Guest guest Posted May 10, 2004 Report Share Posted May 10, 2004 I have a patient that had a herniated disc at L4-L5 and then had surgery and now he's in worse shape---the docs say that it is from scar tissue pressing on the nerve and there's nothing they can do. His pain is across the back but worse on the left (I guess it was herniated to the left) and then he has FRONT thigh pain and is numb from the knee down on his left leg. I've tried a number of different acupuncture treatments and none have helped at all---and one made him much worse for a few days. So, I'm wondering about herbs. I questioned whether the pain really was from actual scar tissue, or if that was how they explained it for lack of a better answer. However, he said that he was shown an x-ray showing a lot of scarring. I am getting the impression that needling anywhere near the area makes him worse---perhaps because there is so much scarring. Anyone have any ideas for an herbal formula for deep scarring? Any acupuncture ideas would be welcome too, but I've tried a lot and haven't gotten any results. Yunnan Paiyao plasters don't even help him. Any ideas would be greatly appreciated! Thanks, Laura Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2004 Report Share Posted May 11, 2004 Hi Laura, You describe a typical scenario of the reductionist aproach of WM the assumption that pain is only a mechanical issue. your patient probably as a result of long term stress has distorted, compressed his structure to the point that he has herniated the lumbars. Yet that is the end product not the cause. The operation, and I have come across this many times, will not deal with the compresses ,distorted muscles, facia etc., To blame the lack of success on the scar tissue is common. As an acupuncturist, to be efective, you need to stay focussed on cause. This means accurate diagnosis, otherwise what happens is that the patient 's stress will be compunded by the indiscrimiante acupuncture and you will then up up saying things like >>>I've tried a number of different acupuncture treatments and none have >helped at all---and one made him much worse for a few days<<< If you focus on the scarring then you are been seduced by WM narrow outlook. As you say, one of your treatments made him much worse. OK, then discover which meridians are responsible and you'll make him much better. salvador www.meridian-qi-acupuncture.com >I have a patient that had a herniated disc at L4-L5 and then had >surgery and now he's in worse shape---the docs say that it is from >scar tissue pressing on the nerve and there's nothing they can do. >His pain is across the back but worse on the left (I guess it was >herniated to the left) and then he has FRONT thigh pain and is numb >from the knee down on his left leg. > >I've tried a number of different acupuncture treatments and none have >helped at all---and one made him much worse for a few days. > >So, I'm wondering about herbs. I questioned whether the pain really >was from actual scar tissue, or if that was how they explained it for >lack of a better answer. However, he said that he was shown an x-ray >showing a lot of scarring. I am getting the impression that needling >anywhere near the area makes him worse---perhaps because there is so >much scarring. > >Anyone have any ideas for an herbal formula for deep scarring? Any >acupuncture ideas would be welcome too, but I've tried a lot and >haven't gotten any results. Yunnan Paiyao plasters don't even help >him. > >Any ideas would be greatly appreciated! > >Thanks, Laura > > > > >Membership requires that you do not post any commerical, swear, religious, >spam messages,flame another member or swear. > > >http://babel.altavista.com/ > > > and adjust >accordingly. > >If you , it takes a few days for the messages to stop being >delivered. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2004 Report Share Posted May 11, 2004 Hi Salvador, Those are some really great points that I need more experience and confidence to get through my thick head. So much of the time I am able to get improvement with pain after the first visit. Therefore I think that I tend to expect that, and therefore I set up my patients to expect it and be disappointed when it doesn't happen. I often wonder whether to stick with my original diagnosis/plan or to try something new at that point. I know that in many cases things will not improve unless I continue along the same path for awhile. But when they are not improving its very hard to keep the faith! Any advice on how to think about this would be helpful. Unfortunately, in this case, the patient came 3 or 4 times and quit and decided to try massage. Perhaps if I'd been able to communicate hope with him better he would have stuck around, but its challenging as a new practitioner when you aren't seeing results with someone. Thanks for your response! Laura Chinese Medicine , " salvador march " <salvador_march@h...