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Herniated Disc

Back Clinic Herniated Disc Chiropractic Team. A herniated disc refers to a problem with one of the rubbery cushions (discs) between the individual bones (vertebrae) that stack up to make your spine.

A spinal disc has a soft center encased within a tougher exterior. Sometimes called a slipped disc or a ruptured disc, a herniated disc occurs when some of the soft centers push out through a tear in the tougher exterior.

A herniated disc can irritate the surrounding nerves which can cause 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 disc will not need surgery to correct the problem.

Symptoms

Most herniated disks occur in the lower back (lumbar spine), although they can also occur in the neck (cervical spine). Most common symptoms of a herniated disk:

Arm or leg pain: A herniated disk in the lower back, typically an individual will feel the most intense pain in the buttocks, thigh, and calf. It may also involve part of the foot. If the herniated disc is in the neck, the pain will typically be most intense in the shoulder and arm. This pain may shoot into the arm or leg when coughing, sneezing, or moving the spine into certain positions.

Numbness or tingling: A herniated disk can feel like numbness or tingling in the body part served by the affected nerves.

Weakness: Muscles served by the affected nerves tend to weaken. This may cause stumbling or impair the ability to lift or hold items.

Someone can have a herniated disc without knowing. Herniated discs sometimes show up on spinal images of people who have no symptoms of a disc problem. For answers to any questions you may have please call Dr. Jimenez at 915-850-0900


Auto Accident Herniation & Decompression Therapy

Auto Accident Herniation & Decompression Therapy

Introduction

The body is a well-tuned machine that is on the move constantly. The different systems like the musculoskeletal system, the immune system, and the joint system, to name a few, can help the body’s motor function to get the body from point A to point B. When injuries or auto accidents affect the body, it can cause various issues to affect the body over time. Many people who suffer from an auto accident injury will experience pain in the cervical and lumbar portions of their spine. It can be nerve-wracking as they are trying to comprehend what is happening. Today’s article will focus on herniation due to auto accidents, how it affects the spine, and how decompression treatments can help many suffering individuals with auto accident herniation. Referring patients to qualified and skilled providers who specialize in spinal decompression therapy. We guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is essential for asking insightful questions to our providers. Dr. Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions or concerns, please call Dr. Jimenez at 915-850-0900.

G-5 - VAX-D Research

How Do Auto Accidents Cause Herniation?

 

Have you experienced pain in your neck or low back? Did you experience whiplash in your neck? Has the pain progressively gotten worse after the accident? Many of the symptoms are primarily the after-effects of an auto accident involving a person. After a person has been involved in an auto accident, the injuries and symptoms usually occur within a few minutes until the next day. Research studies have shown that auto accident injury symptoms like herniation occur when the cervical and lumbar portions are injured, causing symptoms like soft tissue strain and disc derangement to be accompanied by radicular pain symptoms. Auto accident herniation also starts to compress the surrounding nerves around the spine. It induces inflammatory markers in the affected areas situated in the neck and lower back. Additional studies have found that auto accident herniation also affects the thoracic portion of the back. Many individuals that suffer from herniation will experience posterior shoulder pain and upper/lower back pain from being involved in an auto accident.

 

How Does It Affect The Spine?

When a person has suffered from an auto accident, the after-effects do take a toll not only on the body but the spine as well. The painful, inflammatory symptoms cause the soft muscle tissues to become tender to the touch. Research studies have mentioned that the spine will experience possible fractures along the lumbar section of the spine due to the force impact causing axial compression and overstretching of the muscles and soft tissues, causing sharp shooting pain. This makes the back and neck succumb to more despair after the auto accident occurs, thus hindering a person’s quality of life. More research studies have shown that many suffering individuals experience lumbosacral radicular pain on top of herniation. When a person has been suffering from disc degeneration and has been involved in an auto accident, the cascading effects cause the intervertebral disc’s outer layer to rupture and allow disc material displacement to cause herniation on the spine. When the ruptured disc becomes herniated, it will constantly press on the nerve roots, and any normal reactions like coughing or sneezing will worsen the pain. Thankfully, there are therapeutic methods that help alleviate herniation and help restore function to the spine.


Mechanical Traction For Herniation-Video

Feeling uncomfortable pain in your neck or back? Have everyday actions like coughing or sneezing hurt your back when not supposed to? Does the pain progressively get worst throughout the entire day? All these symptoms are due to disc herniation caused by auto accidents and can affect a person’s quality of life. The good news is that traction therapy may be the answer for relieving some of the symptoms like herniation on the spine. The video above shows how mechanical traction is used for many individuals suffering pain in the cervical area of the body. Traction therapy is a form of decompression treatment that is either non-surgical or surgical, depending on how severe the pain affects the body. Traction helps the spine through gentle pulling, causing the herniated discs to withdraw from the compressed nerves and establish healing properties to remoisturize in the affected discs while increasing the disc space between the spinal vertebrae. Decompression/traction therapy for either the lumbar or cervical regions of the spine has many beneficial factors in preventing disc herniation. This link will explain how decompression or traction offers impressive relief for many people who suffer from neck and low back pain herniation caused by auto accident injuries.


How Decompression Treatments Help Auto Accident Herniation

 

After a person suffers from an auto accident injury, the body will sometimes experience the painful effects the next day since the body has an adrenaline rush that masks the pain. When this happens, therapeutic methods help alleviate the pain and try to repair the body to be functional again. Research studies have shown that decompression treatments have helped many individuals suffering from herniation due to auto accidents by using unloading force traction from the therapy to reduce herniation on the spine. This opposing force helps ease the painful symptoms caused by disc herniation while the compressed nerves are relieved. Other research studies have mentioned that traction therapy, when utilized for herniation, causes vertebral separation to increase the disc space and decrease the nerve root compression. This allows the spinal ligaments to tense up, which is beneficial for the herniated discs to return to the spine and cause relief to the suffering individuals.

 

Conclusion

Overall the after-effects of an auto accident injury that causes the spine to become herniated affect a person’s quality of life. The painful symptoms cause compression to the surrounding nerve roots, sending pain signals to disrupt the brain and overstretch the muscles when the spine is injured. After the auto accident has occurred, the residual pain will cause tenderness in the cervical and lumbar portions of the spine causing even more pain to the person. Treatments like traction therapy allow individuals to find the relief they desperately need as the herniated disc is relocated to its original position and laid off on the nerve roots. Traction therapy provided beneficial relief to the spine due to negative pressure and brought back the spine’s functionality to the body.

 

References

Cornips, Erwin M J. “Crippling Upper Back Pain after Whiplash and Other Motor Vehicle Collisions Caused by Thoracic Disc Herniations: Report of 10 Cases.” Spine, U.S. National Library of Medicine, 20 May 2014, pubmed.ncbi.nlm.nih.gov/24718062/.

Hashish, Rami, and Hasan Badday. “Frequency of Acute Cervical and Lumbar Pathology in Common Types of Motor Vehicle Collisions: A Retrospective Record Review.” BMC Musculoskeletal Disorders, BioMed Central, 9 Nov. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5680606/.

Kumari, Anita, et al. “Effects of One-Fifth, One-Third, and One-Half of the Bodyweight Lumbar Traction on the Straight Leg Raise Test and Pain in Prolapsed Intervertebral Disc Patients: A Randomized Controlled Trial.” BioMed Research International, Hindawi, 16 Sept. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8463178/.

Oakley, Paul A, and Deed E Harrison. “Lumbar Extension Traction Alleviates Symptoms and Facilitates Healing of Disc Herniation/Sequestration in 6-Weeks, Following Failed Treatment from Three Previous Chiropractors: A CBP® Case Report with an 8 Year Follow-Up.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Nov. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5702845/.

Pachocki, L, et al. “Biomechanics of Lumbar Spine Injury in Road Barrier Collision-Finite Element Study.” Frontiers in Bioengineering and Biotechnology, Frontiers Media S.A., 1 Nov. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8591065/.

Suri, Pradeep, et al. “Inciting Events Associated with Lumbar Disc Herniation.” The Spine Journal : Official Journal of the North American Spine Society, U.S. National Library of Medicine, May 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2919742/.

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Decompression Traction Relieves Bulging Discs In Spine

Decompression Traction Relieves Bulging Discs In Spine

Introduction

The spine provides many functions that the body requires when it is on the move. Without it, the body will not be able to stay upright and give the everyday movement that the body needs. The spine has three sections that provide an S-shaped curvature in the back: cervical, thoracic, and lumbar. These three sections of the spine have ligaments, soft muscle tissues, and spinal nerves enveloped around the spine to protect the spinal cord. The spinal cord consists of spinal discs and a spinal column part of the central nervous system. When acute injuries or traumas start to affect the spine, it can develop a bulging disc in the spine. Today’s article will focus on the signs of a bulging disc, how a person can distinguish between disc herniation and a bulging disc, and how decompression traction can help prevent bulging discs from developing further into herniation. Referring patients to qualified and skilled providers who specialize in spinal decompression therapy. We guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is essential for asking insightful questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions or concerns, please call Dr. Jimenez at 915-850-0900.

SpineMed #2

Signs You Have Bulging Discs

 

Have you been feeling a dull ache located in your lower back? Does it hurt when you are sitting down and trying to relax? Or have ordinary activities been challenging to manage due to the excruciating pain you are experiencing? Some of these symptoms could be signs that a bulging disc is starting to develop as research has defined a bulging disc as a dull ache on the spine that is barely protruding out and is considered the first stage for a herniated disc. When the body starts to age naturally, so do the spinal discs, as these cushion-like discs between the spinal joints help absorb the shock that the spine goes through. When spinal discs lose their water retention and begin to stiffen up, it causes the outer layer to crack and release the inner layer to bulge out a bit. Other research studies have found that the inner layer or the nucleus pulposus can develop the process of disc herniation. When the nucleus pulposus starts to protrude out of the outer layer of the spinal discs can develop into other spinal issues like sciatica, herniation, radicular pain, and myelopathy. 

 

Is It A Herniated Disc Or Bulging Discs?

A person can tell if they are suffering from a herniated disc or a bulging disc. As stated earlier, a bulging disc is where it is barely protruding out of the spinal column and is considered the first stage of disc herniation. For herniated discs, however, research studies have defined that herniated discs are commonly diagnosed due to degenerative spinal abnormalities that extend out and compress the surrounding nerves all over the body. Herniated discs can cause various symptoms ranging from a dull minor ache to radiating pain that travels down to the affected areas like the neck and lower back. Sometimes injuries can cause herniated discs or bulging discs due to the severity, as additional information has shown that nerve compression in the spinal canal is from disc bulging/herniation or can even degenerate muscle tissue expansion from overusing the back muscles. These causes start the development of a bulging disc or herniated disc and can cause immense painful symptoms to the body’s affected neck and back areas. Fortunately, there are accessible treatments that help prevent bulging discs from progressing further into herniation and reduce the pain from nerve compression.

 


Lumbar Spine Traction For Bulging Discs-Video

Have you been experiencing radiating nerve pain down your legs? How about a dull ache that seems to worsen throughout the day? Do you feel tenderness in your lower back or certain areas around your neck? You might be experiencing disc herniation or bulging issues affecting the cervical or lumbar sections of your spine. Why not try decompression or traction therapy to help prevent it from causing more problems? The video above explains what spinal traction does for the spine and how many individuals can utilize it. Spinal traction and decompression therapy allow the spine to be gently stretched out for the spinal discs that are herniated or bulging out to return to their original forms before the injuries that caused them to be herniated. This type of treatment allows the aggravated nerves surrounding the spine to finally relax and stop sending pain signals to the affected areas. Decompression/traction therapy for either the lumbar or cervical regions of the spine has many beneficial factors in preventing disc herniation and bulging. This link will explain how decompression offers impressive relief for many people who suffer from neck and low back pain in the affected regions due to disc herniation.


How Decompression Traction Helps Prevents Bulging Discs

 

Decompression traction therapy is the best way many individuals can prevent disc bulging from progressing into herniation by utilizing treatment to help rehydrate the spinal discs back to their original function. Research studies have found that decompression/traction is adequate for many individuals suffering from herniated discs by improving the symptoms. With decompression traction, it allows the spinal column to be gently pulled, causing the herniated disc’s size to decrease and promoting relief to the body. Other research studies have found that decompression traction is beneficial for individuals suffering from acute low back pain and even helps improve lumbar range of motion flexion for the back. Decompression traction can help many people bring back their quality of life, knowing that there is a way to alleviate low back or neck pain.

 

Conclusion

Overall the spine can succumb to many unwanted factors or injuries that can cause the spinal disc to bulge or herniate, depending on how severe the injury has affected the body. With decompression traction, it can relieve the affected spinal nerves by pulling the spinal disc back to its original position. This gentle pull on the spine can help rehydrate the discs and repair the outer layers from cracking under pressure. Incorporating decompression traction as part of an individual’s wellness treatment will provide beneficial results that rejuvenate the spine to its original functioning state.

 

References

De Cicco, Franco L, and Gaston O Camino Willhuber. “Nucleus Pulposus Herniation – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 1 May 2022, www.ncbi.nlm.nih.gov/books/NBK542307/.

Donnally, Chester J, et al. “Lumbosacral Disc Injuries.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 12 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK448072/.

Karimi, Noureddin, et al. “Effects of Segmental Traction Therapy on Lumbar Disc Herniation in Patients with Acute Low Back Pain Measured by Magnetic Resonance Imaging: A Single Arm Clinical Trial.” Journal of Back and Musculoskeletal Rehabilitation, U.S. National Library of Medicine, 2017, pubmed.ncbi.nlm.nih.gov/27636836/.

Ozturk, Bulent, et al. “Effect of Continuous Lumbar Traction on the Size of Herniated Disc Material in Lumbar Disc Herniation.” Rheumatology International, U.S. National Library of Medicine, May 2006, pubmed.ncbi.nlm.nih.gov/16249899/.

Shelerud, Randy A. “Bulging Disk vs. Herniated Disk: What’s the Difference?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 May 2022, www.mayoclinic.org/diseases-conditions/herniated-disk/expert-answers/bulging-disk/faq-20058428.

Vialle, Luis Roberto, et al. “Lumbar Disc Herniation.” Revista Brasileira De Ortopedia, Elsevier, 16 Nov. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4799068/.

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Alleviate Cervical & Lumbar Herniation With Decompression

Alleviate Cervical & Lumbar Herniation With Decompression

Introduction

The spine is an S-shaped curve that runs down the back from the skull down to the pelvic bone. The vertebrae that make up the spine helps keep the body standing upright and do everyday movements to function. Whether the person is doing physical activities, running errands, or even sitting down and relaxing, the body always ends up in weird positions that may look uncomfortable and cause pain without even the individual realizing it. The cervical and lumbar regions of the spine have succumbed to injuries that can develop into lower back and neck pain if it is not treated right away. Fortunately, there are available treatments that provide the necessary relief in both regions of the spine. Today’s article looks at disc herniation, how it affects the lumbar and cervical areas of the spine, and how spinal decompression can help relieve disc herniation in these two regions. Referring patients to qualified and skilled providers who specialize in spinal decompression therapy. We guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is essential for asking insightful questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions or concerns, please call Dr. Jimenez at 915-850-0900.

FreeReport-Herniations

What Is Disc Herniation?

Feeling muscle tension on your neck or your lower back? Does the pain seem to be a gradual nuisance or a dull ache? Do you often find that different positions work better for pain relief? If you have experienced these symptoms, it could be due to disc herniation in your spine. The spine works because it is enveloped with musculoskeletal soft tissues, ligaments, and spinal discs that help protect the spinal cord from injuries. When the spine suffers from an injury or naturally ages, the spinal discs’ outer layers will begin to compress and start to protrude out, causing pain to the body. Research studies have defined disc herniation as a common condition that affects the spine. Disc herniation causes the outer layers of the spinal disc to bulge out of their original position and start to irritate the surrounding spinal nerves that are spread out the entire body. When a herniated disc starts to press on the spinal nerves, it causes those nerve roots to send out pain signals to the affected areas around the spine and back. These compressed nerves can also cause spinal cord dysfunction or myelopathy pain in the areas that can affect the body’s sensory and motor functions. 

 

How Does It Affect The Cervical & Lumbar Regions?

The spine’s two regions, the cervical and the lumbar sections help the body stay functional. The cervical area of the spine incorporates the upper back, neck, head, shoulders, and arms, while the lumbar section has the lower back, hips, legs, and feet. When disc herniation starts to affect either one of these two regions, it can cause severe neck and lower back problems. Research studies have found that cervical herniated discs are one of the leading causes of many people suffering from neck pain. Many people often tell their primary physicians that they feel muscle stiffness in their necks from ordinary factors like being hunched over for an extended period or from an injury that causes them to develop whiplash. The nerves surrounding the cervical section of the spine will cause an increase in the inflammatory cytokines to cause radiating pain symptoms to affect the upper body. 

 

Now just like the cervical area being affected by disc herniation, the lumbar region of the spine will suffer as well. Research studies have shown that when many people suffer from low back pain, the leading cause is lumbar disc herniation. When the spinal disc becomes herniated in the lumbar section of the spine, it does the same thing where it compresses the spinal root. Other forms of low back symptoms that lumbar disc herniation causes can include sciatica and leg pain. When disc herniation starts to affect the lumbar and cervical areas of the spine, it can cause a person to have motor dysfunction and make them succumb to more pain. Luckily there are treatments to help reduce the effects of disc herniation by restoring the herniated disc back to its original position.


