Paul has cervical radiculopathy (from a bulging disc) - advice?

May be getting a tad OT, but re: ice cream benefits, I'll plug tapioca. I think it's more DIY (except for the tropical source of tapioca) than ice cream, but almost as satisfying. I add a couple of eggs and a big spoonful of butter and/or coconut at the very end.... and maybe cinnamon; and the amount of sweetener can be controlled.

At the surgeon's office, I noticed the official diagnosis is cervical stenosis and radiculopathy.

I agree with Paul that the surgeon was awesome to talk with yesterday. He was mostly amused by Paul talking about how in the surgery the "throaty bits" are moved aside. He couldn't stop chuckling about "throaty bits."

The surgery is called anterior cervical discectomy and fusion. They'd basically replace his blown disc with a cadaver bone.

I said, 'Paul, you'd be a zombie!'

He said, 'no; a zombie hybrid!'

Weston Prices work regarding his son, the root canal, the root canal tooth and the rabbits that he experimented on using the tooth will be of interest to you when considering having a cadaver bone permanently installed in your spine. One of my biggest regrets is not paying attention to how my diet was destroying my teeth earlier in life and the problems that root canals pose long term. Leaving a "dead piece of you in you" turns out to be a terrible thing health wise. Fortunately the two I have left are not giving me problems at the moment but there will probably come a day that they need to be extracted for my own good. One was infected so bad it need to be extracted.

joe pacelli wrote:Paul-

I work with people in chronic back and neck pain every day. I work with people that have had back surgeries every day.

If you are considering surgery, look into minimally invasive laser back surgery for bulging discs. Don't let the pain management doctors talk you into any type of surgery that involves the word, "fusion" without looking into minimally invasive laser.

The gabapentin/neurontin can help. People I work with have also found that cymbalta can help.

I cannot tell you how many hundreds of people I've spoken with that regret getting epidurals in the long run. They tell me its a lot of hassle for 2-3 days of relief.

I remembered this good advice from Joe, so I went looking for information about the laser option. My preferred information source is UpToDate.com - it's an online medical textbook. In the article about compressive cervical radiculopathy, there's no mention of laser treatment. They go over pain meds (NSAIDs recommended, narcotics not recommended), mention cyclobenzaprine might help, a short course of oral steroids, physical therapy, maybe cervical traction. They talked about epidural corticosteroid injections being iffy - randomized studies don't show that injecting medicine does any better than injecting saline. Of course, there haven't been a lot of randomized studies with placebo controls. I'm going to share the whole section on surgery:

UpToDate.com wrote:SURGERY — The benefit of surgery for the treatment of cervical radiculopathy has not been clearly established, and data from controlled trials are sparse.

A 2010 systematic review identified only a single small randomized trial of surgery versus conservative management for the treatment of cervical radiculopathy that met criteria for inclusion [35]. In this trial, which evaluated 81 patients with clinical and radiological signs of nerve root compression lasting more than three months, patients were randomly assigned to treatment with either surgery (anterior cervical discectomy), physiotherapy, or immobilization with a hard cervical collar [36]. Those with spinal cord compression, whiplash, and other serious associated diseases were excluded.

The following results were reported [36]:

●At four months, the surgically treated patients showed greater improvement in pain, muscle strength, and sensory loss than the nonsurgically treated patients
●At one year, there was no significant difference in pain or sensory disturbances between the surgical and nonsurgical treatment groups, although the surgical group had a small advantage in muscle strength
A subsequent two-year randomized trial of 63 patients with cervical radiculopathy due to disc disease assigned patients to either anterior cervical discectomy and fusion combined with physical therapy or physical therapy alone [37]. There was no significant difference between the groups for any of the outcome measures, which included neck active range of motion, neck muscle endurance, and hand-related function. Patients in both groups improved over time to a similar degree on these measures, though function remained below normative values.

In contrast to the evidence from these randomized trials, the findings from two prospective observational studies suggest that surgery is beneficial for patients with cervical radiculopathy, with substantial improvement in pain and weakness in approximately 75 percent of patients [38,39]. These studies did not document the percentage of patients with complete pain resolution. Earlier observational studies had found that improved outcome with surgery was more likely in patients with radicular pain than those without radicular pain [3].

Indications for surgery — Proposed indications for surgery in patients with cervical radiculopathy are unremitting radicular pain despite six to eight weeks of conservative treatment, progressive motor weakness, or the presence of myelopathy [3].

