TLJ
by Sharon
(Wilmington NC)
I have mild scoliosis and have been told that I have a weak core. I've always pushed myself physically very hard, long distance running, military, and in my daily job. I once had some sort of tearing injury to my mid lower back when I bent over, then I had a few episodes of sciatic like burning over my buttocks and posterior thighs that happened from time to time sporadically over the coming years. Also experienced painful intercourse. Then one day it was like an explosion happened in my body. And I have had level 10 daily pain for 3.5 years since. I have pudendal neuralgia along with symptoms of TLJ syndrome in my back, buttocks, hip, legs, feet, vagina, anus, perineal area, the labia, groin, piriformis,skin over the mons pubis...it is severe nerve pain everywhere. After seeing every specialist on earth I was simply given a diagnosis of pudendal neuralgia and hypertonic pelvic floor dysfunction. But that just never really seemed entirely accurate. Its definately the pudendal nerve, however its also other nerves. My mid-lower back feels completely immobile and locked up. Every PT kept telling me that this was somehow coming from higher up in my back so I had the Radiologists review my imaging ONE LAST TIME. This time I asked them to look at T-12 specifically because they had initially dictated a small perineural cyst and probable benign hemangioma at T-12 and I knew symptoms I was having matched the dermatomes and nerve distributions at T-12 L-1, and I felt like it was somehow linked to the pudendal nerve as well. This time they looked closer at T-12 and now say they missed initially seeing a moderate sized laterally herniated T-12 disk with mass effect seen on the nerve root laterally exiting. And I also have a small herniated disk at L1 and L2. Along with L5 S1.
So now I have a dilemma in my mind. I really need this pain to stop soon. I don't have it in me to wait and try another year of PT etc... But if this herniation is due to a subluxation of the spine will surgery even be enough to get the pressure off of the nerves? I have zero quality of life from this, I cannot sit AT ALL, I am in pain whether standing, laying down etc it never lets up at all. I am 46 years old and now at the point of complete disability. Should I have back surgery then follow up with PT or chiropractor to then address the core issues and spinal instability? I don't know what the correct path to take here is anymore, but I need to get pressure off these nerves asap. I've tried 3 years of PT already with multiple therapists and without results. Any advice is appreciated,
Hello Sharon,
Firstly a sincere apology for missing your passionate letter. You have certainly suffered; I hope getting it off your chest in the writing also may be therapeutic.
It's not for me to be partisan and suggest chiropractic over physical therapy, but you have tried the later without success, perhaps it's time to start looking around for a conscientious and thorough DC. Take you time looking. You need something more than someone who can just crack your back.
I have been a DC for over 40 years now, and if there is one thing I am absolutely convinced of, it's a daily set of exercises done EVERY SINGLE MORNING, BEFORE ARISING. In bed.
Starting with something very basic which will irritate you because you were so fit and strong, have my doubts about those weak core muscles, though they may be weak now.
If you look at "exercises" at Chiropractic Help you'll find my favourites. Just start slowly, you're not aiming for the winter olympics!
One of my favourites for the thoraco-lumbar area is a pelvic tilt with your flat hands under your spine, starting at T12 area, high as you can get, and coming down one vertebra at a time, right down to the sacrum, and then wending your way up again, using your hands as the fulcrum, mobilising each joint.
And the "hip hike". Do them slowly and gently. DAILY.
Do you know if the sciatic and femoral nerve stretches are positive? Is there any paresis in the legs? Loss of reflex? Numbness on pinwheel exam?
The T/L region is particularly difficult to adjust in some people. Has anyone used a sitting extension technique with your fists behind you in the T12 region?
Don't discount your diet either. Grocery store food these days is high inflammatory. Learn about anti-inflammatory foods, and especially avoid large amounts of polyunsaturates. In small quantities they are essential, but we eat far too much of them. Look to many coloured foods every day, beetroot, many greens, red peppers, carrots, winter squash, olive oil and avocados.
You have had a huge amount of professional care without success. What I'm suggesting now is self-help, stuff you do yourself, for yourself, especially the twin disciplines of daily gentle exercise and good diet, whatever that is, highly controversial.
Personally I have been profoundly influenced and helped by what I call "Blue Zone longevity." Those people in five places in the world where a vigorous, busy ninety plus is the norm. Find out about the Blue Zones on the net, and there's an excellent short series on Netflix if you have it.
I have another site, Bernard-Preston.com, my nom de plume. You can look for Blue Zones there.
And then start looking for a hard working, conscientious chiro in your area.
I wish I was nearer! But I'm on the other side of the planet. Keep in touch, and I hope and pray some of this may contribute.
See what you can do to help yourself.
Best wishes,
Dr B