Most of us will experience it at some point — but how does it influence on athletic performance? Chiropractic injury specialist, Dr. Alexander Jimenez investigates.
Research postulates that 80 percent of the populace will undergo an acute onset of back pain at least once in their lifetimes. This adds a considerable financial burden not just on the medical system (physician consultations, prescribed drugs, physiotherapy) but also the financing of the workforce in lost employee hours and loss in productivity.
The types of lower back pain that an individual may experience include (but are not limited to):
1. Lumbar spine disc herniation with/ without sciatica
8. Inflammatory arthritis such as rheumatoid and anklyosing spondylitis
9. Facet joint sprains
10. Bone injuries such as stress fractures, pars defects and spondylolisthesis.
The focus for this paper will be on the previous group — that the bone injuries. This may be simply postural (slow onset repetitive trauma) or related to sports; for instance, gymnastics.
The two demographic groups that tend to endure the most extension-related low back pain are:
1. People who endure all day, for instance, retailers, army, security guards etc.. Prolonged position will obviously force the pelvis to start to migrate to an anterior tilt management. This may begin to place compressive pressure on the facet joints of the spinal column as they also change towards an expansion position since they accompany the pelvic tilt.
2. Extension sports such as gymnastics, tennis, swimming, diving, football codes, volleyball, basketball, track and field, cricket fast bowlers. This is more pronounced in sports that involve extension/rotation.
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Pathomechanics
With normal extension of the lumbar spine (or backward bending), the facet joints begin to approximate each other and compress.�The articular processes of this facet above will abut the articular process of the facet below. This is a normal biomechanical movement. However, if the extension ranges are excessive, the procedures will impinge quite aggressively and damage to the cartilage surfaces within the facet joint can result. Sports such as gymnastics, functioning in tennis, and handling in American Soccer may all involve uncontrolled and excessive extension.
It would be unlikely that a bone stress response or even a stress fracture could be brought on by an isolated expansion injury. It would be more likely that a sudden forced extension injury may damage an already pre-existing bone strain reaction.
Similarly, if an individual stands daily and the pelvis migrates into lateral tilt, then the aspects will be placed under low load compression but for extensive intervals.
With ongoing uncontrolled loading, stress is then transferred from the facet joint to the bone below (pars interarticularis). This originally will manifest as a pressure reaction on the bone. This bone strain may advance to a stress fracture throughout the pars if uncorrected. This fracture is also referred to as a “pars flaw”, or spondylolysis.
It was initially considered that stress fractures of the pars was a congenital defect that introduced itself at the teenage years. However, it is now agreed that it is probably obtained through years of overuse into extension positions, especially in young sportspeople involved with expansion sports. What’s more, one-sided pars defects often occur more commonly in sport which also included a rotational component such as tennis serving or fast bowling in cricket.
The stress fracture can then advance to impact the opposite side, causing a bilateral strain fracture, with anxiety subsequently being transferred to the disk in between both levels.
Spondylolisthesis features bilateral pars defects which could possibly be a result of repetitive stress into the bilateral pars in extension athletics, but more likely it is an independent pathology that manifests in the early growing stages (9-14) as this pathology is often viewed in this age category. If they become symptomatic in later years because of involvement in expansion sports, it is exceedingly likely that the defects were there by a young age but presented asymptomatically. As a result of rapid growth spurts in teenage years and the high-volume training experienced by teenaged athletes, it is possible that these dormant spondylolisthesis then pose as ‘acute onset’ back pain in teenage years.
In summary, the progression of this bone stress reactions tends to follow the following continuum:
1. Facet joint irritation
2. Pars interarticularis stress response
3. Stress fracture to the pars
4. Pars defect (or spondylolysis)
5. Spondylolisthesis due to activity or more likely congenital and found later in teenage years due to participation in�extension sports.
The landmark publication related to spondylolysis and spondylolisthesis was presented by Wiltse et al (1976) and they classified these injuries as follows:
1. Type I: dysplastic � congenital abnormalities of L5 or the upper sacrum allow anterior displacement of L5 on the sacrum.
2. Type II: isthmic � a lesion in the pars interarticularis occurs. This is subclassified as
a. lytic, representing a fatigue fracture of the pars,
b. elongated but intact pars, and c. acute fracture.
3. Type III: degenerative � secondary to long-standing intersegmental instability with associated remodeling of the articular processes.
4. Type IV: traumatic � acute fractures in vertebral arch other than the pars.
5. Type V: pathological � due to generalized or focal bone disease affecting the vertebral arch.
The vast majority of spondylolysis and sponylolisthesis accidents are Type II — the isthmic variety.
For the purposes of this paper, we will refer to the above stages as the posterior arch bone stress injuries (PABSI).
Epidemiology
It is a lot more widespread at the L5 level (85-90 percent). It’s a high asymptomatic prevalence in the general population and is often found unintentionally on x ray imaging. Nonetheless, in athletes, particularly young athletes, it is a common reason for persistent low back pain. From the young athlete, the problem is often referred to as ‘active spondylolysis’.
Active spondylolysis is normal in virtually every gamenevertheless, sports such as gymnastics and diving and cricket pose a much greater danger due to the extension and turning character of the sport. The progression from an active spondylolysis into a non-union type spondylolisthesis has been associated with a greater prevalence of spinal disk degeneration.
Early detection through screening and imaging, therefore, will highlight those early at the bone stress phase and if caught early enough and managed, the progression to the larger and more complicated pathologies are avoided as a result of therapeutic capacity of the pars interarticularis in the early stages.
It is more common to find teens and young adults afflicted by PABSI. This will highlight the rapid growth of the spine through growth spurts that is also characterized by a delay in the motor control of the muscle system during this period. Furthermore, it’s thought that the neural arch actually gets stronger in the fourth decade hence possibly explaining the low incidence of bone stress reactions in mid ages.
