Back Clinic Spinal Hygiene. The spine is the protective housing for the nervous system, a system so powerful that it controls every function in the human body. The nervous system tells your body to breath, tells your heart to beat, tells your arms and legs to move, tells your body when and how to produce new cells and it even has the power to control healing. A damaged or misaligned spine can dramatically interfere with the signals constantly being sent through the nervous system, eventually resulting in bodily pain, internal deterioration and loss of many of the everyday functions we take for granted.
Spinal hygiene is extremely important, yet 89 percent of the world’s population does not realize the importance of maintaining proper alignment of the vertebrae through chiropractic adjustment, as well as protecting the spine from injury through healthy living practices. Instead we neglect our spines. As children we start our lives with tumbles and trips that jar our spines, we grow into adults with poor posture, we lift things that are too heavy, carry overloaded back packs, and we suffer injury through car accidents, sports impacts and stress.
Get in on the health trend of the future-today. Join the growing percentage of the population that enjoys greater health and wellness through regular care of their spines. Talk to your chiropractor today about ways you can improve your spinal hygiene.
Can individuals with Ehlers-Danlos syndrome find relief through various non-surgical treatments to reduce joint instability?
Introduction
The joints and ligaments surrounding the musculoskeletal system allow the upper and lower extremities to stabilize the body and be mobile. The various muscles and soft connective tissues that surround the joints help protect them from injuries. When environmental factors or disorders start to affect the body, many people develop issues that cause overlapping risk profiles, which then affect the stability of the joints. One of the disorders that affect the joints and connective tissue is EDS or Ehlers-Danlos syndrome. This connective tissue disorder can cause the joints in the body to be hypermobile. It can cause joint instability in the upper and lower extremities, thus leaving the individual to be in constant pain. Today’s article focuses on Ehlers-Danlos syndrome and its symptoms and how there are non-surgical ways to manage this connective tissue disorder. We discuss with certified medical providers who consolidate our patients’ information to assess how Ehlers-Danlos syndrome can correlate with other musculoskeletal disorders. We also inform and guide patients on how various non-surgical treatments can help reduce pain-like symptoms and manage Ehlers-Danlos syndrome. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating various non-surgical therapies as part of their daily routine to manage the effects of Ehlers-Danlos syndrome. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
What Is Ehlers-Danlos Syndrome?
Do you often feel extremely tired throughout the day, even after a full night of sleep? Do you bruise easily and wonder where these bruises are coming from? Or have you noticed that you have an increased range in your joints? Many of these issues are often correlated with a disorder known as Ehlers-Danlos syndrome or EDS that affects their joints and connective tissue. EDS affects the connective tissues in the body. The connective tissues in the body help provide strength and elasticity to the skin, joints, as well as blood vessel walls, so when a person is dealing with EDS, it can cause a significant disruption to the musculoskeletal system. EDS is largely diagnosed clinically, and many doctors have identified that the gene coding of the collagen and proteins that interact in the body can help determine what type of EDS affects the individual. (Miklovic & Sieg, 2024)
The Symptoms
When understanding EDS, it is essential to know the complexities of this connective tissue disorder. EDS is classified into numerous types with distinct features and challenges that vary depending on the severity. One of the most common types of EDS is hypermobile Ehlers-Danlos syndrome. This type of EDS is characterized by general joint hypermobility, joint instability, and pain. Some of the symptoms that are associated with hypermobile EDS include subluxation, dislocations, and soft tissue injuries that are common and may occur spontaneously or with minimal trauma. (Hakim, 1993) This can often cause acute pain to the joints in the upper and lower extremities. With its broad range of symptoms and the personal nature of the condition itself, many often don’t realize that joint hypermobility is common in the general population and may present no complications that indicate that it is a connective tissue disorder. (Gensemer et al., 2021) Additionally, hypermobile EDS can lead to spinal deformity due to the hyperextensibility of the skin, joints, and various tissue fragility. The pathophysiology of spinal deformity associated with hypermobile EDS is primarily due to muscle hypotonia and ligament laxity. (Uehara et al., 2023) This causes many people to reduce their quality of life and daily living activities significantly. However, there are ways to manage EDS and its correlating symptoms to reduce joint instability.
Movement Medicine: Chiropractic Care-Video
Ways To Manage EDS
When it comes to looking for ways to manage EDS to reduce pain and joint instability, non-surgical treatments can help address the physical and emotional aspects of the condition. Non-surgical treatments for individuals with EDS commonly focus on optimizing the body’s physical function while improving muscular strength and joint stabilization. (Buryk-Iggers et al., 2022) Many individuals with EDS will try to incorporate pain management techniques and physical therapy anduse braces and assistive devices to reduce the effects of EDS and improve their quality of life.
Non-surgical Treatments For EDS
Various non-surgical treatments like MET (muscle energy technique), electrotherapy, light physical therapy, chiropractic care, and massages can help strengthen while toning the surrounding muscles around the joints, provide sufficient pain relief, and limit long-term dependence on medications. (Broida et al., 2021) Additionally, individuals dealing with EDS aim to strengthen the affected muscles, stabilize the joints, and improve proprioception. Non-surgical treatments allow the individual to have a customized treatment plan for the severity of EDS symptoms and help reduce the pain associated with the condition. Many individuals, when going through their treatment plan consecutively to manage their EDS and reduce the pain-like symptoms, will notice improvement in symptomatic discomfort. (Khokhar et al., 2023) This means that non-surgical treatments allow individuals to be more mindful of their bodies and reduce the pain-like effects of EDS, thus allowing many individuals with EDS to lead fuller, more comfortable lives without feeling pain and discomfort.
