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.
Contents
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).
Contents
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.
Exactly how effective are injury-prevention programs in soccer? El Paso, TX.s Scientific chiropractor Dr. Alexander Jimenez looks at the very latest evidence…
Football is the world’s most popular team sport. Injuries are a significant issue for both amateur and professional players. Indeed, previous research has estimated that soccer players are among the most injury-prone athletes having an estimated injury rate of 17-24 accidents per 1000 playing hours(1). Nineteen per cent of all sports injuries which exist in the Netherlands are because of soccer(two) and in Britain alone, the expense of therapy and time lost from work owing to football injuries is estimated to be approximately #1billion annually(1)!
In a landmark study, researchers followed two Champions League teams and gathered data on 2,229 players over seven seasons to examine the injury profile of muscular injuries in soccer players(3). They also analyzed the gamers’ training schedules and data out of their games to construct a detailed picture of the injury risks that were associated. The findings were as follows:
2,908 muscle injuries have been enrolled;
Normally, a player sustained 0.6 muscle injuries each season (equating to around 15 muscle injuries per season at a squad of 25 players);
Muscle injuries constituted 31 percent of all injuries and caused 27% of the total injury lack;
Ninety-two per cent of muscle injuries affected the four Big muscle groups of the lower limbs: hamstrings (37 percent), adductors (23 percent), quadriceps (19%), and calf muscles (13%);
Sixteen per cent of the muscular injuries were re-injuries; nonetheless, these re-injuries caused significantly longer absences than did the first injuries.
The prevalence of muscular injury increased with age.
The exact same group of researchers also carried out a follow-up study (published in 2013) in which they sought to establish the consequences of fixture congestion on injury rates among the gamers(4). Time-loss and exposure injuries were enrolled prospectively from 27 teams over 11 seasons. Matches were grouped based on the amount of recovery days before each match and the accident rates were compared between classes. The results showed that compared to a recovery interval of more or six days, muscular injury rates and overall injury rates were raised in league matches where players had had four or less recovery days.
Given the high levels of trauma among football players (a risk that is increased during periods of match congestion) and the financial pressure of the modern game, it’s perhaps unsurprising that medical team caring for players find that treatment of injuries in players is quite a frustrating and also a never-ending struggle. In addition, it clarifies why some players end up returning to contest prior to the injury has healed completely, setting the stage for injury recurrence, together with protracted absence of this participant from competition and training.
Contents
Injury Treatment
Treating injuries in football is both time- consuming and expensive, particularly at the elite level. And while there’s a large literature on the epidemiology of sports injuries, established protocols for treating muscular injuries and assessment criteria for imaging, and a number of clinical and functional tests that could assist the health staff in deciding the optimal point where an athlete can be safely returned to full participation(5,6), the current guidelines haven’t translated into a significant reduction in muscle injury levels in professional sports such as soccer.
To simplify things further, the evidence indicates a new injury often occurs within a couple of weeks after return to contest, and typically costs the player more lost playing time than the key injury(7). The most probable reasons for this observation are likely associated with bodily alterations following the first injury, such as muscle stiffness and/or fatigue, scar tissue formation, biomechanical alterations, neuromuscular inhibition, as well as inadequate treatment — for instance, overly aggressive or incomplete rehabilitation(8-10).
Injury-Prevention Programs
Even armed with knowledge that is up-to-date and the best technology is fraught with difficulty. Remembering the old adage that ‘an ounce of prevention is worth a pound of cure’, a alternative that is far better to attempt to prevent injuries from happening in the first place with an injury-prevention program. This is easier said than done. It is correct that there is an abundance of literature on the effectiveness of methods to avoid harm recurrence and muscle injury, such as enhancing flexibility eccentric and concentric exercises and drills. Despite this and apps like FIFA’s ‘The II’ (see Box 1), the incidence of muscle injuries generally, and the recurrence rate particularly, remains stubbornly high(11-16).
More recent studies indicate that in higher levels of functionality, there might not be much in the way of significant added benefits, while some early study appeared to give evidence for the efficacy of programs in football, as described in box 1. At a follow up to the study described above(18) and that was published this past year, the same group of investigators looked to see if an injury prevention program comprising 10 exercises designed to enhance stability, muscle strength, co-ordination, and versatility of the back, hip and leg muscles (FIFA’s ‘The II’) was effective concerning reducing injury levels and whether it offered any advantages in terms of reducing the related costs of following treatment for injuries that did occur(19).
From the analysis, 479 adult male amateur gamers aged 18-40 years have been split into two classes: the intervention group had been taught to do exercises focusing on core stability, bizarre training of thigh muscles, proprioceptive training, dynamic stabilization, and plyometrics with straight-leg orientation at every training session (2-3 sessions per week) through one season. The management team, meanwhile, continued their usual warm up.
As in the previous study, there were no significant differences in the percentage of players that are injured and injury rates between the two groups. What was intriguing was that in the intervention group, the price of injury treatment was 256 per participant. In the control group nonetheless treatment costs were twice at $606 per participant. The investigators commented that the cost savings in the intervention group may be the result of a rate of knee injuries, which have costs because of more lengthy rehabilitation periods and much more time lost at work compared to a number of different injuries.
