Back Clinic Chiropractic Spine Care Team. The spine is designed with three natural curves; the neck curvature or cervical spine, the upper back curvature or thoracic spine, and the lower back curvature or lumbar spine, all of which come together to form a slight shape when viewed from the side. The spine is an essential structure as it helps support the upright posture of humans, it provides the body with the flexibility to move and it plays the crucial role of protecting the spinal cord. Spinal health is important in order to ensure the body is functioning to its fullest capacity. Dr. Alex Jimenez strongly indicates across his collection of articles on spine care, how to properly support a healthy spine. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
Can individuals dealing with scoliosis incorporate various exercises and stretches to improve their posture and reduce pain?
What Is Scoliosis?
More often than anything, many people have tried to maintain proper posture to prevent musculoskeletal and spinal conditions from forming. However, it can be difficult to maintain an appropriate posture when strenuous environmental factors come into play. This can range from being in a hunched position to developing spinal conditions that can affect the curvature of the spine. One of the most well-known spinal conditions many people can develop through numerous risk factors is spinal scoliosis. Spinal scoliosis is often defined as a curvature deviation in the normal vertical spinal line. (Janicki & Alman, 2007) This causes the spine to develop an S or C curve in the thoracic or lumbar portion of the spine, leading to overlapping risk profiles in the body and causing pain-like symptoms that can make a person feel miserable. Today’s article looks at scoliosis, how it affects the body, and how various exercises can help manage scoliosis. We discuss with certified medical providers who inform our patients how non-surgical treatments, like various exercises, help manage symptoms associated with scoliosis. While asking informed questions to our associated medical providers, we advise patients to include various exercises and pain management techniques to reduce pain-like symptoms correlating with scoliosis. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.
How Does It Affect The Body?
Since scoliosis is a spinal deformity condition that affects the spine, it can happen at any age and is categorized into four group forms:
Congenital (Presented by birth)
Neuromuscular (Resulted from cerebral palsy or muscular dystrophy)
Idiopathic (The common spinal condition)
Degenerative (Adult-onset scoliosis)
Within these four groups of scoliosis, some of the pain-like symptoms can vary depending on the size of the curve and how far the progression leads to overlapping risk profiles in the thoracic and lumbar spine portions. (Aebi, 2005) Some of the symptoms that are associated with scoliosis are back pain. Many individuals with scoliosis, especially adolescent individuals, have back pain associated with adolescent idiopathic scoliosis due to increasing age, injuries, and how severe the spine is curved. (Achar & Yamanaka, 2020) Additional symptoms that many individuals experience with scoliosis that can affect their bodies have specific features that cause pain. Individuals with scoliosis often have increasing asymmetrical pain when standing for prolonged periods and residing at rest, thus mimicking sciatica pain. (Zaina et al., 2023) This is because pain is one of the biomarkers for scoliosis. When pain starts to affect the body, issues like muscle dysfunction, concave disc pressure, asymmetrical facet joint strains, and a high BMI (body mass index) become the main mechanical parameters in the body. They are assessed by doctors when being examined. (Ilharreborde et al., 2023) When individuals are being assessed by their doctors to manage scoliosis, non-surgical treatments can help manage the pain-like symptoms and restore joint stability and mobility to the body.
Movement Medicine: Chiropractic Care- Video
Various Exercises For Managing Scoliosis
When many individuals dealing with scoliosis go in for non-surgical treatments, they will be assessed and evaluated by pain specialists to determine what the next steps for treatment can be provided for them. For scoliosis, non-surgical treatments like chiropractic care can be provided to reduce the musculoskeletal conditions associated with scoliosis. Chiropractors utilize mechanical and manual spinal manipulation of the spine. They can set the vertebra back in place while restoring the spinal joint with optimal motion, improving the range of motion, and allowing the body to function properly. (Milne et al., 2022) At the same time, chiropractors can recommend various exercises and stretches to help manage symptoms associated with scoliosis as part of their treatment plan. Incorporating various exercises can help rectify spinal deformity, help the different muscle groups become stronger, and allow the individual to work a bit on managing scoliosis symptoms. Below are some of the various exercises and stretches to manage scoliosis.
Practicing Good Posture
Practicing good posture can benefit many individuals with scoliosis, especially young ones. Many people realize that maintaining good posture can help reduce muscle pain and tension in the back. It allows many people to realign their bodies and retrain them to stand with good posture naturally. Maintaining good posture, whether standing or seated, can allow doctors to scan the body for any tension signs. For those with scoliosis, it can gradually strengthen the weak core muscles in their bodies.
