Leaning to the left too much
- 06-14-2014, 06:19 PM
Leaning to the left too much
I'm having trouble with my posture. I unconsciously lean to the left too much and it's putting too much stress on my left foot.
I would notice it during jogging or just sitting down. I always pull myself upright but then I'd find myself leaning again to the left side.
I can't seem to find anything on the net about it and I'm still searching for info while I wait for my appointment to an ortho doctor.
- 06-14-2014, 06:32 PM
(Not a joke). Is one leg longer? Have a buddy who was having posture issues and after he went to the doc, they found his legs were WAAAY off, and it was messing his hips up. He has custom shoes to fix it with 1" sole extensions on one side. Looks silly, but only because I know about it
- 06-14-2014, 06:57 PM
Any back and/or hip issues?M.Ed. Ex Phys
06-14-2014, 07:27 PM
You may have a point. I don't know how to measure my legs accurately so i guess I'll have to wait for my appointment.
06-14-2014, 07:28 PM
06-14-2014, 07:34 PM
06-14-2014, 07:47 PM
06-15-2014, 11:41 AM
06-18-2014, 04:05 PM
the back is a strange and funny critter it will shift on its own to relieve pressure on a nerve. if your not having pain and odd sensations down the leg burning, or cold and weakness you can rule out disk compression on the transverse nerves( the nerves that run out of the spinal space and to the limb) if you have had x-rays of the back and there is no scoliosis(abnormal curves of the spinal bones) that MAY eliminate this as well. it sounds like a posture issue or as some above me said a small difference in length between the right and left leg. get it checked out by your primary care and he may recommend a good ortho
MYOKEM BOARD REP
06-18-2014, 06:28 PM
Well i did have 3-4 days where my left calf was numb almost painful on the outer side.
06-19-2014, 06:18 AM
MYOKEM BOARD REP
06-19-2014, 10:21 AM
If you haven't already, get an MRI done, just to be certain.
06-19-2014, 10:25 AM
Ok thanks for the replies guys.
I did have one incident when I was 20, I had a very intense lower back pain that I bad trouble getting up from bed. It disappeared after 3 days.
Then last year, I was napping in the ER during break by sitting down with my head leaning forward on a table. That's when my left outer calf started numbing.
My appointment got moved due to an OR sched of the ortho doctor.
06-19-2014, 10:35 AM
An Ortho is your best bet. Should be able to figure it out. I need to visit one myself soon.
06-19-2014, 10:43 AM
If it's just your feet it could be your wear to small of shoes, i had major foot issues about 2 years ago to the point were I almost couldn't walk when I woke up in the morning. Tried everything from rolling ball on my foot to chiropractor. None of it helped then finally I went to get a new pair of shoes and got my feet professionally measured I was wearing shoes 2 1/2 sizes to small within a week the pain went away. It was pretty silly and stupid but sometimes we overlooks the simplest things.
Bigcountry's Getting a little smaller: Epi/Stano Log
06-19-2014, 12:29 PM
06-19-2014, 07:34 PM
06-19-2014, 07:36 PM
06-19-2014, 07:39 PM
Honestly I would recommend against jumping to this conclusion at this point, I'd say see a professional and let them decide. MRI's of the back are often inconclusive. Do an MRI of a lifters back and your likely to see many small herniations etc. but often are not the source of pain
06-20-2014, 08:08 AM
minor herniation of a disk on a normal spine may not contact a nerve which is where the pain comes from but if said person has a narrowing of the spinal canal (Stenosis) which is common in most active males age 30+ a small herniation can be very uncomfortable.
I don't think you have a spinal injury that happened from a trauma, but i have had my fair share of spinal injuries and an MRI will reveal all inconsistency and injuries. the majority of people will have a some sort of MINOR herniation where the disk presses on the outer casing but 7 times out of 10 reside in a few weeks with out you knowing it, the doctors especially the ones that practice in spinal injuries know this and tell you this. The other times the disk tears its nucleus sack in leaks the nuclei out into the spinal fluid area and there is where it calcifies and starts to cause pain. also the longer the sack is torn the faster the deterioration starts inside the disk (disk degeneration) once this occurs the likelihood of the disk to reside back to natural position becomes much less.
sorry for the information rant but the back is something i have a fair amount of knowledge in. have have sat with many of specialist and discussed treatment for my injuries and conditions.
As i said before in previous posts talk with your primary care doctor don't waste time with the ER unless your incontinent because they are useless and a waste of a 250 deductible. describe your pain to the pc and go from there
MYOKEM BOARD REP
06-20-2014, 01:38 PM
I am not sure what portion you are questioning.
