Berkeley Parents Network: Back Problems

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Back Problems

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Degenerative Disc Disease
Should I have back surgery?
Injured my back carrying the carseat

Degenerative Disc Disease

May 2003

I have been ''diagnosed'' with degenerative disc disease by my well-thought-of orthopedic dr. I have had significant lower back pain for ages, and it has increased a lot in the last 6 mo.s - 1 year. I have had xrays and most recently an MRI. So far the treatments have been neurontin, ibuprofin, facet joint injections (which were very uncomfortable, almost really painful, and after one day of no pain brought no lasting relief). I have no disc or pad between two of my lower vertabrae, and there is a lot of inflammation and stuff going on that is now affecting my mobility and ''quality of life''. In the mornings especially I am extremely achy and very stiff and feel like my back is going ''give out'' at any minute. My dr. has now prescribed hydrocodone, which helps a bit esp. at night, but does not seem to be a long term solution. Any thoughts on long term improvement in this? I am a single mom, work full time as a teacher, and time for things like regular yoga or other exercise is limited to say the least. Dr. has mentioned surgery as an option, but has not gone into details about procedure or recuperation. Anyone who has similar back issues and has resolved them to any significant degree? Any thoughts on surgery? recuperation times? chances for improvement? I am only 41 and I feel like I am over the hill physically due to this. Any advice would be greatly appreciated. mb

My mother was also diagnosed with degenerative disc disease about 18 months ago. She was 58 the time, and was in great and almost constant pain. After all the usual pain pills and shots from her doctor, she finally took my brother up on his advice to see his chiropractor. This is a woman who utterly pooh-poohs ANY form of alternative anything.

The result? She's a changed woman. The chiro managed to re-align her spine in such a way as to relieve the pain, and has made her a total convert to the merits of alternative possibilities. The weekly massages she gets from his staff don't hurt, either. She goes for an adjustment every other week, and her pain is largely gone, she says, although it returns if she abuses her back in any way, such as lifting heavy things, etc. She also takes a mineral - carbon? - that has made her feel very much less stiff overall. Email me and I'll find out exactly what it is she takes - her massage therapist turned her onto it. This route worked wonders for my mom - it might work for you as well. Good luck - I know what back pain is like. Julie T.

I went through a bout of severe back pain myself about 5 years ago in my late 20s, so I understand how devastating it can be to both mind and psyche. I went through the whole round of Western medical ''diagnosis'' and was ultimately found to have a severly herniated disc at L5/S1. Thankfully, I was resistent to invasive ''treatments'' -- yes, I put this in quotes for a reason, namely that Western med really has no proof of the causal relation between structural back peculiarities and pain -- and ended up seeing an acupuncturist for the pain. The acupuncture lessoned the pain symptoms somewhat, but the truly invaluable gift the doc gave me was a book recommendation HEALING BACK PAIN by John Sarno, MD. All I can say is, this book will change your life. It is very rare for (1) a structural back issue to cause pain; and (2) for it not to heal on its own. Orthopedists, neurosurgeons and physical therapists won't tell you this because it just isn't in their realm of possibility. Read the book. Be open to Sarno's method. Google him and find hundreds of stories and case studies online. You'll see yourself in every word. I have recommended this book to several dozen people with chronic back pain and its corollary illnesses (carpal tunnel, tendonitis, fibromyalgia, ad infinitim) and nearly every one has found it to be helpful if not downright life-altering. Good luck to you! kim

The book MIND OVER BACK PAIN by Sarno can give you a good overview of your options. He specifically addresses ''diagnoses'' of ''degenerative back pain'' and gives statistics about the (extremely low) success rate of surgery. He gives guidelines for general back care that maximize the back you have to work with. And if nothing else, the book is a good springboard for further questions you might want to ask. I bet you're in much better shape than you think. Anonymous

I hesitated to respond to your post at first because I have almost too much to say on the topic of chronic back pain, but I can't resist the opportunity to (hopefully) help a fellow back pain sufferer (I'll try not to go on for toooo long).