> wrote: > Hi Laura, > > You describe a typical scenario of the reductionist aproach of WM the > assumption that pain is only a mechanical issue. > > your patient probably as a result of long term stress has distorted, > compressed his structure to the point that he has herniated the lumbars. Yet > that is the end product not the cause. The operation, and I have come across > this many times, will not deal with the compresses ,distorted muscles, > facia etc., To blame the lack of success on the scar tissue is common. > > As an acupuncturist, to be efective, you need to stay focussed on cause. > This means accurate diagnosis, otherwise what happens is that the patient 's > stress will be compunded by the indiscrimiante acupuncture and you will then > up up saying things like > > >>>I've tried a number of different acupuncture treatments and none have > >helped at all---and one made him much worse for a few days<<< > > If you focus on the scarring then you are been seduced by WM narrow outlook. > As you say, one of your treatments made him much worse. OK, then discover > which meridians are responsible and you'll make him much better. > > salvador > www.meridian-qi-acupuncture.com > > > > > >I have a patient that had a herniated disc at L4-L5 and then had > >surgery and now he's in worse shape---the docs say that it is from > >scar tissue pressing on the nerve and there's nothing they can do. > >His pain is across the back but worse on the left (I guess it was > >herniated to the left) and then he has FRONT thigh pain and is numb > >from the knee down on his left leg. > > > >I've tried a number of different acupuncture treatments and none have > >helped at all---and one made him much worse for a few days. > > > >So, I'm wondering about herbs. I questioned whether the pain really > >was from actual scar tissue, or if that was how they explained it for > >lack of a better answer. However, he said that he was shown an x- ray > >showing a lot of scarring. I am getting the impression that needling > >anywhere near the area makes him worse---perhaps because there is so > >much scarring. > > > >Anyone have any ideas for an herbal formula for deep scarring? Any > >acupuncture ideas would be welcome too, but I've tried a lot and > >haven't gotten any results. Yunnan Paiyao plasters don't even help > >him. > > > >Any ideas would be greatly appreciated! > > > >Thanks, Laura > > > > > > > > > >Membership requires that you do not post any commerical, swear, religious, > >spam messages,flame another member or swear. > > > >To translate this message, copy and paste it into this web link page, > >http://babel.altavista.com/ > > > > > > and adjust > >accordingly. > > > >If you , it takes a few days for the messages to stop being > >delivered. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2004 Report Share Posted May 12, 2004 Hi Laura, Before you abandon AP in this case, what AP points did you use? Did you try LI04 + GB34 + LV03 + BL60? Did you identify any especially sensitive points in or near the scar? Did you try lasering the scar, or TENS? Best regards, Phil > I have a patient that had a herniated disc at L4-L5 and then had > surgery and now he's in worse shape---the docs say that it is from > scar tissue pressing on the nerve and there's nothing they can do. > His pain is across the back but worse on the left (I guess it was > herniated to the left) and then he has FRONT thigh pain and is numb > from the knee down on his left leg. I've tried a number of > different AP treatments and none have helped at all---and one made > him much worse for a few days. So, I'm wondering about herbs. I > questioned whether the pain really was from actual scar tissue, or > if that was how they explained it for lack of a better answer. > However, he said that he was shown an x-ray showing a lot of > scarring. I am getting the impression that needling anywhere near > the area makes him worse---perhaps because there is so much > scarring. Anyone have any ideas for an herbal formula for deep > scarring? Any AP ideas would be welcome too, but I've tried a lot > and haven't gotten any results. Yunnan Paiyao plasters don't even > help him. Any ideas would be greatly appreciated! Thanks, Laura Best regards, Email: < WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland Mobile: 353-; [in the Republic: 0] HOME : 1 Esker Lawns, Lucan, Dublin, Ireland Tel : 353-; [in the Republic: 0] WWW : http://homepage.eircom.net/~progers/searchap.