The incidence of spondylolysis has been reported to be around 4-6% in the Caucasian population (Friedrikson et al 1984). The rates seem to be lower in females and also in African-American males. It has also been suggested that a link exists between pars defects and spina bifida occulta.
The incidence of spondylolysis seems to be higher in the young athletic population than in the general population. Studies in gymnasts, tennis, weightlifting, divers and wrestlers all show disproportionately high incidence of spondylolysis compared with the general population of age-matched subjects.
Tennis
The tennis serve generates excessive extension and rotation force. In addition, the forehand shot may also produce elevated levels of spinning/ extension. The more traditional forehand shot demanded a great deal of weight shift through the legs to the torso and arms. However, a more favorite forehand shot is to currently face the ball and also generate the force of this shot utilizing hip rotation and lumbar spine extension. This action does increase ball speed but also puts more extension and compressive loads on the spine potentially resulting in a greater degree of stress on the bone components.
Golf
The most likely skill component involved in golf that may cause a PABSI are the tee shot with a 1 wood when forcing for distance. The follow-through of this shot entails a significant quantity of spine rotation with maybe a level of spine expansion.
Cricket
Fast bowlers in cricket are the most susceptible to PABSI. This will occur on the opposite side to the bowling arm. As the front foot engages on plant stage, the pelvis abruptly stops moving but the spine and chest continue to proceed. With the wind-up of this bowling action (rotation), when coupled with expansion this can place large forces on the anterior arch of the thoracic. More than 50% of fast bowlers will create a pars stress fracture. Young players (up to 25) are most vulnerable. Cricket governments have implemented training and competition guidelines to avoid such injuries by restricting the number of meals in training/games.
Field Events
The more common field events to cause a PABSI would be high leap followed by javelin. Both these sports create enormous ranges of backbone extension and under significant load.
Contact Sports
Sports like NFL, rugby and AFL all require skill components that need backbone expansion under load.
Gymnastics/Dancers
It goes without saying that gymnastics and dancing involves a substantial amount of repetitive spine expansion, particularly backflips and arabesques. It has been suggested that nearly all Olympic degree gymnasts could have suffered from a pars defect. Many organizing bodies now put limits on the number of hours young gymnasts can instruct to prevent the repetitive loading on the spine.
Diving
Spine extension injuries occur mostly off the spring board and on water entrance.
Diagnosis Of PABSI In Athletes
Clinical investigation
These can pose as preventable injuries. Research shows that the incidence was emphasized from the general population that have nil indicators of back pain. But, individuals will typically complain of back ache that is deep and generally unilateral (one side). This may radiate into the buttock area. The most offending movements tend to be described as expansion moves or backward bending movements. This may be a slow progression of pain or might be initiated by one acute episode of back pain in a competitive extension motion.
On clinical examination:
1. Pain may be elicited with a one-leg extension/rotation test (standing on the leg on the affected side) � stork test.
2. Tenderness over the site of the fracture.
3. Postural faults such as excessive anterior tilt and/or pelvic asymmetry.
The one-legged hyperextension test (stork test) was suggested to be pathognomonic for busy spondylolysis. A negative evaluation was stated to effectively exclude the diagnosis of a bone stress-type injury, thus creating radiological investigations unnecessary.
But, Masci et al (2006) examined the connection between the one-legged hyperextension test and gold standard bone scintigraphy and MRI. They discovered that the one-legged hyperextension test was neither sensitive nor specific for active spondylolysis. Moreover, its negative predictive value was so poor. Thus, a negative test can’t exclude energetic spondylolysis as a possible cause.
Masci et al (2006) go on to indicate that the bad relationship between imaging and the one-legged test may be because of a number of factors. The extension test would be expected to move a significant extension force on to the lower back spine. In addition to putting substantial strain on the pars interarticularis, it might also stress different regions of the spinal column like facet joints as well as posterior lumbar disks, and this may subsequently induce pain in the existence of other pathology such as facet joint arthropathy and spinal disc disease. This will explain the poor specificity of the test. Conversely, the inadequate sensitivity of the test may be related to the subjective reporting of pain by issues performing the maneuvre, which may vary based on individual pain tolerance. Additionally, this evaluation can preferentially load the fifth cervical vertebra, and so bone stress located in the upper lumbar spine may not test positive.
Grade 1 spondylolisthesis are normally asymptomatic; nonetheless, grade 2+ lesions often present with leg pain, either with or without leg pain. On examination, a palpable slip could be evident.
Imaging
Clinical assessment of active spondylolysis and the more severe pars defects and spondylolisthesis can be notoriously non-specific; this is, not all patients suffering PABSI will present with favorable abstract features or positive signs on analyzing. Thus, radiological visualization is important for diagnosis. The imaging methods available in the diagnosis of bone stress injury are:
1. Conventional radiology. This test is not very sensitive but is highly unique. Its limits are partially because of the cognitive orientation of the pars defect. The oblique 45-degree films may show the timeless ‘Scotty Dog’ appearance. Spondylolisthesis can be looked at simply on a lateral movie x-ray.
2. Planar bone scintigraphy (PBS) and single photon emission computed tomography (SPECT). SPECT enhances sensitivity in addition to specificity of PBS than straightforward radiographic study. Comparative research between PBS and conventional radiology have shown that scintigraphy is more sensitive. Patients with positive SPECT scan must then undergo a reverse gantry CT scan to assess whether the lesion is active or old.
3. Computed tomography (CT). The CT scan is considered to be more sensitive than conventional radiology and with higher specificity than SPECT. Regardless of the type of cross-sectional image utilized, the CT scan provides information on the state of the flaw (intense fracture, unconsolidated flaw with geodes and sclerosis, pars in procedure for consolidation or repair). The “inverse gantry” perspective can evaluate this condition better. Repeat CT scan can be used to track progress and recovery of the pars defect.
