Back Clinic Treatments. There are various treatments for all types of injuries and conditions here at Injury Medical & Chiropractic Clinic. The main goal is to correct any misalignments in the spine through manual manipulation and placing misaligned vertebrae back in their proper place. Patients will be given a series of treatments, which are based on the diagnosis. This can include spinal manipulation, as well as other supportive treatments. And as chiropractic treatment has developed, so have its methods and techniques.
Why do chiropractors use one method/technique over another?
A common method of spinal adjustment is the toggle drop method. With this method, a chiropractor crosses their hands and pressed down firmly on an area of the spine. They will then adjust the area with a quick and precise thrust. This method has been used for years and is often used to help increase a patient’s mobility.
Another popular method takes place on a special drop table. The table has different sections, which can be moved up or down based on the body’s position. Patients lie face down on their back or side while the chiropractor applies quick thrusts throughout the spinal area as the table section drops. Many prefer this table adjustment, as this method is lighter and does not include twisting motions used in other methods.
Chiropractors also use specialized tools to assist in their adjustments, i.e., the activator. A chiropractor uses this spring-loaded tool to perform the adjustment/s instead of their hands. Many consider the activator method to be the most gentle of all.
Whichever adjustment method a chiropractor uses, they all offer great benefits to the spine and overall health and wellness. If there is a certain method that is preferred, talk to a chiropractor about it. If they do not perform a certain technique, they may recommend a colleague that does.
Can various stretches be beneficial for individuals dealing with wrist and hand pain by reducing pain and discomfort to the extremities?
Introduction
In a technological-driven world, it is common for people to experience wrist and hand pain at some point in their lives. The hands are part of the body’s upper extremities and are used for various tasks and chores throughout the entire day. The forearms provide a causal relationship with the hands and wrists for the upper extremities since they offer very important motor functions to the body. The hands support the body when carrying something; the various muscles, ligaments, tendons, and joints help the wrist with mobility and flexibility. However, when injuries or everyday movements begin to affect the forearms and cause issues with the hands and wrist, it can be difficult to do simple tasks and negatively impact a person’s way of life. Fortunately, numerous ways exist to reduce the pain and discomfort of the wrist and hands. Today’s article focuses on what causes wrist and hand pain, how to prevent wrist and hand pain from returning, and how incorporating various can help reduce the pain-like effects. We discuss with certified medical providers who consolidate our patients’ information to assess the multiple causes that lead to the development of wrist and hand pain. We also inform and guide patients on how various stretches and techniques can help reduce the chances of wrist and hand pain from returning. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating these stretches and techniques into their daily routines to live healthier lives. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
What Causes Hand and Wrist Pain?
Do you often feel pain or stiffness in your wrist after typing all day on the computer or phone? Do you have trouble gripping items in your hands? Or how often do your hands ache that massaging them causes temporary relief? Many people, including older adults, have experienced pain at some point, and most of the time, it affects the hands and wrists. Since everyone uses their hands and wrists when performing various tasks, when injuries or repetitive movements start to affect the hands and wrists, it can have a huge impact on simple tasks. When dealing with wrist and hand pain, it can make life unbearable for the person. Since pain is a normal protective response to any injuries and potentially harmful stimuli in its acute form, when prolonged or dysfunctional neuromuscular issues start to affect the body, it may contribute to disability and pain. (Merkle et al., 2020) For wrist and hand pain, many occurrences that lead to its development result from micro-stress or repetitive tear usage.
This is because since the world is technological-driven, many people are using computers or smartphones to communicate with each other, which can be one of the causes of the development of wrist and hand pain. When many people frequently use electronic devices, the frequent movements and uses of the thumbs will increase their load and become a higher prevalence of musculoskeletal disorders. (Baabdullah et al., 2020) Other studies stated that when many individuals begin to do repetitive movements constantly and have different positions of their wrist joints while using their electronic devices continually, it can cause pain to their wrist joints and affect the structure. (Amjad et al., 2020) Additionally, when repetitive vibration exposures or forceful angular motions affect the hands and wrists, it can lead to carpal tunnel syndrome and affect the hands. (Osiak et al., 2022) The various joints, tendons, and muscles also become affected in the hands and wrist as trigger points in the forearm. Fortunately, there are multiple ways that many people can reduce the pain-like effects of wrist and hand pain.
The Benefits of Stretching-Video
How To Prevent Wrist & Hand Pain From Returning
There are numerous ways to reduce wrist and hand pain, and many people try to find therapeutic solutions to mitigate the pain. Non-surgical treatments like manual therapy can help with wrist and hand pain by using mobilization forces to allow wrist flexion and extension to improve motor function. (Gutierrez-Espinoza et al., 2022) Another non-surgical treatment that can help with wrist and hand pain is acupuncture. Acupuncture utilizes small, solid, thin needles to be placed in various acupoints in the forearm to reduce the pain intensity and bring back the mobility function to the hands and wrist. (Trinh et al., 2022)
Various Stretches For Wrist & Hand Pain
Fortunately, there’s a simple and accessible way for many individuals to reduce the effects of wrist and hand pain-stretching and incorporating yoga into their routine. Yoga stretches for the hands and wrists can help decompress and reduce stiffness, and these stretches can be done for just a few minutes, providing beneficial results. (Gandolfi et al., 2023) Below are some of these stretches that can be easily incorporated into anyone’s routine, making it easier for you to take control of your wrist and hand health.
Wrist Flexor Stretch
How to Do It:
Extend your arm in front of you with your palm up.
Use your other hand to gently pull the fingers back toward the body until you feel a stretch in your forearm.
Hold this position for about 15 to 30 seconds.
Repeat 2-3 times with each wrist.
Wrist Extensor Stretch
How to Do It:
Extend your arm in front of your body with your palm facing down.
Gently pull the fingers towards your body with your other hand until you feel a stretch on the outside of your forearm.
Hold for 15 to 30 seconds.
Do this 2-3 times per wrist.
Prayer Stretch
How to Do It:
Put the palms together in a prayer position in front of the chest, below the chin.
Slowly lower the conjoined hands towards the waistline, keeping the hands close to your stomach and your palms together until you feel a stretch under your forearms.
Hold for at least 30 seconds and repeat a few times.
Tendon Glides
How to Do It:
Start with your fingers extended straight out.
Then, bend your fingers to form a hook fist; you should feel a stretch but no pain.
Return to the starting position and bend your fingers to touch the top of your palm, keeping your fingers straight.
Finally, bend your fingers into a full fist.
Repeat the sequence ten times.
