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.
As we get older, we become more prone to injuries, since our bodies are not as elastic as they once were. This is especially true for the inner material of your spine’s discs. Every year you become a little more at risk of experiencing herniated discs, a condition where a stressed disc ruptures, because the elasticity and water content of your intervertebral discs reduces overall.
But herniated discs aren’t only a problem for elderly people. A disc herniation can be experienced by anyone as a result of twisting or lifting the wrong way. And in the event that you currently have a bulging disc, a disc that is hurt but still intact, chances are higher that stress on the affected disc could cause it to rupture or become “herniated”.
A herniated disc can cause pain throughout the entire body, not just back pain. And as you might think of surgery being the sole remedy for a herniated disc, there are lots of complementary and alternative treatment option for herniated discs. Chiropractic specializes in supplying non-invasive spinal decompression treatment and therapy methods.
A visit to your chiropractor will help you confirm whether you have a herniated disc, a bulging disc, or even some other spinal problem altogether. If you do have an injured disc, a doctor of chiropractic can create an individual treatment plan to assist you avoid surgery and return to enjoying your life, pain-free.
What are Herniated Discs?
The 24 vertebrae of your spine are separated from one another by pads of cartilage known as intervertebral discs. These discs have an outer coating with a soft interior to cushion against stresses and strains as well as the shocks experienced in your spine. The discs are subject to injury, disease, and degeneration with use over time. Certain activities and types of work increase the risk of discs being damaged or deteriorating.
Once the soft inside material of a disc pushes or is bulged out through a tear or weakening in the outside covering, the disc is reported to be herniated. Slipped, ruptured and �prolapsed discs are also known as protruding, bulging, or degenerated discs. There are distinctions between these terms, but they really refer to a disc that is no longer in its normal condition and/or position and may require chiropractic care to treat them. Herniated discs trigger pain by impinging on (intruding upon, irritating, and pinching) as well as depriving nerves in the spine.
Chiropractic for Herniated Discs
A healthcare professional can help address back pain along with other herniated disc symptoms. In your first appointment, your chiropractor will go through your medical history, do a physical exam, and carry out orthopedic and neurological tests. The chiropractor will also look over your posture, and may order an X-ray or MRI, if necessary, to aid with the diagnostic procedure and determine the presence of a disc herniation.
Chiropractors assess the whole spine. Your chiropractor will examine your neck, too, even when you simply have back pain. She or he wants to see how well your backbone is functioning and recall: What happens in one area of your spine can affect other parts of your spine and/or body.
After reviewing this information, your physician can ascertain whether you have an intervertebral disc injury. The type of disc injury you have will determine what treatments your chiropractor will use to address your symptoms. Your chiropractor can provide treatment options to you to address your pain and other symptoms.
To treat a herniated disk, your physician will develop a treatment program that might include spinal manipulation–also called adjustments–and other chiropractic techniques to help alleviate your herniated disc symptoms. It might consist of therapy and exercises, although this will be an individualized treatment plan.
The particulars of what are on your treatment strategy are particular to your own pain, level of activity, general health, and what your chiropractor thinks is best. As with any treatment option, do not be afraid to ask questions regarding what chiropractic treatments are being recommended and why. You want to be sure you know how it can help relieve your pain and what will be performed. Therapy is safe and effective for most patients.
Chiropractic provides the distinctive training, techniques, and experience needed to safely and effectively adjust your spine so the stress on the discs is minimized, the pain alleviated, the damaged or displaced structures given a opportunity to heal, and your capacity to return to normal functioning restored.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
Physical therapy plays a part in herniated disc recovery. Its methods not only offer you immediate pain relief, but they also teach you how you can condition your body to prevent further injury.
The discs are pads that serve as “cushions” between the vertebral bodies that serve to minimize the impact of movement on the spinal column. Each disc is designed like a jelly donut with a central softer component (nucleus pulposus).
As the disc degenerates from age or injury, the softer central portion can rupture (herniate) through the surrounding outer ring (annulus fibrosus). This abnormal rupture of the central portion of the disc is referred to as a disc herniation. The most common location for a herniated disc to occur is in the disc at the level between the fourth and fifth lumber vertebrae in the low back.
