Anecdote of the Jar

Anecdote of the jar has more tales from the Chiropractic Coalface; though true case histories, they have no more scientific value than fairy tales. Nevertheless, they call for my investigation to validate them.

Having said that, behind every yarn, often there lurks a kernel of truth, a real gem. And then sometimes it's pure hogwash.

Only by placing our theories under the scientific spotlight, without prejudice and manipulation of the statistics, can we sift the grain from the chaff.

Today there is a huge amount of research going on into the value of manipulation in general, chiropractic in particular, in both the mainline medical literature and the complementary health sciences.

Some validates what we have been saying; other research contradicts our beliefs. Yet further studies report uncertainty at this point in time.

Interestingly, much of the research simply states that there is no certainty that either medicine or chiropractic can permanently help conditions like carpal tunnel syndrome and frozen shoulder. Each are equally ineffective according to the literature.

Not all research is independent and unqualified either; recent findings point out that researchers who sought to broaden the definition of high cholesterol were in fact paid retainers by the drug companies manufacturing statins.

In short, it's a minefield.

The famous Dutch artist MC Escher's geese know how to find their grain without the use of stats. If you ever get to The Hague, don't miss the Escher museum.

Anecdote of the Jar

Melanoma

A dark mole, particularly if it is expanding, itching or bleeding is always a concern. Melanoma is a deadly cancer.

Recently I was concerned about mole on a patient's leg, a very experienced nursing sister to boot, and recommend she consult a dermatologist.

This morning I received this email:

Hi Doc,

My back is a lot better, thank you. And the shoulder. Incidentally the mole on my ankle turned out to be a Malignant Melanoma Mark 3 [whatever that means]. I will have to go for a deep excision and they will do a skin graft – there is not much flesh on my ankle.

Hip Arthritis

There are few more difficult conditions to predict how they will respond to Chiropractic treatment than hip arthritis.

Mrs P, 58-years lady has had right lateral thigh, hip and buttock pain such that walking became difficult. Her doctors spoke of "trochanteric bursitis", and in fact the bursa was tender. But five years down the road, no one had clearly tested whether flexion, adduction and internal rotation were limited. Not one of her doctors thought to take an X-ray. Negligence? Perhaps in her favour.

After only one of treament she no longer needs painkillers, is not waking at night in pain, and can walk the mall "heen en weer", this end to that, and back.

Yesterday, with a grin, she gave a skip, adducting her leg (swinging it across to the opposite side). For the first time in over two years she was able to walk the mall.

But I can think of other patients with less arthritis in their hips (X-rays of her hip now taken show moderately advanced hip arthritis) that haven't responded well at all.

Considering the cost of a total hip replacement and the dangers of Anaesthetic Alzheimers I think a course of Chiropractic treatment for every arthritic hip is worth consideration before the "final solution."

I have umpteen patients with hip arthritis who come in once a month for maintainance for their arthritic hips and knees and feet. Mostly they're happy. Me too!

Do understand: Without weight loss there is no long term future in conservative treatment for arthritic lower limbs. Get it off, or go for the total joint replacement. EasiER free weight loss programs ...

"There's the man who made me pregnant!"

Mrs J is one of those half dozen patients who every year fall pregnant after consulting me after long years of trying. Whilst we are in the business of treating, in the main, neck and back pain, every year there are titillating stories like those of Mrs J. I can assure you there was nothing untoward about our relationship, tho she chose to make fun of it. She first consulted me about a year ago suffering from a plethora of pain syndromes. Now, after more than five years of trying, she's fallen pregnant.

Of concern, she developed coccyx pain and a numb pain on the side of her hip. Meralgia paresthetica. Whilst the coccyx pain, I'm sure is directly related to being 18 weeks pregnant, the MP is unexpected. Not surprisingly, she has a L1 fixation, and extreme tenderness. It's a lesion affecting the Lateral Femoral Cutaneous nerve. It's a double-crush syndrome, a pinched nerve in the upper lumbar spine and the groin. We'll fix it.