Thumb Stretch
How to Do It:
Extend your hand with your fingers together.
Pull your thumb away from your fingers as far as comfortable.
Hold for 15 to 30 seconds.
Repeat 2-3 times with each thumb.
Shake It Out
How to Do It:
After stretching, shake your hands lightly as if trying to dry them off. This helps reduce tension and promote circulation.
References
Amjad, F., Farooq, M. N., Batool, R., & Irshad, A. (2020). Frequency of wrist pain and its associated risk factors in students using mobile phones. Pak J Med Sci, 36(4), 746-749. doi.org/10.12669/pjms.36.4.1797
Baabdullah, A., Bokhary, D., Kabli, Y., Saggaf, O., Daiwali, M., & Hamdi, A. (2020). The association between smartphone addiction and thumb/wrist pain: A cross-sectional study. Medicine (Baltimore), 99(10), e19124. doi.org/10.1097/MD.0000000000019124
Gandolfi, M. G., Zamparini, F., Spinelli, A., & Prati, C. (2023). Asana for Neck, Shoulders, and Wrists to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yoga Protocol. J Funct Morphol Kinesiol, 8(1). doi.org/10.3390/jfmk8010026
Gutierrez-Espinoza, H., Araya-Quintanilla, F., Olguin-Huerta, C., Valenzuela-Fuenzalida, J., Gutierrez-Monclus, R., & Moncada-Ramirez, V. (2022). Effectiveness of manual therapy in patients with distal radius fracture: a systematic review and meta-analysis. J Man Manip Ther, 30(1), 33-45. doi.org/10.1080/10669817.2021.1992090
Merkle, S. L., Sluka, K. A., & Frey-Law, L. A. (2020). The interaction between pain and movement. J Hand Ther, 33(1), 60-66. doi.org/10.1016/j.jht.2018.05.001
Osiak, K., Elnazir, P., Walocha, J. A., & Pasternak, A. (2022). Carpal tunnel syndrome: state-of-the-art review. Folia Morphol (Warsz), 81(4), 851-862. doi.org/10.5603/FM.a2021.0121
Trinh, K., Zhou, F., Belski, N., Deng, J., & Wong, C. Y. (2022). The Effect of Acupuncture on Hand and Wrist Pain Intensity, Functional Status, and Quality of Life in Adults: A Systematic Review. Med Acupunct, 34(1), 34-48. doi.org/10.1089/acu.2021.0046
Can incorporating various yoga poses help reduce neck tension and provide pain relief for individuals dealing with neck pain?
Introduction
Within the hustling and bustling of modern life, it is common for many individuals to carry stress in their bodies. When the body deals with everyday stressors, tension, discomfort, and pain can often manifest in the upper and lower portions of the body. When the body’s upper and lower portions deal with these issues, they can cause overlapping risk profiles in the musculoskeletal system. One of the most common musculoskeletal issues is neck pain. It can cause many problems to the cervical portion of the spine and cause the surrounding muscles to become tense and in pain from the stress of everyday responsibilities. Luckily, there are numerous ways to reduce stress from the neck and help relax the affected muscles from discomfort, including yoga. In today’s article, we will look at how neck pain affects the upper body, the benefits of yoga for neck pain, and various yoga poses to reduce the overlapping effects of neck pain. We discuss with certified medical providers who consolidate our patients’ information to assess how neck pain is correlated with everyday stressors that affect the upper body. We also inform and guide patients on how yoga and the various poses can benefit the body and provide pain relief to the surrounding muscles. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating yoga into their daily routine to reduce muscle tension and provide clarity to their bodies. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
How Does Neck Pain Affect The Upper Body?
Do you feel discomfort or pain in your neck and shoulders after a long, hard workday? Do you notice you hunched more than usual when doing your daily routine? Or do you see yourself developing a hunched posture from looking at the computer screen or phone for an extended period? Many of these normal motions are often correlated with the upper body, especially in the neck and shoulder regions, which causes neck pain. As one of the most common problems affecting many people worldwide, neck pain is a multifactorial disease with numerous risk factors contributing to its development. (Kazeminasab et al., 2022) Like back pain, neck pain can have acute and chronic stages depending on the severity and environmental factors leading to its development. The various muscles, ligaments, and tissues surrounding the neck and shoulders keep the neck stable and mobile. When many individuals overuse these muscles in the neck and shoulders repetitively, it can increase neck pain in the upper body in adulthood. (Ben Ayed et al., 2019)
When acute neck pain turns chronic, it can cause the individual to be in constant discomfort, pain, and misery, so they start to look for various solutions to reduce the correlating symptoms when speaking to their primary doctors. When many individuals begin to explain to their doctors what their daily routine looks like, many doctors will start to assess and formulate a plan that focuses on any specific description of any injuries, including potential mechanisms, inciting and relieving factors, and pain patterns they have encountered throughout the day to come up with a personalized treatment plan to not only reduce neck pain but also provide relief to tension and discomfort to the body. (Childress & Stuek, 2020)
The Science of Motion- Video
The Benefits Of Yoga For Neck Pain
Many primary doctors will work with associated medical providers to develop a personalized plan to relieve neck pain and its associated symptoms in many individuals. Many of these customized treatment plans include spinal manipulation, acupuncture, massage, decompression therapy, and therapeutic exercises. One of the therapeutic exercises that many individuals have utilized is yoga. Yoga is a holistic practice encompassing breathing control, meditation, and various poses to stretch and strengthen the affected upper muscles. Yoga is excellent for reducing neck pain and helping with upper cervical spine mobility, stretching the neck musculature to help the individual improve mobility and flexibility. (Raja et al., 2021) Additionally, the effects of yoga and its many poses can reduce tension, give clarity to the mind, and allow the nutrients and oxygen to the musculo-articular system to naturally heal the body itself. (Gandolfi et al., 2023)
Yoga Poses For Neck Pain
At the same time, many individuals with sedentary jobs that correlate to neck pain have implemented yoga as part of their routine. Yoga improves their range of joint motion and cognitive function and helps relieve musculoskeletal discomfort in the neck and shoulder regions. (Thanasilungkoon et al., 2023) Below are some of the various yoga poses that can help reduce the pain-like symptoms of neck pain and ease the surrounding muscles.
Seated Neck Stretches
For seated neck stretches, this yoga pose helps stretch and release the neck muscles that carry tension and stress in the cervical region of the body.
In a seated upright position, turn the head to the right and gently lift the chin.
You should feel a stretch along the left side of the neck and shoulders.
Hold the position for three to five breaths and repeat on the left side.
