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I know most of you are not doctors, but some of you are bound to have had this ailment before. It started with minor lower back pain Wednesday night, but has progressively gotten worse until now. I can't lay down, I can't stand up and I can only sit on my left buttcheek. Walking is a major ordeal. Luckily, I had enough hydrocodone from a previous injury to last me thru the weekend. I have tried heat, cold, stretching, etc, with no relief. The pain goes from my right lower back all the way to my ankle, and my foot is cold, numb and tingling. Besides the ER, what can I do?
You need a neuro surgeon. I had the same issue when I was in the car accident a couple of years ago. My back surgery corrected the problem. You need to try Ibuprofen ...800 mg 3 times per day. The ibuprofen will reduce the inflamation. Aleve is a good OTC drug to try for low back pain. DONT take 800 mg of that! Follow the mfg recommendations. IF you get something like Advil, or another pure ibuprofen drug, take the 800 mg...with food. If you have a history of GI bleed or ulcers..dont take the ibuprofen.
Either way, get yourself to a doc ASAP.
Jamison...wondered wher eyou have been since your goat hunt in WY! Listen to NurseKat! Been there done it with the back pain.
I've been doing the Ibuprofen 3x a day (800 mg) and it hasn't really helped. I need to make it thru tomorrow to Monday so I can see my regular doc...My last ER trip was $13K, and $5K of that comes out of my pocket...I need to make it to Jan 1 before any serious money is spent...
I destroyed my back in September 2001. Spent 4 1/2 years fighting Oregon workers comp. been to all kinds of doctors and they all sat the same thing, not a candidate for surgery and there is no help or hope. I have chronic pain, 24/7/52.

That said there is hope for those of us who have to live this way. Keep your mind busy and do not let pain ruin your life. I take no pain medications, not even over-the-counter.

Look at it this way; if you break the first rule of carpentry (NEVER hit the pink nail) Where does it hurt. Hint: it is not your thumb. It is in your head. Now find that place in your brain and turn the switch off.

Hope it is a temporary thing for you but this may help until you get real relief. It has worked for me for years. If we were to spend a day together you may not know I was ever hurt and live in pain because I have tuned it out, turned the switch off and most days do am non conscience of the pain myself. It can work that well.
Can you do the proper lower back stretches that a physical therapist would have you do?
Yes, I am stretching as much as possible..What really hurts is the right leg, my back isn't so bad. I have had this before n the upper back, and it took a couple of shots and some steroids to get rid of the pain. That was in '93, and I forgot how bad it hurt...
Here's my home remedy. I lay on my bed with my hands balled into fists with my knuckles applying pressure into my lower back. I slowly rotate my hands back and forth, up and down my lower back into the top area of the buttocks to massage out the muscle. When i do the above, I'll also push down at the top of my azz to provide a stretch.

Don't laugh. It works wonder for me. I'll also let my lower body hang while resting on my forearms from my dip bars. that works too.

Good luck Chris.
NurseKat... You're back!!! Welcome home!

What to do about the back...

My son is a physician.

One day, getting out of the shower, there was a little squish in my back, and I was suddenly not only wet, but in screaming agony. My wife dried me off, and sent for my son.

He laid me on my back on the bed, with my knees about at the edge of the bed. He planted one of my feet against his chest, my shins parallel to the bed, and pressed forward quite firmly. He relaxed the pressure, and reapplied it 4-5 times. Then he did the other leg.

It was amazing the amount of relief I got.

Maybe the same will work for you.

Oh... and listen to NurseKat.
Originally Posted by Scott F
the first rule of carpentry (NEVER hit the pink nail)


laugh laugh
Originally Posted by NurseKat
You need a neuro surgeon.


Before I went to an ortho or neuro surgeon, I'd try to find a good chiropractor in your area. I've had cracked/compressed vertebrae, pinched nerves, etc. and have never required surgery to get pain free.
Go to a good chiropractor and have him adjust your hips to take the pressure off the nerve. Your sciatic nerve is pinched in your lumbar region. move the bone back where its supposed to be and take the pressure off the nerves. Your nerves dont hurt because there is a lack of drugs in your body, they hurt because they are pinched. A surgon will only remove cartilage and the like in the area and if a disk is truely blown, they take the jelly off the nerve, but if the bone isn't corrected, it will persist in the near future.
Originally Posted by salmonhead
Go to a good chiropractor and have him adjust your hips to take the pressure off the nerve. Your sciatic nerve is pinched in your lumbar region. move the bone back where its supposed to be and take the pressure off the nerves. Your nerves dont hurt because there is a lack of drugs in your body, they hurt because they are pinched. A surgon will only remove cartilage and the like in the area and if a disk is truely blown, they take the jelly off the nerve, but if the bone isn't corrected, it will persist in the near future.