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2004 Report Share Posted May 13, 2004 In addition to Phil's excellent suggestions, I'd offer Tuina to this patient as well. Tuina has some excellent protocols for lower back pain, lumbar disk protrusion, and chronic lumbar pain caused by scarring, strain, bone spurs, and other causes. In cases such as you're describing dealing with possible sciatia-caused numbness, Tuina can help with circulation and sensation, as well as relive pain and loosen adhesions. Best Wishes, Kathy Kerr AOMA Chinese Medicine , " " <@e...> wrote: > Hi Laura, > > Before you abandon AP in this case, what AP points did you use? > Did you try LI04 + GB34 + LV03 + BL60? > > Did you identify any especially sensitive points in or near the scar? > Did you try lasering the scar, or TENS? > > Best regards, > Phil > > WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland > Mobile: 353-; [in the Republic: 0] > > HOME : 1 Esker Lawns, Lucan, Dublin, Ireland > Tel : 353-; [in the Republic: 0] > WWW : http://homepage.eircom.net/~progers/searchap.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2004 Report Share Posted May 15, 2004 Laura: > I have a patient that had a herniated disc at L4-L5 and then had > surgery and now he's in worse shape---the docs say that it is from > scar tissue pressing on the nerve and there's nothing they can do. > His pain is across the back but worse on the left (I guess it was > herniated to the left) and then he has FRONT thigh pain and is numb > from the knee down on his left leg. > > Herniation is a SP phenomenon. Radiation to thigh front is a ST manifestation. While it is tempting to needle Earth points, hold your hand and look for a deeper imbalance: a. Check shoulder height, maybe one is higher than another. This would skew the hip and precipitate herniation and pain. b. Check GB 21 bilaterally to see if one is harder or indurate, one would guess the L would be. If + ve this could have precipitated pain at L 4 and 5. b. Check spine to see if one is there is scoliosis or kypho-lordosis. Check esp a small segment at T 3 4 5 for a small bend. If + ve this can have caused the pain. In the same manner exclude disparate sternomastoid muscles, brachial reflex, neck reflexes, certainly a skewed sphenoid bone [think cranio-sacral but in acupuncture terms]. If any of these seen, correcting these would resolve pain. In short, heal, but not by addressing the pain. Dr. Holmes Keikobad MB BS DPH Ret. DIP AC NCCAOM LIC AC CO & AZ www.acu-free.com - 15 CEUS by video. NCCAOM reviewed. Approved in CA & most states. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 16, 2004 Report Share Posted May 16, 2004 Phil I have seen it often as you say and treated accordingly. Lower lumbar with upper lesions contralateral and certainly SECONDARY as the upper can be cleared in one treatment. The lower lumbosacral being more often than not the PRIMARY not to forget that the low back is usually more in weakness and harder to resolve. Richard In a message dated 5/16/2004 7:52:40 PM Eastern Daylight Time, writes: Hi Holmes & All, Homes wrote: > Herniation is a SP phenomenon. Radiation to thigh front is a ST > manifestation. While it is tempting to needle Earth points, hold > your hand and look for a deeper imbalance: (a) Check shoulder > height, maybe one is higher than another. This would skew the hip > and precipitate herniation and pain. (b) Check GB 21 bilaterally to > see if one is harder or indurate, one would guess the L would be. > If + ve this could have precipitated pain at L4 and L5. © Check > spine to see if one is there is scoliosis or kypho-lordosis. Check > esp a small segment at T 3 4 5 for a small bend. If + ve this can > have caused the pain. In the same manner exclude disparate > sternomastoid muscles, brachial reflex, neck reflexes, certainly a > skewed sphenoid bone [think cranio-sacral but in acupuncture > terms]. If any of these seen, correcting these would resolve pain. > In short, heal, but not by addressing the pain. Holmes Interesting comments, but are you sure that upper lesions / changes are not SECONDARY to the lumbar