Camel Pose
For the camel pose, this yoga pose helps strengthen the front neck muscles while easing tension on the shoulders and back of the neck.
You can kneel on a yoga mat by keeping your knees and feet hip-distance apart while keeping the pelvis neutral.
Lift the chest while arching your back and pressing the pelvis slightly forward.
Bring the fingertips to the heels or yoga blocks beside the ankles.
Focus on drawing the chin close to the neck while pressing the feet to the mat.
Hold the position for three to five breaths before releasing and lifting the sternum to rise back up.
Sphinx Pose
The sphinx pose allows you to lengthen and strengthen the spine while stretching the shoulders and releasing tension.
On a yoga mat, lie on your stomach with the elbows under the shoulders.
Press your palms and forearms on the mat and tighten the lower half to support you as you lift your upper torso and head.
Keep looking straight ahead as you are being mindful of lengthening the spine.
Hold this position for three to five breaths.
Thread The Needle Pose
The thread-the-needle pose helps release tension stored in the neck, shoulders, and back.
On a yoga mat, start in an all-fours position with the wrist under the shoulders and the knees under the hips.
Lift the right hand and move it to the left along the floor with the palm facing up.
Hold the position for three to five breaths for thirty seconds and release.
Return to the all-fours position and repeat to the left side.
Conclusion
Overall, incorporating yoga as part of a daily routine can provide beneficial results in reducing neck pain and its associated comorbidities. Yoga does not require hours of practice or even contorting into various poses, as just a few minutes of gentle stretching and mindful breathing each day can provide positive results. When people start to utilize yoga as part of their daily activities, they will notice their posture improving, their minds clearer than ever, and live a happier, healthier life without dealing with neck pain.
References
Ben Ayed, H., Yaich, S., Trigui, M., Ben Hmida, M., Ben Jemaa, M., Ammar, A., Jedidi, J., Karray, R., Feki, H., Mejdoub, Y., Kassis, M., & Damak, J. (2019). Prevalence, Risk Factors and Outcomes of Neck, Shoulders and Low-Back Pain in Secondary-School Children. J Res Health Sci, 19(1), e00440. www.ncbi.nlm.nih.gov/pubmed/31133629
Childress, M. A., & Stuek, S. J. (2020). Neck Pain: Initial Evaluation and Management. American Family Physician, 102(3), 150-156. www.ncbi.nlm.nih.gov/pubmed/32735440
Gandolfi, M. G., Zamparini, F., Spinelli, A., & Prati, C. (2023). Asana for Neck, Shoulders, and Wrists to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yoga Protocol. J Funct Morphol Kinesiol, 8(1). doi.org/10.3390/jfmk8010026
Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord, 23(1), 26. doi.org/10.1186/s12891-021-04957-4
Raja, G. P., Bhat, N. S., Fernandez-de-Las-Penas, C., Gangavelli, R., Davis, F., Shankar, R., & Prabhu, A. (2021). Effectiveness of deep cervical fascial manipulation and yoga postures on pain, function, and oculomotor control in patients with mechanical neck pain: study protocol of a pragmatic, parallel-group, randomized, controlled trial. Trials, 22(1), 574. doi.org/10.1186/s13063-021-05533-w
Thanasilungkoon, B., Niempoog, S., Sriyakul, K., Tungsukruthai, P., Kamalashiran, C., & Kietinun, S. (2023). The Efficacy of Ruesi Dadton and Yoga on Reducing Neck and Shoulder Pain in Office Workers. Int J Exerc Sci, 16(7), 1113-1130. www.ncbi.nlm.nih.gov/pubmed/38287934
How do healthcare professionals in a chiropractic clinic provide a clinical approach to preventing medical errors for individuals in pain?
Introduction
Medical errors resulted in 44,000–98,000 hospitalized American deaths annually, and many more caused catastrophic injuries. (Kohn et al., 2000) This was more than the number of people who died annually from AIDS, breast cancer, and auto accidents at the time. According to later research, the actual number of deaths may be closer to 400,000, placing medical errors as the third most common cause of death in the US. Frequently, these mistakes are not the product of medical professionals who are inherently bad; rather, they are the outcome of systemic issues with the health care system, such as inconsistent provider practice patterns, disjointed insurance networks, underutilization or absence of safety protocols, and uncoordinated care. Today’s article looks at the clinical approach to preventing a medical error in a clinical setting. We discuss associated medical providers specializing in various pretreatments to aid individuals suffering from chronic issues. We also guide our patients by allowing them to ask their associated medical providers very important and intricate questions. Dr. Alex Jimenez, DC, only utilizes this information as an educational service. Disclaimer
Defining Medical Errors
Determining what medical error is the most crucial step in any conversation about preventing medical errors. You might assume this is a very easy chore, but that is only until you delve into the vast array of terminology utilized. Many terms are used synonymously (sometimes mistakenly) since some terminology is interchangeable, and occasionally, the meaning of a term depends on the specialty being discussed.
Even though the healthcare sector stated that patient safety and eliminating or reducing medical errors were priorities, Grober and Bohnen noted as recently as 2005 that they had fallen short in one crucial area: determining the definition of “perhaps the most fundamental question… What is a medical error? A medical error is a failure to complete a planned action in a medical setting. (Grober & Bohnen, 2005) However, none of the terms that one would often identify expressly with a medical error—patients, healthcare, or any other element—are mentioned in this description. Despite this, the definition offers a solid framework for further development. As you can see, that specific definition consists of two parts:
An execution error: A failure to complete a planned action as intended.
A planning error: is a technique that, even with perfect execution, does not produce the desired results.
The concepts of faults of execution and planning errors are insufficient if we are to define a medical error adequately. These may occur anywhere, not only at a medical establishment. The component of medical management must be added. This brings up the idea of unfavorable occurrences, known as adverse events. The most common definition of an adverse event is unintentional harm to patients brought about by medical therapy rather than their underlying disease. This definition has gained international acceptance in one way or another. For example, in Australia, the term incidents are defined as in which harm resulted in a person receiving health care. These consist of infections, injury-causing falls, and issues with prescription drugs and medical equipment. Certain unfavorable occurrences might be avoidable.
Common Types of Medical Errors
The only issue with this notion is that not all negative things happen accidentally or intentionally. Because the patient may ultimately benefit, an expected but tolerated adverse event may occur. During chemotherapy, nausea and hair loss are two examples. In this instance, refusing the recommended treatment would be the only sensible approach to prevent the unpleasant consequence. We thus arrive at the concept of preventable and non-preventable adverse occurrences as we further refine our definition. It isn’t easy to categorize a choice to tolerate one impact when it is determined that a favorable effect will occur simultaneously. But purpose alone isn’t necessarily an excuse. (Patient Safety Network, 2016, para.3) Another example of a planned mistake would be a right foot amputation due to a tumor on the left hand, which would be accepting a known and predicted unfavorable event in the hopes of a beneficial consequence where none has ever arisen before. There is no evidence to support the anticipation of a positive outcome.
