'The back is not done evolving...every second it doesn't hurt is a lucky second.

[tantric superman 4667]

So just found out have a ruptured disc L3/L4.  Will try to get an injection (semen and non-semen) (conservative approach), but think that microscopic lumbar discectomy is inevitable.

This is the thread where you tell me that you have a ruptured disc, but avoided the surgery, and are doing fine, or that you had the surgery, and it went perfectly.  This is not the thread where you say bad things about american medicine.

 

[Gil Bang 25951]

Find the best spine guy around.  Travel if you must. 

That's all I got. 

[Nice Guy Eddie 13512]

Go to the ring-dinger chiro "doc" in houston.   he might paralyze you but you'll be an youtube star.

[Kringelbert Fishtybuns 943]

I had a C6-C7.  It took a while to get to see any Drs (3weeks) as in the beginning they thought it was just severe muscle spasms. At that point, I wanted to just get cut and be done with it, but luckily the Dr I had convinced me to try a week of painkillers and see how I was.  Once the piercing pain went away and I could finally get some sleep, everything seemed manageable.  A couple of months of PT and it was nothing but a dull pain in the neck.

Every now and the my neck hurts a little bit.  A couple of weeks of doing the Pt exercises and everything goes back to normal.

If you aren’t old, I would try a long time of conservative treatment and pain management before I got cut.

[Liquor and Poker 3659]

I heard good things about Fentanyl from a guy, but he died. 

[Onboard 2.0 9083]

The brother had a ruptured disc in college from wrestling. He had surgery (1990's so you know its much better today). He is still competitive in Ju jitzu as a master, and has been fighting/sparring MMA in Vegas up until a few years ago. He now teaches in his own studio, and still competes against guys almost half his age. So it's not an end of active life injury.

 

Get the best specialist you can afford !!!!!!

[tantric superman 4667]

I'm old. Wrong side of 50.

[Onboard 2.0 9083]

10 minutes ago, tantric superman said:

I'm old. Wrong side of 50.

He's 49 now, and trains 7 days a week, competes every month or so.  His body is a train wreck , but has back hasn't given him issues in years. So there's hope for activity still.

[Spur08 382]

I had/have a left L5-S1 herniation.  At its worst, I couldn't even stand up straight without excruciating pain.  I had constant back spasms while sitting down and my legs would often "give out" when holding my daughter.  I work in the realm of neuro/spine surgery so know some great docs to go to in DFW and who to avoid, so I ended up showing my MRI to the guy who I'm with twice per week (for the past 10 years).  For my particular situation, I was put on a steroid pack and given multiple stretches to do every day.  I was able to slowly (and I mean slowly) gain some relief over about 2-3 months and, right now, I'm about 4+ years post that episode.  Sure, I occasionally have some flare-ups from time to time, but never to the degree that I had it previously.  When it happens, I just take things easy and go back to my stretches.  At its worst, I was incredibly close to getting cut on, but I have a doc that I know and trust give me advice to avoid it, which I am quite grateful.  If you are local, I'd happily pass his name on.  I'll see if I can find the stretches for you as well

[tantric superman 4667]

1 hour ago, Spur08 said:

I had/have a left L5-S1 herniation.  At its worst, I couldn't even stand up straight without excruciating pain.  I had constant back spasms while sitting down and my legs would often "give out" when holding my daughter.  I work in the realm of neuro/spine surgery so know some great docs to go to in DFW and who to avoid, so I ended up showing my MRI to the guy who I'm with twice per week (for the past 10 years).  For my particular situation, I was put on a steroid pack and given multiple stretches to do every day.  I was able to slowly (and I mean slowly) gain some relief over about 2-3 months and, right now, I'm about 4+ years post that episode.  Sure, I occasionally have some flare-ups from time to time, but never to the degree that I had it previously.  When it happens, I just take things easy and go back to my stretches.  At its worst, I was incredibly close to getting cut on, but I have a doc that I know and trust give me advice to avoid it, which I am quite grateful.  If you are local, I'd happily pass his name on.  I'll see if I can find the stretches for you as well

Thanks, yes in DFW.  Right now talking to folks at the Carrell Clinic Spine group.  Doing PT there as well. 

