New study review suggests we may be wasting our money on back belts, shoe inserts, and other back care items. The findings support the most effective way of treating and preventing back pain is exercise.
To evaluate which preventive methods for low back pain are effective in easing its discomfort, the researchers analyzed data from 23 studies with a total of nearly 31,000 participants. The analysis found that exercise alone could reduce a person’s risk of low- back pain by 35 percent, and it could also cut the use of sick time by 78 percent over the course of a year.
People who participated in an exercise program and also received additional educational instruction were 45 percent less likely to have low back pain over the course of one year, compared with people who were not involved in both programs, according to the research, published online today (Jan. 11) in the journal JAMA Internal Medicine. [This is by far the best way to prevent low back pain, Huffington Post]
These findings support The Center for Total Back Care’s approach to treating and helping prevent back pain. We found the Med-X system in conjunction with traditional rehabilitation, is the most effective way to treat neck and back pain. To learn more about our approach to spinal care, contact us at (480) 633-8293.
Pain in the spine is the most common symptom of a herniated disc. But is herniated disc just limited to this? Are there more facts you need to learn about herniated disc? This post will clarify many of your questions about a herniated disc and give you the most effective management of a herniated disc.
What Is a Herniated Disc?
Herniated disc is a condition that affects the cushions in between the vertebrae that makes up your spine.The cushions are called the spinal disc. A spinal disc has two main parts. It has a fibrous exterior (annulus fibrosis) made of a several layers and a soft interior (nucleus pulposus) made of a gel-like material. Each disc functions to cushion the spine, absorb shock, and maintain spacing between the vertebrae. If there is a crack in the exterior of the disc, the jelly substance inside the spinal disc seeps out – which thereby arises to a condition called herniated disc. Imagine stepping on a jelly doughnut- this is what a herniated disc looks like.This causes irritation in the nearby nerves which results in pain, numbness and weakness in the adjacent body parts.
What Are The Symptoms Of a Herniated Disc?
A herniated disc can be asymptomatic (shows no symptoms). Only a few people report signs and symptoms of this condition. Below are the major signs and symptoms of a herniated disc that you need to be aware of:
Pain localized to the spine
Many times a herniated disc can result in pain in the spine without radiation into the arm or leg. Usually if you are not responding to conservative care and MRI will be performed to see if there is underlying pathology such as a herniated or bulging disc.
Pain in the arm or leg
The location of the pain depends on the location of the herniated disc. If herniation occurs in the neck, pain can be felt in the shoulders and arms. On the other hand, herniation in the lower back results to pain in the buttocks, thighs and legs. This pain will usually worsen sitting, movement especially bending or twisting, coughing or sneezing.
Tingling or numbness in the legs
Seeping out of the jellylike of the disc causes irritation of the nerves around it. As a result, tingling sensation around the affected area can be felt.
Weakness of muscles
If there is actual compression of the nerve root the muscles innervated by the affected nerves also get affected. This results to weakness or numbness of such muscles which may cause you to lose balance or your grip.
What Are The Warning Signs That Would Call For Immediate Medical Attention?
Be sure to seek immediate medical attention if you develop any of the following symptoms:
Loss of bowel or bladder control
Pain that travels to the extremities
Progressive muscle weakness
What Causes a Herniated Disc?
It is hard to pinpoint the exact cause of a disk herniation because it usually occurs over time. There is some indication that it is hereditary which means it is passed from parent to offspring. Usually it is the result of the aging process and the constant wear and tear over the years. It can also be as a result of muscle weakness in the deep muscles of the spine caused by repetitive trauma although this muscle weakness may also be a consequence of the herniated disc. A healthy spinal disc can be injured by a specific incident, but this is very rare and would require a significant trauma such as a fall from a distance landing on your buttocks. An injury such as this would more likely result in a compression fracture to one of the vertebra, rather than a herniated disc. A herniated disc is usually asymptomatic and becomes actively inflamed by movements such as bending twisting or lifting over your head. This can be a result of something as simple as bending over to tie your shoe or pick up the soap in the shower, or coughing or sneezing.
How Is It Diagnosed?
