Spinal Decompression

EXERCISES FOR BACK RELIEF

Many people believe that rest is best for a painful back, but actually, what your back really needs when it's hurt is exercise. Regular exercise relieves back pain by strengthening and stretching the muscles that support the spine and helps to prevent future injury. This is a use it or lose it situation: the more you rest, the weaker your back gets, even if it is hurt. Studies have actually shown that you can heal your back pain faster and get back to your regular activities with just two days of rest. This article will focus on Yoga Exercises. Remember to contact your doctor before beginning any exercise program.

YOGA EXERCISES FOR YOUR BACK

A good, regular yoga practice will go far in relieving the stress and tension that sometimes cause mild back pain, and in fact, studies have shown that yoga is the number one most effective exercise for relieving back pain. However, not all yoga poses relieve back pain, and some can in fact aggravate existing pain, so it is important to know which poses will be most helpful in relieving back pain. It is best to do these exercises under the supervision of a certified yoga instructor, and if you encounter any problems with these poses, you should consult an expert. Even just one or two sessions with a yoga instructor can help, as an instructor will help you with your form and posture during poses. Here are some of the best yoga poses for relieving back pain. Each pose should be held from five to ten seconds, depending upon your level of comfort, and should be done on a mat or other soft, supportive surface.

CORPSE: Lie flat on your back in a relaxed position, arms resting at your sides, palms down, and legs lying naturally, with knees turned out slightly. If it hurts your back to have your knees turned outward, do this pose with knees bent, feet flat on the floor. Breathe in and out for a few seconds while allowing any tension to leave the body.

CAT STRETCH: Start out on your hands and knees with a flat back. Your hands should be directly under your shoulders with fingers spread. Knees should be directly under the hips. Head is held loosely so that you are looking at the floor between your hands. Inhale, and as you exhale, arch your back toward the ceiling, tuck your chin in to your chest so that you are looking at your navel, and tuck your tailbone underneath. Hold, then release back into your original position.

WIND-RELEASING POSE: Lie flat on your back as in Corpse pose. As you inhale, bend your knee, place your hands right below the knee, and draw your leg towards your chest. Your left leg should remain flat on the floor. Exhale and bring your forehead up to touch your knee. Inhale, and then as you exhale, return to your original position. Repeat with the other leg.

SAGE TWIST: Warning for this pose-it involves twisting your back, so you should take particular care not to twist too far or you risk aggravating any existing back pain. This should be a gentle stretch; twist just as far as is comfortable. Sit on the floor with both legs out in front of you. Bend your right knee, lift your right leg over your left, and place your right foot on the floor next to your left knee. Sitting with spine straight, place your left elbow on the right side of your right knee. Bend your left arm so that your left fingertips are touching your right hip, while at the same time, twisting to look over your right shoulder. This is where you need to be careful not to twist too far. Hold for a few seconds, release, and repeat on the opposite side.

PALM TREE: Stand with feet facing forward, arms at your sides, weight distributed evenly on both feet. Raise both arms over your head, interlock your fingers, and turn your hands so that your palms are facing upward. Next, place your palms on your head and turn your head so that you are looking slightly upward. Stretch your arms upwards, and at the same time, come up onto your toes if you can do so without pain. Stretch your entire body upward and hold, if you can. Some people have difficulty balancing during this pose, so just do the stretching part if you need to.

FISH POSE: Lie on your back with knees bent and arms at your side. Arch your back as far as you comfortably can and raise it off the ground by pushing the floor with your elbows. If you can, tilt your head backwards and rest the crown of your head on the floor. Breathe deeply from the diaphragm and hold pose for one minute if you can.

LOCUST: Lie face down with arms at the side, palms down, and elbows slightly bent with fingers pointing towards the feet. Raise your legs and thighs as high off the ground as possible without causing your back any pain. Hold for one second and repeat up to twelve times. This can be a vigorous exercise so you must take care to strain already injured muscles.

BENDING FORWARD POSTURE: Stand up straight with feet together and arms hanging loosely along your sides. Breathe in deeply and raise your arms straight above your head. While breathing out, bend forward and touch your toes if you can. If you can't reach your toes, grab hold of your ankles or calves. To complete the pose, you should touch your head to your knees, but this may be too difficult for many who suffer from lower back pain. Your movements during this pose should be smooth, not jerky.

Coughing generally has the purpose of expelling mucus and other materials from the lungs and upper respiratory pathways, though sometimes it is a symptom of an allergic reaction and produces nothing. Whether your cough is related to a cold, flu, allergies or asthma, coughing can cause chest and back pain. There are two main types of coughing back pain.

