!
|I knew this was coming :-) (nm)||ET|
Jan 3, 2002 2:25 PM
|I knew this was coming :-) (nm)||Daniel|
Jan 3, 2002 3:02 PM
|I read the before mentioned book. I should have used the money for a good sandwhich instead.
Try swimming. Last summer I did a lot of swimming. It really helped. I still have it, but there has been definite improvement. I should really do more swimming.
|I knew this was coming :-) (nm)||gtx|
Jan 3, 2002 3:24 PM
|$13 should buy TWO good sandwhiches. :) Hey, just throwing it out there--worked for me. And yes, I did a lot of swimming, too. Did seem to help a bit but wasn't a total cure. I also hate chlorine.|| |