More stringent indications for surgery have also been proposed that require the presence of all of the following criteria [4]:

●Symptoms and signs of cervical radiculopathy (ie, nerve root dysfunction, pain, or both)
●Evidence of cervical nerve root compression by magnetic resonance imaging (MRI) or computed tomography (CT) myelography at the appropriate side and level(s) to explain the clinical symptoms and signs
●Persistence of radicular pain despite nonsurgical therapy for at least six to 12 weeks or progressive motor weakness that impairs function
We suggest surgery only for patients who meet these stringent criteria for cervical radiculopathy. As part of a presurgical evaluation, flexion and extension plain films are necessary to assess the stability of the cervical spine [40]. There are two main surgical approaches: anterior cervical discectomy and fusion, and posterior laminoforaminotomy. Artificial disc replacement is a surgical strategy that we regard as investigational.

So, my first reaction to hearing about surgery was "No!, not fusion surgery!" but it does seem like if the surgery happens in four weeks then all of the most stringent indications have been met. Anterior cervical discectomy and fusion is the procedure associated with less post-surgical pain, so that would be my choice, if I had to choose. It's a crappy choice, but it may be the best crappy choice. Sigh.

In the meantime, is there any reasonable way to get you inverted? A tilt table would be ideal. Also, they mentioned a cervical pillow. Have you gotten one of those? Are you still wearing the inflatable cervical collar, and does it still help? What about one of those closed cell foam cervical collars that people with whiplash wear? Sorry. Lots of questions. I'm sliding into interrogation mode - it doesn't help that I'm writing this at work!

First, I have to confess that my brain power has been greatly reduced due to lack of sleep combined with pain. So I am struggling to get my head wrapped around a lot of the things being talked about here- little loan being able to sort out which bits are great advice and which bits are silly.

I also confess that I forgot about Joe's advice on the laser thing instead of whittling out bits the old school way. I don't even know if the laser style is available in Missoula.

Foam neck brace: I think it might help 5%. I also think it might help 80% if it was 30% taller.

Inflatable neck thing: it will usually work. The directions say that I should not use it for more than 20 minutes. Yesterday the doctor told me it was okay to use it for up to an hour. So I used it to get home which is actually about 40 minutes, and when I got home I was in a lot of pain. So it wasn't cutting it.

Cervical pillow: what is that?

I got the impression from the doctor that there is a better than 50% chance that this will just go away in the next 4 weeks. In other words, doing nothing at all could be the best cure. And it seemed to be what he was rooting for.

Another way of looking at it is that I have four weeks to try all of the other ideas. Unfortunately, I'm having a hard time even thinking about the other ideas.

People are suggesting books and videos and I feel terrible that I'm not consuming this information. I suspect that in there somewhere is the very thing that will save me from surgery. And, thus, make all of this insurance bullshit become easy to dismiss.

I feel fortunate to have several physicians caring about my Medical gobbledygook in this very thread. And it is fascinating to see them agreeing with each other and they probably have no idea that the other is also a physician.

Jocelyn Campbell wrote:At the surgeon's office, I noticed the official diagnosis is cervical stenosis and radiculopathy.

I agree with Paul that the surgeon was awesome to talk with yesterday. He was mostly amused by Paul talking about how in the surgery the "throaty bits" are moved aside. He couldn't stop chuckling about "throaty bits."

The surgery is called anterior cervical discectomy and fusion. They'd basically replace his blown disc with a cadaver bone.

I said, 'Paul, you'd be a zombie!'

He said, 'no; a zombie hybrid!'

Yawn. Zombies have become mainstream -> http://www.cdc.gov/phpr/zombies.htm



full disclosure: Just being tongue in cheek. Still pulling for you big guy

This is may or may not be useful info, but Dr. David Hanscom, an orthopedic surgeon with Swedish Hospital, in Seattle, has written a book, 'Back in Control', which continues in the direction pioneered by Dr. Sarno.

Dr. Hanscom has done a lot of back surgery, had back surgery done on himself, and has questions about how useful it is in many cases.... some yes, but his experience indicates not always, and he has found other approaches. Just another fyi :)

paul wheaton wrote:
Foam neck brace: I think it might help 5%. I also think it might help 80% if it was 30% taller.

Inflatable neck thing: it will usually work. The directions say that I should not use it for more than 20 minutes. Yesterday the doctor told me it was okay to use it for up to an hour. So I used it to get home which is actually about 40 minutes, and when I got home I was in a lot of pain. So it wasn't cutting it.

Perhaps what will work is a combination of multiple things, like a couple of different foam braces, or a hard plastic brace plus a foam brace. You might want to put a call in to your physical therapist to see if they have any ideas.

If you wore the inflatable neck brace in the car on the way home, that's a bigger "ask" than just carefully sitting in a non-moving chair or walking about. But, the best thing is to do about at much as you can take and no more.

Julia Winter wrote:

joe pacelli wrote:Paul-

I work with people in chronic back and neck pain every day. I work with people that have had back surgeries every day.