Muscular Pain

When you cough, a number of muscles in your body contract. These are the normal respiratory and the accessory respiratory muscles. The muscles of the stomach and ribs are normal respiratory muscles. Accessory muscles are found in the back and chest.

You are most likely to suffer a muscle strain from coughing if your cough is prolonged or violent. The constant tensing of a muscle causes it to fatigue, at which point it is not receiving fresh blood flow or ridding waste properly. An overworked muscle can suffer small tears that normally heal within a couple of days, but only if allowed to rest. If you continue to cough, the tears may accumulate and the strain becomes a prolonged situation.

Muscular pain from a cough tends to be sharp. It can be felt especially when coughing, but the muscle will also be tender and sore when you aren't coughing. In order to repair the muscle, you need to get a handle on your cough. This may require prescription medications, over-the-counter medications or home remedies like apple cider vinegar and honey or steam-bathing your head over a pot of hot water infused with eucalyptus oil.

Ice is the best way to manage painful inflammation in and around the injured muscle. With your cough under control and frequent icing for 15 minutes at a time during the first two days of injury, your muscle strain should heal. If the strain has become exacerbated by an inability to stop coughing, talk to a doctor about your options.

Nerve and Disc Pain

When you cough, the pressure in your chest and abdomen increases. This is caused by the relaxation of the diaphragm combined with the tightening of your rib and stomach muscles when you cough. As pressure increases inside the body, it pushes outward on surrounding structures, including the spine.

If you have a bulging or herniated disc in your lower or upper back, coughing will likely be especially painful. A disc is comprised of a fluid center and a tough exterior ring. If the ring weakens, the fluid is pushed to the weaker side and a bulge forms. If the ring breaks and the fluid leaks out, the disc has herniated. Both of these situations can cause nerve impingement; spinal nerves run through a column in the spine positioned behind the discs. When a disc bulge or herniated fluid irritates a spinal nerve, sharp localized pain is felt as well as pain, numbness and/or tingling along the affected nerve's pathway.

The increase in pressure experienced during a cough affects the lower and upper back. If a bulging or herniated disc is present, the push it experiences from the stomach or chest will cause more fluid to be pushed into the bulge or out of the herniation, leading to the symptoms above. In rare cases, a chronic cough could cause disc damage due to the near-constant pressure on the spine, but it is more likely that the disc problem existed already and coughing has merely exacerbated it.

Disc problems are best treated with decompression treatments, chiropractic care or exercise therapy depending on the cause.

Coughing can strain muscles and place excess pressure on injured discs. Getting your cough under control is the first step to relieving these types of back pain.

DRX9000 spinal decompression treatment is one of the latest innovations in dealing with chronic back pain caused by DDD or degenerative disc diseases, herniated disc and other spine and disc diseases. It is developed by Axiom Worldwide to be used in decompressing by determining through its computer system the amount of decompression that is needed to treat spinal compressions. It can make adjustments by decreasing the amount of traction if it senses that the spine muscles are resisting to the force of the pull. If it senses that the muscles are already relaxed, it will continue pulling the spine and reducing muscles tension allowing the spaces between the vertebrae to increase resulting into a well decompressed spine. After several sessions, pain will be alleviated and best results will be achieved.

However, there are many considerations about this treatment. DRX9000 spinal decompression treatment might work for one but it may not be effective for another. Some may be able to afford it but others will not even try to think about it. DRX9000 treatment is truly very expensive, so much more is the DRX9000 machine itself. When you can have a $300 inversion table which can also be used in spine decompression through inversion therapy, DRX9000 cost about a hundred thousand dollars and using it will require you to hire a health professional for more accurate results. You wouldn't want to spend fortune just to cure back pain or some less serious disc disease.

Also even if you will not think about purchasing the machine, each session of DRX9000 treatment will still cost you thousands of dollars. DRX9000 spine decompression machine is indeed a good option only for those who can afford it. If you are one of them, then you are lucky. However if you are someone who can actually afford but thinks in a more practical way, then you will be looking into some cheap spinal decompression alternative treatment but can still be effective as well.

Physical therapy and just plain rest can go a long way in the quest for neck pain relief but often medications are indicated. People typically start with over-the-counter medications, but if they are not effective for you, consult a doctor. There are many choices that your doctor will give you and it may take some experimentation but typically you will find the drug(s) that work for your particular ailment.

