Can working individuals with low back pain incorporate nonsurgical treatments to reduce limited mobility and provide relief?
Introduction
Many working individuals will slowly develop low back pain due to excessive standing or sitting, physical demands that cause them to lift heavy objects, or improper footwear that causes them to be imbalanced. Since the spine is part of the musculoskeletal system, the spinal discs in the lumbar region are the most susceptible to being compressed. They can be one of the issues why many individuals tend to develop lower back pain. Low back pain is common for working individuals and is a multifactorial musculoskeletal disorder that causes many working people to miss out on work. However, many people with low back pain often seek treatment to reduce the pain and help them get back to work. Today’s article looks at the causes of low back pain and how nonsurgical treatments can help reduce low back pain and restore mobility to the body. We speak with certified medical providers who incorporate our patients’ information to provide various treatments to ease low back pain. We also inform patients how nonsurgical treatments can help restore mobility to the body while giving numerous techniques to reduce the chances of low back pain returning. We encourage our patients to ask intricated questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with their backs. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.
The Causes For Low Back Pain
Do you feel stiffness in your lower back after a hard workday? Do you experience muscle aches or pain in your lower back after picking up a heavy object? Or do you experience limited mobility and stiffness over time after excessive standing or sitting at your job? Many individuals in these pain-like scenarios have experienced low back pain at some point in their lives, and it has impacted them to miss out on work. Since many people worldwide have experienced low back pain at some point in their lives, it has become a common problem that has become the leading cause of disability and is often associated with high cost. (Chou, 2021) Low back pain is a multifactorial condition that is specific or non-specific depending on the severity of the person’s experience. Non-specific low back pain often refers to when there isn’t a particular disease or structural reason for the pain to occur. This causes many people to go into early retirement due to losing their ability to work and become a socio-economic burden when seeking treatment. (Chenot et al., 2017) Specific low back pain is due to repetitive trauma and overusing the surrounding muscles that can cause the spine and spinal disc to be constantly compressed. This causes musculoskeletal pain symptoms and affects the rest of the lower extremities. (Will et al., 2018)
Some of the causes that low back pain is associated with can range from normal environmental factors to traumatic injuries that many working individuals have endured. Since low back pain is one of the leading causes of lost workdays around the world, some of the common causes that are contributed to low back pain include:
Mechanical strain
Obesity
Poor body mechanics
Trauma
Repetitive motions (twisting, bending, or lifting)
Herniated disc
Spinal stenosis
These pain-like causes can affect the upper and lower extremities and, when not being treated, lead to pain-like symptoms from radiating pain to limited mobility. However, when many people decide that enough is enough and want to get the treatment they need, they will seek out something that is not only affordable but can reduce the pain while restoring mobility.
The Power Of Chiropractic Care-Video
Nonsurgical Treatments For Low Back Pain
When it comes to seeking treatment for low back pain, many individuals are looking for something that is not only cost-effective but can help reduce the pain-like symptoms associated with the lower back. Nonsurgical treatments can help reduce low back pain and are cost-effective for many individuals including working individuals. Treatments like acupuncture, chiropractic care, and spinal decompression have various techniques and methods to provide pain relief to many individuals dealing with low back pain. Knowing the prevalence of the multiple pathologies of low back pain, a detailed history, and physical examination maneuvers allow doctors to accurately and quickly classify the most common causes of low back pain. (Kinkade, 2007) This will give them a better understanding of what kind of low back pain treatment they need to restore mobility to their bodies.
Chiropractic Care
Chiropractic care is a nonsurgical treatment that incorporates manual and mechanical manipulation to realign the body out of subluxation from low back pain. Chiropractic care can be incorporated into a person’s health and wellness treatment plan as it can help improve pain and disability associated with low back pain. (Bussieres et al., 2018) Chiropractors combine various techniques to stretch and strengthen weak muscles around the lower back and reduce low back pain intensity and disability. (Vining et al., 2020) Chiropractic care can also work with other forms of therapies to reduce the chances of low back pain from returning.
Spinal Decompression
Spinal decompression is another form of nonsurgical treatment that can help the lumbar spine through gentle traction and help decompress affected spinal discs from causing mechanical back pain. Spinal decompression can also alleviate the referred pain-like symptoms from the nerve roots involved in the lumbar region while rehydrating herniated discs. Spinal decompression can also help many individuals have their lumbar range of motion back and improve their pain and endurance while restoring their quality of life. (Amjad et al., 2022) Just like chiropractic care, spinal decompression can be combined with other therapies to strengthen the surrounding muscles and ligaments.
Acupuncture
With low back pain being a common problem for many individuals, sometimes it could be due to aggravated nerve roots along the surrounding muscles that are causing referred trigger pain correlating with low back pain. When that happens, many individuals will seek out acupuncture to reduce the pain and improve their quality of life. (Baroncini et al., 2022) Acupuncture can reduce the inflammatory effects caused by inflammation associated with low back pain and can increase mobility in the sacroiliac joint to improve mobility. (Sudhakaran, 2021) Depending on the source of pain in the back, acupuncture can help reduce the pain and provide relief. Many individuals seeking treatment for their lower back can incorporate these treatments to improve their health and restore their quality of life.