If you are considering surgery, look into minimally invasive laser back surgery for bulging discs. Don't let the pain management doctors talk you into any type of surgery that involves the word, "fusion" without looking into minimally invasive laser.

The gabapentin/neurontin can help. People I work with have also found that cymbalta can help.

I cannot tell you how many hundreds of people I've spoken with that regret getting epidurals in the long run. They tell me its a lot of hassle for 2-3 days of relief.

I remembered this good advice from Joe, so I went looking for information about the laser option. My preferred information source is UpToDate.com - it's an online medical textbook. In the article about compressive cervical radiculopathy, there's no mention of laser treatment. They go over pain meds (NSAIDs recommended, narcotics not recommended), mention cyclobenzaprine might help, a short course of oral steroids, physical therapy, maybe cervical traction. They talked about epidural corticosteroid injections being iffy - randomized studies don't show that injecting medicine does any better than injecting saline. Of course, there haven't been a lot of randomized studies with placebo controls. I'm going to share the whole section on surgery:

UpToDate.com wrote:SURGERY — The benefit of surgery for the treatment of cervical radiculopathy has not been clearly established, and data from controlled trials are sparse.

A 2010 systematic review identified only a single small randomized trial of surgery versus conservative management for the treatment of cervical radiculopathy that met criteria for inclusion [35]. In this trial, which evaluated 81 patients with clinical and radiological signs of nerve root compression lasting more than three months, patients were randomly assigned to treatment with either surgery (anterior cervical discectomy), physiotherapy, or immobilization with a hard cervical collar [36]. Those with spinal cord compression, whiplash, and other serious associated diseases were excluded.

The following results were reported [36]:

●At four months, the surgically treated patients showed greater improvement in pain, muscle strength, and sensory loss than the nonsurgically treated patients
●At one year, there was no significant difference in pain or sensory disturbances between the surgical and nonsurgical treatment groups, although the surgical group had a small advantage in muscle strength
A subsequent two-year randomized trial of 63 patients with cervical radiculopathy due to disc disease assigned patients to either anterior cervical discectomy and fusion combined with physical therapy or physical therapy alone [37]. There was no significant difference between the groups for any of the outcome measures, which included neck active range of motion, neck muscle endurance, and hand-related function. Patients in both groups improved over time to a similar degree on these measures, though function remained below normative values.

In contrast to the evidence from these randomized trials, the findings from two prospective observational studies suggest that surgery is beneficial for patients with cervical radiculopathy, with substantial improvement in pain and weakness in approximately 75 percent of patients [38,39]. These studies did not document the percentage of patients with complete pain resolution. Earlier observational studies had found that improved outcome with surgery was more likely in patients with radicular pain than those without radicular pain [3].

Indications for surgery — Proposed indications for surgery in patients with cervical radiculopathy are unremitting radicular pain despite six to eight weeks of conservative treatment, progressive motor weakness, or the presence of myelopathy [3].

More stringent indications for surgery have also been proposed that require the presence of all of the following criteria [4]:

●Symptoms and signs of cervical radiculopathy (ie, nerve root dysfunction, pain, or both)
●Evidence of cervical nerve root compression by magnetic resonance imaging (MRI) or computed tomography (CT) myelography at the appropriate side and level(s) to explain the clinical symptoms and signs
●Persistence of radicular pain despite nonsurgical therapy for at least six to 12 weeks or progressive motor weakness that impairs function
We suggest surgery only for patients who meet these stringent criteria for cervical radiculopathy. As part of a presurgical evaluation, flexion and extension plain films are necessary to assess the stability of the cervical spine [40]. There are two main surgical approaches: anterior cervical discectomy and fusion, and posterior laminoforaminotomy. Artificial disc replacement is a surgical strategy that we regard as investigational.

So, my first reaction to hearing about surgery was "No!, not fusion surgery!" but it does seem like if the surgery happens in four weeks then all of the most stringent indications have been met. Anterior cervical discectomy and fusion is the procedure associated with less post-surgical pain, so that would be my choice, if I had to choose. It's a crappy choice, but it may be the best crappy choice. Sigh.

In the meantime, is there any reasonable way to get you inverted? A tilt table would be ideal. Also, they mentioned a cervical pillow. Have you gotten one of those? Are you still wearing the inflatable cervical collar, and does it still help? What about one of those closed cell foam cervical collars that people with whiplash wear? Sorry. Lots of questions. I'm sliding into interrogation mode - it doesn't help that I'm writing this at work!

Ah, up to date .com , the folks in the Emergency Department love that website!

While fusion has been around longer, and more surgeons specialize in fusion, my experience is that patients end up getting more fusion surgeries in a few years (above and below the original fusion site, as native bone degenerates). Considering how cervical spinal stenosis tends to 'mature' over time, a patient's first neck surgery is a big decision with serious risk.