4. Magnetic resonance imaging (MRI). This technique shows pronounced changes in the signal in the amount of the pars. This is recognized as “stress response” and can be classified into five different degrees of action. MRI can be helpful for evaluating elements that stabilize isthmic lesions, for example intervertebral disc, common anterior ligament, and related lesions. The MRI isn’t as specific or sensitive as SPECT and CT combination.
Therefore, the current gold standards of investigation for athletes with low back pain are:
1. bone scintigraphy with single photon emission computed tomography (SPECT); if positive then
MRI has many advantages over bone scintigraphy, for instance, noninvasive nature of the imaging along with the absence of ionizing radiation. MRI changes in active spondylolysis include bone marrow edema, visualized as increased signal in the pars interarticularis on edema-sensitive sequences, and fracture, visualized as reduced signal in the pars interarticularis on T1 and T2 weighted sequences.
However, there is greater difficulty in detecting the changes of busy spondylolysis from MRI. Detecting pathology from MRI relies on the interpretation of distinct contrasts of signals compared with normal tissue. Unlike stress fractures in different parts of the body, the little region of the pars interarticularis may make detection of those changes harder.
However, unlike MRI, computed tomography has the capability to differentiate between acute and chronic fractures, and this differentiation might be an important determinant of fracture healing. Accordingly, in areas using pars interarticularis fractures discovered by MRI, it might nonetheless be necessary to execute thin computed tomography slices to determine whether or not a fracture is severe or chronic — an important factor in fracture resolution.
A herniated disc can lead to pain as well as disrupt your daily activities, as you likely know. That is probably what brings you to the office of the doctor: You have back pain or neck pain, and you’d love to understand why.
Your doctor will ask you questions and execute a few exams. This is to try to find the origin of your pain and also to find out which intervertebral disks are herniated. An accurate diagnosis will help your doctor develop a treatment plan method to help you recover and to handle your herniated disc pain and other spine symptoms.
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Physical Exam: Herniated Disc Diagnosis
As part of the physical exam, your doctor will ask about your current symptoms and remedies you have already tried for your pain. Some average herniated disc diagnostic questions include:
When did the pain begin? Where’s the pain (cervical, thoracic or mid-back, or lumbar or lower back)?
What activities did you lately do?
What do you do for your herniated disc pain?
Can the disc herniation pain radiate or travel to other parts of your body?
Does anything reduce the disk pain or make it even worse?
Your doctor may also observe your position, range of movement, and physical condition both lying down and standing up. Movement that causes pain will be noticed. A Las�gue evaluation, also referred to as the Straight-Leg Raising evaluation, may be accomplished. You’ll be asked to lie down and extend your knee with your hip bent. If it produces pain or makes your pain worse, this may indicate a herniated disc.
With a herniated disc (or a bulging or ruptured disc), you might feel stiff and may have lost your normal spinal curvature because of muscle strain. Your physician may also feel for tightness and note the spine’s curvature and alignment.
Neurological Exam: Herniated Disc Diagnosis
Your spine specialist will also run a neurological exam, which tests your reflexes, muscle strength, other nerve changes, and pain disperse. Radicular pain (pain that travels away from the source of the pain) can increase when stress is applied directly to the affected area. You might, for instance, have sciatica; this is radicular pain that might be caused by the herniated disk. Since the disc is compressing a nerve, you might experience pain and symptoms in other areas of the body, although the origin of the pain is on your spine.
Imaging Tests for Herniated Discs
Your spine specialist may order imaging tests to help diagnose your injury or condition; you might have to see an imaging facility for those evaluations.
An X-ray may demonstrate a secondhand disk space, fracture, bone spur, or arthritis, which might rule out disk herniation. A computerized axial tomography scan (a CT or CAT scan) or a magnetic resonance imaging test (an MRI) equally can show soft tissue of a bulging disk or herniateddisc. So that you may get treatment these tests will demonstrate location and the stage of the herniated discs.
Other Tests to Diagnose�a Herniated Disc
To obtain the most accurate identification, your spine specialist may order additional tests, for example:
Electromyography (EMG): He or she may order an examination known as an electromyography to measure your nerves respond, if your spine pro suspects you’ve got nerve damage.
Discogram or discography: A sterile procedure where dye is injected into one of your vertebral disc and seen under special conditions (fluoroscopy). The goal is to pinpoint which disk(s) might be causing your pain.
Bone scan: This technique generates film or computer images of bones. A very small number of radioactive substance is injected into a blood vessel throughout the blood flow. It collects on your bones and can be detected by a scanner. This procedure helps doctors detect spinal problems such as disease, a fracture, tumor, or arthritis.
Laboratory evaluations: Typically blood is attracted (venipuncture) and tested to determine if the blood cells are normal or abnormal. A metabolic disease which might be contributing to a back pain may be indicated by Chemical changes in the blood.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
There are a number of important factors to take into consideration, such as the timing of when an MRI scan must be performed and limitations with interpretation of findings, to get an MRI scan for herniated discs.
To begin with, the difficulty with the results of an MRI scan, as with a number of other diagnostic studies, is that the abnormality may not always be the source of an individual’s back pain or other symptoms. Numerous studies have shown that approximately 30 percent of people in their twenties and forties have a lumbar disc herniation in their MRI scan, even though they don’t have any pain.
An MRI scan cannot be interpreted on its own. Everything Has to Be well-correlated into the individual patient’s condition, for example:
Symptoms (such as the duration, location, and severity of pain)
Any deficits in their examination
Another concern with MRI scans is the time of when the scan is done. When a patient has experienced the following symptoms would be the only time that an MRI scan is needed immediately:
Bowel or bladder incontinence
Progressive weakness due to nerve damage in the legs.