References
Broida, S. E., Sweeney, A. P., Gottschalk, M. B., & Wagner, E. R. (2021). Management of shoulder instability in hypermobility-type Ehlers-Danlos syndrome. JSES Rev Rep Tech, 1(3), 155-164. doi.org/10.1016/j.xrrt.2021.03.002
Buryk-Iggers, S., Mittal, N., Santa Mina, D., Adams, S. C., Englesakis, M., Rachinsky, M., Lopez-Hernandez, L., Hussey, L., McGillis, L., McLean, L., Laflamme, C., Rozenberg, D., & Clarke, H. (2022). Exercise and Rehabilitation in People With Ehlers-Danlos Syndrome: A Systematic Review. Arch Rehabil Res Clin Transl, 4(2), 100189. doi.org/10.1016/j.arrct.2022.100189
Gensemer, C., Burks, R., Kautz, S., Judge, D. P., Lavallee, M., & Norris, R. A. (2021). Hypermobile Ehlers-Danlos syndromes: Complex phenotypes, challenging diagnoses, and poorly understood causes. Dev Dyn, 250(3), 318-344. doi.org/10.1002/dvdy.220
Hakim, A. (1993). Hypermobile Ehlers-Danlos Syndrome. In M. P. Adam, J. Feldman, G. M. Mirzaa, R. A. Pagon, S. E. Wallace, L. J. H. Bean, K. W. Gripp, & A. Amemiya (Eds.), GeneReviews((R)). www.ncbi.nlm.nih.gov/pubmed/20301456
Khokhar, D., Powers, B., Yamani, M., & Edwards, M. A. (2023). The Benefits of Osteopathic Manipulative Treatment on a Patient With Ehlers-Danlos Syndrome. Cureus, 15(5), e38698. doi.org/10.7759/cureus.38698
For individuals who have exhausted all other treatment options for low back pain and nerve root compression, can laser spine surgery help alleviate nerve compression and provide long-lasting pain relief?
Laser Spine Surgery
Laser spine surgery is a minimally invasive surgical procedure that uses a laser to cut through and remove spinal structures that are compressing nerves and causing intense pain. The minimally invasive procedure often results in less pain, tissue damage, and faster recovery than more extensive surgeries.
How It Works
Minimally invasive procedures result in less scarring and damage to surrounding structures, often reducing pain symptoms and a shorter recovery time. (Stern, J. 2009) Small incisions are made to access spinal column structures. With open-back surgery, a large incision is made down the back to access the spine. The surgery differs from other surgeries in that a laser beam, rather than other surgical instruments, is used to cut structures in the spine. However, the initial incision through the skin is made with a surgical scalpel. Laser is an acronym for Light Amplification Stimulated by Emission of Radiation. A laser can generate intense heat to cut through soft tissues, especially those with a high water content, like spinal column discs. (Stern, J. 2009) For many spine surgeries, the laser cannot be used to cut through bone as it generates instant sparks that can damage surrounding structures. Rather, laser spine surgery is primarily used to perform a discectomy, which is a surgical technique that removes a portion of a bulging or herniated disc that is pushing against the surrounding nerve roots, causing nerve compression and sciatic pain. (Stern, J. 2009)
Surgical Risks
Laser spine surgery may help resolve the cause of nerve root compression, but there is an increased risk of damage to nearby structures. Associated risks include: (Brouwer, P. A. et al., 2015)
Infection
Bleeding
Blood clots
Remaining symptoms
Returning symptoms
Further nerve damage
Damage to the membrane around the spinal cord.
Need for additional surgery
A laser beam is not precise like other surgical tools and requires practiced mastery and control to avoid damage to the spinal cord and nerve roots. (Stern, J. 2009) Because lasers cannot cut through bone, other surgical instruments are often used around corners and at different angles because they are more efficient and allow greater accuracy. (Atlantic Brain and Spine, 2022)
Purpose
Laser spine surgery is performed to remove structures that are causing nerve root compression. Nerve root compression is associated with the following conditions (Cleveland Clinic. 2018)
Bulging discs
Herniated discs
Sciatica
Spinal stenosis
Spinal cord tumors
Nerve roots that are injured or damaged and constantly send chronic pain signals can be ablated with laser surgery, known as nerve ablation. The laser burns and destroys the nerve fibers. (Stern, J. 2009) Because laser spine surgery is limited in treating certain spinal disorders, most minimally invasive spine procedures do not use a laser. (Atlantic Brain and Spine. 2022)
Preparation
The surgical team will provide more detailed instructions on what to do in the days and hours before surgery. To promote optimal healing and a smooth recovery, it is recommended that the patient stay active, eat a healthy diet, and stop smoking prior to the operation. Individuals may need to stop taking certain medications to prevent excess bleeding or interaction with anesthesia during the operation. Inform the healthcare provider about all prescriptions, over-the-counter drugs, and supplements being taken.
