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 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
Can individuals with herniated discs find the relief they are looking for from traction therapy or decompression to provide pain relief?
Introduction
The spine allows the individual to be mobile and flexible without feeling pain and discomfort when a person is on the move. This is because the spine is part of the musculoskeletal system that consists of muscles, tendons, ligaments, the spinal cord, and spinal discs. These components surround the spine and have three regions to allow the upper and lower extremities to do their jobs. However, the spine also ages when the body starts to age naturally. Many movements or routine actions can cause the body to be stiff and, over time, can cause the spinal disc to herniate. When this happens, a herniated disc can lead to pain and discomfort in the extremities, thus making individuals deal with a reduced quality of life and pain in three spinal regions. Luckily, there are numerous treatments, like traction therapy and decompression, to alleviate the pain and discomfort associated with herniated discs. Today’s article looks at why herniated discs cause issues in the spine and the effects of how these two treatments can help reduce herniated discs. We talk with certified medical providers who consolidate our patients’ information to assess how a herniated disc in the spine may be the issue causing musculoskeletal pain. We also inform and guide patients on how integrating spinal decompression and traction therapy can help realign the spine and reduce disc herniation that is causing spinal issues. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating non-surgical treatments as part of their routine to reduce pain and discomfort in their bodies. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Why Herniated Discs Causes Issues In The Spine?
Have you been experiencing constant discomfort in your neck or back that doesn’t allow you to relax? Do you feel tingling sensations in your upper and lower extremities, making grasping objects or walking difficult? Or have you noticed that you are hunching over from your desk or standing and that stretching causes pain? As the spine keeps the body upright, its main components include the moveable vertebrae, the nerve root fibers, and spinal discs to help send neuron signals to the brain to allow movement, cushion the shocked forces on the spine, and be flexible. The spine allows the individual to perform various tasks without pain and discomfort through repetitive movements. However, when the body ages, it can lead to degenerative changes in the spine, causing the spinal disc to herniate over time. A herniated disc is a common degenerative musculoskeletal condition that causes the nucleus pulposus to break through any weak region of the annulus fibrosus and compress the surrounding nerve roots. (Ge et al., 2019) Other times, when repetitive motions start to cause a developing herniated disc, the inner portion of the disc can become desiccated and brittle. In contrast, the outer portion becomes more fibrotic and less elastic, causing the disc to shrink and be narrow. A herniated disc can affect young and old populations as they can have a multifactorial contribution that causes proinflammatory changes to the body. (Wu et al., 2020)
When many people are dealing with pain associated with a herniated disc, the disc itself goes through morphological change through the characterization of the disc being partial damage, which is then followed by the displacement and herniation of the inner disc portion in the vertebral canal to compress the spinal nerve roots. (Diaconu et al., 2021) This causes symptoms of pain, numbness, and weakness in the upper and lower body portions through nerve impingement. Hence why, many individuals are dealing with referred pain symptoms from their arms and legs that are radiating pain. When nerve compression associated with herniated discs starts to cause pain and discomfort, many individuals begin to seek out treatment to reduce the pain that the herniated disc is causing to provide relief for their bodies.
Spinal Decompression In Depth-Video
The Effects Of Traction Therapy In Reducing Herniated Disc
Many people who are suffering from pain that is being affected by herniated discs in their spines can seek out treatments like traction therapy to alleviate pain. Traction therapy is a non-surgical treatment that stretches and mobilizes the spine. Traction therapy can be mechanically or manually done by a pain specialist or with the help of mechanical devices. The effects of traction therapy can reduce the compression force on the spinal disc while reducing nerve root compression by expanding the disc height within the spine. (Wang et al., 2022) This allows the surrounding joints within the spine to be mobile and positively affect the spine. With traction therapy, intermittent or steady tension forces help stretch the spine, reduce pain, and improve functional outcomes. (Kuligowski et al., 2021)
The Effects Of Spinal Decompression In Reducing Herniated Disc
Another form of non-surgical treatment is spinal decompression, a sophisticated version of traction that uses computerized technology to help apply controlled, gentle pulling forces to the spine. Spinal decompression does is that it can help decompress the spinal canal and help pull the herniated disc back to its original position while stabilizing the spine and keeping the vital bones and soft tissues safe. (Zhang et al., 2022) Additionally, spinal decompression can create negative pressure on the spine to allow the flow of nutritional fluids and blood oxygen back to the discs while creating an inverse relationship when tension pressure is introduced. (Ramos & Martin, 1994) Both spinal decompression and traction therapy can offer many therapeutic pathways to provide relief to many individuals dealing with herniated discs. Depending on how severe the herniated disc has caused issues to the person’s spine, many can rely on non-surgical treatments due to its customizable plan that is personalized to the person’s pain and can be combined with other therapies to strengthen the surrounding muscles. By doing so, many people can be pain-free over time while being mindful of their bodies.