Bingo.
Originally Posted by salmonhead
Your sciatic nerve is pinched in your lumbar region.


Chris-

Do you remember me coming home early from a certain school at Fort Chaffee? I couldn't get up off of the firing line without help. (I think Dolan tried to crush us under our rucks, and it apparently compressed something in my back).

It was my sciatic nerve.

It would come and go randomly, but has since developed into a more frequent nuisance, to some varying degree of discomfort, over the years. It is now constant.

Aleve sometimes helps. Otherwise, I've learned to live with it. I don't like it, but have accepted it for the most part.

Good luck.
Same problem. Chiropracor for 25+yrs. Functioned ok until May07 when I couldn't straighten up. Tried 5mths of shots and oral meds. Surgery in Oct07. Not quite 1yr for recovery. Now back to normal.

til later
My oldest daughter had something similar occur just before Christmas a few years ago. Since I have a chronic back/neck problem I was able to schedule an appointment with my orthopedic surgeon. After a MRI & X Rays it was determined that nerves were being pinched & permanent damage could result. The orthopedic had a neurosurgeon see her the next day & surgery was scheduled the following day. Both the surgeons performed the operation, orthoscopically, & within 2 days she was out of the hospital & pain free. Certainly try a bone crusher for temporary relief but, see a surgeon ASAP. Good luck.
Don't put off going to a neuro for too long. I hurt my back a few years ago and went to a chiropractor for two months. If they're not giving you treatments they're not making money. He finally referred me to a neuro at my request. By the time I got in I had permanent nerve damage to my left leg and the calf muscle had atrophied to the point of no return. It was too late for surgery to make a difference. The neuro said in all likelihood a micro-disectomy surgery which can sometimes be an outpatient procedure would have resolved the problem with no nerve damage.

The muscle loss I sustained (inside of the left calf muscle is gone) resulted in a considerable loss of balence when walking on uneven ground, going up and down steep inclines or standing in my boat in rough water. I've got to think about which foot to push off with for about everything but walking on level ground or I run the risk of falling and possible additional injury.

Surgery isn't a good thing to contemplate. There's always risk but I know two people that have had this procedure and they've had no further problems. Neuros probably do more of these than any other procedure and have gotten good at it.

First I'd get a history; i.e.,did you injure yourself recently, surgeries, etc., blood work and then you need a lumbar spine MRI. I'd also do a neuromuscular check of your lower extremeities. Any weakness or sensory loss (numbness, "pins & needles") of the leg affected?

It sounds like you have a radiculopathy, an inflammation of a lumbar nerve root and there are basically four on each side that give innervation and affect the muscles to each leg.

The history, physical exam, and MRI are usually 100% diagnostic; since you have acute pain (it started very recently-or is this a reoccurence) I'd probably try some pain pills, anti-seizure med's (yes, they can help), and NSAIDS (non-steroidal antiiflammatory drugs-celebrex) first with physical therapy or a good chiropracter who specializes in pure spinal manipulation.

Failing a course of that or both there are certain injections such as a lumbar epidural steroid injection or a selective nerve root block I'd do if it sounds like what I think it is and doesn't respond to the more conservative therapy.

edited to add as the poster above mentioned if it progresses to numbness, loss of bladder or bowel control, you skip most of the above (you will get an MRI anyway)and go straight to the OR. Once nerves are severely compromised they need to be relieved pronto as their capability and time to heal would make a snail crawling on a Dec Iowa sidewalk look like lightening.

Gdv
I've posted this before but it bares repeating before you let someone cut you open!


I went to a chiropractor for years until he convinced me that if I inverted daily I could avoid the need for his service.

I've taken care of my back since 1992 with this device. The good thing is that I can take immediate action at home without scheduling an appointment with a chiropractor who might not be able to see me for days!