pain, and its consequential " guarding " , and taking weight off the affected leg? In horses, as assessed by reaction to pressure palpation, pain in the low lumbar to coccygeal area is very common. IMO, this is mainly muscular, as midline (dorsal) palpation (even heavy) of the vertebral spines and intervertebral spaces rarely elicits a pain response. The affected rump muscles usually are in spasm. If left untreated, some local muscular atrophy often occurs in 1-3 weeks, due to " lazy use " of the affected leg. Circa 70% of these horses show hypersensitivity to pressure palpation of the contralateral neck, especially in the muscles directly overlying the cervical vertebraal bodies (esp C4-C7). Most horse vets with experience of AP diagnosis (by palpating the BL and other Channels) put the HIND problem as the PRIMARY and the contralateral FRONT problem as the SECONDARY. For example, horses not " pushing enough " with the RIGHT HIND, compensate by " pulling too much " with the LEFT FORE. This usually causes overstrain in the lower left neck (or, rarely, in the left scapular muscles). Acupuncture of the NECK or scapular muscles of these horses usually does NOT help the contralateral rump pain, and vice-versa. BOTH the front and hind ends must be treated to get the best results. Could it be that human sciatica-type pain (as in low lumbar or sacroiliac invlvement, herniated lumbar disc, etc) is the PRIMARY and the thoracic, cervical, or sphenoid problems are only compensatiory.SECONDARIES? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2004 Report Share Posted May 17, 2004 Hi Holmes & All, Homes wrote: > Herniation is a SP phenomenon. Radiation to thigh front is a ST > manifestation. While it is tempting to needle Earth points, hold > your hand and look for a deeper imbalance: (a) Check shoulder > height, maybe one is higher than another. This would skew the hip > and precipitate herniation and pain. (b) Check GB 21 bilaterally to > see if one is harder or indurate, one would guess the L would be. > If + ve this could have precipitated pain at L4 and L5. © Check > spine to see if one is there is scoliosis or kypho-lordosis. Check > esp a small segment at T 3 4 5 for a small bend. If + ve this can > have caused the pain. In the same manner exclude disparate > sternomastoid muscles, brachial reflex, neck reflexes, certainly a > skewed sphenoid bone [think cranio-sacral but in acupuncture > terms]. If any of these seen, correcting these would resolve pain. > In short, heal, but not by addressing the pain. Holmes Interesting comments, but are you sure that upper lesions / changes are not SECONDARY to the lumbar pain, and its consequential " guarding " , and taking weight off the affected leg? In horses, as assessed by reaction to pressure palpation, pain in the low lumbar to coccygeal area is very common. IMO, this is mainly muscular, as midline (dorsal) palpation (even heavy) of the vertebral spines and intervertebral spaces rarely elicits a pain response. The affected rump muscles usually are in spasm. If left untreated, some local muscular atrophy often occurs in 1-3 weeks, due to " lazy use " of the affected leg. Circa 70% of these horses show hypersensitivity to pressure palpation of the contralateral neck, especially in the muscles directly overlying the cervical vertebraal bodies (esp C4-C7). Most horse vets with experience of AP diagnosis (by palpating the BL and other Channels) put the HIND problem as the PRIMARY and the contralateral FRONT problem as the SECONDARY. For example, horses not " pushing enough " with the RIGHT HIND, compensate by " pulling too much " with the LEFT FORE. This usually causes overstrain in the lower left neck (or, rarely, in the left scapular muscles). Acupuncture of the NECK or scapular muscles of these horses usually does NOT help the contralateral rump pain, and vice-versa. BOTH the front and hind ends must be treated to get the best results. Could it be that human sciatica-type pain (as in low lumbar or sacroiliac invlvement, herniated lumbar disc, etc) is the PRIMARY and the thoracic, cervical, or sphenoid problems are only compensatiory.SECONDARIES? Best regards, Email: < WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland Mobile: 353-; [in the Republic: 0] HOME : 1 Esker Lawns, Lucan, Dublin, Ireland Tel : 353-; [in the Republic: 0] WWW : http://homepage.eircom.net/~progers/searchap.