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Herniated Disc Analysis with MRI
Obtaining an MRI (magnetic resonance imaging) can be an important step in correctly assessing a herniated disc in the spine. Unlike an X-ray, MRI uses a magnetic field and a computer to create and record detailed pictures of the internal workings of your entire body. This technology can also be capable of producing cross-sectional views in identifying a disc of the body, which greatly help doctors. MRI scans are based on new technology, but they have become essential in diagnosing a number of back and neck issues, such as spinal stenosis, herniated discs and bone spurs.
An MRI scan has a number of benefits that greatly help a herniated disc patient. The advantages of an MRI can be:
Unobtrusive
Painless and free of radiation
Can focus on a particular part of the entire body
Extremely accurate
Diagnosing Disc Herniation
Should you believe you have a herniated disc in the neck or back, the very first step would be to visit a physician. Your physician will have the ability to supply you with a complete evaluation and inspection of your medical history to create a identification. Following that, you may be referred to execute an MRI stabilize and to confirm the herniated disc.
At the imaging center you’ll be put to the tubular MRI machine to get a body scan. You may remain enclosed in the MRI device for up to an hour while the comprehensive scan of place where the herniated disc along the spine is completed. The MRI can reveal the exact condition of the herniated disc and surrounding arrangements. This allows your doctor to produce the treatment plan that is right for you and to understand the origin of the disc damage and pain.
Herniated Disc Follow-Up Treatment
Most patients are able to successfully treat herniated disc pain using nonsurgical standard treatments prescribed by their physician. These include relaxation, compression treatment and mild exercise. Surgery can then be explored when months or weeks of treatment do not bring a return to previous action.
If you’re researching surgical options and have become concerned by a number of the risks and unsuccessful results of traditional open back operation, contact a specialist. Spine surgery specialists perform minimally invasive spine surgery, including invasive stabilization surgeries and minimally invasive decompression, which can treat a number of the very acute herniated discs. They may review your MRI to determine if you are a candidate for minimally invasive spine surgery, which may help you get your life back.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
A healthcare professional’s clinical diagnosis focuses on finding out the source of a patient’s pain. For this reason, the clinical identification of pain in the herniated disc relies on more than only the findings from a diagnostic evaluation, like CT scan or an MRI scan.
The spine care professional arrives at a clinical diagnosis of the cause of the patient’s pain by means of a combination of findings by a comprehensive medical history, conducting a complete physical exam, and, if appropriate, running one or more diagnostic tests:
Medical history: The physician will choose the patient’s medical history, such as a description of if sciatica, the back pain or other symptoms occur, a description of how the pain feels, what remedies, positions or activities make the pain feel better and more.
Physical examination: The physicians will conduct a physical exam of the individual, such as muscle power and analyzing neural function in parts of the leg or arm, analyzing for pain in positions and much more. Ordinarily, this series of physical tests will give a good idea of the type of back issue the individual has to the spine professional.
Diagnostic tests: After the physician has a fantastic idea of the origin of the patient’s pain, a diagnostic evaluation, such as a CT scan or a MRI scan, is often ordered to confirm the presence of an anatomical lesion at the backbone. The evaluations can give a picture of the location of nerve roots and the disc.
It’s important to emphasize that MRI scans and other diagnostic tests aren’t utilized to diagnose the patient’s pain; rather, they are only utilized to confirm the existence of an anatomical problem that was suspected or identified throughout the medical history and physical examination. Because of this, while the radiographic findings on an MRI scan or other tests are significant, they aren’t as important in diagnosing the reason for the patient’s pain (that the clinical investigation demonstrated) as are the findings from the medical history and physical examination. Many times, an MRI scan or other kind of evaluation will be used for the purpose of treatment, so the healthcare specialist can determine the way it’s currently impinging on the nerve root and precisely where the herniated disc is.
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When MRI is Used to Diagnose Herniated Discs
When patients have predominantly experienced leg pain along with a lumbar disc herniation, MRI scans are usually recommended early in a patient’s path of pain.
Therefore, physicians often recommend waiting 3 to 6 months (following the onset of lower back pain) prior to having an MRI scan done as a way to see whether the pain will get better with conservative (nonsurgical) remedies. As a very general guideline, if the results of the MRI scan aren’t likely to affect a patient’s further back pain therapy, and �the patient will continue with non-surgical treatments such as chiropractic treatments, physical therapy and drugs, waiting to acquire an MRI scan, as well as other imaging scans, in most situations is a fair option.
What Happens When a Disc Herniates
Though the spinal discs are made to withstand significant amounts of force, injury and other issues with the disc can happen. After the disc ages or is injured, the outer portion (annulus fibrosus) of a disk may be torn as well as the disc’s inner substance (nucleus pulposus) can herniate or extrude out of the disk. Nerves, and the inner portion of the disc surround each spinal disc that leaks out comprises proteins, therefore when this material comes in contact with a nerve wracking pain that may travel down the length of the nerve can be caused by it. Even a tiny disk herniation which enables a small quantity of the inner disc material to touch the nerve may cause pain.
Pain from a Herniated Disc vs. Degenerative Disc Disease
A herniated disc will generally create another type of pain than degenerative disk disease (another common disc problem).
When a patient has a symptomatic degenerated disc (one which causes pain or other symptoms), it’s the disc space itself which is debilitating and is the origin of pain. This type of pain is called axial pain.
When a patient has a symptomatic herniated disc, it is not the disk space itself that hurts, but rather the disc difficulty is causing pain in a nerve in the spine. This kind of pain is typically called radicular pain (nerve root pain, or tingling from a lumbar herniated disk).