The diagnosis of herniated disc involves a combination of the following:
Careful physical examination
Treatment for Herniated Disc
There are several treatment options for herniated discs. At the Center for Total Back Care, the most effective approach is non-surgical decompression called the VAX-D. VAX-D, otherwise known as Vertebral Axial Decompression, has really two effects on the disc: 1) It increases nutrition to the disc through a process called imbibition (diffusion of nutrients from the vertebra above and below the disc through normal spinal movement) and; 2) By causing a negative pressure in the disc, a vacuum is formed in the disc causing the disc material to resorb. When you have a herniated disc the muscles around the disc become weak. This has a negative effect on the ability to transport nutrients into the disc through your normal activities of daily living or demands of employment by the process of imbibition as described above. Strengthening of the deep spinal muscles is a critical component of treatment for a herniated disc. This must be done to not only stabilize the spine but also to restore the normal imbibition process. This is most effectively performed by utilizing the MedX Medical Spinal Testing and Rehabilitation equipment offered at this clinic. See videos below showing the Med-x and VAX-D treatments.
The Center for Total Back Care was the first clinic in the Valley to offer VAX-D treatment. We have been using it since 1998 and through extensive experience, gained over the years, have been able to develop evaluation and treatment protocols that help us identify which patients are candidates for VAX-D and which patients would respond to a specific rehabilitation program utilizing the MedX Medical Spinal Testing and Rehabilitation equipment.
If you are enduring the suffering associated with a herniated disc, have been told you need surgery, or are simply not happy with the treatment you are now receiving, it’s about time you give it the attention it deserves. Contact the Center for Total Back Care today so we can develop the most suitable treatment and rehabilitation program for you and get back to a pain-free life as soon as possible. If you are unsure as to what treatment would be best for your case, come talk to us. Call today and schedule a free consultation. There is no obligation! Call us at 480-633-8293!
Pain can result from a condition called a pinched nerve, a layman’s term for nerve compression. If you experience pain, don’t just ignore this symptom. Oftentimes, pain is a warning signal that there is something wrong. When you have a pinched nerve, signals are sent to the brain through your spinal cord which interprets it as pain. The earlier you report your symptoms, the better the prognosis will be and the best chance for relief.
If ever you are wondering if your pain and other discomforts are associated with a pinched nerve, let this post be your guide. Here, we’ll talk about what a pinched nerve is as well as its risk factors, causes, symptoms, diagnosis and treatment.
What Is A Pinched Nerve?
A pinched nerve is a term used for the discomfort, pain, and numbness that result from pressure on a nerve. This pressure leads to irritation and damage. Most often, this is associated with the nerve roots that come from the spine and is usually diagnosed as radiculopathy (cervical radiculopathy or sciatica), but any nerve in your body can be affected by this condition. In the majority of cases due to herniated or bulging discs the pain in the arm or leg is due to irritation of the nerve root by the chemicals that are released as a result of the inflammation in the damaged disc.
What Are The Risk Factors?
Almost anything that causes an increased pressure to your nerves may cause a pinched nerve. Some of the common causes or risk factors are:
Bulging or herniated disc
Water retention especially those associated with thyroid conditions
Pressure on a nerve root or peripheral nerve can result in irritation and denervation (loss of nerve supply) to the muscles supplied by the nerve. When this happens, the nerve cannot function properly which can lead to pain, numbness, tingling and if not addressed weakness and atrophy of the muscles supplied by the nerve or nerve root.
What Are The Signs And Symptoms Of A Pinched Nerve?
A person with a pinched nerve may experience one or more of the following around the affected area:
Radiating pain (pain that travels from one area to another)
Muscle atrophy or wasting
How Is A Pinched Nerve Diagnosed?
A qualified health care professional can make a diagnosis of a pinched nerve after performing the following:
Careful physical examination
What Is The Treatment For A Pinched Nerve?
Treatment of a pinched nerve varies depending on the location and cause. Elimination of the cause will usually result in relief of the signs and symptoms as long as it is addressed in a timely manner. Elimination of the cause is often challenging and often requires multiple treatment modalities. These include:
Resting the affected area will often prevent further irritation of the nerve but will not address the cause.
Physical therapy. Conservative care such as physical therapy is usually an effective treatment and should be tried before more invasive treatments.
Spinal Manipulation. This is one of the most effective treatments, but should be used in a very judicious manner and by someone who has extensive experience utilizing this modality.
VAX-D (Vetebral Axial Decompression). If the pain is a result of a herniated, bulging or degenerative disc this treatment will help heal the damaged discs often resulting in a complete resolution of symptoms. (see video below for example of VAX-D treatment)
MedX Lumbar and Cervical Extension Machines. These tools can isolate the affected muscles of the spine, help determine the source of pain or weakness, and then we can customize the exercise, range of motion and resistance that will strengthen this weakness. (see video below for example of Med-X treatment)
Pain Management. Specific injections including epidurals or trigger point injections are effective in reducing the pain and inflammation and facilitating more functional treatments such as those described above.