Medical errors that cause harm to the patient are typically the focus of our research. Nonetheless, medical mistakes can and do occur when a patient is not harmed. The occurrence of near misses could provide invaluable data when planning how to reduce medical errors in a healthcare facility. Still, the frequency of these events compared to the frequency clinicians report them needs to be investigated. Near misses are medical errors that could have caused harm but did not to the patient, even if the patient is doing well. (Martinez et al., 2017) Why would you acknowledge something that could potentially result in legal action? Consider the scenario where a nurse, for whatever reason, had just been looking at photographs of different medications and was about to provide a medication. Maybe something lingers in her memory, and she decides that’s not how a specific medication looks. Upon checking, she found that the incorrect medicines had been administered. After checking all the paperwork, she fixes the mistake and gives the patient the right prescription. Would it be possible to avoid an error in the future if the administration record included photographs of the proper medication? It is easy to forget that there was a mistake and a chance for harm. That fact remains true regardless of whether we were fortunate enough to find it in time or suffer any negative consequences.
Errors of Outcomes & Process
We need complete data to develop solutions that improve patient safety and decrease medical errors. At the very least, when the patient is in a medical facility, everything that can be done to prevent harm and put them in danger should be reported. Many doctors have determined that using the phrases errors and adverse events was more comprehensive and suitable after reviewing mistakes and adverse events in health care and discussing their strengths and weaknesses in 2003. This combined definition would increase data gathering, including mistakes, close calls, near misses, andactive and latent errors. Additionally, the term adverse events includes terms that usually imply patient harm, such as medical injury and iatrogenic injury. The only thing that remains is determining whether a review board is a suitable body to handle the separation of preventable and non-preventable adverse events.
A sentinel event is an occurrence where reporting to the Joint Commission is required. The Joint Commission states that a sentinel event is an unexpected occurrence involving a serious physical or psychological injury. (“Sentinel Events,” 2004, p.35) There isn’t a choice, as it needs to be documented. Most healthcare facilities, however, do keep their records outlining sentinel incidents and what to do in the event of one to guarantee that the Joint Commission standards are met. This is one of those situations when it’s better to be safe than sorry. Since “serious” is a relative concept, there may be some wriggle room when defending a coworker or an employer. On the other hand, reporting a sentinel event incorrectly is better than failing to report a sentinel event. Failing to disclose can have serious consequences, including career termination.
When considering medical errors, people frequently make the mistake of focusing just on prescription errors. Medication errors are undoubtedly frequent and involve many of the same procedural flaws as other medical errors. Breakdowns in communication, mistakes made during prescription or dispensing, and many other things are possible. But we would be gravely misjudging the issue if we assumed that drug errors are the only cause of harm to a patient. One major challenge in classifying the different medical errors is determining whether to classify the error based on the procedure involved or the consequence. It is acceptable to examine those classifications here, given numerous attempts have been made to develop working definitions that incorporate both the process and the outcome, many of which are based on Lucian Leape’s work from the 1990s.
Enhance Your Lifestyle Today- Video
Analyzing & Preventing Medical Errors
Operative and nonoperative were the two main categories of adverse events that Leape and his colleagues distinguished in this study. (Leape et al., 1991) Operative problems included wound infections, surgical failures, non-technical issues, late complications, and technical difficulties. Nonoperative: headings such as medication-related, misdiagnosed, mistreated, procedure-related, fall, fracture, postpartum, anesthesia-related, neonatal, and a catch-all heading of the system were included under this category of adverse occurrences. Leape also classified errors by pointing out the point of process breakdown. He also categorized these into five headings, which include:
System
Performance
Drug Treatment
Diagnostic
Preventative
Many process faults fall under more than one topic, yet they all help to pinpoint the exact cause of the issue. If more than one physician was engaged in determining the precise areas that need improvement, then additional questioning might be required.
Technically, a medical error can be made by any staff member at a hospital. It is not limited to medical professionals like physicians and nurses. An administrator may unlatch a door, or a cleaning crew member could leave a chemical within a child’s grasp. What matters more than the identity of the perpetrator of the mistake is the reason behind it. What before it? And how can we make sure that doesn’t occur again? After gathering all the above data and much more, it’s time to figure out how to prevent similar errors. As for sentinel events, the Joint Commission has mandated since 1997 that all of these incidents undergo a procedure called Root Cause Analysis (RCA). However, using this procedure for incidents that need to be reported to outside parties would need to be corrected.
What Is A Root Cause Analysis?
RCAs “captured the details as well as the big picture perspective.” They make evaluating systems easier, analyzing whether remedial action is necessary, and tracking trends. (Williams, 2001) What precisely is an RCA, though? By examining the events that led to the error, an RCA can focus on events and processes rather than reviewing or placing blame on specific people. (AHRQ,2017) This is why it is so crucial. An RCA frequently makes use of a tool called the Five Whys. This is the process of continuously asking yourself “why” after you believe you have determined the cause of an issue.
The reason it’s called the “five whys” is because, while five is an excellent starting point, you should always question why until you identify the underlying cause of the problem. Asking why repeatedly could reveal many process faults at different stages, but you should keep asking why about every aspect of the issue until you run out of other things that could be adjusted to provide a desirable result. However, different tools besides this one can be utilized in a root cause investigation. Numerous others exist. RCAs must be multidisciplinary and consistent and involve all parties involved in the error to avoid misunderstandings or inaccurate reporting of occurrences.
Conclusion
Medical errors in healthcare institutions are frequent and mostly unreported events that seriously threaten patients’ health. Up to a quarter of a million individuals are thought to pass away each year as a result of medical blunders. These statistics are unacceptable in a time when patient safety is supposedly the top priority, but not much is being done to alter practices. If medical errors are accurately defined and the root cause of the problem is found without assigning blame to specific staff members, this is unnecessary. Essential changes can be made when fundamental causes of system or process faults are correctly identified. A consistent, multidisciplinary approach to root cause analysis that uses frameworks like the five whys to delve down until all issues and defects are revealed is a helpful tool. Although it is now necessary for the wake of sentinel events, the Root Cause Analysis may and should be applied to all mistake causes, including near misses.