I first started suffering from chronic back pain when I was in my late 30s. I quickly learned that traditional MDs are worse than useless when it comes to back pain -- they know virtually nothing about it, but they also don't know that they don't know (and I say that as a person who is mostly a believer in Western medicine). Their entire back treatment repetoire consists of pain pills and surgery, neither of which tend to be very effective (back surgery has almost as much potential to make things worse as better). If those don't work, they shake their head and tell you you'll ''just have to live with it'', and treat you like a whiny 3 year old if you object. Thankfully, I decided to ignore their opinion that my back pain was a life sentence (many health insurance plans won't even cover treatments for back pain if you've had it for 6 months, since they then consider it ''chronic'', and therefore incurable!).

I should mention that I too was given a ''diagnosis'' of degenerative disc disease. This sounds incredibly scary, but it's really a non-diagnosis. Studies have shown that a very large percentage of the population (something like 70%) have degenerated discs -- it's a normal part of the aging process for discs to compress and become less flexible or somewhat misshapen as we age -- but the vast majority of people with ''degenerated'' discs suffer no pain whatsoever. Take me for example -- I'm sure that my discs are as ''degenerated'' as ever (probably more so), and yet, at the age of 44, I have now been pain free for several years.

I began to explore alternative treatments. I found that I only got temporary relief from chiropractic. I'll ''cut to the chase'' and say that, of all the things I tried, what helped me the most was cranial sacral manipulations by an osteopath, and yoga. The osteopath I went to was Hennie Sholars, who I highly recommend -- she's in SF (don't have the number handy but you can find her through information). I found the type of manipulations she did to be at once more subtle, more powerful and, most importantly, led to more long-lasting improvement for me than chiropractic. Briefly, some other treatments I tried that were helpful were acupuncture, deep tissue massage and, believe it or not, Rolfing (I went to Georgette Delvaux, in Berkeley) -- I recommend you wait till your back is more recovered before you try Rolfing, but it definitely made lasting structural changes which have put my body into better alignment.

Yoga has also made a huge difference, in fact it's the only thing I'm doing now to maintain a healthy back -- I suffered a significant relapse a few years ago when I started slacking off on my yoga practice, so I now do it religiously. I know what you mean about not having time -- I'm a single mom too -- but ask yourself how much time and energy you lose by being in constant pain. Wouldn't it be worth a few hours a week of your time to be pain free? I highly recommend finding the time to do yoga long enough to at least see if it works for you -- make a commitment to do it 2-3 times a week for at least 8-10 weeks -- I bet you'll see an improvement long before that time is up, but don't expect it to be an instant cure -- it took your back 41 years to get into the condition it's in now -- expect it to take at least a few months to get better.

Anyway, I could go on, but I won't. If you'd like to talk with me about this more, please email me.

My parting thought is this please don't accept your ''diagnosis'' as a life sentence -- it's not. Explore alternative treatments, give yoga a try, and eventually your back will get better!

Good luck! Diane

Chiropractic is great for degenerative disc disease. it can keep it from getting worse , keep the joints moving , even help to reverse it in some cases. i have a great dc in Fremont, Dr. Nichols . he's on Mowry. his number is 510-593-7743

May I add to advice that was given, but which might be going off on a tangent? Someone recommended yoga for back problems. While I also have practiced yoga and love it, I have been injured/reinjured three or four times while practicing it. The most recent time was while taking a yoga class from the movement instructor from my chiropractor's office! She was aware of my particular problem, yet even she with her years of experience was not able to guide me so that I didn't aggravate my problem. I just assumed that since she had vast experience with back problems that the yoga postures she was teaching me would be fine. Wrong!

What I'm trying to say is that yoga can actually aggravate an existing back problem or cause a new one if you do a pose incorrectly or one which puts additional strain on a sensitive area. Ideally, if you want to go the yoga route, you should find an instructor who is familiar with back problems. Even then there aren't any guarantees. I'm sadly stearing clear of yoga for now because I don't trust that the instructors have enough knowledge to prevent injuries among their students. anon

Should I have back surgery?