Laser spine surgery is an outpatient procedure at a hospital or outpatient surgical center. The patient will likely go home on the same day of the operation. (Cleveland Clinic. 2018) Patients cannot drive to or from the hospital before or after their surgery, so arrange for family or friends to provide transportation. Minimizing stress and prioritizing healthy mental and emotional well-being is important to lowering inflammation and aiding recovery. The healthier the patient goes into surgery, the easier the recovery and rehabilitation will be.
Expectations
The surgery will be decided by the patient and healthcare provider and scheduled at a hospital or outpatient surgical center. Arrange for a friend or family member to drive to the surgery and home.
Before Surgery
The patient will be taken to a pre-operative room and asked to change into a gown.
The patient will undergo a brief physical examination and answer questions about medical history.
The patient lies on a hospital bed, and a nurse inserts an IV to deliver medication and fluids.
The surgical team will use the hospital bed to transport the patient in and out of the operating room.
The surgical team will assist the patient in getting onto the operating table, and the patient will be administered anesthesia.
The patient may receive general anesthesia, which will cause the patient to sleep for the surgery, or regional anesthesia, injected into the spine to numb the affected area. (Cleveland Clinic. 2018)
The surgical team will sterilize the skin where the incision will be made.
An antiseptic solution will be used to kill bacteria and prevent the risk of infection.
Once sanitized, the body will be covered with sterilized linens to keep the surgical site clean.
During Surgery
For a discectomy, the surgeon will make a small incision less than one inch in length with a scalpel along the spine to access the nerve roots.
A surgical tool called an endoscope is a camera inserted into the incision to view the spine. (Brouwer, P. A. et al., 2015)
Once the problematic disc portion causing the compression is located, the laser is inserted to cut through it.
The cut disc portion is removed, and the incision site is sutured.
After Surgery
After surgery, the patient is brought to a recovery room, where vital signs are monitored as the effects of the anesthesia wear off.
Once stabilized, the patient can usually go home one or two hours after the operation.
The surgeon will determine when the individual is clear to resume driving.
Recovery
Following a discectomy, the individual can return to work within a few days to a few weeks, depending on the severity, but it can take up to three months to return to normal activities. Length of recovery can range from two to four weeks or less to resume a sedentary job or eight to 12 weeks for a more physically demanding job that requires heavy lifting. (University of Wisconsin School of Medicine and Public Health, 2021) During the first two weeks, the patient will be given restrictions to facilitate the spine’s healing until it becomes more stable. Restrictions can include: (University of Wisconsin School of Medicine and Public Health, 2021)
No bending, twisting, or lifting.
No strenuous physical activity, including exercise, housework, yard work, and sex.
No alcohol in the initial stage of recovery or while taking narcotic pain medications.
No driving or operating a motor vehicle until discussed with the surgeon.
The healthcare provider may recommend physical therapy to relax, strengthen, and maintain musculoskeletal health. Physical therapy may be two to three times weekly for four to six weeks.
Process
Optimal recovery recommendations include:
Getting enough sleep, at least seven to eight hours.
Maintaining a positive attitude and learning how to cope and manage stress.
Maintaining body hydration.
Following the exercise program as prescribed by the physical therapist.
Practicing healthy posture with sitting, standing, walking, and sleeping.
Staying active and limiting the amount of time spent sitting. Try to get up and walk every one to two hours during the day to stay active and prevent blood clots. Gradually increase the amount of time or distance as recovery progresses.
Do not push to do too much too soon. Overexertion can increase pain and delay recovery.
Learning correct lifting techniques to utilize the core and leg muscles to prevent increased pressure on the spine.
Discuss treatment options for managing symptoms with a healthcare provider or specialist to determine if laser spine surgery is appropriate. Injury Medical Chiropractic and Functional Medicine Clinic care plans and clinical services are specialized and focused on injuries and the complete recovery process. Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, therapists, trainers, and premiere rehabilitation providers. We focus on restoring normal body functions after trauma and soft tissue injuries using Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols.
Brouwer, P. A., Brand, R., van den Akker-van Marle, M. E., Jacobs, W. C., Schenk, B., van den Berg-Huijsmans, A. A., Koes, B. W., van Buchem, M. A., Arts, M. P., & Peul, W. C. (2015). Percutaneous laser disc decompression versus conventional microdiscectomy in sciatica: a randomized controlled trial. The spine journal : official journal of the North American Spine Society, 15(5), 857–865. doi.org/10.1016/j.spinee.2015.01.020
University of Wisconsin School of Medicine and Public Health. (2021). Home Care Instructions after Lumbar Laminectomy, Decompression or Discectomy Surgery. patient.uwhealth.org/healthfacts/4466
For individuals who are dealing with back pain and problems, could knowing how to improve and maintain intervertebral disc health help alleviate symptoms?
Intervertebral Disc Health
The spinal column comprises 24 movable bones and 33 bones called vertebrae. The vertebral bones are stacked on top of each other. The intervertebral disc is the cushioning substance between the adjacent bones. (Dartmouth. 2008)
Bones
The vertebral bones are small and round in an area called the vertebral body. In the back is a bony ring from which protrusions extend and arches and pathways are formed. Each structure has one or more purposes and includes: (Waxenbaum JA, Reddy V, Williams C, et al., 2023)
Stabilizing the spine.
