very tight right leg and poor mobility

Posted by yeeko @yeeko, Aug 7 11:16am

Due to fall last May from a computer rolling chair at home, I injured my right butt and leg, did dozens of PT, Chiro, Acupunctures, and pain medications, after more than a year, my core area still very discomfort due to bulging disk per MRI, pinched nerve, my right leg is very tight preventing me from standing more than 10 minutes and very poor walking for more than five minutes, very distressed and frustrating, home bond for more than a year, no life but hoping to get better to be able to move around, any advice or treatment to loosen up right leg and relief for my lower back would be greatly grateful

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yeeko, you might consider minimally invasive microdiscectomy https://www.brycejohnsonmd.com/minimally-invasive-lumbar-discectomy-spine-surgeon-irvine-fountain-valley-ca/
Compression can eventually damage the nerve making repair slow to impossible and worsening your symptoms.

REPLY
Profile picture for gently @gently

yeeko, you might consider minimally invasive microdiscectomy https://www.brycejohnsonmd.com/minimally-invasive-lumbar-discectomy-spine-surgeon-irvine-fountain-valley-ca/
Compression can eventually damage the nerve making repair slow to impossible and worsening your symptoms.

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@gently
Thank you for your input, it sounded intimidating to me as I live alone also at age of 85, the Dr. suggested MBB injections and chiro using decompression nerve machine to see if that works to relieve the discomfort of my lower back and tightness of the leg, your thoughts please

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yeeko, I like both the injections and traction machine at the chiropractor. Chiropractic adjustments can also help. The injection numb the nerve that carries pain signals to the brain--the medial branch nerve. It is a quick simple procedure. If it works they can use radiofrequency to sever that little nerve.
The concern for me is the tightness in the leg because it may be a different nerve than the medial branch. The decompression nerve machine is traction. Sometimes the protrusion of the disc can retract if given enough space. I've never seen it happen, but discs can heal themselves, given the chance.
A low back adjustment from a chiropractor can give your restore balance to the spine and could also relieve the tightness and the pain. Chiropractors really give the best physical exams for spinal movement. I see them about once a week. And you won't have to wait three months to get in. You could probably get in tomorrow.
Many offices don't have the traction machine, but they do manual traction.
I know exactly how you feel about the importance of maintaining independence.
I'm curious what you think about chiropractors. Some are better than others, but I never met one that I didn't like.

REPLY
Profile picture for gently @gently

yeeko, I like both the injections and traction machine at the chiropractor. Chiropractic adjustments can also help. The injection numb the nerve that carries pain signals to the brain--the medial branch nerve. It is a quick simple procedure. If it works they can use radiofrequency to sever that little nerve.
The concern for me is the tightness in the leg because it may be a different nerve than the medial branch. The decompression nerve machine is traction. Sometimes the protrusion of the disc can retract if given enough space. I've never seen it happen, but discs can heal themselves, given the chance.
A low back adjustment from a chiropractor can give your restore balance to the spine and could also relieve the tightness and the pain. Chiropractors really give the best physical exams for spinal movement. I see them about once a week. And you won't have to wait three months to get in. You could probably get in tomorrow.
Many offices don't have the traction machine, but they do manual traction.
I know exactly how you feel about the importance of maintaining independence.
I'm curious what you think about chiropractors. Some are better than others, but I never met one that I didn't like.

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HI @gently, appreciated your valuable inputs, I had my MBB injection on 7/30 so far no relief for my back, might need a second one was told. On 7/27 chiropractor did a 8 minutes so called reflex machine lying down pushing my core area up and down for 8 minutes but no relief as yet, Dr. prescribed naproxen but no relief either, coming 8/13 having a visit about the result of MBB injection on 7/30 and chiropractor doing something else. Any suggestions to ask both the Dr. for prescription and chiropractor for traction machine would greatly appreciated. Blessings to you for your taking time to give me your experienced and knowledgeable inputs.