You will find a variety of physical therapy techniques, such as passive treatments, which help relax your body and include deep tissue massage, hot and cold therapy, electric stimulation (eg, TENS), and hydrotherapy, among others.
Your physical treatment program will usually begin with passive remedies. But once your body heals, you will start active treatments that strengthen your body and protect against additional pain. Your therapist will work with you to develop a strategy which best suits you.
Passive Physical Treatments for Herniated Discs
Deep Tissue Massage: There are more than 100 kinds of massage, but deep tissue massage is an ideal option when you’ve got a herniated disc because it uses a lot of pressure to ease deep muscle tension and spasms, which develop to stop muscle movement at the affected place.
Hot and Cold Therapy: Both hot and cold therapies offer their own set of advantages, and your physical therapist may alternate between them to get the best outcomes.
Your physical therapist may use heat to increase blood flow to the target region. Blood helps by delivering nutrients and additional oxygen cure the area. Blood also removes waste byproducts.
Conversely, cold therapy (also called cryotherapy) slows circulation. This decreases inflammation, muscle spasms and pain. Your physical therapist may put an ice pack give you an ice massage, or use a spray known to cool tissues.
Hydrotherapy: As the name implies, hydrotherapy involves water. As a passive therapy, hydrotherapy may involve sitting in warm shower or a bath. Hydrotherapy gently relieves pain and relaxes muscles.
Transcutaneous electric nerve stimulation (TENS): A TENS machine utilizes an electrical current to stimulate your muscles. It isn’t painful, although it seems extreme. A electric current is sent by electrodes to key points on the neural pathway. TENS reduces muscle spasms and is generally believed to activate the release.
Traction: The goal of traction is to decrease the effects of gravity to the spine. The aim is to cut back the disk herniation, by pulling the bones apart. The analogy is similar to a flat tire “disappearing” when you place a jack under the car and take strain off the tire. It can be carried out in the lumbar or cervical spine.
Active Physical Treatments for Herniated Discs
Active remedies help address flexibility, posture, strength, core stability, and joint motion. An exercise program may also be prescribed to achieve results. This will not just suppress recurrent pain but may also benefit your health. Your therapist may work with you to develop a schedule based on your diagnosis and health history.
Core equilibrium: Many people don’t realize how important a strong heart is to their spinal health. Your core (abdominal) muscles help your back muscles support your spine. It puts pressure when your heart muscles are weak. Your physical therapist may teach core to you.
Flexibility: Learning appropriate stretching and endurance techniques will prepare one for aerobic and strength exercises. Flexibility helps your body move simpler by warding off stiffness.
Hydrotherapy: Compared to just sitting in a hot bath or bath like its counterpart that is passive, active hydrotherapy can demand water to help condition your body without unnecessary strain.
Muscle strengthening: Strong muscles are a great support system for your backbone and better handle pain.
Your physician will teach you ways to condition and strengthen your back to help prevent future pain. So that you realize how to best treat your symptoms, you may learn fundamentals. The aim is that you develop the knowledge to maintain a way of life.
It is essential that you understand how to exercise and condition your back following the formal physical therapy ends. You won’t appreciate its results, if you don’t implement the lessons you learned during physical therapy. You might prevent additional disc pain, by taking care of your back on your own.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
Complementary and alternative treatments like massage, acupressure, and acupuncture can relieve pain related to a bulging or herniated disc.
If you’re considering these remedies, you need to consult a complementary and alternative medicine (CAM) professional. This title can be confusing, although complementary medicine and other medicine follow the very same techniques, they’re distinct in that forms are used in place of traditional medicine, whereas complementary treatments are used with conventional medication.
A herniated disk refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine. A spinal disk is a little like a jelly donut, with a softer center encased within a tougher exterior. Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer “jelly” pushes out through a tear in the tougher exterior.
A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. On the other hand, many people experience no symptoms from a herniated disk. Most people who have a herniated disk don’t need surgery to correct the problem, as a matter of fact, they can explore alternative treatment approaches.