Usually surgery should be a last resort, however if the problem is due to bony compression from spinal degenerative changes or stenosis; or you are noting progressive weakness and/or atrophy in the affected muscles or a foot drop, a surgeon should be consulted.
Because treatment of a pinched nerve usually requires multiple treatment modalities it is best to choose a treatment facility that offers multiple treatments such as the Center for Total Back Care. If you are tired of struggling with the pain associated with a pinched nerve and cannot find relief, don’t give up. At the Center for Total Back Care, we can provide you with a safe and effective treatment and rehabilitation program to help eliminate your pain. Simply book a free consultation with us so we can identify the most effective treatment for you. Call us at 480-633-8293 now!
Physical Therapy or surgery, what is the best option for back pain?
When it comes to lumbar(low-back) stenosis, physical therapy seems to be more effective! A recent study conducted by Harvard Medical School evaluated 170 people in their 60’s diagnosed with lumbar stenosis.
These people were randomly assigned to receive either surgery or physical therapy. The surgery removed areas of bone that were narrowing the spine and pressing on nerves. The physical therapy program lasted 6 weeks. But people in the physical therapy group were allowed to get surgery instead. More than half of them did so. People in both groups had tests of movement 10 weeks, 6 months and a year after surgery or physical therapy. They also were asked about pain. After 2 years, they filled out a survey to assess overall results. In the long term, both groups had equal reductions in pain. Both groups also had similar changes in movement and quality of life. Not everyone showed improvement. The journal Annals of Internal Medicine published the study.
A couple of key findings:
Symptom relief with conservative physical therapy treatment seems to be faster than surgery
Long-term outcomes were similar for both surgical and physical therapy patients
20% of the people that opted for surgery, had to have another surgical procedure done.
Based on the results of this recent study, physical therapy should be considered as the initial option to surgery. If results are not obtained with physical therapy treatment, the surgical procedure may be the next step.
While there is a time and a place for MRI, injections, and surgical procedures, often the first choice can be physical therapy. Often during the course of treatment a physical therapist may recommend that a patient seek there physician for a more comprehensive examination and treatment for the condition.
Physical therapy helps address the underlying problem and help educate the patient, while other more expensive treatments tend to focus on alleviating the symptoms and at times doesn’t correct what caused the problem in the first place. If you are considering the more conservative and more economical approach to treating your back pain, give physical therapy a try!
VAX-D vs Traction – Is Vax-D the same as traction?
We are often asked this question and the simple answer is “no”. The following is a well written explanation from Pinhook Chiropractic Clinic in Lousiana
Although traction devices can stretch the lower back, the y have not demonstrated the ability to decompress the lumbar discs and spinal nerves. Traction tables have a small electric wench that attaches to the head of the table. A rope and pulley are then attached to either a cervical device or lumbar belts. Either static or intermittent traction modes can be chosen, but neither have been shown to reduce intradiscal pressure and decompress the discs and nerves.
VAX-D Therapy has been proven as an effective therapy in several separate and distinct clinical settings. In one study, radiological research was carried out in which fluoroscopic videos of patients with a myelogram were recorded while patients were undergoing VAX-D therapy. Distraction of intervertebral lumbar spaces was observed on VAX-D Therapy, and the filling defect of a myelogram from a herniated disc was decreased. Records were obtained showing a myelogram displacement, from a herniated disc at L4-5, change from a convex image of a disc bulge to a concave image, created by decompressing the intradiscal space during VAX-D Therapy.
The greatest amount of intervertebral distraction and subsequent spinal decompression is achieved at the L4-5 and L5-S1 disc space and decreases gradually toward the upper lumbar and lower thoracic levels of the spinal column.
Treatment begins with a VAX-D technician fitting you with a special lumbar belt. Then you lie down on the table and take hold of the handles at the head of the table. The tech then attaches the strap from the lumbar belt to the foot of the table. During a treatment, the bottom half of the VAX-D table gently glides apart from the top half. Because the lumbar belt you are wearing is attached at the bottom, you will feel a very strong but painless force pull on your lower spine. This is the decompression part of the treatment, and it dramatically reduces the pressure inside the center of your injured disc. After sixty seconds, the lower half of the table glides back home again. This allows your lower back to relax for sixty seconds. Then the lower half glides away again and after another sixty seconds of decompression, it returns home for another sixty seconds of relaxation. These alternating cycles of decompression and relaxation continue for thirty to forty five minutes. The patented design of the table allows the patient to let go of the special hand grips at any time during the course of the treatment. This helps the patient to be more relaxed and causes less muscle spasms or guarding during the treatment. If spasms do occur, the tension meter recognizes this and releases pressure until the muscles relax and then it begins to pull again. In situations where the patient is unable to hold onto the hand pads due to shoulder injuries, a special shoulder harness is used to distract the spine.
