How to be a Patient Patient

Many times time is the best healer. Dr. Shim explains when it is best to simply let the body heal a herniated or slipped disc.
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Citations:
Kesikburun B, Eksioglu E, Turan A, Adiguzel E, Kesikburun S, Cakci A. Spontaneous regression of extruded lumbar disc herniation: Correlation with clinical outcome. Pak J Med Sci. 2019 Jul-Aug;35(4):974-980. PubMed PMID: 31372127
Cornefjord M, Olmarker K, Otani K, Rydevik B. Nucleus pulposus-induced nerve root injury: effects of diclofenac and ketoprofen. Eur Spine J. 2002 Feb;11(1):57-61. PubMed PMID: 11931065
Pourahmadi MR, Taghipour M, Ebrahimi Takamjani I, Sanjari MA, Mohseni-Bandpei MA, Keshtkar AA. Motor control exercise for symptomatic lumbar disc herniation: protocol for a systematic review and meta-analysis. BMJ Open. 2016 Sep 27;6(9):e012426. PubMed PMID: 27678542
Mosley GE, Evashwick-Rogler TW, Lai A, Iatridis JC. Looking beyond the intervertebral disc: the need for behavioral assays in models of discogenic pain. Ann N Y Acad Sci. 2017 Dec;1409(1):51-66. PubMed PMID: 28797134
Risbud MV, Shapiro IM. Role of cytokines in intervertebral disc degeneration: pain and disc content. Nat Rev Rheumatol. 2014 Jan;10(1):44-56. PubMed PMID: 24166242
Nemoto Y, Matsuzaki H, Tokuhasi Y, Okawa A, Uematu Y, Nishimura T, Oda H. Histological changes in intervertebral discs after smoking and cessation: experimental study using a rat passive smoking model. J Orthop Sci. 2006 Mar;11(2):191-7. PubMed PMID: 16568393
Music credit: Creative Minds by BenSound

[@JungleSpeaks]

Dr John Shimp...truely you are the best doctor I ever seen in my life. Your way of lucid explaination is marvelous. I got benefitted from your videos. I have cervical spondylosis and due to your correct information i am getting better. God bless you. You deserve millions of subscribers.

[@cindyost]

I would use the love button if available. Thank you for spreading the word.

[@knunez4862]

Thank you, great advice. You do more than all The doctors I have recently seen. I used to have a high tolerance for pain, but let me tell you back pain is horrible.

[@sanjayyoutubepremium6960]

Thank you doctor after i watched your video i got hope ...

[@ulyconst28]

The best doctor

[@itsok3783]

Love 💘 u doc must needed video at the right time. Love from India.

[@ogDnice]

Hello Doc, love all the videos. I am in the same situation with a 2mm bulge on the L5/S1 not touching any nerves. . It healed in 2 months but came back after a few months randomly. I'm now in 7 months from that time and it's slowly getting better. I haven't got any shots and just started PT on my own following McGill and McKenzie methods. Should I just wait it out or maybe consider shots and or surgery?

[@benitoipatzi9174]

Hey how are you doing now? I’m the same. Since beginning of August I had low back pain more like soreness. At that time the doctor told me it could be just muscle spasms. Then I got an MRI done towards the end of August cause soreness continued and I had a flare up that lasted 2 days for moving a chair. Then from my MRI report, I found out that I have L5 - S1 I have mild loss of disc height central broad based 3mm protrusion indenting the thecal sac with annular fissure/tear. Slightly touching S1 root and mild bilateral facet athropathy. I didn’t know what that meant or to do. The general Doc said “don’t lift anything heavy bend or kneel. I’m going to refer you to a specialist”. Then 1 night the 1st week of September, I slept wrong position with my stomach and face down and aggravated. The whole month of September I suffered. Then I started to get better the first 2 weeks of October, and I started to feel no pain. I felt really happy for the 1st time. Until on 21st of October, 10 days ago, I gained confidence to lift some plants and move them around my house and then bam. I’m suffering again. Soreness and a mild flare up throughout the the day. These plants were not that heavy, only no more than 15lbs. I hope your doing much better. Like this Doc, says, be a patient patient. I’m already going on 4 months in and all I’m doing is walking close to 2 miles every day. I’ve heard back machanic by Dr McGill is good book and also heard of Foundation Training by Eric Goodman. I’m going to give Foundation training a shot along with loosing weight and eating healthy anti inflammatory foods. I already lost 10lbs as I am overweight. Any update on you?

[@ogDnice]

@@benitoipatzi9174 I feel as my healing is taking forever because I can't tell a difference. My doc said my pain can be from disc degeneration but they don't know for sure. At the moment I am trying to lose weight by using the elliptical machine every day for 30mins and then doing some PT for the other 30 mins. I am starting PT soon somewhere so maybe that might help but I am running out of options.

[@kunal4350]

How is your progress now? What is your age?