References
Amjad, F., Mohseni-Bandpei, M. A., Gilani, S. A., Ahmad, A., & Hanif, A. (2022). Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord, 23(1), 255. https://doi.org/10.1186/s12891-022-05196-x
Baroncini, A., Maffulli, N., Eschweiler, J., Molsberger, F., Klimuch, A., & Migliorini, F. (2022). Acupuncture in chronic aspecific low back pain: a Bayesian network meta-analysis. J Orthop Surg Res, 17(1), 319. https://doi.org/10.1186/s13018-022-03212-3
Bussieres, A. E., Stewart, G., Al-Zoubi, F., Decina, P., Descarreaux, M., Haskett, D., Hincapie, C., Page, I., Passmore, S., Srbely, J., Stupar, M., Weisberg, J., & Ornelas, J. (2018). Spinal Manipulative Therapy and Other Conservative Treatments for Low Back Pain: A Guideline From the Canadian Chiropractic Guideline Initiative. J Manipulative Physiol Ther, 41(4), 265-293. https://doi.org/10.1016/j.jmpt.2017.12.004
Chenot, J. F., Greitemann, B., Kladny, B., Petzke, F., Pfingsten, M., & Schorr, S. G. (2017). Non-Specific Low Back Pain. Dtsch Arztebl Int, 114(51-52), 883-890. https://doi.org/10.3238/arztebl.2017.0883
Vining, R., Long, C. R., Minkalis, A., Gudavalli, M. R., Xia, T., Walter, J., Coulter, I., & Goertz, C. M. (2020). Effects of Chiropractic Care on Strength, Balance, and Endurance in Active-Duty U.S. Military Personnel with Low Back Pain: A Randomized Controlled Trial. J Altern Complement Med, 26(7), 592-601. https://doi.org/10.1089/acm.2020.0107
Can individuals dealing with neck and back pain find the relief they need from the effects of spinal decompression therapy?
Introduction
Across the world, many individuals deal with neck or back pain from excessive sitting or standing, poor posture, or lifting heavy objects that cause their spine and muscles to ache constantly. Since the body is in constant movement, the spine is being compressed through repetitive movement that can cause the spinal discs to pop out of their original position and aggravate the surrounding nerves to cause pain-like symptoms in the neck and back regions. Many people start to complain about their necks and backs hurting and feeling referred pain in different locations in the upper and lower body portions. This can range from acute to chronic, depending on the severity of the pain. When people are experiencing these musculoskeletal pain disorders in their bodies, many will seek treatment to alleviate the pain in their necks and backs to return to their daily routines. Hence why, treatments like spinal decompression can have a positive effect on providing the relief that many individuals deserve. Today’s article looks at why the neck and back in the human body are the most common pain areas many people endure and how spinal decompression can reduce neck and back pain. We speak with certified medical providers who incorporate our patients’ information to provide various techniques to relieve neck and back pain from the body. We also inform patients how treatments like decompression can reduce musculoskeletal pain disorders from the neck and back. We encourage our patients to ask intricated questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with their neck and back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.
Why Are The Neck & Back Common Pain Areas?
Do you feel muscle tension in your neck after being hunched on the computer or your phone for a long time? Do you feel aches and pains in your back after carrying or lifting a heavy object? Or do you feel tingling or numbness in your arms or legs? Many of these pain-like symptoms are often correlated with neck and back pain that can be a nuisance to many individuals. So why is it that the neck and back of the human body are the most common pain areas that many people worldwide endure? Many people with highly demanding jobs often perform normal movements repetitively, which causes stress on the surrounding muscles, ligaments, and joints, and the accessory muscles will begin to be overworked and tight. Neck and back pain are amongst the most common symptom-related complaints that contribute to high levels of lost workdays, disability, and health care use. (Corwell & Davis, 2020) This causes many individuals to have unwanted socio-economic stress when they visit their primary care doctors. Additionally, neck and back pain are non-neurologic causes in the musculoskeletal system; these can generate pain in the muscles, tendons, ligaments, spinal discs, articular cartilage, and bone. (Meleger & Krivickas, 2007) To that point, when neck and back pain are not treated right away, it can lead to correlating pain symptoms that can lead to a life of disability. Since the spine has multiple structures, from the neck to the lower back, when a person is in pain, it can lead to various pain generators that can cause some visceral pain. (Patel et al., 2015) Hence why, neck and back pain are multi-factorial and lead to numerous disorders.
When it comes to reducing neck and back pain from the body, many individuals will seek medical treatment to relieve themselves from the pain. However, many primary care doctors will assess their patients to determine what the root cause of their pain by taking notes of their daily routine. Many normal causes of neck and back pain can be due to:
Poor Posture
Stress
Physical Inactivity
Trauma/Injuries
Excessive sitting/standing
Lifting/carrying heavy objects
These causes can lead to a life of disability and affect a person’s quality of life; however, luckily, many individuals have researched and looked for treatment that is cost-effective and can help reduce the pain they are experiencing.