In conclusion, when an individual begins to experience painful symptoms along their lower back, or lumbar spine, although they may sometimes not experience any symptoms, it a herniated disc is suspected, its recommended to seek immediate medical attention and to consider having an MRI, CT scan or other imaging tests to properly diagnose the presence of a herniated disc or other injury and/or condition before following with treatment.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
Exercise is a frequent component of disc treatment. Your pain will be reduced by maintaining a proactive approach and help ensure the long-term health of your spine.
A herniated disc may need 1 or 2 days rest to relieve pain. You need to resist the desire to lie in bed for days at a time since your muscles need conditioning to help the healing procedure. Your body may not respond to treatment, should you forgo physical activity and exercise.
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Benefits of Exercise for Herniated Discs
Exercising is an efficient method to strengthen and stabilize your low back muscles and prevent additional injury and pain. Strong muscles support your own body weight and bones, carrying pressure.
However, even if you have powerful muscles to support your spine, you must get rid of �excess weight to truly support your spine. Your back is strained by carrying around extra weight constantly, you’re practically doing all of the time to heavy lifting! Losing weight will reduce your pain and encourage the health of your back. If you need to lose weight, talk to you physician about �the different choices you may have.
Types of Exercise for Herniated Discs
You don’t need to endure an intense cardio program or lift heavy weights, simple stretches and aerobic exercises may efficiently control your herniated disc pain.
Stretching programs like yoga and Pilates enhance flexibility and strength, and supply relief of severe pain in your leg and low back. Your physician can also prescribe dynamic lumbar stabilization exercises. This program contains exercises that work the abdominal and back muscles to address posture, flexibility, and stamina.
Moderate aerobic activities, including walking, biking, and swimming, also help relieve pain. Some activities might be better suited to your particular condition. Speak with your doctor about what exercises will help you.
When beginning an aerobic exercise program, start slow–perhaps 10 minutes the first day–and gradually increase your time each day. Eventually, you should aim for 30 to 40 minutes of activity 5 days per week.
Exercise may be a pleasant and satisfying method to take care of symptoms associated with a herniated disc. Your physician and you can work together to develop a program which you will lower your pain and could stick with. In the end, exercise can help you feel better, and it should help relieve your pain from a herniated disc.
Herniated Disc Exercises (Video)
When Should You Go to a Doctor For Herniated Disc Pain?
Oftentimes, patience and time (and perhaps some medication) are sufficient to reduce the pain of a lumbar herniated disc, however, a new study indicates that waiting too long to seek medical treatment for your low back pain may end up doing more harm than good.
The findings, which were introduced in the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), revealed that patients who waited more than 6 months to report their herniated disc symptoms to a doctor didn’t respond to therapy in addition to those who waited less than 6 weeks to seek out medical advice.
In this study, researchers compared 927 patients who had lumbar herniated disc symptoms for less than 6 weeks to 265 patients who had symptoms for more than 6 months.
The researcher team found that the patients who sought medical therapy within 6 weeks of first experiencing symptoms reacted better to both nonsurgical and surgical treatments.
The lesson patients ought to learn from this research, researchers say, is not to wait too long to see your doctor if your herniated disc pain is severe. Visiting a doctor sooner rather than later might enhance the success of your treatment, in case you have low back pain that persists.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
Chiropractic care is a nonsurgical treatment option for discs. But what is a chiropractor’s approach to healing a herniated disc?
With the exception of the initial 2 vertebrae in the neck–the atlas (C1) and the axis (C2), there is an intervertebral disc between each vertebra of the spine. Discs supply flexibility, and act as a shock absorber and a shock distributor.
Picture if you jump up and down. What would occur to the stack of bony vertebrae that form the spine without the cushioning and support of those disks? Now, move your back from side to side. Again, you can picture the give and take between the vertebrae of the discs. Without these discs, your spine couldn’t function.
Intervertebral discs do not really “slip”, even though the term “slipped disc” has come into popular usage to refer to bulging, ruptured, or herniated discs. Throughout this guide, we will refer to herniated discs, which is the term that is correct.
Your disks comprise of the annulus fibrosus (the tough outer layer) and the nucleus pulposus (that contains a gentle, gelatin-like centre). The material inside of the disc can begin to push out, when cracks happen in the outer layer of this disk. A lot of factors can cause a disc herniation.
For example, there could be too much stress on the disc due to bad posture or from becoming obese. In actuality, a combination of a physical injury or variables can cause herniated discs.
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Chiropractic Care and Herniated Discs
A chiropractor can help address back pain and other herniated disk symptoms. In your first appointment, your chiropractor will undergo your medical history, do a physical examination, and perform neurological and orthopaedic evaluations.
Your physician will look for several things. The chiropractor will also carefully look at your position, and they may purchase an X-ray or MRI, if needed, to aid with the diagnostic procedure.
Chiropractors evaluate the entire spine. Your chiropractor will analyze your neck, also if you simply have lower back pain. Recall, he or she wants to see how well your spine is working overall: What happens in one area of your spine can influence other components of your spine and/or body.
After reviewing this information, your physician can ascertain whether you have an intervertebral disk injury. The kind will use to handle your symptoms.
Some patients are not good candidates for some sorts of chiropractic care remedies. As an example, when you have cauda equina syndrome (a condition where you lose control of your bowel/bladder with an uncontrollable intervertebral disk injury), then you will need immediate medical care because this is something which cannot be treated by your physician.
In addition, if your physician finds that you’ve advanced lack of power, sensation, reflexes, and other unusual neurological findings, then he or she will refer you to a spine surgeon.
But, most intervertebral disk injuries are associated with a herniated disc, along with your chiropractor can give you various therapy alternatives to deal with your pain and other ailments.
To deal with a herniated disk, your physician will create a treatment plan which might include spinal manipulation, also called adjustments, and other chiropractic methods to help ease your herniated disk symptoms. It may include exercises and manual therapy, although this is going to be an individualized treatment plan.