Abdominal Presses
Abdominal presses allow the individual to maintain neutral spinal alignment while strengthening the abdominal core muscles. To do this:
Individuals must lie on their backs on a yoga mat, keeping their backs in a neutral, tension-free position with bent knees.
They raise both feet and thighs off the mat to form a 90-degree angle with their knees above the hips. *They can support themselves with a chair or wall.
Next, individuals can use their hands to push and pull the knees with their abdominal muscles.
When doing this static exercise, make sure that they hold for three full breaths in two sets of ten and relax in between.
Bird-Dog
Bird-dog is a yoga move that can help stretch tight and weak muscles in the back and allow the body to balance itself. To do this:
Individuals can be on their hands and knees with a neutral spine position on a yoga mat, ensuring their hands are under their shoulders and their knees are under their hips.
With controlled breathing, extend one arm straight out while extending the opposite leg back.
Maintain the position for five to thirty seconds, andslowly return to the neutral spine.
Repeat the motion with the opposite for 10 to 15 reps.
Incorporating these exercises can help manage pain-like symptoms associated with scoliosis, help many individuals strengthen their weak muscles, and help improve their posture on their health and wellness journey.
References
Achar, S., & Yamanaka, J. (2020). Back Pain in Children and Adolescents. American Family Physician, 102(1), 19-28. www.ncbi.nlm.nih.gov/pubmed/32603067
Ilharreborde, B., Simon, A. L., Shadi, M., & Kotwicki, T. (2023). Is scoliosis a source of pain? J Child Orthop, 17(6), 527-534. doi.org/10.1177/18632521231215861
Janicki, J. A., & Alman, B. (2007). Scoliosis: Review of diagnosis and treatment. Paediatr Child Health, 12(9), 771-776. doi.org/10.1093/pch/12.9.771
Milne, N., Longeri, L., Patel, A., Pool, J., Olson, K., Basson, A., & Gross, A. R. (2022). Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review. BMC Pediatr, 22(1), 721. doi.org/10.1186/s12887-022-03781-6
Zaina, F., Marchese, R., Donzelli, S., Cordani, C., Pulici, C., McAviney, J., & Negrini, S. (2023). Current Knowledge on the Different Characteristics of Back Pain in Adults with and without Scoliosis: A Systematic Review. J Clin Med, 12(16). doi.org/10.3390/jcm12165182
Can cervical retraction be a good addition to a home exercise program for individuals with neck pain, spinal arthritis, or needing to strengthen their neck muscles?
Cervical Retraction
Cervical retraction is a neck exercise that involves gently sliding the head backward while keeping the chin tucked. It can help with:
Neck pain
Stretching and loosening the muscles at the back of the neck.
Headaches
Tightness
Improve posture
Improve flexibility and mobility
Preparation
Basic steps for performing a cervical retraction exercise:
Sit upright with good posture.
Tuck your chin as far as you can comfortably.
Look up while keeping your chin tucked.
Rotate the neck 1-2 inches to each side.
Return to the starting position.
Stop the exercise if you experience pain.
You want to get good at this without loading the joints while learning the movement. Gently and accurately moving your head in alignment with the neck will help you find the correct head action as it moves. Then, it can be performed as a full exercise. Performing the movement correctly requires focus. This is why cervical retraction is done while sitting in a chair with proper posture. Individuals can also stand, but it is more complicated for the body to coordinate than sitting, but it can be done once the individual has practiced.
Sitting or Standing
Gently tuck your chin down toward your neck.
The focus is alignment.
Keeping your chin where it is, press your head back.
There will be soreness, especially for those with pain symptoms, but the neck should feel better.
Be mindful of any intense or severe pain resulting from cervical retraction.
Individuals with cervical spondylosis (neck arthritis) stop if pain presents. (Cleveland Clinic, 2023)
Other Neck Exercises
Another good neck-strengthening exercise is the isometric neck press. In this exercise, you move your head forward, backward, and to each side while your hand provides resistance. This develops flexibility and is recommended for those with arthritis in this area. (Sadeghi, A. et al., 2022) Other exercises include: (Pain Consultants of West Florida, 2019)
Neck extensions: Backward bending can help relieve nerve compression and ease the strain on the cervical spine.
Side rotation: This exercise can improve neck mobility.
Shoulder rolls: This exercise can help keep the neck and shoulder joints fluid.
