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I have an L5-S1 problem resulting from a car accident in…

Customer Question
I have an L5-S1...

I have an L5-S1 problem resulting from a car accident in which I was a passenger back in June of 2014. I used to walk 60-65 miles monthly just before the car accident. My entire spine was aggravated and destabilized.

Doctor's Assistant: What are all the symptoms you're experiencing (e.g. loss of appetite, fever, rash)?

I would appreciate knowing whether, or not, Low Light Laser Therapy (LLLT) treatments can actually HELP alleviate my daily spine pains?

Doctor's Assistant: How long have you had the pain? What seems to make the pain better or worse?

Since the accident June 12, 2014. I have not walked or played golf for fear of injuring myself further. The pain has not gotten better but rather worse. I've been to Orthopedic Doctors, Neurologists, etc., I've been to 5 PT Clinics, one kicked me out telling me that I was being let go because I was "regressing" instead of progressing. I've had Epidural Injections-5 and lots of Tramadol, Diclofenac, Metaxalone 800mg and Hydrocodone to help alleviate these awful pains. I've also been doing exercises which appear to lessen the affecting pain factors. Please answer my question. Thank you..***@******.*** - C:(###) ###-####Will LLLT help reduce my L5-Si ongoing pains?

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I had a spinal laminectomy (to remove 5 of 13 Neurofibromas in my CNS which my Orthopedic Surgeon Dr. Benjamin Venger told me very likely acquired from being exposed to radiation while working at Nevada Test Site (from 6 months TDY as an Army Photographer 1963). He told me his father (was also an Orthopedic Surgeon) who treated both civilians and military that had worked there, exposed to radiation and died from cancer. I was fortunate, my tumors were nonmalignant. Still have 8 going up my spine but they shouldn't cause Sciatica pains in both legs. Does this doctor truly know if LLLT helps alleviate these horrible pains?

Submitted: 5 months ago.Category: Neurology
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Answered in 7 hours by:
11/8/2017
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 5 months ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,122
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I am sorry to hear about the entire spine got aggravated & destabilized after that unfortunate car accident you had sustained in year 2014 and resulted in torturesome pain, which has not responded to the various treatments that you have tried so far, and you have inquired whether LLLT can help you in this regard. As a neurologist I frequently diagnose & treat this type of health situation, and also I am very familiar with LLLT and I can certainly help you in this regard.

I see that you have tried myriad treatments for the pain but all in vain. And to your main question, Yes laser therapy can help you, it is indeed one of the commonly tried treatment options for severe and refractory pain like the one you are having.

There are different forms of laser therapy, one is called as LLLT (Low level laser therapy) or also called as Cold laser therapy. This is commonly used by pain management doctors and therapists to help with severe spine related pain. The other form of laser therapy called as HPLT or high power laser therapy too can help in relieving spine related pain, but it is usually the LLLT which is tried more commonly than the HPLT, although either of them can help.

How does the laser therapy help? What is the mechanism of action? Laser therapy is thought to stimulate body’s natural repair process and help in relieving the pain. Patients with chronic pain from back, neck, shoulder areas & leg may get significant relief of their pain with this mode of treatment. And if the laser therapy helps then you then you will be able to avoid pain meds too.

You may go through these 4 web sites to gather all the details on laser therapy (one of the below link will provide you with the other form of laser therapy tooHPLT – just in case necessary to be used in the future)

http://www.pulselaserrelief.com.au/low-level-laser-therapy-for-neck-and-back-pain

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137223/

https://www.spine-health.com/treatment/pain-management/cold-laser-therapy-pain-management-treatment

https://www.spineuniverse.com/treatments/physical-therapy/pain-relief-healing-laser-therapy

What I will also do is try to provide you with a list of various other modalities of treatments that also can be tried to get relief from the spine related pain, if you see if you have not already used them then you may consider these options too)

The following are the various conservative (non-surgical) treatment approaches & options that can be tried to help with the severe pain secondary to spine injury;

A) Protection from further injuries by avoiding physical activities that can exacerbate this type of injury again - please try to AVOID the following activities because AVOIDING these can help in preventing any further injuries and exacerbations, and Avoiding these activities can help in getting relief from the pain too;

Avoid excessive, especially strenuous physical activities that may burden the spine/back/neck area in the form of twisting or excessive bending the spine – especially bending at 90 degrees and sudden abrupt bending

Avoid lifting heavy weights or heavy objects from the ground or floor, carrying heavy weights or heavy objects

Avoid pushing/pulling heavy weights or heavy objects

Avoid overstretching the limbs and body to reach for something

Avoid jogging or running especially long distance

Please try to avoid all the above mentioned situations or activities as much as possible because all these can strain the spine region further, and also can exacerbate the pain, and possibly delay the healing too

B) The following are the various general measures, and/or home remedies, and/or OTC (Over the counter) treatments that can be tried to help with your condition;

Weight loss (If applicable)