The ironic thing about my deal is that about four weeks ago I told myself I needed to start stretching and work on my core.  So did some really basic yoga poses, some simple stretching, and some just sitting around squating.  Was also doing planks, dead bugs and boats.    Not sure what happened but pain started shooting into my right leg a couple weeks ago, and then turned to more constant pain/numbness down the whole leg.  I got the Friday, then went to a wedding in Houston (by car).  Coming back was agony.  Wife had to stop a couple of times so I could stretch out.

And now I find out I have a really big herniation.  And squatting is the most comfortable position I can be in.

[Gil Bang 25951]

11 minutes ago, tantric superman said:

Thanks, yes in DFW.  Right now talking to folks at the Carrell Clinic Spine group.  Doing PT there as well. 

The ironic thing about my deal is that about four weeks ago I told myself I needed to start stretching and work on my core.  So did some really basic yoga poses, some simple stretching, and some just sitting around squating.  Was also doing planks, dead bugs and boats.    Not sure what happened but pain started shooting into my right leg a couple weeks ago, and then turned to more constant pain/numbness down the whole leg.  I got the Friday, then went to a wedding in Houston (by car).  Coming back was agony.  Wife had to stop a couple of times so I could stretch out.

And now I find out I have a really big herniation.  And squatting is the most comfortable position I can be in.

that's fuckng terrifying.  I have the same symptoms for a couple of days now.  The doc said it was probably a pinched nerve and prescribed muscle relaxers and steroids.  

Shit shit shit

I flew to Hawaii and back in two days and I thought it was a shitty airplane seat that got me. 

 

Edited March 12, 2019 by Gil Bang

[tantric superman 4667]

13 minutes ago, Gil Bang said:

that's fuckng terrifying.  I have the same symptoms for a couple of days now.  The doc said it was probably a pinched nerve and prescribed muscle relaxers and steroids.  

Shit shit shit

I flew to Hawaii and back in two days and I thought it was a shitty airplane seat that got me. 

 

The good news is it probably is in your case.  This happened to me about 20 years ago and it was a pinched nerve with some spasms.  The muscle relaxants and pain meds did the trick.  I walked around gingerly for a few weeks but got back to normal. 

[Mikey4 2476]

I herniated a disc in early December. For about 3 weeks everything was excruciating. The very worst was getting out of bed and driving. Just torture.

In early January, I saw an ortho doc who prescribed an oral steroid for 1 week and PT. The pain basically went away while I was on the steriod. I did PT for about 6 weeks and slowly improved.

Now it's been about three months since the initial injury. I've been 98% pain free for about a month. I've started working out again, albeit at light weights/high reps and doing more PT and core exercises than I'd like to do. (and still no back to squats and deadlifts -- not sure if I'll ever do them again)

Definitely exhaust your options for steriods and PT before you consider surgery.

Also, there is a school of thought that says chronic back pain can be closely linked to your subjective expectations. I.e., if you are pessimistic and fear a chronic or catastrophic injury, then your injury is more likely to be chronic and catastrophic. But if you believe that you'll be fine and keep moving, you're more likely to have a short-term injury.

I don't know if there is any truth to it, but I basically tried to be optimistic and keep moving, and my results have been good so far. Might be coincidence, but there's certainly no harm in having a positive mindset. Good luck.

[Marshall_Lucky 624]

Two years ago, in March ‘17 I slipped on ice in Portland landing flush on my tailbone. I mean, feet went flying, landing horizontal on concrete. ER imaging of sacrum and coccyx showed no fracture, so assumed all was well. By Memorial Day, my sciatica was so intense, I couldn’t stand for more than 5 minutes or so at a time. Having had two previous L4/L5 herniations, I took the conservative route of PT and time. Saw a neurologist in September ‘17 and MRI showed stenosis at L5. Had Laminotomy on L4/L5, followed by 5 months completely pain free. 

Pain returned in February, 2018, foot numbness, muscular atrophy, etc. Enrolled in the pain clinic at OHSU: PT, epidurals, etc. No relief. Second MRI in June ‘18 showed herniation on L5 and again I took the conservative route with no improvement. Had 3rd MRI in November 2018, followed by Microdiscectomy on January 9. Began PT three weeks later and finished two weeks ago. Hopefully the disc stays intact... Neuro said I’m one more herniation away from fusion.Right now I feel like a million bucks.