Injury Medical Chiropractic and Functional Medicine Clinic
If you have a neck condition or radiculopathy that causes pain or other symptoms going down the arm or are unsure how to do it, check with a healthcare provider or physical therapist before trying the exercise. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Sadeghi, A., Rostami, M., Ameri, S., Karimi Moghaddam, A., Karimi Moghaddam, Z., & Zeraatchi, A. (2022). Effectiveness of isometric exercises on disability and pain of cervical spondylosis: a randomized controlled trial. BMC sports science, medicine & rehabilitation, 14(1), 108. doi.org/10.1186/s13102-022-00500-7
For individuals trying to retrain their body movements for back health improvement, what is the spinal area that helps the body twist, bend, and stand upright?
Lumbosacral Joint L5-S1
The L5-S1, also called the lumbosacral joint, is a term used to describe a part of the spine. It is where the lumbar spine ends and the sacral spine begins, and it connects these bones. The lumbosacral joint is also susceptible to misalignment and injury, such as disc herniation or a spinal disorder called spondylolisthesis.
The spinal column is the structure that allows the body to stand upright and helps you twist, bend, and alter trunk and neck position. Typically, 24 movable bones in the spine connect to the sacrum and the coccyx, or the tailbone. The sacrum and the coccyx each have multiple bones that fuse over time. L5-S1 consists of the last bone in the lumbar spine, called L5, and the triangle-shaped bone under it, known as the sacrum. S1 is at the top of the sacrum and comprises five fused bones.
Risk of Injury
Each area of the spine has a curve that goes in opposite directions. The places where the spinal curve directions change are junctional levels. The risk of injuries may be higher at junctional levels because the body weight shifts direction as the curves shift. The L5-S1 junction is located between the lumbar curve and the sacral curve. The lumbar curve sweeps forward, and the sacral curve goes backward.
The lumbosacral joint L5-S1 junction is highly vulnerable to misalignment, wear and tear, and injury. This is because the top of the sacrum is positioned at an angle for most individuals. Aging and injury increase the vulnerability of the L5-S1 junction even more. Pain coming from L5-S1 is usually treated with:
Heat and/or ice
Over-the-counter anti-inflammatory medications
Prescription pain medications
Muscle relaxers
Physical therapy
Chiropractic adjustments
Epidural steroid injections
If these therapies do not help, surgery may be recommended. L5-S1 is one of the two most common sites for back surgery.
Conditions
Disc herniation at L5-S1 is a common injury and cause of sciatica, which can cause pain and other issues (MedlinePlus, 2024). The L5-S1 junction is often the site of a condition known as spondylolisthesis.
Disc Herniation
Discs separate the vertebrae, cushioning the spinal column and allowing movement between vertebrae. A disc herniation means the disc slips out of place. (MedlinePlus, 2022) A disc herniation at L5-S1 is a common cause of sciatica. Symptoms of sciatica include:
Burning
Numbness
Pain or tingling that radiates from the buttock down the leg to the knee or foot.
Disc herniation can also cause chronic back pain and stiffness and trigger painful muscle spasms. Bowel problems are also possible with disc issues at L5-S1. Research links irritable bowel syndrome to herniated discs in the lower back. (Bertilson BC, Heidermakr A, Stockhaus M. 2015) Additional studies found disc problems at L5-S1 can lead to difficulty with sphincter control. (Akca N. et al., 2014) Initial treatments for disc herniation include rest and pain relievers to reduce inflammation and swelling, then physical therapy. Most recover with conservative interventions, and those who don’t may require a steroid injection or surgery. (MedlinePlus, 2022)
Spondylolisthesis
Spondylolisthesis occurs when a vertebra slips forward relative to the bone below it. The most common form of this condition is degenerative spondylolisthesis, which generally begins when the spine wears down with age. Isthmic spondylolisthesis is another common variation and starts as a tiny fracture in the pars interarticularis, a bone that connects the adjoining parts of the facet joint. (American Academy of Orthopaedic Surgeons, 2020) These fractures often occur before age 15, but symptoms do not develop until adulthood. Degeneration of the spine in later adulthood can further worsen the condition.