Understanding Academic Low Back Pain- Video
Do you feel aches and pains in your neck and back? Do you feel stress in your muscles that cause you to feel miserable? Or do you feel pain in your upper or lower body portions affecting your daily routine? Many of these scenarios correlate with neck and back pain, a common issue many individuals experience. If not treated right away, it can lead to a life of disability and, for working individuals, lose a day of work. However, many individuals seek cost-effective treatments that can help reduce the pain affecting their necks and back. Treatments like chiropractic care, traction therapy, massage therapy, and spinal decompression are all non-surgical, affordable, and can help reduce pain-like symptoms associated with neck and back pain. The video above explains the causes of academic low back pain and how non-surgical treatments like chiropractic care can work with additional therapies to prevent back and neck pain from returning. At the same time, when individuals begin to reduce their workload and educate themselves on what to do to avoid neck and back pain from returning, they can start feeling better. (Tyrdal et al., 2022)
The Effects Of Decompression On Neck & Back Pain
As part of the non-surgical treatments, spinal decompression can help many individuals dealing with neck and back pain. What spinal decompression does is incorporate gentle traction on the spine to decompress the affected spinal disc that can be associated with neck and back pain. When the spine is being treated with spinal decompression, the gravitational traction pull helps produce a greater disc space on the spine to decrease intradiscal pressure and pain. (Vanti et al., 2021) This allows all the nutrients and fluids to return to the spine and spinal discs while promoting the body’s natural healing process.
Additionally, many individuals with neck and back pain will begin to notice a huge reduction in their pain and disability through consecutive treatment. (Vanti et al., 2023) By incorporating healthy habits to reduce the chances of neck and back pain from returning, many individuals can make small changes to their daily routine. This allows them to have a positive outlook and continue their health and wellness journey.
References
Corwell, B. N., & Davis, N. L. (2020). The Emergent Evaluation and Treatment of Neck and Back Pain. Emerg Med Clin North Am, 38(1), 167-191. https://doi.org/10.1016/j.emc.2019.09.007
Patel, V. B., Wasserman, R., & Imani, F. (2015). Interventional Therapies for Chronic Low Back Pain: A Focused Review (Efficacy and Outcomes). Anesth Pain Med, 5(4), e29716. https://doi.org/10.5812/aapm.29716
Tyrdal, M. K., Veierod, M. B., Roe, C., Natvig, B., Wahl, A. K., & Stendal Robinson, H. (2022). Neck and back pain: Differences between patients treated in primary and specialist health care. J Rehabil Med, 54, jrm00300. https://doi.org/10.2340/jrm.v54.363
Vanti, C., Saccardo, K., Panizzolo, A., Turone, L., Guccione, A. A., & Pillastrini, P. (2023). The effects of the addition of mechanical traction to physical therapy on low back pain? A systematic review with meta-analysis. Acta Orthop Traumatol Turc, 57(1), 3-16. https://doi.org/10.5152/j.aott.2023.21323
Vanti, C., Turone, L., Panizzolo, A., Guccione, A. A., Bertozzi, L., & Pillastrini, P. (2021). Vertical traction for lumbar radiculopathy: a systematic review. Arch Physiother, 11(1), 7. https://doi.org/10.1186/s40945-021-00102-5
Can individuals with herniated pain associated with low back pain find relief through spinal decompression to restore mobility?
Introduction
Many people worldwide have experienced pain in the back region and often complain that it affects their mobility when doing their normal routine. The musculoskeletal system has various muscles, soft tissues, joints, ligaments, and bones that help surround the spine and protect the vital organs. The spine consists of bones, joints, and nerve roots that have an outstanding relationship with the central nervous system and musculoskeletal system as the spinal cord is protected by the spinal joints and discs that have the nerve roots spread out and help provide the sensory-motor function to the upper and lower extremities. When various pathogens or environmental factors start to cause the spine to compress the spinal discs constantly, it can lead to herniation and affect the body’s mobility over time. Individuals, both young and old, will notice that the pain is not going away from home remedies and may have to seek out treatment if the pain is too much. However, it can lead to dealing with unnecessary stress when looking for affordable treatment. Today’s article looks at how herniation can affect low back mobility and how treatments like decompression can help restore the spine. We speak with certified medical providers who incorporate our patients’ information to provide various solutions to restore low back mobility to the spine. We also inform patients how treatments like decompression can restore the spine’s mobility to the body. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with disc herniation affecting the spine. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.