Other Treatments for Herniated Discs
Exploring alternative approaches may not only help you feel relaxed and hassle free but these can also keep you away from the operating room. For a ruptured or herniated disc, you might want to try:
Acupuncture: This ancient Chinese practice is rooted in the belief that everyone has an energy force called the Chi (sometimes spelled Qi, but the two are pronounced “chee”). When the Chi is blocked or unbalanced, your body may react with sickness, pain and discomfort. Traditional acupuncturists aim to free up Chi channels, called meridians, by inserting extremely thin needles into certain points in your own body’s meridians.
Based on your particular diagnosis, the practitioner will probably insert multiple needles which are left in for approximately 20-40 minutes.
It’s also been suggested that acupuncture triggers the release of endorphins into the blood flow. In other words, endorphins are the body’s natural pain relievers. As such, their discharge decreases your perception of pain. Similarly, the Gate Control Theory can play a part in acupuncture’s efficacy in reducing pain. This theory maintains that pain signals traveling slowly from the area of injury to the spinal cord into the brain because the nerves may only deal with a limited number of signals at the same time. Acupuncture is supposed to create signals to audience the pain signs that were slow-moving, blocking out the pain.
Acupressure: Not surprisingly, acupressure is very much like acupuncture. Both are techniques that restore a healthy flow of energy throughout the entire body by stimulating specific meridian points. But acupressure relies on hands palms, and elbows, not needles, to manage pressure. Acupressure is for people of all ages but not for pregnant women (several acupressure points may lead to miscarriage) and those with high blood pressure.
Massage: When received frequently, massage can provide chronic low back pain relief. A massage involves the stroking, kneading, and manipulation of your tissues. Blood flow, which provides oxygen and nutrients to the muscles is increased by these movements. Extra blood also carries waste byproducts that may accumulate away.
Whilst massage is not a proven treatment for herniated discs, it is usually safe and free of side effects. However, massage might not be perfect for you in the event that you suffer from deep vein thrombosis, osteoporosis, skin infections, open wounds, or arthritis in or close to the area to be massaged.
You’ll find over 100 types of massage techniques. A Swedish massage, for example, uses long strokes to impact the superficial layers of the muscles. In contrast, a deep tissue massage uses slow strokes and direct pressure to soothe your layers of muscle and relieve chronic strain. Your massage therapist will work with you to determine what special massage will most likely reduce your pain.
When you start any new medical plan, let your practitioner know if you have any health conditions apart from pain from your herniated disc. Additionally, it is important to be aware that these treatments are best when used as complementary treatments (that can be combined with conventional medicine).
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
Herniation of the nucleus pulposus, abbreviated as HNP, occurs when the nucleus pulposus, frequently described to have a gel-like substance, breaks through the anulus fibrosus, the tire-like structure of the intervertebral disc which acts as a spinal shock absorber.
A herniated disc occurs most frequently in the lumbar region of the backbone or spine, particularly at the L4-L5 and L5-S1 levels (L = Lumbar and S = Sacral). This is primarily because the lumbar spine generally carries the majority of the body’s weight. Since the elasticity and water content of the nucleus decreases with age through the natural process of degeneration, individuals between the ages of 30 and 50 often seem to be �more vulnerable to disc herniation.
The progression of a herniation of the nucleus pulposus, best known as a herniated disc, can vary and typically occurs gradually over time. There are four stages: (1) disc protrusion (2) prolapsed disk (3) disc extrusion (4) sequestered disc. Stages 1 and 2 are known as incomplete disc herniations, or as a disc bulge, where 3 and 4 are known as complete disc herniations, ruptured discs or herniated discs. Pain may be combined with some radiculopathy, which means deficit. The deficit might include sensory alterations, such as tingling sensations and/or numbness, or motor changes, such as weakness and/or �weight loss. Nerve compression resulting from added pressure, compression or impingement of the spinal nerves due to the substance from the herniated disc is often what causes these changes.
Progression of Herniated Disc
The extremities affected by herniated discs are dependent upon the vertebral level at which they occur in. Consider the following examples:
Cervical – Pain, discomfort and other symptoms in the throat, shoulders, and arms.