The particulars of what are in your treatment plan are particular to your own pain, amount of activity, general wellness, and exactly what your chiropractor believes is best. As with any treatment option, do not hesitate to ask questions about what treatments are being recommended and why. You need to be certain that you understand what’s going to be done and how it can help relieve your pain. Chiropractice treatment is safe and effective .
Below are some examples of chiropractic techniques used for herniated discs.
Flexion-distraction Technique for Herniated Discs
A mutual chiropractic technique is your flexion-distraction procedure, which may be used to help address herniated disc symptoms.
Flexion-distraction entails the use of a technical table that softly “distracts” or stretching the backbone. This allows the chiropractor to isolate the affected region while marginally “bending” the backbone using a pumping rhythm.
There is typically no pain associated with this treatment. Rather, the flexion-distraction technique’s gentle pumping to the painful area makes it possible for the middle of the intervertebral disc (called the nucleus pulposus) to assume its central place in the disk. Disc height may be also improved by flexion-distraction.
This technique can help move the disk away from the nerve, reducing inflammation of the nerve root, and eventually any associated pain and inflammation into the leg (if there’s any associated with your herniated disc).
With flexion-distraction, you generally require a collection of treatments together with adjunctive ultrasound, muscle stimulation, physiotherapy, supplementation, and at-home treatments (your physician will let you know what those are). Gradually, specific nutritional supplements and nutritional recommendations will be integrated into your treatment plan. Your physician will track you.
Manipulation Under Anesthesia (MUA)
Manipulation under anesthesia or MUA is also a suitable chiropractic treatment for some spinal ailments. MUA is performed at hospital or an ambulatory care centre. The type of anesthesia is called sleep; meaning that the duration of sleep and also sedsation is brief. While your body is in, even though the patient is sedated, the therapy area stretches and manipulates Relaxed state. This therapy is generally conducted during 1 to 3 sessions that are.
Pelvic Blocking Strategies for Herniated Discs
Chiropractors also utilize pelvic blocking methods to treat herniated disc symptoms.
Pelvic blocking remedies include using cushioned pliers, which can be placed under both sides of the pelvis. Gentle exercises may be utilized. These will allow changes in mechanisms to draw your disk away from the guts it may be pressing on.
Misconceptions about Chiropractic
It is a misconception that chiropractors “pop up a disc back in position” using forceful alterations. The “pop” sound comes from the release of gas under pressure in a joint. It is similar to the sound.
Another misconception is that chiropractic care involves a few quick remedies, which may “fix” your disc. Instead, as explained above, herniated discs using gentle practices that are low-force are treated by chiropractors.
In Conclusion
Your chiropractor will create a treatment strategy for your herniated disk, and if your symptoms don’t improve with chiropractic care methods, your physician may recommend and comanage your condition with a pain medicine specialist and/or a spine surgeon.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
Several lumbar spine (lower back) disorders can cause sciatica. Sciatica is often described as moderate to intense pain at the left or right leg. Sciatica is caused by compression of at least one of the 5 places of nerve roots in the lower spine. Sometimes physicians call a radiculopathy sciatica. Radiculopathy is a term used to refer to pain, numbness, tingling, and weakness in the arms or legs brought on by a nerve root issue. If the nerve problem is in the neck, then it is called a cervical radiculopathy. However, because the low back is affected by sciatica, it is called a lumbar radiculopathy.
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Pathways to Reduce Nerve Pain
Five sets of nerve roots at the lumbar spine combine to produce the sciatic nerve. Beginning at the back of the pelvis (sacrum), the sciatic nerve runs from the trunk, beneath the buttocks, and downward through the hip place into every leg. Nerve roots aren’t “solitary” structures but are a part of the body’s entire nervous system capable of transmitting pain and sensation to other areas of the human body. Radiculopathy occurs when compression of a nerve due to a disc rupture (herniated disc) or bone spur (osteophyte) occurs in the lumbar spine prior to it joining the sciatic nerve.
What Causes Sciatic Nerve Compression?
Several spinal disorders can lead to nerve compression or lumbar radiculopathy. The 5 are:
a bulging or herniated disc
lumbar spinal stenosis
spondylolisthesis
Injury
piriformis syndrome
Lumbar Bulging Disc or Herniated Disc
A bulging disc is also called a contained disc disorder. This usually means the gel-like center (nucleus pulposus) remains “contained” inside the tire-like outer wall (annulus fibrosus) of the disc.
A herniated disc occurs when the nucleus breaks throughout the annulus fibrosus. It’s known as a “non-contained” disc disease. Whether a disc herniates or bulges, disc material can press against an adjacent nerve root and compress lead to sciatica and nerve tissue.
A disc’s consequences are somewhat worse. Not only does the herniated disc cause direct compression of the nerve root from the interior of the bony spinal canal, but also the disc material itself also contains an acidic, chemical irritant (hyaluronic acid) which causes nerve inflammation. In both situations, nerve wracking and irritation cause pain and swelling, muscle weakness, tingling, and often leading to extremity numbness.
Lumbar Spinal Stenosis
Spinal stenosis is a neural compression disease. Leg pain may happen as a result of lumbar spinal stenosis. The pain is usually positional, frequently brought on by activities such as walking or standing and relieved by sitting down.
Spinal nerve roots branch out in the spinal cord called foramina comprised of bone and ligaments. Between each set of vertebral bodies, situated on the right and left sides, is a foramen. Nerve roots pass through these openings and extend outward beyond the spinal column to innervate different parts of the human body. Whenever these passageways become obstructed causing nerve compression or lean, the expression foraminal stenosis is utilized.