The angle of the sacrum can also contribute to spondylolisthesis. This is because the S1 tips down in the front and up in the back rather than being horizontal. Individuals with a greater tilt are usually at a higher risk of spondylolisthesis. (Gong S. et al., 2019) However, individuals with spondylolisthesis may not have any symptoms. Those who do may experience: (American Academy of Orthopaedic Surgeons, 2020)
Back stiffness
Standing difficulties
Walking difficulties
Lower back pain
Hamstring tightness
Spondylolisthesis is typically treated with non-surgical interventions that can include:
Pain medications
Heat and/or ice application
Physical therapy
Epidural steroid injections
Usually, non-surgical care is tried for at least six months. If pain and symptoms persist, surgery may be an option. Spinal fusion surgery can be effective but requires a long recovery time and can have additional risks.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Bertilson, B. C., Heidermark, A., & Stockhaus, M. (2015). Irritable Bowel Syndrome–a Neurological Spine Problem. Journal of Advances in Medicine and Medical Research, 4(24), 4154–4168. doi.org/10.9734/BJMMR/2014/9746
Akca, N., Ozdemir, B., Kanat, A., Batcik, O. E., Yazar, U., & Zorba, O. U. (2014). Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness. Journal of craniovertebral junction & spine, 5(4), 146–150. doi.org/10.4103/0974-8237.147076
Gong, S., Hou, Q., Chu, Y., Huang, X., Yang, W., & Wang, Z. (2019). Anatomical factors and pathological parts of isthmic fissure and degenerative lumbar spondylolisthesis.
Can individuals dealing with joint pain incorporate turmeric as part of their treatment to reduce inflammation and restore joint health?
Introduction
Many people realize that when the body ages, so do the bones, joints, and spinal discs. This causes musculoskeletal issues to develop and lead to joint pain. Many environmental factors, like improper posture, injuries, accidents, and heavy-loaded objects, are pain-like issues that can affect an individual’s health and well-being. This is because joint pain is associated with these environmental factors, which cause pain and inflammatory effects that can impact their well-being. Additionally, many people will try to find ways to reduce the inflammatory effects caused by joint pain, and one of them is found in their kitchen pantry, which is known as turmeric. Today’s article focuses on the connection between the joints and inflammation, what is turmeric, and its beneficial properties for the joints. We talk with certified associated medical providers who inform our patients about how adding turmeric to their daily routine can reduce the inflammatory effects on the joints. While asking associated medical providers intricate questions, we advise patients to incorporate turmeric in their meals and find therapeutic ways to reduce joint pain in their upper and lower extremities. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
Joint Pain & Inflammation Connection
Do you feel localized or referred pain in your joints that causes you to rest for an extended period? Do general morning aches and pains get better throughout the day? Or do you notice that you are losing your grip occasionally? Many of these scenarios are correlated with joint pain. The joints are part of the musculoskeletal system, and their primary job is to provide movement to the upper and lower extremities without pain. However, when the human body ages, the joints also gradually age. When the joints start to lose their cartilage, environmental factors can cause pain-like symptoms like inflammation to affect the joints, thus causing pain, stiffness, and inflammation. Additionally, it can also lead to joint disorders in the body. While inflammation helps heal the affected area in the body, it is beneficial for the natural healing process; however, when inflammation is chronic, it can do more harm than good.
This is because the immune cells are involved in neuroimmune interplay, which plays a key role in generating and maintaining pain in diseases with an inflammatory component. (Vasconcelos et al., 2022) Additionally, when environmental factors start to affect the joints, the inflammatory effects can cause peripheral nerve damage, and that can cause structural damage to the joints, leading to altered gait and abnormal loading patterns through movement. (McDougall & Reid, 2022) When individuals experience inflammatory effects that affect their joints, many will try to find ways to reduce the pain-like effects in their joints.
Fighting Inflammation Naturally-Video
What Is Turmeric?
Many individuals dealing with pain and inflammation in their joints will seek out therapeutic options to restore joint health. Many people can incorporate anti-inflammatory supplements and treatments to reduce joint inflammation. Turmeric is one of the anti-inflammatory supplements found in India and Southern Asia; anti-inflammatory components can help treat a wide variety of conditions and general health and wellness. (“Turmeric,” 2012) Turmeric is also a functional food due to its health-promoting properties that can help decrease inflammatory cytokines and reduce joint pain, which can help improve joint mobility. (Kepinska-Pacelik & Biel, 2023)
Turmeric’s Beneficial Properties For The Joints
Now, when it comes to the beneficial properties of turmeric for joint pain, many people can take turmeric in supplement form and, over time, will begin to notice less pain in their joints. This is because the main purpose of incorporating turmeric as part of a therapeutic routine is to relieve pain, delay joint degeneration progression, and restore joint function. (Zeng et al., 2021) Additionally, turmeric can help control inflammation and improve joint health since it can have a positive effect or equivalency of anti-inflammatory medication for individuals wanting to reduce joint pain’s life effects. (Panknin et al., 2023) When people want to think about their well-being and joint health, taking turmeric supplements or incorporating them in dishes can be a stepping stone to improving joint function. At the same time, incorporating strength training exercises into the surrounding muscles can help with joint improvement, and non-surgical treatments like chiropractic care can help reduce the inflammatory effects of degenerating the joints. This, in turn, can help people live pain-free lives, giving them a sense of control over their well-being.