Kohn, L. T., Corrigan, J., Donaldson, M. S., & Institute of Medicine (U.S.). Committee on Quality of Health Care in America. (2000). To err is human : building a safer health system. National Academy Press. books.nap.edu/books/0309068371/html/index.html
Leape, L. L., Brennan, T. A., Laird, N., Lawthers, A. G., Localio, A. R., Barnes, B. A., Hebert, L., Newhouse, J. P., Weiler, P. C., & Hiatt, H. (1991). The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med, 324(6), 377-384. doi.org/10.1056/NEJM199102073240605
Martinez, W., Lehmann, L. S., Hu, Y. Y., Desai, S. P., & Shapiro, J. (2017). Processes for Identifying and Reviewing Adverse Events and Near Misses at an Academic Medical Center. Jt Comm J Qual Patient Saf, 43(1), 5-15. doi.org/10.1016/j.jcjq.2016.11.001
Can individuals with Ehlers-Danlos syndrome find relief through various non-surgical treatments to reduce joint instability?
Introduction
The joints and ligaments surrounding the musculoskeletal system allow the upper and lower extremities to stabilize the body and be mobile. The various muscles and soft connective tissues that surround the joints help protect them from injuries. When environmental factors or disorders start to affect the body, many people develop issues that cause overlapping risk profiles, which then affect the stability of the joints. One of the disorders that affect the joints and connective tissue is EDS or Ehlers-Danlos syndrome. This connective tissue disorder can cause the joints in the body to be hypermobile. It can cause joint instability in the upper and lower extremities, thus leaving the individual to be in constant pain. Today’s article focuses on Ehlers-Danlos syndrome and its symptoms and how there are non-surgical ways to manage this connective tissue disorder. We discuss with certified medical providers who consolidate our patients’ information to assess how Ehlers-Danlos syndrome can correlate with other musculoskeletal disorders. We also inform and guide patients on how various non-surgical treatments can help reduce pain-like symptoms and manage Ehlers-Danlos syndrome. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating various non-surgical therapies as part of their daily routine to manage the effects of Ehlers-Danlos syndrome. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
What Is Ehlers-Danlos Syndrome?
Do you often feel extremely tired throughout the day, even after a full night of sleep? Do you bruise easily and wonder where these bruises are coming from? Or have you noticed that you have an increased range in your joints? Many of these issues are often correlated with a disorder known as Ehlers-Danlos syndrome or EDS that affects their joints and connective tissue. EDS affects the connective tissues in the body. The connective tissues in the body help provide strength and elasticity to the skin, joints, as well as blood vessel walls, so when a person is dealing with EDS, it can cause a significant disruption to the musculoskeletal system. EDS is largely diagnosed clinically, and many doctors have identified that the gene coding of the collagen and proteins that interact in the body can help determine what type of EDS affects the individual. (Miklovic & Sieg, 2024)
The Symptoms
When understanding EDS, it is essential to know the complexities of this connective tissue disorder. EDS is classified into numerous types with distinct features and challenges that vary depending on the severity. One of the most common types of EDS is hypermobile Ehlers-Danlos syndrome. This type of EDS is characterized by general joint hypermobility, joint instability, and pain. Some of the symptoms that are associated with hypermobile EDS include subluxation, dislocations, and soft tissue injuries that are common and may occur spontaneously or with minimal trauma. (Hakim, 1993) This can often cause acute pain to the joints in the upper and lower extremities. With its broad range of symptoms and the personal nature of the condition itself, many often don’t realize that joint hypermobility is common in the general population and may present no complications that indicate that it is a connective tissue disorder. (Gensemer et al., 2021) Additionally, hypermobile EDS can lead to spinal deformity due to the hyperextensibility of the skin, joints, and various tissue fragility. The pathophysiology of spinal deformity associated with hypermobile EDS is primarily due to muscle hypotonia and ligament laxity. (Uehara et al., 2023) This causes many people to reduce their quality of life and daily living activities significantly. However, there are ways to manage EDS and its correlating symptoms to reduce joint instability.
Movement Medicine: Chiropractic Care-Video
Ways To Manage EDS
When it comes to looking for ways to manage EDS to reduce pain and joint instability, non-surgical treatments can help address the physical and emotional aspects of the condition. Non-surgical treatments for individuals with EDS commonly focus on optimizing the body’s physical function while improving muscular strength and joint stabilization. (Buryk-Iggers et al., 2022) Many individuals with EDS will try to incorporate pain management techniques and physical therapy anduse braces and assistive devices to reduce the effects of EDS and improve their quality of life.
Non-surgical Treatments For EDS
Various non-surgical treatments like MET (muscle energy technique), electrotherapy, light physical therapy, chiropractic care, and massages can help strengthen while toning the surrounding muscles around the joints, provide sufficient pain relief, and limit long-term dependence on medications. (Broida et al., 2021) Additionally, individuals dealing with EDS aim to strengthen the affected muscles, stabilize the joints, and improve proprioception. Non-surgical treatments allow the individual to have a customized treatment plan for the severity of EDS symptoms and help reduce the pain associated with the condition. Many individuals, when going through their treatment plan consecutively to manage their EDS and reduce the pain-like symptoms, will notice improvement in symptomatic discomfort. (Khokhar et al., 2023) This means that non-surgical treatments allow individuals to be more mindful of their bodies and reduce the pain-like effects of EDS, thus allowing many individuals with EDS to lead fuller, more comfortable lives without feeling pain and discomfort.
References
Broida, S. E., Sweeney, A. P., Gottschalk, M. B., & Wagner, E. R. (2021). Management of shoulder instability in hypermobility-type Ehlers-Danlos syndrome. JSES Rev Rep Tech, 1(3), 155-164. doi.org/10.1016/j.xrrt.2021.03.002
Buryk-Iggers, S., Mittal, N., Santa Mina, D., Adams, S. C., Englesakis, M., Rachinsky, M., Lopez-Hernandez, L., Hussey, L., McGillis, L., McLean, L., Laflamme, C., Rozenberg, D., & Clarke, H. (2022). Exercise and Rehabilitation in People With Ehlers-Danlos Syndrome: A Systematic Review. Arch Rehabil Res Clin Transl, 4(2), 100189. doi.org/10.1016/j.arrct.2022.100189
Gensemer, C., Burks, R., Kautz, S., Judge, D. P., Lavallee, M., & Norris, R. A. (2021). Hypermobile Ehlers-Danlos syndromes: Complex phenotypes, challenging diagnoses, and poorly understood causes. Dev Dyn, 250(3), 318-344. doi.org/10.1002/dvdy.220
Hakim, A. (1993). Hypermobile Ehlers-Danlos Syndrome. In M. P. Adam, J. Feldman, G. M. Mirzaa, R. A. Pagon, S. E. Wallace, L. J. H. Bean, K. W. Gripp, & A. Amemiya (Eds.), GeneReviews((R)). www.ncbi.nlm.nih.gov/pubmed/20301456
Khokhar, D., Powers, B., Yamani, M., & Edwards, M. A. (2023). The Benefits of Osteopathic Manipulative Treatment on a Patient With Ehlers-Danlos Syndrome. Cureus, 15(5), e38698. doi.org/10.7759/cureus.38698
For individuals dealing with sciatica, can non-surgical treatments like chiropractic care and acupuncture reduce pain and restore function?