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2004 Report Share Posted May 17, 2004 I just read this post so perhaps the information I am giving has already been addressed. With any type of disc disorder you also need to evaluate the quadratus lumborum muscle and specifically the psoas muscle. Approx. 80 % or more of individuals with a disc problem will have a weak psoas due to spasm and tightness. By looking at the anatomy of the psoas muscle, evaluating it for weakness via standard orthopedic muscle testing and pain or tenderness upon palpation will give you a good idea if there is a problem. A good book to learn from is Janet Travell, I would recommend both editions. I have seen several patients over the years that have not responded to chiropractic, acupuncture, physical therapy, massage, etc. and all patients told me this was muscle was never evaluated. The treatment would be specific acupuncture points in the muscle, stimulating or sedating the origin and insertion of the muscle with massage and doing myofascial and mobilization techniques. Also the hips need to be evaluated to see if one is higher than the other. Most of the times the imbalance of the hips can be treated using orthotics if the patient is not able to go thru a course of treatment to also include the imbalance of the hips. Either way, I find that using orthotics or a heel lift duing the course of treatment always helps to keep the hips balanced during the course of treatment. Hope this help Brian N Hardy, DC, LAc, CCN < wrote: Hi Holmes & All, Homes wrote: > Herniation is a SP phenomenon. Radiation to thigh front is a ST > manifestation. While it is tempting to needle Earth points, hold > your hand and look for a deeper imbalance: (a) Check shoulder > height, maybe one is higher than another. This would skew the hip > and precipitate herniation and pain. (b) Check GB 21 bilaterally to > see if one is harder or indurate, one would guess the L would be. > If + ve this could have precipitated pain at L4 and L5. © Check > spine to see if one is there is scoliosis or kypho-lordosis. Check > esp a small segment at T 3 4 5 for a small bend. If + ve this can > have caused the pain. In the same manner exclude disparate > sternomastoid muscles, brachial reflex, neck reflexes, certainly a > skewed sphenoid bone [think cranio-sacral but in acupuncture > terms]. If any of these seen, correcting these would resolve pain. > In short, heal, but not by addressing the pain. Holmes Interesting comments, but are you sure that upper lesions / changes are not SECONDARY to the lumbar pain, and its consequential " guarding " , and taking weight off the affected leg? In horses, as assessed by reaction to pressure palpation, pain in the low lumbar to coccygeal area is very common. IMO, this is mainly muscular, as midline (dorsal) palpation (even heavy) of the vertebral spines and intervertebral spaces rarely elicits a pain response. The affected rump muscles usually are in spasm. If left untreated, some local muscular atrophy often occurs in 1-3 weeks, due to " lazy use " of the affected leg. Circa 70% of these horses show hypersensitivity to pressure palpation of the contralateral neck, especially in the muscles directly overlying the cervical vertebraal bodies (esp C4-C7). Most horse vets with experience of AP diagnosis (by palpating the BL and other Channels) put the HIND problem as the PRIMARY and the contralateral FRONT problem as the SECONDARY. For example, horses not " pushing enough " with the RIGHT HIND, compensate by " pulling too much " with the LEFT FORE. This usually causes overstrain in the lower left neck (or, rarely, in the left scapular muscles). Acupuncture of the NECK or scapular muscles of these horses usually does NOT help the contralateral rump pain, and vice-versa. BOTH the front and hind ends must be treated to get the best results. Could it be that human sciatica-type pain (as in low lumbar or sacroiliac invlvement, herniated lumbar disc, etc) is the PRIMARY and the thoracic, cervical, or sphenoid problems are only compensatiory.SECONDARIES? Best regards, Email: < WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland Mobile: 353-; [in the Republic: 0] HOME : 1 Esker Lawns, Lucan, Dublin, Ireland Tel : 353-; [in the Republic: 0] WWW : http://homepage.eircom.net/~progers/searchap.htm Membership requires that you do not post any commerical, swear, religious, spam messages,flame another member or swear. http://babel.altavista.com/ and adjust accordingly. If you , it takes a few days for the messages to stop being delivered. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.