References
Kepinska-Pacelik, J., & Biel, W. (2023). Turmeric and Curcumin-Health-Promoting Properties in Humans versus Dogs. Int J Mol Sci, 24(19). doi.org/10.3390/ijms241914561
McDougall, J. J., & Reid, A. R. (2022). Joint Damage and Neuropathic Pain in Rats Treated With Lysophosphatidic Acid. Front Immunol, 13, 811402. doi.org/10.3389/fimmu.2022.811402
Panknin, T. M., Howe, C. L., Hauer, M., Bucchireddigari, B., Rossi, A. M., & Funk, J. L. (2023). Curcumin Supplementation and Human Disease: A Scoping Review of Clinical Trials. Int J Mol Sci, 24(5). doi.org/10.3390/ijms24054476
Vasconcelos, D. P., Jabangwe, C., Lamghari, M., & Alves, C. J. (2022). The Neuroimmune Interplay in Joint Pain: The Role of Macrophages. Front Immunol, 13, 812962. doi.org/10.3389/fimmu.2022.812962
Zeng, L., Yu, G., Hao, W., Yang, K., & Chen, H. (2021). The efficacy and safety of Curcuma longa extract and curcumin supplements on osteoarthritis: a systematic review and meta-analysis. Biosci Rep, 41(6). doi.org/10.1042/BSR20210817
Incorrect manual handling and lifting is a leading cause of workplace injuries. Can health and safety training help reduce injuries and lost workdays?
Correct Manual Lifting Technique
Manually lifting objects using incorrect techniques can lead to acute back injuries, herniated discs, sciatica, and long-term issues like increased risk of reinjury, body misalignment, and chronic back pain. Individuals can prevent spinal disc compression and/or lower back muscle strain by learning to use correct manual lifting techniques. (CDC. The National Institute for Occupational Safety and Health (NIOSH). 2007)
Lifting Guide
Individuals can protect their backs and prevent injury by following simple steps when lifting objects.
Support Base
Ensure there is a healthy support base from which to lift.
Keep feet shoulder-width apart with one foot slightly in front of the other.
Ask For Help
If coworkers or colleagues are available, ask for assistance.
If the load is too heavy, ask for help lifting and moving the object/s.
Use Mechanical Assistant Devices
Use hand trucks, dollies, or pushcarts whenever possible for uneven and heavy loads.
Squat To Lift Object
Bend at the hips and knees only, not the back.
Put one knee on the ground to ensure stability before lifting.
Check Posture
Looking straight ahead, maintain posture upright with the chest out, shoulders back, and lower back slightly arched.
Lift Slowly
Lift with the knees and hips only, gradually straightening the lower back.
Load Positioning
Once upright, hold the load close to the body around the stomach.
Move and Maintain Alertness
Always take small steps.
Maintain alertness as to where you are going.
Keep the shoulders square with the hips when changing directions to avoid twisting and losing or shifting balance.
Rest
If you are fatigued, set the load/object down and rest for a few minutes until you can fully engage in the task.
Squat To Set Object Down
Squat with the knees and hips and set the load down slowly.
Avoid quickly rising and jerking movements, and allow the legs, hips, and back muscles to reset.
Planning and Tips
Lifting anything heavy takes planning to prevent muscle spasms, back strain, and other musculoskeletal injuries. Considerations to keep in mind:
Make a Plan Before Lifting
Knowing what object/s are being lifted and where they are going will prevent individuals from making awkward movements while holding and carrying something heavy.
Set and clear a path.
If lifting something with another person, ensure both agree and understand the plan.
Lift Close to The Body
Individuals are stronger and more stable lifters if the object is held close to their body rather than at the end of their reach.
Make sure there is a firm hold on the object.
It is easier to maintain balance close to the body.