[Linked Image] [Linked Image]



"NOW YOU CAN GET RELIEF FROM NAGGING BACKACHE IN MINUTES!"
Invertrac counters the degenerative effects of gravity.
Invertrac allows for the benefits of spinal decompression without trauma to ankle, knee, or hip joints.

Natural traction occurs in the lower back when subject is in bent leg position.
The lumbar curve is flattened allowing this to more readily occur.

Invertrac helps eliminate stress and tension by stretching spine and back muscles allowing complete relaxation.

Circulation is greatly enhanced through inversion.

Invertrac is lightweight, portable and comfortable.

THE INVERSION TRACTION CONCEPT

The effects of gravity on the human form are reversed by hanging inverted on the Invertrac unit. Tension on the spine is relieved and vertebrae are separated, easing pressure on the discs. If a disc has slipped, (herniated) instant relief from pain may occur by releasing the "pinch" of the nerve when it returns to its normal position. Displaced vertebrae, (the cause of back pain) are realigned and muscle spasms are reduced. Invertrac may not only instantly relieve back ailments, but may aid in chronic spinal difficulties.
Copyright � 1997

Inversion Can Help to Relieve Many Forms of Back Pain

There are many causes of back pain, including poor posture, weak back and stomach muscles, and muscles spasms to name a few. Many of these causes can actually be attributed to one force we must all battle: gravity.

So how can Inversion help you to relieve your back pain? Quite simply, inversion therapy puts gravity to work for you by placing your body in line with the downward force of gravity. Inversion elongates the spine, increasing the space between the vertebrae, which relieves the pressure on discs, ligaments and nerve roots. Less pressure means less back pain.

Every nerve root leaves the spine through an opening between the vertebrae-the size of this opening is largely controlled by the height of the intravertebral disc. Discs that are plump and contained in their ligament "wrappers" are necessary to keep the nerve roots free of pressure and your body free from pain.

Stress and tension can cause muscle spasms in the back, neck and shoulders, as well as headaches and other problems. Tense muscles produce spasms and pain by reducing the supply of oxygen and by reducing blood and lymph flow, allowing the accumulation of waste chemicals in the muscles.

Inverting yourself for a few minutes a day can help relax tense muscles and speed the flow of lymphatic fluids which flush out the body's wastes and carry them to the blood stream. The faster this waste is cleared, and fresh supplies of oxygen are introduced, the faster stiffness and pain in the muscles can disappear. A study conducted by physiotherapist L.J. Nosse found that, "EMG (electromyographic) activity, an indicator of muscle pain, declined over 35% within ten seconds of assuming the inverted position.

Inversion can also help to encourage good posture. When inverted, your body is in line with gravity. Your spine wants to naturally go to its proper form (a gentle "s" curve). A regular program of inversion can help you to maintain proper posture and keep your body in balance.

Inversion Helps Provide Care and Feeding for the Discs


Your discs have three jobs: to separate the vertebrae, provide flexibility to the spine and to act as shock absorbers. Disc separation is especially important since all communication between the brain and the body is via nerves that pass between each vertebra. Insufficient distance between the vertebrae can result in nerve root pressure and pain.

The inner core of your discs is made of jelly-like material that provides the flexibility and "cushioning" in your back. When you are sitting, standing, or exercising, �weight-bearing activities�, fluid is squeezed out of your discs and into adjacent soft tissue (just as you would squeeze moisture out of a sponge). As a result, your discs lose some of their moisture and height. To prove this fact, measure yourself in the morning and then again at night. You will lose 1/2" to 3/4" in height by the end of the day. This lost fluid translates into your discs loosing some of their cushioning effect.

When you are sleeping, "a non-weight bearing activity", your discs (or "intravertebral sponges") expand as they soak up fluid and nutrients and increase the length of your spine by as much as 3/4". But you don't gain the full height back, accumulating to a total of 1/2" to 2" in height throughout your lifetime.

When your discs are compressed and thinned, your vertebrae potentially place more pressure on these nerve roots. More pressure equals more pain. As you relax, your spine begins to stretch. The space between each vertebra will increase, thus decreasing the pressure on the discs between each vertebra. This encourages fluid movement back into the disc, helping to keep your discs plump and happy and decreasing the pain in your back.
Inversion Helps to Relieve Stress

Your body will let you know when you are stressed out-back and neck pain, headaches and muscle tension is your body's way of protesting against stress and forcing you to slow down.