References
Diaconu, G. S., Mihalache, C. G., Popescu, G., Man, G. M., Rusu, R. G., Toader, C., Ciucurel, C., Stocheci, C. M., Mitroi, G., & Georgescu, L. I. (2021). Clinical and pathological considerations in lumbar herniated disc associated with inflammatory lesions. Rom J Morphol Embryol, 62(4), 951-960. doi.org/10.47162/RJME.62.4.07
Ge, C. Y., Hao, D. J., Yan, L., Shan, L. Q., Zhao, Q. P., He, B. R., & Hui, H. (2019). Intradural Lumbar Disc Herniation: A Case Report and Literature Review. Clin Interv Aging, 14, 2295-2299. doi.org/10.2147/CIA.S228717
Kuligowski, T., Skrzek, A., & Cieslik, B. (2021). Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature. Int J Environ Res Public Health, 18(11). doi.org/10.3390/ijerph18116176
Ramos, G., & Martin, W. (1994). Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg, 81(3), 350-353. doi.org/10.3171/jns.1994.81.3.0350
Wang, W., Long, F., Wu, X., Li, S., & Lin, J. (2022). Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis. Comput Math Methods Med, 2022, 5670303. doi.org/10.1155/2022/5670303
Wu, P. H., Kim, H. S., & Jang, I. T. (2020). Intervertebral Disc Diseases PART 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease. Int J Mol Sci, 21(6). doi.org/10.3390/ijms21062135
Zhang, Y., Wei, F. L., Liu, Z. X., Zhou, C. P., Du, M. R., Quan, J., & Wang, Y. P. (2022). Comparison of posterior decompression techniques and conventional laminectomy for lumbar spinal stenosis. Front Surg, 9, 997973. doi.org/10.3389/fsurg.2022.997973
Can individuals with spinal pain in their necks and back utilize decompression therapy to restore spinal disc height and find relief?
Introduction
Many people don’t realize that as the body gets older, so does the spine. The spine is part of the musculoskeletal system that provides structural support to the body by keeping it upright. The surrounding muscles, ligaments, and tissues surrounding the spine help with stability and mobility, while the spinal disc and joints provide shock absorption from the sheer vertical weight. When a person is on the move with their daily activities, the spine can allow the individual to be mobile without pain or discomfort. However, as time passes, the spine goes through degenerative changes that can cause pain and discomfort to the body, thus leaving the individual to deal with overlapping risk profiles that can affect their neck and back. To that point, many people seek out treatments to reduce the pain affecting their spine and restore the disc height in their bodies. Today’s article looks at how spinal pain affects a person’s neck and back and how treatments like spinal decompression can reduce spinal pain and restore disc height. We talk with certified medical providers who consolidate our patients’ information to assess how spinal pain can significantly impact a person’s well-being and quality of life in their bodies. We also inform and guide patients on how integrating spinal decompression can help reduce spinal pain and restore spinal disc height. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating non-surgical treatments into a health and wellness routine to relieve spinal pain and regain their quality of life. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
How Spinal Pain Affects A Person’s Neck & Back
Do you feel constant muscle aches and pains in your neck and back? Have you experienced stiffness and limited mobility when you are twisting and turning? Or do heavy objects cause muscle strain when moving from one location to another? Many individuals will be on the move and be in weird positions without feeling pain and discomfort when it comes to the spine. This is due to the surrounding muscles and tissues being stretched and the spinal discs taking on the vertical pressure on the spine. However, when environmental factors, traumatic injuries, or natural aging start to affect the spine, it can lead to the development of spinal pain. This is because the outer portion of the spinal disc is intact, and the inner portion of the disc is being affected. When abnormal stresses start to reduce the water intake within the disc, it can internally stimulate the pain receptors without nerve root symptoms inside the disc. (Zhang et al., 2009) This causes many individuals to deal with neck and back pain in their bodies and reduces their quality of life.