I certainly traveled the conservative route, but I’d reached the point where my life was deteriorating. Chronic back pain is no fucking joke. I saw Richard Weiner at Dallas Neurological at Presbyterian. Highly recommend for all the DFW Surlys.

[Your Mom 4805]

I herniated L5/S1.  Tried steroid injections twice and did lots of stretching and physical therapy. None of it helped.  My symptoms were excruciating sciatic pain. Sitting made it worse. 

 I had the microdiscectomy done a little over a year ago. I woke up pain-free and have been completely pain-free ever since except for some minor discomfort around the incision for a couple of days.    

 I am one year post surgery. I’m back to a completely normal life. I lift, I mountain bike, I do some running but not as much as before. I’m training for a backpacking trip with my son this summer. I eased into the training but now I’m up to 3-4 hours per week with a 35 pound pack all with the doctors blessing and everything is great.  I do a lot more core work now than I did before. Mine was not the result of an injury it was just years of slouching, bad posture, and not doing enough core work. I used to do tons of cycling and running. I’ve had a six-pack my entire adult life and I always thought that was enough and that I didn’t need to do much core work.  I was wrong. 

 My only regret is putting the surgery off as long as I did. I lived with the pain and discomfort and conservative treatments too long. The relief was instant after the surgery. 

[tantric superman 4667]

About three months post surgery.  Saw doc for final post op appointment today  Pain gone.  Creakier rehab than I thought.  Really lost lots of muscle in one leg.  Slowly bringing it back.  Long sitting spells still a bit uncomfortable.  But doing normal stuff. 

Will start increasing the mileage on the bike, which I have avoided.  Going to be a regular at the gym. 

Didn't realize how shitty my core was until started PT.  The elastic bands and doing squats on the wobbly were the biggest eye openers. 

[Spur08 382]

About three months post surgery.  Saw doc for final post op appointment today  Pain gone.  Creakier rehab than I thought.  Really lost lots of muscle in one leg.  Slowly bringing it back.  Long sitting spells still a bit uncomfortable.  But doing normal stuff. 
Will start increasing the mileage on the bike, which I have avoided.  Going to be a regular at the gym. 
Didn't realize how shitty my core was until started PT.  The elastic bands and doing squats on the wobbly were the biggest eye openers. 

Who did you end up seeing

[tantric superman 4667]

Billy "the Kid" Hotchkiss.  I think he is the youngest guy in the Carrell Clinic galaxy of stars, but he was the one who had a perfectly spaced opening, and I heard some good things about him.

 

[TwiceHorn 31457]

On 3/11/2019 at 8:35 PM, Gil Bang said:

that's fuckng terrifying.  I have the same symptoms for a couple of days now.  The doc said it was probably a pinched nerve and prescribed muscle relaxers and steroids.  

Shit shit shit

I flew to Hawaii and back in two days and I thought it was a shitty airplane seat that got me. 

 

Was this meralgia paresthetica?  I broke my collarbone in December and had to sleep sitting up.  Between that and a cat in my lap all night, I compressed,/aggravated the lateral femoral cutaneous nerve.  I diagnosed on the internet and ortho confirmed.  Shortening of the inguinal ligament by prolonged sitting and/or compression by having a laptop or cat in your lap among other things, can cause it.  Stopping whatever you were doing, doing psoas stretches, and time make it dissipate.  Was pretty intense and painful at first.

[dmtx 159]

Tiger Woods used a spine doctor in Dallas/Plano.... for what its worth. I forget his name, but it can be googled

 

[HRSchenker 2268]

The only spine physician I know in the Dallas/Plano area got busted for whipping out his dong while riding around deep ellum. 

[Spur08 382]

Tiger Woods used a spine doctor in Dallas/Plano.... for what its worth. I forget his name, but it can be googled
 

Dr. Guyer.

[Spur08 382]

The only spine physician I know in the Dallas/Plano area got busted for whipping out his dong while riding around deep ellum. 

Ha! He was a pain doc.. technically not spine

[Patricio Swayze 17058]

I have bulging discs at L4-L5 and L5-S1. Typically I don’t have a lot of back pain although it does happen. I do have sciatica abs some days it’s unbearable. I have been on all kinds of meds, don’t physical therapy, stopped and restarted Brazilian jiu jitsu many times since the issue really started showing up in 2012, 2 epidural steroids...and here I am, essentially just dealing with it. One doc wanted to do surgery, second opinion didn’t want to. Kind of at a loss. There were points where I would take a dose of 30mg of Vicodin just to deal with it. Prefer dealing with it with a plant because not only does it help the pain, but helps with sleep. But our shitfuck backwards as state and federal government prefer people be addicted to pills. CBD tincture should be sitting st my door when I get home today. Not sure if it will be as helpful as it’s cousin with THC. Crossing my fingers. I want to go back to BJJ. I also want to sleep through the whole night a few times before I die.