Spinal Decompression For Herniated Discs-Video

Have you been experiencing pain either in your neck or lower back? It seems that certain activities are impossible to do because you are in pain? Do you feel muscle stiffness in either the neck or lower back? If you have been experiencing these systems throughout your entire life, it could be disc herniation located in the cervical and lumbar regions of the body. The video above shows how herniated discs are alleviated through the DRX9000 decompression machine. Decompression treatments are utilized for many suffering individuals with either neck or low back pain looking for relief. What the DRX9000 does is that it gently pulls the spine to increase the disc height and reduce the pressure off of the surrounding nerve roots. Decompression/traction therapy for either the lumbar or cervical regions of the spine has many beneficial factors in a person’s wellness treatment. This link will explain how decompression offers impressive relief for many people who suffer from neck and low back pain in the affected regions.


How Spinal Decompression Help With Disc Herniation

 

When disc herniation starts to affect the cervical or lumbar section of the spine, many people have found ways to try and alleviate the pain so they can continue with their days. Some people will incorporate hot and cold packs to reduce the pain to a dull minor ache, while others use decompression treatments to help restore their spine back to its original function. Research studies have mentioned that non-surgical decompression has helped alleviate the pain factors that herniated discs have caused by increasing the spinal disc height and providing stability to the torso of the body. When decompression increases the spinal’s height, it allows the herniated disc to lay off on the surrounding nerves and even provide relief to the affected areas. Additional information has been provided that the negative pressure produced by decompression allows the disc to be rehydrated and pressure reduced to the affected nerves. When people incorporate decompression for cervical or lumbar disc herniation, they will begin to feel relief after a few sessions.

 

Conclusion

Overall, having neck or low back pain is miserable when the pain starts to affect a person’s day. When the cervical or lumbar regions of the spine are affected by disc herniation, it can disrupt the motor and sensory to operate the neck or lower back, thus causing unwanted issues to make a person suffer in pain. Decompression therapy helps people by using negative pressure to gently stretch the spine and restore it to its original function without pain. Decompression therapy allows the herniated discs to return to the spine and lay off on the aggravating nerves around the spine. This will enable people to continue with their daily activities pain-free.

 

References

Al Qaraghli, Mustafa I, and Orlando De Jesus. “Lumbar Disc Herniation – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 30 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK560878/.

Choi, Jioun, et al. “Influences of Spinal Decompression Therapy and General Traction Therapy on the Pain, Disability, and Straight Leg Raising of Patients with Intervertebral Disc Herniation.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4339166/.

Dydyk, Alexander M, et al. “Disc Herniation – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 18 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK441822/.

Kang, Jeong-Il, et al. “Effect of Spinal Decompression on the Lumbar Muscle Activity and Disk Height in Patients with Herniated Intervertebral Disk.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Nov. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5140813/.

Sharrak, Samir, and Yasir Al Khalili. “Cervical Disc Herniation – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK546618/.

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Decompression Therapy For Relieving Cervical Herniation

Decompression Therapy For Relieving Cervical Herniation

Introduction

As part of the upper body, the neck’s job is to keep the head upright while providing motor functions to turn up, down, left, and right while rotating it counter and clock-wise without any issues or pain. Like the lower back, the neck is enveloped by the spinal cord, ligaments, and soft muscle tissues that protect the cervical area of the spinal column from unwanted factors and injuries. When undesirable factors or injuries cause neck issues, it can affect a person’s ability to keep their head upright. Many injuries or natural factors cause a person to look down constantly and cause tension in the neck and shoulder muscle areas that makes them hunched over. Luckily, treatments are available to help restore neck function back to the individual. Today’s article discusses cervical herniation, how it affects the neck, and how decompression treatments can help relieve the cervical area on the spine. Referring patients to qualified and skilled providers who specialize in spinal decompression therapy. We guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is essential for asking insightful questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions or concerns, please call Dr. Jimenez at 915-850-0900.

FreeReport-Herniations

What Is Cervical Herniation?

 

Have you been feeling stiffness around your neck and shoulder areas? Does your neck ache after hunching over the computer after work? How about the crick in your neck that seems to be irritating? All of these symptoms are due to herniation in the cervical area of the spine. Research studies have defined cervical disc herniation as one of the most common causes of neck pain in individuals. When the body starts to naturally age, the spine does as well. The cervical area of the spine protects the spinal cord through ligaments, soft tissues, nerves, and spinal discs, just like the lower back in the lumbar regions. When there are issues that cause pain in the cervical area, additional research shows that nerve root irritation can cause a wide range of pain in the neck. The pain can be mild to severe depending on the herniated disc’s impact and the severity of the neck’s injury.

 

How Does It Affect The Neck?

Research studies have found that cervical herniation can affect the neck due to the variety of symptoms that it causes. In the upper and lower segments of the spine, disc herniation symptoms are mainly caused due to compression along the spinal nerves, causing them to become aggravated in these two regions. Some of the progressing pain that the neck suffers from cervical herniation can affect one area of the neck, which is axial pain, or it can affect the cervical nerve root that travels down from the shoulders to the hands, which is known as radicular pain. These types of neck pain can be due to cervical herniation and cause a person to be miserable. Additional research studies have shown that when cervical disc herniation starts to progress further, individuals with a sedentary lifestyle haven’t found ways to alleviate the progressing pain that the neck is suffering from. Fortunately, there are treatments for relieving not only neck pain but can restore the cervical spinal discs back in the spine.

 


Cervical Traction For Neck Herniation-Video

Have you been experiencing muscle stiffness in the cervical portion of your neck? How about traveling pain from your shoulders to your hands? Do you feel any pain from stretching your neck from side to side to try and relieve it? Experiencing cervical herniation is no joke regarding your neck and spinal health. Why not give cervical decompression or traction a try? The video above shows what cervical traction does for individuals suffering from neck herniation. Cervical traction can provide beneficial results for people who need relief from neck pain, tension headaches, and migraines impacting their lives. Cervical traction allows the cervical herniated discs to lay off on the irritated cervical nerve and relieve the neck through gentle pulling. Cervical decompression/traction therapy has many beneficial factors in a person’s wellness treatment. This link will explain how cervical decompression offers impressive comfort for many people who suffer from neck pain and cervical herniation.


How Does Decompression Therapy Help With Cervical Herniation

 

Since the neck helps make sure that the head is kept upright and unwanted circumstances and injuries occur on the neck, many treatments are there to help many individuals who suffer from cervical herniation or neck pain. Research studies have found that spinal decompression treatments for the cervical spine can help improve cervical disc herniation symptoms in the neck. What cervical decompression does to the neck is that it helps promote inflammatory absorption in the neuromuscular tissues while also enhancing and restoring the natural curvature of the cervical spine. When individuals utilize cervical decompression therapy for their neck pain, it helps them rebuild the lost biomechanical balance in the cervical vertebrae and promotes healing of the neck. 

 

Conclusion

The neck’s primary function in the body is to make sure that the head is upright and can move around without feeling any pain or issues. However, just like the lower back, the neck can suffer from injuries like disc herniation, neck pain, and neck-related problems that can cause a person to be miserable. Cervical decompression/traction therapy has been a promising non-surgical treatment for neck pain by gently pulling on the cervical area, allowing the cervical disc herniation to be back in the spine and cause relief to the person. This treatment can be a part of a person’s wellness journey in finding ways to relieve pain one section at a time.

 

References

Curtis, Scott. “All about Neck Pain.” Spine, Spine-Health, 9 Dec. 2019, www.spine-health.com/conditions/neck-pain/all-about-neck-pain.

Dydyk, Alexander M, et al. “Disc Herniation – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 18 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK441822/.

Sharrak, Samir, and Yasir Al Khalili. “Cervical Disc Herniation – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK546618/.

Turk, Okan, and Can Yaldiz. “Spontaneous Regression of Cervical Discs: Retrospective Analysis of 14 Cases.” Medicine, Wolters Kluwer Health, Feb. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6407963/.

Xu, Qing, et al. “Nonsurgical Spinal Decompression System Traction Combined with Electroacupuncture in the Treatment of Multi-Segmental Cervical Disc Herniation: A Case Report.” Medicine, Lippincott Williams & Wilkins, 21 Jan. 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC8772752/.

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Spinal Decompression Therapy Alleviates Wear & Tear Herniated Discs

Spinal Decompression Therapy Alleviates Wear & Tear Herniated Discs

Introduction

For keeping the body upright and on the move, the spine plays an essential role in allowing the body to do these ordinary functions. The S-shaped curve enables the body to rotate from side to side, bend back and forth, and twist without feeling discomfort. The spine is enveloped with ligaments, nerve roots, spinal discs, and soft muscle tissues originating from the spinal column; these components protect the spinal cord from being injured. When the back suffers from unforeseen circumstances or starts to naturally age, the spinal discs in the spine will lose their structure, causing them to shrink and become herniated, depending on how severe the pain is. Fortunately, there are treatments available for herniated discs. Today’s article will focus on wear and tear herniation on the spine, how it affects the back, and how decompression therapy can help herniation. Referring patients to qualified and skilled providers who specialize in spinal decompression therapy. We guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is essential for asking insightful questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions or concerns, please call Dr. Jimenez at 915-850-0900.

FreeReport-Herniations

What Is Wear & Tear Herniation?

Have you been experiencing pain shooting from your lower back to your feet? Does it hurt when you are doing daily activities like walking or running? Have you been experiencing muscle stiffness in your lower back or your neck? You might be suffering from a disc herniation from wear and tear from your spine. Research studies have defined that herniation on the spine happens when the spinal discs between the spinal joint columns are damaged. Natural wear and tear on the spine when the muscles have been overworked due to heavy lifting or when the outer layer of the spinal discs starts to crack under pressure, letting the inner layers protrude out of alignment of the spine and press on the nerve roots that are connected to the spine.

 

Additional information has provided that disc herniation is usually associated with DDD or disc degeneration disease and contributes to low back pain. When a herniated disc starts to affect the spinal column and press on the spinal nerve roots extending all over to work with the back muscles providing motor and sensory function for the body to move, it increases the inflammatory pathways to cause radiating pain to the body. Wear and tear herniation also causes the inner walls of the spinal disc to become weak due to dehydration when the outer layer is cracked. Research studies have also mentioned that the cervical and lumbar regions of the spine are susceptible to disc herniation due to spinal pathologies that affect the spine itself. Spinal pathologies can include RA (rheumatoid arthritis), fractures, osteoporosis, and infections associated with herniated discs that can cause significant issues on the back and make a person in more pain than they already are. 

 

How Does It Affect The Back?

Disc herniation is associated with low back pain, but other spinal issues that cause disc herniation will affect the back even more, when it is not treated. When disc herniation starts to affect the spine, it affects the back, especially the lower back. Research studies have shown the spinal disc in the spine begins to protrude out, inflammation and nerve compression begin to affect the lower back, causing lumbar radicular pain. Other research studies have shown that lumbar disc herniation causes changes in disc height in the spine while shrinking the dural sac. This causes the spinal joints to rub against each other. At the same time, the herniated disc protrudes to compress the spinal nerve roots, thus sending sudden, throbbing pain all over the back, making the individual miserable.

 


Spinal Decompression Therapy For Herniated Disc-Video

Have you been experiencing aches and pains along your lower back? How about throbbing pain along your sciatic nerve? Does your neck or back feel stiff after suffering from an injury? These are all signs of low back pain associated with disc herniation, and spinal decompression can help alleviate these symptoms. Spinal decompression, as shown in the video above, helps many individuals suffering from low back herniation associated with low back pain. Many decompression machines help suffering individuals with a lumbar disc herniation through gentle pulling on the spine to restore the disc space and take pressure off the surrounding nerves. Decompression helps rehydrate the spinal disc’s outer layer and allows the substances to repair the outer layers. Spinal decompression therapy has many beneficial factors as part of a person’s wellness treatment. This link will explain how spinal decompression offers impressive comfort for many people who suffer from wear and tear herniation.


How Decompression Therapy Can Help Wear & Tear Herniation

 

With lumbar disc herniation affecting the lower back, many treatments are available for restoring the spine from herniated discs. Research studies have provided that non-invasive spinal decompression is very effective for many miserable individuals from herniation on their spine. Spinal decompression allows the affected herniated discs to be reabsorbed back into the spine, allowing the spinal disc height to increase. This type of therapy allows the herniated disc to be taken off the compressed roots and reduces pain signals from affecting the lower half of the body. Additional research studies have found that decompression allows the negative pressure to pull the herniated discs back to the spine and is safe for individuals suffering from lumbar pain. The main goal of decompression therapy is to provide relief to suffering individuals by alleviating spinal and low back issues from their backs. 

 

Conclusion

Overall, disc herniation is caused by natural wear and tear of the spine due to overusing the back muscles in the body. When this happens, the herniated discs are compressing the nerves causing low back pain and spinal issues, causing radiating pain to travel all over the body. Treatments like spinal decompression allow the herniated discs to be pulled back into the spine gently and take the irritating pressure off the nerve roots. When people start to take care of their spine’s health through decompression, they will feel so much better in the long run.

 

References

Al Qaraghli, Mustafa I, and Orlando De Jesus. “Lumbar Disc Herniation – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 30 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK560878/.

Dydyk, Alexander M, et al. “Disc Herniation – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 18 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK441822/.

Kjaer, Per, et al. “Progression of Lumbar Disc Herniations over an Eight-Year Period in a Group of Adult Danes from the General Population–a Longitudinal MRI Study Using Quantitative Measures.” BMC Musculoskeletal Disorders, BioMed Central, 15 Jan. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4714478/.

N;, Demirel A;Yorubulut M;Ergun. “Regression of Lumbar Disc Herniation by Physiotherapy. Does Non-Surgical Spinal Decompression Therapy Make a Difference? Double-Blind Randomized Controlled Trial.” Journal of Back and Musculoskeletal Rehabilitation, U.S. National Library of Medicine, 22 Sept. 2017, pubmed.ncbi.nlm.nih.gov/28505956/.

Oh, Hyunju, et al. “Effects of the Flexion-Distraction Technique and Drop Technique on Straight Leg Raising Angle and Intervertebral Disc Height of Patients with an Intervertebral Disc Herniation.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Aug. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6698474/.

Yang, Hao, et al. “Low Back Pain Associated with Lumbar Disc Herniation: Role of Moderately Degenerative Disc and Annulus Fibrous Tears.” International Journal of Clinical and Experimental Medicine, e-Century Publishing Corporation, 15 Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4402739/.

Zielinska, Nicol, et al. “Risk Factors of Intervertebral Disc Pathology-a Point of View Formerly and Today-A Review.” Journal of Clinical Medicine, MDPI, 21 Jan. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC7865549/.

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Disc Bulge & Herniation Chiropractic Care Overview

Disc Bulge & Herniation Chiropractic Care Overview

Disc bulge and disc herniation are some of the most common conditions affecting the spine of both young and middle-aged patients. It is estimated that approximately 2.6% of the US population annually visits a clinician to treat spinal disorders. Roughly $ 7.1 billion alone is lost due to the time away from work.

Disc herniation is when the whole or part of the nucleus pulposus is protruded through the torn or weakened outer annulus fibrosus of the intervertebral disc. This is also known as the slipped disc and frequently occurs in the lower back, sometimes also affecting the cervical region. Herniation of the intervertebral disc is defined as a localized displacement of disc material with 25% or less of the disc circumference on an MRI scan, according to the North American Spine Society 2014. The herniation may consist of nucleus pulposus, annulus fibrosus, apophyseal bone or osteophytes, and the vertebral endplate cartilage in contrast to disc bulge.

There are also mainly two types of disc herniation. Disc protrusion is when a focal or symmetrical extension of the disc comes out of its confines in the intervertebral space. It is situated at the intervertebral disc level, and its outer annular fibers are intact. A disc extrusion is when the intervertebral disc extends above or below the adjacent vertebrae or endplates with a complete annular tear. In this type of disc extrusion, a neck or base is narrower than the dome or the herniation.

A disc bulge is when the outer fibers of the annulus fibrosus are displaced from the margins of the adjacent vertebral bodies. Here, the displacement is more than 25% of the circumference of the intervertebral disc. It also does not extend below or above the margins of the disc because the annulus fibrosus attachment limits it. It differs from disc herniation because it involves less than 25% of the disc’s circumference. Usually, the disc bulge is a gradual process and is broad. The disc bulge can be divided into two types. In a circumferential bulge, the whole disc circumference is involved. More than 90 degrees of the rim is involved asymmetrically in asymmetrical bulging.

Normal Intervertebral Disc Anatomy

Before going into detail about the definition of disc herniation and disc bulge, we need to look at the standard intervertebral disc. According to spine guidelines in 2014, a standard disc is something that has a classic shape without any evidence of degenerative disc changes. Intervertebral discs are responsible for one-third to one-fourth of the height of the spinal column.

One intervertebral disc is about 7 -10 mm thick and measures 4 cm in anterior-posterior diameter in the lumbar region of the spine. These spinal discs are located between two adjacent vertebral bodies. However, no discs can be found between the atlas and axis and the coccyx. About 23 discs are found in the spine, with six in the cervical spine, 12 in the thoracic spine, and only five in the lumbar spine.