Spinal pain can lead to overlapping risk profiles that cause many individuals to deal with severe low back pain and neck pain, which then causes the surrounding muscles to become weak, tight, and overstretched. At the same time, the surrounding nerve roots are also affected as the nerve fibers surround the outer and inner parts of the spinal disc, which causes nociceptive pain properties to the neck and back region and leads to discogenic pain. (Coppes et al., 1997) When many individuals are dealing with muscle pain correlated with the spinal discs, it causes a pain-spasm-pain cycle that can affect their bodies due to not moving enough and causing painful muscular activities when trying to be mobile. (Roland, 1986) When a person has limited mobility cause they are experiencing spinal pain, their natural disc height slowly degenerates, causing more issues to their bodies and socioeconomic burdens. Fortunately, when many individuals are dealing with spinal pain, numerous treatments can reduce spinal pain and restore their disc height.
Movement Medicine- Video
How Spinal Decompression Reduces Spinal Pain
When people are seeking treatments for their spinal pain, many will seek surgical treatments to reduce their pain, but it will be a bit pricey. However, many individuals will opt for non-surgical treatments due to their affordability. Non-surgical treatments are cost-effective and customizable to a person’s pain and discomfort. From chiropractic care to acupuncture, depending on the severity of the person’s pain, many will find the relief they seek. One of the most innovative treatments for reducing spinal pain is spinal decompression. Spinal decompression allows the individual to be strapped into a traction table. This is because it gently pulls on the spine to realign the spinal disc by reducing the pressure on the spine to invoke the body’s natural healing process to relieve pain. (Ramos & Martin, 1994) Additionally, when many individuals are using spinal decompression, the gentle traction provides a motorized distraction to the spine that may induce physical changes to the spinal disc and help restore a person’s range of motion, flexibility, and mobility. (Amjad et al., 2022)
Spinal Decompression Restoring Spinal Disc Height
When a person is being strapped into the spinal decompression machine, the gentle traction helps the spinal disc return to the spine, allowing the fluids and nutrients to rehydrate the spine, increasing the spine’s disc height. This is because spinal decompression creates negative pressure on the spine, allowing the spinal disc to return to its original height and providing relief. Plus, the amazing thing that spinal decompression does is that it can be combined with physical therapy to help stretch and strengthen the surrounding muscles near the spine to provide more stability and flexibility. (Vanti et al., 2023) This allows the individual to be more mindful of their bodies and start incorporating small habit changes to reduce the pain from returning. When many people begin to think about their health and wellness by going to treatment, they will regain their quality of life and get back to their daily routine without the issues affecting their spine.
References
Amjad, F., Mohseni-Bandpei, M. A., Gilani, S. A., Ahmad, A., & Hanif, A. (2022). Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord, 23(1), 255. doi.org/10.1186/s12891-022-05196-x
Coppes, M. H., Marani, E., Thomeer, R. T., & Groen, G. J. (1997). Innervation of “painful” lumbar discs. Spine (Phila Pa 1976), 22(20), 2342-2349; discussion 2349-2350. doi.org/10.1097/00007632-199710150-00005
Ramos, G., & Martin, W. (1994). Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg, 81(3), 350-353. doi.org/10.3171/jns.1994.81.3.0350
Roland, M. O. (1986). A critical review of the evidence for a pain-spasm-pain cycle in spinal disorders. Clin Biomech (Bristol, Avon), 1(2), 102-109. doi.org/10.1016/0268-0033(86)90085-9
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
Zhang, Y. G., Guo, T. M., Guo, X., & Wu, S. X. (2009). Clinical diagnosis for discogenic low back pain. Int J Biol Sci, 5(7), 647-658. doi.org/10.7150/ijbs.5.647
Learning the cause of the problem and how to effectively manage it can help individuals experiencing back spasms to quickly and safely return to previous levels of function and activity.