Spondylolisthesis
Spondylolisthesis is a disorder that most often affects the lumbar spinal column. It’s characterized by a single vertebra slipping forward over an adjacent vertebra. A vertebra slips and is displaced, when, spinal nerve root compression often triggers sciatic leg pain and happens. Spondylolisthesis is categorized as developmental (found at birth, develops during childhood) or acquired from spinal degeneration, injury or physical strain (eg, lifting weights).
Trauma and Injury
Sciatica can result from nerve compression brought on by external forces to the lumbar or sacral nerve roots. Examples include motor vehicle accidents. The impact may injure the nerves or, sometimes, the nerves may be compressed by fragments of bone.
Piriformis Syndrome
Piriformis syndrome is named after the muscle and the pain caused when the sciatic nerve irritates. The piriformis muscle and the thighbone is located in the lower portion of the spine, connect, and aids in cool rotation. The sciatic nerve runs beneath the piriformis muscle. When muscle aches grow in the muscle compressing the nerve, Piriformis syndrome develops. It may be difficult to diagnose and treat due to the deficiency of x ray or magnetic resonance imaging (MRI) findings.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
Pain that travels from the back down the leg and into the foot is known as sciatica, which is an overall expression for pain that is excruciating. The term does not clarify why, or what tissue is injured. In reality accidents can cause gastrointestinal pain, together with piriformis syndrome, lumbar spinal disc herniations, and sprains being the three most frequent types of injuries and conditions affecting health and wellness.
Piriformis syndrome is commonly misdiagnosed as a spinal disc herniation, because the pattern of radiating pain, in the back to the lower elevation, is similar in both cases. With both injuries, individuals experience pain with the same type of motions, particularly rising from a seated position, standing for prolonged period of time, or sleeping. At the same time, the pain related to both injuries feels better once you curl up in the fetal position on your side.
A spinal disc herniation occurs when the jelly-like substance from inside the lumbar disc compresses the spinal cord or nerve. Either the disc material compresses the nerves when squeezed out of this disc, or else the compression of the nervous tissue is caused by inflammation. A spinal disc herniation is generally considered a severe injury, causing a massive amount of restriction and back pain. Some folks lose sensation in their legs. They can experience numbness and tingling through the day. Several have tingling, burning, dull, or pain in leg, glutes, and their own back. These are all symptoms associated with sciatica. Compression of particular nerves causes muscle fatigue and loss of feeling.
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Herniated Disc Treatments
Therapy entails helping the body break down the spinal disc material, and relieving the compression of the nerves. Spinal disc decompression treatments are treatments for disc herniations. Flexion distraction therapy is also a way of decreasing pressure in the low back. Patients benefit from at-home utilization of inversion tables. Improve movement in the back joints and stretches and light exercises are used to decrease muscle spasms.
Massage treatment is focused on the back, buttocks, and hamstring muscles to decrease spasms and to reach the lumbar spine and pelvis. Individuals with disc herniations have weakness within their muscles, which need to be strengthened with therapy in order to increase strength, endurance, and muscle coordination patterns. Patients with a history of previous disc herniations or back injuries benefit immensely from strengthening therapy to prevent injuries.
Piriformis Syndrome and Treatment
The piriformis muscle is a really strong and powerful muscle that runs from the sacrum into the femur. It runs beneath gluteal muscles the nerve travels beneath them. If this muscle goes into spasm, then the nerve creates radiating pain, numbness, tingling, or burning out of the buttocks to the leg and foot. People do experience pain together with the syndrome. Other people develop the syndrome while dealing with chronic low back pain.
Activities and motions that cause the piriformis muscle to contract further compress the sciatic nerve, causing pain. This muscle can be contracted once we squat, or stand, walk , go up steps. It tends to tighten when we sit at any position for more than 20 to 30 minutes.
Individuals who have a history of chronic low back pain frequently assume that their radiating sciatic pain is traceable to their lower spine. Their history of disc herniations, or sprains, strains has taught them to assume that it will go away like normal, and that the pain is out of their spine. It is just when the pain doesn’t respond as usual that individuals seek therapy, thus delaying their recovery.
Treatment for piriformis syndrome entails decreasing the intensity of the piriformis muscle spasm that’s controlling the sciatic nerve. Trigger point therapy, massage therapy, ice, heat, electrical, and stretching are involved with the early stages of care. Deep massage therapy is not advised in the first phases of piriformis syndrome. Some of the pain may be relieved during the therapy, but individuals experience worsening symptoms the following day. After the piriformis muscle is worked deeply it might relax for a short time period before it goes to a bigger spasm, further worsening the gastrointestinal pain.
Chiropractic Therapy for Sciatica Symptoms
Chiropractic therapies and treatment goals are to increase joint selection of motion and reduce muscle spasms. Muscle spasms increase tension and pressure on the lumbosacral and sacroiliac regions, which raises back pain. Treatment restores motion in these regions. Treatment and remedies to improve flexibility and reduce spasms accelerate healing and healing times for many types of back pain.
Often, people aggravate their piriformis muscle when they’re protecting or protecting their low back. They may have strength and capacity to compensate, bend, turn, and twist — thus, to squat, they overwork piriformis muscles and their glutes. Treatment should focus on increasing strength and endurance of their muscles, to reduce strain and injury.
Both piriformis syndrome and spinal disc herniations produce radiating pain in the very low back and to the leg. They are two different injuries, requiring treatments for recovery and regular healing. They are both commonly associated with flexibility and low back weakness. Treatment should address the acute traumas but also the core weaknesses that resulted in the condition.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
Herniated discs are a common condition that can occur anywhere along the back or spine, but most often affects the lower back or neck region of the spine.
Also known as a slipped disc or ruptured disc, a herniated disc develops when one or several of the pads found between the vertebrae moves from position and presses on adjacent nerves, resulting in a variety of painful symptoms.