If nothing else, Inversion is a great way to take a break and relax. The full body stretch can be rejuvenating and can also help to reduce muscle tension. A study conducted by physiotherapist LJ Nose found that EMG activity (a measure of muscle tension) declined over 35% within ten seconds of inverting. Inversion, therefore, is helpful in relieving tension and pain in your muscles that may have been caused by stress.

In fact, for centuries yoga practitioners have recognized the concept of turning the body upside down to find relaxation. The head stand position is a form of "postural exchange" (reversing the direction of gravity). Not everyone wants to do headstands, so inversion creates an easier alternative with the added benefit of joint decompression.
Inversion Helps Improve Circulation and Accelerates the Cleansing of Blood and Lymph Fluids

The cardiovascular system is made up of the heart, veins, arteries, and capillaries. It is your body's transportation system, carrying food and oxygen to your body's cells. Your heart pumps blood through the system: oxygen-rich blood from the lungs goes out through the arteries and waste-filled blood comes back through the veins to be cleansed and recharged with oxygen. The cardiovascular system also retrieves blood from your legs and lower torso, carrying it upwards against the force of gravity. Inversion allows your body to work with gravity to ease the circulation process.
Unlike the cardiovascular system, the lymphatic system has no pump. Only the alternate contraction and relaxation of muscles moves lymphatic fluid "uphill" through capillaries and one-way valves to the upper chest for cleansing. Inverting the body so that gravity works with, not against, these one-way valves helps to push the lactic fluid up to the chest. The faster the lymphatic system is cleared the faster the ache and pain of stiff muscles disappears.

Inversion Helps Increase Oxygen Flow to the Brain

Your heart must work against gravity to pump blood up to your brain, which is the body's largest consumer of oxygen. Although it is only three percent of the body's total weight, the brain consumes 25 percent of the body's oxygen intake. Win Wenger, in How to Increase Your Intelligence, noted that "only those brain cells which are close to an ample capillary blood supply are thoroughly developed. Away from such source of supply, brain cells remain undeveloped and useless." Wenger describes "upside down activities" to increase oxygen supply to the brain. He states, "In short, you can much improve the physical state of your entire brain." A brain that is better nourished simply works better.
Some people claim that increasing the circulation of blood to the head through inversion may also improve the color and tone of your skin, stimulate mental alertness, and improve hearing and vision. In addition, some claim that hair will be healthier, and may even grow again, if the scalp is well supplied with blood.

Inversion Enables the Body to Stretch and Re-Align

Nearly every physical activity involves some form of compression of the spine. The compressive effect of gravity is compounded by activities such as running, weightlifting, aerobics, skiing, biking, and golf, which can exact an incredible toll on the spine, discs, and back muscles.
If we perform our daily activities in the wrong way we can create skeletal misalignments. Most often these misalignments are nominal and will readily correct themselves given the opportunity. Inversion with movement (such as side-to-side bends, back arches, and a partial sit-up or two) provides that opportunity.

One-sided activities can be particularly troublesome for the athlete for two reasons: The body will tend to over compensate for the strong-side muscle groups, pulling the spine out of alignment, and one-sided activities usually involve rotation of the spine, often under incredible loads. Examples of these activities are golf, water skiing, tennis, bowling, racquetball, and baseball. Inversion after physical activity may help to realign the spine and keep athletes performing at higher levels for longer periods of time.

Still other physical activities tend to create tension in the muscles due to a contraction of the major muscle groups for long periods of time. In-line skating, swimming, bicycling, windsurfing and rowing are examples of activities which tend to create a great deal of lower back strain. Athletes in these sports can receive a tremendous boost from daily inversion therapy.


Inversion Reduces Pain in Overworked Muscles

Athletes prone to stiffness or muscle spasms after a workout can benefit from the lymphatic wash provided by inversion. Intense muscle activities cause muscles to become sore. This is due to the build up of large amounts of lactic acid and cellular debris in the muscles. The faster this waste is cleared, the faster the stiffness in the muscles disappears.

Inversion Provides Balance and Orientation Training

The performance of inverted activities can be enhanced through inversion training. Inversion helps to develop balance awareness, which occurs when the upper regions of the inner ear are stimulated. Skydivers, gymnasts, springboard divers, and scuba divers find that inversion therapy fine-tunes the body and inner ear to the inverted world. Inversion therapy has also been used to normalize the ear canal as a treatment for motion sickness.