Back Spasm
Individuals dealing with back pain or sciatica usually describe the symptoms as the back muscles tightening or spasming. A back spasm can feel mild, like a fist pressing into one side of the spine or an intense pain that prevents the individual from sitting, standing, or walking comfortably. Bask spasms can become severe, causing difficulty maintaining normal upright posture.
What Is A Spasm
A back spasm is a sudden onset of back muscle tightness. Sometimes, the tight sensation becomes so intense and severe that it prevents the individual from moving normally. Some individuals have difficulty bending forward because of the pain and tightness.
Symptoms
Most episodes last several hours to several days. Severe cases can last about six to eight weeks, but the spasms and pain subside gradually, allowing the individual to move normally and resume normal activity. Common sensations and symptoms can include:
Difficulty bending.
A tight sensation in the back.
Pulsing pains and sensations.
Pain on one or both sides of the back.
Sometimes, the spasm can cause radiating pain in the buttocks and hips. When severe, it can be accompanied by nerve pain, numbness, and tingling that radiates down one or both legs. (Medline Plus. 2022)
Causes
Back spasms are caused by tight muscle tissue, which often results from some mechanical stress. The stress causes the muscle tissue near the spine to be pulled abnormally. As a result of the pulling, the muscle fibers become taut and painful. Mechanical causes of back spasms may include: (Merck Manual, 2022)
Poor sitting and/or standing posture.
Repetitive overuse injury.
Lumbar strains.
Lumbar disc herniations.
Low back osteoarthritis.
Spondylolisthesis – vertebrae shift out of position, including anterolisthesis and retrolisthesis.
Spinal stenosis
All these can place increased stress on the anatomical structures in the spine. The lower back muscles near these structures may go into a protective spasm that can also cause a tight and painful sensation in the back. Other non-mechanical causes of low back spasms include: (Merck Manual, 2022)
Poor sitting posture or sitting for long periods without back support.
Lack of physical conditioning.
Being overweight or obese.
Psychological conditions – anxiety, depression, and emotional stress.
Family medical history of ankylosing spondylitis.
Smoking
Individuals can stop smoking, start exercising, or engage in positive activities to help manage stress. Individuals dealing with back spasms may need to see a healthcare provider for a proper diagnosis and treatment.
Treatment
Treatment for back spasms can include home remedies or therapies from medical providers. The treatments are designed to relieve the spasms and manage the mechanical stresses that may have caused them. Medical professionals can also show strategies to prevent spasms. Home remedies can include: (Merck Manual, 2022)
If self-care strategies are unable to provide relief, individuals may need to visit a medical professional for treatment. Medical treatments can include: (Merck Manual, 2022)
Most individuals are able to manage symptoms with physical therapy or chiropractic, which includes learning exercises and posture adjustments to relieve tightness.
Bhatia, A., Engle, A., & Cohen, S. P. (2020). Current and future pharmacological agents for the treatment of back pain. Expert opinion on pharmacotherapy, 21(8), 857–861. doi.org/10.1080/14656566.2020.1735353
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
For individuals suffering from back pain, can knowing basic chiropractic terminology help in understanding diagnosis and treatment plan development?
Chiropractic Terminology
The chiropractic principle is that a properly aligned spine positively affects an individual’s overall health. One of the main aspects of chiropractic care is applying calculated force to the spinal joints to restore correct spinal alignment. Chiropractic terminology describes specific types of techniques and care.
General Subluxation
A subluxation can mean different things for various doctors. In general, a subluxation is a significant structural displacement or an incomplete or partial dislocation of a joint or organ.