LOL: I've had a few letters objecting to the title of this paragraph. But it's true, she walked into a full waiting room, baby in pram, and announced to all and sundrey: "There's the man...L!" Whilst life at the Chiropractic Coalface is arduous and serious, we have our lighter moments. And make the most of them.

HEALTHY LONG LIFE

I asked Mr S, an 85-year old patient, what the secret to his healthy long life was. He consulted me about two years ago with very severe lower back pain of some three months duration but happily it responded well to some gentle chiropractic.

Said he: "Well, I've kept active all my life. I used to play tennis and squash and when I got too old for them I moved on to golf. I can't manage golf any more, but I now play bowls three times a week."

And did he eat well? "Yes, pretty healthily. We have salad EVERY day, I had five different fruits for breakfast... ". His weight is perfect.

On the way out the door (he came for a routine 6weeks consultation), I asked if he was doing anything interesting that day. "Oh, nothing much. Just bridge this afternoon."

There you have it folks. Want to reach 85 with all your marbles intact? Keep active, eat fruit and salad until it comes out of your ears, and don't forget the mind. Bridge? Chess? Write websites? Learn a new language? Read good books, like those of Bernard Preston; hint, wink, try me

And now for a chronic lower back pain case that will interest many of you.

Mr P, a 72 year old man has had lower back pain for many years. Three years ago he had a very severe episode radiating to the front of the leg, but it passed over. High in the lumbar spine, with the Femoral nerve comes from, supplying the front of the leg, he has very severe degenerative changes.

One month ago, he consulted me complaining of daily LBP, and having to take anti inflammatories daily, or be unable to function. Interesting, the examination revealed the pain was coming from L5 where he has very little degenerative arthritis. A very gentle side posture drop on a drop table, plus these exercises, and he tells me has almost no pain. After only half a dozen treatments:

Getting off the chiropractic table the correct way is important.

If you have a lower back complaint, and even if you do not, it is best when lying on the back, first to roll onto your side, and then sitting up sideways.

I had a patient yesterday who came in for hip and groin pain treatment. I didn't treat her back at all, but sitting up from the table she got a stab of pain in the back. Not looking good, and I am the guilty party. I usually make patients turn on their side, and must have had a senile moment.

Not nice to go the chiropractor with one complaint, and come home with another. Did you know that happens to 40% of people who go to hospital? Good idea to keep away from chiropractors and doctors in general!

Rather eat well, keep exercising and enjoying life. And stop smoking if need be...

HIP ARTHRITIS

This is a frustrating condition at the Chiropractic Coalface as it is very difficult to predict the outcome. A month ago a woman in her lower sixties consulted to me to see I could help: she was having great difficulty walking, with aching thighs. And she couldn't cross her legs, and opening her legs for intercourse almost impossible.

On examination, it was a clear case of hip arthritis bilaterally, severely reduced flexion, adduction and internal rotation. The very limited Fabere test explained why sex was becoming impossible.

What made it particularly difficult was that for some reason she brought up the case of her husband who a year previously had a full hip replacement, and the surgeon somehow got his leg a full 3cm short. Walking has been very difficult. And I now had to tell her that in all probability, she needed TWO such ops!

Yesterday she told me how much better she was. She can now cross her legs, she is walking much better and indeed the range of motion is improving. She is tackling home care with vigour. Frequent exercises, lots of fatty fish and our chicken bones soup. One big plus, her weight is perfect. And her obvious enthusiasm for life.

I haven't asked about intercourse!

BETTER HEALTH

Just how does a doctor movtivate his patients to aspire to that place where they can reach and enjoy happy and healthy old age, with their marbles in tact, enjoying watching their grandchildren grow up around them...? Sometimes with great difficulty.

A patient in her early fifties recently consulted me suffering from headaches. Her history was ominous to say the least. Her deeply lined face spoke of a smoker, which she was. She has had two strokes from which she recovered reasonably well. Her cholesterol is sky high, and she is on the maximum dose of statins. She is overweight, but surprisingly her blood pressure is reasonably good.

Any mention of smoking or diet change and exercise was met with great hostility. "My doctor says it's all hereditary and there is nothing I can do about it." Bullshit, I wanted to scream, but held my tongue.