I hope my rant has helped you.

[Bevo 13576]

On 3/11/2019 at 8:23 PM, tantric superman said:

Thanks, yes in DFW.  Right now talking to folks at the Carrell Clinic Spine group.  Doing PT there as well. 

The ironic thing about my deal is that about four weeks ago I told myself I needed to start stretching and work on my core.  So did some really basic yoga poses, some simple stretching, and some just sitting around squating.  Was also doing planks, dead bugs and boats.    Not sure what happened but pain started shooting into my right leg a couple weeks ago, and then turned to more constant pain/numbness down the whole leg.  I got the Friday, then went to a wedding in Houston (by car).  Coming back was agony.  Wife had to stop a couple of times so I could stretch out.

And now I find out I have a really big herniation.  And squatting is the most comfortable position I can be in.

I had similar issues and was in tons of pain. A spinning instructor recommended a guy who does Arrosti (which is basically PT with trigger point massage therapy). Arrosti was started with the San Antonio Spurs and who you go to makes a difference. They don't have you come back a lot and usually after a few treatments, you are improved. Generally, I am not a big fan of that kind of stuff, but my instructor said, "What do you have to lose? If it doesn't work for you, go back to the doctor." Anyway, the guy dug his thumb under my hip which hurt like hell and gave me exercises to do. After 2 visits, I was probably at 95% better and then just continued to stretch and do Yoga for athletes and I have been fine since that time. Personally, if I was you, I'd follow the same course and add in swimming and see how that goes before surgery.

[tantric superman 4667]

Yeah, I had a pretty big herniation/extrusion, coundn't sleep unless I was on the floor, with legs up on the bed, and I had visibly smaller right quad than left quad, and according to the doc I really didn't have much of a reflex on the right leg.  Apparently the nerve had just been in full blown constant firing mode for two long.

Someone did mention Arrosti and I probably would have tried the conservative approach, but the doctor seemed generally concerned that there was a risk in waiting.  Wife had a say in it to and she wanted me "fixed".

Hopefully, will never really know what the best course of action was. 

[torre 1285]

On 6/11/2019 at 2:25 PM, tantric superman said:

About three months post surgery.  Saw doc for final post op appointment today  Pain gone.  Creakier rehab than I thought.  Really lost lots of muscle in one leg.  Slowly bringing it back.  Long sitting spells still a bit uncomfortable.  But doing normal stuff. 

Will start increasing the mileage on the bike, which I have avoided.  Going to be a regular at the gym. 

Didn't realize how shitty my core was until started PT.  The elastic bands and doing squats on the wobbly were the biggest eye openers. 

Congrats on your  progress and recovery !

Can you expound on squats on the wobbly  ?    I am always searching for core exercises.

[tantric superman 4667]

So one of the exercises the pt had me do was pretty basic.  She had me to three sets of squats on the wobbly.  (If I am getting my terms wrong, apologies -- I basically only do machines at the gym until now.)  I'm using wobbly to refer to any board where you have to balance.  The one I used looked like a skateboard with a ball underneath.

First exercise was just standing on the board, balancing in a squat position.  Next two were one footed balances on each.  Also did two footed ones also used elastic band around knees to push outward and work the glutes.

[torre 1285]

Appreciate the detailed reply.

Looks interesting,  though I would definitely need a PT to provide instruction.

Edited June 12, 2019 by torre

[destroya 377]

19 hours ago, Patricio Swayze said:

I have bulging discs at L4-L5 and L5-S1. Typically I don’t have a lot of back pain although it does happen. I do have sciatica abs some days it’s unbearable. I have been on all kinds of meds, don’t physical therapy, stopped and restarted Brazilian jiu jitsu many times since the issue really started showing up in 2012, 2 epidural steroids...and here I am, essentially just dealing with it. One doc wanted to do surgery, second opinion didn’t want to. Kind of at a loss. There were points where I would take a dose of 30mg of Vicodin just to deal with it. Prefer dealing with it with a plant because not only does it help the pain, but helps with sleep. But our shitfuck backwards as state and federal government prefer people be addicted to pills. CBD tincture should be sitting st my door when I get home today. Not sure if it will be as helpful as it’s cousin with THC. Crossing my fingers. I want to go back to BJJ. I also want to sleep through the whole night a few times before I die.

