What is a Herniated Disc?
Herniation of the nucleus pulposus (HNP) occurs when the nucleus pulposus (gel-like substance) breaks through the anulus fibrosus (tire-like structure) of an intervertebral disc (spinal shock absorber).
A herniated disc occurs most often in the lumbar region of the spine especially at the L4-L5 and L5-S1 levels (L = Lumbar, S = Sacral). This is because the lumbar spine carries most of the body’s weight. People between the ages of 30 and 50 appear to be vulnerable because the elasticity and water content of the nucleus decreases with age.
The progression to an actual HNP varies from slow to sudden onset of symptoms. There are four stages: (1) disc protrusion (2) prolapsed disc (3) disc extrusion (4) sequestered disc. Stages 1 and 2 are referred to as incomplete, where 3 and 4 are complete herniations. Pain resulting from herniation may be combined with a radiculopathy, which means neurological deficit. The deficit may include sensory changes (i.e. tingling, numbness) and/or motor changes (i.e. weakness, reflex loss). These changes are caused by nerve compression created by pressure from interior disc material.
Progression of Herniated Disc
The extremities affected are dependent upon the vertebral level at which the HNP occurred. Consider the following examples:
Cervical – Pain in the neck, shoulders, and arms Thoracic – Pain radiates into the chest Lumbar – Pain extends into the buttocks, thighs, legs
Cauda Equina Syndrome occurs from a central disc herniation and is serious requiring immediate surgical intervention. The symptoms include bilateral leg pain, loss of perianal sensation (anus), paralysis of the bladder, and weakness of the anal sphincter.
Diagnosis of a Herniated Disc
The spine is examined with the patient laying down and standing. Due to muscle spasm, a loss of normal spinal curvature may be noted. Radicular pain (inflammation of a spinal nerve) may increase when pressure is applied to the affected spinal level.
A Lasegue test, also known as Straight-leg Raising Test, is performed. The patient lies down, the knee is extended, and the hip is flexed. If pain is aggravated or produced, it is an indication the lower lumbosacral nerve roots are inflamed.
Other neurological tests are performed to determine loss of sensation and/or motor function. Abnormal reflexes are noted as these changes may indicate the location of the herniation.
Radiographs are helpful, but Computed Axial Tomography (CAT) or Magnetic Resonance Imaging (MRI) provides more detail. The MRI is the best method enabling the physician to see the soft spinal tissues unseen in a conventional x-ray.
Radiographic Evidence of HNP
The findings from the examination and tests are compared to make a proper diagnosis. This includes determining the location of the herniation so treatment options can be reviewed with the patient.
Chiropractor, Dr. Alexander Jimenez examines being able to have sex despite having back pain.
The results of SpineUniverse’s national survey on Sexual Satisfaction and Back Pain (read the article Back Pain and Its Impact on Sexual Satisfaction for survey results) indicate that back pain is ruining the sex lives of many people.
It is vital to consider that behind the numbers are real individuals, while the statistical results of the survey are very important. People who care about their partner’s and about their sexual gratification satisfaction. People who are now frustrated and even depressed regarding the impact of back pain on their sex lives.
What exactly can they do to better their situation?
Most specialists agree that three tips can allow you to have better sex� even with back pain:
Tip # 1: Talk It Out
For many people, talking about sex comes for others, their faces turn red even thinking about possibly referring to sex.
Nonetheless, you as well as your partner have to locate a method to discuss your back malady, and the way that it will impact-� or already does change�your relationship.
Take the time to talk through the five dilemmas below:
Back pain: How intense is the pain? Where does it hurt? What moves or increase or positions alleviate the pain?
Sex drive: Is your back pain killing your sex drive? Then you’ve got to discuss this, if it is. If you do not clarify why and simply begin avoiding having sex, you�re your relationship with your partner can be damaged. It’s more straightforward to identify that it is a problem, and never simply theirs �and then find a solution together.
Emotional Impact: What does back pain do to your emotions? Do you feel less appealing to your own partner? Depressed?
Physical Limitations: Living with back pain means living with physical constraints in multiple facets of your daily life. What physical constraints would you now need to work about during sex?
Intimacy: What physical and nonphysical steps can enhance familiarity? (Yes, familiarity means more than sex.) Within the limits caused by back pain, what else can you do to feel close and connected?
Tip # 2: Practical Changes
Here we go, the nitty gritty details of what to do (or not do). (It is ok in case you skipped ahead to this part, but make sure to return and browse the remaining post.)
Position Matters
It may not be the sexiest thing to think about, but you have to remember your diagnosis. Have you got spinal stenosis? A herniated disc? Degenerative changes in your spine? Because what is causing your pain affects how your body reacts to different positions, your analysis is vitally important during sex. For example:
If you have spinal stenosis, your back pain will probably get worse if you arch your back during sex.