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yeeko, usually the after the first few hours of a MBB there is pain relief from numbing effect if it is the facet joint causing the pain, even when the steroid doesn't reduce the swelling enough to be effective.
Sometimes there is a reaction to the steroid that temporarily makes the pain worse.
I suspect the doctor will be wanting to try another MBB. Usually they perform two before deciding if it is helpful.
You might ask the md if they think the pain might be more central canal. You could ask about an epidural.
I include this link to be clear on the different placement for each injection https://greatertxortho.com/medial-branch-blocks-vs-facet-joint-injections/
I think the doctor was suggesting traction for you. It doesn't sound like the chiropractor was using traction. And it is difficult to know if the chiropractor adjusted your low back and your SI joints.
Some chiropractors use various devices that don't make me happy. I prefer the Palmer method of manual adjustment.
Your thigh tightness makes me suspect that the disc bulge is more central canal.
You might try a different chiropractor on your own. You probably don't need a referral. In CA I don't need referrals with original medicare.
I think the treatment your doctor refers to might be the same as what they used to call by the machine name VAX D https://www.webmd.com/back-pain/features/vax-d-treating-back-pain-without-surgery
Theoretically it can stretch apart the vertebra that might be trapping the disc bulge and allow it to reverse position back into the disc area. It the outer layer of the disc is separated and the inner contents are spilled, I don't think traction can help.
Without knowing anything, I hazard the guess that you have central canal stenosis which could be relieved by making more space in the central canal by removing something surgically. Sometimes the remove a portion of the ligament, sometimes a portion of the bone, sometimes the bulging portion of the disc.
They are all minimally invasive ambulatory surgeries.
I'd ask the doctor if the procedure the chiropractor performed is the one he had considered for you.
If an epidural might be more effective. (You may not even want an epidural)
If the plan is for RFA if the injections are effective.
You might ask the pain specialist if he knows a good minimally invasive spine surgeon.
I'd ask the chiropractor if he can perform a thrust adjustment for the sacroiliac joint and the lumbar vertebra.
While I don't think any of the medications are very effective against this pain, the ones I've seen as most effective are the fentanyl patch ( which you probably can't get and might make you loopy anyway), and Percocet, which is also pretty restricted.
I do think there is relief available to you. It's good you are looking for the least invasive options first. It sounds as though you have one level affecting your entire being.
Does your MRI talk about spondylosis or positioning of the vertebra in relation to each other.

REPLY
Profile picture for yeeko @yeeko

HI @gently, appreciated your valuable inputs, I had my MBB injection on 7/30 so far no relief for my back, might need a second one was told. On 7/27 chiropractor did a 8 minutes so called reflex machine lying down pushing my core area up and down for 8 minutes but no relief as yet, Dr. prescribed naproxen but no relief either, coming 8/13 having a visit about the result of MBB injection on 7/30 and chiropractor doing something else. Any suggestions to ask both the Dr. for prescription and chiropractor for traction machine would greatly appreciated. Blessings to you for your taking time to give me your experienced and knowledgeable inputs.

Jump to this post

@yeeko I am VERY picky about who does injections in/near my spine, and how they are done. I have muddled along pretty well for years, but disc degeneration and stenosis are worsening, so I have an epidural scheduled next week. My ortho and I are "on the same page" as far as methodology - a pain management doc will do an x-ray guided injection, referring to the notes from the latest MRI.
Did your doctor use imaging to guide the injection? If not, you may want to ask for a different practitioner?

REPLY
Profile picture for gently @gently

yeeko, usually the after the first few hours of a MBB there is pain relief from numbing effect if it is the facet joint causing the pain, even when the steroid doesn't reduce the swelling enough to be effective.
Sometimes there is a reaction to the steroid that temporarily makes the pain worse.
I suspect the doctor will be wanting to try another MBB. Usually they perform two before deciding if it is helpful.
You might ask the md if they think the pain might be more central canal. You could ask about an epidural.
I include this link to be clear on the different placement for each injection https://greatertxortho.com/medial-branch-blocks-vs-facet-joint-injections/
I think the doctor was suggesting traction for you. It doesn't sound like the chiropractor was using traction. And it is difficult to know if the chiropractor adjusted your low back and your SI joints.
Some chiropractors use various devices that don't make me happy. I prefer the Palmer method of manual adjustment.
Your thigh tightness makes me suspect that the disc bulge is more central canal.
You might try a different chiropractor on your own. You probably don't need a referral. In CA I don't need referrals with original medicare.
I think the treatment your doctor refers to might be the same as what they used to call by the machine name VAX D https://www.webmd.com/back-pain/features/vax-d-treating-back-pain-without-surgery
Theoretically it can stretch apart the vertebra that might be trapping the disc bulge and allow it to reverse position back into the disc area. It the outer layer of the disc is separated and the inner contents are spilled, I don't think traction can help.
Without knowing anything, I hazard the guess that you have central canal stenosis which could be relieved by making more space in the central canal by removing something surgically. Sometimes the remove a portion of the ligament, sometimes a portion of the bone, sometimes the bulging portion of the disc.
They are all minimally invasive ambulatory surgeries.
I'd ask the doctor if the procedure the chiropractor performed is the one he had considered for you.
If an epidural might be more effective. (You may not even want an epidural)
If the plan is for RFA if the injections are effective.
You might ask the pain specialist if he knows a good minimally invasive spine surgeon.
I'd ask the chiropractor if he can perform a thrust adjustment for the sacroiliac joint and the lumbar vertebra.
While I don't think any of the medications are very effective against this pain, the ones I've seen as most effective are the fentanyl patch ( which you probably can't get and might make you loopy anyway), and Percocet, which is also pretty restricted.
I do think there is relief available to you. It's good you are looking for the least invasive options first. It sounds as though you have one level affecting your entire being.
Does your MRI talk about spondylosis or positioning of the vertebra in relation to each other.