Intervertebral discs are made of fibro cartilages, forming a fibrocartilaginous joint. The outer ring of the intervertebral disc is known as the annulus fibrosus, while the inner gel-like structure in the center is known as the nucleus pulposus. The cartilage endplates sandwich the nucleus pulposus superiorly and inferiorly. The annulus fibrosus comprises concentric collagen fiber sheets arranged in a radial tire-like structure into lamellae. The fibers are attached to the vertebral endplates and oriented at different angles. With their cartilaginous part, the endplates anchor the discs in their proper place.

The nucleus pulposus is composed of water, collagen, and proteoglycans. Proteoglycans attract and retain moisture, giving the nucleus pulposus a hydrated gel-like consistency. Interestingly, throughout the day, the amount of water found in the nucleus pulposus varies according to the person’s level of activity. This feature in the intervertebral disc serves as a cushion or a spinal shock-absorbing system to protect the adjacent vertebra, spinal nerves, spinal cord, brain, and other structures against various forces. Although the individual movement of the intervertebral discs is limited, some form of vertebral motion like flexion and extension is still possible due to the features of the intervertebral disc.

Effect of Intervertebral Disc Morphology on Structure and Function

The type of components present in the intervertebral disc and how it is arranged determine the morphology of the intervertebral disc. This is important in how effectively the disc does its function. As the disc is the most important element which bears the load and allows movement in the otherwise rigid spine, the constituents it is made up of have a significant bearing.

The complexity of the lamellae increases with advancing age as a result of the synthetic response of the intervertebral disc cells to the variations in the mechanical load. These changes in lamellae with more bifurcations, interdigitation and irregular size and number of lamellar bands will lead to the altered bearing of weight. This in turn establishes a self-perpetuated disruption cycle leading to the destruction of the intervertebral discs. Once this process is started it is irreversible. As there is an increased number of cells, the amount of nutrition the disc requires is also increasingly changing the normal concentration gradient of both metabolites and nutrients. Due to this increased demand, the cells may also die increasingly by necrosis or apoptosis.

Human intervertebral discs are avascular and hence the nutrients are diffused from the nearby blood vessels in the margin of the disc. The main nutrients; oxygen and glucose reach the cells in the disc through diffusion according to the gradient determined by the rate of transport to the cells through the tissues and the rate of demand. Cells also increasingly produce lactic acid as a metabolic end product. This is also removed via the capillaries and venules back to the circulation.

Since diffusion depends on the distance, the cells lying far from the blood capillaries can have a reduced concentration of nutrients because of the reduced supply. With disease processes, the normally avascular intervertebral disc can become vascular and innervated in degeneration and in disease processes. Although this may increase the oxygen and nutrient supply to the cells in the disc, this can also give rise to many other types of cells that are normally not found in the disc with the introduction of cytokines and growth factors.

The morphology of the intervertebral disc in different parts of the spine also varies although many clinicians base the clinical theories based on the assumption that both cervical and lumbar intervertebral discs have the same structure. The height of the disc was the minimum in the T4-5 level of the thoracic column probably due to the fact that thoracic intervertebral discs are less wedge-shaped than those of cervical and lumbar spinal regions.

From the cranial to caudal direction, the cross-sectional area of the spine increased. Therefore, by the L5-S1 level, the nucleus pulposus was occupying a higher proportion of the intervertebral disc area. The cervical discs have an elliptical shape on cross-section while the thoracic discs had a more circular shape. The lumbar discs also have an elliptical shape though it is more flattened or re-entrant posteriorly.

What is a Disc Bulge?

The bulging disc is when the disc simply bulges outside the intervertebral disc space it normally occupies without the rupture of the outer annulus fibrosus. The bulging area is quite large when compared to a herniated disc. Moreover, in a herniated disc, the annulus fibrosus ruptures or cracks. Although disc bulging is more common than disc herniation, it causes little or no pain to the patient. In contrast, the herniated disc causes a lot of pain.

Causes for Disc Bulging

A bulging disc can be due to several causes. It can occur due to normal age-related changes such as those seen in degenerative disc disease. The aging process can lead to structural and biochemical changes in the intervertebral discs and lead to reduced water content in the nucleus pulposus. These changes can make the patient vulnerable to disc bulges with only minor trauma. Some unhealthy lifestyle habits such as a sedentary lifestyle and smoking can potentiate this process and give rise to more severe changes with the weakening of the disc.

General wear and tear due to repeated microtrauma can also weaken the disc and give rise to disc bulging. This is because when the discs are strained, the normal distribution of weight loading changes. Accumulated micro-trauma over a long period of time can occur in bad posture. Bad posture when sitting, standing, sleeping, and working can increase the pressure in the intervertebral discs.

When a person maintains a forward bending posture, it can lead to overstretching and eventually weakness of the posterior part of the annulus fibrosus. Over time, the intervertebral disc can bulge posteriorly. In occupations that require frequent and repetitive lifting, standing, driving, or bending, the bulging disc may be an occupational hazard. Improper lifting up of items, and improper carrying of heavy objects can also increase the pressure on the spine and lead to disc bulges eventually.

The bulging intervertebral discs usually occur over a long period of time. However, the discs can bulge due to acute trauma too. The unexpected sudden mechanical load can damage the disc resulting in micro-tears. After an accident, the disc can become weakened causing long-term microdamage ultimately leading to bulging of the disc. There may also be a genetic component to the disc bulging. The individual may have a reduced density of elastin in the annulus fibrosus with increased susceptibility to disc diseases. Other environmental facts may also play a part in this disease process.

Symptoms of Disc Bulging

As mentioned previously, bulging discs do not cause pain and even if they do the severity is mild. In the cervical region, the disease will cause pain running down the neck, deep pain in the shoulder region, pain radiating along the upper arm, and forearm up to the fingers.

This may give rise to a diagnostic dilemma as to whether the patient is suffering from a myocardial infarction as the site of referred pain and the radiation is similar. Tingling feeling on the neck may also occur due to the bulging disc.

In the thoracic region, there may be pain in the upper back that radiates to the chest or the upper abdominal region. This may also suggest upper gastrointestinal, lung, or cardiac pathology and hence need to be careful when analyzing these symptoms.

The bulging discs of the lumbar region may present as lower back pain and tingling feeling in the lower back region of the spine. This is the most common site for disc bulges since this area holds the weight of the upper body. The pain or the discomfort can spread through the gluteal area, thighs, and to the feet. There may also be muscle weakness, numbness or tingling sensation. When the disc presses on the spinal cord, the reflexes of both legs can increase leading to spasticity.

Some patients may even have paralysis from the waist down. When the bulging disc compresses on the cauda equine, the bladder and bowel functions can also change. The bulging disc can press on the sciatic nerve leading to sciatica where the pain radiates in one leg from the back down to the feet.

The pain from the bulging disc can get worse during some activities as the bulge can then compress on some of the nerves. Depending on what nerve is affected, the clinical features can also vary.

Diagnosis of Disc Bulging

The diagnosis may not be apparent from clinical history due to similar presentations in more serious problems. But the chronic nature of the disease may give some clues. Complete history and a physical examination need to be done to rule out myocardial infarction, gastritis, gastro-oesophageal reflux disease, and chronic lung pathology.

MRI of Disc Bulge

Investigations are necessary for the diagnosis. X-ray spine is performed to look for gross pathology although it may not show the bulging disc directly. There may be indirect findings of disk degeneration such as osteophytes in the endplates, gas in the disc due to the vacuum phenomenon, and the loss of height of the intervertebral disc. In the case of moderate bulges, it may sometimes appear as non-focal intervertebral disc material that is protruded beyond the borders of the vertebra which is broad-based, circumferential, and symmetrical.

Magnetic resonance imaging or MRI can exquisitely define the anatomy of the intervertebral discs especially the nucleus pulposus and its relationships. The early findings seen on MRI in disc bulging include the loss of normal concavity of the posterior disc. The bulges can be seen as broad-based, circumferential, and symmetrical areas. In moderate bulging, the disc material will protrude beyond the borders of the vertebrae in a non-focal manner. Ct myelogram may also give detailed disc anatomy and may be useful in the diagnosis.

Treatment of Disc Bulging

The treatment for the bulging disc can be conservative, but sometimes surgery is required.

Conservative Treatment

When the disc bulging is asymptomatic, the patient does not need any treatment since it does not pose an increased risk. However, if the patient is symptomatic, the management can be directed at relieving the symptoms. The pain is usually resolved with time. Till then, potent pain killers such as non-steroidal anti-inflammatory drugs like ibuprofen should be prescribed. In unresolved pain, steroid injections can also be given to the affected area and if it still does not work, the lumbar sympathetic block can be tried in most severe cases.

The patient can also be given the option of choosing alternative therapies such as professional massage, physical therapy, ice packs, and heating pads which may alleviate symptoms. Maintaining correct posture, tapes, or braces to support the spine are used with the aid of a physiotherapist. This may fasten the recovery process by avoiding further damage and keeping the damaged or torn fibers in the intervertebral disc without leakage of the fluid portion of the disc. This helps maintain the normal structure of the annulus and may increase the recovery rate. Usually, the painful symptoms which present initially get resolved over time and lead to no pain. However, if the symptoms get worse steadily, the patient may need surgery

If the symptoms are resolved, physiotherapy can be used to strengthen the muscles of the back with the use of exercises. Gradual exercises can be used for the return of function and for preventing recurrences.

Surgical Treatment

When conservative therapy does not work with a few months of treatment, surgical treatment can be considered. Most would prefer minimally invasive surgery which uses advanced technology to correct the intervertebral disc without having to grossly dissect the back. These procedures such as microdiscectomy have a lower recovery period and reduced risk of scar formation, major blood loss, and trauma to adjacent structures when compared to open surgery.

Previously, laminectomy and discectomy have been a mainstay of treatment. However, due to the invasiveness of the procedure and due to increased damage to the nerves these procedures are currently abandoned by many clinicians for disc bulging.

Disc bulging in the thoracic spine is being treated surgically with costotransversectomy where a section of the transverse process is resected to allow access to the intervertebral disc. The spinal cord and spinal nerves are decompressed by using thoracic decompression by removing a part of the vertebral body and making a small opening. The patient may also need a spinal fusion later on if the removed spinal body was significant.

Video-assisted thoracoscopic surgery can also be used where only a small incision is made and the surgeon can perform the surgery with the assistance of the camera. If the surgical procedure involved removing a large portion of the spinal bone and disc material, it may lead to spinal instability. This may need bone grafting to replace the lost portion with plates and screws to hold them in place.

What is a Disc Herniation?

As mentioned in the first section of this article, disc herniation occurs when there is disc material displaces beyond the limits of the intervertebral disc focally. The disc space consists of endplates of the vertebral bodies superiorly and inferiorly while the outer edges of the vertebral apophyses consist of the peripheral margin. The osteophytes are not considered a disc margin. There may be irritation or compression of the nerve roots and dural sac due to the volume of the herniated material leading to pain. When this occurs in the lumbar region, this is classically known as sciatica. This condition has been mentioned since ancient times although a connection between disc herniation and sciatica was made only in the 20th century. Disc herniation is one of the commonest diagnoses seen in the spine due to degenerative changes and is the commonest cause of spinal surgery.

Classifications of Disc Herniation

There are many classifications regarding intervertebral disc herniation. In focal disc herniation, there is a localized displacement of the disc material in the horizontal or axial plane. In this type, only less than 25% of the circumference of the disc is involved. In broad-based disc herniation, about 25 – 50 % of the disc circumference is herniated. The disc bulge is when 50 – 100 % of the disc material is extended beyond the normal confines of the intervertebral space. This is not considered a form of disc herniation. Furthermore, the intervertebral disc deformities associated with severe cases of scoliosis and spondylolisthesis are not classified as a herniation but rather adaptive changes of the contour of the disc due to the adjacent deformity.

Depending on the contour of the displaced material, the herniated discs can be further classified as protrusions and extrusions. In disc protrusion, the distance measured in any plane involving the edges of the disc material beyond intervertebral disc space (the highest measure is taken) is lower than the distance measured in the same plane between the edges of the base.

Imaging can show the disc displacement as a protrusion on the horizontal section and as an extrusion on the sagittal section due to the fact that the posterior longitudinal ligament contains the disc material that is displaced posteriorly. Then the herniation should be considered an extrusion. Sometimes the intervertebral disc herniation can occur in the craniocaudal or vertical direction through a defect in the vertebral body endplates. This type of herniation is known as intravertebral herniation.

The disc protrusion can also be divided into two focal protrusion and broad-based protrusion. In focal protrusion, the herniation is less than 25% of the circumference of the disc whereas, in broad-based protrusion, the herniated disc consists of 25 – 50 % of the circumference of the disc.

In disc extrusion, it is diagnosed if any of the two following criteria are satisfied. The first one is; that the distance measured between the edges of the disc material that is beyond the intervertebral disc space is greater than the distance measured in the same plane between the edges of the base. The second one is; that the material in the intervertebral disc space and material beyond the intervertebral disc space is having a lack continuity.

This can be further characterized as sequestrated which is a subtype of the extruded disc. It is called disc migration when disk material is pushed away from the site of extrusion without considering whether there is continuity of disc or not. This term is useful in interpreting imaging modalities as it is often difficult to show continuity in imaging.

The intervertebral disc herniation can be further classified as contained discs and discs that are unconfined. The term contained disc is used to refer to the integrity of the peripheral annulus fibrosus which is covering the intervertebral disc herniation. When fluid is injected into the intervertebral disc, the fluid does not leak into the vertebral canal in herniations that are contained.

Sometimes there are displaced disc fragments that are characterized as free. However, there should be no continuity between disc material and the fragment and the original intervertebral disc for it to be called a free fragment or a sequestered one. In a migrated disc and in a migrated fragment, there is an extrusion of disc material through the opening in the annulus fibrosus with a displacement of the disc material away from the annulus.

Even though some fragments that are migrated can be sequestered the term migrated means just to the position and it is not referred to the continuity of the disc. The displaced intervertebral disc material can be further described with regard to the posterior longitudinal ligament as submembranous, subcapsular, subligamentous, extra ligamentous, transligamentous, subcapsular, and perforated.

The spinal canal can also get affected by an intervertebral disc herniation. This compromise of the canal can also be classified as mild, moderate, and severe depending on the area that is compromised. If the canal at that section is compromised only less than one third, it is called mild whereas if it is only compromised less than two-thirds and more than one third it is considered moderate. In a severe compromise, more than two-thirds of the spinal canal is affected. For the foraminal involvement, this same grading system can be applied.

The displaced material can be named according to the position that they are in the axial plane from the center to the right lateral region. They are termed as central, right central, right subarticular, right foraminal, and right extraforaminal. The displaced intervertebral disc material’s composition can be further classified as gaseous, liquefied, desiccated, scarred, calcified, ossified, bony, nuclear, and cartilaginous.

Before going into detail on how to diagnose and treat intervertebral disc herniation, let us differentiate how cervical disc herniation differs from lumbar herniation since they are the most common regions to undergo herniation.

Cervical Disc Herniation vs. Thoracic Disc Herniation vs Lumbar Disc Herniation

Lumbar disc herniation is the most commonest type of herniation found in the spine which is approximately 90% of the total. However, cervical disc herniation can also occur in about one-tenth of patients. This difference is mainly due to the fact that the lumbar spine has more pressure due to the increased load. Moreover, it has comparatively large intervertebral disc material. The most common sites of intervertebral disc herniation in the lumbar region are L 5 – 6, in the Cervical region between C7, and in the thoracic region T12.

Cervical disc herniation can occur relatively commonly because the cervical spine acts as a pivoting point for the head and it is a vulnerable area for trauma and therefore prone to damage in the disc. Thoracic disc herniation occurs more infrequently than any of the two. This is due to the fact that thoracic vertebrae are attached to the ribs and the thoracic cage which limits the range of movement in the thoracic spine when compared to the cervical and lumbar spinal discs. However, thoracic intervertebral disc herniation can still occur.

Cervical disc herniation gives rise to neck pain, shoulder pain, pain radiating from the neck to the arm, tingling, etc. Lumbar disc herniation can similarly cause lower back pain as well as pain, tingling, numbness, and muscle weakness seen in the lower limbs. Thoracic disc herniation can give rise to pain in the upper back radiating to the torso.

Epidemiology

Although disc herniation can occur in all age groups, it predominantly occurs between the fourth and fifth decade of life with the mean age of 37 years. There have been reports that estimate the prevalence of intervertebral disc herniation to be 2 – 3 % of the general population. It is more commonly seen in men over 35 years with a prevalence of 4.8% and while in women this figure is around 2.5%. Due to its high prevalence, it is considered a worldwide problem as it is also associated with significant disability.

Risk Factors

In most instances, a herniated disc occurs due to the natural aging process in the intervertebral disc. Due to the disc degeneration, the amount of water that was previously seen in the intervertebral disc gets dried out leading to the shrinking of the disc with the narrowing of the intervertebral space. These changes are markedly seen in degenerative disc disease. In addition to these gradual changes due to normal wear and tear, other factors may also contribute to increasing the risk of intervertebral disc herniation.

Being overweight can increase the load on the spine and increase the risk of herniation. A sedentary life can also increase the risk and therefore an active lifestyle is recommended in preventing this condition. Improper posture with prolonged standing, sitting, and especially driving can put a strain on the intervertebral discs due to the additional vibration from the vehicle engine leading to microtrauma and cracks in the disc. The occupations which require constant bending, twisting, pulling and lifting can put a strain on the back. Improper weight lifting techniques are one of the major reasons.