I declined to manipulate her upper neck, the risk is just too great. I wonder if she'll reach 55...

FACIAL PAIN

Mrs B is one of those tall, willowy beautiful Dutch women, but with a problem. Severe facial pain and suboccipital headaches. It all started 14 years ago for no obvious reason. She's a top waterpolo player, but it got so bad she had to stop. When she first consulted me a year ago she was taking 8 antiinflammatories and painkillers on average every week. And had been for years.

That was a year ago. Today she came for her regular six weeks consultation, a different person. She has had only one attack in the last six months and is taking no medication.

The problem? A severe fixation in her left TMJ anatomy. The jaw joint can cause severe facial pain and migraine headaches. It's often "gepaard" as we say in Dutch - tethered with another horse in front of a buggy - with neck pain, because the sensory nucleus of the jaw joint lies in the upper neck.

In medical terms, it's called a Trigeminal neuralgia, one of the most devastating pains. It literally leads sufferers to suicide.

TMJ ANATOMY ...


FEATHER IN THE CAP

Health is often mysterious. Why does one patient with a difficult condition respond quickly, whilst another with a niggle has pain for months?

Mrs S a 60 year old woman had severe groin and mid lumbar pain for three months, getting worse. X-rays revealed a hip condition called Femero Acetabular impingement syndrome (mild) and severe disc degeneration. The side of the her thigh was 90% numb. Yet with just a few weeks of treatment she has virtually no pain. Tis mystery all...

LUMBAR COMPRESSION FRACTURE

Three weeks ago a patient phoned in desperate trouble over the weekend. A week previously he bent over and lifted a heavy dog (90 lbs) that also needed a chiropractor (collapsing hind quarters). He felt something give in his back, and within hours he had very severe pain at the lumbo-thoracic junction.

What is astonishing is how well he has responded to gentle chiropractic treatment. Within 4 days he had fifty percent pain, could roll over in bed un-aided...

He is currently undergoing tests. I recommended he also see his medical doctor: one doesn't expect big strong men to fracture vertebrae unless they fall. So far tests have come up with nothing malignant. Just a heavy dog...

His pain was primarily from the facet joints. Extension and Kemp's test were EXTREMELY painful. Within a week they were almost completely painfree. It is going to take 6-8 weeks to heal, and he has had to stop for a few weeks. The first time in his whole working life (he is 64) that he has taken a day's sick-leave. Now that should go down in the Guiness book, eh!

UNRESPONSIVE TO ONE FORM OF CHIROPRACTIC TREATMENT

50 percent less pain rule ...

Mrs S has been experiencing right low back pain, without radiation to the leg for six weeks. She went to a chiropractor who uses exclusively the drop-piece treatment. There was no improvement.

She consulted me for the first time two weeks ago, and surely enough we got a satisfying click out of her lumbar facet syndrome ...

At the second consult she decleared the pain was 80% less. And ignored my plea that 50 percent less pain was the dangerous time. That evening she went to a first belly dancing class. At 73. Now we're back to square one.

There are many different times of chiropractic treatment for lower back pain. If one doesn't help, don't feel embarrassed to try another. And never forget the 50 percent less pain rule. The dangerous time.

If you follow this column with any regularity, you'll know that chiropractors adjust the cervical spine of the dizzy patient with extra special care. Especially young women in the 35 to 50 bracket.

Mrs S consulted me a month ago with a multiple problems in her neck, shoulder, a Tietzes syndrome, or breastbone pain, and stabs in the hip. And a serious attack of vertigo three years ago which never totally let up.

The so called Hallpike Dix test for an Benign Positional Paroxysmal Vertigo BPPV was slightly positive. So I decided to give her the Brandt Daroff exercises you can get by registering for Chiropractic Tips; you'll get the them in an email. I avoided adjusting her neck and treated her other conditions first.

It was most encouraging that she reported that within two weeks the last remaining vestiges of dizziness had completely cleared.

VERTIGO DIZZINESS ...

HIP ARTHRITIS

Mr P, 52-years old, had a mild case of Hip Dysplasia that was missed when he was born. Since he was about 45 years old he has increasing stiffness in the right hip, with onset of pain three years ago. It's complicated by a leg length inequality, and Scheuermann's disease in the lumbar spine. He had been coming once a month for Chiropractic management of his arthritic hip and low back pain.