Disc Herniation Affecting Low Back Mobility
Do you often experience stiffness or limited mobility in your lower back that causes you to walk a little slower than usual? Do you feel pain in your lower back muscles from stretching or bending down to pick up an object? Or do you feel numbness or tingling sensations down your legs that feel uncomfortable? When many individuals start to do repetitive motions, that can cause their spinal discs to compress over time and eventually become herniated. When many individuals overwork their bodies, their spinal discs can eventually crack, causing the inner portion to protrude and press on the surrounding nerve root. This causes the disc tissue to have a central ballon-type cyst that causes degenerative changes, leading to low back pain and herniation. (Ge et al., 2019)
At the same time, when many individuals start to deal with lower back pain from herniated discs, they will begin to lose mobility in their lower backs. This could be due to weak abdominal muscles combined with limited mobility. When many individuals do not have strong core muscles to provide support and mobility to their lower backs, it can start with simple muscle aches, leading to constant lower back pain without treatment and negatively impacting their quality of life. (Chu, 2022) However, dealing with low back pain does not have to be tedious as numerous therapies can reduce the effects of low back pain correlated with disc herniation while restoring low back spinal mobility.
The Science Of Motion-Video
Have you ever experienced unquestionable muscle aches that radiate from your lower back and travel down your legs? Do you feel stiffness when bending down to pick up an object that causes muscle strain on your lower back? Or do you feel pain in your lower back from excessive sitting or standing? When many people are dealing with these pain-like issues in their lower backs, it can lead to a life of disability while affecting their quality of life. This is due to a disc herniation that affects a person’s lower back mobility and, when not treated right away, can lead to chronic issues. However, many individuals will seek treatment for their lower back pain and find the relief they need. Many therapeutic exercises combined with non-surgical treatments can help retrain the weakened trunk muscles to stabilize the lower back better and help reduce lower back pain. (Hlaing et al., 2021) When individuals start to think about their health and wellness, especially when they are dealing with low back pain affecting their mobility, they will find that most of the pain is from normal, repetitive factors that cause their spinal disc to be compressed and herniated. Hence, applying traction to the lumbar spine can help reduce lumbar disc protrusion that causes low back pain. (Mathews, 1968) Treatments like chiropractic care, traction therapy, and spinal decompression are all non-surgical treatments that are cost-effective and gentle on the spine. They help realign the body and help kick start the body’s natural healing factor to rehydrate the spinal discs. When many individuals start to do continuous treatment to reduce their lower back pain associated with herniated discs, they will begin to see improvements in their spinal mobility and their pain diminished. Check out the video above to look at how non-surgical treatments can help restore mobility to the body and reduce pain-like symptoms.
Decompression Restoring The Spine
When it comes to reducing pain-like symptoms caused by disc herniation that is causing limited mobility and low back pain, spinal decompression could be the answer that many individuals are looking for to incorporate into their health and wellness routine. Since lumbar herniated spinal discs are a common cause of low back pain and radiculopathy, spinal decompression can help gently pull the herniated disc back to its original position to promote healing. Since spinal decompression and lumbar traction are part of the physiotherapy treatment, they can help decrease the pain intensity from the spine and reduce the size of the herniated disc. (Choi et al., 2022) When many individuals feel relief from the gentle pull from spinal decompression, they will notice that their mobility is back. After consecutive treatment, their pain will be diminished as their spinal disc is completely healed. (Cyriax, 1950) With many individuals who are looking for numerous treatments to reduce their lower back pain and regain their sense of life, incorporating these treatments can provide beneficial results to their musculoskeletal system.
References
Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P. B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 6343837. https://doi.org/10.1155/2022/6343837
Chu, E. C. (2022). Large abdominal aortic aneurysm presented with concomitant acute lumbar disc herniation – a case report. J Med Life, 15(6), 871-875. https://doi.org/10.25122/jml-2021-0419
Ge, C. Y., Hao, D. J., Yan, L., Shan, L. Q., Zhao, Q. P., He, B. R., & Hui, H. (2019). Intradural Lumbar Disc Herniation: A Case Report and Literature Review. Clin Interv Aging, 14, 2295-2299. https://doi.org/10.2147/CIA.S228717
Hlaing, S. S., Puntumetakul, R., Khine, E. E., & Boucaut, R. (2021). Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord, 22(1), 998. https://doi.org/10.1186/s12891-021-04858-6
For individuals experiencing tightness in the lower back and hamstrings, can utilizing the sit and reach test help determine an individual’s risk for future pain and injury?
Sit and Reach Test
Lower back and hamstring tightness and pain symptoms are usually brought on by muscle stiffness. The sit-and-reach test is one of the most common ways to measure lower back and hamstring flexibility. Exercise physiologists, physical therapists, chiropractors, and fitness trainers use the sit-and-reach test to measure lower back and hamstring flexibility to assess baseline flexibility. The test has been around since 1952 (Katharine F. Wells & Evelyn K. Dillon 2013) and has an extensive database of results across all age groups and genders.
Individuals can use the sit-and-reach test to compare flexibility to the average result for individuals of the same gender and age.
For healthcare providers, the test may be repeated after several weeks to determine flexibility progress.