Jump to this post

@gently, grateful again for your prompt and detailed inputs, I have traditional medicare,and I live in California, since I fell last May, I went to urgent care three times, ER twice trying to relieve my right leg severe pain and poor mobility, received five injections for pain, then my PCP referred to pain management md got another epidural injection, since none helped my pain md referred me to an Orthopedic surgeon, he looked at my MRI and X ray, said no surgery needed just went for PT to strengthen my core area and the leg pain and numbness should go away, but after 30 plus PT and 10 chiros my leg still tight and difficult to walk and core area still did not improve since last May. So my PCP finally referred me to a Lifekind Health to do the MBBx2 injections which I did one and one chiro at the same Center for 8 minutes so called reflex machine bouncing up and down on my core area, so far those two visits had not helped. my back is not really painful what I feel is tightness for both back and right leg very uncomfortable, unable to walk longer than five to ten minutes and stand up straight for ten minutes. The best comfortable way is to lie down straight, for more than a year I felt so depressed and no life but home bound trying to figure out how to improve my mobility. As you mentioned the second MBB injection should be tscheduled for my follow up visit this coming Thursday and one chiro called decompression the nerve suggested from last visit. Getting frustrated for no help and no hope, might just have to ride it out from bad luck accident sad to say! None of the Drs explained to me about my MRI in detailed, justs said degeneration, arthritis, bulging disks can't be treated, all other medical terms are unremarkable. Again your messages were deeply appreciated

REPLY
Profile picture for Sue, Volunteer Mentor @sueinmn

@yeeko I am VERY picky about who does injections in/near my spine, and how they are done. I have muddled along pretty well for years, but disc degeneration and stenosis are worsening, so I have an epidural scheduled next week. My ortho and I are "on the same page" as far as methodology - a pain management doc will do an x-ray guided injection, referring to the notes from the latest MRI.
Did your doctor use imaging to guide the injection? If not, you may want to ask for a different practitioner?

Jump to this post

@sueinmn thank you for your inputs , yes I was told my mbb injection was x ray guided

REPLY
Profile picture for yeeko @yeeko

@gently, grateful again for your prompt and detailed inputs, I have traditional medicare,and I live in California, since I fell last May, I went to urgent care three times, ER twice trying to relieve my right leg severe pain and poor mobility, received five injections for pain, then my PCP referred to pain management md got another epidural injection, since none helped my pain md referred me to an Orthopedic surgeon, he looked at my MRI and X ray, said no surgery needed just went for PT to strengthen my core area and the leg pain and numbness should go away, but after 30 plus PT and 10 chiros my leg still tight and difficult to walk and core area still did not improve since last May. So my PCP finally referred me to a Lifekind Health to do the MBBx2 injections which I did one and one chiro at the same Center for 8 minutes so called reflex machine bouncing up and down on my core area, so far those two visits had not helped. my back is not really painful what I feel is tightness for both back and right leg very uncomfortable, unable to walk longer than five to ten minutes and stand up straight for ten minutes. The best comfortable way is to lie down straight, for more than a year I felt so depressed and no life but home bound trying to figure out how to improve my mobility. As you mentioned the second MBB injection should be tscheduled for my follow up visit this coming Thursday and one chiro called decompression the nerve suggested from last visit. Getting frustrated for no help and no hope, might just have to ride it out from bad luck accident sad to say! None of the Drs explained to me about my MRI in detailed, justs said degeneration, arthritis, bulging disks can't be treated, all other medical terms are unremarkable. Again your messages were deeply appreciated

Jump to this post

@yeeko, I'm especially sorry that you've been depressed and homebound. It's true that you had an unfortunate experience. Those chairs are a hazard. But your injury seems to be, well--too mild for surgery (fusion). And that is good.
You might be best served by a minimally invasive spine surgeon.
I see where you are over there in the east with Lifekind. Would it be difficult to get to UCLA or Irvine?

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Profile picture for gently @gently

@yeeko, I'm especially sorry that you've been depressed and homebound. It's true that you had an unfortunate experience. Those chairs are a hazard. But your injury seems to be, well--too mild for surgery (fusion). And that is good.
You might be best served by a minimally invasive spine surgeon.
I see where you are over there in the east with Lifekind. Would it be difficult to get to UCLA or Irvine?

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@gently, thank you for your kind suggestions, if I have to, I can find a way to get to UCLA or Irvine, but I don't know any good surgeons there, besides there are a few surgeons with Eisenhower Health I heard, my ortho did not recommend but I would need to get a second opinion with a reliable surgeon, besides I live alone it would take a caregiver and times to recover, so I tried to find non surgical treatment to see if relief can be achieved first, but I suffered for over a year and getting depressed for the discomfort I feel every day. The Lifekind was recently referred by my PCP as a full service pain management clinic, none of the drs. I was referred to mentioned MBBx2 injections, so the Lifekind did it and none chiro mentioned any traction or decompression devices, only Lifekind did it. So I will take a chance to try them out before any surgery. Appreciated deeply your suggestions.

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