May 2003

Does anyone have advice on whether I should consider the disc-ectomy that my doctor has proposed as an option for my chronic pain? Anyone have experience, good and bad, with this procedure? Or alternative treatment that has been successful? I've had back trouble ranging from total debilitation to constant but low grade pain for over a year now. I had sciatic pain through the latter half of my pregnancy and then after the birth via c-section, my back ''went out'', incredible pain and numbness down to the foot. I've seen doctors at Kaiser and the MRI showed a disc bulge. They say the numbness may be permanent, but surgery should stop the pain in my hip. It seemed to be getting better after one year and a lot of accupuncture. This week has been a real set back, though, and I am feeling depressed. I'd like to be able to do normal things again. I'm hesitant to go under the knife again since I lost a lot of blood from the c-section and it took a very long time to recover physically from the birth, also recovery seems daunting with 1 year old.* carol

I'm sorry that you are in so much pain. I have done evidence based reviews in the literature for chronic pain for my job and have the following to say. I would definitely get a second opinion since it sounds like you're wary of surgery. Sometimes (and I say this knowing NOTHING of your medical situation) people with chronic pain can be sent down a fruitless path of surgeries. If you are a northern CA Kaiser patient, ask your doctor to refer you to the chronic pain program (I believe you use the CRES referral system - I'll check that). You will get a multidisciplinary evaluation - very thorough and you will also receive a multidisciplinary treatment plan. This is done by three (or four?) different specialists in pain medicine. Now, they may end up telling you the same thing you know now, but at least you'll have more thorough info. The key principles in chronic pain management include having a multimodal treatment plan (meaning using different treatments at the same time for greater benefits - e.g., medication, physical therapy, relaxation exercises) and playing an active role in your treatment. If you're feeling depressed, you should know that's incredibly common for people with chronic pain and you can and should ask for help with that. Kaiser has a great pain program, with classes and experts. There's good evidence for the use of various pain meds, physical therapy, graded exercise, pain management classes, acupuncture (short term) and massage. Good luck!

PLEASE, PLEASE, PLEASE do not agree to back surgery untill you have seen a good chiropractor. Bulging discs are serious and can make you miserable but with the proper chiropractic care and a maintenance exercise program you can live your life pain free. As a massage therapist who works with chiropractors I have seen MANY types of back problems from chronic to acute be helped with chiropractic care.

I, myself have disc problems in my neck. I get numbness and tingling in my hands (why, is a long story). Through proper neck exercises, chiropractic care and home care (I do 10 minutes of traction on my neck every night to relieve pressure on my discs and re-educate the musculature around my cervical spine) my neck stays in pretty good shape even with the work I do. With my maintenance routine it is not likely that my situation will get worse.

Chiropractors are spine specialists, whereas MD's are usually not. Some MD's will refer their patients in your situation to chiropractors, but unfortunately more often they will prescribe meds, surgery and tell patients to live with their problem that nothing can be done....NOT TRUE.

So often there are further problems after back surgery (not always, but often) and recovery can be long and difficult especially if you don't have the proper physical therapy. Surgery may be what you need, but it may not and it would be tragic to put yourself through that before checking out another alternative possibility.

A good chiropractor will also recognize that surgery may be helpful for you if their care is not helping your situation. I'd like to recommend 2 really good chiropractors to you. Dr. Bruce Rizzo, at 843-1234 is at 2509 Milvia. I work with Bruce and aside from being a wonderfully great person, he is a very skilled, competant and caring doctor. Also Dr. Charlie Prins on Solano ave in Berkeley (his number is in the phone book, sorry I don't have it right now) is really great. Very experienced, kind, compassionate guy. I see both chiropractors for different issues and recommend them both very highly. I imagine you'll get a lot of feedback on your post from people feeling similarly to me. I do hope you'll consider seeing a chiropractor before deciding on surgery. Good luck to you. June

If you are unsure about surgery, I would highly recommend checking out the Spine Center at UCSF for the new minimally invasive laproscopic discectomy. My husband had this surgery for his sciatica last December and it has been a lifesaver for us. He was in the hospital only one night, and experienced a huge reduction in his pain only two weeks after the surgery with Dr. Berven. He was back to his pre-injury routines six weeks after the surgery, and now experiences only occasionaly, mild soreness after strenuous activity.