Also, meeting criteria for a particular procedure does not inform us about long-term outcome.


If it were my neck, I would take my scans down to Bonati in Florida in a heartbeat, and, Dr. Kevin Gill at UT in Dallas (he's got clinical trials on-going now).

Spine J. 2014 Oct 1;14(10):2405-11. doi: 10.1016/j.spinee.2014.01.048. Epub 2014 Jan 30.

Complications, outcomes, and need for fusion after minimally invasive posterior cervical foraminotomy and microdiscectomy.

Minimally invasive PCF with or without MI-PCD is an excellent alternative for cervical radiculopathy secondary to foraminal stenosis or a laterally located herniated disc. There is a low rate (1.1% per index level per year) of future index site fusion and a very low rate (0.9% per adjacent level per year) of adjacent-level disease requiring surgery.

http://www.ncbi.nlm.nih.gov/pubmed/24486472


Paul-- I'm working on a visit!

Joe

This is excellent! Two doctors hashing out my health. It is fucking awesome being me!

Maybe we should arrange for both of you to come out here and got at my pitifulness. Or, maybe the two of you should exchange phone numbers!

I have not tried a tilt table. I am a giant and have crushed a few chairs. I would be worried about the capacity of a tilt table.

I have tried to read some of the things the two of you have mentioned. I understood some of it.

Here are a couple of factors to add to this discussion: when I am on my back my pain level fluctuates between zero and four. When I sit or stand it fluctuates between two and 6.5. This is on a scale where 10 equates to being actively mauled by a bear.

At home, in bed, I can be fine or I could be making whining sounds. But the drive to town is torture- and it gets worse with every passing minute. The idea of travel is nearly unacceptable. Part of me thinks that I could be knocked out for the travel - but then I am concerned that I could end up with some kind of permanent damage to my spinal cord. After all, the pain guides me to be gentler on my spinal cord.

I suppose it could be possible to be mounted with something that could keep me in a perpetual state of traction. So far, that device has not been introduced to me.

My favorite healing path so far is the one that the surgeon suggested: do nothing and it goes away. I like the idea of considering options that enhance this path. Unfortunately, my ability to research is hobbled by pain and lack of sleep. If people know things in this space, recommending a video or book does not seem to be working for me. Perhaps if the recommendation were augmented by A simplified summary I might be able to wrap my head around it better. Maybe a mention of the technique and why it works.

FWIW: did not sleep so good last night. I thought I was feeling well enough but I would not need another one of those pills. So my sleep was repeatedly interrupted by pain.

Just thinking about the suggestions for a tilt table. My mom loves her inverser every time she has any back pain.

Would it be possible for someone to put something under the bottom two feet of your bed so that you can lay on the bed with your head tilted down? Hook your knees over the edge of the bed so that your body weight isn't putting added pressure on your neck. I think this would be a reasonable test of concept. If it provides measurable relief, then it might be worth the effort of working out a more elaborate tilt table.

Here is something I read on line. Might be worth looking into.
Acute Back Pain

And comfrey is effective in the treatment of acute upper and lower back pain. This is pain that was not due to some identifiable problem such as disc or nerve damage. Usually, but not always, acute back pain lasts for no longer than a few weeks or months and can be caused by injury or strain to a muscle or ligament. To test comfrey's effectiveness in treating back pain 120 people aged between 18 and 60 were given ointment, either a placebo or with comfrey root extract. They rubbed it in 3 times a day for 4 or 5 days. Those on the placebo had an average pain reduction of 37.8% between the beginning and end of the treatment period. This is not unusual in cases of acute pain because it is often short lived and gets better on its own. But those using the comfrey ointment saw an average pain reduction of 95.2%.(5) Now, even though comfrey root was tested in those who were suffering from acute back pain I imagine that even those with chronic back pain could find some relief from the pain caused by inflammation.

I am going to insist though it seems that it was not taken into account:
Paul, you feel that it is better with this device to stretch the neck, BUT you cannot use it long.
It cannot be used long because when the body feels a stretch, then it contracts afterward.
That is why it does not work long.
But something works doesn't it?

Then they say that is can go away by itself.
Doing nothing. Yes, the body does things by itself, through the nervous system. We can help it, or prevent it do it. That is why I mentionned somatic experiencing and breathing Buteyko method.

So the solution is not to strech but to shorten passively the muscles. In any active movement, we shorten our muscles, but actively. The passive way is when someone do it for you. There is a way to do this so that it breaks the contraction pattern. You have one, or else no streching would help. But as I say in all ways I can, an active strech induce a spasm reaction just afterward.

It is funny you mention this. Moments ago I ordered to new neck braces. Each is a taller size. The idea is that I might be able to go outside, or sit at a computer through the day while this continues to heal.