Inversion Strengthens Ligaments

Ligaments are the fibrous strips that hold your bones together. Ligaments are flexible but not very elastic, and can tear when they are stretched too much. The gentle reverse loading and movement that occurs while you invert strengthens ligaments and connective tissue, and helps to protect the athlete from serious injury. Ligaments that are not moved regularly in the right way, become stiff, inelastic and more easily torn.

A Final Thought

The constant pull of gravity is the most powerful force your body will see during your lifetime. Inversion offers a system of stretching and light exercise that helps to slow or reverse the harmful, compression of the body by gravity. Used sensibly, inversion is extremely beneficial, and no more dangerous than many other popular and widely practiced fitness activities. Sometimes there's an explanation for why inversion works and sometimes there isn't.
The experience of thousands of people who invert regularly is that it gives them the relief from back pain they've been looking for. Just as important, they gain the rejuvenating effects of inversion on the entire body, providing health benefits far beyond the relief of back pain.


i wouldnt go to a backcracker till you get the exact cause diagnosed.......my buddy had the exact same pain but instead of the normal pinching of a nerve the pinch was caused by a ruptured disk.....dont think there is a back cracker that will touch you if thats the case cause it can make the problem worse.....if its from an alignment thing thats out of whack than a chiropractor can fix it.....if its what my buddy had you need a surgeon....
I'm smack dab in the middle of your issue as we speak, Just finished up my second lower back surgery for the same thing.

NurseKat has it right...see a neuro surgeon. Pinch or impinged nerves don't get better on their own, unfortunately.

Good luck and don't put off what inevitably you're going to have to do anyway, whether sooner or later is your call obviously.

Take care.....................

There is EXTREME danger in allowing an incacerated or ruptured disk impinging spinal nerves to be manipulated via chiropractic, ect. I DO BELIEVE in chiropractic help as I seek that out myself. However, if you have disc damage, that MUST be repaired before a competent chiropractor will touch you. If you find a chiropractor willing to work on your back without a diagnostic MRI....RUN!!!!!!!!!!!!!
I said first an exam with blood work and an MRI. It is important to read posts thoroughly and not infer what it is not there or put things out of order.

If your foot is actually colder to the touch than the other the sympathetic nervous system may be involved too or a seperate coincidental process such as arterial claudication (similar to coronary heart disease but in the leg). All the more reason to get a good exam and MRI pronto (or other tests as the practitioner is lead). You don't need a neurosurgeon for that as you'll get referred right away if you go to a good pain specialist initially; if you have a pain clinic handy that'll do initially or a good family physician you trust.

If you are close to a neuro- guy and can get in without a referral from one of the above I mentioned, which is not always the case, go for it.

PM me if you wish.
Originally Posted by Nebraska
Originally Posted by NurseKat
You need a neuro surgeon.


Before I went to an ortho or neuro surgeon, I'd try to find a good chiropractor in your area. I've had cracked/compressed vertebrae, pinched nerves, etc. and have never required surgery to get pain free.


I agree! they are lot's cheaper, and a really good one will fix it unless there is permanent damage. And a good one (if you know one) will recommend you to a neuro surgen if it is beyond their scope....

I go to a good one twice a month - just for maintainence- and am progressively better....

If the chiro just does "adjustments" frequently without additional recommendations (including massage therapy, and exercises) - get another chiro..

My first 3 were quacks.....
Sounds a lot like myself 14 months ago. See your vet and get an MEI to see whats going on inside. My problem was a disk jamming into the nerve which cut of all function to the leg and it HURT!

A trip to the neurosurgeon and a little trimming solved the problem.
Quote
The pain goes from my right lower back all the way to my ankle, and my foot is cold, numb and tingling.


This statement by it self say's you need more than a back-cracker.

rattler hit it right on the head, no amount of chiro-praticing is going to help a blown disc or a couple spurs grinding against each other.

Self medication in such large doses can also cause more problems than they cure.

Lack of circulation in the feet ain't a good sign either...

You best get to a Medical Doctor, and heed his warnings.