Your pain will probably improve should you bend forward during sex when you have a disc herniation or degenerative disk disorder.
So if you’re able to identify which positions naturally lessen your back pain, you can then accommodate your position during sex to help make the experience less painful, given your specific state. For example:
Men that have degenerative disk disease may locate their back pain is decreased by lying with a pillow placed under their low back, while their partner straddles them.
Change The Place
As we’ve learned from Hollywood films, sex does not occur merely in a bed. And perhaps being out of bed will actuality help lower your back pain. For example:
In case you like lying in your back during sex, a solid surface, such as a rug on the floor, may be more comfy for you.
But remember, back pain is individual, if you are on a soft mattress, and perhaps your pain is less during sex. You are required to figure out what’s best for you and your partner.
Rest Your Back
Back pain is frequently made worse by your muscles becoming tense as well as knotted around the region that was painful. Going in a hot tub before sex, having a soothing massage, and sometimes even just using heat or ice packs on the affected region can all ease away muscle pains just before sex.
For more practical tips about sex and back pain and more details on sexual positions go to Sex & Back Pain.
Tip # 3: Speak To A Medical Specialist
We know, talking about sex together with your doctor isn’t the most appealing notion (unless your doctor is Dr. Ruth). But think of this: When Viagra first became available, many men were too embarrassed to talk about erectile dysfunction using their doctor. Subsequently Bob Dole appeared in among their advertisements, and that made it more easy to talk to your physician about sex. (Maybe the thinking was�’If Bob Dole, a politician, can declare he has a problem, maybe I can, too!’)
Besides, physicians have heard it all and they’re prepared to help. Your physicians care about all facets of your physical and emotional well-being; they won’t pity, judge or mock you. So take a deep breath, push past the potential embarrassment, and confer with your physician about how back pain is affecting your sex life. Often, physicians can give advice that is really useful. By way of example, even just a modest change in a medication can make a major difference to your pain.
Because Sex Is More Than�
Sex is more than just the sum of its own physical parts�it’s more than a formula of physical steps that lead to the “perfect” experience. Lots of that which we see in films and on TV these days makes sex the pinnacle of a relationship, the one thing that clearly defines you as a couple (think Grey’s Anatomy).
However, for the vast bulk of people, sexual satisfaction depends on numerous variables, not just physical performance. Factors for example emotional connectedness, a bouquet of flowers sent for no reason, attentive listening, saying thank you for the small things, or sending the kids to Grandma can add to sexual gratification.
And your back pain limits none of those things. You can still have a satisfying, intimate relationship�back pain or not.
Getting overweight adults to adopt new heart-healthy eating habits is an uphill battle. But giving them a handout about nutrition may be better than nothing, new research suggests.
“There’s an urgent need for innovative approaches to support the implementation of current dietary advice,” said Dr. David Jenkins, lead author of the new study from the University of Toronto. To prevent chronic disease, U.S. nutrition guidelines recommend diets rich in fruits, vegetables and whole grains, plus foods that lower cholesterol such as oats, barley, nuts and soy.
Jenkins, who is chair of nutrition and metabolism at the university, and his team tried three ways of encouraging these healthy habits. The researchers randomly assigned more than 900 overweight adults to one of four groups.
Encouraging Healthy Eating Habits
One group received advice about diet through phone calls. Another got a weekly food basket but no advice about diet. The third group got both advice and food baskets. A fourth group, used as “controls,” did not receive advice or food baskets. Everybody in each group got a “food guide” handout about diet.
Six months later, participants overall had only slightly increased their consumption of healthier foods like fruits and vegetables, regardless of group. The researchers said the only consistent increases were seen in the group that received both food and advice. And by 18 months, that slight increase in healthy eating was dwindling, the investigators found. Still, weight and blood pressure dipped a bit in all the groups, including the control group, according to the study.
The results were published Feb. 27 in the Journal of the American College of Cardiology.
“These data demonstrate the difficulty in effectively promoting fruit, vegetable and whole grain cereals to the general population using recommendations that, when followed, decrease risk factors for chronic disease,” Jenkins said in a journal news release.
But the author of an accompanying journal editorial suggested looking at the results as a “glass half-full.”
“Each country and scientific society must prioritize the strategies best adapted to local customs and regulations,” wrote Dr. Ramon Estruch, an internist at the Hospital Clinic of Barcelona, in Spain.
“However, it appears that simply giving a copy of healthy dietary guidelines causes small changes in the right direction. Perhaps we should start with this extremely simple, no-cost procedure at schools, workplaces, clinics or sports centers, while the other strategies are slowly developed and implemented,” Estruch suggested. Jenkins disclosed grant funding from several food-related companies.