Maintain Feet Shoulder-Width Apart
Keep the feet about shoulder-width apart.
Having a solid base of support is important while lifting.
Placing the feet too close together will cause instability while placing them too far apart will hinder movement.
Take short steps.
Visualize The Motions Involved and Practice The Motions Before Lifting
Think about the motion before lifting.
Practice the lifting motion before lifting the object.
Focus on keeping the spine straight.
Raise and lower to the ground by bending the knees.
Avoid bending at the waist or hips.
Tighten the Stomach Muscles
Tightening the abdominal muscles will hold the back in a healthy lifting position and help prevent excessive force on the spine.
Lift With the Legs
The legs are stronger than the back muscles, so let the leg strength do the work.
Lower yourself to the ground by bending the knees, not the back.
Keep Eyes Up
Looking slightly upwards will help maintain a better spine position and help keep the back straight.
Avoid Twisting or Bending
Face in the direction you are walking.
Stop, take small steps, and continue walking if turning is required.
Back Belts
It has become common for many who work in jobs requiring manual lifting to wear back belts or support. However, research does not show that they decrease the risk of a lifting injury. (CDC and The National Institute for Occupational Safety and Health, 2023) Instead, it is recommended that the belt be thought of as a reminder of where the back muscles are positioned to keep the individual aligned, combined with the correct lifting techniques.
Injury Medical Chiropractic and Functional Medicine Clinic
Training the body and maintaining its optimal health for correct manual lifting techniques requires daily efforts through practice, conscious position corrections, and ergonomics. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Chiropractic Care For Injury Recovery
References
CDC. The National Institute for Occupational Safety and Health (NIOSH). (2007). Ergonomic Guidelines for Manual Material Handling. (No. 2007-131). Retrieved from www.cdc.gov/niosh/docs/2007-131/pdfs/2007-131.pdf
CDC. The National Institute for Occupational Safety and Health (NIOSH) (2023). Back Belts – Do They Prevent Injury? (No. 94-127). Retrieved from www.cdc.gov/niosh/docs/94-127/
Individuals experiencing persistent pain, weakness, numbness, and tingling in the back could be suffering from nerve root encroachment. Could surgery ease nerve compression and improve symptoms for persistent and severe cases?
Surgical Decompression
The pain, weakness, numbness, and tingling associated with nerve root encroachment are usually first treated with non-surgical therapies that include:
Anti-inflammatory medications
Physical therapy
This can be enough to address the irritation of the spinal nerve root. But when cases become severe, surgical decompression may be recommended and necessary. It can be done in a couple of different ways.
Causes and Symptoms
Vertebrae are bones in the spine. Small openings called foramina allow a spinal nerve root to pass through on each side of the vertebra. When nerve root encroachment is present, the spinal nerve root gets compressed, pinched, and trapped, which can cause peripheral symptoms such as numbness, tingling, pain, or weakness to develop. Nerve root encroachment is typically caused by normal aging degenerative wear and tear changes in the vertebrae. (Choi Y. K. 2019) These degenerative changes can include:
Facet joint hypertrophy
Ligament and bone hypertrophy
Disc disorders
Formation of bone spurs or osteophytes.
If these degenerative changes progress, they can encroach and compress a nerve root, leading to peripheral symptoms. (Choi Y. K. 2019)
When Surgery Is Recommended
When symptoms occur, initial treatment will involve:
Physical therapy
Chiropractic realignment
Massage therapies
Rest
Lifestyle adjustments
Nonsteroidal anti-inflammatories – NSAIDs
Corticosteroid injections into the spine
If conservative therapies don’t fully heal or improve symptoms or there are neurological problems like difficulty with balance or walking, then surgery may be recommended. Severe pain that limits normal function is an indication for surgery, and rapidly progressive weakness of the arms and/or legs or signs of cauda equina syndrome are indications for emergency surgery.
Surgery Options
Different types of spinal surgery may be performed. A neurosurgeon will decide the best procedure for each patient based on their case, age, medical conditions, and other factors. Specific spinal surgical decompression depends on what is causing the nerve compression. In most cases, it involves removing bone or tissue to relieve nerve pressure or provide support to stabilize the joint. The most common types of surgical decompression include: (Mayo Clinic Health System, 2022)
Maintain the stability and alignment of the spine.
Improve the stability and alignment of the spine.