First and foremost:
An MRI of the back is indicated if:
1. Persons signs and symptoms present red flags, out of the ordinary symptoms
2. If the person has severe loss of motor function or loss of sensation, cauda equina syndrome etc
3. If the symptoms the person has warrants the possibility of surgery
4. If MRI dictates treatment
In OP's case, he complains of a curved spine. If by visual/physical examination it appears his spine is significantly curved then this would indicate an x-ray.
Let the physician make the call, in my opinion his symptoms do not appear anywhere near the level that would indicate use of MRI. Additionally, it would not change his initial treatment plan which most likely would include either medication (anti-inflams) conservative care (PT) or bracing.
Furthermore I would like to point out some erroneous statements:
"minor herniation of a disk on a normal spine may not contact a nerve which is where the pain comes from but if said person has a narrowing of the spinal canal (Stenosis) which is common in most active males age 30+ a small herniation can be very uncomfortable. "
prevalence of spinal stenosis is not very high
"this cross-sectional study was performed as a part of the research on osteoarthritis/osteoporosis against disability (ROAD) in Japan and 1,009 subjects (335 men, 674 women, mean age 66.3 years, age range 21-97 years) were analyzed. An experienced orthopedic surgeon obtained the medical history and performed the physical testing for all participants. Symptomatic LSS diagnostic criteria required the presence of both symptoms and radiographic LSS findings. A 6-m walking time, chair standing time, and one-leg standing time were obtained from all participants.RESULTS:
The prevalence of symptomatic LSS was 9.3% (95% confidence interval [CI]: 7.7-11.3) overall, 10.1% (CI: 7.4-13.8) in men and 8.9% (CI: 7.0-11.3) in women. There was a difference in the prevalence with increasing age by gender. The LSS prevalence showed little difference with age greater than 70 years for men, but the LSS prevalence for women was higher with increasing age. Among physical performance measures, 6-m walking time at a maximal pace was significantly associated with symptomatic LSS (P = 0.03).
The prevalence of symptomatic LSS was approximately 10% in a cohort resembling the general Japanese population. "
10% in people whom average an age of 66 years old
In addition, even with presence of stenosis, most people are asymptomatic
"We found that 77.9% of participants had more than moderate central stenosis and 30.4% had severe central stenosis. Logistic regression analysis after adjustment for age, sex, body mass index, and severity of radiographic LSS showed that severe central stenosis was related to clinical symptoms. However, only 17.5% of the participants with severe central stenosis were symptomatic.
Although radiographic LSS was common in our cohort, which resembled the general Japanese population, symptomatic persons were
Not to mention MRI's of the back
"Given that many asymptomatic adults have abnormal findings on lumbar spine magnetic resonance imaging, this modality generally should not be performed for nonspecific chronic low back pain in the absence of red flags. Whole body scanning is not supported by current evidence."
[Indications for magnetic resonance imaging for low back pain in adults].
[Article in Spanish]
Millán Ortuondo E1, Cabrera Zubizarreta A2, Muñiz Saitua J3, Sola Sarabia C3, Zubia Arratibel J4.
Low back pain is a common disorder that generates many medical consultations. Magnetic Resonance Imaging (MRI) is commonly used in the clinical management of some of these patients. However, the cost of inappropriate MRI use is high, so there is a need to develop guidelines to help physicians make correct decisions and optimize available resources.
To determine the main clinical indications for MRI scanning in adults with low back pain.
MATERIAL AND METHODS:
The RAND/UCLA appropriateness method was used: After a systematic review (May 2012), a list of the clinical indications for MRI scanning in patients with low back pain was prepared. A multidisciplinary expert panel scored each indication from 1, «totally inappropriate» to 9, «totally appropriate». A first on-line round, an in-person panel meeting, where results of the first round were discussed, and a final second on-line round were arranged. A clinical indication was considered appropriate if the median score was 6.5 or higher, and there was agreement between experts (IPRAS index was used).
An MRI test is considered appropriate if cancer, spinal infection or a fracture, even with a negative X-ray test is suspected.; if there is inflammatory back pain; severe/progressive neurological deficit; severe and progressive low back pain; subacute or chronic low back pain with radicular involvement unresponsive to conservative therapy.
Clinical indications for a MRI scanning are based on the suspicion of a secondary serious pathology. This methodology helps to set clinical indications for MRI, and may be of great value for both clinicians and health managers.
Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.
"Eight studies were included in this review. Strata were defined for separate pathologies i.e. lumbar disc herniation (HNP) and spinal stenosis. Five studies comparing MRI to findings at the surgery for identifying HNP were included in a meta-analysis. Pooled analysis resulted in a summary estimate of sensitivity of 75% (95% CI 65-83%) and specificity of 77% (95% CI 61-88%). For spinal stenosis pooling was not possible.
The results suggest that a considerable proportion of patients may be classified incorrectly by MRI for HNP and spinal stenosis. However, the evidence for the diagnostic accuracy of MRI found by this review is not conclusive, since the results could be distorted due to the limited number of studies and large heterogeneity."