UCSF is currently in the middle of study of herniated disc treatment, basically comparing the results of those who choose to have surgery and those who dont. As part of the study, they have a videotape that explains all the treatment options and outcomes, and interviews with people on both sides of the fence. They will give you the video even if you dont want to participate in the study. Dr. Berven and both of the nurse practioners are excellent, though the office staff is incredibly disorganized. Here is their website

http//www.ucsf.edu/orthopaedics/patientserv/spine.html

please feel free to email me if you need any more information pj

My husband recently had his second bout in a 4 yr period with a bulged disk. Last time he avoided surgery and it eventually got better. This time he was in extreme sciatic pain, and the drs were predicting 8 mos for recovery without surgery. After doing much research, he decided to opt for a microdiskectomy at Stanford. It was a godsend! He will be back to work (at a physical job) after 9 weeks of recovery, and the pain is totally gone. My understanding is that most people recover on their own, it's just that surgery causes recovery to happen faster. The procedure he had done was an outpatient procedure, and he felt quite a bit better already after only a couple of days. Good luck! Also, someone in an earlier post recommended chiropractors. Beware! My husband tried that last time before he realized that he had a bulged disk, and he is convinced that the manipulation actually aggrevated the condition. mack

Injured my back carrying the carseat

July 2003

I have recently injured my back carrying my 4 month old's car seat. I could barely walk for about a month. My back is a bit better but still not 100%. It seems to be stiff all the time and I think I might have a pinched nerve because my right leg and toes are partially numb. It seems that my body has become a wreck since having a baby!

I was wondering if someone could let me know what type of Dr. I should see about this problem? Do I see a chiropractor? Accupuncturist? or any other type of Dr?? Has anyone else had this type of problem? If so, what helped cure it?

This type of problem is new to me so any recommendations would be helpful! Thanks! anon

I've had back pain off and on for over 20 years, definitely made worse by carrying children around. I've tried chiropractic, physical therapy, acupuncture, massage, and various kinds of bodywork. Some were useless but most had some positive benefit. However the two modalities that really worked best for me were Feldenkrais, a form of bodywork, and a book called ''Healing Back Pain'' by John Sarno. You'll need an open mind for the book as it is a radical approach.

Forget the doc. I experienced the same problems. Join a gym and focus on leg and stomach exercises... David

I saw an orthopedist. I've lost two seperate 5-6 month periods in my life due to chronic, lower-back pain. I couldn't do ANYTHING. Rest, rest, and more rest is the first step to healing. IMO, I wouldn't see a chiropractor right now. What your back joints and muscles need right now is rest and inactivity. I know, not easy with a toddler, work, etc. Only after your back feels 100% better (I made the mistake of returning to regular activity too soon), you need to begin a routine of stretching and strenghtening excercises to ensure you don't re-injure yourself. A good doctor can point you in the right direction, as well as prescribe medication to help with the pain.

As much as possible, have others lift things for you. Hold your child while seated. Don't stand for long periods. My doctor gave me several pamphlets with good advice for caring for an injured back and what excercises to do after I've recovered.

Just my experience. What you are going through sounds similar to what I've endured. It takes time and patience for a back to heal. And it's depressing too, because you can't do anything without pain. Also, this is obvious (and even I don't always do this), but if you must lift something, injured or not, remember to use your knees. Good luck. I hope you are feeling better soon. Mike

st. mary's spine center in san francisco is a great place! they have everything under one roof - osteopath, acupuncture, physical therapy, surgery. they're conservative and avoid surgery if at all possible. husband has a herniated disc and was able to avoid surgery by going there. good luck! i've had good results for lesser pain with gentle chiropractic and acupuncture. peggy

I am currently getting over the worst back problem I have ever had as well. I have an almost five year old and a nineteen month old who I used to carry a lot on my hips. What has worked for me

1. Changing my body mechanics. My friend lent me a book called ''How to Raise Children without Breaking Your Back'' by Alex Pirie and Hollis Herman. Very helpful in that regard. 2. My mother is a physical therapist so she has been working on me. Some deep myofacial work, some cranio-sacral therapy. And some other stuff I'm not sure about. It helps immensely. IN fact, when I first hurt my back, she went on vacation, then I went on vacation right when she returned, and I didn't see her for about a month. I was not doing well at all. Now that she has been seeing me again, its made a huge difference. 3. Walking and doing the exercises/stretches she has told me to do. 4. Ice and heat both, and trying to stay off my feet and lie down as much as is possible. 5. Swimming

I am slowly healing and have to change some things about my life so that this does not happen again. Its too brutal. But PT has worked really well for me. Hilary