SOURCE: Journal of the American College of Cardiology, news release, Feb. 27, 2017
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Weight Loss Eases Back Pain
Back pain and symptoms of sciatica can affect a majority of the population throughout their lifetime. Research studies have demonstrated that people who are overweight or obese experience more back complications than people with a healthy weight. A proper nutrition along with regular physical fitness can help with weight loss as well as help maintain a healthy weight to eliminate symptoms of back pain and sciatica. Chiropractic care is also another natural form of treatment which treats back pain and sciatica utilizing manual spinal adjustments and manipulations.
A gluten free diet can work for fibromyalgia patients and provide relief from common symptoms. According to the research, it is important to note that the gluten free (GF) diet may help both fibromyalgia (FM) patients with and without celiac disease. Before you start a new diet, you should consult a doctor, but first consider the following studies.
Gluten free diet for fibromyalgia helps non-celiac gluten sensitivity
A study published in Rheumatology International reveals that fibromyalgia patients who have not been diagnosed with celiac disease may still benefit from going on the gluten free diet. Researchers point out that it is possible for these patients to have non-celiac gluten sensitivity. This means that the celiac disease tests come back negative, but the patients are still reacting to gluten.
According to the researchers, when fibromyalgia patients adhered to the gluten free diet, they were able to reduce or eliminate many FM symptoms. They point out that 90 patients out of the 246 who participated in the study responded well to the gluten free diet. All of these patients reported a reduction in pain, and some were able to return to work and normal life. In addition, the patients noted that their fatigue, depression, gastrointestinal symptoms and migraines improved on the gluten free diet.
Gluten free diet for fibromyalgia and celiac disease
It is possible to have both fibromyalgia and celiac disease. A study published in BMC Gastroenterology reveals that patients who have fibromyalgia and celiac disease benefit from the gluten-free diet. After one year of following the gluten free diet, the patients reported an improvement in the quality of their lives and a reduction in fibromyalgia symptoms.
The patients had fewer tender points and better scores on the health assessment questionnaire. In addition, both their celiac disease, fibromyalgia pain and other symptoms decreased. Furthermore, they were able to reduce the number of prescribed drugs they took.
Should you try the gluten-free diet for fibromyalgia?
It is important to consider the diet advice from experts about fibromyalgia. Several studies have shown that the gluten free diet can help patients with this medical condition. However, each case is unique, so you have to consult your doctor before making significant diet changes.
If you have fibromyalgia, you may want to consider being tested for celiac disease. Some of the main symptoms of celiac disease are abdominal pain and gastrointestinal problems such as bloating, diarrhea, constipation, gas, indigestion and nausea. You may also experience cramps, itchy rashes, weight loss, fatigue and many other symptoms.
The gluten free diet requires you to eliminate all wheat, barley and rye products. Gluten is a protein, and it can appear as an ingredient in many products. In addition, cross-contamination is a big issue, so many products can be contaminated with gluten and not safe on this diet. If you decide to follow this diet, you must start by reading labels carefully.
The Division of Workers� Compensation recognized Shelton & Shelton Plumbing, LP in Killeen and Texas Hydraulics, Inc. in Temple for exemplary workplace safety programs and low rates of work-related injuries and illnesses. The Division presented the companies with the Division of Workers� Compensation�s (DWC�s) Lone Star Safety Program Award.
�I�m proud to award these Texas employers for their outstanding safety practices,� said Commissioner of Workers� Compensation Ryan Brannan. �We think they will serve as models for other employers.�
Shelton & Shelton Plumbing, LP builds wastewater, storm, and sewer lines. The company is a first-time recipient of the Lone Star Safety Award, and is recognized for increasing safety inspections, maintaining employee and management training in identification of hazards, reinforcing the reporting of safety and health concerns, and increasing employee participation. Shelton & Shelton Plumbing also participates in DWC�s Occupational Safety and Health Consultation (OSHCON) Program, and was recently awarded its ninth Safety and Health Achievement Recognition Program (SHARP) designation by DWC and the federal Occupational Safety and Health Administration (OSHA). SHARP recipients are exempt from certain OSHA inspections.
Texas Hydraulics manufactures hydraulic cylinders. The company is a first-time recipient of the Lone Star Safety Award. Texas Hydraulics is recognized for a strong safety management system, increasing required safety training for employees and management, and maintaining excellent safety conditions at plant buildings and yards by upgrading to new, enclosed machinery.