Providing a space for the connective tissue and back muscles to attach.
Providing a tunnel for the spinal cord to pass through cleanly.
Providing a space where nerves exit and branch out to all areas of the body.
Structure
The intervertebral disc is the cushioning that sits between the vertebrae. The design of the spine allows it to move in various directions:
Flexion or bending
Extension or arching
Tilting and rotation or twisting.
Powerful forces act upon and influence the spinal column to produce these movements. The intervertebral disc absorbs shock during movement and protects the vertebrae and spinal cord from injury and/or trauma.
Ability
On the outside, strong woven fiber tissues form an area called the annulus fibrosis. The annulus fibrosis contains and protects the softer gel substance in the center, the nucleus pulposus. (Y.S. Nosikova et al., 2012) The nucleus pulposis provides shock absorption, flexibility, and pliability, especially under pressure during spinal movement.
Mechanics
The nucleus pulposus is a soft gel substance located in the center of the disc that allows elasticity and flexibility under stress forces to absorb compression. (Nedresky D, Reddy V, Singh G. 2024) The swivel action alters the tilt and rotation of the vertebra above and below, buffering the effects of spinal motion. The discs swivel in response to the direction the spine moves. The nucleus pulposus is made mostly of water, which moves in and out through small pores, acting as byways between the vertebra and disc bone. Body positions that load the spine, like sitting and standing, push the water out of the disc. Lying down on the back or in a supine position facilitates water restoration into the disc. As the body ages, the discs lose water/dehydrate, leading to disc degeneration. The intervertebral disc has no blood supply, which means that for a disc to receive necessary nutrition and for waste removal, it must rely on water circulation to stay healthy.
Care
Some ways of maintaining intervertebral disc health include:
Paying attention to posture.
Changing positions frequently throughout the day.
Exercising and moving around.
Applying correct body mechanics to physical activities.
Sleeping on a supportive mattress.
Drinking plenty of water.
Eating healthy.
Maintaining a healthy weight.
Drinking alcohol in moderation.
Quitting smoking.
At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by improving an individual’s ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. Our chiropractic team, care plans, and clinical services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Acupuncture, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Beyond the Surface: Understanding the Effects of Personal Injury
Waxenbaum, J. A., Reddy, V., Williams, C., & Futterman, B. (2024). Anatomy, Back, Lumbar Vertebrae. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/29083618
Nosikova, Y. S., Santerre, J. P., Grynpas, M., Gibson, G., & Kandel, R. A. (2012). Characterization of the annulus fibrosus-vertebral body interface: identification of new structural features. Journal of anatomy, 221(6), 577–589. doi.org/10.1111/j.1469-7580.2012.01537.x
Can individuals with joint hypermobility find relief through nonsurgical treatments in reducing pain and restoring body mobility?
Introduction
When a person moves their body, the surrounding muscles, joints, and ligaments are incorporated into various tasks that allow them to stretch and be flexible without pain or discomfort. Many repetitive motions enable the individual to continue their routine. However, when the joints, muscles, and ligaments are stretched farther than normal in the upper and lower extremities without pain, it is known as joint hypermobility. This connective tissue disorder can correlate with other symptoms that affect the body and cause many people to seek treatment to manage joint hypermobility symptoms. In today’s article, we will look at joint hypermobility and how various non-surgical treatments can help reduce pain caused by joint hypermobility and restore body mobility. We talk with certified medical providers who consolidate our patients’ information to assess how their pain may be associated with joint hypermobility. We also inform and guide patients on how integrating various non-surgical treatments can help improve joint function while managing the associated symptoms. We encourage our patients to ask their associated medical providers intricate and insightful questions about incorporating non-surgical therapies as part of their routine to reduce pain and discomfort from joint hypermobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
What Is Joint Hypermobility?
Do you often feel your joints locked up in your hands, wrists, knees, and elbows? Do you experience pain and fatigue in your joints when your body feels constantly tired? Or when you stretch your extremities, do they extend farther than usual to feel the relief? Many of these various scenarios are often correlated with individuals experiencing joint hypermobility. Joint hypermobility is an inherited disorder with autosomal dominant patterns that characterize joint hyperlaxity and musculoskeletal pain within the body extremities. (Carbonell-Bobadilla et al., 2020) This connective tissue condition is often related to the flexibility of the connected tissues like ligaments and tendons in the body. An example would be if a person’s thumb is touching their inner forearm without feeling pain or discomfort, they have joint hypermobility. Additionally, many individuals dealing with joint hypermobility will often have a difficult diagnosis as they will develop skin and tissue fragility over time, causing musculoskeletal complications. (Tofts et al., 2023)
When individuals deal with joint hypermobility over time, many often have symptomatic joint hypermobility. They will present with musculoskeletal and systemic symptoms that lead to displaying skeletal deformities, tissue and skin fragility, and structural differences in the body’s system. (Nicholson et al., 2022) Some of the symptoms that joint hypermobility are shown in a diagnosis include:
Muscle pain and joint stiffness
Clicking joints
Fatigue
Digestive issues
Balance issues
Luckily, there are various treatments that many people can use to help restrengthen the surrounding muscles around the joints and reduce the correlating symptoms caused by joint hypermobility.
