When Lumbar Disc Pain Is Not Due to Lumbar Discs. Think That Herniated Disc Is Causing the Pain? Think Again!
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Written by Dr. Stephen Kaufman, D.C.   
Friday, 21 August 2009 12:06 Read : 804 times

I teach techniques that use neurological reflexes to instantly turn off myofascial pain. I’ve demonstrated these to 1000’s of DC’s at state association meetings. At every meeting, several doctors come up with sciatica and low back pain of many years duration, which they are convinced is due to protruding lumbar discs.

In many of these patients, their pain stops within minutes with the treatment we demonstrate. Frequently, numbness resolves as well. Often the results are long lasting. The techniques work by resolving areas of ischemia within muscles.

Since the advent of MRI’s, an enormous amount of pathology has been visualized that couldn’t be seen before. A patient with low back pain, with or without sciatica, may show bulging of one or more lumbar discs on an MRI. It is naturally assumed that the pain is caused by the bulging disc or other pathology. The more severe the pain, the more likely the patient and the doctor think it is due to the disc. If the pain resists treatment long enough, surgery is usually recommended, with the aim of removing or repairing the damaged structure. Even after surgery, the pain may continue.

What is not usually considered is that the patient’s symptoms may be completely unrelated to the pathology; the herniated disc may not be causing the patient’s pain at all.

 

Many studies find herniated discs often don’t cause pain!

In 1984, Wiesel, et al.,10 found that 30% of patients over age 40, with no back pain at all, had herniated lumbar discs on CAT Scan. (82% had facet degeneration!) Under age 40, a full 20% of asymptomatic patients had disc herniations. In 1994, Jensen, et al.,4 published a study showing that 52% of 100 patients with no back pain at all had bulging lumbar discs. 38% of this asymptomatic population had two or more bulging discs.

Qurioz-Moreno, et al.,6 in 2008, reported 55% of an asymptomatic population had lumbar disc bulges or protrusions. Baldwin3 stated, "The majority of individuals with degenerative disc disease are asymptomatic." Weishaupt, et al.,9 found disc protrusions or bulging in 67% of an asymptomatic population. Numerous other studies have reported similar findings.

Although these studies go back 25 years, many doctors still believe that, when a herniated disc is found, it is causing all the patient’s symptoms. I meet many chiropractors who have had what may have been unnecessary disc surgery, with no resolution of pain. Hubert Rosomoff, M.D.7, a neurosurgeon, estimated that only one in 500 lumbar disc surgeries is really necessary.

 

If it is not the disc, then what IS causing the pain?

Sciatica (as well as severe low back pain) is often due to muscular trigger points, not the disc structures, according to Baldry,2 and Travell and Simons.8 Although most DC’s are aware of the existence of myofascial trigger points, they usually do not know that they often cause radicular and incapacitating pain, like sciatica.

Existing methods for treating trigger points are often painful, ineffective, time consuming, hard on the doctor, and do not even make trigger points less tender. We have found that the proper use of neurological reflexes to actually turn off trigger points is far superior—it’s very often effective, painless, and produces instant results.

 

The severity of the pain doesn’t always correspond to the severity of the problem!

Many doctors feel that, because pain is severe, there must be a serious pathology causing it. Of course, this is sometimes the case; but, as the previous studies showed, many times patients have the pathology (herniated discs) with no symptoms whatsoever. Further, often even severe pain is due to myofascial trigger points, which do not show up on MRI’s, and may respond immediately to proper treatment. Obviously, symptoms other than pain (such as paresis, altered reflexes, loss of bladder and bowel control, cauda equina syndrome, muscle atrophy, etc.) may signal an emergency situation. But the severity of the pain alone is often not a sign that the condition is due to pathology, and will often respond to proper treatment of the muscular structures. It is critically important to keep in mind that the finding of a herniated disc may be incidental. However, you must still rule out pathology prior to treating.

Effective home treatment developed by an orthopedic clinic to avoid surgery.

One form of home treatment that we’ve found very effective was developed by an orthopedic clinic many years ago. It has enabled many patients to avoid surgery. We have the patient place an ice pack over the suspected disc area and walk with the ice in place for ten minutes maximum. (Any more than that may cause tissue damage.) This can be repeated three times daily, but the patient must actually walk, not sit. Sometimes the relief is so pronounced that what looked like it would be a long course of treatment became a short one.

Dr.-Stephen-KaufmanFor further information, go to www.painneutralization.com or call Dr. Steve Kaufman at 1-800-774-5078.


 
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