Measurement
The test can be a valuable measurement of functional flexibility to sit with the legs straight in front and reach the toes. Jobs, sports, and everyday tasks regularly require bending over, reaching, and lifting objects. These are real-life examples of how having a healthy back and hamstring flexibility is vital in preventing pain symptoms and injuries. New flexibility assessments are currently being developed, and many trainers and therapists use their own versions with patients and clients. But even with more advanced specialized flexibility tests, the sit and reach test can be a functional testing tool for tracking general flexibility changes over time. (Daniel Mayorga-Vega et al., 2014)
Performing The Test
A special sit-and-reach testing box is used; however, individuals can make their own testing box by finding a heavy-duty box around 30cm or 11.811 inches tall. Set a measurement ruler/stick on top of the box so that 26 cm or 10.2362 inches of the ruler extends over the front edge toward the individual being tested. The 26cm mark should be at the edge of the box.
Get into position – Remove shoes and sit on the floor with legs stretched out in front with the knees straight and feet flat against the front end of the test box.
Start the movement – In a slow, steady motion, lean forward, keeping the knees straight, and slide the hands up the ruler as far as possible.
Stretch and repeat – Extend as far as possible, record the results, rest, and repeat three times.
Calculate the results – Average the results.
Results
Results compare flexibility over time to norms, or averages, for gender and age. Adequate flexibility is reaching the toes – the 26-cm mark on the ruler while keeping the legs straight.
Adult Women
37cm or 14.5669 inches or above: Excellent
33 to 36cm or 12.9921 inches: Above average
29 to 32cm or 11.4173 inches: Average
23 to 28cm or 9.05512 inches: Below average
Below 23cm or 8.66142 inches: Poor
Adult Men
34cm or 13.3858 inches or above: Excellent
28 to 33cm or 11.0236 inches: Above average
23 to 27cm or 9.05512 inches: Average
16 to 22cm or 6.29921 inches: Below average
Below 16cm or 5.90551 inches: Poor
Alternatives
Individuals can test their own hamstring and lower back flexibility with some easy at-home tests. Use these methods while working on flexibility, and keep a record to see improvements. (Brittany L. Hansberger et al., 2019) One alternative is the V-sit reach test.
To perform this, make a line on the floor with tape, then place a measuring tape perpendicular to the tape, making a cross.
Sit with the feet in a V shape, touching the tape, feet about a foot apart, with the measuring tape between the legs; the 0 end starts where the legs part.
Overlap hands with arms outstretched in front.
Repeat three times, leaning forward and reaching with hands out.
Then, repeat and take note of how far the hands could reach.
Individuals will need someone to measure the distance between their fingertips and the floor.
Warm up with a few practice stretches of standing and bending toward the floor.
Then, measure how far from the floor the fingertips are.
The ability to touch the floor is a good sign.
Improving Flexibility
Individuals with less than adequate flexibility are recommended to work on stretching the major muscle groups in both the upper and lower body on a regular basis to improve and maintain body flexibility.
Individuals can incorporate dynamic stretching, which consists of active movements utilizing a full range of motion as part of warming up for workouts, sports, or other activities.
Static stretching is recommended when cooling down after the muscles are warmed up and joints are lubricated.
The American College of Sports Medicine recommends 2 to 3 sessions a week of flexibility training and learning to stretch daily.
Stretches should be held for 15 to 30 seconds, then released and repeated 2 to 4 times. (Phil Page 2012)
This will take time and dedication, but with the help of trained specialists, regaining flexibility and full range of motion can be accomplished.
Benefits of Stretching
References
Katharine F. Wells & Evelyn K. Dillon (1952) The Sit and Reach—A Test of Back and Leg Flexibility, Research Quarterly. American Association for Health, Physical Education and Recreation, 23:1, 115-118, DOI: 10.1080/10671188.1952.10761965
Mayorga-Vega, D., Merino-Marban, R., & Viciana, J. (2014). Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: a Meta-Analysis. Journal of sports science & medicine, 13(1), 1–14.
Hansberger, B. L., Loutsch, R., Hancock, C., Bonser, R., Zeigel, A., & Baker, R. T. (2019). EVALUATING THE RELATIONSHIP BETWEEN CLINICAL ASSESSMENTS OF APPARENT HAMSTRING TIGHTNESS: A CORRELATIONAL ANALYSIS. International journal of sports physical therapy, 14(2), 253–263.
Page P. (2012). Current concepts in muscle stretching for exercise and rehabilitation. International journal of sports physical therapy, 7(1), 109–119.
Individuals experiencing pain symptoms like shooting, stabbing, or electrical sensations to the latissimus dorsi of the upper back could be caused by a nerve injury to the thoracodorsal nerve. Can knowing the anatomy and symptoms help healthcare providers develop an effective treatment plan?
Thoracodorsal Nerve
Also known as the middle subscapular nerve or the long subscapular nerve, it branches out from a part of the brachial plexus and provides motor innervation/function to the latissimus dorsi muscle.