Movement As Medicine-Video
Nonsurgical Treatments For Joint Hypermobility
When dealing with joint hypermobility, many individuals need to seek treatments to reduce the correlating pain-like symptoms of joint hypermobility and help relieve the body’s extremities while restoring mobility. Some excellent treatments for joint hypermobility are non-surgical therapies that are non-invasive, gentle on the joints and muscles, and cost-effective. Various non-surgical treatments can be customized for the individual depending on how severe their joint hypermobility and comorbidities affect the person’s body. Non-surgical treatments can relieve the body from joint hypermobility by treating the causes of the pain through reduction and maximizing functional capacity and restoring a person’s quality of life. (Atwell et al., 2021) The three non-surgical treatments that are excellent for reducing pain from joint hypermobility and helping strengthen the surrounding muscles are below.
Chiropractic Care
Chiropractic care utilizes spinal manipulation and helps restore joint mobility in the body to reduce the effects of joint hypermobility by stabilizing the affected joints from the hypermobile extremities. (Boudreau et al., 2020) Chiropractors incorporate mechanical and manual manipulation and various techniques to help many individuals improve their posture by being more mindful of their bodies and work with multiple other therapies to emphasize controlled movements. With other comorbidities associated with joint hypermobility, like back and neck pain, chiropractic care can reduce these comorbidity symptoms and allow the individual to regain their quality of life.
Acupuncture
Another non-surgical treatment that many individuals can incorporate to reduce joint hypermobility and its comorbidities is acupuncture. Acupuncture utilizes small, thin, solid needles that acupuncturists use to block pain receptors and restore the body’s energy flow. When many individuals are dealing with joint hypermobility, their extremities in the legs, hands, and feet are in pain over time, which can cause the body to be unstable. What acupuncture does is help reduce the pain caused by joint hypermobility associated with the extremities and restore balance and functionality to the body (Luan et al., 2023). This means that if a person is dealing with stiffness and muscle pain from joint hypermobility, acupuncture can help rewire the pain by placing the needles in the body’s acupoints to provide relief.
Physical Therapy
Physical therapy is the last non-surgical treatment many people can incorporate into their daily routine. Physical therapy can help manage joint hypermobility that are tailored to help strengthen weak muscles that are surrounding the affected joints, improving a person’s stability and helping reduce the risk of dislocation. Additionally, many individuals can use low-impact exercise to ensure optimal motor control when doing regular exercises without putting excessive strain on the joints. (Russek et al., 2022)
By incorporating these three non-surgical treatments as part of a customized treatment for joint hypermobility, many individuals will begin to feel a difference in their balance. They will not experience joint pain by being more mindful of the body and incorporating small changes in their routine. Even though living with joint hypermobility can be a challenge for many individuals, by integrating and utilizing the right combination of non-surgical treatments, many can begin to lead active and fulfilling lives.
References
Atwell, K., Michael, W., Dubey, J., James, S., Martonffy, A., Anderson, S., Rudin, N., & Schrager, S. (2021). Diagnosis and Management of Hypermobility Spectrum Disorders in Primary Care. J Am Board Fam Med, 34(4), 838-848. doi.org/10.3122/jabfm.2021.04.200374
Boudreau, P. A., Steiman, I., & Mior, S. (2020). Clinical management of benign joint hypermobility syndrome: a case series. J Can Chiropr Assoc, 64(1), 43-54. www.ncbi.nlm.nih.gov/pubmed/32476667
Carbonell-Bobadilla, N., Rodriguez-Alvarez, A. A., Rojas-Garcia, G., Barragan-Garfias, J. A., Orrantia-Vertiz, M., & Rodriguez-Romo, R. (2020). [Joint hypermobility syndrome]. Acta Ortop Mex, 34(6), 441-449. www.ncbi.nlm.nih.gov/pubmed/34020527 (Sindrome de hipermovilidad articular.)
Luan, L., Zhu, M., Adams, R., Witchalls, J., Pranata, A., & Han, J. (2023). Effects of acupuncture or similar needling therapy on pain, proprioception, balance, and self-reported function in individuals with chronic ankle instability: A systematic review and meta-analysis. Complement Ther Med, 77, 102983. doi.org/10.1016/j.ctim.2023.102983
Nicholson, L. L., Simmonds, J., Pacey, V., De Wandele, I., Rombaut, L., Williams, C. M., & Chan, C. (2022). International Perspectives on Joint Hypermobility: A Synthesis of Current Science to Guide Clinical and Research Directions. J Clin Rheumatol, 28(6), 314-320. doi.org/10.1097/RHU.0000000000001864
Russek, L. N., Block, N. P., Byrne, E., Chalela, S., Chan, C., Comerford, M., Frost, N., Hennessey, S., McCarthy, A., Nicholson, L. L., Parry, J., Simmonds, J., Stott, P. J., Thomas, L., Treleaven, J., Wagner, W., & Hakim, A. (2022). Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations. Front Med (Lausanne), 9, 1072764. doi.org/10.3389/fmed.2022.1072764
Tofts, L. J., Simmonds, J., Schwartz, S. B., Richheimer, R. M., O’Connor, C., Elias, E., Engelbert, R., Cleary, K., Tinkle, B. T., Kline, A. D., Hakim, A. J., van Rossum, M. A. J., & Pacey, V. (2023). Pediatric joint hypermobility: a diagnostic framework and narrative review. Orphanet J Rare Dis, 18(1), 104. doi.org/10.1186/s13023-023-02717-2
For individuals looking to improve their spinal health, can understanding the anatomy of the intervertebral foramen help in injury rehabilitation and prevention?