06-20-2014, 02:21 PM
are you a doctor? have you had significant injuries to the spine?
reason I ask i have spent the past 7yrs of my life learning why i have stenosis, degenerative disk disorder
and i dont read spinal forums or websites since the last time i brought one to my surgeon he crumbled it up and laughed said these things are a joke.
stenosis is very common more common then your study shows and it is very easily detected on an mri. if you read the last post i did i simply stated that the x-ray would only show curves which can also be seen in an MRI as well. if filmed at the side profile.
if you want me to post an image of an MRI and show and educate symptoms I had I will gladly post my most recent from December 2013.
patient studies are performed daily and there is always a second done to contradict the first and previous.
most web sites if you go that route show that stenosis is a process of aging some people get it earlier then others but all it is is the hardening of soft tissue or enlarged bone growth it happens with time, other cases develop it from injuries to the spine such as ruptured disks.
we could debate all day about this, but speaking from experience from spinal injuries and spending many days and nights dealing with ortho and nuro im sharing what i have been told by highly rearguard specialist from both boston when i asked some of the same questions
MYOKEM BOARD REP
06-20-2014, 02:55 PM
This is a quick look at my last mri this caused sever pain in both left and right legs with left side drop foot and 80% strength loss also Cauda Equina Syndrome lost bladder function
L5-S1 dislocation the vertebra slipped and collapsed the disk result TILF (trans intrabody lumbar fusion) they used two rods and 4 screws and autograph bone. they had to remove all the bone and tissue overgrowth from L2-L4 with L2-L3 complete disk removal which caused the bladder loss
This link will show a normal spine MRI with a small bulge at L1-L2 that a specialist would look right over and dismiss as a source of pain
Emerald Coast Pain Services
MYOKEM BOARD REP
06-20-2014, 04:50 PM
I'm not really sure how any of this applies to OP, which is what this thread is about. He asked about how to fix his posture and correct a spinal curve, don't really think an MRI is indicated for that.
I'm not going to sit here and discuss your mri and story and muffle this thread with irrelevant information.
06-23-2014, 09:07 AM
I agree this is about the OP, but your information was not on point so we started a discussion inside the thread on it. I followed up with information and a couple of pics explaining certain spinal conditions
To be clear the I feel the OP does not have nerve related issues but still needs to get looked at by his primary care so they can make the correct course of actions and follow up with ortho to get full diagnoses.
MYOKEM BOARD REP
06-23-2014, 06:07 PM
Thanks for all the tips.
I got checked by a different ortho. Not the one I wanted. He just prodded my back and looked at my foot and prescribed Sirdalud, a muscle relaxant. :/
I'm not asking for a worse diagnosis but he could have at least tried to diagnose me. I guess I'll get a second opinion.
06-23-2014, 07:43 PM
I hope you that this wasn't an orthopedic surgeon. Unfortunately the consensus is they typically spend little time with you. If you do not appear to be a surgical candidate this is often the case (your story). I'd explore other options especially if you are not considering surgery.
06-23-2014, 08:46 PM
To the OP ------ Regardless of what anyone is saying in here, without an MRI, it's all guesswork.
If you can afford the copay on an MRI, may as well do it. Don't let anyone force you not to do it for whatever reason. It's one of the best imaging methods out there. Why not use it... It is far beyond me why anyone would so strongly advise AGAINST an MRI... geeez.. to go to the trouble of typing all that up to be SO against an MRI is completely overkill. If you can afford it and have insurance, you may as well get a better look at what's going on
Even better though, definitely make an Ortho appointment
06-23-2014, 09:28 PM
Because its the erroneous thought that an MRI takes all the guess work out of a diagnosing someone,especially with back pain. Furthermore I will reiterate the fact that an MRI is typically necessary only if it dictates conservative treatment.
For example, Jimmy walks into clinic with moderate back pain at L3-L4 with mild symptoms traveling distally into the posterior left hamstring. He presents without red flags (reflexes intact, intact bowel/bladder, without unrelenting pain, fevers etc).
From here Jimmy can proceed down two paths:
a. Jimmy receives MRI, has mild disc herniation (which is suspected via physical exam) jimmy gets NSAIDs and gets referred to PT
b. Jimmy doenst get MRI, receives NSAIDS gets referred to PT.
