chiropractor or ortho speacialist?

[JAYB1999]

I recently had a MRI and was told to go to a chiroprator. this worries me as I think I need to see an ortho speacialist.
L5-S1: The posterior disc margin shows broad-based central and left sided disc protrusion. facets show moderate to marked left and moderate right degenerative changes. Left more than right subarticular recess narrowing is seen. The nerve root canals are widely patent on the right and moderate to moderately severly narrowed on the left.

L4-5: there is broad-based bulging with right-sided small disc protrusion. Superimposed upon a small canal is right greater than left subarticular recess narrowing. Mild right and mild to moderate left facet degeneration changes are seen. The nerve root canals so not appear significantly narrowed.

L3-4: ther is broad-based bulging and central disc protrusion. Superimposed upon a small central canal, there is mild right more than left subarticular recess narrowing. facets show mild to moderate degenerative changes bilaterally. The nreve root canals are mildly narrowed on teh right and widely patent on the left.

L2-3: the posterior disc margin shows minor bulging on the right. There is a small right-sided disc protrusion. Right more than left facet degeneration changes are seen. the nreve root canals do not appear wignificanly narrrowed..

L1-2: there is a tiny left-sided disc protrusion indenting CSF. No nerve root cord cntact is seen.

this was a Safittal T!, proton density and T2 and STIR images of lumbar spine. Axial proton density and T-2 weighted images were performed.

would this explain intence pain and numbess on my left leg and mild numbness on my right side? I can't walk, sit or lay for very long. thak god my job allows movement.Should a chiroprator or othro doc be seen?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Your symptoms (which I am not sure what they are exactly) could be explained by the MRI results. For example, a herniated disc at L5/S1 could cause sensory symptoms down the buttock through the back of the thigh and leg to the lateral aspect of your foot. In most people, the pain of a herniated disk resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. Only a minority of people ever require surgery. With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. Therefore, for the majority of people, non-surgical treatment is the first option. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muscle relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications.

One means of assessing the extent of nerve damage is a test called an EMG/NCS which assesses how fast the nerve conducts electricity and how the muscle responds. This type of test is done by neurologists in most centers. It would be best for you to discuss this with your physician.

I suggest you ask your physician his/her thoughts on your referral. You should also ask him/her if seeing a physical therapist would be useful.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[JAYB1999]

Thank you! I had to cut short my S/Sx because of character restriction of 2000. I have numbness in my left foot that causes me to lose my balance. Mild numbness in my R. I have to walk very carefully. I am in pain 3-4/10 every morning  and it progress to a 5-8/10 at the end of the day.  I wake up in pain 1-2 times a night with a 8-9/10 and have to reposition. Sometimes more depending on what I did that day.I have to find what i call a sweet spot on my L side in a half fetal possition. Left leg straight and right leg brought up as far as I am able. I am up at 7am and home by 7pm. I am in and out of my car all day.I am so stiff and cringe at my first steps  in the am as the pain in my L buttocks shoots down my leg.  this happens when i get home out of the car I am bent over and cannot straighten up, it also happens throught out the day.I never know when this is going to happen. when it hits it is a 10/10. the pain is there all the time. I take 800mg of advil every 5-6hours or i would not be working. I have a horrible limp. and I am bent I cannot straighten up against a wall. I have to use a shopping cart or I cannot shop and i can only walk 10-15 minutes. I can only sit 15minutes. Laying down i have to repositionall the time or the sharp pain progresses to out of control pain. I am 60 Y/O female and the sole provider and must work another 10 years. I am in home health and have a wonderful job I need to keep so I want advise on what to do. I have tried PT, heat cold , stretching massage, and advil. I Take 1/2 percocet and only 1/2 percocet at bedtime so i can try and get to sleep. If surgery can stop the pain so I can go on with my life i would do it in a minute. So that is why I am asking if my MD was correct to advise a chiroprator therpy instead of a spinal specialist consult? I also have a mild scolious and 3/8ths of an inch leg shorter on the right. thank you for your time I do appreciate any information about this. I also cannot rotate my legs out to the side or the pain in my lower back is 10/10. I cannot take pain meds except advil during the day or when i am on call. so i go around hurting all the time. I am getting so tired dealing with the hurt. So thank you for answering me. I do  want this pain to stop.