Anatomy
The brachial plexus is a network of nerves that stem from the spinal cord in the neck. The nerves supply most of the sensation and movement of the arms and hands, with one on each side. Its five roots come from the spaces between the fifth through eighth cervical vertebrae and the first thoracic vertebra. From there, they form a larger structure, then divide, re-combine, and divide again to form smaller nerves and nerve structures as they travel down the armpit. Through the neck and chest, the nerves eventually join and form three cords that include:
Lateral cord
Medial cord
Posterior cord
The posterior cord produces major and minor branches that include:
Axillary nerve
Radial nerve
The minor branches include:
Superior subscapular nerve
Inferior subscapular nerve
Thoracodorsal nerve
Structure and Position
The thoracodorsal nerve branches off the posterior cord in the armpit and travels down, following the subscapular artery, to the latissimus dorsi muscle.
It connects to the upper arm, stretches across the back of the armpit, forming the axillary arch, and then expands into a large triangle that wraps around the ribs and the back.
The thoracodorsal nerve lies deep in the latissimus dorsi, and the lower edge typically reaches close to the waist.
Variations
There is a standard location and course of the thoracodorsal nerve, but individual nerves are not the same in everyone.
The nerve typically branches off the posterior cord of the brachial plexus from three different points.
The lats can have a rare anatomical variation known as a Langer’s arch, which is an extra part that connects to muscles or connective tissue of the upper arm beneath the common connecting point.
In individuals with this abnormality, the thoracodorsal nerve supplies function/innervation) to the arch. (Ahmed M. Al Maksoud et al., 2015)
Function
The latissimus dorsi muscle cannot function without the thoracodorsal nerve. The muscle and nerve help:
Stabilize the back.
Pull the body weight up when climbing, swimming, or doing pull-ups.
Assist with breathing by expanding the rib cage during inhalation and contracting when exhaling. (Encyclopaedia Britannica. 2023)
Rotate the arm inward.
Pull the arm toward the center of the body.
Extend the shoulders by working with the teres major, teres minor, and posterior deltoid muscles.
Bring down the shoulder girdle by arching the spine.
Pain that can be shooting, stabbing, or electrical sensations.
Numbness, tingling.
Weakness and loss of function in the associated muscles and body parts, including wrist and finger drop.
Because of the nerve’s path through the armpit, doctors have to be cautious of the anatomical variants so they don’t inadvertently damage a nerve during breast cancer procedures, including axillary dissection.
The procedure is performed to examine or remove lymph nodes and is used in staging breast cancer and in treatment.
According to a study, 11% of individuals with axillary lymph node dissection suffered damage to the nerve. (Roser Belmonte et al., 2015)
Breast Reconstruction
In breast reconstruction surgery, the lats can be used as a flap over the implant.
Depending on the circumstances, the thoracodorsal nerve can be left intact or severed.
There is some evidence that leaving the nerve intact can cause the muscle to contract and dislocate the implant.
An intact thoracodorsal nerve may also cause atrophy of the muscle, which can lead to shoulder and arm weakness.
Graft Uses
A portion of the thoracodorsal nerve is commonly used in nerve graft reconstruction to restore function after injury, which includes the following:
Musculocutaneous nerve
Accessory nerve
Axillary nerve
The nerve can also be used to restore nerve function to the triceps muscle in the arm.
Rehabilitation
If the thoracodorsal nerve is injured or damaged, treatments can include:
Braces or splints.
Physical therapy to improve range of motion, flexibility, and muscle strength.
If there is compression, surgery may be required to alleviate the pressure.
Exploring Integrative Medicine
References
Chu B, Bordoni B. Anatomy, Thorax, Thoracodorsal Nerves. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539761/
Al Maksoud, A. M., Barsoum, A. K., & Moneer, M. M. (2015). Langer’s arch: a rare anomaly affects axillary lymphadenectomy. Journal of surgical case reports, 2015(12), rjv159. https://doi.org/10.1093/jscr/rjv159
Britannica, The Editors of Encyclopaedia. “latissimus dorsi“. Encyclopedia Britannica, 30 Nov. 2023, https://www.britannica.com/science/latissimus-dorsi. Accessed 2 January 2024.
Belmonte, R., Monleon, S., Bofill, N., Alvarado, M. L., Espadaler, J., & Royo, I. (2015). Long thoracic nerve injury in breast cancer patients treated with axillary lymph node dissection. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 23(1), 169–175. https://doi.org/10.1007/s00520-014-2338-5
Kwon, S. T., Chang, H., & Oh, M. (2011). Anatomic basis of interfascicular nerve splitting of innervated partial latissimus dorsi muscle flap. Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 64(5), e109–e114. https://doi.org/10.1016/j.bjps.2010.12.008
Individuals that have gone through a back injury may develop a synovial spinal cyst as a way to protect the spine that could cause pain symptoms and sensations. Can knowing the signs help healthcare providers develop a thorough treatment plan to relieve pain, prevent worsening of the condition and other spinal conditions?
Spinal Synovial Cysts
Spinal synovial cysts are benign fluid-filled sacs that develop in the spine’s joints. They form because of spinal degeneration or injury. The cysts can form anywhere in the spine, but most occur in the lumbar region/lower back. They typically develop in the facet joints or junctions that keep the vertebrae/spinal bones interlocked.