Introduction
The human body is a complex machine that allows the host to be mobile and stable when resting. With various muscle groups in the upper and lower body portions, the surrounding muscles, tendons, nerves, and ligaments serve a purpose for the body as they all have specific jobs in keeping the host functional. However, many individuals have developed various habits that cause strenuous activities that cause repetitive motions to their muscles and nerves and affect their musculoskeletal system. One of the nerves that many individuals have been dealing with pain is the sciatic nerve, which causes many issues in the lower body extremities and, when not treated right away, leads to pain and disability. Luckily, many individuals have sought non-surgical treatments to reduce sciatica and restore body function to the individual. Today’s article focuses on understanding sciatica and how non-surgical therapies like chiropractic care and acupuncture can help reduce the sciatic pain-like effects that are causing overlapping risk profiles in the lower body extremities. We discuss with certified medical providers who consolidate with our patients’ information to assess how sciatica is often correlated with environmental factors that cause dysfunction in the body. We also inform and guide patients on how various non-surgical treatments can help reduce sciatica and its correlating symptoms. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating various non-surgical therapies as part of their daily routine to reduce the chances and effects of sciatica from returning. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Understanding Sciatica
Do you often feel radiating pain that travels down one or both legs when sitting down for a long period? How often have you experienced tingling sensations that cause you to shake your leg to reduce the effect? Or have you noticed that stretching your legs causes temporary relief? While these overlapping pain symptoms can affect the lower extremities, many individuals may think it is low back pain, but in actuality, it is sciatica. Sciatica is a common musculoskeletal condition that affects many people worldwide by causing pain to the sciatic nerve and radiating down to the legs. The sciatic nerve is pivotal in providing direct and indirect motor function to the leg muscles. (Davis et al., 2024) When the sciatic nerve is compressed, many people state that the pain can vary in intensity, accompanied by symptoms like tingling, numbness, and muscle weakness that can affect a person’s ability to walk and function.
However, some of the root causes that lead to the development of sciatica can play into the factor that causes the pain in the lower extremities. Several inherent and environmental factors are often associated with sciatica, causing lumbar nerve root compression on the sciatic nerve. Factors like poor health status, physical stress, and occupational work are correlated with the development of sciatica and can impact a person’s routine. (Gimenez-Campos et al., 2022) Additionally, some of the root causes of sciatica can include musculoskeletal conditions like herniated discs, bone spurs, or spinal stenosis, which can correlate with these inherent and environmental factors that can reduce many individuals’ motility and life quality. (Zhou et al., 2021) This causes many individuals to seek out treatments to relieve sciatica pain and its correlating symptoms. While the pain caused by sciatica can vary, many individuals often seek non-surgical treatments to alleviate their discomfort and pain from sciatica. This allows them to incorporate effective solutions to managing sciatica.
Beyond Adjustments: Chiropractic & Integrative Healthcare- Video
Chiropractic Care For Sciatica
When it comes to seeking non-surgical treatments to reduce sciatica, non-surgical treatments can reduce the pain-like effects while helping restore body function and mobility. At the same time, non-surgical treatments are customized to the individual’s pain and can be incorporated into a person’s routine. Some non-surgical treatments like chiropractic care are excellent in reducing sciatica and its associated pain symptoms. Chiropractic care is a form of non-surgical therapy that focuses on restoring the body’s spinal movement while improving body function. Chiropractic care utilizes mechanical and manual techniques for sciatica to realign the spine and help the body heal naturally without surgery or medication. Chiropractic care can help decrease intradiscal pressure, increase intervertebral disc space height, and improve the range of motion in the lower extremities. (Gudavalli et al., 2016) When dealing with sciatica, chiropractic care can alleviate the unnecessary pressure on the sciatic nerve and help reduce the risk of reoccurrence through consecutive treatments.
The Effects of Chiropractic Care For Sciatica
Some of the effects of chiropractic care for reducing sciatica can provide insight to the person as chiropractors work with associated medical providers to devise a personalized plan to relieve the pain-like symptoms. Many people who utilize chiropractic care to reduce the effects of sciatica can incorporate physical therapy to strengthen the weak muscles that surround the lower back, stretch to improve flexibility and be more mindful of what factors are causing sciatic pain in their lower extremities. Chiropractic care may guide many people on proper poster ergonomics, and various exercises to reduce the chances of sciatica returning while offering positive effects to the lower body.
Acupuncture For Sciatica
Another form of non-surgical treatment that can help reduce the pain-like effects of sciatica is acupuncture. As a key component in traditional Chinese medicine, acupuncture therapy involves professionals placing thin, solid needles at specific points on the body. When it comes to reducing sciatica, acupuncture therapy can exert analgesic effects on the body’s acupoints, regulate the microglia, and modulate certain receptors along the pain pathway to the nervous system. (Zhang et al., 2023) Acupuncture therapy focuses on restoring the body’s natural energy flow or Qi to promote healing.
The Effects of Acupuncture For Sciatica
Regarding the effects of acupuncture therapy on reducing sciatica, acupuncture therapy can help reduce the pain signals that sciatica produces by changing the brain signal and rerouting the corresponding motor or sensory disturbance of the affected area. (Yu et al., 2022) Additionally, acupuncture therapy can help provide pain relief by releasing endorphins, the body’s natural pain reliever, to the specific acupoint that correlates with the sciatic nerve, reducing inflammation around the sciatic nerve, thus alleviating pressure and pain and helping improve nerve function. Both chiropractic care and acupuncture offer valuable non-surgical treatment options that can provide aid in the healing process and reduce pain caused by sciatica. When many people are dealing with sciatica and looking for numerous solutions to reduce the pain-like effects, these two non-surgical treatments can help many people address the underlying causes of sciatica, enhance the body’s natural healing process, and help provide significant relief from the pain.