You are suggesting something about rerouting nerves or building new muscles. I do not understand what this has to do with the bulge on my spinal cord and the pain that comes with that. Even if you build new nerves or muscles, I would still have that bulge and, thus, still be in extreme pain.

A tilt table can be easily built that will support your size Paul. A friend of mine built one. A sheet of thick plywood as the 'bed', padded as you wish, with something comfy to strap your ankles in place. These straps are the part that will be bearing most of the weight when you are tilted, and need to be comfy on your ankles doing that. A pivot point and cantilever so that the bed tilts, easily and the person on the bed can 'right' him/herself easily. I'm sure that a guy of your ingenuity can design and have it fabricated to your specs. Look at a few designs or models online to get ideas.

Every Time you guys say 'tilt table' I have this image of Paul being placed on an alpaca shearing table:



I think poor Paul, why would anyone think that makes you feel better.

But then I realize what we're really talking about and it all makes sense.

paul wheaton wrote:It is funny you mention this. Moments ago I ordered to new neck braces. Each is a taller size. The idea is that I might be able to go outside, or sit at a computer through the day while this continues to heal.

You are suggesting something about rerouting nerves or building new muscles. I do not understand what this has to do with the bulge on my spinal cord and the pain that comes with that. Even if you build new nerves or muscles, I would still have that bulge and, thus, still be in extreme pain.

I do not know who suggest this, as this is not me.
Just in case it was still not clear, I suggest that the pain comes from this bulge because of a spasm of some muscles.
This tend to be proved that this is the case as the stretching help.
But the stretching causes some contracting reaction afterward.
So I suggest to look for the other way to obtain the stretching of the muscles.
This is under control of the autonomous nervous system, that is why it has to occur by itself (or not under the cortex brain decisionl or else you would have done it for long!)

That it is under autonomous system control does not mean nothing can be done. There is a way to cheat the system and make it do what we want. And this is what I had tried to explain. Only when the brain receive the signal "there is no more pulling on the articulation" it can decide to send the message "stop contracting" to the muscles that are too tight.

Tilt table: I suspect that this could be used for only a short time. Maybe 5 to 10 minutes at a time?

The people that are currently here very much wish to work on permaculture related things. Ants are dedicated to working on their aunt plots.

I might be able to persuade somebody to stop working on permaculture things in order to build such a table, but I would need to make it very much worth their while. So the table ends up being very expensive.

I am hopeful that the same effect can be had by improved collars. With the added bonus that I can walk, sit, and do all sorts of normal things.

Actually, my mom slept on her inversor after pulling something in her back. Just tied it so that it had only a mild incline rather than dangling upside down.
I still think you should test the concept by lifting the foot of your bed. They sale those blocks for lifting beds (to increase underbed storage) but as long as it's not on wheels, you could probably get the same effect with a wide board. If it works, I don't see why you couldn't use an incline while you sleep and the collars in waking hours.

Inversion via a table can be used for hours, if your weight is well supported.

If your bed is up on four feet, tilting it by simply raising the bottom two feet could lead to the top two legs breaking (from trying to bear weight at an angle). I second the suggestion of building a strong table, ideally one that can tilt, but more simply one that is set up at a moderate angle permanently.

I sent you a facebook message with a picture of a complete tilted desk system that looked pretty cool (but also pretty expensive).

I have not been out to Facebook for several weeks. The last time I was out of Facebook what is because I heard there was spam on my wall. I think it was the first time I actually used my laptop since getting cervical radiculopathy. I was on just long enough to delete the spam.

For everything else, I am using my cell phone. And I choose to not use Facebook on my cell phone.

I'm just not a facebook person I guess.

Jocelyn, on the other hand, probably uses Facebook a normal amount.

Good point. I think it's the same one described here in this Wired article.

And, these people are selling them.

Julia Winter wrote:Good point. I think it's the same one described here in this Wired article.

And, these people are selling them.

Wow. That would totally work for me. Of course the price puts it way out of my league. But it looks like one of them would even do that whole tilt bed like thing. I could continue to work while being partially upside down.

I'm currently dealing with lower back pain and have no idea whether this would be relevant to Paul's issues, but here goes anyway...

My chiropractor uses Theralase cold laser treatment as well as chiro adjustments. I've found it helpful.
http://theralase.com/how-it-works/

I had a herniated disc in my spine. Specifically my L5 in my low back. It squished out and impinged my sciatic nerve, so that pain radiated down my thigh and my big toe was numb 24 hours a day. I also felt insane pain in my back from the smallest movements. It hurt so bad to drive to the store that I would put off getting groceries as long as possible.