The key to success of VAX-D treatments, and what makes VAX-D altogether different from traction or the flexion/distraction treatments done by physical therapist and chiropractors, is the extraordinarily low pressure that is created within the injured disc. Normally, even when you are lying down and resting, the pressure within each one of your discs is approximately 75 mm of mercury. Upon standing this pressure can rise to as much as 180 mm of Hg. (“mm” of mercury is simply the way scientists measure the amount of pressure inside the disc.)
During VAX-D, treatments are able to reduce the pressure in the lumbar spine down to levels of –180 mm of mercury, allowing fluids and nutrients to re-enter the disc; reducing swelling and relieving the pressure on pinched nerves. This is a very low pressure. Traction and distraction devices cannot achieve this. This is important because this is what allows the magic of VAX-D to take place.
Intradiscal pressure measurements on patients undergoing VAX-D therapy have shown that the extent of decompression measured in mm of Hg follows an inverse relationship to the tension applied to the pelvic belt during therapy. The amount of decompression generated by the VAX-D table is computer controlled and guided by the use of a tension meter. The technician can also change this by simply changing the working air pressure.
Remember, while there are veins and arteries in the vertebrae around your discs, there is no blood getting from them into the discs. However, the extremely low, negative pressure created within the disc during a VAX-D treatment works like a vacuum, and that vacuum allows three things to happen. First, much of the bulging or herniated material is pulled back into the center of the disc. Second, the torn or ruptured annulus fibers are pulled together and realigned for the first time. Third and just as important, nutrients, vitamins, and minerals are sucked into the disc from the blood supply in the surrounding vertebrae.
This is vital to the healing process, and it’s actually what makes VAX-D such a clinical breakthrough. The disc is nourished, the nucleus pulposus is pulled back to the center of the disc and the bulge is eliminated, the annulus fibers are realigned and heal, and you, the patient, are no longer in pain.
So when it comes to VAX-D vs Traction, this is primary reason The Center for Total Back Care uses VAX-D therapy to treat patients with disc bulges and herniations versus other clinics that use traction. Contact us to learn more about how VAX-D can help you.
The one thing that has become clear over the years as technology progresses, so do the new conditions related to the use of the new technology. In the early 2000’s, physical therapy and chiropractors started seeing an increase in neck pain related to pinching the ever “smaller” cell phones between peoples neck and shoulders. This lead to the development in hands free devices and functions on the cell phones. By 2005 the first smartphones started to arrive on the market and texting began to become the normal form of quick communication vs. the phone call. This lead to “Blackberry Thumb”, due to the original keyboards on the smartphones needing to be depressed to enter the text and thumbs were the primary digits for keying. This lead to the development of touch screen and auto text to decrease keying and force needed to key.
Now, the new condition is called “Text Neck”, which is related to the use of any smart phone or tablet. This condition comes from the standard posture with the device being held low and your neck being bent forward to interact with the device. This constant forward head posture puts significant stress on the muscles, ligaments, and joints in the neck leading to chronic neck pain. This type of pain was usually more specific to people who worked in specific industries, like, welders and dentists.
This condition is affecting a wide range of people and starting at much earlier ages. Dr. Brad Davis, a physiatrist, or rehabilitation physician, with Carolina Spine and Neurosurgery Center in Asheville, said he sees patients every day with chronic neck pain – and more of them are young. “From what I gather,” he said, “on average folks are spending a couple of hours a day (on these devices), which translates to hundreds of hours on an annual basis of not having the correct cervical spine and head posture.” “Over time with this repetitive stress of long durations, you end up with more of a chronic neck condition,” he said. “And once an individual starts feeling the effects of chronic pain, they learn to change their posture.” And, Van Pelt said, the full impact this behavior has on children is not yet known. “The worrisome part of this is that younger and younger people and people with immature spines are using these devices and over prolonged periods this may result in the spine not growing to a normal curvature,” he said. “I’m sure we’ll find out over the next 10 years the effects of it.” (Greenville Online, Smartphone use causing painful “text neck”)
So what can you do?
The best thing you can do is prevention. Eliminating some of the poor texting habits are the keys to reducing this poor posture and neck pain.