Symptoms
In most cases, synovial cysts don’t cause symptoms. However, the doctor or specialist will want to monitor for signs of degenerative disc disease, spinal stenosis, or cauda equina syndrome. When symptoms do present, they typically cause radiculopathy or nerve compression, which can cause back pain, weakness, numbness, and radiating pain caused by the irritation. The severity of symptoms depends on the size and location of the cyst. Synovial cysts can affect one side of the spine or both and can form at one spinal segment or at multiple levels.
Effects Can Include
Radiculopathy symptoms can develop if the cyst or inflammation caused by the cyst comes into contact with a spinal nerve root. This can cause sciatica, weakness, numbness, or difficulty controlling certain muscles.
Neurogenic claudication/impingement and inflammation of spinal nerves can cause cramping, pain, and/or tingling in the lower back, legs, hips, and buttocks. (Martin J. Wilby et al., 2009)
If the spinal cord is involved, it may cause myelopathy/severe spinal cord compression that can cause numbness, weakness, and balance problems. (Dong Shin Kim et al., 2014)
Symptoms related to cauda equina, including bowel and/or bladder problems, leg weakness, and saddle anesthesia/loss of sensation in the thighs, buttocks, and perineum, can present but are rare, as are synovial cysts in the middle back and neck. If thoracic and cervical synovial cysts develop, they can cause symptoms like numbness, tingling, pain, or weakness in the affected area.
Causes
Spinal synovial cysts are generally caused by degenerative changes like osteoarthritis that develop in a joint over time. With regular wear and tear, facet joint cartilage/the material in a joint that provides protection, a smooth surface, friction reduction, and shock absorption begins to waste away. As the process continues, the synovium can form a cyst.
Traumas, large and small, have inflammatory and degenerative effects on joints that can result in the formation of a cyst.
Around a third of individuals who have a spinal synovial cyst also have spondylolisthesis.
This condition is when a vertebrae slips out of place or out of alignment onto the vertebra underneath.
It is a sign of spinal instability.
Instability can occur in any spine area, but L4-5 are the most common levels.
This segment of the spine takes most of the upper body weight.
Epidural corticosteroid injections can reduce inflammation and could be an option to relieve pain.
Patients are recommended to receive no more than three injections per year.
Surgical Options
For severe or persistent cases, a doctor may recommend decompression surgery to remove the cyst and surrounding bone to relieve pressure on the nerve root. Surgical options range from minimally invasive endoscopic procedures to larger, open surgeries. The best surgical option varies based on the severity of the situation and whether associated disorders are present. Surgical options include:
Laminectomy – Removal of the bony structure that protects and covers the spinal canal/lamina.
Hemilaminectomy – A modified laminectomy where a smaller portion of the lamina is removed.
Facetectomy – The removal of part of the affected facet joint where the synovial cyst is located, usually following a laminectomy or hemilaminectomy.
Fusionof the facet joints and vertebra – Decreases vertebral mobility in the injured area.
Most individuals experience immediate pain relief following a laminectomy or hemilaminectomy.
Fusion can take six to nine months to heal completely.
If surgery is performed without fusion where the cyst originated, the pain could return, and another cyst could form within two years.
Surgery Complications include infection, bleeding, and injury to the spinal cord or nerve root.
How I Gained My Mobility Back With Chiropractic
References
Wilby, M. J., Fraser, R. D., Vernon-Roberts, B., & Moore, R. J. (2009). The prevalence and pathogenesis of synovial cysts within the ligamentum flavum in patients with lumbar spinal stenosis and radiculopathy. Spine, 34(23), 2518–2524. https://doi.org/10.1097/BRS.0b013e3181b22bd0
Kim, D. S., Yang, J. S., Cho, Y. J., & Kang, S. H. (2014). Acute myelopathy caused by a cervical synovial cyst. Journal of Korean Neurosurgical Society, 56(1), 55–57. https://doi.org/10.3340/jkns.2014.56.1.55
Epstein, N. E., & Baisden, J. (2012). The diagnosis and management of synovial cysts: Efficacy of surgery versus cyst aspiration. Surgical neurology international, 3(Suppl 3), S157–S166. https://doi.org/10.4103/2152-7806.98576
Can individuals with sensory nerve dysfunction incorporate nonsurgical decompression to restore sensory-mobility function to their bodies?
Introduction
The spinal column in the musculoskeletal system comprises bones, joints, and nerves that work together with various muscles and tissues to ensure that the spinal cord is protected. The spinal cord is part of the central nervous system where the nerve roots are spread out to the upper and lower body parts that supply sensory-motor functions. This allows the body to move and function without pain or discomfort. However, when the body and spine ages or when a person is dealing with injuries, the nerve roots can become irritated and cause weird sensations like numbness or tingling, often correlating with body pain. This can cause a socio-economic burden on many individuals and, if not treated right away, can lead to chronic pain. To that point, it can lead to many individuals dealing with body extremity pain associated with sensory nerve dysfunction. This causes many individuals dealing with musculoskeletal disorders to start looking for treatment. Today’s article examines how nerve dysfunction affects the extremities and how nonsurgical decompression can help reduce nerve dysfunction to allow mobility back to the upper and lower limbs. We speak with certified medical providers who incorporate our patients’ information to provide nonsurgical solutions like decompression to help individuals with nerve dysfunction. We also inform patients how nonsurgical decompression can restore mobility-sensory to the upper and lower extremities. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the sensory nerve dysfunction. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.