Herniated discs are caused by overuse injuries or trauma to the spine, nonetheless, disc conditions can also develop as a result of the normal aging process or due to degeneration. It’s also understood that there is a genetic element that leads to the development of disc herniation and disc degeneration.
Symptoms of a herniated disc may generally include sharp or dull pain and discomfort, muscle spasm or cramping, fatigue, tingling sensations, numbness or referred pain.
But here is something to consider: From time to time, a disc does not cause any symptoms . That’s called an asymptomatic herniated disc. Your intervertebral disc could be bulging or herniated, but it won’t cause any symptoms, such as pain, unless it is pressing on the spinal cord, its nerve roots or individual nerves.
This brings up a fantastic point about herniated disc symptoms: Your symptoms are dependent on where you’ve got a herniated disc.
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Cervical Herniated Disc Symptoms
If you’ve got a herniated disc or bulging disc on your neck (cervical spine), then you will experience:
Neck pain
Muscle tightness or cramping on your neck
Pain which radiates (or travels) down your arm(s) (this can be called referred pain or cervical radiculopathy)
Tingling in your arm(s) or hand(s)
Weakness in your arm(s) or hand(s)
Lumbar Herniated Disc Symptoms
A herniated disc in the low back (lumbar spine) may cause the following symptoms:
Low back pain
Muscle tightness or cramping in your back
Pain that radiates down your leg(s) (this can be known as referred pain, lumbar radiculopathy, or sciatica)
Tingling in your leg(s) or foot/feet
Weakness in your leg(s) or foot/feet
Really infrequent: Loss of bowel or bladder control (Please, even if this occurs, seek prompt medical care.)
A Note on Referred Pain Brought on by a Herniated Disc
Referred pain means that you’ve got pain in another part of your body as a result of the intervertebral disc issue. As an example, in case you’ve got a bulging disc or a herniated disc in your low back (lumbar spine), you may have known pain in your leg. This is called lumbar radiculpathy or sciatica, a shooting pain that can extend from the buttock into the leg and to the foot. Only one leg is typically affected.
When you’ve got a herniated disc in your neck (cervical spine), then you may have referred pain down your arm and into your hand. Arm and shoulder pain caused by a herniated disc is also called radiculopathy.
Lower Back Pain: Causes & Symptoms (Video)
Herniated Disc Symptoms: When Should You Find a Doctor?
The pain from a herniated disc can make it hard to enjoy your daily life; it may make it tough to walk, sit, or even sleep comfortably. If your disc symptoms linger for more than fourteen days, you should make a doctor appointment. Should you experience unexpected onset of pain (after lifting something heavy incorrectly, as an instance), call your physician.
It’s very rare, but herniated discs can sometimes affect bowel or bladder control (as mentioned above). If this occurs, seek medical attention immediately for a proper diagnosis, followed up by treatment.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
A herniated (ruptured or “slipped”) disc results whenever a disc moves from place or bulges and puts pressure on the nerves or nerve roots. This kind of injury is comparatively common. Repetitive movements, lifting, being obese, and high-impact injuries, as well as simply the aging process, can cause a herniated disc.
As we age, we become more prone to disc injuries over time, primarily because the discs begin to degenerate: they dry out and can become torn and cracked. Moreover, certain genetic elements may also predispose a person to suffer from a herniated disc and disc degeneration.
Intervertebral discs would be the cushion-like pads that sit between the vertebrae of the spine; they act like shock absorbers and permit the spine to become elastic. A strong outer layer known as the annulus fibrosus surrounds a center called the nucleus pulposus, similar to a hard candy with a soft center. The spine can be broken up into regions. The vertebrae are numbered, and the discs are numbered by level. For example, the lumbar spine (lower back) vertebrae are tagged L1 to L5, and the discs are labeled L1-L2, all the way down to L5-S1 (where the spine joins the sacrum).
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Lumbar Herniated Disc and Sciatica
Several symptoms may indicate a LHD, or lumbar herniated disc. Pain can range from a dull ache to a severe, sharp pain. Sciatica is a type of nerve pain which could be caused by a lumbar disc compressing the nerve. The sciatic nerve originates in the lumbar spine and extends down the buttocks and down each leg. When a disc protrudes, it can compress the nerves, causing sciatica where pain extends from the buttock and thigh down into the leg and below the knee. You might have other symptoms, such as numbness on your leg or foot, burning or tingling sensations (paresthesias), muscular fatigue and/or weakness, abnormal reflexes, and, in severe cases, loss of bladder or bowel control (that constitutes a medical emergency and needs immediate attention).
Lumbar Herniated Disc Diagnosis
The science of a medical diagnosis starts with a history and physical examination. Your doctor will assess body movements and asks about your symptoms. If lifting up the leg while lying down generates pain which radiates down your leg, a diagnosis of LHD is possible, especially if you have other symptoms, such as numbness or paresthesias.
Although X-rays may help rule out other conditions, such as a fracture, for example, other imaging studies, such as magnetic resonance imaging (MRI), are necessary for a diagnosis of lumbar herniated disc. X-rays don’t show soft tissues like discs and nerves. Additional tests, such as nerve conduction studies and an electromyogram (EMG) are needed to confirm that a herniated disc is the source of the symptoms.
LHD and Sciatica Statistics
While low back pain is a common ailment, sciatica happens less frequently. Approximately 80% of the general population experiences low back pain but only 2-3% of people with low back pain actually have sciatica. Most cases of LHD occur in people aged 30 to 50 decades. The level of herniation is L4-L5, followed.
Is Surgery Necessary for LHD?
Herniated disks and sciatica often heal on their own with appropriate care, such as medications, injections, and physical therapy, including chiropractic care and other alternative treatment options. If the symptoms progress and when neurologic problems (such as shooting numbness or pain in the leg) become more severe, or when weakness in the leg or foot gets worse, surgery may be suggested.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
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