Anterior Surgery
The anterior approach to surgery means that the spine is accessed through the anterior/front of the spine. In this surgery, one or more discs and bone spurs may be removed through an incision in the front of the neck. (American Association of Neurological Surgeons, 2024) For example, an anterior cervical discectomy may alleviate pressure on one or more nerve roots in the neck. With an anterior lumbar interbody fusion, a surgeon removes a degenerative disc in the lower spinal area by going through a patient’s lower abdomen. (American Association of Neurological Surgeons, 2024) After the disc is removed, a structural device, usually made of bone, fills the space where it once was. This device encourages bone healing and helps the vertebrae’s bodies fuse.
Posterior Surgery
Posterior surgery means the spine is accessed through the posterior/back of the spine. An example is removing a thickened ligament, bone spur, or disc material in the neck. To do this, a small incision in the back of the neck may be made to remove part of the back of the vertebrae called the lamina. This is called a posterior cervical laminectomy. (American Association of Neurological Surgeons, 2024) A posterior lumbar interbody fusion removes a degenerative disc by going through the back. (American Association of Neurological Surgeons, 2024) Like the anterior approach, a structural device often contains bone to fill the space where the disc once was to fuse the bones.
Potential Risks
As with any surgery, it’s important that the individual and their healthcare provider carefully discuss the benefits and risks. Spinal surgical decompression includes: (Proietti L. et al., 2013)
Bleeding
Blood clots
Surgical site infection
Urinary tract infection
Lung infection
Intestinal blockage
There are also specific risks to the area of the spine being operated on and how it is surgically approached. For example, a cervical anterior procedure may injure the esophagus, trachea, or carotid artery. Likewise, damage to the C5 nerve root/C5 palsy can occur from cervical spinal decompressive surgery. This complication causes weakness, numbness, and pain in the shoulders. (Thompson S. E. et al., 2017) The spinal cord may also be injured during surgery and result in paralysis, although this is rare. (American Association of Neurological Surgeons, 2024)
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
The Non-Surgical Solution
References
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
Proietti, L., Scaramuzzo, L., Schiro’, G. R., Sessa, S., & Logroscino, C. A. (2013). Complications in lumbar spine surgery: A retrospective analysis. Indian journal of orthopaedics, 47(4), 340–345. doi.org/10.4103/0019-5413.114909
Thompson, S. E., Smith, Z. A., Hsu, W. K., Nassr, A., Mroz, T. E., Fish, D. E., Wang, J. C., Fehlings, M. G., Tannoury, C. A., Tannoury, T., Tortolani, P. J., Traynelis, V. C., Gokaslan, Z., Hilibrand, A. S., Isaacs, R. E., Mummaneni, P. V., Chou, D., Qureshi, S. A., Cho, S. K., Baird, E. O., … Riew, K. D. (2017). C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases. Global spine journal, 7(1 Suppl), 64S–70S. doi.org/10.1177/2192568216688189
For individuals with cervical arthritis, can physical therapies help manage symptoms and bring pain relief?
Cervical Arthritis
Cervical spondylosis, more commonly known as cervical arthritis or arthritis of the neck, refers to the wearing down of neck bones, discs, tendons, ligaments, and joints. The primary symptoms are neck pain and stiffness. However, it is also possible to have cervical spondylosis and not have any symptoms. The condition affects over 85% of individuals over age 65. (American Academy of Orthopaedic Surgeons, 2021) Treatment can consist of conservative therapies and includes physical therapies, alternative medicine therapies, at-home self care, and over-the-counter and prescription medications. Severe cases of cervical spondylosis are treated with surgery to repair damaged parts of the spine.
Symptoms
Neck pain and headaches at the back of the head are usually the first symptoms. (Kazeminasab S. et al., 2022) The neck can also feel stiff, with worse morning symptoms that improve throughout the day. (Johns Hopkins Medicine, 2024) Symptoms can range from mild discomfort to severe pain. As cervical spondylosis progresses, individuals can experience:
Inability to turn the head or bend the neck.
A clicking or grinding noise when turning the neck.
Tenderness with pressure on the neck.
Pain that radiates to the shoulders or shoulder blades.
Pain and symptoms that disrupt sleep, sometimes causing waking up throughout the night.
Symptoms that decrease with rest.
More severe symptoms include:
Cervical Bone Spurs – Osteophytes
Some with cervical spondylosis have bony growths that can place pressure on the spinal nerves (a pinched nerve) (Bon Secours, 2024). Compression of spinal nerve roots produces cervical radiculopathy, which leads to pain, tingling, and weakness that radiates into the shoulders, arms, and hands.