When back muscles are used in lifting heavy objects instead of lifting with the legs and twisting while lifting can make the lumbar discs more vulnerable to herniation. Therefore patients should always be advised to lift weights with their legs and not the back. Smoking has been thought to increase disc herniation by reducing the blood supply to the intervertebral disc leading to degenerative changes of the disc.

Although the above factors are frequently assumed to be the causes for disc herniation, some studies have shown that the difference in risk is very small when this particular population was compared with the control groups of the normal population.

There have been several types of research done on genetic predisposition and intervertebral disc herniation. Some of the genes that are implicated in this disease include vitamin D receptor (VDR) which is a gene that codes for the polypeptides of important collagen called collagen IX (COL9A2).

Another gene called the human aggrecan gene (AGC) is also implicated as it codes for proteoglycans which is the most important structural protein found in the cartilage. It supports the biochemical and mechanical function of the cartilage tissue and hence when this gene is defective, it can predispose an individual to intervertebral disc herniation.

Apart from these, there are many other genes that are being researched due to the association between disc herniation such as matrix metalloproteinase (MMP) cartilage intermediate layer protein, thrombospondin (THBS2), collagen 11A1, carbohydrate sulfotransferase, and asporin (ASPN). They may also be regarded as potential gene markers for lumbar disc disease.

Pathogenesis of Sciatica and Disc Herniation

The sciatic pain originated from the extruded nucleus pulposus inducing various phenomena. It can directly compress the nerve roots leading to ischemia or without it, mechanically stimulate the nerve endings of the outer portion of the fibrous ring and release inflammatory substances suggesting its multifactorial origin. When the disc herniation causes mechanical compression of the nerve roots, the nerve membrane is sensitized to pain and other stimuli due to ischemia. It has been shown that in sensitized and compromised nerve roots, the threshold for neuronal sensitization is around half of that of a normal and non-compromised nerve root.

The inflammatory cell infiltration is different in extruded discs and non-extruded discs. Usually, in non-extruded discs, the inflammation is less. The extruded disc herniation causes the posterior longitudinal ligament to rupture which exposes the herniated part to the vascular bed of the epidural space. It is believed that inflammatory cells are originating from these blood vessels situated in the outermost part of the intervertebral disc.

These cells may help secrete substances that cause inflammation and irritation of the nerve roots causing sciatic pain. Therefore, extruded herniations are more likely to cause pain and clinical impairment than those that are contained. In contained herniations, the mechanical effect is predominant while in the unconfined or the extruded discs the inflammatory effect is predominant.

Clinical Disc Herniation and What to Look for in the History

The symptoms of the disc herniation can vary a great deal depending on the location of the pain, the type of herniation, and the individual. Therefore, history should focus on the analysis of the main complaint among the many other symptoms.

The chief complaint can be neck pain in cervical disc herniation and there can be referred pain in the arms, shoulders, neck, head, face, and even the lower back region. However, it is most commonly referred to as the interscapular region. The radiation of pain can occur according to the level at the herniation is taking place. When the nerve roots of the cervical region are affected and compressed, there can be sensory, and motor changes with changes in the reflexes.

The pain that occurs due to nerve root compression is called radicular pain and it can be described as deep, aching, burning, dull, achy, and electric depending on whether there is mainly motor dysfunction or sensory dysfunction. In the upper limb, the radicular pain can follow a dermatomal or myotomal pattern. Radiculopathy usually does not accompany neck pain. There can be unilateral as well as bilateral symptoms. These symptoms can be aggravated by activities that increase the pressure inside the intervertebral discs such as the Valsalva maneuver and lifting.

Driving can also exacerbate pain due to disc herniation due to stress because of vibration. Some studies have shown that shock loading and stress from vibration can cause a mechanical force to exacerbate small herniations but flexed posture had no influence. Similarly, activities that decrease intradiscal pressure can reduce the symptoms such as lying down.

The main complaint in lumbar disc herniation is lower back pain. Other associated symptoms can be a pain in the thigh, buttocks, and anogenital region which can radiate to the foot and toe. The main nerve affected in this region is the sciatic nerve causing sciatica and its associated symptoms such as intense pain in the buttocks, leg pain, muscle weakness, numbness, impairment of sensation, hot and burning or tingling sensation in the legs, dysfunction of gait, impairment of reflexes, edema, dysesthesia or paresthesia in the lower limbs. However, sciatica can be caused by causes other than herniation such as tumors, infection, or instability which need to be ruled out before arriving at a diagnosis.

The herniated disc can also compress on the femoral nerve and can give rise to symptoms such as numbness, tingling sensation in one or both legs, and a burning sensation in the legs and hips. Usually, the nerve roots that are affected in herniation in the lumbar region are the ones exiting below the intervertebral disc. It is thought that the level of the nerve root irritation determines the distribution of leg pain. In herniations at the third and fourth lumbar vertebral levels, the pain may radiate to the anterior thigh or the groin. In radiculopathy at the level of the fifth lumbar vertebra, the pain may occur in the lateral and anterior thigh region. In herniations at the level of the first sacrum, the pain may occur in the bottom of the foot and the calf. There can also be numbness and tingling sensation occurring in the same area of distribution. The weakness in the muscles may not be able to be recognized if the pain is very severe.

When changing positions the patient is often relieved from pain. Maintaining a supine position with the legs raised can improve the pain. Short pain relief can be brought by having short walks while long walks, standing for prolonged periods, and sitting for extended periods of time such as in driving can worsen the pain.

The lateral disc herniation is seen in foraminal and extraforaminal herniations and they have different clinical features to that of medial disc herniation seen in subarticular and central herniations. The lateral intervertebral disc herniations can when compared to medial herniations more directly irritate and mechanically compress the nerve roots that are exiting and the dorsal root ganglions situated inside the narrowed spinal canal.

Therefore, lateral herniation is seen more frequently in older age with more radicular pain and neurological deficits. There is also more radiating leg pain and intervertebral disc herniations in multiple levels in the lateral groups when compared to medial disc herniations.

The herniated disc in the thoracic region may not present with back pain at all. Instead, there are predominant symptoms due to referred pain in the thorax due to irritation of nerves. There can also be predominant pain in the body that travels to the legs, tingling sensation and numbness in one or both legs, muscle weakness, and spasticity of one or both legs due to exaggerated reflexes.

The clinician should look out for atypical presentations as there could be other differential diagnoses. The onset of symptoms should be inquired about to determine whether the disease is acute, sub-acute, or chronic in onset. Past medical history has to be inquired about in detail to exclude red flag symptoms such as pain that occurs at night without activity which can be seen in pelvic vein compression, and non-mechanical pain which may be seen in tumors or infections.

If there is a progressive neurological deficit, with bowel and bladder involvement is there, it is considered a neurological emergency and urgently investigated because cauda equine syndrome may occur which if untreated, can lead to permanent neurological deficit.

Getting a detailed history is important including the occupation of the patient as some activities in the job may be exacerbating the patient’s symptoms. The patient should be assessed regarding which activities he can and cannot do.

Differential Diagnosis

  • Degenerative disc disease
  • Mechanical pain
  • Myofascial pain leading to sensory disturbances and local or referred pain
  • Hematoma
  • Cyst leading to occasional motor deficits and sensory disturbances
  • Spondylosis or spondylolisthesis
  • Discitis or osteomyelitis
  • Malignancy, neurinoma or mass lesion causing atrophy of thigh muscles, glutei
  • Spinal stenosis is seen mainly in the lumbar region with mild low back pain, motor deficits, and pain in one or both legs.
  • An epidural  abscess can cause symptoms similar to radicular pain involving spinal disc herniation
  • Aortic aneurysm which can cause low back pain and leg pain due to compression can also rupture and lead to hemorrhagic shock.
  • Hodgkin’s lymphoma in advanced stages can lead to space-occupying lesions in the spinal column leading to symptoms like that of intervertebral disc herniation
  • Tumors
  • Pelvic endometriosis
  • Facet hypertrophy
  • Lumbar nerve root schwannoma
  • Herpes zoster infection results in inflammation along with the sciatic or lumbosacral nerve roots

Examination in Disc Herniation

Complete physical examination is necessary to diagnose intervertebral disc herniation and exclude other important differential diagnoses. The range of motion has to be tested but may have a poor correlation with disc herniation as it is mainly reduced in elderly patients with a degenerative disease and due to disease of the joints.

A complete neurological examination is often necessary. This should test muscle weakness and sensory weakness. In order to detect muscle weakness in small toe muscles, the patient can be asked to walk on tiptoe. The strength of muscle can also be tested by comparing the strength to that of the clinician. There may be dermatomal sensory loss suggesting the respective nerve root involvement. The reflexes may be exaggerated or sometimes maybe even absent.

There are many neurologic examination maneuvers described in relation to intervertebral disc herniation such as the Braggart sign, flip the sign, Lasegue rebound sign, Lasegue differential sign, Mendel Bechterew sign, Deyerle sign both legs or Milgram test, and well leg or Fajersztajin test. However, all these are based on testing the sciatic nerve root tension by using the same principles in the straight leg raising test. These tests are used for specific situations to detect subtle differences.

Nearly almost all of them depend on the pain radiating down the leg and if it occurs above the knee it is assumed to be due to a neuronal compressive lesion and if the pain goes below the knee, it is considered to be due to the compression of the sciatic nerve root. For lumbar disc herniation detection, the most sensitive test is considered to be radiating pain occurring down the leg due to provocation.

In the straight leg raising test also called the Lasegue’s sign, the patient stays on his or her back and keeps the legs straight. The clinician then lifts the legs by flexing the hip while keeping the knee straight. The angle at which the patient feels pain going down the leg below the knee is noted. In a normal healthy individual, the patient can flex the hip to 80- 90? without having any pain or difficulty.

However, if the angle is just 30 -70? degrees, it is suggestive of lumbar intervertebral disc herniation at the L4 to S1 nerve root levels. If the angle of hip flexion without pain is less than 30 degrees, it usually indicates some other causes such as tumor of the gluteal region, gluteal abscess, spondylolisthesis, disc extrusion, and protrusion, malingering patient, and acute inflammation of the dura mater. If pain with hip flexion occurs at more than 70 degrees, it may be due to tightness of the muscles such as gluteus maximus and hamstrings, tightness of the capsule of the hip joint, or pathology of sacroiliac or hip joints.

The reverse straight leg raising test or hip extension test can be used to test higher lumbar lesions by stretching the nerve roots of the femoral nerve which is similar to the straight leg raising test. In the cervical spine, in order to detect stenosis of the foramina, the Spurling test is done and is not specific to cervical intervertebral disc herniation or tension of the nerve roots. The Kemp test is the analogous test in the lumbar region to detect foraminal stenosis. Complications due to the disc herniation include careful examination of the hip region, digital rectal examination, and urogenital examination is needed.

Investigation of Disc Herniation

For the diagnosis of intervertebral disc herniation, diagnostic tests such as Magnetic resonance imaging (MRI), Computed tomography (CT), myelography, and plain radiography can be used either alone or in combination with other imaging modalities. Objective detection of disc herniation is important because only after such a finding the surgical intervention is even considered. Serum biochemical tests such as prostate-specific antigen (PSA) level, Alkaline phosphatize value, erythrocyte sedimentation rate (ESR), urine analysis for Bence Jones protein, serum glucose level, and serum protein electrophoresis may also be needed in specific circumstances guided by history.

Magnetic Resonance Imaging (MRI)

MRI is considered the best imaging modality in patients with history and physical examination findings suggestive of lumbar disc herniation associated with radiculopathy according to North American Spinal Society guidelines in 2014. The anatomy of the herniated nucleus pulposus and its associated relationships with soft tissue in the adjacent areas can be delineated exquisitely by MRI in cervical, thoracic, and lumbosacral areas. Beyond the confines of the annulus, the herniated nucleus can be seen as a focal, asymmetric disc material protrusion on MRI.

On sagittal T2 weighted images, the posterior annulus is usually seen as a high signal intensity area due to radial annular tear associated with the herniation of the disc although the herniated nucleus is itself hypointense. The relationship between the herniated nucleus and degenerated facets with the nerve roots which are exiting through the neural foramina are well-demarcated on sagittal images of MRI. Free fragments of the intervertebral disc can also be distinguished from MRI images.

There may be associated signs of intervertebral disc herniation on MRI such as radial tears on the annulus fibrosus which is also a sign of degenerative disc disease. There may be other telling signs such as loss of disc height, bulging annulus, and changes in the endplates. Atypical signs may also be seen with MRI such as abnormal disc locations, and lesions located completely outside the intervertebral disc space.

MRI can detect abnormalities in the intervertebral discs superiorly to other modalities although its bone imaging is a little less inferior. However, there are limitations with MRI in patients with metal implant devices such as pacemakers because the electromagnetic field can lead to abnormal functioning of the pacemakers. In patients with claustrophobia, it may become a problem to go to the narrow canal to be scanned by the MRI machine. Although some units contain open MRI, it has less magnetic power and hence delineates less superior quality imaging.

This is also a problem in children and anxious patients undergoing MRI because good image quality depends on the patient staying still. They may require sedation. The contrast used in MRI which is gadolinium can induce nephrogenic systemic fibrosis in patients who had pre-existing renal disease. MRI is also generally avoided in pregnancy especially during the first 12 weeks although it has not been clinically proven to be hazardous to the fetus. MRI is not very useful when a tumor contains calcium and in distinguishing edema fluid from tumor tissue.

Computed Tomography (CT)

CT scanning is also considered another good method to assess spinal disc herniation when MRI is not available. It is also recommended as a first-line investigation in unstable patients with severe bleeding. CT scanning is superior to myelography although when the two are combined, it is superior both of them. CT scans can show calcification more clearly and sometimes even gas in images. In order to achieve a superior imaging quality, the imaging should be focused on the site of pathology and thin sections taken to better determine the extent of the herniation.

However, a CT scan is difficult to be used in patients who have already undergone laminectomy surgical procedures because the presence of scar tissue and fibrosis causes the identification of the structures difficult although bony changes and deformity in nerve sheath are helpful in making a diagnosis.

The herniated intervertebral discs in the cervical disc can be identified by studying the uncinate process. It is usually projected posteriorly and laterally to the intervertebral discs and superiorly to the vertebral bodies. The uncinate process undergoes sclerosis, and hypertrophy when there is an abnormal relationship between the uncinate process and adjacent structures as seen in degenerative disc disease, intervertebral disc space narrowing, and general wear and tear.

Myelopathy can occur when the spinal canal is affected due to disc disease. Similarly, when neural foramina are involved, radiculopathy occurs. Even small herniated discs and protrusions can cause impingement of the dural sac because the cervical epidural space is narrowed naturally. The intervertebral discs have attenuation a little bit greater than the sac characterized in the CT scan.

In the thoracic region, a CT scan can diagnose an intervertebral disc herniation with ease due to the fact that there is an increased amount of calcium found in the thoracic discs. Lateral to the dural sac, the herniated disc material can be seen on CT as a clearly defined mass that is surrounded by epidural fat. When there is a lack of epidural fat, the disc appears as a higher attenuated mass compared to the surrounding.

Radiography

Plain radiography is not needed in diagnosing herniation of the intervertebral discs, because plain radiographs cannot detect the disc and therefore are used to exclude other conditions such as tumors, infections, and fractures.

In myelography, there may be deformity or displacement of the extradural contrast-filled thecal sac seen in herniation of the disc. There may also be features in the affected nerve such as edema, elevation, deviation, and amputation of the nerve root seen in the myelography image.

Diskography

In this imaging modality, the contrast medium is injected into the disc in order to assess the disc morphology. If pain occurs following injection that is similar to the discogenic pain, it suggests that that disc is the source of the pain. When a CT scan is also performed immediately after discography, it is helpful to differentiate the anatomy and pathological changes. However, since it is an invasive procedure, it is indicated only in special circumstances when MRI and CT have failed to reveal the etiology of back pain. It has several side effects such as headache, meningitis, damage to the disc, discitis, intrathecal hemorrhage, and increased pain.

Treatment of Herniated Disc

The treatment should be individualized according to the patient-guided through history, physical examination, and diagnostic investigation findings. In most cases, the patient gradually improves without needing further intervention in about 3 – 4 months. Therefore, the patient only needs conservative therapy during this time period. Because of this reason, there are many ineffective therapies that have emerged by attributing the natural resolution of symptoms to that therapy. Therefore, conservative therapy needs to be evidence-based.

Conservative Therapy

Since the herniation of the disc has a benign course, the aim of treatment is to stimulate the recovery of neurological function, reduce pain, and facilitate early return to work and activities of daily living. The most benefits of the conservative treatment are for younger patients with hernias that are sequestered and in patients with mild neurological deficits due to small disc hernias.

Bed rest has long been considered a treatment option in herniation of the disc. However, it has been shown that bed rest has no effect beyond the first 1 or 2 days. The bed rest is regarded as counterproductive after this period of time.

In order to reduce the pain, oral non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen can be used. This can relieve the pain by reducing inflammation associated with the inflamed nerve. Analgesics such as acetaminophen can also be used although they lack the anti-inflammatory effect seen in NSAIDs. The doses and the drugs should be appropriate for the age and severity of the pain in the patient. If pain is not controlled by the current medication, the clinician has to go one step up on the WHO analgesics ladder. However, the long-term use of NSAIDs and analgesics can lead to gastric ulcers, liver, and kidney problems.