I hope my rant has helped you.

Curious why you don’t do PT. I’ve had back issues, although no herniated disc thankfully, and stretching and some other exercises keep things in check. 

[Patricio Swayze 17058]

Curious why you don’t do PT. I’ve had back issues, although no herniated disc thankfully, and stretching and some other exercises keep things in check. 

I did for awhile. It honestly didn’t seem to help. Just kind of tired of the inconclusiveness of the doctors. Actually, I went to BJJ several times since this started being a problem, typically 6 months at a time then I would have to sit out. This last time I made it over a year and actually stopped because of my shoulder. I do agree that core strength is critical in getting over these things. I can’t say that PT had me doing the wrong thing, but it didn’t see to help.

[Shaggybevo 353]

I have very bad lower back pain.  

Any Surly recommendations for doctors/clinics in Austin?

[huge 3793]

I had a fall/injury in 2003 that has caused intermittent lower back pain over there years, from dull to debilitating.  I have had xrays and seen the issue/tweak towards the bottom of my spine.

I have been going to a chiro off and on that mostly does DEEP muscle/fascia manipulation and stretching.  She has been great.  This is in Houston if anyone is interested.

[pearlandhorn 3269]

If you guys don’t mind me asking, how did you all injure your backs? Can you attribute it to one fall/episode or was it just gradual and prolonged sitting at your desks for work?

I train the hell out of my lower back and take my back exercises very serious at the gym to try and avoid things like this.

[Patricio Swayze 17058]

If you guys don’t mind me asking, how did you all injure your backs? Can you attribute it to one fall/episode or was it just gradual and prolonged sitting at your desks for work?
I train the hell out of my lower back and take my back exercises very serious at the gym to try and avoid things like this.

At first I thought it was Brazilian jiu jitsu, but then realized for the most part, it made it feel better (the stretching, blood flow, etc). Then I thought I had done something stupid with kettlebells. But really, I think it is/was the amount of time I spend driving around doing photography. When this first started to be an issue in 2011/12 I was in my truck for hours on end during the weekends. I often feel the sciatica when I am sitting.

[Liquor and Poker 3659]

2 minutes ago, Patricio Swayze said:

 

At first I thought it was Brazilian jiu jitsu, but then realized for the most part, it made it feel better (the stretching, blood flow, etc). Then I thought I had done something stupid with kettlebells. But really, I think it is/was the amount of time I spend driving around doing photography. When this first started to be an issue in 2011/12 I was in my truck for hours on end during the weekends. I often feel the sciatica when I am sitting.

 

I first read that as "pornography" and it was both more impressive and made more sense.

[Nolacycling 893]

Swimming. Non-swimmers hate it, it's time consuming. Worked for me. 

[Your Mom 4805]

On 8/23/2019 at 12:35 PM, pearlandhorn said:

If you guys don’t mind me asking, how did you all injure your backs? Can you attribute it to one fall/episode or was it just gradual and prolonged sitting at your desks for work?

I train the hell out of my lower back and take my back exercises very serious at the gym to try and avoid things like this.

I’m pretty sure my problems began gradually. Decades of bad posture, slouching, sitting at work too long,  etc...   ultimately it was  squatting or dead lifting more than I should have without perfect form that herniated my disk. I knew better.  But it was the decades of bad habits before that that put me in that weak position in the first place. You can have a strong back and still injure it. I had weak hips according to my physical therapist. And my back was doing work that my hips should’ve been doing. So even with a strong back it’s being overtaxed and subject to injury.

 I will reiterate a couple things. When your back is injured do not spend time resting it. Move. Be active. At the very least go walking. Maybe be careful about how much you lift and the manner in which you lift it but, in general, being active is far better for your back recovery than laying down or sitting all day.   