How Nerve Dysfunction Affects The Extremities
Do you experience tingling or numb sensations in your hands or feet that don’t want to go away? Do you feel pain in different back portions that can only be relieved through stretching or resting? Or does it hurt to walk for long distances that you feel like you need to rest constantly? Many pain-like scenarios are associated with sensory nerve dysfunction that can affect the upper and lower extremities. When many individuals experience sensory nerve dysfunction and deal with weird sensations in their extremities, many think it is due to musculoskeletal pain in their neck, shoulders, or back. This is only part of the issue, as many environmental factors can be associated with sensory nerve pain, as the nerve roots are being compressed and agitated, causing sensory nerve dysfunction in the extremities. Since the nerve roots are spread out from the spinal cord, the brain sends the neuron information to the nerve roots to allow sensory-mobility function in the upper and lower extremities. This allows the body to be mobile without discomfort or pain and functional through daily activities. However, when many individuals start to do repetitive motions that cause the spinal disc to be compressed constantly, it can lead to potential disc herniation and musculoskeletal disorders. Since numerous nerve roots are spread to the different extremities, when the main nerve roots are aggravated, it can send pain signals to each extremity. Hence, many people are dealing with nerve entrapment that leads to lower back, buttock, and leg pain that can affect their daily routine. (Karl et al., 2022) At the same time, many people with sciatica are dealing with sensory nerve dysfunction that affects their walking ability. With sciatica, it can be associated with spinal disc pathology and causes many individuals to seek treatment. (Bush et al., 1992)
Sciatica Secrets Revealed-Video
When it comes to looking for treatment to reduce sensory nerve dysfunction, many individuals will opt for nonsurgical solutions to minimize the pain-like symptoms and reduce the pain signals that are causing the upper and lower extremities to suffer. Nonsurgical treatment solutions like decompression can help restore sensory nerve function through gentle traction by causing the spinal disc to lay off the aggravated nerve root and start the body’s natural healing process. At the same time, it helps reduce musculoskeletal disorders from returning. The video above shows how sciatica associated with sensory nerve dysfunction can be decreased through nonsurgical treatments to allow the body’s extremities to feel better.
Nonsurgical treatments can help reduce low back pain associated with sensory nerve dysfunction to restore sensory-motor function to the upper and lower extremities. Many individuals who incorporate nonsurgical treatments like decompression as part of their health and wellness routine can see improvement after consecutive treatment. (Chou et al., 2007) Since many healthcare practitioners incorporate nonsurgical treatments like decompression into their practices, there has been quite an improvement in pain management. (Bronfort et al., 2008)
When many individuals start to use nonsurgical decompression for sensory nerve dysfunction, many will see improvement in their pain, mobility, and activities of their daily living. (Gose et al., 1998). What spinal decompression does for the nerve roots is that it helps the affected disc that is aggravating the nerve root, pulls the disc back to its original position, and rehydrates it. (Ramos & Martin, 1994) When many individuals start thinking about their health and wellness, nonsurgical treatments can be effective for them due to their affordable cost and how they can be combined with other therapies to manage better the pain associated with nerve dysfunction affecting their body extremities.
References
Bronfort, G., Haas, M., Evans, R., Kawchuk, G., & Dagenais, S. (2008). Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine J, 8(1), 213-225. https://doi.org/10.1016/j.spinee.2007.10.023
Bush, K., Cowan, N., Katz, D. E., & Gishen, P. (1992). The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up. Spine (Phila Pa 1976), 17(10), 1205-1212. https://doi.org/10.1097/00007632-199210000-00013
Chou, R., Huffman, L. H., American Pain, S., & American College of, P. (2007). Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med, 147(7), 492-504. https://doi.org/10.7326/0003-4819-147-7-200710020-00007
Gose, E. E., Naguszewski, W. K., & Naguszewski, R. K. (1998). Vertebral axial decompression therapy for pain associated with herniated or degenerated discs or facet syndrome: an outcome study. Neurol Res, 20(3), 186-190. https://doi.org/10.1080/01616412.1998.11740504
Karl, H. W., Helm, S., & Trescot, A. M. (2022). Superior and Middle Cluneal Nerve Entrapment: A Cause of Low Back and Radicular Pain. Pain Physician, 25(4), E503-E521. https://www.ncbi.nlm.nih.gov/pubmed/35793175
Ramos, G., & Martin, W. (1994). Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg, 81(3), 350-353. https://doi.org/10.3171/jns.1994.81.3.0350
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