I'm sorry that you're having back pain. It's the worst. I've had chronic lower back pain on and off since I was 15 after being in a car accident. I've been to chiropractors but for me, they seemed to make my back worse. Accupuncture helped, but what really helped was pilates. I used to do it at the pilates studio on Grand Ave. in Oakland. Private sessions aren't cheap ($60), but I did group classes, which were great for $10/ class. My back has been fine (knock wood) for the past year so I've been lazy and haven't been keeping up with it, but if it starts to hurt again, I'll go back. I also tried bikram yoga, which helped, but was a bit more aggressive than pilates. I like the kinder, gentler method of relief. Good luck, hang in there.... heidi

The pain on one leg and toe numbness sounds like a nerve injury of some sort. I don't know what insurance you have, but see whomever you need to see who can order an MRI(ask for a Neurology referral if you primary won't order the MRI). This will help determine if there is spinal and/or disk involvement. It is most likely something that can be fixed with the right combination of exercise, manual treatment (Physical Therapy or chiropractor, depending on what is causing your symptoms) and specific muscle reeducation and training( postural muscles). Those infant car seats are great but are horrible on your muscle and spinal alignment! I wouldn't run to a chiropractor without knowing what the cause is(ie if you have partially or fully herniated a disk, a chiropractor could be dangerous... although a good chiropractor wouldn't treat you if they suspected that. I have never had this experience myself, but I am a Physical Therapist and have treated many people with back injuries. Get it diagnosed by someone you feel confident in... then explore treatment options. Good luck and feel free to email me if you'd like more information. ender

There are many types of people to see. I am responding as a person who has been dealing with back and leg pain for the first time in my life. I think that each individual responds to different kinds of therapy. I have had success with cranio-sacral massage therapy and physical therapy. It is a very confusing issue because there are so many different approaches. Feel free to contact me. I would be happy to talk with you about this. Elyse

[See recommendations for Back in Action and Charlie Prins] Acupuncture is great too, but in my opinion will not fix your misaligned spine or pinched nerve. It may help relieve your pain and enhance your energy to promote healing (I admit I don't fully understand how it works), but I believe you need manual manipulation to truely help your condition, as well as rest, possibly heat, or ice, and certain stretching and strengthening exercises as you heal. Good luck finding the help you need. June Kamerling NCTMB

I have been dealing with back problems like yours for the past 5 years, and have been finally figureing it out. I am also a Licensed Acupuncturist. That this happended soon after pregnancy is telling me you might have the same problem as I did, but you have to get it checked out by a good chiropractor. Kaiser or other mainstream med systems will only give you ibuprofen or other stonger pain killers, maybe send you to physical therapy, or want to inject you with steriods! While you may need some pain killers for now, DON'T let them inject you with prednisone. Its efficacy is 50/50, and the side effects aren't worth it. There are better ways. It is extremely common for women, especially soon after pregnancy, to get a sacro-iliac joint dislocation. The sacrum and the hip are connected by tendons and ligaments, and the hormones of pregnancy make this connection looser. It is easy for it to get a little out of place. Even a fraction of an inch can cause major problems.. It also puts stress on the lower back. A Chiropractor can diagnose if this is going on and put it back in place. Acupuncture can help with the pain and help it heal. Nutritional supplements can add to this. Yoga then helps you build the muscles that are weak and stretch the ones that are too tight, and correct posture, to prevent it from happening again. Mine kept going out every six months. At first, I didn't know what was happening. Chiropractic and Acupuncture helped it heal very quickly, but it kept coming back. Finally, about 2 years ago, it went out really bad. I was down for a couple weeks, decided to try a regular doctor, but didn't get anywhere. Finally went back to a chiropractor, and as soon as he put it back in place, it started to get much better. This time, I determined to keep it from happening again. Over the last 2 years, I've experimented, and found that with Yoga, I prevent to root of the problem. Now, I can even feel if it's starting to go out a little, and self adjust with the right stretches. I would be happy to recommend a chiropractor is you don't know one, and can also give you acupuncture and nutritional consultation/coordinate your care if you so desire. Feel free to give me a call/drop me a line with any questions. (510) 306-0067 Rhoda Climenhaga, L.Ac.

I got a badly herneated disc from moving our 2 year old in a very very bad lifting position (always lift with your back straight, blah blah).

I tried accupunture but to tell you the truth -- they're kind of kooky and they don't want you talking with doctors. There's the whole conspiracy theory going on there that they are the unrecognized field of medical insight.