In order to reduce the inflammation, other alternative methods such as applying ice in the initial period and then switching to using heat, gels, and rubs may help with the pain as well as muscle spasms. Oral muscle relaxants can also be used in relieving muscle spasms. Some of the drugs include methocarbamol, carisoprodol, and cyclobenzaprine.

However, they act centrally and cause drowsiness and sedation in patients and it does not act directly to reduce muscle spasm. A short course of oral steroids such as prednisolone for a period of 5 days in a tapering regime can be given to reduce the swelling and inflammation in the nerves. It can provide immediate pain relief within a period of 24 hours.

When the pain is not resolved adequately with maximum effective doses, the patient can be considered for giving steroid injections into the epidural space. The major indication for the steroid injection into periradicular space is discal compression causing radicular pain that is resistant to conventional medical treatment. A careful evaluation with CT or MRI scanning is required to carefully exclude extra discal causes for pain. The contraindications for this therapy include patients with diabetes, pregnancy, and gastric ulcers. Epidural puncture is contraindicated in patients with coagulation disorders and therefore the foraminal approach is used carefully if needed.

This procedure is performed under the guidance of fluoroscopy and involves injecting steroids and an analgesic into the epidural space adjacent to the affected intervertebral disc to reduce the swelling and inflammation of the nerves directly in an outpatient setting. As much as 50% of the patients experience relief after the injection although it is temporary and they might need repeat injections at 2 weekly intervals to achieve the best results. If this treatment modality becomes successful, up to 3 epidural steroidal injections can be given per year.

Physical therapy can help the patient return to his previous life easily although it does not improve the herniated disc. The physical therapist can instruct the patient on how to maintain the correct posture, walking, and lifting techniques depending on the patient’s ability to work, mobility, and flexibility.

Stretching exercises can improve the flexibility of the spine while strengthening exercises can increase the strength of the back muscles. The activities which can aggravate the condition of the herniated disc are instructed to be avoided. Physical therapy makes the transition from intervertebral disc herniation to an active lifestyle smooth. The exercise regimes can be maintained for life to improve general well-being.

The most effective conservative treatment option that is evidence-based is observation and epidural steroid injection for the relief of pain in the short-term duration. However, if the patients so desire they can use holistic therapies of their choice with acupuncture, acupressure, nutritional supplements, and biofeedback although they are not evidence-based. There is also no evidence to justify the use of trans electrical nerve stimulation (TENS) as a pain relief method.

If there is no improvement in the pain after a few months, surgery can be contemplated and the patient must be selected carefully for the best possible outcome.

Surgical Therapy

The aim of surgical therapy is to decompress the nerve roots and relieve the tension. There are several indications for surgical treatment which are as follows.

Absolute indications include cauda equina syndrome or significant paresis. Other relative indications include motor deficits that are greater than grade 3, sciatica that is not responding to at least six months of conservative treatment, sciatica for more than six weeks, or nerve root pain due to foraminal bone stenosis.

There have been many discussions over the past few years regarding whether to treat herniation of intervertebral disc disease with prolonged conservative treatment or early surgical treatment. Much research has been conducted in this regard and most of them show that the final clinical outcome after 2 years is the same although the recovery is faster with early surgery. Therefore, it is suggested that early surgery may be appropriate as it enables the patient to return to work early and thereby is economically feasible.

Some surgeons may still use traditional discectomy although many are using minimally invasive surgical techniques over recent years. Microdiscectomy is considered to be the halfway between the two ends. There are two surgical approaches that are being used. Minimally invasive surgery and percutaneous procedures are the ones that are being used due to their relative advantage. There is no place for the traditional surgical procedure known as a laminectomy.

However, there are some studies suggesting microdiscectomy is more favorable because of its both short-term and long-term advantages. In the short term, there is a reduced length of operation, reduced bleeding, relief of symptoms, and reduced complication rate. This technique has been effective even after 10 years of follow-up and therefore is the most preferred technique even now. The studies that have been performed to compare the minimally invasive technique and microdiscectomy have resulted in different results. Some have failed to establish a significant difference while one randomized control study was able to determine that microdiscectomy was more favorable.

In microdiscectomy, only a small incision is made aided by an operating microscope and the part of the herniated intervertebral disc fragment which is impinging on the nerve is removed by hemilaminectomy. Some part of the bone is also removed to facilitate access to the nerve root and the intervertebral disc. The duration of the hospital stay is minimal with only an overnight stay and observation because the patient can be discharged with minimal soreness and complete relief of the symptoms.

However, some unstable patients may need more prolonged admission and sometimes they may need fusion and arthroplasty. It is estimated that about 80 – 85 % of the patients who undergo microdiscectomy recover successfully and many of them are able to return to their normal occupation in about 6 weeks.

There is a discussion on whether to remove a large portion of the disc fragment and curetting the disc space or to remove only the herniated fragment with minimal invasion of the intervertebral disc space. Many studies have suggested that the aggressive removal of large chunks of the disc could lead to more pain than when conservative therapy is used with 28% versus 11.5 %. It may lead to degenerative disc disease in the long term. However, with conservative therapy, there is a greater risk of recurrence of around 7 % in herniation of the disc. This may require additional surgery such as arthrodesis and arthroplasty to be performed in the future leading to significant distress and economic burden.

In the minimally invasive surgery, the surgeon usually makes a tiny incision in the back to put the dilators with increasing diameter to enlarge the tunnel until it reaches the vertebra. This technique causes lesser trauma to the muscles than when seen in traditional microdiscectomy. Only a small portion of the disc is removed in order to expose the nerve root and the intervertebral disc. Then the surgeon can remove the herniated disc by the use of an endoscope or a microscope.

These minimally invasive surgical techniques have a higher advantage of lower surgical site infections and shorter hospital stays. The disc is centrally decompressed either chemically or enzymatically with the use of chymopapain, laser, or plasma (ionized gas) ablation and vaporization. It can also be decompressed mechanically by using percutaneous lateral decompression or by aspirating and sucking with a shaver such as a nucleosome. Chemopapin was shown to have adverse effects and was eventually withdrawn. Most of the above techniques have shown to be less effective than a placebo. Directed segmentectomy is the one that has shown some promise in being effective similar to microdiscectomy.

In the cervical spine, the herniated intervertebral discs are treated anteriorly. This is because the herniation occurs anteriorly and the manipulation of the cervical cord is not tolerated by the patient. The disc herniation that is due to foraminal stenosis and that is confined to the foramen are the only instances where a posterior approach is contemplated.

The minimal disc excision is an alternative to the anterior cervical spine approach. However, the intervertebral disc stability after the procedure is dependent on the residual disc. The neck pain can be significantly reduced following the procedure due to the removal of neuronal compression although significant impairment can occur with residual axial neck pain. Another intervention for cervical disc herniation includes anterior cervical interbody fusion. It is more suitable for patients with severe myelopathy with degenerative disc disease.

Complications of the Surgery

Although the risk of surgery is very low, complications can still occur. Post-operative infection is one of the commonest complications and therefore needs more vigorous infection control procedures in the theatre and in the ward. During the surgery, due to poor surgical technique, nerve damage can occur. A dural leak may occur when an opening in the lining of the nerve root causes leakage of cerebrospinal fluid which is bathing the nerve roots. The lining can be repaired during the surgery. However, headache can occur due to loss of cerebrospinal fluid but it usually improves with time without any residual damage. If blood around the nerve roots clots after the surgery, that blood clot may lead to compression of the nerve root leading to radicular pain which was experienced by the patient previously. Recurrent herniation of the intervertebral disc due to herniation of disc material at the same site is a devastating complication that can occur long term. This can be managed conservatively but surgery may be necessary ultimately.

Outcomes of the Surgery

There has been extensive research done regarding the outcome of lumbar disc herniation surgery. Generally, the results from the microdiscectomy surgery are good. There is more improvement of leg pain than back pain and therefore this surgery is not recommended for those who have only back pain. Many patients improve clinically over the first week but they may improve over the following several months. Typically, the pain disappears in the initial recovery period and it is followed by an improvement in the strength of the leg. Finally, the improvement of the sensation occurs. However, patients may complain of feeling numbness although there is no pain. The normal activities and work can be resumed over a few weeks after the surgery.

Novel Therapies

Although conservative therapy is the most appropriate therapy in treating patients, the current standard of care does not address the underlying pathology of herniation of the intervertebral discs. There are various pathways that are involved in the pathogenesis such as inflammatory, immune-mediated, and proteolytic pathways.

The role of inflammatory mediators is currently under research and it has led to the development of new therapies that are directed at these inflammatory mediators causing damage to the nerve roots. The cytokines such as TNF ? are mainly involved in regulating these processes. The pain sensitivity is mediated by serotonin receptor antagonists and ?2 adrenergic receptor antagonists.

Therefore, pharmacological therapies that target these receptors and mediators may influence the disease process and lead to a reduction in symptoms. Currently, cytokine antagonists against TNF ? and IL 1? have been tested. Neuronal receptor blockers such as sarpogrelate hydrochloride etc have been tested in both animal models and in clinical studies for the treatment of sciatica. Cell cycle modifiers that target the microglia that are thought to initiate the inflammatory cascade have been tested with the neuroprotective antibiotic minocycline.

There is also research on inhibiting the NF- kB or protein kinase pathway recently. In the future, the treatment of herniation of the intervertebral disc will be much more improved thanks to the ongoing research. (Haro, Hirotaka)

 

El Paso Chiropractor Near Me

Dr. Alex Jimenez DC, MSACP, RN, CCST

 

A disc bulge and/or a herniated disc is a health issue that affects the intervertebral discs found in between each vertebra of the spine. Although these can occur as a natural part of degeneration with age, trauma or injury as well as repetitive overuse can also cause a disc bulge or a herniated disc. According to healthcare professionals, a disc bulge and/or a herniated disc is one of the most common health issues affecting the spine. A disc bulge is when the outer fibers of the annulus fibrosus are displaced from the margins of the adjacent vertebral bodies. A herniated disc is when a part of or the whole nucleus pulposus is protruded through the torn or weakened outer annulus fibrosus of the intervertebral disc. Treatment of these health issues focuses on reducing symptoms. Alternative treatment options, such as chiropractic care and/or physical therapy, can help relieve symptoms. Surgery may be utilized in cases of severe symptoms. – Dr. Alex Jimenez D.C., C.C.S.T. Insight

Curated by Dr. Alex Jimenez D.C., C.C.S.T.

 

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  • Kerr, Dana et al. What Are Long-Term Predictors Of Outcomes For Lumbar Disc Herniation? A Randomized And Observational Study. Clinical Orthopaedics And Related Research, vol 473, no. 6, 2014, pp. 1920-1930. Springer Nature, doi:10.1007/s11999-014-3803-7.
  • Buy, Xavier, and Afshin Gangi. Percutaneous Treatment Of Intervertebral Disc Herniation. Seminars In Interventional Radiology, vol 27, no. 02, 2010, pp. 148-159. Thieme Publishing Group, doi:10.1055/s-0030-1253513.
  • Haro, Hirotaka. Translational Research Of Herniated Discs: Current Status Of Diagnosis And Treatment. Journal Of Orthopaedic Science, vol 19, no. 4, 2014, pp. 515-520. Elsevier BV, doi:10.1007/s00776-014-0571-x.

 

 

Spinal Decompression Institute

Spinal Decompression Institute

Injury Medical Chiropractic Functional Medicine and Spinal Decompression Institute offer progressive technology to treat neck and back-related injuries, conditions, and disorders. We utilize a non-surgical spinal decompression system combined with chiropractic adjustments and therapeutic massage that combats back and neck pain. These combined techniques relieve nerve compression and separate the vertebrae in the back or neck to allow for optimal healing. Individuals suffering from herniated discs, sciatica, spinal stenosis, or pinched nerves can undergo decompression treatment to slow, stop, and reverse back issues.

Spinal Decompression Institute

Spinal Decompression Institute

The spine/back is a complex structure of joints, bones, ligaments, and muscles. Individuals can sprain ligaments, strain muscles, rupture disks, and irritate joints, leading to back issues and pain. Injuries from work, school, automobile accidents, and sports can lead to health issues that can become chronic and cause permanent damage.

  • Motorized mechanical decompression separates the vertebrae and discs, allowing them to realign and reset properly while increasing circulation, hydration, and oxygenation into the discs to heal fully.
  • This removes the compression on pinched nerves.
  • This is spinal retraining so the spine can remember a new healthy position.

What A Session Consists Of

  • The individual’s doctor, spine specialist, or chiropractor will determine the treatment plan after their in-person physical evaluation and review of imaging scans like X-rays and/or MRI.
  • Every case is different, but a session typically requires 20-30 minutes.
  • Treatment plans differ in the number of sessions per week and the number of weeks necessary.
  • Patients remain clothed during a spinal decompression therapy session and lie on a motorized table.
  • Depending on the condition or injury, the patient could be in the prone position lying face down or lying supine face up.
  • A harness is placed around the hips or neck.
  • The technician/therapist sets up the program.
  • The table will move slowly back and forth and/or to the sides to provide spinal traction, release the compression, and promote relaxation.
  • There is no pain during or after the decompression therapy, but the patient will feel their spine stretch.
  • To avoid any discomfort, the system has emergency stop switches for the patient and the therapist technician.
  • The switches terminate the treatment immediately if the patient experiences pain or discomfort.

Physiological Well Being

  • Increases blood circulation and promotes nutrient supply through the spine.
  • Allows for proper disc rehydration.
  • Prevents herniations from advancing or worsening.

Physical Well Being

  • Lowers stress levels.
  • Pain alleviation.
  • Improves spinal mobility.
  • Improves joint flexibility.
  • Resume normal daily activities.
  • Prevents muscle guarding.
  • Helps to develop core strength.
  • Helps to prevent new injuries.

At the Spinal Decompression Institute, we offer total care for complete health and well-being. Our goal is to thoroughly investigate the body’s health and determine the root cause of the pain. A successful spinal decompression program will help identify what led to the problem/s to prevent and avoid a recurrence of symptoms.


DRX9000 Non-Surgical Spinal Decompression System


References

Apfel, Christian C et al. “Restoration of disk height through non-surgical spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort study.” BMC musculoskeletal disorders vol. 11 155. 8 Jul. 2010, doi:10.1186/1471-2474-11-155

Daniel, Dwain M. “Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media?.” Chiropractic & osteopathy vol. 15 7. 18 May. 2007, doi:10.1186/1746-1340-15-7

Koçak, Fatmanur Aybala et al. “Comparison of the short-term effects of the conventional motorized traction with non-surgical spinal decompression performed with a DRX9000 device on pain, functionality, depression, and quality of life in patients with low back pain associated with lumbar disc herniation: A single-blind randomized controlled trial.” Turkish Journal of physical medicine and rehabilitation vol. 64,1 17-27. 16 Feb. 2017, doi:10.5606/tftrd.2017.154

Macario, Alex, and Joseph V Pergolizzi. “Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain.” Pain practice: the official journal of World Institute of Pain vol. 6,3 (2006): 171-8. doi:10.1111/j.1533-2500.2006.00082.x

The Effects Of Spinal Decompression For Lumbar Disc Herniation

The Effects Of Spinal Decompression For Lumbar Disc Herniation

Introduction

The spine is encompassed by soft tissues, the spinal cord, ligaments, and cartilage in an S-shaped curvature in the back. The spine’s primary function is to make sure that the body is supported in an upright position and holds parts of the musculoskeletal system while also making sure that the body bends, sits, moves, twists, and turns for proper functionality. When the body goes through an injury, the symptoms can range from mild to severe depending on how bad the damage is on the person and how severe it is. When a back injury causes immense pain to the individual, the pain can radiate from the back to the legs. However, there are ways to lower the effects of back pain through non-surgical treatments like spinal decompression to help alleviate back pain symptoms. In this article, we will be looking at what lumbar disc herniation is, its symptoms, and how spinal decompression can help lower the effects of lumbar disc herniation. By referring patients to qualified and skilled providers specializing in spinal decompression therapy. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions, please call Dr. Jimenez at 915-850-0900.

Axiom-JapanStudy

What Is Lumbar Disc Herniation?

In the back, the spine is in an S-shaped curve protected by soft tissue, the spinal disc, and the spinal cord. The spine makes sure that the body is moving and staying upright, and when there are factors that can cause back pain, it can lead to chronic issues that can affect the entire body. One of the chronic issues that can cause back pain is lumbar disc herniation. Research studies have found that lumbar disc herniation is due to aging and general wear and tear that causes the spinal disc to lose some of the fluid that makes them pliable and sponge-like. 

 

 

Lumbar disc herniation is when the spinal disc’s outer ring can bulge, crack or tear when pressure is on the spine. This will cause the disc to protrude and push against a nearby spinal nerve root, causing shooting pain to the buttock and the leg. Research studies have shown that lumbar disc herniation is most often the result of disc degeneration. It is often due to individuals using their back muscles instead of their leg muscles to lift heavy objects. This can cause the spinal disc to twist and turn while lifting the heavy object and thus leading to a painful experience on the lower back.