Thoracic – Symptoms radiate into the chest.
Lumbar – Symptoms extend into the buttocks, thighs, legs and feet. Sciatica is common.
Cauda Equina Syndrome is serious disorder requiring immediate surgical intervention which occurs from from a disc herniation. The symptoms include bilateral leg pain, reduction of perianal sensation (rectum), paralysis of the bladder, and weakness of the anal sphincter.
Analysis of Herniated Discs
The backbone is analyzed with the patient standing and laying down. Because of muscle spasm, a loss of normal spinal curvature may be noted. Radicular pain, described as inflammation of a spinal nerve, may increase if pressure is placed on the affected spinal segment.
A Lasegue test, also known as Straight-leg Raising Test, is often performed to determine the extent of the herniated disc and its manifested symptoms. To perform this test, the patient lies down, the knee is extended, and the hip is flexed. If pain is aggravated or produced, it is an indication the lower lumbosacral nerve roots may be inflamed.
Other neurological tests are performed to ascertain loss of sensation and/or engine function. Reflexes are noted as these changes may indicate the location of the herniation.
Radiographs can be helpful to determine the presence of a herniated disc, but Computed Axial Tomography (CAT) or Magnetic Resonance Imaging (MRI) provides more detail. The MRI is the best method allowing the physician to find the soft spinal tissues that are unseen in other imaging procedures.
Evidence of HNP
The findings in the examination and evaluations, such as the one below, are compared to earn a diagnosis. This includes ascertaining the precise location of the herniation so treatment options can be reviewed with the patient.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
A common cause of lower leg and back pain is a ruptured disc or herniated disc. Symptoms of a herniated disc may include muscle spasm or cramping sharp or dull pain, sciatica, and leg weakness or loss of leg work. Sneezing, coughing, or bending intensify the pain.
Rarely, bowel or bladder control is lost, and when this happens, seek medical attention at once.
Sciatica is a symptom often associated with a lumbar herniated disc. Stress on one or several nerves that contribute to the sciatic nerve can lead to pain, burning, tingling, and numbness that extends from the buttocks into the leg and into the foot. Normally one side (left or right) is affected.
Anatomy of Lumbar Spine Discs
First, a brief overview of spinal anatomy so that you can better understand the way the lumbar herniated disc may lead to lower back pain and leg pain.
In between each of the 5 lumbar vertebrae (bones) is a disc, a tough, fibrous shock-absorbing pad. Endplates line the endings of every vertebra and help hold discs in place. Every disc includes a tire-like outer ring (annulus fibrosus) that encases a gel-like material (nucleus pulposus).
Disc herniation occurs when the annulus fibrous breaks open or cracks, permitting the nucleus pulposus to escape. Though you may have heard it be called a ruptured disc or even a bulging disc, this is called a herniated nucleus pulposus or herniated disc.
When a disc herniates, it can press on the spinal cord or spinal nerves. All along your spine, nerves are branching off from the spinal cord and travelling to various parts of your body. The nerves pass through small passageways between the vertebrae and discs, so if a herniated disc presses into that passageway, it can compress (or “pinch”) the nerve. This can result in the pain associated with herniated discs. (In the case below, you can observe a close-up look at a herniated disc pressing on a spinal nerve.)
Lumbar Herniated Disc Risk Factors
Many factors can increase the risk for disc herniation, including:
Lifestyle choices like tobacco use, lack of regular exercise, and insufficient nourishment significantly contribute to inadequate disc health.
As the body ages, natural chemical modifications cause discs to slowly dry out, which can impact disc strength and resiliency. To put it differently, the aging process can make your discs less capable of absorbing the shock from the body’s movements, which is one of their most important jobs.
Poor posture combined with the habitual use of incorrect body mechanics stresses the lumbar spine and influences its usual ability to take the bulk of the body’s weight.
Combine these factors with the eeffects from daily wear and tear, injury, incorrect lifting, or twisting and it is simple to comprehend why a disc may herniate. For example, lifting something incorrectly may lead to disc pressure.