�Both companies have created exceptional safety cultures by fostering active participation at all levels,� Brannan said. �I hope more employers will follow their lead and participate in the Lone Star Safety Program, which can help employers save money and keep employees safer on the job.�
Know a company with an excellent safety program? Nominate it for the Lone Star Safety Award. Employers must have a proven safety program, injury incidence rates below the national average for three years prior to application, and no work-related fatalities within the prior 12 months.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Neck Pain and Auto Injury
During an automobile accident, the body is exposed to a sheer force from the impact which causes the head and neck to abruptly jerk back-and-forth in relation to the rest of the body, which remains stationary in the car seat. Due to this motion, it�s common for the neck to suffer from whiplash, a painful injury which leads to neck pain as well as other symptoms.
N.L. chiropractors� association says workers also get back on the job faster
CBC News
The Newfoundland &�Labrador Chiropractic Association
Seeing A�Chiropractor First After�A Workplace Injury Gets Workers Back On The Job Faster
Dr. Darrell Wade, CEO of the association, said the September 2016 study�analyzed data from more than 5,500 injured workers in Ontario.
�What it found was that the initial provider of care for back pain was a very strong determinant of the duration of financial compensation for at least the first five months of the claim,� he told CBC Radio�s On the Go.
The study, published in the Journal of Occupational Rehabilitation, found that workers who saw a chiropractor first, rather than a physician or a physiotherapist, needed full compensation for a shorter time.
�What they found was that people who had seen a chiropractor first had seen about a 20 per cent less cost in these claims over those who visited their family physician,� he said.
The study involved more than 5,000 injured workers in Ontario, comparing time lost depending on which health care professional they saw first. (CBC)
A majority of workplace injuries are related to joints and muscles, making chiropractors a logical choice for the first visit, said Wade.
�Getting to the person who is most adequately equipped to treat your injury in the first place is what really accounts for the reductions in lost time from work and compensation costs,� he said.
In the study, done by researchers at the University of Montreal, just 11 per cent of the workers saw a chiropractor first, and Wade says that percentage would be less in Newfoundland and Labrador.
�It does speak to a great potential for improvement in our system, were we to use chiropractors more as the front line for musculoskeletal injuries, in particular, back pain,� he said.
�All too often these patients are not getting to us until three�months after an injury and at that point the chance of success decreases significantly.�
All marathon runners eventually slow down. But, a new study finds that whether a runner is average or elite, or whether they are a man or a woman, may determine at what age and how much their pace will decline.
The researchers reviewed 2001-2016 data from three of the largest U.S. marathons — Boston, Chicago and New York City.
“We found that marathon performance decline begins at about 35 years old,” said study lead author Dr. Gerald Zavorsky, of Georgia State University. “For top runners, we determined the slowdown is about 2 minutes per year beginning at age 35 for men. And for women, it’s actually a little bit statistically faster of a slowdown, around 2 minutes and 30 seconds per year beginning at the age of 35,” Zavorsky said in a university news release.
He is an associate professor in the university’s department of respiratory therapy. The researchers also found that marathoners aged 25 to 34 had the fastest times, with overall champion males at 28.3 years old and overall champion females at 30.8 years of age.
However, people with “average” marathon times don’t see a big impact on their performance until later in life, the findings showed.
“If you’re an average runner finishing in the middle of your age group, statistically the slowdown starts at age 50. It’s similar if you’re a man or woman. The decline with aging in average runners is around 2 minutes and 45 seconds per year beginning at age 50,” Zavorsky said.
The researchers suspect the reason that average runners see a decline later in life is that they likely started running later in life.
“Elite athletes realize their potential when they’re young, and they’re able to maximize that potential when they’re young. But average runners might not realize their potential until they’re a lot older and by that time physiological aging comes in. They try to reach their maximum potential, but they’re trying to reach it at a much older age and their ceiling for improvement is not as high,” Zavorsky suggested.
The rate of marathon performance decline between ages 35 and 74 is fairly steady, and female age-group winners have a 27 second per year larger decline than male age-group winners, according to the study. Although you might never reach elite status if you start running in your 50s, the researchers don’t want to discourage older people from getting involved in marathons.
“If you’re an older person and you want to pick up marathon running, yes you can still improve because you’ve just now begun running. There’s always room for improvement, but physiologically, you were probably at your prime somewhere between 25 and 34 years old,” Zavorsky said.
“But people who are older can still train to achieve personal goals and get the health benefits of exercise, such as lower blood pressure, lower blood cholesterol and enhanced psychological well-being,” he added.
The study was published online recently in the journal PLoS ONE.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Sports Injuries
Many athletes largely depend on chiropractic care to enhance their physical performance. New research studies have determined that aside from maintaining overall health and wellness, chiropractic can also help prevent sports injuries. Chiropractic is an alternative treatment option utilized by athletes to improve their strength, mobility and flexibility. Spinal adjustments and manual manipulations performed by a chiropractor can also help correct spinal issues, speeding up an athlete’s recovery process to help them return-to-play as soon as possible.
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