Phil

Been there-done that! Herniated the disc between L4/L5 back in '86. It will only get worse as that Sciatic nerve that runs all the way to your foot continues to be pressured. Stay away from the "Orthopedic" surgeons. They use metal implants and prefer bone fusion. Neurosurgeons tend to take a less invasive approach to the problem. Much better chance to live normally afterwards! My best advise from having gone through it. My best wishes for your recovery!!!
I have the exact problem. I've had it to one degree or another since August when I was assaulted by an inmate. I take 800mg Ibuprophin and then two hour later 1000mg Tylenol. That gets me throught the day but, like I suspect you experiance, nights are the worst! I haven't had a decent nights sleep in two weeks. I just called my doc and asked for something that might help, probably Vicoden at night.

I am suppose to see a nerosurgon and a chiro but the woman at the doctors office hasn't submitted the paperwork to BWC yet, that from the 22nd. Slow woman needs a prod up her azz to get her moving. She was the one that delayed my wifes paperwork many times.
Greyghost is not correct. There is a very good possibility that there is no disc involved. Can you lie on your back and raise your legs a few inches off the ground w/o intense pain? Does it hurt if you take a breath and bear down like you were constipated? No to the first question may indicate a disc problem, Yes to the second question indicates the same.

I'm a chiropractor and see this same thing in my office every day. 95% of these cases result in complete resolution w/o surgery. Take the conservative approach first, go see a chiropractor. Give it a few weeks (more than likely this has been an ongoing process in your body for a while and it won't go away with one adjustment) and if you aren't getting any results then check in with a neurosurgeon.

PM me if you have any questions.

Whip
"Go to a good chiropractor. Your sciatic nerve is pinched"

DON"T let anyone cut on you...................!!!!!!!!!!!!!!!!!!

You MUST find someone to recommend a chiropractor. Because the best ones have the art or gift of healing.

Say away from quake chiropractors.

The best chiropractors are Palmer trained and I would not go to any others.

Please remember it may take several visits and adjustments through several weeks.
Anyone mention getting a massage?
It's the best RX there is.
Get an MRI and find out what's going on.

I had a chiropractor "treat" my back/leg pain/numbness for three months (courtesy Naval Medicine). After a point I was on crutches and could barely take a $hit without seeing bright lights flashing in my brain.

Finally got an MRI and the L4/5 disc was ruptured. The Chiropractor's eyes bugged out when he saw the MRI pics, and he said there is nothing he can do for me.

Finally on to a neurosurgeon and a diskectomy. I'm now in constant pain. Managing it without a lot of drugs is the best way to live.
Everyone with this problem needs to make an informed decision on how they want to handle it. I went the chiropractic route because of getting immediate but not total relief the first time I went. At that time in my life I NEEDED to keep working and it just so happens that my chiropractor kept me going up until I needed a neurosurgeon which he informed me from the get go I would eventually need. My back condition was caused by abuse and not an accident which also helped me make my decision to keep with my chiropractor. I recoverd VERY well from my surgery with no apparent permanent nerve damage. Call it luck if you want but if had it to do over again I'd go the same route. If the recent surgery on my neck(which was needed because of two accidents)turns out as well,and it seems to be,I'll be happy.

til later
I am a physician and at bone and joint hospital. I do spine surgery three days a week. No offense meant, but do not go to a Chiropractor. Go see a neurologist or spine surgeon. They will not cut on you if you do not need it. If there is vascular damage it is emergent. If there is significant nerve damage, you could end up with RSD. See a physician first.
go to a chiro for quick relief and get an inversion table for maintenance.

I have a dissolving disk between L4 & L5, 6 weeks of physical therapy did nothing for it. After the 1st visit to the chiro 80% of the pain was gone and I could walk again. 2 more visits and I was back to normal. I still visit the chiro when I do something stupid and need a quick tune-up.

The inversion table works......

ETA: my chiro had my MRI's and X-rays in hand before he treated me. I figured that was a given as no chiro that was worth a [bleep] would treat you without knowing what he was dealing with. Also, if the chiro has a "loan officer" for you to visit so you can schedule the treatment plan.....RUN away.
got no problems seeing a chiropractor for back problems, i do on a regular basis.....HOWEVER what Jamison described can be anything from an alignment of the vertebrae being out of whack to a herniated disk......if its an alignment issue i would see a chiropractor....herniated disk i would see a surgeon....and until i knew which it was no one would be touching my back......
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