Dr. Jolie Bookspan's methods are fixing my back. I did not need surgery or an inversion table. The numbness in my toe is almost completely gone now. Here is what she says... "Disc degeneration or slippage (herniation) can heal - if you let it, no differently than a sprained ankle. Stop damaging your discs with bad bending, standing, and sitting habits and the discs can heal. It takes years to herniate a disc, and only days to weeks to heal it by stopping bad habits."

She says to first try a Wall Test for diagnosis:
1. Stand near a wall, with your back close to, but not touching the wall.
2. Back up toward the wall. See what touches first, and how it feels most habitual for you to stand.

Do this wall test, described above,
to see if you have the healthy positioning needed to avoid neck and upper back pain.
This is a test to tell what is the problem, not an exercise to fix it.

Her "Stretching Smarter Stretching Healthier" book shows you which exercises to do depending on your Wall Test results. Basically, you do stretches to help your body be flexible enough to do all your daily activities with good posture. The real work is learning good posture all day long. At first I did the wall test about 20 times a day. Now I am down to about 10 times a day as I am gradually learning what it feels like to correct my posture. It is simple but difficult, but it is actually doable. I started feeling better the first time I tried her recommendations. She has some free info and stretches on this web page about neck pain http://www.drbookspan.com/NeckPainArticle.html I would also recommend her "Fix Your Own Pain Without Drugs or Surgery" book.

Paul I don't think an inversion table will do much if it was your lower back I'd say yes
but neck , It works by using the weight of your body to expand your spine and deflate the budge by negative pressure .
my wife used a thing that strapped around her head and went up to top of door she could pull a rope and stretch her neck same as inversion just pulling up.
as far as waiting to see if it fixes itself .
when I had one I was told that it took at least 8 weeks to start forming a callous on the nerve that would relief pain
I would guess dependent on conditions on results.
1990 to now I still know it's there, I have to watch what I do If I over do it it comes back which I think is from swelling,I still see a chiropractor ,mine was lower L4-L5
The first doctor suggested immediate surgery.I would say that would be the last resort.
but I do know some that has had immediate relieve and other not so.
I know all the feelings and mental that comes with this and they were as hard to deal with as the actual injury.
just know they do get better,and you have lots of people pulling for you.

paul wheaton wrote:

Julia Winter wrote:Good point. I think it's the same one described here in this Wired article.

And, these people are selling them.

Wow. That would totally work for me. Of course the price puts it way out of my league. But it looks like one of them would even do that whole tilt bed like thing. I could continue to work while being partially upside down.

I would contribute to a kickstarter to buy paul one of these ergoquest zero gravity chairs.

Anyone else?

Joe

What Mira brought here looks great.... I read the link.

More about the problem with stretching the postural muscles by pulling:

contracting and stretch reflex:
When a muscle contracts (= active shortening, tightening), and to help it contracts, a signal to relax is sent to the antagonistic muscle, through the nervous system. Normally, there is a reciprocal control between antagonistic muscles.
Our bodies have a system to protect our muscles from being overstretched. It depends on the autonomous nervous system, so that it can react quickly and adequately to an accidental pull. Our muscles also protect our articulations and ligaments.

All muscles have a muscle fiber called annulo-spiral receptor. This receptor is responsive to the speed and length muscles are being stretched. As a muscle lengthens (stretching), and according to the speed and extend of the stretch, this receptor sends a signal telling the muscle to contract.

That is why a method by passive shortening can work. It is when someone makes your neck do the movement of contraction without you contracting, and goes back. It is not self-help, you need someone who is trained. Found about Jones techniques in French only at the moment... http://institut-heritage.com/ressources/rebouteux/le-relachement-tissulaire/

In English, I found "passive body positioning of spasmed muscles and dysfunctional joints toward positions of comfort... The purpose of movement toward shortening is to relax aberrant reflexes that produce the muscle spasm... This allows the joints influenced by the now relaxed muscle to function optimally increasing its range of motion and easing muscle pain."

https://en.wikipedia.org/wiki/Strain_and_counterstrain

Originally developed by an osteopathic physician, Lawrence Jones, DO, FAAO, strain-counterstrain technique is a method for reducing chronic and/or acute muscle spasm anywhere in the body. The big advantage of this technique is its extreme gentleness to the patient. The patient often wonders how this technique can work when the therapist does not seem to be "doing anything".

The treatment is done when the therapist finds specific areas of pain and tenderness. She/he then positions the body in a way that eases or completely stops the pain. She holds the position until she feels a softening in the area of pain (about 90 seconds). This is followed by gentle stretching of the muscle.

OK, there is a Lawrence Jones school in Northern California called The Jones Institute They have a "find a practitioner" page that won't work if you put in Missoula, Montana, but does work if you use the zip code function. Here are the names of all the people who've trained in this technique, who are (or were) in Missoula.