[@Preeti-lw9jc]

​@@benitoipatzi9174how are you now??? Hope you're doing well ❤️‍🩹

[@RAMRRR545]

Thank you for sharing this. I have downloaded your app as well :)

[@LJ77777]

Dr. I have been experiencing lower back pain due to annular fissures for the past 3 weeks. But prior to 3 weeks ago, I was working out regularly-alternating PiYo and rebounding on the JumpSport (bungee chords). Both workouts are low impact. The rebounding healed my Achilles’ tendon from an injury two years ago and I would especially like to resume that one. Would you recommend that I resume those workouts and how soon? Thank You in advance!

[@Preeti-lw9jc]

How are you now?? Hope you're doing well ❤️‍🩹. Is your back okay

[@carlosmorgan8123]

Thanks doc I feel better

[@calsonyap8337]

Doctor, today's is the 2nd week i am suffering from sciatica pain. There's pin and needless prickling and tingling in my left feet. Is this getting better or getting worse ?

[@varunvvvv138]

Thanks

[@TrainEnthusiast]

Wonderful

[@nourincheshmi2321]

Thank you sir

[@marcinpiekarski89]

Hi Doctor, I'm 30 years old and unfortunately I have two herniated discs - large C5/6 (which turned out to be very old due to large ostheophytes) and C4-5 (a "fresh" herniation). C5/6 herniation and ostheophytes are pressing spinal cord (to be honest it looks quite scary on MRI image). In May this year I started having some pain in my neck/arm and weakness in my arm. After 3 months my pain and weakness are gone - currently no serious issues at all (some muscles twitching in my left arm are still present). I had appointments with two doctors and got two different recommendations - 1. no pain/weakness = no surgery needed; 2. due to serious spinal cord compression surgery is recommended (artficial disc replacement - 2 levels). I would really appreciate your advice - should I do the surgery because of the spinal cord compression or is it unnecessary in my case? Thank you in advance for your time. Best regards, Marcin Piekarski

[@ShimSpineVideos]

Unfortunately, we are not able to give individual advice. In the end, it is between You and the Surgeon you trust. Please take a look at our play lists of other video's on similar topics. kzbin.info/aero/PLOWZPluvY7F9NJuGiuuyQbzZvfveS1w_a

[@kunal4350]

What you did at end? Are you better now

[@TheDirthound]

What are the projected long term outcomes from annular tears? It seems that it leads to further pain and DDD. If/when it does heal what are some activity modifications that need to be made? I am very active and fear that that part of my life is virtually over for fear of causing more trauma. Is going on an extended hike with a back pack or mountain bike ride now out of the question? I assume that decision is made by the individual relative to the pain that is experienced. However when healed how durable is it?

[@ShimSpineVideos]

Annular fissuring is a part of life and an expected finding on most MRI's of people over the age of 40. I would not focus too much on the MRI finding and instead focus on your current complaints and it effects on your ability to be productive and enjoy life. We all age over time. The key is to learn how to accommodate your concerns while remaining productive and engaged.

[@TheDirthound]

@@ShimSpineVideos Thank You for taking the time to reply. You mentioned in your video that fissures heal. There seems to be conflicting reports on that, many saying they don't fully heal and that surgery of some sort is the only option. Can you elaborate?

[@ShimSpineVideos]

@@TheDirthound Any herniated disc, by definition has an annular fissure. That is how the disc herniates. Greater than 95% of people do not even know they has a disc, but realized they had some back pain that went away over time. Disc herniations get better and the vast majority of people get back to ALL their activities. Because you need an annular fissure to have a disc herniation, that means annular fissures get better and people get back to their lives. kzbin.info/www/bejne/bmWzXqVrjb1qnqs

[@TheDirthound]

@@ShimSpineVideos You are a true professional Dr. Thank You very much. I'll just have to cross that bridge when I come to it.

[@vortex21rainz26]

It’s very hard I been dealing with disc bulging for 9 months. I hope I get better without surgery I am very young for the surgery

[@maxiwolff2435]

Is it possible for a disc bulge (3mm) not to heal? I have been dealing with it for 4 -5 months now, tried physical therapy and gentle exercise. How long should you wait for it to heal in your opinion until you consider other options such as surgery? Thanks!

[@ShimSpineVideos]

Are you sure the pain is coming from the bulge? 3 mm is not that big. There may be other reasons. Ultimately, the decision to seek more aggressive treatment is yours not the doctors. Options can include more therapy, medications and injections. Surgery should always be the last option.

[@maxiwolff2435]

@@ShimSpineVideos yes its definitely from a disc bulge, i had an mri and its definitely cause of pain..The problem is that i dont have severe pain so im not considering surgery but after 5 months of not healing im afraid it may not heal

[@maxiwolff2435]

@@ShimSpineVideos Thank you so much for a reply!

[@ShimSpineVideos]

I would be more confident, as most do heal over time.

[@KBradAdams]

@@maxiwolff2435 Maxi has anything changed since you replied? I am a year in pain at L5/S1 and thinking I need a surgery, I figured if a disc can heal itself why has it not started healing. I am 0% better now compared to a yea ago?