There have been no miracles, but he says it's definitely considerably better than when he started one year ago. Simply stopping the progressive deterioration can be considered a success. He may still have a hip replacement one day, but it will be at least be only one. They only last about 15 years. Developmental Hip Dysplasia ...

HIP ARTHRITIS ...

THREE SERIOUS DISC HERNIATIONS

ANECDOTE OF THE JAR. Sometimes reading sites like this you might get the impression that we cure everything, that we think there is no further need for medicine, when it comes to backs. Not so.

Three weeks ago I had three new patients, all three with serious low back and leg pain. All three had the usual history: years of low back pain that was neglected. And then the sword of Damocles fell! Sudden onset of severe pain radiating down the leg.

What are the bad signs of a serious disc injury?

1. More pain in the leg than in the back.
2. Difficulty raise your big toe, or standing on your toes on one leg.
3. Numbness in the lower leg.
4. The crossed sign: Raising one leg provokes pain in the other leg.
5. Loss of a reflex, though you wouldn't notice that yourself.

All three had several of these signs.

After 10 days two were advised by their doctors to go for an operation. I think too soon, but they had severe leg pain. The third patient is doing great. The pain in her leg is nearly over, and all the tests are almost negative.

If you have a serious disc injury, and you really want to avoid surgery: Give your chiropractor a good three weeks. We are not God! 10 days for a serious injury is insufficient. It would have been better not to have started.

The husband of one has started with treatment for his neck. His neck and shoulder are much improved after a five treatments. He tells me his wife is progressingly nicely. But she will miss at least four months of work he tells me. The surgeon will only allow her to go back to work in September. Could I have done better, had she been more patient? Perhaps.

LOW BACK PAIN

ANECDOTE OF THE JAR. A 17-year old young woman consulted me 6 weeks ago with acute right low back pain. The pain started 9 months ago after a long trip- for no obvious reason except that sitting is difficult for many people. Despite various treatments it never went over.

It was good to see her today. No pain for three weeks.

What made the condition problematic was the "crossed-sciatic" sign: lifting her left leg gave her right low back pain. That is never a good sign.

That was in reality nothing problematic, except that nine months pain is nine months pain: it's not good for a 17- year old to have a diagnosis of chronic low back pain.

The sacroiliac tests were also strongly positive in the beginning, so there was some doubt over the diagnosis: a lumbar disc or a sacroiliac condition? In the end it made no difference. She has no pain.

What worries me a little: she's already not doing the exercises faithfully. That's not a good omen...

SACROILIAC JOINT ANATOMY ...

LOW BACK PAIN ...

ANECDOTE OF THE JAR: With the elderly one keeps wondering when it's going to turn bad again. A relief to see Mrs G again for her five week check up. She came six months ago with a 6 months history of severe low back pain, starting shortly after her second hip replacement.

She had a little understood condition all those years ago: Developmental Hip Dysplasia. It was not well cared for and the result was thus inevitable: Two new hips. That was fairly successful, but her strange gait upset her lumbar spine.

A happy lady, and a relieved chiropractor. Het gaat goed! Prima. She's delighted to be able to walk again without pain.

TAKING HORMONES?

ANECDOTE OF THE JAR:

A HORRID DEPRESSING DAY.

Mrs J has been a patient for some years, a favourite lady. But she never told me her doctor had prescribed her hormones for the menopause. My fault, I suppose, I should have asked. The research is unequivocal: they cause cancer with a big C. CANCER. And you're at higher risk from stroke, losing your marbles prematurely, incontinence... DON'T! Except in extreme circumstances.

Two weeks ago she went in for a routine mammogram, only it turned out not to be routine. Double amputation next week.

Taking hormones? DON'T. In Holland, we say 'levensgevaarlijk' - deadly. Opvliegers, the hot flushes have been experienced since time immemorial. Far better than the Big C.