Meanwhile, another study on an injury- prevention program (based on The II) in male amateur players had been printed in the end of last year(20). It discovered that (like the previous studies), an intervention program did not decrease the incidence of harm throughout the course of a season. However, such as the study, the players in the intervention group did incur less health care costs, although a justification for this finding wasn’t given. As if to validate the confusion surrounding the value of injury-prevention programs for football players, then a recently published systematic overview of all of the previous studies released thus far fought to achieve a definitive conclusion(21). Six studies involving a total of 6,099 participants met the inclusion criteria and the results of these were conflicting two of the six studies (among large and one of moderate quality) reported a decrease in injury rates that were actual. Four of the six research an ‘preventive effect’, even though the effect of a single study wasn’t statistically significant. Possible reasons for these contradictory findings might be subject choice (sex and level of ability), differences between the intervention programs implemented (content, training frequency and duration) and compliance with this application. What’s clear, however, is that studies investigating the type and seriousness of exercises within an injury-prevention program are still required to reduce the incidence of accidents in soccer efficiently.
Good News On Prevention
Since the review study cited previously(21) was printed, two quite newly published studies on injury-prevention apps in soccer seem to provide more encouraging news — for muscle injuries at least. In one, researchers studied elite players competing over two consecutive seasons, where the first (2008-2009) function as intervention period and the second, the management period (2009-2010)(22). In total, 26 (08/09) and 23 (09/10) elite male pro football players competing within the Scottish Premier League and European competition participated. The accident prevention training program was conducted twice weekly to the entirety of this season (58 avoidance sessions) and the results were compared with the control (no injury-prevention program) year.
On first inspection, the results were disappointing, showing an increase in the complete number of accidents within the intervention period (88 vs 72). But this was largely because of the greater quantity of contusion injuries sustained inside the intervention season (44) compared with control season (23). Assessing like for muscular injuries that were significantly fewer were observed during the intervention season, which had been even more impressive given the larger squad size at the intervention season.
Another newly published study by Italian scientists who researched the effect of a two-tiered injury-prevention program on initial injury and re-injury prevalence in 36 elite male football players also causes encouraging reading(23). During the season prior to that examined in the study, there had been 27 muscle injuries in the group, which accounted for 58.7 percent of the total injuries: 13 of these had occurred throughout practice and 14 during matches. The general incidence of muscular injuries was 5.6 injuries/1000 hours of training/playing exposure and the effect was 106.4 times absence/1000 hours exposure.
To try and decrease the speed of injury through the following season, the team doctor (also among the study’s authors) found an injury-prevention program, conducted 2-3 times per week. This consisted of two elements: a collection of core stability exercises conducted by the whole group prior to each practice session (see Box 2) along with an individualized injury prevention program, which has been started after assessment with kinesiologic and diagnostic tests. At the start of the year, every athlete underwent testing of leg flexibility using the Ober evaluation, Thomas evaluation and straight-leg-raising [SLR] test(24-26). The prone instability test(27) was completed to show spinal instability along with the stork test (28,29) to assess sacroiliac dysfunction. Quadriceps and hamstring strength were measured isokinetically and attention was directed in evaluation of immunity of gluteus medius’ power.
The injuries that happened based on MRI and clinical imaging findings were diagnosed by the medical team. An injury was defined as though it caused the participant to miss the next training session or match, and happened during a scheduled training session or match. An injured player was defined injured before the club medical staff cleared him for participation. Re-injuries were described as those that occurred as those that occurred at the same website no longer than three months following the player had returned to full involvement at early re-injuries and exactly the exact same site.
Results
Throughout the intervention season, a total of 64 injuries occurred — 36 (56 percent) during practice and 28 (44%) during matches. Of them, 20 were muscle injuries, accounting for 31.3 percent of the total injuries; 14 of which occurred during practice and 6 during games. In all, three re-injuries happened and (15 percent of overall muscle injuries) and there were not any premature re-injuries. In comparison with the preceding season with no intervention-program set up, there was a reduction in the number of times and muscle injuries . Specifically, whereas muscle injuries accounted for 31 percent of harms they accounted for 59% of all injuries. Significantly, the number of injuries per 1000 hours of training and playing time was reduced by over half of 5.6 to 2.5. Meanwhile, the number of days fell by nearly two-thirds 106 into 37. The investigators put the success of this intervention down to three key aspects:
An injury prevention program that comprised of core stability exercises similar to those in ‘The II’ program but which differed in its two-tiered arrangement (group and individual sessions), allowing for intense and special training. In contrast, the combined results in research into The II app are probably because of the non- special content and ineffective intensity.
The program’s continuity of commitment by the players to both the group and individual areas.
The addition of bizarre hamstring training in the group program (2 sets of 5 repetitions per week) combined with all the personalized application for players with a history of injury.
Using ice baths in the conclusion of every training session
The investigators cautioned that their study would have included a larger number of topics, but the data still showed a critical progress by the prior year over that. They also argued that by increasing the number of group and individual prevention training sessions, the outcomes could be enhanced.
Summary & Recommendations
Injury treatment in aggressive soccer is equally costly and time-consuming also given the pressures of the game, injury avoidance is more important than ever. But, despite extensive published literature on harm prevention strategies and initiatives such as FIFA’s ‘The II’, the injury rates in soccer remain high, especially in the higher levels.
The latest research indicates that while overall injury prevention programs such as The II might reduce the incidence of trauma in amateur gamers, especially by reducing the incidence of knee injury. However, they will probably not benefit professional players or level. Instead, combining a more individualized approach (using a far greater emphasis on particular exercises determined by kinesiologic and diagnostic testing) with team sessions seems to be desirable. Additionally, it is important that gamers are ‘on-board’ with almost any program and take part regularly (at least twice weekly) to achieve all the potential advantages.
References
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