 

The Symptoms

Research studies have found that nearly 80% of the population will usually sustain low back pain at least once. Since low back pain can be due to different factors, intervertebral degeneration leads to DDD (degenerative disc disease), and lumbar disc herniation as common sources. When the spinal disc starts to protrude from the spinal nerve, it can cause lumbar disc herniation to cause symptoms on the spine and the body. Some of the symptoms include:

  • Inflammatory signaling
  • The presence & effects of Propionibacterium acnes
  • Microstructural changes to the nerve root
  • Radicular pain
  • Sensory abnormalities
  • Pain from sitting, walking, sneezing

What Is Herniated Disc?-Video

Research studies have found that a herniated disc is a spinal injury. The spinal disc’s outer layer is weakened and cracked from the compressed pressure that the spine sustained from an injury, and the inner layer pushes through the crack to bulge out. Herniated discs from the spine are one of the leading causes of sciatica and can happen anywhere on the neck or the lower back. There are therapeutic treatments that individuals can utilize once the pain of herniated disc has gone away. Some of the treatments include:


How Spinal Decompression Effect Disc Herniation

Research studies have stated that spinal decompression therapy and general traction therapy can provide effective results in improving the pain and disability of individuals suffering from intervertebral disc herniation. Since mostly about 80% of individuals have experienced lumbar pain, utilizing spinal decompression can help alleviate the effects of disc herniation. Other research studies have found that spinal decompression therapy can effectively help resorption the herniation and increase the disc height for individuals with lumbar disc herniation.

 

 

As part of a treatment for lumbar disc herniation, spinal decompression therapy can withdraw the inflammation from the sciatic nerve and reduce lumbar lordosis. The gentle traction on the spine from the traction table can reduce the pressure from the inside, thus shrinking the disc herniation and drawing in the necessary fluids, nutrients, and oxygen back to the spinal disc.

 

Conclusion

It is crucial to utilize spinal decompression therapy to treat lower back pain, herniated discs, and other common back problems. The spine makes sure that the body moves, twists, and turns. When a person pulls a muscle or injures their back from an accident or lifting something heavy will cause the spinal disc to bulge out and cause back problems to arise. Utilizing treatments for back pain like spinal decompression can help many individuals get the relief they deserve from the gentle spinal stretching to get the necessary nutrients back to the spine and alleviate the pressure pushing on the spinal disc.

 

References

Amin, Raj M, et al. “Lumbar Disc Herniation.” Current Reviews in Musculoskeletal Medicine, Springer US, Dec. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5685963/.

Choi, Jioun, et al. “Influences of Spinal Decompression Therapy and General Traction Therapy on the Pain, Disability, and Straight Leg Raising of Patients with Intervertebral Disc Herniation.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4339166.

Demirel, Aynur, et al. “Regression of Lumbar Disc Herniation by Physiotherapy. Does Non-Surgical Spinal Decompression Therapy Make a Difference? Double-Blind Randomized Controlled Trial.” Journal of Back and Musculoskeletal Rehabilitation, U.S. National Library of Medicine, 22 Sept. 2017, pubmed.ncbi.nlm.nih.gov/28505956/.

Härtl, Roger. “Lumbar Herniated Disc: What You Should Know.” Spine, Spine-Health, 6 July 2016, www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc.

Medical Professionals, Cleveland Clinic. “Herniated Disk: What It Is, Diagnosis, Treatment & Outlook.” Cleveland Clinic, 1 July 2021, my.clevelandclinic.org/health/diseases/12768-herniated-disk.

Staff, Mayo Clinic. “Herniated Disk.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Feb. 2022, www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095.

Disclaimer

Non-Surgical Spinal Decompression For Chronic Low Back Pain

Non-Surgical Spinal Decompression For Chronic Low Back Pain

Introduction

The body makes sure that the spine is keeping it upright as the body allows the spine to twist, bend, and turn in different positions. When the body suffers from an injury, the immune system starts to take effect and begins to heal the body naturally in the affected areas. When the back gets injured from an accident or injured, the spinal disc in the spine will get damaged and lead to chronic issues that can cause a person to be miserable if it is not treated right away. However, there are non-surgical treatments that can relieve back pain symptoms and cause immense relief to the individual. In this article, we will be looking at what causes chronic back pain, its symptoms, and how non-surgical decompression can provide relief for chronic back pain. By referring patients to qualified and skilled providers specializing in spinal decompression therapy. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions, please call Dr. Jimenez at 915-850-0900.

New Study #2

What Causes Chronic Low Back Pain?

Mostly everyone would see a doctor or miss a couple of days at work due to having some back pain that causes them to be in pain and not do their daily activities due to it being common. Research studies have shown that back pain can range from a dull constant ache to a sudden, sharp pain that can be very mild or severe depending on the injury. The causes of back pain can be from an accident that a person went through, lifting heavy objects, or can develop when a person ages naturally when the spinal disc is losing fluid and nutrients. 

 

 

Two types of back pain can affect a person’s way of life depending on how severe the injury is. Acute back pain can last from a few days to a few weeks and can be resolved with a few days of self-care, and a person can take it easy with light activity. Chronic back pain is when the pain continues for about 12 weeks or more, causing it to persist where the individual needs medical treatment to relieve the pain. Other research studies have found many disorders like inflammatory disorders, trauma, DDD  (degenerative disc disease), and other chronic disorders that can cause chronic back pain symptoms. Chronic back pain can also cause significant rates of disability while being a contributor to morbidity and mortality in a person.

 

The Symptoms

Since chronic pain is often defined as persisting pain that goes beyond the normal healing time, research studies have shown that chronic pain can cause a significant impact on musculoskeletal conditions like chronic back pain. The presence of chronic pain can create more chronic issues that a person is experiencing. Other research studies have stated that the symptoms that chronic low back pain causes in a person include:

 


An Overview On Chronic Low Back Pain-Video

Research studies have shown that chronic low back pain is a chronic pain syndrome in the lower back region of the spine that can last for at least three months. Chronic low back pain is often the second leading cause of disability worldwide. It is influenced by psychological factors like stressdepression, or anxiety that can impact a person’s way of life. Other research studies have shown that low back pain can cause pain, muscle stiffness, or tension localized below the costal margin and above the inferior gluteal fold, characterized by sciatica symptoms. Chronic low back pain can be persistent for more than 12 weeks. It can cause immense individual pain, especially if the causes to have chronic low back pain have been associated with individual and workplace factors that cause the transition to chronic low back pain.


Non-Surgical Decompression For Chronic Low Back Pain

There are ways that many individuals can find relief after suffering from chronic low back pain and don’t require surgery. Non-surgical decompression therapy is where the individual is lying on a traction machine, and their spine gets a gentle stretch to relieve the compressed spinal disc’s pressure. Research studies have shown that non-surgical decompression therapy creates negative intradiscal pressure on the spine, allowing the herniated disc material to be pulled back into the spinal disc. Non-surgical decompression therapy also promotes the passage of healing nutrients back into the disc while fostering a better healing environment for the spine.

 

Many individuals who have non-surgical decompression therapy have reported at least 90% of improvement in back pain and have a better function when doing daily activities. Research studies have shown that spinal decompression therapy and general traction effectively improve the pain and disability of chronic low back pain issues for individuals suffering from intervertebral disc herniation and getting back their quality of life.

 

Conclusion

Chronic low back pain is caused by heavy lifting, injury, age, or accidents that cause the spinal disc to be compressed under immense pressure. Sometimes the pain levels can range from mild to severe, causing pain from the lower back to the legs and feet. When a person is suffering from chronic low back pain, it can cause them to be dysfunctional and ruin their daily lives. Non-surgical treatments like spinal decompression can help alleviate chronic back pain symptoms by gently stretching the spine and allowing the nutrients back to the spine. This will relieve the person’s spine and alleviate the painful symptoms causing back pain, causing the person to be pain-free and continue on their wellness journey.

 

References

Allegri, Massimo, et al. “Mechanisms of Low Back Pain: A Guide for Diagnosis and Therapy.” F1000Research, F1000Research, 28 June 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4926733/.

Casiano, Vincent E, et al. “Back Pain – Statpearls – NCBI Bookshelf.” StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 22 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK538173/.

Choi, Jioun, et al. “Influences of Spinal Decompression Therapy and General Traction Therapy on the Pain, Disability, and Straight Leg Raising of Patients with Intervertebral Disc Herniation.” Journal of Physical Therapy Science, U.S. National Library of Medicine, Feb. 2015, pubmed.ncbi.nlm.nih.gov/25729196/.

Chou, Roger. “Low Back Pain (Chronic).” BMJ Clinical Evidence, BMJ Publishing Group, 8 Oct. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC3217809/.

Gay, Ralph. “How Spinal Decompression Therapy Is Thought to Work.” Spine, Spine-Health, 24 Sept. 2013, www.spine-health.com/treatment/chiropractic/how-spinal-decompression-therapy-thought-work.

Husky, Mathilde M, et al. “Chronic Back Pain and Its Association with Quality of Life in a Large French Population Survey.” Health and Quality of Life Outcomes, BioMed Central, 26 Sept. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6158815/.

Medical Professionals, NINDS. “Low Back Pain Fact Sheet.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, 15 Nov. 2021, www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet.

Peloza, John. “Lower Back Pain Symptoms.” Spine, Spine-Health, 20 Apr. 2017, www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms.

Disclaimer

Treating Sensory Nerve Dysfunction With Spinal Decompression

Treating Sensory Nerve Dysfunction With Spinal Decompression

Introduction

The spine is encompassed by ligaments, the spinal cord, nerves, and discs that ensure that the entire body is upright and allow it to move, bend, twist, and turn. The spine also holds parts of the musculoskeletal system as the muscles make sure that the muscles are doing their job correctly. When a person suffers from an injury or a pulled muscle on the back, it can cause unwanted symptoms that can affect the back and affect the entire body. When the spine gets injured, it can also cause many individuals to be in pain, affecting their daily activities. Many treatments can relieve the painful symptoms of back and spinal injury, including spinal decompression. In this article, we will be looking at sensory nerve dysfunction and how the effects of spinal decompression therapy can alleviate sensory nerve dysfunction. By referring patients to qualified and skilled providers specializing in spinal decompression therapy. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions, please call Dr. Jimenez at 915-850-0900.

G-11 - Decompression and Sensory nerves

What Is Sensory Nerve Dysfunction?

As part of the central nervous system, the sensory nerves send information from the peripheral nervous system to the spinal cord to the brain. These nerves make sure that the body feels something that a person is touching. When there is an injury affecting the peripheral nerves, it is known as peripheral nerve injury. Research studies have shown that peripheral nerve injury is when there is nerve damage to the body, affecting the brain’s ability to communicate with the muscles and organs. When the sensory nerve becomes damaged from an injury, this will cause many individuals to have a tingling sensation on their hands and feet.

 

Other research studies have also stated that neuropathic pain can damage the sensory nerve receptor that sends the signals from the spinal cord to the brain. It can cause many symptoms that can be altered and disorder the sensory nerves to develop neuropathic pain symptoms. Since the nerves from the central nervous system send the information from the spinal cord to the entire body, nerve pain damage can disrupt the signals and cause the individual to fall, causing injury to the body, especially on the back. Research studies have shown that many individuals suffering from peripheral nerve damage can result from traumatic injurymetabolic problemsexposure to toxins, and inherited causes that cause the nerve signals to be disrupted.


What Is Spinal Decompression Therapy?-Video

Spinal decompression therapy is a non-surgical treatment that gently stretches the spine using a traction table to relieve back and leg pain. Research studies have found that spinal decompression therapy is used on the spine. It creates a negative intradiscal pressure to retract and reposition herniated or bulging disc material back to its original position in the spine. The gentle stretching from the traction machine allows the nutrients and other beneficial substances to go back to the spine and relieve the painful symptoms that cause injury to the spine. If you want to learn more about spinal decompression therapy, this link will explain the benefits of spinal decompression and how it can alleviate low back pain symptoms.


How Spinal Decompression Can Alleviate Sensory Nerve Dysfunction

The spine is encompassed by ligaments, the spinal cord, and discs that protect the spine from injury. When the spinal disc gets injured or naturally wears and tears due to age, it can cause the disc to lose the fluid that makes them sponge-like and compressed. When there is compression on the spinal disc, it can cause pain in the back. There is no pain when there is compression on the peripheral nerves unless the peripheral nerves have been irritated or pinched earlier. There are therapeutic treatments that can help alleviate the painful symptoms caused by the pinched nerves and bring back a person’s quality of life.

 

Research studies have found that ice treatments, electric treatments, and spinal decompression therapy allow individuals to get back their quality of life to about 90%. Since spinal decompression has a direct mechanical effect and a biochemical effect, the gentle traction will allow the intradiscal pressure from the damaged nerves to be reduced and retract the herniated disc. Spinal decompression therapy can influence sensory nerve dysfunction and restore motor functions in the body. Other research studies have also found that stretching, infrared radiation, and spinal decompression traction can significantly improve the pain and disability levels that are causing the individual pain in their lower back. Spinal decompression therapy will even alter the biomechanics and biochemistry of the spinal disc and nerve root, causing many individuals relief.

 

Conclusion

Therefore, the spine’s primary function is to make sure that the body can twist, bend, turn, and stay upright. When the back gets injured from a pulled muscle or an accident, it can immobilize the individual and disrupt their quality of life. If there is nerve damage from the injury, it can disrupt the nerve signals in the brain and cause the individual to lose balance and injure themselves even more. Utilizing non-surgical treatments like ice treatments, stretching, and physical therapy with the combination of spinal decompression therapy can help restore the back by gently stretching the spine with a traction table and restoring the lost nutrients of the spinal disc as well as restoring the motor and sensory nerve functions to the body.

 

References

Alrwaily, Muhammad, et al. “Assessment of Variability in Traction Interventions for Patients with Low Back Pain: A Systematic Review.” Chiropractic & Manual Therapies, BioMed Central, 17 Sept. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6139896/.

Colloca, Luana, et al. “Neuropathic Pain.” Nature Reviews. Disease Primers, U.S. National Library of Medicine, 16 Feb. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5371025/.

Daniel, Dwain M. “Non-Surgical Spinal Decompression Therapy: Does the Scientific Literature Support Efficacy Claims Made in the Advertising Media?” Chiropractic & Osteopathy, BioMed Central, 18 May 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC1887522/.

Staff, Mayo Clinic. “Peripheral Nerve Injuries.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 17 Apr. 2020, www.mayoclinic.org/diseases-conditions/peripheral-nerve-injuries/symptoms-causes/syc-20355631.

Staff, Mayo Clinic. “Peripheral Neuropathy.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 3 July 2021, www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061.

Disclaimer

The Efficacy of Spinal Decompression For Chronic Low Back Pain

The Efficacy of Spinal Decompression For Chronic Low Back Pain

Introduction

The body needs the spine to stay upright, bend, move, twist, and turn to function properly. The spine is an S-shaped curve structure protected by ligaments, soft tissues, the spinal cord, and muscle tissue if the back gets injured. When the body gets injured, or a back muscle is pulled, it can affect the spine and cause the individual to be in pain. Many individuals will experience some back pain that can affect their daily activity and try to find relief for their back pain. Some therapeutic treatments can help relieve back pain and help decompress the spine to cause instant relief. This article will look at what causes chronic low back pain, why it is expensive, and how efficient spinal decompression therapy is for chronic low back pain. By referring patients to qualified and skilled providers specializing in spinal decompression therapy. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions, please call Dr. Jimenez at 915-850-0900.

JOURNAL OF MEDICINE

What Causes Chronic Low Back Pain?

 

Since the spine is an S-shaped curve protected by joints, ligaments, nerves, and muscles, its primary function is to provide the body with the support, strength, and flexibility it needs to move and function. Research studies have found that the low back supports the upper body’s weight, and when there is an injury to the muscles, ligaments, joints, or spinal disc, it can cause minor to severe pain to the back. When there is a significant overlap of nerves, it causes some difficulty for the brain to sense where the pain originates accurately. Other research studies have found that back pain is common due to soft tissue injury and mechanical issues that can cause low back pain to be chronic. Some of the factors that can cause chronic low back pain include:

 

Why Is It Expensive To Treat?

Since chronic low back pain is an expensive benign condition in most industrialized countries, it is often one of the most frequent reasons for many individuals to visit their primary care physicians. This will allow them to take time off from work due to sickness or short-term disability and hospital admission and surgery. Research studies have stated that chronic low back pain can range from mild to severe, making it difficult for individuals to do everyday activities. About one-third to two-thirds of adults will suffer from low back pain at some time, and the prevalence of low back pain increases with age, and women are affected more often than men.

 

What Is Discogenic Pain?

Research studies have shown that discogenic low back pain is one of the common types of chronic low back pain that causes the formation of vascularized granulation tissue to degenerate. Discogenic pain most commonly affects the lower back, buttocks, and hips. Discogenic pain also involves:

  • The degenerative changes in the intervertebral disc in the spine.
  • Causing structural defects in the spine.
  • Causing the result of biomechanical instability and inflammation of the back.

Other research studies have found that discogenic back pain is multifactorial, causing physicians to struggle to identify the source of pain coming from the back.

 


How Efficient Is The DRX9000?-Video

The DRX9000 is a spinal decompression traction machine that helps alleviate chronic lower back pain in individuals. Research studies have found that the DRX9000 uses a motor pulley that causes traction force on the spine to pull, causing it to decompress gently. The traction force from the DRX9000 allows the spine to stretch the soft tissues and separate joint surfaces causing instant relief to individuals suffering from lower back pain. Many individuals who use the DRX9000 as part of their spinal decompression therapy will begin to feel instant relief from their spine and regain their quality of life. If you want to learn more about spinal decompression therapy, this link will explain the benefits of spinal decompression and how it can alleviate low back pain symptoms.