Disc Herniation Phases
A herniation may develop suddenly or slowly over weeks or months. The four phases to a herniated disc are:
1) Disc Degeneration: Chemical modifications related to aging causes discs to weaken, but with no herniation.
2) Prolapse: The form or position of the disc changes with a few small impingement into the spinal canal and/or spinal nerves. This stage is also referred to as a bulging disc or a disc that was protruding.
3) Extrusion: The gel-like nucleus pulposus breaks through the tire-like wall (annulus fibrosus) but remains within the disc.
4) Sequestration or Sequestered Disc: The nucleus pulposus fractures throughout the annulus fibrosus and can then go outside the intervertebral disc.
Lumbar Herniated Disc Diagnosis
Lately, not every herniated disc causes symptoms. Some people discover they have a ruptured disc or herniated disc after an x-ray for an unrelated reason.
Most of the time, the symptoms, notably the pain, prompt the patient to seek medical attention. The trip with the doctor includes a physical exam and neurological exam. He or she will examine your medical history, and inquire about what remedies you have tried for pain relief and what symptoms you’ve experienced.
An x-ray may be needed to rule out other causes of back pain like osteoarthritis (spondylosis) or spondylolisthesis. A CT or MRI scan verifies the extent and location of disc damage.These imaging tests can show the soft tissues (including the disc).
Sometimes a myelogram is essential. In that evaluation, you will receive an injection of a dye; the dye will appear on a CT scan, so allowing your physician to readily see problem areas.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
Clay-shoveler’s fracture is a breakage of the vertebrae in the spine as a consequence of stress in the neck or upper back. It is often described as a steady fracture during the process of a vertebra happening at C7 or C6, classically at some of the cervical or thoracic vertebrae.
Clay-shoveler’s fracture usually occurs in laborers who engage in tasks involving lifting weights with the arms stretched. Examples of these actions include physical activities like shoveling soil, rubble or snow up and over the head backwards, using a pickax or scythe, and pulling out roots.
Back in Australia in the 1930s, men digging deep ditches tossed clay 10 to 15 feet above their heads using long handled shovels. Rather than separating, the clay would stick to the spade; the employee would hear a pop followed by a sudden pain between the shoulder blades, making them unable to continue working.
Mechanism of Injury: Clay Shoveler’s Fracture
The mechanism of injury is thought to be secondary to reflex and muscle strain through the supraspinous ligaments with force transmission.
The spinous process is pulled on by the enormous force. The fracture is diagnosed by plain film examination. The shear power of the muscles (trapezius and rhomboid muscles) yanking on the spine at the bottom of the neck actually tears from the bone of the spine.
Symptoms of clay-shoveler’s fracture include burning, “knife- like” pain in the level of the fractured spine between the top shoulder blades. The pain may increase with repeated action that strains the muscles of the upper back. The broken spine and muscles that are nearby are exquisitely tender. Often these injuries found incidentally years later when the cervical spine is imaged for other explanations and only are unrecognised in the time.
Acutely, they tend to be associated with:
Motor vehicle accidents
sudden muscle contraction
Blows into the spine
Radiographic Features
The fracture is seen on lateral radiographs as an oblique through the spinous process, usually of C7. There’s usually substantial displacement. Other radiographic characteristics of the fracture include ghost signals on an AP view (i.e. double spinous process of C6 or C7 caused by displaced fractured spinous process).
Clay Shoveler’s Fracture
Atypical Clay Shoveler’s Fracture
While the extreme pain slowly subsides in days to weeks, the region may intermittently develop burning pain with certain activities that involve prolonged extending of their arms (such as computer function).
No therapy is required for most patients. Physical therapy, pain drugs, and massage can be of help. Surgical removal of the suggestion of the spine is performed for anyone who have pain.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
A good read to understanding alteration of motion segment integrity (AOMSI) is the article �Biomechanical Analysis of clinical instability in the cervical spine� White, et al., Clin Ortho Relat Res, 1975;(109):85-96.