PT will treat symptoms, NOT MRI findings, pending in person physical exam and will most likely base treatment off symptom free movement patterns. In end, jimmy ends up in same place minus saving us (taxpayers), 2 grand
As information provided above has shown, many of jimmy's symptoms may not correlate with MRI findings. He could have a number of issues:
a. Overweight/high BMI resulting in anterior displaced moment arm which causes increased flexion moment and dull achy back pain
b. Leg length discrepancy
c. Poor overall endurance in conjunction with core deconditioning
d. Piriformis syndrome
e. improper lifting technique (abdominal bracing)
f. Postural dysfunction
g. Flexibility issues
h. Not to mention symptom free movement patterns will dictate treatment regardless of findings
Not to be rude but evidenced based practice is important, and is highly regarded on this forum for all the ingredients in the supplements we promote here on the forums. Try and look at this topic objectively, not subjectively. MRI is 2 grand, OP has 0 red flag signs hence why Ortho gave him muscle relaxant and sent him home. MRI is used for a surgical consult and/or red flag items, thats standard protocol.
Its a huge public misconception that MRI's are this magical diagnostic tool. MRI's need to be read, which brings in a huge human element, a good radiologist makes an enormous difference. Lastly, I am NOT advocating so hard against MRI's. I am merely pointing out why an MRI appears unnecessary at this specific point in time based off OP's report here, but again this is the internet and there is no way anyone in here can make that call either way. This is merely my opinion. In the end the physician has this call, he writes the script and that is why they get paid the big bucks.
My original post states:
"Honestly I would recommend against jumping to this conclusion at this point," (and henceforth stated let the medical professional decide, which he did, as suspected, against)
I will reiterate clinical guidelines:"Given that many asymptomatic adults have abnormal findings on lumbar spine magnetic resonance imaging, this modality generally should not be performed for nonspecific chronic low back pain in the absence of red flags. Whole body scanning is not supported by current evidence"
If this was me in this position, I would go to a respected Physiotherapist( via direct access) or chiro and begin now while waiting for another appointment with a surgeon. But that's just me.
My final point is a subjective one, In my experience, it has benefited me greater seeing a Physical Rehab Physician for issues that are not clear cut orthopedic surgery cases (in which case a rehab physician will refer you to one). In my experience, rehab physicians tend to spend more time examining you as well as have more time to answer questions. They also have the ability to order MRI if they feel the need. Ortho surgeons can have monster case loads and are in and out in less than 5 mins in the times I have interacted with them .
06-23-2014, 10:29 PM
Too long, didn't read.
An MRI is a great diagnostic tool, period. I did not say it is all he requires to figure out what's wrong, but it sure is better than just an x-ray.
I would only choose a good sports therapy clinic and not just any chiro. Chiro's can do more damage. I've been to plenty. All I use chiro's for is their TENS unit, some A.R.T. and some other things. I do not believe in spinal manipulation whatsoever.
OP - if you decide to seek some treatment, be careful what you do. If you have muscular pain, a TENS unit, A.R.T, and massage will work wonders.
A good Yoga class will do MUCH better for the spine than a chiro. Take it from someone with long term practical experience in this.
06-23-2014, 10:33 PM
06-23-2014, 10:35 PM
06-24-2014, 06:39 AM
@Gutterpump i agree with you MRI is the king of imagining, it shows EVERYTHING.
I didn't get too technical with my statements but,
Jimmy walks in to the ER with pain in the lower back with accompanied sharp pain in the outer quad and hamstring area. Jimmy has has no history of trauma. the doctors assume that he is having symptoms from a moderate disk bulge they give him muscle relaxers and NSAIDs symptoms subside in 2 weeks
Jimmy is back in the ER same issues they perform MRI and found a tumor jimmy is now in for surgery and it was not a disk.
what I'm getting at is an MRI will show everything and yes a human has to read the image but this point also states that a human can miss a diagnoses a physical exam too, since there are so many variables and with out a proper images its nothing more than a crap shoot.
OP, get a damn MRI push with your primary care get a clear cut image of whats going on it it makes you feel better its the only way to clear the mind sometimes
MYOKEM BOARD REP
06-24-2014, 11:56 AM
First of all, the question isn't whether MRI or MRA is a good imaging device. Its whether it is indicated in this particular case, notice how you provide an example of someone going to the emergency room for back pain, which is a red flag. As far as we know OP is in abscence of any red fflags, which is in accordance for clinical guidelines against imaging of low back pain. In addition although MRI may show abnormalities, often these abnormalities are not the source of pain as in someone whom may have a minor disc issue but is actually suffering from piriformis syndrome.
Again, I will state it is up to the medical professional to decide, not the am forums and with that I am unsubsribed to this thread, nothing personal I just don't see any thing changing in this discussion.
07-03-2014, 10:29 PM
There are several things that needs assessment. Something is likely pulling your sacrum out of balance, and it could be lack of transversus abdominis activation (very common), way tight piriformis, dysfunction of gluteus medius (and quadratus lumborum substitution) amongst others.
Also check whether you're pronating or supinating your feet, and whether you're in an anterior or posterior pelvic tilt.
My bet is TrA and/or GM dysfunction. Strengthen them, and work on diaphragmatic breathing and core activation in your daily life.
Hope this helps!
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