To medical doctors, a subluxation refers to a partial dislocation of a vertebrae.
This is a serious condition, usually brought on by trauma, that can result in a spinal cord injury, paralysis, and/or death.
X-rays show a conventional subluxation as an obvious disconnect between the vertebrae.
Chiropractic Subluxation
The chiropractic interpretation is more subtle and refers to the misalignment of adjacent spinal vertebrae.
Subluxation in this context refers to position changes in the joints and soft tissues of the spine.
Vertebral misalignment is believed to lead to pain and abnormal intervertebral joint motion.
This difference between the serious subluxation medical condition and the chiropractic version may cause individuals to dismiss seeking back pain treatments.
Motion Segment
Chiropractors and surgeons use it as a technical term.
Motion segment refers to two adjacent vertebrae and the intervertebral disc between them.
This is the area chiropractors assess and adjust.
Adjustment
The chiropractor performs a spinal manual adjustment to realign joint subluxations.
Adjustments involve applying force to motion segments to bring them back into a centered alignment.
The goal for adjustments and realigning the vertebrae includes:
Spinal manipulation is a technique used by chiropractors to provide relief for musculoskeletal pain related to the back and neck. Manipulation provides mild to moderate relief and works as well as some conventional treatments like pain-relieving medications. (Sidney M. Rubinstein et al., 2012)
Spinal manipulation is divided into grades of mobilization.
Depending on their training, practitioners of various medical disciplines may be licensed to perform grade 1 to grade 4 mobilizations.
Only physical therapists, osteopathic physicians, and chiropractors are licensed to perform grade 5 mobilizations, which are high-velocity thrust techniques.
Most massage therapists, athletic trainers, and personal trainers are not licensed to perform spinal manipulations.
Based on a systematic review, the effectiveness of these treatments found that there is quality evidence that manipulation and mobilization can help reduce pain and improve function for individuals with chronic low back pain, with manipulation appearing to produce a more profound effect than mobilization. Both therapies are safe, with multimodal treatments potentially being an effective option. (Ian D. Coulter et al., 2018)
As with any treatment, results vary from person to person and with different chiropractors. There are also potential risks with spinal manipulation. Though rare, cervical, carotid, and vertebral artery dissections have occurred with cervical/neck manipulation. (Kelly A. Kennell et al., 2017) Individuals with osteoporosis may be advised to avoid chiropractic adjustments or manipulation because of the increased risk of injury. (James M. Whedon et al., 2015)
Many individuals choose chiropractic treatment for a variety of conditions. Understanding chiropractic terminology and reasoning allows individuals to ask questions as they discuss their symptoms to develop a personalized treatment plan and restore function and wellness.
What Causes Disc Herniation?
References
Henderson C. N. (2012). The basis for spinal manipulation: chiropractic perspective of indications and theory. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology, 22(5), 632–642. doi.org/10.1016/j.jelekin.2012.03.008
Blanchette, M. A., Stochkendahl, M. J., Borges Da Silva, R., Boruff, J., Harrison, P., & Bussières, A. (2016). Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies. PloS one, 11(8), e0160037. doi.org/10.1371/journal.pone.0160037
Rubinstein, S. M., Terwee, C. B., Assendelft, W. J., de Boer, M. R., & van Tulder, M. W. (2012). Spinal manipulative therapy for acute low-back pain. The Cochrane database of systematic reviews, 2012(9), CD008880. doi.org/10.1002/14651858.CD008880.pub2
Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The spine journal : official journal of the North American Spine Society, 18(5), 866–879. doi.org/10.1016/j.spinee.2018.01.013
Kennell, K. A., Daghfal, M. M., Patel, S. G., DeSanto, J. R., Waterman, G. S., & Bertino, R. E. (2017). Cervical artery dissection related to chiropractic manipulation: One institution’s experience. The Journal of family practice, 66(9), 556–562.
Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2015). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66 to 99 years. Spine, 40(4), 264–270. doi.org/10.1097/BRS.0000000000000725
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
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