The first on on the list (Monique Krebsbach) has no individual website, but seems to still be doing physical therapy in Missoula, and currently using that phone number. Maybe you can convince her to make a house call? I decided to share all the names in the hopes that somebody on this list has a connection - social networks are complicated things. Sorry for the giant screen grab, I'm no good at formatting. . .

Monique Krebsbach P.T.
Missoula , MT 59803
406-829-0728
Level of Training: SCS VC
Courses Completed: SCS ISCS II - SCS N1SCS IIISCS IVSCS LVSCS V&LSCS ARSCS VC
**********
Gail Nevin P.T.
Missoula , MT 59803
406-542-0177
Level of Training: SCS AR
Courses Completed: SCS ISCS II - SCS IIISCS IVSCS V&LSCS AR
**********
Brenda Dahl MSPT
Hamilton , MT 59840
406-273-9033
Level of Training: SCS VC
Courses Completed: SCS I - SCS IIISCS VC
**********
Lindsay Tripp D.P.T.
Missoula , MT 59801
406-541-9500
Level of Training: SCS II
Courses Completed: SCS ISCS II -
**********
Miri Disney-Faller PT, ATC
Missoula , MT 59803
406-549-3847
Level of Training: SCS II
Courses Completed: SCS ISCS II -
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Troy McDonough P.T.
Missoula , MT 59803
406-721-8858
Level of Training: SCS II
Courses Completed: SCS ISCS II -
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Amy Haynes N.D.
Missoula , MT 59803
406-721-2147
Level of Training: SCS II
Courses Completed: SCS ISCS II -
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Lynne Jenko P.T.
Missoula , MT 59808
406-329-7558
Level of Training: SCS II
Courses Completed: SCS ISCS II -
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Catherine Gilbert P.T.
Missoula , MT 59801
406-329-7340
Level of Training: SCS II
Courses Completed: SCS ISCS II -
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Ian Nesbit Dr
Missoula , MT 59807
406-541-7672
Level of Training: SCS II
Courses Completed: SCS ISCS II -
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I am knocking on wood...

I am feeling much better. As long as I stay on my back I am not in nearly as much pain. In fact the pain level has dropped down to as low as zero or as high as one - being a level that is irritating but I should be able to work through it or sleep through it.

I have gotten a lot of work done the last couple of days. Although it is painfully slow to go through a cell phone.

When I stand up I do start to get pain in my arm, but so far it is 1 - 2.5. I get myself laying down again more about concern of permanent nerve damage than anything else. Well, I guess I'm also concerned that the pain will get even worse.

Maybe this is what it's like to get better. I mean to say this is the early stages of being all better from this.

Course, I'm not really sure what helped me to get better. A lot of things were tried. Lots of good food. Lots of good wishes from people. And one guy had my consulting fee in order to be able to do is energy work over the phone. He also suggested that I eat more asparagus, figs and chocolate.

I don't think I'm all better just yet... Maybe in another day or two.

Just thought you all would like to know.

That's great news, and I think that's how healing happens many times....so slowly that you don't notice for awhile or can't be sure, and then you begin to realize that you are moving better and not hurting as much.
Good Wishes for continued positive progress

Soooo grateful for the update :) Thanks a big bunch. And, just a thought, it may be 'painfully slow', i.e., frustrating, to work on the phone, but maybe that's one of the lessons.... slowing down, smelling the roses, stopping to notice stuff... like posture, etc ... ?

> recovering

Good to hear. When I had back pain it seemed to help a lot when I remembered to make every move s-l-o-w-l-y...

> inversion

Seems to me it's not meant to put you upside down but rather at some angle which relieves some of the load (toward your feet) your neck normally carries - not really trying to stretch anything. For long periods it might give your neck "room" to heal. Raising the foot of the bed seems like an easy test, maybe even a practical method.

Here's a back presentation. It has numerous highfalutin words and language as well as personal names to aid future research and inquiry. There are some pages specifically about the neck about 2/3 way down. Doesn't present detail or concepts much - bullets seem aimed at those who know.

http://www.denverbackpainspecialists.com/wp-content/uploads/2012/06/Spine-Stabilization-Concepts-dbps1.ppt

It ends w/a strong recommendation for exercise.

One last idea: LazyBoy. Used ones can be found sometimes. Since you can't go check it out personally, I guess it'd need to be dirt cheap or returnable. Just a thought. They can be very good, but it varies.

Best wishes.

Rufus

Hey Paul is this what you are looking for?

http://missoula.craigslist.org/fuo/5477864665.html

Or maybe the electric bed in this post?

http://missoula.craigslist.org/hab/5469183951.html

Might be able to get them for less money than they are asking?

