If you have disc bulges I would not see a chiropractor. I have personally seen chiropractors make spine problems far worse than they where to start with.

Many will push you into trying various methods to shrink the disc that are not successful in most cases, cost quite a bit of money that insurance will no doubt not pay for and they will trap you into 20 or more treatments just to see if this type of traction thing works.

You say your MRI shows nerve compression at the L4 and disc protrusion at L4/l5.
You also said that conservative measures have not helped.

The combination of a 3 year old injury and 3 month aggravated injury causing pain all indicate that any further attempts at conservative measures and a chiropractor, at best, is conservative measures, is not going to work.

It sounds like surgery is your only option at any pain relief.

Have you had more than one opinion from a spine surgeon?

If you have only one opinion, you should get at least one more opinion before going ahead with surgery. Especially when you are trying to find an alternative to surgery.

You don't say what kind of surgery has been suggested, but there might be other options in the type of surgery that is suggested that would be better options than you have already been told.

It is always best to get at least one other opinion before having spinal surgery, preferably yo should get 2 or 3 others first.

Good luck

Fran

Why not at least give it a go make sure you see a good one someone who doesnt use traction. Many people report positive effects from chiropractic treatment there are many people who report a decline in the health of there spine after pt or surgery i would never give you a guarantee there are risks to every type of treatment reports of chiro aggravating injuries are largely scare tactics i think. One doctor in this forum describes chiropractic as a valid form of treatment.

Again, I see there are extremely differing views on Chiropractors. Given the severity of my back problem, I am reluctant to have someone 'crack' my back but can they really do more damage than is already there? I mean, I'm getting surgery so it's pretty damned bad as it is. Can a chiro potentially fix a protruding disc through spinal manipulation? And take the pressure off my nerve root? I don't know. Physiotherapy seems way too passive (ultrasound, massage, simple excercises). I just don't feel Physio is doing much compared to the intense pain of my nerve root compression. I need a more radical approach, but since surgery is the most radica, is there no good medium?

Physical therapy may seem 'way to passive" but it can be of help. At the very least it will help you to strengthen your core muscles prior to surgery.
The stronger they are before surgery, the easier it will be to rehab after the surgery.

PT is a slow process that can take time. If you have not had any improvement in about 6-8 weeks, then all you are doing is strengthening the cores.

When conservative measures fail to help a spinal problem, then the choices really become only 2.
1. live with the pain
2. surgery.

Have you had more than one opinion on your diagnosis?
What specific surgery had your present spine surgeon suggested?

It would be best to have more than one opinion before making any decision to have surgery. Preferably several other opinions first.

Good luck

Fran

I have not seen a surgeon yet. My anaesthesiologist, who is also my pain doctor, mentioned fusion or discectomy. Seems right to me. I prefer discectomy though as my disc spaces are quite good and X-Rays are all normal. I believe it's the disc protrusion at L4-L5 with nerve compression that is the source of most my sciatic pain. In the meantime until my surgical consultation I am doing physiotherapy and home excercises, including tens machine twice a day, strengthehing and stretching eercises and inversion table hanging once a day. Sound good?
I really hope I can avoid surgery. I also have heard that disc problems eventually go away ontheir own. Could this be true in my case?

As far as disk problems going away peoples symptoms have been known to diminish over time, they also can deteriorate, studies have shown that those who have surgery, and those that don't have on average pretty much the same level of pain at five, and ten year intervals, but some people in both groups will improve while others will get worse, though some people clearly need surgery, and the benefits clearly out weigh the risks. Its one reason why doctors down play peoples symptoms, and are reluctant to operate its there way of saying try living with it before we operate as operations once done cant be undone and patients are not always happy with the results.

conservative measures can help to relieve the problem with disc protrusions. A good round of PT to strengthen the cores, teach you proper body mechanics, proper moving and good exercises is an excellent option.

Even if surgery becomes your choice, the strengthened cores will be an advantage to you in recovery.

I have read good and bad results with inversion tables. Helps some, makes others worse, but the results of helping some, that I have read, is only been temporary.

In my opinion, I would not do the inversion table. I would not take the risk of making the disc protrusion worse.

We all hope we can avoid spinal surgery, but sometimes the choice becomes living with the pain or having surgery. That is the choice only the patient can make.

Have you had more than 1 ESI? If not, you might want to try a second one since the first one gave you a few days pain relief. It may be that a second one will provide you with pain relief and enough time for the protrusion to heal.

It is true that good doctors try to avoid spinal surgery when they can.

If you have nerve compression and conservative measures do not relieve your pain and take the compression off of the nerves, then you do run the risk of permanent nerve damage. How long that will take, no one really knows as each of us is an individual.

I would wait and see the spine specialist for his/her opinion and then go from there. Listen carefully to all that is said. Be prepared to ask questions, lots of them.

Ask why disectomy and not microdisectomy.
Asky what will and will not be done such as:
will there be any widening of the foramen to provide more space.
Is there any stenosis and if so where?
How long will I be in the hospital?
How long do you anticipate my recovery will be
What kind of restrictions will I have post op and for how long.
Will I have an permanent restrictions after surgery.

Ask any others that you can think of.

Then take all of your info from your present spine surgeon, get all copies of your MRI and all other tests you have had and proceed to get a second and even a third opinion before agreeing to any surgery.

It is very important to have more than one opinion.

Then you will be sure that you should or shouldn't have surgery, if you are satsified with your present spine surgeon or you want to change surgeons.

Good luck

Fran