Intervertebral Foramen
The intervertebral foramen, aka neural foramen, is the opening between the vertebrae through which spinal nerve roots connect and exit to other body areas. If the foramina narrows, it can place added pressure on the nerve roots near and around them, causing pain symptoms and sensations. This is known as neuroforaminal stenosis. (Sumihisa Orita et al., 2016)
Anatomy
The vertebrae comprise the spinal column.
They protect and support the spinal cord and most of the weight placed on the spine.
Foramen is the singular form, and foramina is the plural form.
Structure
The body is the large, round part of the bone that makes up each vertebra.
The body of each vertebra is attached to a bony ring.
Stenosis can occur in the spinal canal, known as central canal stenosis, and the foramina.
Pain brought on by neuroforaminal spinal stenosis and arthritis-related bone growth/bone spurs/osteophytes that are present in one or more foramen rub against the nerve root that passes through the space, causing radicular pain.
Pain accompanied by other sensations, like tingling or numbness, is known as radiculopathy. (Young Kook Choi, 2019)
The main symptom is pain.
Numbness and/or tingling can present depending on the injury.
Neurogenic claudication occurs as a result of ischemia or a lack of blood circulation to the nerves and typically presents with a heaviness in the legs.
It is typically associated with central stenosis rather than foraminal stenosis.
Most individuals with spinal stenosis feel better when flexing or bending forward and worse when arching their backs.
Stenosis treatment aims to relieve pain and prevent nerve symptoms from occurring or worsening. Conservative treatments are recommended and can be highly effective.
These include:
Myelopathy in the neck and/or upper or mid-back (myelopathy symptoms are spinal cord related and occur in central canal stenosis) (Cleveland Clinic. 2021)
Intense incapacitating pain
Different surgical techniques include:
Decompression laminectomy – entails removing the buildup of bone in the spinal canal.
Spinal fusion – when there is instability of the spine or severe foraminal stenosis.
Orita, S., Inage, K., Eguchi, Y., Kubota, G., Aoki, Y., Nakamura, J., Matsuura, Y., Furuya, T., Koda, M., & Ohtori, S. (2016). Lumbar foraminal stenosis, the hidden stenosis including at L5/S1. European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 26(7), 685–693. doi.org/10.1007/s00590-016-1806-7
Choi Y. K. (2019). Lumbar foraminal neuropathy: an update on non-surgical management. The Korean journal of pain, 32(3), 147–159. doi.org/10.3344/kjp.2019.32.3.147
Lee, S. Y., Kim, T. H., Oh, J. K., Lee, S. J., & Park, M. S. (2015). Lumbar Stenosis: A Recent Update by Review of Literature. Asian spine journal, 9(5), 818–828. doi.org/10.4184/asj.2015.9.5.818
Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. doi.org/10.1136/bmj.h6234
Can working individuals dealing with degenerative pain syndrome incorporate decompression to provide body relief and mobility?
Introduction
As part of the musculoskeletal system, the spine allows the body to stand vertically and helps protect the spinal cord from injuries. Since the central nervous system provides neuron signals from the brain to the nerve roots, the human body can be mobile without pain or discomfort. This is due to the spinal discs between the facet joints, which can be compressed, absorb the vertical axial pressure, and help distribute the weight to the lower and upper extremity muscles. However, as many people realize, repetitive movements and wear and tear on the spinal structure can lead to overlapping risk profiles that can cause the spinal disc to degenerate and invoke pain in the musculoskeletal system. To that point, it can cause the individual to be in extreme pain and discomfort over time. Today’s article looks at how degenerative pain syndrome affects the spine, the symptoms it’s associated with, and how decompression can reduce degenerative pain syndrome. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve degenerative pain syndrome that is causing mobility issues on the spine. We also inform and guide patients on how decompression can help reduce the pain-like symptoms correlating with degenerative pain syndrome. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from degenerative pain that is affecting their quality of life. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.
Degenerative Pain Syndrome On The Spine
Do you feel muscle aches or pains in your back after an extended period of lying down, sitting, or standing? Do you feel constant pain after carrying a heavy object from one location to another? Or does twisting or turning your torso provide temporary relief? Many people often don’t realize that many of these pain-like issues are associated with degenerative pain syndrome that affects the spine. Since the body ages naturally, the spine does as well through degeneration. When the spinal discs start to degenerate, it can cause the vertical axial pressure to flatten and squeeze the disc, disrupting its ability to keep hydrated and causing it to protrude out of its original position. At the same time, the height of the spinal disc will gradually fall, and the consequence is a change in dynamics in the affected spine segments. (Kos et al., 2019) Degeneration can cascade down to the surrounding ligaments, muscles, and joints when degeneration starts to affect the spine.