Gimenez-Campos, M. S., Pimenta-Fermisson-Ramos, P., Diaz-Cambronero, J. I., Carbonell-Sanchis, R., Lopez-Briz, E., & Ruiz-Garcia, V. (2022). A systematic review and meta-analysis of the effectiveness and adverse events of gabapentin and pregabalin for sciatica pain. Aten Primaria, 54(1), 102144. doi.org/10.1016/j.aprim.2021.102144
Gudavalli, M. R., Olding, K., Joachim, G., & Cox, J. M. (2016). Chiropractic Distraction Spinal Manipulation on Postsurgical Continued Low Back and Radicular Pain Patients: A Retrospective Case Series. J Chiropr Med, 15(2), 121-128. doi.org/10.1016/j.jcm.2016.04.004
Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., . . . Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ Open, 12(5), e054566. doi.org/10.1136/bmjopen-2021-054566
Zhang, Z., Hu, T., Huang, P., Yang, M., Huang, Z., Xia, Y., Zhang, X., Zhang, X., & Ni, G. (2023). The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails. Front Neurosci, 17, 1097830. doi.org/10.3389/fnins.2023.1097830
Zhou, J., Mi, J., Peng, Y., Han, H., & Liu, Z. (2021). Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study. Front Endocrinol (Lausanne), 12, 740200. doi.org/10.3389/fendo.2021.740200
For individuals experiencing shoulder and upper back pain, could periscapular bursitis be a possible cause?
Periscapular Bursitis
The scapula/shoulder blade is a bone that shifts position with upper body and shoulder movement. The scapula motion is critical to the normal function of the shoulder and the spine. When abnormal or sudden shoulder movements occur, inflammation and pain symptoms can develop. (Augustine H. Conduah et al., 2010)
Normal Scapula Function
The scapula is a triangular bone on the upper back outside the rib cage. Its outer or lateral side contains the shoulder joint socket /glenoid, while the rest of the bone serves as attachment points for the different shoulder and back muscles. The scapula shifts on the rib cage when moving the arm forward and back. This movement is called scapulothoracic motion and is critical to the normal function of the upper extremity and the shoulder joint. When the scapula does not glide in a coordinated motion, the function of the torso and shoulder joints can become stiff and painful. (J. E. Kuhn et al., 1998)
Scapular Bursa
A bursa is a fluid-filled sac that allows smooth, gliding motion between structures, body tissues, bones, and tendons. Bursae are found throughout the body, including those in front of the kneecap, outside the hip, and at the shoulder joint. When a bursa becomes inflamed and irritated, normal movements can become painful. There are bursae around the scapula in the upper back. Two of these bursa sacs are between the bones and the serratus anterior muscle that controls scapular movement on the chest wall. One bursa sac is located on the upper corner of the scapula, close to the spine at the base of the neck, and the other is at the bottom corner of the scapula, close to the mid-back. Either or both bursa sacs can be affected by periscapular bursitis. There are other bursae around the scapula and the surrounding tendons, but the two corner sacs tend to be the primary bursae that develop periscapular bursitis.
Inflammation
When these bursae become inflamed and irritated, swollen, and thickened, the condition known as bursitis results. When bursitis occurs near the scapula, muscle, and shoulder blade movements can lead to discomfort and pain. The most common symptoms of periscapular bursitis include:
An examination of the scapula may display abnormal movements of the shoulder blade. This can lead to winging, where the shoulder blade is not held correctly to the rib cage and protrudes abnormally. Individuals with winging of the scapula typically have abnormal shoulder joint mechanics because the shoulder’s positioning is altered.
Causes
The causes of periscapular bursitis can be varied. The most common is overuse syndrome, where a specific activity is causing irritation to the bursa. These can include:
Sports-related activities that result from repetitive use.
Work-related activities that result from repetitive use.
Traumatic injuries that cause inflammation or irritation to the bursa.
Some conditions can cause abnormal anatomy or bone protuberances, irritating the bursa. One condition is a benign bone growth known as an osteochondroma. (Antônio Marcelo Gonçalves de Souza and Rosalvo Zósimo Bispo Júnior 2014) These growths can project off the scapula, leading to irritation and inflammation.
Treatment
Treatment of periscapular bursitis begins with conservative therapies. Invasive treatments are rarely needed to correct the problem. Treatment can include:
Rest
The first step is to rest the irritated bursa and settle the inflammation.
This can take a few weeks and can be accomplished by modifying physical, sports, or work-related activities.
Ice
Ice is useful for reducing inflammation and controlling pain.
Knowing how to ice an injury properly can help manage the pain and swelling.
Physical Therapy
Physical therapy can alleviate the symptoms of inflammation through various exercises and stretches.
The therapy can improve scapular mechanics so the injury does not become ongoing and recurrent.
Abnormal movement of the scapula on the rib cage can not only lead to the development of bursitis, but if these abnormal mechanics are not addressed, the problem may recur.
Anti-Inflammatory Medications
Non-steroidal anti-inflammatory medications are used to control the inflammation in the short term. (Augustine H. Conduah et al., 2010)
The medications can help block the inflammatory response.
Before taking any medication, individuals should confirm with their healthcare provider that it is safe.
Cortisone Injections
Successful treatment with a cortisone shot is a sign that surgery will be more effective for individuals who may need surgery.
Cortisone injections can be very helpful in delivering a powerful anti-inflammatory dose directly to the site of inflammation. (Augustine H. Conduah et al., 2010)
Cortisone injections should be limited in terms of how many injections are offered to an individual, but in limited doses can be very helpful.
However, cortisone shots should only be performed once the diagnosis is confirmed.
Surgery
Surgery is seldom necessary but can be effective in individuals who are unable to find relief with conservative treatments.
Surgery is often used for individuals with abnormal scapular anatomy, like bone growths or tumors.
At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by improving an individual’s ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. Our chiropractor care plans and clinical services are specialized and focused on injuries and the complete recovery process. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Scapular Winging in Depth
References
Conduah, A. H., Baker, C. L., 3rd, & Baker, C. L., Jr (2010). Clinical management of scapulothoracic bursitis and the snapping scapula. Sports health, 2(2), 147–155. doi.org/10.1177/1941738109338359
Kuhn, J. E., Plancher, K. D., & Hawkins, R. J. (1998). Symptomatic scapulothoracic crepitus and bursitis. The Journal of the American Academy of Orthopaedic Surgeons, 6(5), 267–273. doi.org/10.5435/00124635-199809000-00001
de Souza, A. M., & Bispo Júnior, R. Z. (2014). Osteochondroma: ignore or investigate?. Revista brasileira de ortopedia, 49(6), 555–564. doi.org/10.1016/j.rboe.2013.10.002
For individuals experiencing back pain from a herniated disc, can understanding the difference between surgery and chiropractic help individuals find the right treatment plan?