Take breaks from you smart phone or tablet – This is very straight forward. The body is amazing and can tolerate poor postures for short periods of time, but it needs time to recover. Taking a break from your device every 20 minutes will give your body a chance to recover
Stretch your neck during your break – The tension built up in your neck needs to be alleviated and to encourage good blood flow to the joint and tissues. Use this neck stretch to address your forward head posture.
Use the voice to text function – Many of the devices have a voice to text function, use it when you can to avoid prolonged forward head posture.
Put the device away – We often feel the need to respond to everything immediately, but often it can wait. When at work put the device in your desk, not on it. Turn it to silent.
Teach your children good device habits – Texting was developed as a quick way to communicate when a telephone conversation wasn’t possible or unnecessary. Call the person or talk to the person face to face, when you know the conversation is going to be longer than a few sentences. First the conversation could be quicker and secondly less painful on the neck!
It is important to look at all possible habits that might be causing your neck pain and many of us are guilty of encouraging “text neck”. Changing your habits, along with proper treatment of your neck pain , can help you avoid chronic neck pain issues.
Your diet – The more weight we put on, the more stress we put on the back.
Not exercising – Exercise helps strengthen muscles and ligaments which help support the spine. It also helps keep weight off by burning more calories.
Slouching – You can refer to our ergonomics articles for more details on this, but studies have shown that slouching can increase stress on your back by up to 25%.
Your chair – Don’t skimp on a cheap chair or one that is ill suited for the tasks you are doing. Make sure you get the right chair for what you are doing, your back will appreciate it.
Your shoes – Ask an architect if they would put a structure up on a poor foundation! So many people wear shoes far beyond their ability to provide proper support. If they are worn, replace them.
Your mattress – Don’t wait for the springs to poke you. If the mattress is over 10 years old and you have back pain, consider getting a new mattress.
Your car – Many people spend a few hours a day in their vehicle. Making sure the seat is adjusted for you is important to making it a comfortable driving experience. Consider your seat when buying the next car if you spend a lot of time on the road.
Your shoulder bag – This could be a purse, carrying case, or laptop bag. Most people place the bag over the same shoulder every time which can lead to back pain. Either get into a habit of swapping shoulders, lighten the bag by getting rid of un-necessary items, or get a backpack to evenly distribute the weight.
Smoking – A smoker is twice as likely to develop back pain as a non-smoker. Smoking weaken joints and tissues which can lead to an injury
The Center for Total Back Care treats many conditions including Piriformis Syndrome. Sometimes the Piriformis muscle can be the culprit when it comes to pain related to the Sciatic nerve. The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. It is important in stabilizing the hip and balance with weight shifts.
As you can see by the diagram to the right, the Sciatic nerve travels through or just beside the Piriformis muscle. The Sciatic pain associated with Piriformis Syndrome is related to compression applied to the Sciatic nerve. Many events can trigger Piriformis syndrome but pain can be increased by sitting for prolonged periods, running or stair climbing.
The good news is that even though its symptoms are similar to that of a herniated disc the treatment is usually less aggressive. Patients will often see improvement within a few appointments.
How to Prevent Piriformis Syndrome
If you are very active change your shoes out. Even when your shoes show little external wear, the cushion and support wear out about every 6 months (sooner if you are using them to exercise). Worn out shoes put extra stress on all the joints, including the hips.
Avoid running long distance on uneven surfaces, which will put extra stress on your balance and hip stabilizers, like the Piriformis muscle.
Use proper form when squatting. Form encourages proper joint motion and alignment, which reduces stress on the leg joints, including the hip.
Treating a bulging or herniated disc is one of our specialties at The Center for Total Back Care. Often we get asked, “What is the difference?”. While they may seem similar they are very different conditions that require very specific approaches to physical therapy and chiropractic care.
To explain this, it is important to define what the disc is made of and its purpose. The disc acts as cushions between the vertebrae in your spine. They’re outer layer of tough cartilage that surrounds softer cartilage in the center. Its design allows for mobility and protection against forces applied to the spine.
Disc outer cartilage(grey) and inner cartilage(blue)
A bulging disc extends outside its normal position in the vertabrae. The bulge is created by the outer cartilage layers stretching or breaking down. It looks similar to a hamburger(disk) in a small hamburger bun(vertebrae). Bulging usually is considered part of the normal aging process of the disc.
A herniated disc, on the other hand, results when the fibers in the tough outer layer of cartilage break and/or rupture, allowing some of the softer inner cartilage to protrude out of the disc. Herniated discs are sometimes called slipped discs.
If you have been diagnosed or suspect you have one of these conditions, contact us at 480-633-8293 to find out what treatment options are available to you!