I haven't followed everything in this post, and am catching up after a few months off the forums.

I get a lot of odd back and neck pains, stiff and sore muscles. They are all made substantially worse by lengthy computer sessions for work and bad posture. I recently got one of these:

https://www.kickstarter.com/projects/1123408990/betterback-perfect-posture-effortlessly

I use it when I'm at my computer and it has made a huge difference in just a few weeks. I'm not suggesting it will help what is clearly an acute injury of some sort, but once you are on the road to recovery it may help keep you from further problems.

I have been living with two herniated discs in my neck (C5-C6, and C6-C7) for close to 10 years now. Once diagnosed, the surgeons wanted to perform a "disc-ectomy" because one of the herniations up against my spinal cord was only accessible via the rest of the disc... This option didn't excite me very much, so I opted to pursue less invasive treatments first, and only go for fusion as a last resort.

What has (mostly) worked for me is a combination of improving my posture, getting up and moving and stretching, and...localized steroid injections. The injections were several years ago, and it took two sets to do the trick. Now, I only get the severe neck/shoulder pain when I'm sedentary and under stress; driving the car and/or riding the motorcycle at night, in the rain, in traffic, or for extended periods of time are the worst for me. As long as I can get up and move around, and flex and stretch and change my position, and relax and not be stressed, I do pretty well. I haven't resorted to fusion surgery as of yet, and hope not to ever.

Best of luck to you, Paul. I'm sure you didn't want to hear about an invasive chemical treatment such as steroid injections, but that is what worked for me. I hope you are able to find another, more "permie" treatment that works for you, brother!

-John

Whew! I have not looked at this thread in a couple weeks and there is too much here for me to read at the moment. Paul has said multiple times that he is relying on me to digest this stuff, and you know, I'm just not doing very much of that.

There have been significant hurdles for us to transverse in the midst of his herniated disc (life doesn't stop) and initially I was sacrificing my sleep to just keep up with things. I'm now more rested, only slightly less overwhelmed, and might be able to research some additional recommendations in this thread this coming weekend.

Here's the treatments so far:
--medications - more than either of us have ever considered or even thought wise in the past; the main one being a powerful nerve pain medication
--steroid injection in the neck - one so far, which might have helped 10-15% or so
--traction and PT - not helping as much recently (could be the muscle contraction reaction issue mentioned above?)
--bed rest - Paul is flat on his back 99% of the day and night, only able to sit or stand for a few minutes at a time before the pain in his arm starts skyrocketing
--anti-inflammatory and recuperation diet - I fed him so much tumeric, he developed a rash on his face(!), so now I've backed off on that while continuing the other efforts to increase vegetables (goal of 9 cups/day/person), keep starchy carbs and sugars down very low, keep UP the good fats and good omega fatty acid ratios, reduce/eliminate any inflammatory fats and foods, increase collagen/gelatin, increase fermented foods. (Though I've recently burnt out/backslid a bit on what was taking me 4-6 hours per day in the kitchen for this.) He is eating to maintain health, and eating far less than he used to, both due to pain, and due to less activity. He ate SO much less at the beginning of this when the pain was at its worst, that he has lost some weight.
--stress - we're mitigating this where we can, though Paul is in some high-stress situations at the moment. I definitely notice his pain worsening during or immediately after talking about stressful things. Remarkably, some of the stress in quite a few areas is improving and his spirits are wonderfully positive and bright. One might even describe him as cheerful. (Is that the drugs? )

The surgeon recommends the ADAF surgery as discussed above, though we have not yet scheduled this. We had thought to schedule it, while continuing other things, with the hope of having enough improvement in the interim that we'd cancel the surgery.

In short, we had really thought the drugs, traction, rest, healthy food, etc., would get Paul to where he could start being a bit more mobile. With more movement, I like the idea that he'll gradually start improving/correcting the body mechanics and such that have, at the very least, contributed to this condition.

Then, we thought the steroid injection could help him be more mobile. And more recently, a lot of this week, Paul was feeling so much better, and with new collar ideas, that between the two, he thought he'd be able to be more mobile.

He still has very little mobility.

As Paul gets more mobility, I'd urge you to look into at least that first PT on the list I published (I know, it's a super long list - I'm sorry! I couldn't figure out how to wean it down). I shared the whole list on the off chance that one or more people has a connection to someone in Paul's circle.

(side note - a local person who wants to help could call these people and find out 1) who is actually in business 2) if they think they could help 3) if they make house calls (unlikely) and 4) what they charge. Actually, anybody with time and free or low-cost long distance phone service could do that.)

Hang in there, Jocelyn! You have a ton on your plate, and you are doing a great job. Cheerful is awesome! (as long as it doesn't come from alprazolam, or lorazepam, or diazepam, etc)