The Symptoms Associated With Degenerative Pain
When the surrounding joints, muscles, and ligaments are affected by degenerative disc pain, it can be due to multiple factors contributing to the pain-like symptoms. Inflammation is one of the symptoms that are associated with degenerative pain syndrome, as disturbances can affect the circadian rhythm and disrupt homeostasis, which then leads to increased stress on the spinal disc, which then contributes to the degenerative process. (Chao-Yang et al., 2021) Inflammation can cause the affected muscles to be inflamed and cause more overlapping risk profiles, as it can affect the upper and lower extremities. Additionally, mechanical loading may affect disc degeneration in various ways at the different vertebral levels. (Salo et al., 2022) This can lead to pain-like symptoms like:
Arm and leg tenderness
Nerve pain
Loss of sensory functions on the upper and lower extremities
Tingling sensations
Muscle pain
However, numerous treatments can help restore spinal mobility and lessen the painful effects of the degenerative pain syndrome of the spine.
The Non-Surgical Approach To Wellness- Video
When it comes to seeking treatment for degenerative pain syndrome, many individuals will do research on which treatment is affordable for their pain, hence why many people opt for non-surgical treatment to alleviate their pain. Non-surgical treatments are customized to the individual’s pain. They can help kickstart the person’s wellness journey, which can include a combination of exercise, manual therapy, and lifestyle modifications. (Brogger et al., 2018) The video above shows how a non-surgical approach can benefit someone with degenerative pain syndrome affecting their spine.
Decompression Reducing Degenerative Pain Syndrome
With many available treatments to reduce pain-like symptoms affecting the spine, non-surgical treatments can be an option. Ranging from chiropractic care to acupuncture, non-surgical treatments can be combined to minimize the pain-like effects. Decompression, as part of the non-surgical treatment options, is an excellent way to reduce the degenerative pain process in the spine. Decompression allows the spinal column to be gently pulled through a traction machine to relieve the spinal disc. When a traction machine decomposes the spine, the pain intensity is significantly reduced in all body parts. (Ljunggren et al., 1984) This is due to negative pressure being reinstated back to the spine to increase disc height and restore the nutrients back to the affected disc and rehydrate them. (Choi et al., 2022) When people start incorporating decompression through consecutive treatment, their pain intensity is reduced, and their spine is mobile again while slowing down the degenerative process on the spine. This allows them to take better care of their bodies by making small changes in their health and wellness.
References
Brogger, H. A., Maribo, T., Christensen, R., & Schiottz-Christensen, B. (2018). Comparative effectiveness and prognostic factors for outcome of surgical and non-surgical management of lumbar spinal stenosis in an elderly population: protocol for an observational study. BMJ Open, 8(12), e024949. doi.org/10.1136/bmjopen-2018-024949
Chao-Yang, G., Peng, C., & Hai-Hong, Z. (2021). Roles of NLRP3 inflammasome in intervertebral disc degeneration. Osteoarthritis Cartilage, 29(6), 793-801. doi.org/10.1016/j.joca.2021.02.204
Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P.-B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 1-9. doi.org/10.1155/2022/6343837
Kos, N., Gradisnik, L., & Velnar, T. (2019). A Brief Review of the Degenerative Intervertebral Disc Disease. Med Arch, 73(6), 421-424. doi.org/10.5455/medarh.2019.73.421-424
Ljunggren, A. E., Weber, H., & Larsen, S. (1984). Autotraction versus manual traction in patients with prolapsed lumbar intervertebral discs. Scand J Rehabil Med, 16(3), 117-124. www.ncbi.nlm.nih.gov/pubmed/6494835
Salo, S., Hurri, H., Rikkonen, T., Sund, R., Kroger, H., & Sirola, J. (2022). Association between severe lumbar disc degeneration and self-reported occupational physical loading. J Occup Health, 64(1), e12316. doi.org/10.1002/1348-9585.12316
Can individuals dealing with neck and back pain find the relief they need from the effects of spinal decompression therapy?
Introduction
Across the world, many individuals deal with neck or back pain from excessive sitting or standing, poor posture, or lifting heavy objects that cause their spine and muscles to ache constantly. Since the body is in constant movement, the spine is being compressed through repetitive movement that can cause the spinal discs to pop out of their original position and aggravate the surrounding nerves to cause pain-like symptoms in the neck and back regions. Many people start to complain about their necks and backs hurting and feeling referred pain in different locations in the upper and lower body portions. This can range from acute to chronic, depending on the severity of the pain. When people are experiencing these musculoskeletal pain disorders in their bodies, many will seek treatment to alleviate the pain in their necks and backs to return to their daily routines. Hence why, treatments like spinal decompression can have a positive effect on providing the relief that many individuals deserve. Today’s article looks at why the neck and back in the human body are the most common pain areas many people endure and how spinal decompression can reduce neck and back pain. We speak with certified medical providers who incorporate our patients’ information to provide various techniques to relieve neck and back pain from the body. We also inform patients how treatments like decompression can reduce musculoskeletal pain disorders from the neck and back. We encourage our patients to ask intricated questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with their neck and back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.
Why Are The Neck & Back Common Pain Areas?