AOMSI is a biomechanical analysis. It�s all about numbers that have clinical meaning and significance. Threshold values have been determined that quantify without a doubt the patient has serious injury. It is a test of structural integrity of the ligaments interconnecting the motion segments. In this case, structural integrity has to do with the material properties of ligament tissue. Those properties include strength and flexibility. When a material is both strong and flexible, it�s called a semi-rigid material. Strength is related to the composition of the material. Strength might be thought of as load carrying capacity before failure.
Mechanism of Injury: Ligaments
Ligament tissue has previously been bench tested to describe its physical characteristics of stress/strain. That is, given so much load (stress) how much elongation will occur (strain). During normal physiologic loads the ligament remains intact and recoils to its original length when the load is removed. If the load becomes too large the materials (ligaments) begin to yield. They go past their elastic limit. When this happens the (strained) ligament fibers will not return to their original shape. The ligament loses its restraining capacity to hold the joint in normal stabilization and hypermobility occurs.
The ligaments, if sufficiently strained or avulsed results in AOMSI. The following paragraphs illustrates that if AOMSI is found there must be gross destruction or yielding of multiple ligaments. We need to build a BIG motion segment with Velcro ligaments. When you tear them off, they make a really nice ripping noise. That drives home the point.
In the White et al work, they found that the motion segment stayed intact i.e., less than 11 degrees� rotation (angualr mtion) and less than 3.5 mm translation, until they transected over 50% of the ligaments from an anterior or posterior approach. And when they transected from either approach the loss of stability was not linear but suddenly catastrophic. And they meant that suddenly the two vertebra totally separated in rotation or translation.
Suddenly Separated: pulled apart, head off of body, all neural components compromised, paralysis. Keeping that in mind, what are the injuries of someone just under the threshold? Severe to very severe. They stand the possibility of a serious event with much less force.
Prevalence of Ligament Injury: AOMSI
If AOMSI is detected, think about more than 50% of ligaments transected. That will start to explain the seriousness of the finding. In a patient/child that demonstrates hypermobility everywhere, then you take a statistical average of all segments, and look at the aberrant statistical finding if it exists. There are clues to injury everywhere when you understand what the numbers mean in reference to stability and function.
To diagnose ligament laxity, it is imperative that imaging be performed and a basic flexion-extension x-ray is all that is required. In today�s medical economy, advanced imaging of MRI or CT Scan, although accurate becomes an unnecessary expenditure and an x-ray renders very accurate demonstrative images to conclude a definitive diagnosis. In determining if there is an impairment, it is necessary to follow the AMA Guides to the Evaluation of Permanent Impairment as the 4th, 5th and 6th editions all render an impairment for AOMSI as sequella to ligament laxity, which is damage to the ligament from trauma.
This document is intended to serve as a simple explanation as to the severity of ligament damage and how to demonstrably diagnose the injury. It is also critical to remember that ligament do �wound repair.� In normal physiology, ligaments grow during puberty from cells within the ligaments called fibroblasts. They produce both collagen (white) and elastin (yellow) tissue, which gives the ligaments both tensile and elastic strength. Upon puberty the cells stop producing tissue and remains dormant. Upon injury, the fibroblast reactivates, but can only produce collage leaving the joint wound repaired in an aberrant juxtaposition (place) with poor movement abilities due to the lack of the requisite elastin. In turn, according to Hauser et. Al (2013) this leads to permanent loss of function of the ligament and arthritis of the joint. This is not a speculative statement; it is based upon Wolff�s that dates back to the late 1800�s and has been a guiding principle in healthcare for more than a century.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
References:
White, et al., Clin Ortho Relat Res, 1975;(109):85-96
Hauser, Dolan,Phillips, Newlin, Moore Woldin, B.A.(2013) Ligament injury and healing: A review of current clinical diagnostics and therapeutics.The Open Rehabilitation Journal, 6,1-20.
Additional Topics: Weakened Ligaments After Whiplash
Whiplash is a commonly reported injury after an individual has been involved in an automobile accident. During an auto accident, the sheer force of the impact often causes the head and neck of the victim to jerk abruptly, back-and-forth, causing damage to the complex structures surrounding the cervical spine. Chiropractic care is a safe and effective, alternative treatment option utilized to help decrease the symptoms of whiplash.
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