I also tried accupuncture and it gives great short term relief. But nothing more. And my schedule and job cannot accomodate that over the long term (much less my PPO insurance!)

Alas, I went to the Stanford Spine Clinic -- they screen you on the way in and by that time my toe and top of my right foot was numb, so they though I was worth seeing. They are the spine specialists and know the bones and spine very very well.

The MRI showed the material squeezed to the wrong location and pinching on the nerve clusters behind the spine. In the end I had a microdiscectomy, and it helped initially 80%, then less so, but now with regular stretching, exercises and swimming I'm back to, basically, pre-injury health. The microdiscecomy is a small incesion (1.5 to 2 inches) in the back and they go in with a microscope to remove the material sqeezed and impinging the spine.

The Spine clinic answered all my questions too, although I guess no one knows exactly how nerves will behave, so that was one area I just did not have a clear estimate as to pros and cons of surgery. That makes me think you may want to also see a neurologist specializing in nervous system. Happy with Microdisectomy

A good accupuncturist might help you (Dr. Robert Zeiger, Berkeley, CA is highly recommended). If that does not help, I would see my internist and get referred. You have been injured for too long. Leslie

I have various reoccuring back problems many of which are resolved with a trip to my massage therapist. I highly recommend you give it a try. Laurie

I had the same type of pain and limited movement from something I did when the girls were babies. From past experience, I'm a believer in gentle chiropractic. [See recommendations for Sandra Waggener] After you're ''fixed'', the best advice is to exercise daily - at least walk and stretch. It's tough to find the time but it really helps. Best wishes, Lori

Two pregnancies with back labor (one was twins) damaged my back. Eventually I had trouble walking and went to the emergency room. They wanted to know what the big emergency was -- sent me home with a bunch of pain killers and said I should just go see my regular doctor. My regular doctor said lots of people have back pain, gave me some excercises to do and sent me to a physical therapist. More exercises. I went to a chiropractor who seemed to help some. I finally ended up seeing Mark Fischer [see recommendation below] elizabeth

Having a baby is hard on the body! I ended up with tendonitis in both sholders and wrists and a sore back. Here are my thougts 1) I always worry when I see people carrying those removable car seats. It really twists your back to hold that kind of weight away from your body. We never even started with this habit. Holding the baby in your arms close to your body is much more stable and protective of your back. We learned how to easily remove our sleeping baby from the car seat without waking him, you can figure it out with a little practice. Also, carying the baby in a sling or snugglie is better for your back. It may seem like a hastle, but after a little while, it becomes second nature. 2) I went to see Susan Shreier 510-482-2276, an alexander technique practitioner who specializes in helping new mothers. I brought my baby with me to the sessions and she watched me lift, carry and breastfeed my baby and helped me to do it in a much more relaxed and aligned fashion. 3) Definitely get some chiropractic and massage and find some time for stretching. I made a habit of stretching each afternoon on the floor with my baby. He would do a little stretching too. 4) After I stopped breastfeeding (when my son was 2) and once he was old enough to walk a lot, not wanting to be carried around as much, my body finally felt like it could heal and get strong again. Good luck! anon

I did not read your original post but got an idea from reading the other responses. After 2 preganacies (one with twins) I have been having sciatic and lower back/hip pains since the birth of my third son 8 months ago. It really started to bother me when I started running regularly to get back into shape. There are two things that I have done that have really given me some relief. One was to buy a little support called the sacro wedgy. I got a massage from a lady who recommended it to me. www.sacrowedgy.com is the address I believe. I found it by typing ''sacro wedgy'' into my search engine. It is a little triangular shaped rubber support that you are supposed to lay on and there have been a couple of nights where this has saved me! The other thing I did was to visit a rolfer. I aactually have a friend who does it and he really helped me out. Before going to him I really did not know what rolfing was but it was just what my body wanted. It is a deep tissue massage therapy and reallignment of your body. I have heard that some people have had painful experiences with rolfing but my friend said that that may have been an old school approach or just a bad rolfer. I did not experience any pain and it really helped me out. I wish I could recommend my friend but he lives in Hawaii so that wouldn't be much use. Good luck less in pain

Recommendations received for Chiropractors:

Back in Action (2) Elon Bartlett, Bruce Rizzo

Paul Walton

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