 Also, my opinion about getting the microdiscectomy done has not changed. It is absolutely the best thing I’ve done and I wish I hadn’t waited so long.  I’m running 20 miles a week, I’m lifting again, albeit at lighter weights and higher reps now, I just got back from a backpacking trip at Philmont with my son.  45 pound pack, 35 miles and 8000’ of ascent in 6 days.  Felt great.  I still have to sit down all day at work but at the end of the day I’m on the move. I go for a run, I go for a walk, I lift, anything except more sitting.   I’ve never felt better. 

[Murfdogg21 4412]

Recommendations should always be the same, (unless a disc was ruptured due to trauma):

1. Lose weight

2. Strengthen back and core muscles

3. Stretch/PT

4. Improve posture throughout all daily activities 

 

I was involved in a 3+ year clinical trial that injected adult stem cells from the patient’s bone marrow into the damaged discs. >70% pain reduction on average, about half the patients were pain free for over 2 years. It is an in office procedure that takes less than an hour. Many spine surgeons and pain management/physiatrists/PM&R/anesthesiologists offer it now; although the spine surgeons are slow adopters to new technology that makes them less money than surgery and is open to be performed by non-surgeons.

[chesthair 231]

I have done:

PT-no help (although i do have an inversion table and i do lightweight box squats, those are the only things that can head off an "episode" when i feel one coming on)

injections-temporary help 

microdiscectomy and laminectomy-4-5 years of 75-80% relief/help

fusion is in my near future

have heard about stem cell treatment, very interested.

As far as how mine happened, it wasnt a specific injury.  I have mild scoliosis but played football for 11 years, I'm sure that attributed to it.  

[Knoxtnhorn 5975]

Any ideas about upper back pain?

I've got something going on between my shoulder blade...going on almost a month now.  I've had a couple of minor herniated discs in my lower back and was under the impression that, generally, back issues only affect one side of the body.  (I had a lot of sciatic pain on my left side/leg when I hurt my lower back before.)  With this, I've had the issue radiate through my left shoulder blade and arm, then over to my right should blade and arm, then, at times, I have pain in the spine itself w/o the radiating pain.  I don't understand why the radiating pain keeps moving around nor do I understand why this hasn't improved over the past month.

Nothing new is going on in my life - same bed, same activities (though less while dealing with this), same job, same chair, same couch, etc...  The pain is not as severe as when I had my lower back, herniated disc(s).  I'd put that pain at a 9.  This is more of a 5 which is why I haven't seen a doctor yet.  I can still function but Good Lord it's starting to really bother me.

[Murfdogg21 4412]

On 9/29/2019 at 2:09 PM, Knoxtnhorn said:

Any ideas about upper back pain?

I've got something going on between my shoulder blade...going on almost a month now.  I've had a couple of minor herniated discs in my lower back and was under the impression that, generally, back issues only affect one side of the body.  (I had a lot of sciatic pain on my left side/leg when I hurt my lower back before.)  With this, I've had the issue radiate through my left shoulder blade and arm, then over to my right should blade and arm, then, at times, I have pain in the spine itself w/o the radiating pain.  I don't understand why the radiating pain keeps moving around nor do I understand why this hasn't improved over the past month.

Nothing new is going on in my life - same bed, same activities (though less while dealing with this), same job, same chair, same couch, etc...  The pain is not as severe as when I had my lower back, herniated disc(s).  I'd put that pain at a 9.  This is more of a 5 which is why I haven't seen a doctor yet.  I can still function but Good Lord it's starting to really bother me.

I’m not a medical doctor, but I haven’t heard many issues with upper back/thoracic disc problems because the spine is stabilized by the ribs. Sounds like the pain could be muscle or tendon tear or a nerve issue. Go see a doctor for physical exam and maybe MRI. 

[Bevo 13576]

I road about 30 miles last Sunday morning and in the evening my back was contorted. All week I was pretty fucked up. I tried foam roller, ibuprofen, stretches, etc. Just getting back to normal for another work week.

[Newdoc 3439]

On 9/29/2019 at 2:09 PM, Knoxtnhorn said:

I don't understand why the radiating pain keeps moving around nor do I understand why this hasn't improved over the past month.

Thoracic back pain is usually not disc related. Most of the time I find it to be functional like a fascial strain or mechanical dysfunction of the spine and surrounding muscles. See your primary doc to confirm and consider seeing PT or reputable chiropractor to address the issue. Usually a MRI is not indicated unless some red flags come up on history or exam.