Surgery or Chiropractic
Living with back pain can be a nightmare, and yet many struggle without seeking care. Today, there are a vast number of surgeries and noninvasive techniques that are better at treating spine and back problems and managing symptoms. For individuals who may have a herniated disc or are curious about ways to relieve their back pain, a health care provider, physical therapist, spine specialist, and chiropractor can inform them of treatment options. Surgery and chiropractic therapy are popular treatments for a herniated, bulging, or slipped disc.
A herniated disc is when the cartilage discs that cushion the vertebrae shift out of position and leak out.
Surgery for a herniated disc involves removing or repairing the disc.
Chiropractic nonsurgically repositions the disc and realigns the spine.
Both treatments have the same goals with key differences.
Chiropractic Care
Chiropractic is a system of therapy that focuses on adjusting and maintaining spinal alignment to help with back and posture problems. Chiropractors are trained and licensed medical professionals who take a nonsurgical approach, a proven therapy for chronic pain, flexibility, and mobility issues.
The Way It Works
Chiropractic treatment encourages and supports the body’s natural healing processes. It is considered for joint pain in the back, neck, legs, arms, feet, and hands. It typically involves sessions in which the chiropractor physically and carefully adjusts the vertebrae by hand, also known as spinal manipulation or chiropractic adjustments. (MedlinePlus. 2023). A chiropractor performs a thorough medical evaluation and runs tests to establish a diagnosis. A chiropractor will develop a treatment plan that may involve a team of massage and physical therapists, acupuncturists, health coaches, and nutritionists to treat affected areas with various techniques, recommend targeted exercises, adjust lifestyle and nutrition to support the treatment, and monitor progress. Combined with stretching and sustained pressure, the multiple methods can increase joint mobility and relieve pain symptoms. (National Center for Complimentary and Integrative Health. 2019) Added protocols to support or enhance chiropractic therapy include:
Heating and ice therapies to reduce inflammation and increase blood circulation.
Using devices to stimulate muscles and nerves electrically.
Developing relaxation and deep breathing techniques.
Incorporating exercises to promote rehabilitation.
Establishing a regular fitness routine.
Making adjustments to diet and lifestyle.
Taking certain dietary supplements.
Spinal manipulation and chiropractic adjustments have been shown to improve symptoms and restore mobility in cases of chronic back pain. One review found that individuals with chronic lumbar/low back pain reported significant improvement after six weeks of chiropractic treatment. (Ian D. Coulter et al., 2018)
Prices
The out-of-pocket expenses of chiropractic treatment depend on a variety of factors.
Insurance may or may not cover the treatment, and the amount an individual has to pay can vary based on the severity of their case, what their plan covers, and where they live. One review found the cost can range between $264 and $6,171. (Simon Dagenais et al., 2015)
Surgery
There is a range of minimally invasive surgical procedures to treat herniated discs. These work to ease nerve compression by removing or replacing damaged discs or stabilizing the vertebrae, relieving pain and inflammation.
The Way It Works
A herniated disc can happen in any part of the spine but is more common in the lower back/lumbar spine and in the neck/cervical spine. Surgery is recommended when: (American Academy of Orthopaedic Surgeons. 2022)
More conservative treatments, like medications and physical therapy, are unable to manage symptoms.
The pain and symptoms impact daily life and functioning.
Standing or walking becomes difficult or impossible.
The herniated disc causes difficulty walking, muscle weakness, and bladder or bowel control loss.
The individual is reasonably healthy, without infection, osteoporosis, or arthritis.
Specific surgical procedures used include:
Fusion Surgery
Spinal fusion is the most common procedure for a lower back herniated disc.
It involves using artificial bone material to fuse vertebrae to increase stability and release and prevent nerve irritation and compression. (American Academy of Neurological Surgeons. 2024)
Laminotomy and Laminectomy
Herniated disc symptoms appear from compression placed on the nerves.
Laminotomy involves making a small cut in the lamina, or the arch of the spinal vertebrae, to release the pressure.
Another approach involves implanting an artificial disc.
This is most often used for hernia in the lower spine; the worn or damaged disc is removed, and a specialized prosthetic replaces the removed disc. (American Academy of Orthopaedic Surgeons. 2022)
This allows for more mobility.
The success of herniated disc surgery depends on different factors. Advances in minimally invasive techniques have significantly improved long-term outcomes, with one review finding that around 80% reported good—excellent results at a six-year follow-up. (George J. Dohrmann, Nassir Mansour 2015) However, there is the possibility of recurrence. About 20% to 25% of individuals with herniated lumbar discs experience re-herniation at some point. (American Academy of Neurological Surgeons. 2024)
Prices
Surgery for a herniated disc is specialized, and the costs depend on the scope and scale of the treatment.
The individual’s specific insurance plan also determines the expenses.
When choosing between chiropractic and surgery for a herniated disc, a number of factors can determine the decision, including:
Chiropractic is the less invasive nonsurgical option.
Chiropractic adjustments cannot help certain severe cases of herniated discs.
Chiropractic adjustments prevent the herniated disc from getting worse and ease symptoms.
Surgery provides pain and symptom relief faster than chiropractic or conservative treatment but requires significant recovery time and is expensive. (Anna N A Tosteson et al., 2008)
Surgery may not be appropriate for individuals with osteoarthritis or osteoporosis.
Chiropractic therapy is among the more conservative treatment options for a herniated disc and may be tried first before proceeding with surgery. Generally, surgery is only recommended when noninvasive methods haven’t been able to stop or manage the pain and symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal.
Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The spine journal : official journal of the North American Spine Society, 18(5), 866–879. doi.org/10.1016/j.spinee.2018.01.013
Dagenais, S., Brady, O., Haldeman, S., & Manga, P. (2015). A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States. BMC health services research, 15, 474. doi.org/10.1186/s12913-015-1140-5
Dohrmann, G. J., & Mansour, N. (2015). Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients. Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 24(3), 285–290. doi.org/10.1159/000375499
Tosteson, A. N., Skinner, J. S., Tosteson, T. D., Lurie, J. D., Andersson, G. B., Berven, S., Grove, M. R., Hanscom, B., Blood, E. A., & Weinstein, J. N. (2008). The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT). Spine, 33(19), 2108–2115. doi.org/10.1097/brs.0b013e318182e390
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