The Efficacy Of Spinal Decompression

 

The efficacy of spinal decompression on chronic low back pain can provide immense relief to many individuals suffering from low back pain. Research studies have shown that spinal decompression therapy is effective for many individuals suffering from lumbar disc herniation as it helps with the resorption of the herniation disc back in the spine and increases the disc height. Research studies have shown that many individuals who completed an entire 6-week course of spinal decompression therapy have reported much improvement from the pain and disability they had suffered from chronic low back pain.

 

Conclusion

Chronic lower back pain is common for many individuals and can be expensive as the symptoms can range from a dull, mild ache to severe sharp, throbbing pain in the lower back. Chronic low back pain causes many individuals to go to their health care providers, allowing them to get out of work and causing early retirement for many working individuals. Incorporating spinal decompression therapy as part of chronic low back pain treatment can cause instant relief to many individuals as the spinal disc are getting the necessary beneficial nutrients back into their spine and improving their quality of life pain-free. All in all, spinal decompression utilizes gentle stretching on the spine using a traction machine, causing instant relief to many individuals that are suffering from chronic lower back pain.

 

References

Choi, Jioun, et al. “Influences of Spinal Decompression Therapy and General Traction Therapy on the Pain, Disability, and Straight Leg Raising of Patients with Intervertebral Disc Herniation.” Journal of Physical Therapy Science, U.S. National Library of Medicine, Feb. 2015, pubmed.ncbi.nlm.nih.gov/25729196/.

Demirel, Ayunur, et al. “Regression of Lumbar Disc Herniation by Physiotherapy. Does Non-Surgical Spinal Decompression Therapy Make a Difference? Double-Blind Randomized Controlled Trial.” Journal of Back and Musculoskeletal Rehabilitation, U.S. National Library of Medicine, Nov. 2016, pubmed.ncbi.nlm.nih.gov/28505956/.

Fujii, Kengo, et al. “Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment.” JBMR Plus, John Wiley and Sons Inc., 4 Mar. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6524679/.

Koçak, Fatmanur Aybala, et al. “Comparison of the Short-Term Effects of the Conventional Motorized Traction with Non-Surgical Spinal Decompression Performed with a DRX9000 Device on Pain, Functionality, Depression, and Quality of Life in Patients with Low Back Pain Associated with Lumbar Disc Herniation: A Single-Blind Randomized-Controlled Trial.” Turkish Journal of Physical Medicine and Rehabilitation, Bayçınar Medical Publishing, 16 Feb. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC6709608/.

Medical Professionals, Cleveland Clinic. “Low Back Pain: Causes, Diagnosis & Treatments.” Cleveland Clinic, 18 Jan. 2021, my.clevelandclinic.org/health/diseases/7936-lower-back-pain.

Peloza, John. “Causes of Lower Back Pain.” Spine, Spine-Health, 20 Apr. 2017, www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain.

Peloza, John. “Lower Back Pain Symptoms, Diagnosis, and Treatment.” Spine, Spine-Health, 20 Apr. 2017, www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms-diagnosis-and-treatment.

Peng, Bao-Gan. “Pathophysiology, Diagnosis, and Treatment of Discogenic Low Back Pain.” World Journal of Orthopedics, Baishideng Publishing Group Co., Limited, 18 Apr. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3631950/.

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How Can Lower Back Decompression Help

How Can Lower Back Decompression Help

Introduction

The body goes through many scenarios that sometimes can get injured depending on the situation. When that happens, the immune system goes on full alert and starts to heal the affected area, and the body will begin to feel better. Sometimes, the injuries will affect the back and spine as the spine makes sure that the body can bend, move, sit, and turn. The back muscles also do the same thing the spine does and even protect the spine from injuries. When injuries or a pulled muscle start to affect the back, it can cause many unwanted problems to rise and cause chronic low back pain and even herniated disc on the spine. Some treatments are non-surgical and can alleviate chronic low back pain for many individuals. In this article, we will be looking at what discogenic low back pain is and its symptoms, and how low back decompression can help many individuals. By referring patients to qualified and skilled providers specializing in spinal decompression therapy. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions, please call Dr. Jimenez at 915-850-0900.

Pain Practice

What Is Discogenic Low Back Pain?

Since it is widespread for individuals to have back pain at some point in their lives and have to go to their primary physician to get time off their jobs to rest, there are two forms of back pain which are acute and chronic. Acute back pain only lasts between a few days to a week with rest and minimal light activity. Chronic back pain is defined as pain that lasts longer than 12 weeks and is considered an expensive benign condition in many industrialized countries. Some of the causes of chronic back pain can be an injury to the lumbosacral muscles and ligaments or even discogenic disorders like DDD (degenerative disc disease) or some form of trauma.

 

Discogenic low back pain is a common cause of chronic low back pain. It involves degenerative changes in the intervertebral disc in the spine while causing structural defects that result in biomechanical instability and inflammationResearch studies have stated that discogenic low back pain is considered multifactorial due to many physicians struggling to identify where the underlying source of pain is located at. Disogenic low back pain can also cause other types of back pain symptoms to pop up and cause the spinal nerve roots to compress and tear, causing chronic issues like herniated discspondylolysis, and foraminal stenosis to cause havoc on the back and making the individual suffering from chronic back pain miserable.

 

The Symptoms

Research studies have shown that discogenic low back pain symptoms usually start when there is an increased activity that causes intradiscal pressure on the spine. Some of the signs that it causes include:

  • Bending forward can increase low back discogenic pain
  • Pinched nerves that cause leg pain in the lower back
  • Sitting for long periods 
  • Factors like stress and inflammation cause low back pain

Many of these symptoms can be the underlying issue when dealing with chronic back pain. If the pain is left untreated, it can develop into chronic problems that can cause immense pain to the back and the rest of the body. There are ways to treat chronic discogenic low back pain, and that is through low back decompression.


How The DOC Decompression Table Works-Video

The video above shows how the DOC decompression table works for individuals suffering from chronic low back pain. The DOC decompression table is part of a non-surgical treatment known as spinal decompression therapy. Research studies have stated that spinal decompression therapy allows gentle spine stretching using a traction machine like the DOC decompression table to relieve low back pain. The machine creates negative intradiscal pressure on the low back and allows the nutrients to return to the spinal disc and restore them. The DOC decompression table also enables many individuals suffering from low back pain to feel instant relief. If you want to learn more about spinal decompression therapy, this link will explain the benefits of spinal decompression and how it can alleviate low back pain symptoms.


How Does Low Back Decompression Help?

 

There are many ways to help treat low back pain, as there are surgical and non-surgical approaches to help alleviate low back pain. However, studies have shown that when many individuals suffering from low back pain go through a 6-week treatment, the results show a reduction in the pressure of the affected disc, causing facilitation of their regeneration and increasing the disc height. Another way to optimize low back decompression is when combined with physical therapy. Research studies have shown that it is more effective as it helps improve the pain, lumbar range of motion, and back muscle endurance. Incorporating these two treatments will help reduce low back pain and help improve the individual’s quality of life.

 

Conclusion

Since chronic low back pain is common for many working individuals, it is essential to know where the pain is located for many physicians to incorporate low back decompression to restore the nutrients in the spine and cause instant relief for many individuals. It is crucial to utilize non-surgical treatments like low back decompression to help alleviate chronic discogenic low back pain in many individuals. With physical therapy and low back decompression, many individuals can regain their quality of life and be worry-free from low back pain.

 

References

Amjad, Fareeha, et al. “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 Musculoskeletal Disorders, BioMed Central, 16 Mar. 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC8924735/.

Apfel, Christian C, et al. “Restoration of Disk Height through Non-Surgical Spinal Decompression Is Associated with Decreased Discogenic Low Back Pain: A Retrospective Cohort Study.” BMC Musculoskeletal Disorders, BioMed Central, 8 July 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2912793/.

Fujii, Kengo, et al. “Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment.” JBMR Plus, John Wiley and Sons Inc., 4 Mar. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6524679.

Gay, Ralph. “All about Spinal Decompression Therapy.” Spine, Spine-Health, 24 Sept. 2013, www.spine-health.com/treatment/chiropractic/all-about-spinal-decompression-therapy.

Mummaneni, Praveen V. “Discogenic Low Back Pain.” SpineUniverse, SPU, 21 May 2019, www.spineuniverse.com/conditions/back-pain/discogenic-low-back-pain.

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Repairing Herniated Disc With Spinal Decompression

Repairing Herniated Disc With Spinal Decompression

Introduction

The spine is encompassed by ligaments, soft tissues, joints, and the spinal cord, where it is protected. The spine also holds the body together by ensuring that the musculoskeletal system keeps the body upright and that it can twist, turn, bend, and move around when it is in motion. When the body sustains an injury from an accident or pulls a muscle, it can significantly affect the spine, causing immense pain to the lower back. When this happens, many treatments can help lower back pain by dampening the inflammation and causing relief to the individual. In this article, we will be looking at what is a herniated disc and its symptoms, as well as how decompression can help repair herniated disc in the spine. By referring patients to qualified and skilled providers specializing in spinal decompression therapy. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions, please call Dr. Jimenez at 915-850-0900.

Journal of Neuro Imaging

What Is Herniated Disc?

Since mainly everyone has dealt with chronic back pain from an injury or pulling a back muscle at some point in their lives, this will cause many individuals to miss work and get treatment from their primary physicians as the pain is excruciating and can cause many people to miss out on everyday activities. Research studies have shown that lower back pain is one of the most common problems. With the different diagnoses for low back pain, DDD (degenerative disc disease) and lumbar disc herniation are considered the most common back pain. Research shows that herniated discs are formed when someone is lifting something heavy or twisting motions on the lower back, causing added stress on the spinal disc.

 

Research studies have stated that herniated disc has been the known cause of neckback, and leg pain, and it is due to an injury to the spine. Herniated discs are caused because, usually, spinal discs have a soft, gel-like center on the inside and are protected by a firm outer layer between the spinal joints. Within time and age, the firm outer layer becomes weak and will eventually crack, causing the inner soft gel-like center to push through the cracks of the outer layer and press on the nearby spinal nerves. This will cause sharp shooting pain in the sciatic nerve, causing it to go from the buttock down to the foot.

 

The Symptoms

Since most herniated discs usually occur in the lower back, research studies stated that they could also occur in the neck. Depending on where the herniated disc is located and pressing on a nerve, it will usually affect one side of the body. Some of the symptoms that herniated discs are causing on the neck and lower back include:

Other research studies have also found that lumbar disc herniation can be compressed and irritate the lumbar nerve root and the dural sac of the spine and cause sciatica to form. Since lumbar disc herniation is one of the most common diagnoses for degenerative abnormalities of the lumbar spine, there are ways to treat lumbar disc herniation.


How Lumbar Traction Rehydrates Lumbar Disc-Video

The video shows how a decompression machine uses traction to gently stretch the lumbar spine to rehydrate the lumbar disc back to its original state. As part of spinal decompression therapy, the decompression machine uses a traction machine to gently stretch the spine, causing instant relief to the individual suffering from low back pain or even herniated disc. When the spine gets a gentle stretch, the beneficial nutrients will go to the spinal disc, rehydrate them back into the spine, and improve the disc height. If you want to learn more about spinal decompression therapy, this link will explain the benefits of spinal decompression and how it can alleviate low back pain symptoms.


Repairing Herniated Disc With Decompression

 

With many treatments that can alleviate lumbar disc herniation, one of the non-surgical treatments providing relief to many individuals is spinal decompression therapy. Research studies have found that spinal decompression therapy has been used to help reduce the pressure of lumbar disc herniation and repair it by supplying nutrients and oxygen back to the lumbar disc. This will cause many individuals to feel instant relief as the herniated disc goes back into the spine with the nutrients and oxygen and repair them back to their original state. Other research studies also found that when combined with physical therapy, spinal decompression therapy is highly effective in the reabsorption of herniation and can increase the disc height for many individuals with lumbar disc herniation.

 

Conclusion

The spine’s primary function is to make sure that the body is upright and can bend, move, twist, and turn without any problems. The spine is encompassed by ligaments, soft tissues, the musculoskeletal system, the spinal cord, and the spinal disc. When a person accidentally pulls a muscle or sustains an injury, it can compress the spinal disc or cause it to develop a herniation and cause the person pain in their lower back. Luckily, treatments like spinal decompression allow gentle stretching on the spine to repair, restore, and rehydrate the spinal disc back to its original state. When this happens, many individuals will begin to feel instant relief and continue their day pain-free.

 

References

Al Qaraghli, Mustafa I, and Orlando De Jesus. “Lumbar Disc Herniation – Statpearls – NCBI Bookshelf.” StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 30 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK560878/.

Choi, Jioun, et al. “Influences of Spinal Decompression Therapy and General Traction Therapy on the Pain, Disability, and Straight Leg Raising of Patients with Intervertebral Disc Herniation.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4339166.

Demirel, Aynur, et al. “Regression of Lumbar Disc Herniation by Physiotherapy. Does Non-Surgical Spinal Decompression Therapy Make a Difference? Double-Blind Randomized Controlled Trial.” Journal of Back and Musculoskeletal Rehabilitation, U.S. National Library of Medicine, 22 Sept. 2017, pubmed.ncbi.nlm.nih.gov/28505956/.

Härtl, Roger. “Lumbar Herniated Disc: What You Should Know.” Spine, Spine-Health, 6 July 2016, www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc.

Medical Professionals, Cleveland Clinic. “Herniated Disk: What It Is, Diagnosis, Treatment & Outlook.” Cleveland Clinic, 1 July 2021, my.clevelandclinic.org/health/diseases/12768-herniated-disk.

Staff, Mayo Clinic. “Herniated Disk.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Feb. 2022, www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095.

Vialle, Luis Roberto, et al. “Lumbar Disc Herniation.” Revista Brasileira De Ortopedia, Elsevier, 16 Nov. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4799068/.

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El Paso Spinal Decompression Treatment

El Paso Spinal Decompression Treatment


Introduction

Dr. Alex Jimenez DC introduces Dr. Brian Self DC, as he explains the procedures of how to treat patients that are dealing with back pain by using the DOC decompression machine. The DOC decompression machine is used for spinal decompression therapy as it utilizes traction by gently stretching the spine to allow nutrients and oxygen back to the compressed spinal discs and increasing the disc height for many individuals that are suffering from a herniated or bulging discs. If you want to learn more about spinal decompression therapy, this link will explain the benefits of spinal decompression and how it can alleviate low back pain symptoms. By referring patients to qualified and skilled providers specializing in spinal decompression therapy. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions, please call Dr. Jimenez at 915-850-0900.

 

[00:00:02] Dr. Brian Self DC: So the first thing we’re going to do is lumber supine. OK, so before the patient gets on the table, a couple of things for them to know, you want everything out of their front and back pockets, keys, wallets, cell phones, everything in their pockets. Have them take their belts off if they’re wearing belts, and then have them use the restroom before they get on the table. I don’t let patients use their phones on the table. I prefer that they relax and fall asleep if they can. The more relaxed the patient is on the table, the better the treatment will be. So when we’re doing a lumbar supine, this would be good for heavier or older patients who can’t lay on their stomachs. Also, flexion-based conditions would be the best supine. So spondylolisthesis or stenosis, or anything where flexion makes it better and the extension makes it worse. When we’re doing a lumbar supine, we’re looking for this red line at the bottom of this thoracic cushion. So we’re going to line this one up where we want it. And then, these two red tabs are equal to the distance from the top of the iliac crest to the lowest rib. OK, so as the patient gets taller, this will slide up. So on our shortest patient, these two red tabs will be touching each other just like that as the patient gets taller; this thoracic harness will slide up. So the pelvic harness always stays; the thoracic harness will slide up as needed. So a two to three-inch gap would be for a patient that’s about five foot four to about six foot tall. A four-to-five-inch gap would be about six foot to about six foot seven. So the shorter patient, this thoracic harness comes down, the taller the patient, the thoracic harness slides up to make more gaps here. So once we know where we want these harnesses, let’s say I’m treating somebody who’s a normal male height. I will put these harnesses exactly where I want them, and then I will tighten this. So that this one is not going to move, and then I’m going to grab one seat belt in each hand, and then I’m going to lay this down one time with the red line right at the cushion where we talked about. So I’m going to lay it down one time. So I’m not messing with the velcro, and I’m going to velcro it right here to kind of hold it in place. And then what I’m going to do is I’m going to spin around and hold everything with my left hand, with my right hand. I’m going to point to where I want the patient to sit, which is right about here at this angle. If they sit too low on the table, then the top of their iliac crest will only be about right here when they lay back. If I have them sit right when they lay back, the top of their iliac crest will be about where you want it, the top of the pelvic harness. So hold all these, so they don’t move around too much. Have the patient sit about right here and then have them lay back. Now, once they lay back, then what you’re going to do is you’re going to take this with your right hands. I think it’s easiest to grab this with your right hand, bring it across, tuck it under, reach across it with your left hand, and then bring it straight across so it’s nice and snug. And with my right hand, I tuck my thumb underneath there so my hands are not in the way. Next, we’re going to do the seatbelt. And we’re going to bring this across now; the easiest way to tighten the seatbelt is not to grab this and pull hard this way because that will move the patient if they’re in pain, OK? The easiest way is to grab this with your right hand. Grab this one with your left hand and feed it through, so you’re feeding it with your right as you’re pulling it with your left hand. So you’re feeding that through to get that nice and snug. And then what we want is this metal ring to be centered on the patient, OK? Now, when the patient sits down on the harness, this will bunch up, and there will be a lot of extra fabric under their rear ends. So what you want to do is grab this and pull it this way. Pull it away from the patient to get all the extra fabric out so that it’s nice and tight. You will go through this ring and back up and attach it to the bottom here. OK. So again, this is all nice and tight now, with no extra fabric in there. And then what we can do is put the knee pillows under. If we want the knee pillows to be taller, we can rotate them like this. So if we want more flexion in the spine, we can use the taller position. OK? So always do your lumbar harness first, and then do your upper harness last. So on our upper harness, we’re looking to come around and down to make an X pattern. OK. You want the patient’s lowest rib to be right in the middle here. 