Interestingly, women in the East who eat a lot of Tofu nutrition, have far less hot flushes due to vegetable hormones that apparently have no deleterious side effects. Just a thought. TOFU NUTRITION ...

LUMBAR STENOSIS

ANECDOTE OF THE JAR

A 62 year old man consulted me six weeks ago with severe pain down his right leg. It was so bad that he could barely walk because placing weight on that leg was extremely painful.

It's good psychology: I ask every patient what they most are missing and want to get back to. It might be tennis, or gardening, or ... in his case, he wanted to get back to work. He is a one man painting contractor, and hadn't been able to work for three months.

Strange at 62 wanting to get back to work so badly. Not so strange: ten years ago he lost his wife to breast cancer (one in eight women in the Netherlands) and, what kept him sane, was continuing to work. He was becoming depressed. Research shows if you stay at home for six months, you'll never return to work. He was starting on the antidepressants, sleeping tablets with their nasty anticholinergic side effects, dual antiinflammatory drugs ...

What characterised his condition was bending to the right, and slightly backwards, produced sharp, searing pain down the leg. A case of CHIROPRACTIC HELP Lumbar Stenosis ... the Slump test was strongly positive.

Yesterday he appeared for his appointment and I wasn't quite sure whether to be pleased or not: his spectacles were spattered with paint. He'd worked the whole previous day without pain. Whilst he's not 'cured' and still has some numbness and tingling in the leg, the Flip test for sciatica is negative, he can walk and he can work. A happy man. A happy chiropractor too! Miracles we do at once, the impossible takes a little longer.

CHIROPRACTIC HELP Lumbar Stenosis ...

Anticholinergic side effects

DUAL ANTIINFLAMMATORY DRUGS - aspirin and brufin.

TENNIS ELBOW

ANECDOTE OF THE JAR

Mrs K, a 65 year old lady came in this morning for her two maintenance check up. Her first consult was nearly 12 months ago: a difficult case of Tennis Elbow, 7 months pain despite various treatments. One of my favourite conditions: within two weeks the pain was 50% less, four weeks 80% less, two months completely gone. She comes in for maintenance and for some TLC for a long standing low back condition.

Odd that today patients find their way into a chiropractor's office with pain in the elbow, rather than a potentially far more serious low back condition. The times are a-changing - your local chiropractor is a lot more than a back specialist.

She brought me a home-made plum pudding for Christmas! Nothing will please your doctor, chiro or dentist more than such a spontaneous gift. If you don't bake, consider giving your Chiropractor one of Bernard Preston's Chiropractic books for Christmas. Read it first!

Tennis elbow ...

ARTHROSCOPY KNEE SURGERY

ANECDOTE OF THE JAR

Mr van den B, 77 years old, consulted me two months ago with severe inner knee pain. He had great difficulty walking, and bending the knee gave sharp stabs. The pijn started 4 months earlier after he had to do a lot of bending after a big storm blew thru Holland, dropping 300 sticks and branches in his garden.

4 orthopedic tests were positive. The Drop Home, Medial McMurrays, MCL test and Clarke's test. All of which was a bit confusing: what was the primary source of pain? Most obvious was a painful click when straightening the knee with McMurray's test.

The MRI scan was not pretty. The medial meniscus was badly damanged.

Within three weeks of the start of the treatment, all four tests were negative and he could walk much better. But pressing the clutch in his Model T Ford remains painful, and he had some residual pain at night, sometimes quite a lot.

His doctor has persuaded him to go for an operation, "because it could happen again". Whilst no miracle, for a problem that he had for so long, I was very encouraged with his progress. He and his doctor not. I wish him well.

It's a difficult question: when should one accept a condition, with it's limitations, instead of continually wanting to be perfectly young and able to do everything again?

Sometimes we suffer with pain that we needn't experience, and sometimes after even more complex treatment, the condition becomes even worse. The horns of a dilemma. Having just lost a good friend, a very fit 60 year old man, who went in for a minor procedure, and had a stroke and died the next day, I'm wary of the man with the knife in his hand! But good surgery can be a wonder, the risks albeit greater. ARTHROSCOPY KNEE SURGERY ...

HIP ARTHRITIS and LUMBAR STENOSIS.