Cervical Myelopathy
This refers to spinal impingement that leads to spinal cord dysfunction. (Spinal cord dysfunction is a nervous system disorder with interruptions in the spinal cord’s motor, sensory, and autonomic functions.) Symptoms include pain, tingling, numbness, muscle spasms, and weakness in areas below the neck. Spinal cord dysfunction can affect mobility, hand use, and bladder or bowel function control.
Causes
Where degenerative changes are commonly associated with cervical spondylosis, other conditions, and factors can lead to it and include:
Autoimmune Diseases
Rheumatoid arthritis and psoriatic arthritis can cause chronic inflammation in the cervical spine.
Trauma
Neck trauma, including injury and repetitive stress on the neck.
Cervical spondylosis is commonly seen in occupations that involve neck-stressing activities, such as sports.
Age
Wearing down of the spinal discs cartilage between the vertebrae.
Genetic components have been identified in connection with cervical spondylosis, meaning that some types of arthritis that lead to spinal damage are hereditary. (Kazeminasab S. et al., 2022)
Treatment
Treatment begins conservatively, using protocols to preserve function and avoid surgery. Nonsurgical treatments include medications, physical therapy, at-home exercises, and alternative medicine. The treatment method a healthcare provider chooses will depend on how severe the spondylosis is and other factors like age, how much pain is being experienced, the cause, and overall health. The main objectives are to relieve pain, prevent long-term damage to the spinal cord and nerves, and help maintain performing daily activities. (Bon Secours, 2024)
Medications
Medicines used to treat cervical spondylosis include:
Nonsteroidal Anti-inflammatory Drugs NSAIDs
NSAIDs, including ibuprofen and naproxen sodium, are available without a prescription to relieve pain and inflammation.
A healthcare provider can prescribe a more powerful NSAID to help manage severe symptoms.
Corticosteroids
A corticosteroid injection or a short course of an oral corticosteroid, like prednisone, can ease pain and reduce inflammation.
Muscle Relaxants
If cervical spondylosis causes muscle spasms, a healthcare provider can prescribe cyclobenzaprine, a muscle relaxant, to manage symptoms.
Antidepressants
Some types of antidepressants can ease neck pain from cervical spondylosis.
Anti-seizure Meds
Some anti-seizure drugs can cause nerve pain resulting from damaged nerves.
Physical Therapies
Physical therapy will help manage pain and stiffness and keep muscles loose and relaxed.
A physical therapist will teach the patient exercises to stretch and strengthen neck and shoulder muscles.
At-Home Self Care
At-home exercises can help relieve pain, stiffness, and swelling. Some can include:
Reducing inflammation and stress on the neck through posture training.
At-home targeted stretches and exercises will help bring pain relief.
Ice treatment reduces swelling.
Heat will increase circulation.
A neck brace may be recommended briefly to avoid muscle weakness and stiffness.
Alternative Medicine
Chiropractic adjustments and massage therapy are alternative treatments that will help manage cervical spondylosis.
Acupuncture can also be beneficial in reducing neck pain and increasing energy circulation. (Gu C. L. et al., 2019)
Various therapeutic massage therapies will help relieve neck pain and stiffness. Talk to a healthcare provider before starting treatment so they can advise on whether neck massages are safe.
Surgery
A healthcare provider may recommend surgical treatment when all other treatments have failed, if neurological symptoms are severe, or if neck arthritis causes extreme pain or disability. Surgery to treat cervical spondylosis can involve removing bone spurs, part of the cervical vertebra, or a herniated disc. The removed portions of the cervical spine are fused with hardware and bone grafts.
Injury Medical Chiropractic and Functional Medicine Clinic
Chiropractic therapy is among the more conservative treatment options and may be tried first before proceeding with surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution.
Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC musculoskeletal disorders, 23(1), 26. doi.org/10.1186/s12891-021-04957-4
Jenkins, H. J., Downie, A. S., Moore, C. S., & French, S. D. (2018). Current evidence for spinal X-ray use in the chiropractic profession: a narrative review. Chiropractic & manual therapies, 26, 48. doi.org/10.1186/s12998-018-0217-8
Gu, C. L., Yan, Y., Zhang, D., & Li, P. (2019). An evaluation of the effectiveness of acupuncture with seven acupoint-penetrating needles on cervical spondylosis. Journal of pain research, 12, 1441–1445. doi.org/10.2147/JPR.S199798
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