 

Lumbar Treatment

Dr. Brian Self DC explains how to set up the DOC decompression traction table for many individuals that are going in for a lumbar treatment. Lumbar treatment is used for many individuals who are suffering from low back pain and is treated by laying on their back.

[00:07:08] Dr. Brian Self DC: OK, so you’re coming across and down to encapsulate the patient’s lowest rib, and that should make an X if you did it correctly. Next, what we want to do is we want to choose the angle that we’re going to be treating. So we go to the computer, and then we’ll go to elevation in targeting. And then, we could do a pre-programmed level to hit L5 S1 on a computer and then begin targeting setup. And then, we can treat it at that predetermined angle. Now, suppose we don’t want to do the predetermined angle. We can constantly adjust the lumbar flex or lumbar flex down until we find the comfortable angle centralizing the symptoms. The most important thing is finding the angle that centralizes the pain, the numbness, the tingling. Anything that makes the pain go farther down the leg into the foot is making it worse. Anything that centralizes and brings those symptoms to the spine probably makes it better. So you’re looking for that comfortable position that centralizes the symptoms. Now, at this point, we could add some lateral flexion if we wanted. So if we go to the bottom of the table here? The table will flex left and right laterally if you squeeze just the left mechanism. OK, so this would be for a lateral bulging disk. The table will rotate left and right if we squeeze just the right one. When that comes into play, if you have a patient sitting in the waiting room and leaning like this to take the pressure off the nerve, you will recreate whatever lean they have on the table and treat it in that position. So if they’re in left lateral flexion with left rotation, you would put the table into left lateral flexion with left rotation. So, recreate whatever position and centralize their symptoms on the table itself. So whether that’s flexion or lateral flexion or rotation or a combination, you want to figure out what positions bring them relief and put the table into that position, OK? Or if they’re walking down the hallway and leaning to the left while they’re walking, then you would just recreate that position on the table and do the treatment in that position. So now that we’ve chosen our angle, we want to tighten everything down so we would come up here, pull this nice and tight, and then go up to this upper one up here. So we go up here for this one, nice and tight, making sure all the slacks are out of there, and then we would be ready to treat. And then so we would go here, go to our automatic decompression menu. If it’s their first week, we will select legacy number one. And then we’re going to hit confirm lumbar treatment; since we’re doing a lumber treatment. And then, we would choose their treatment kilograms, which will be based on one-third of the patient’s body weight for a lumbar or 10 percent for cervical. So we put in our kilograms and then select the number of cycles that we want to do. The number of cycles determines the amount of time that the treatment takes. I recommend starting with one cycle for the first visit and seeing how they do. And then going up one cycle per visit for the first five visits. So visit one, one cycle, visit two, two cycles, visit three, three cycles, visit four, four cycles, and then visit five, five cycles. And then that’s about the most you would want to do on legacy one because that’s going to be about a twenty-five-minute treatment that would allow you to do a 30-minute appointment time. And your treatment time is going to be about twenty-four minutes, which gives you six minutes to take the patient on and off the table and still maintain 30-minute appointment times. So around twenty-three minutes is about the most I would do on a lumber treatment. With your cervical treatments, you can get away with less time. You can do as low as 15 minutes on the cervical and get good results. Once we’re all set up here, once we’ve set up our treatment parameters in the computer, we would just hit start and start the treatment.

 

[00:12:36] Dr. Alex Jimenez DC: Remind me that we start on legacy one cycle one on the first day, correct?

 

[00:12:48] Dr. Brian Self DC: Correct.

 

[00:12:50] Dr. Alex Jimenez DC: And every day, one cycle.

 

[00:12:53] Dr. Brian Self DC: Correct, and only up to five cycles on that.

 

[00:12:56] Dr. Alex Jimenez DC: Five cycles. OK. And we should continue with those five cyles?

 

[00:13:07] Dr. Brian Self DC: Until you feel like they’re stable and until you feel like you’re not going to make them worse and they’re ready to go on to a more aggressive treatment, which would be K one if it’s a herniated or a bulging disc or K five if it’s a degenerative disc.

 

[00:13:28] Dr. Alex Jimenez DC: Well, I’ll clarify one thing. I’m just asking if we should maintain the five cycles after 14 days?

 

[00:14:00] Dr. Brian Self DC: Yes, unless you feel like you’re going to maintain those five cycles until you feel like they’re ready to progress to K1. Now, that might be after one week. It might be after two weeks, but do the five cycles until you feel like they’re ready to go to the following protocol.

 

[00:14:22] Dr. Alex Jimenez DC: Is it normal to continue the cycles for one week or two weeks?

 

[00:14:29] Dr. Brian Self DC: Yeah, one to two weeks is usually average for most people.

 

[00:14:34] Dr. Alex Jimenez DC: Right.

 

[00:14:37] Dr. Brian Self DC: Now, if the patient is stable on their end, they’re not that bad every once in a while. You might progress a little bit faster. Or sometimes, patients are just prolonged to respond. And in that case, then you might want to do the legacy one, you know, for a lot longer. It just depends on the patient.

 

[00:15:03] Dr. Brian Self DC: OK, so that’s lumber supine.

 

[00:15:09] Dr. Alex Jimenez DC: So we continue the cycles for the next two weeks, and when we feel the patient is now ready to progress to the following protocol, can we go for the K1 protocol?

 

[00:15:43] Dr. Brian Self DC: Yes, you can go for K1 whenever you feel the patient is ready. 

 

[00:15:49] Dr. Alex Jimenez DC: And how long is the K1 protocol?

 

[00:15:52] Dr. Brian Self DC: Generally that the whole rest of the treatment. So if it’s a herniated or a bulging disc, you would do K1 for weeks two through six, or if it’s a degenerative disc, you will do K5 for weeks two through six.

 

Prone Treatment

Dr. Brian Self DC explains how the DOC decompression is used for prone treatment. Prone spinal treatments are for many individuals that are suffering from posterior-lateral herniated or bulging disks and are treated by laying down on their stomachs either at an angle or flat on the DOC table.

[00:16:45] Dr. Brian Self DC: So next, it will be prone. Prone is suitable for younger patients with a posterior or a posterior-lateral herniated disk. So any patient that comes in between like 20 and 40 years old, that’s got a posterior bulging disk. And they say that flexion makes it worse. And extension makes it better; you’re probably going to put them prone. You would do prone because if they’re lying on their stomach on a poster bulging disk, the disk will be pointing up. Gravity is working in the direction you want the disk to go. So on a posterior bulging disc, prone is generally going to be a better treatment position. Now for prone, you’re probably starting with the table flat. So for prone, you’re probably going to start with the table flat, and then I’ll usually go up a couple of degrees per treatment if they can tolerate it. So for the first visit in prone, you don’t need these knee pillows, you would just lay them flat, and then you may come up into extension about two or three degrees per treatment. So as long as they can tolerate it, you can go up to extension with each treatment as long as they’re handling it. Now, it might not be super comfortable, but it can be more effective from a treatment standpoint, and then you can even add some extension here in the cervical. So this is putting them almost into like a MacKenzie type of protocol. And again, this is best for a herniated or bulging disc in a young patient where flexion makes it worse, and the extension makes it better. Now they may only be able to tolerate prone completely flat, and that’s OK. That’s a good position too. So just do prone, but completely flat. The only difference is with your armrests; you will have your armrests in the lower slots facing forward for a prone. OK, so your armrests are down there in the lower slots. Whereas supine, they’re going to be in the upper slots in line with the table.

 

[00:19:52] Dr. Brian Self DC: If the patient is supine, this would go in the upper slots just directly in line with the table there. OK, so that’s going to be supine, and then down here is where you put your armrests for your prone treatment. 

 

[00:21:46] Dr. Brian Self DC: So there’s no predetermined angle for prone. Everything is going to be the same as supine. The only difference is you’re just going to manually go up or down depending on how much flexion or extension you are. You’re still going to choose legacy one and then confirm a lumber treatment.

 

Cervical Treatment

Dr. Brian Self DC explains how the DOC decompression machine is used for cervical treatment. Cervical treatment is used for many individuals that are suffering from neck and shoulder pains. The DOC decompression machine gently stretches the neck for the individual to have relief. 

[00:22:40] Dr. Brian Self DC: So next, I want to go over cervical. So for cervical, what you’re going to do is you’re going to take your pelvic harness. And I usually just drap it off the end of the table out of the way with your thoracic harness. You need to remember that you want to take this post out with a thoracic harness, OK? So never pull this through this clamp because most people will put it back in the wrong way, and then it doesn’t work. So always when you’re doing this cervical, always take this whole bar out with this and then just set it to the side. So what you’re going to do is you’re going to take your cervical headpiece, and the first thing you’re going to do is adjust the width of the head posts. So a number two on each side is about a small female neck, or a number three on each side would be like a larger female neck and a smaller male neck. So number three on each side. And number four on each side would be a large male head now, once you get up to number four. Then I recommend taking this pad out because if you have a really large head, you want it to sit a little deeper in there. So if you get a huge head and this is pulling out from underneath their head, then take this out so it can sink a little bit.

 

[00:25:23] Dr. Brian Self DC: So next, what you’ll do is you’ll go ahead and place this in between the two face cushions. OK, so please don’t put it in the slot where you took the other post out; it will go in between the two face cushions there. Next, what you want to do is you want to come to the table and adjust the flexion that you want, depending on which disc we’re treating. So if you go into your elevation and targeting menu, you’ll see where it says cervical flexion angle. And then, you would go to your chart and know that negative 18 degrees is C6 C7.

 

[00:26:07] Dr. Brian Self DC: If we were treating C6 C7, we would take our cervical flexion angle on our computer until it says negative 18 degrees. Now what I like to do is just take a hand towel and put it over the cervical headpiece. Kind of tuck it down under. 

 

[00:26:39] Dr. Brian Self DC: So tuck your towel in there, lay the patient down, and then you’re going to bring this up over their forehead start and then bring this just above their eyebrows. OK, so now the towel will keep all of the makeup, sweat, and everything off of your headpiece. OK, so that way, you don’t have to wipe everything down every time you can when the treatment is done. This covers everything.

 

[00:27:28] Dr. Brian Self DC: You can put the knee pillows under for comfort, for the knees, and then everything else would be the same except that your force will be about 10 percent of the patient’s body weight. So on the lumbar, we were about a third of the bodyweight. We’re going to be about 10 percent of the bodyweight on the cervical.

 

[00:28:11] Dr. Brian Self DC: You just go to the main menu and then elevation in targeting. And then just watch your cervical flexion angle in your bottom left-hand corner, and then you would look at your chart that I sent you, and then you would say, “OK, C7-T1 is negative.”

 

[00:28:34] Dr. Brian Self DC: You would look at the chart and say, “OK, C7-T1 is negative twenty-two degrees.” So you would just go up until your cervical flexion angle says negative twenty-two degrees.

 

[00:28:52] Dr. Brian Self DC: Or if it were C6 C7, you would go down until it says negative 18 degrees.

 

[00:29:19] Dr. Brian Self DC: So that’s it for cervical. And then you would just choose legacy number one for the first one to two weeks, and then you would go to K1 if it’s a herniated or bulging disc for weeks two through six or K5, if it’s a degenerative disc, for weeks two through six.

 

[00:29:39] Dr. Alex Jimenez DC: Now, what is the length or duration of treatment for cervical?

 

Conclusion

Dr. Brian Self DC recaps the number of sessions for spinal decompression using the DOC decompression machine. Whether it is for lumbar, prone, or cervical treatment, spinal decompression will provide instant relief for many individuals.

[00:29:50] Dr. Brian Self DC: You will probably do it every day for two weeks and then three times a week for two weeks and two times a week for two weeks.

 

[00:30:04] Dr. Alex Jimenez DC: And lumbar is every four weeks?

 

[00:30:06] Dr. Brian Self DC: Yes. The cervical will generally respond faster and easier, so you can get away with it three times a week for six or seven weeks if you have to on cervical. Now lumbar, I recommend every day, with cervical; you could do a little bit less and still get excellent results. Now I will tell you that patients don’t tolerate the cervical sometimes. They complain that it makes the area go numb back here or complain about a temporary headache over the forehead. Right? That’s OK. That’s perfectly normal. I tell patients, you know, just to be patient. The results will still be excellent, but it’s not comfortable for some patients. The other thing I forgot to tell you is if patients are wearing glasses, have them take off their glasses. If they have huge earrings like big hoop earrings, then have them take off the earrings. But other than that, it’s pretty straightforward.

 

[00:31:12] Dr. Alex Jimenez DC: So, if you feel some numbness on the back or have a headache on the forehead, what should be the way to manage the patient? I mean, if somebody is complaining, then how should we do that?

 

[00:31:26] Dr. Brian Self DC: You can add this if you want. So this will go in between the two black occipital posts. So you can add this, I wouldn’t say I like to use this if I don’t have to, but you can add that and then add the towel over that to make it a little more comfortable.

 

Disclaimer

Spinal Decompression Nutrition

Spinal Decompression Nutrition

Non-surgical spinal decompression relieves pain related to spinal conditions, injuries, and disorders that provides a comfortable, affordable alternative treatment option to costly and invasive surgical procedures. Non-surgical spinal decompression can also relieve pain associated with post-surgical rehabilitation. A key to successful outcomes is including added components of the treatment that includes spinal decompression nutrition.

Spinal Decompression Nutrition

Spinal Decompression Nutrition

Proper nutrition and a balanced diet are essential elements of overall health. Individuals suffering from herniated discs, bulging discs, degenerated discs, sciatica, and chronic low back and neck pain are often deficient in vitamins and minerals, leading to inflammation and pain. These deficiencies can cause or exacerbate the pain and prevent or slow down healing. The bones, muscles, and other structures in the spine need proper nutrition to be strong enough to support the body and perform functions optimally. A health coach and nutritionist can recommend the proper diet and supplements to expedite healing, depending on the patient, the circumstances, and the individual situation. A non-inflammatory diet can make a big difference in patients’ symptoms and the effectiveness of decompression therapy.

The Right Foods

Eating a balanced diet with the right amount and variety of vitamins and nutrients can reduce back problems by nourishing the spine’s bones, muscles, discs, and other structures. While a healthy diet calls for various vitamins and nutrients, several healthy choices can directly benefit the spine. First and foremost is:

Sugar and Nitrate Reduction

  • High sugar diets lack the nutrients needed to prevent the release of inflammatory mediators.
  • The average individual consumes around 100 lbs of sugar per year.
  • Dessert foods are high in fatty acids, which increase inflammation.
  • Any foods containing high fructose corn syrup like salad dressings and sodas.
  • Processed foods high in nitrates like hot dogs, sausage, and lunch meats.

Super Foods

Increase healing of the spine at the cellular level with superfoods that include:

  • Shellfish – shrimp, crab, prawns, and oysters.
  • Dark green vegetables – spinach, asparagus, kale, and collards.
  • Red Fruits and Vegetables – red peppers, beets, dark berries like blackberries and blueberries.
  • Avocados
  • Olive oil.
  • Black olives.
  • Red onions and apples.
  • Flaxseeds, chia seeds, grains, and nuts.
  • Beans – navy beans, kidney beans, soybeans.
  • Cold Water Fish – sardines, mackerel, salmon, anchovies, and herring.
  • Winter Squash.
  • Water – maintaining hydration is important for re-hydrating degenerated, dried-out discs.

Pre Spinal Decompression Nutrition

The human body was created to heal itself; however, getting the proper nutrition can be difficult as circulation is impeded/blocked when going through a back injury or spinal condition. Eating and/or supplementing with essential nutrients and minerals could be recommended to encourage and engage the healing process. Using nutrients to improve recovery and healing is known as immunonutrition. Pre-decompression allows the tissues to begin healing. Then the chiropractic health team can prepare the tissues for decompression through therapeutic massage, heat, low-level laser therapy, and ultrasound.


DRX9000 Explained by a Neurosurgeon


References

Calder, Philip C. “Fatty acids and inflammation: the cutting edge between food and pharma.” European journal of pharmacology vol. 668 Suppl 1 (2011): S50-8. doi:10.1016/j.ejphar.2011.05.085

Gay R. “All About Spinal Decompression Therapy.” Spine-health. www.spine-health.com/treatment/chiropractic/all-about-spinal-decompression-therapy. Published September 2013. Accessed April 2015.

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What is inflammation? 2010 Nov 23 [Updated 2018 Feb 22]. Available from: www.ncbi.nlm.nih.gov/books/NBK279298/

Innes, Jacqueline K, and Philip C Calder. “Omega-6 fatty acids and inflammation.” Prostaglandins, leukotrienes, and essential fatty acids vol. 132 (2018): 41-48. doi:10.1016/j.plefa.2018.03.004