ANECDOTE OF THE JAR

Mrs P is an 82 year old woman with a long history of low back pain and hip arthritis. A hopeless muddle of confusing signs and symptoms.

After suffering for two years with left buttock pain that radiating down her left leg, she was eventually told that the cause was hip arthritis, and a hip replacement would fix her pain. However, the operation did not one jot for the pain in her LEFT lower leg. Eventually the hip surgeon admitted that the pain in her leg was not from her hip (which it wasn't) but from her back. Indeed. That was three years ago.

She first consulted me two months ago, very miserable, and unable to walk even ten minutes. Unable to do even basic shopping, she was faced with an old age home, her worst dread.

A careful examination revealed three things:

1. A successful LEFT hip replacement.
2. A severe left sided sciatica caused by spinal stenosis. LOWER LUMBAR BACK PAIN ...
   
   
3. Severe, advanced RIGHT hip arthritis. HIP ARTHRITIS ...
   
   

I won't pretend it's been an easy case. What Mrs P has in her favour is a grim determination to avoid the old age home, she's a non-smoker and has very good weight.

Know how to calculate your Body Mass Index BMI? Free weight loss programs ...

Without all three I wouldn't have given her a chance. So she did her exercises faithfully, and followed my instructions to the letter.What I was expecting to be the worst hurdle was the spinal stenosis causing pain down her left leg. Actually it responded quite quickly, within a month it was 50% less and now she has almost no left leg pain. Lower back and leg pain ...

The RIGHT hip arthritis has been a tougher nut altogether. Against my expectations: I was more hopeful about her arthritic hip that her stenosis. We are now into the third month of care, and Mrs P is very pleased. More so than I am oddly. She still can only walk with painkillers (for the right arthritic hip), but for her the treatment has made one enormous difference. With said painkillers she can now walk for half an hour, long enough to do her basic shopping. We're keeping the old age home at bay; There's danger from taking more than one pain killer.

VERTIGO

ANECDOTE OF THE JAR

Mrs B celebrated her 85th last week. Her's is the next anecdote of the jar. She proudly told me today that all her children, grandchildren and nine great-grandchildren (all boys) were present. Number ten is on the way, and the big question is whether the football team is going to be all male, or is the goalie or striker going to be a girl?!

Perhaps more important, she said that she has had only one attack of vertigo this year - in comparison with 7 last year. And she gets it badly - a minimum of three days flat on her back, any move making her terribly giddy.

The difference? She does her Brandt and Daroff exercises EVERY SINGLE DAY she proudly said. You can download them for free from Chiropractic Tips, or if you can read Dutch, then the Brandt en Daroff exercises for duizelig (heid)/vertigo.

- attributed to Mark Twain.

Athlete's Foot.

I received some intriguing correspondence for ANECDOTE OF THE JAR today, let it be said not from some quack but a Chiropractor of thirty-five years experience, and some eminence in the profession:

(now this is going to get tongues wagging! Who? Journalists have the right to remain silent, yes? Me too.)

"I HAVE HAD, IN OVER 35 YEARS OF PRACTICE, SEVERAL PATIENTS WHO CLAIM TO HAVE HAD ATHLETES FOOT CURED AFTER THE CORRECTION OF A MISALIGNED PUBIC SYMPHYSIS.

WHAT IS THE EXPLANATION?"

I'll admit to be a little astonished. But why? If Chiropractic can help women fall pregnant and help with menstrual cramps, indigestion and Infantile Colic, why not this anecdote of the jar with infection too? We already know that small children with Otitis Media respond well to Chiropractic (though I have no experience thereof) and Shingles (there I have plenty of experience), then why not with Athlete's Foot. But why the Pubic Symphysis subluxation? Neither he nor I know, and I confess to be being a Doubting Thomas until some research comes up confirming that subluxations of the Pubic Symphysis are (one of?) the underlying causes of an outbreak of a fungal infection popularly known as Athlete's Foot.

Regarding treatment of a misaligned Pubic Symphasis, he says ...