Appropriate Postural adjustments/postural corrections

Contour pillow - Using proper pillows below the neck, or back or head regions during sleeping

Cold therapy & Heat therapy in the form of using Cold or Ice packs or Hot or Heat packs

Using a Spine Brace can help in minimizing the movements of the spine and can help in reducing the pain & help with faster recovery too

Gentle stretching exercises for the back muscles can help in relieving the compression of the nerve roots, and help in reliving the muscle tension and spasms and will make you feel better

Massaging the painful areas is also very useful

Over the counter essential oil rubs such as Eucalyptus oil, or Wintergreen oil

Epsom Salt Compress or Epsom Salt Soaking, or Epsom Salt Bath can help too etc

C) These are some additional treatments including certain prescription treatments too;

Physical therapy (you have tried already)

Hydrotherapy

Trigger point therapy (if any trigger points are present)

Stronger prescription anti-inflammatory painkillers like Tramadol, Diclofenac (you have tried already)

Nerve-pain pills like Gabapentin, or Amitriptyline

Muscle relaxants like Baclofen, or Tizanidine

Prescription patches like Diclofenac anti-inflammatory pain relieving skin patches, or Lidocaine anesthetic pain relieving skin patches

Steroid Iontophoresis

Narcotic pain killer like Hydrocodone containing preparations (you have tried already)

Hot fomentation

Short wave diathermy

Infra-red light therapy

Ultrasound therapy

TENS (Transcutaneous Electric Nerve Stimulation)

Interferential therapy

Stimpod NMS460 neuromodulation device

Laser therapy (Cold laser therapy or Low Level Laser Therapy) – this is your main question and I have explained it separately

Traction therapy

Inversion therapy table

Calmare Scrambler Pain therapy

Nonsurgical spinal decompression therapy including IDD therapy (Intervertebral Differential Dynamics Therapy)

Chiropractor spinal manipulations/SMT (Spinal Manipulative therapy)

Osteopathic spinal manipulations

ESI (Epidural steroid injection) – you have tried this already

Other special forms of spinal injection treatments - PRP (platelet Rich Plasma) spinal injection, Prolotherapy spinal injections, Etanarcept spinal injections, Botox spinal injections etc

Foam roller (Self Massage or Self Myofascial Release therapy) – either Cervical Foam Roller or Lumbar Foam Roller

Acupressure Mat and Pillow Set for the relief of pain

CES (Cranial Electrotherapy Stimulation) treatment

Complementary & Alternative medicine treatments like;

Biofeedback

Hypnotherapy

Acupuncture etc

If none of the above help then the following more aggressive treatments too can be considered;

Spinal cord stimulator

Intrathecal pain pump etc

I am not telling all these above mentioned treatments are required in your case; I am trying to provide a list of the various treatment options like this so that you are familiar with various treatment options that are available for your condition and you may try to use them as necessary. I am sure you have already tried many of the treatments mentioned in the above list, if you see any of the above treatments you have already tried please disregard them and you may explore the treatment options which you may have not yet tried.

D) In addition to the above treatments the following natural treatments too can help;

One or more of the herbal preparations mentioned here too may be considered for treating the pain secondary to the spine conditions - Devil’s claw Secondary Root, Limbrel (Flavocoxid), Noni concentrate, Nettle Root extract, S adenosyl methionine, shark cartilage, White Willow Bark Extract etc

One or more of the nutritional supplements mentioned here too may be considered for treating the pain secondary to the spine conditions, and also to help with maintaining the optimum health of bones, joints & discs etc in the spine – examples of such nutritional supplements to improve the health of the spine include Tablet Osteo Bi Plex Triple Strength, or Tablet Flexoplex - these combination pills contain several nutritional supplements like Glucosamine, Chondroitin, MSM etc. The following additional nutritional supplements too can be consider to optimize the health of the spine - Acetyl L Carnitine, Methyl-Guard Plus (combination pill containing active forms of Vitamin B12, Folate, Vit B6), ALA (Alpha Lipoic Acid), CoQ10etc

Once again I am not telling you will require all the above mentioned herbal preparations or supplement preparations but these are the various preparations to consider and these can help in improving the health of the spine, discs, spinal nerve roots, and also help in getting relief from the torturesome pain you have been suffering from.

And once again to your main question, Yes, the LLLT can help you, it is in fact commonly used to help patients with severe pain from spine injuries or damage, and it is helpful and it is considered safe too, so it is worth considering trying LLLT to help you with your torturesome pain secondary to the spine condition you are suffering from.

I earnestly hope you find the above information including the list of treatments helpful.

Wishing you a quick & complete recovery! And also Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further. And please take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. If you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Best Regards!

Dr Subbanna MD

Ask Your Own Neurology Question
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 5 months ago

Hi, have you received the answer I have posted above, and have you had a chance to go through the above answer?

Do you have any additional health questions? Do you want to discuss this further? Please let me know and I am available here.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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