Do you feel muscle tension in your neck after being hunched on the computer or your phone for a long time? Do you feel aches and pains in your back after carrying or lifting a heavy object? Or do you feel tingling or numbness in your arms or legs? Many of these pain-like symptoms are often correlated with neck and back pain that can be a nuisance to many individuals. So why is it that the neck and back of the human body are the most common pain areas that many people worldwide endure? Many people with highly demanding jobs often perform normal movements repetitively, which causes stress on the surrounding muscles, ligaments, and joints, and the accessory muscles will begin to be overworked and tight. Neck and back pain are amongst the most common symptom-related complaints that contribute to high levels of lost workdays, disability, and health care use. (Corwell & Davis, 2020) This causes many individuals to have unwanted socio-economic stress when they visit their primary care doctors. Additionally, neck and back pain are non-neurologic causes in the musculoskeletal system; these can generate pain in the muscles, tendons, ligaments, spinal discs, articular cartilage, and bone. (Meleger & Krivickas, 2007) To that point, when neck and back pain are not treated right away, it can lead to correlating pain symptoms that can lead to a life of disability. Since the spine has multiple structures, from the neck to the lower back, when a person is in pain, it can lead to various pain generators that can cause some visceral pain. (Patel et al., 2015) Hence why, neck and back pain are multi-factorial and lead to numerous disorders.
When it comes to reducing neck and back pain from the body, many individuals will seek medical treatment to relieve themselves from the pain. However, many primary care doctors will assess their patients to determine what the root cause of their pain by taking notes of their daily routine. Many normal causes of neck and back pain can be due to:
Poor Posture
Stress
Physical Inactivity
Trauma/Injuries
Excessive sitting/standing
Lifting/carrying heavy objects
These causes can lead to a life of disability and affect a person’s quality of life; however, luckily, many individuals have researched and looked for treatment that is cost-effective and can help reduce the pain they are experiencing.
Understanding Academic Low Back Pain- Video
Do you feel aches and pains in your neck and back? Do you feel stress in your muscles that cause you to feel miserable? Or do you feel pain in your upper or lower body portions affecting your daily routine? Many of these scenarios correlate with neck and back pain, a common issue many individuals experience. If not treated right away, it can lead to a life of disability and, for working individuals, lose a day of work. However, many individuals seek cost-effective treatments that can help reduce the pain affecting their necks and back. Treatments like chiropractic care, traction therapy, massage therapy, and spinal decompression are all non-surgical, affordable, and can help reduce pain-like symptoms associated with neck and back pain. The video above explains the causes of academic low back pain and how non-surgical treatments like chiropractic care can work with additional therapies to prevent back and neck pain from returning. At the same time, when individuals begin to reduce their workload and educate themselves on what to do to avoid neck and back pain from returning, they can start feeling better. (Tyrdal et al., 2022)
The Effects Of Decompression On Neck & Back Pain
As part of the non-surgical treatments, spinal decompression can help many individuals dealing with neck and back pain. What spinal decompression does is incorporate gentle traction on the spine to decompress the affected spinal disc that can be associated with neck and back pain. When the spine is being treated with spinal decompression, the gravitational traction pull helps produce a greater disc space on the spine to decrease intradiscal pressure and pain. (Vanti et al., 2021) This allows all the nutrients and fluids to return to the spine and spinal discs while promoting the body’s natural healing process.
Additionally, many individuals with neck and back pain will begin to notice a huge reduction in their pain and disability through consecutive treatment. (Vanti et al., 2023) By incorporating healthy habits to reduce the chances of neck and back pain from returning, many individuals can make small changes to their daily routine. This allows them to have a positive outlook and continue their health and wellness journey.
References
Corwell, B. N., & Davis, N. L. (2020). The Emergent Evaluation and Treatment of Neck and Back Pain. Emerg Med Clin North Am, 38(1), 167-191. doi.org/10.1016/j.emc.2019.09.007
Meleger, A. L., & Krivickas, L. S. (2007). Neck and back pain: musculoskeletal disorders. Neurol Clin, 25(2), 419-438. doi.org/10.1016/j.ncl.2007.01.006
Patel, V. B., Wasserman, R., & Imani, F. (2015). Interventional Therapies for Chronic Low Back Pain: A Focused Review (Efficacy and Outcomes). Anesth Pain Med, 5(4), e29716. doi.org/10.5812/aapm.29716
Tyrdal, M. K., Veierod, M. B., Roe, C., Natvig, B., Wahl, A. K., & Stendal Robinson, H. (2022). Neck and back pain: Differences between patients treated in primary and specialist health care. J Rehabil Med, 54, jrm00300. doi.org/10.2340/jrm.v54.363
Vanti, C., Saccardo, K., Panizzolo, A., Turone, L., Guccione, A. A., & Pillastrini, P. (2023). The effects of the addition of mechanical traction to physical therapy on low back pain? A systematic review with meta-analysis. Acta Orthop Traumatol Turc, 57(1), 3-16. doi.org/10.5152/j.aott.2023.21323
Vanti, C., Turone, L., Panizzolo, A., Guccione, A. A., Bertozzi, L., & Pillastrini, P. (2021). Vertical traction for lumbar radiculopathy: a systematic review. Arch Physiother, 11(1), 7. doi.org/10.1186/s40945-021-00102-5
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