ANECDOTE OF THE JAR

"One of my specialist areas was pregnancy and pelvic dysfunction syndrome. You are well aware of the problems with carrying and giving birth I am sure. After birth the pubic symphysis has frequently opened to let the baby out but does not always return to its original position. We find that on palpation, patient supine, you can feel either the superior left or right edge will be superior or inferior and anterior or posterior. This of course will affect the whole position of the pelvic girdle and can cause problems in the SI joints.

Manipulation is carried out using a quick light toggle recoil to the anterior or superior surface of the bones and/or quick light pisiform thrust along the longitudinal (head to feet) border of the symphysis.

Together with Pelvic rotation and torque, and the SI adjustment this has proved to be very effective in treating pelvic dysfunction problems."

I confess to only very rarely examining the pubic symphysis. One of the great benefits of pages like Anecdote of the Jar, is that it broadens my perspective. I'll be checking the pubes regularly now.

The SACROILIAC JOINT ANATOMY ...
Infertility Chiropractic ...

Two men ...

Two consecutive patients today got me thinking about a contribution to ANECDOTE OF THE JAR. Both men, in their mid-forties injured their lower backs about nine months ago. Both consulted their doctors and went for medical care based on "best practice guidelines". Approximately two months later both started developing painful twinges down one leg.

Mr A decided to consult me. I won't pretend it was easy. He stood in a posture akin to the leaning tower of Pisa.

A banker of some prominence, I had a tough time convincing him that he should work from home for some weeks, sitting as little as possible, and at least until he was out of the antalgic posture. What's an antalgic posture? POSTERO MEDIAL DISK HERNIATION ... Within three weeks he was standing upright and the pain in his leg was abating. It was a full eight weeks of twice a week treatment (less frequent towards the end in the rehab phase when I was teaching him exercises that I expect him to do to the end of his days. I do them myself every morning without fail. I also had a hernia some fifteen years ago.)

He came in today beaming for his two monthly treatment. I did very little. The main treatment was the addition of a heel lift - his left leg is 9mm shorter than the right. A happy ending to this Anecdote of the Jar, but the next ...

Mr X on, the other hand, consulted me only two weeks ago. A compliant man, he continued to follow the "best-care" medical guidelines his doctor was advocating, even though he knew it wasn't working. He makes a quite different contribution to ANECDOTE OF THE JAR. Six months ago he had the first back operation, and for some reason the surgeon completely missed the lesion. The post-operative MRI was exactly the same as the first. A huge prolapse.

After the second surgery, about six weeks ago, he had considerably less pain for about two weeks and returned to work (in my opinion) far too soon. He first consulted me two weeks ago in very severe pain, with distinct weakness in one of the foot muscles, and ominously unable to empty his bladder (a muscle) properly. He can't "exert pressure". Normally I wouldn't accept a patient with this bladder problem, but after two surgeries ... is it worth a try? Can Chiropractic help him? I'm not sure. After four treatments he has no less pain, but he told me today that he can again exert "pressure" when he pees. Tomorrow he sees the surgeon for a follow-up consultation. I wonder if I'll see him again. A third op?

Did you know that solid scientific research concludes that you are less likely to end up in the state if you first consult a chiropractor rather than a medical doctor for a low back complaint?

A prominent medical journal states: "A UCLA low back pain study published in Spine 30(19) found that: The fact that back pain patients have better satisfaction if they choose chiropractic care is now beyond debate. This has been consistently demonstrated by observational studies and randomized trials."

Oh, there is one other significant difference between Mr A and Mr X. The latter is a smoker. Oodles of research showing that smoking is the single biggest factor leading to the so-called FAILED BACK SYNDROME.

Update: Mr X got the use of his bladder back within one week of starting chiropractic treatment, but no reduction in pain (was Rome built in a day?) so he's decided to go with the surgeon's advice. A third surgery. Good luck, Mr X. There's no good news from this Anecdote of the Jar.

• The rationale for Chiropractic Therapy ...
• Why are HYDROGENATED FOODS like margarine bad for you?
• Return from ANECDOTE OF THE JAR to the CHIROPRACTIC COALFACE …
  
• Go from our ANECDOTES to CHIROPRACTIC HELP home page …
  
• More short anecdotes.