LIGHT to MODERATE Neck Pain
These "over-the-counters" are effective for mild to moderate neck pain.

Acetaminophen - this drug can be a very effective pain medication, but it does not treat inflammation from arthritis of the vertebral joints- which is a cause of pain for many people. Acetaminophen is generally safe but may lead to kidney damage if overused.

Drugs in this category include: Tylenol- the most widely prescribed brand name of this drug.

NSAIDS (Non-steroidal anti-inflammatory drugs) - these drugs relieve pain and reduce swelling by inhibiting the body's natural inflammatory response. People taking blood-thinners such as Warfarin (Coumadin) should avoid ibuprofen because it also thins the blood, which may lead to excessive bleeding.

Drugs in this category include: Advil (ibuprophen) and Aleve (naproxen).

MODERATE to SERIOUS Neck Pain
Opioids - Opioids may be prescribed by your doctor for more severe neck pain that can not be controlled using over-the-counters like acetaminophen or NSAIDs. These drugs work by interfering with the brain's normal processing of pain signals. Some of the medications in this category are combined with acetaminophen or aspirin so they contain anti-inflammatory properties, such as Vicatin (hydrocodone and acetaminophen). One must be careful because the body can develop a strong physical dependence on these drugs over time. Side effects may include nausea, drowsiness, and dizziness.

Drugs in this category include: Methadone, Codeine, Fentanyl, Hydrocodone, Morphine (MS Cotin), and Oxycodone (Oxycotin).

Muscle Relaxants - These medications help relieve neck pain caused by muscle spasms and are most appropriate for short-term use. Using Muscle Relaxants for Neck Pain Treatment may lose their effectiveness after about two weeks. Some are habit-forming and cause side effects, like drowsiness, dizziness, and confusion.

Drugs in this category include: Soma (carispoprodol), Flexeril (cyclobenzaprine), Robaxin (methocarbanol), Zanaflex (tizanidine), and Valium (diazepam).

Neuropathic and Nerve - Blocking Medications- For neck pain caused by a pinched nerve or nerve disorder; relief may come from these anti-depressants, anti-convulsants, and nerve blockers. These medications work by interfering with the way that the brain receives or interprets pain signals or by blocking the signals being sent from an irritated nerve. Side effects from the anti-depressants and the anti-convulsion drugs can include: restlessness, dry mouth, anxiety, drowsiness, and weight gain. Anesthetics can cause dizziness, drowsiness, and nausea.

Drugs in these categories include:
Anti-depressants such as: duloxetine (Cymbalta), paroxetine (Paxil), amitriptyline (Elavil), escitalopram (Lexapro), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), fluoxetine (Prozac), sertraline (Zoloft), and venlafaxine (Effexor)

Anti-convulsants such as: levetiracetam (Keppra), pregabalin (Lyrica), gabapentin (Neurontin), phenytoin (Dilantin), and topiramate (Topamax).

Nerve-blocking medications such as: local anesthetics- bupivacaine, novocaine, and lidocaine, and primary neuron-blockers such as over-the-counter pepper creams, and a capsaicin prescription cream called Zostrix.

Steroids - These drugs are powerful anti-inflammatory hormones used to treat pain caused by inflammation. These chemicals must be used with caution because they can have side effects, if taken for longer than a week. Steroids are known to promote osteoporosis; can cause fluid retention and swelling; may inhibit the immune system; and could dramatically increase blood sugar levels.
Drugs in this category include: Medrol (methylprednisolone), Decadron (dexamethasone), Prednisolone and prednisone.

Botulinum Toxin - These drugs can be used for treating neck pain caused by severe muscle spasms by partially paralyzing the involved muscles. Side effects may include more serious paralysis of those muscles than wanted and difficulty swallowing.

Drugs in this category include: botulinum toxin type A (Botox) and botulinum toxin type B (Myobloc).

NOTE: It is important to consult your doctor when over-the-counter medications do not relieve your neck pain. Your doctor can help find out the underlying cause(s) of your discomfort and prescribe the appropriate medical treatment.

Avoid Drugs with Neck Traction Device
Instead of using drugs, you can also use a neck traction device. A neck traction device can be used at home for neck pain treatment. Neck traction Devices helps maintain proper neck posture and release the cervical pressure by slowly pulling up the cervical spine. It supports the neck by using three different air layers. You can control the traction force by using the air pump.

In the past, chiropractic has been frowned upon by many people. It's no secret when it comes to how people portray chiropractors and the body healing itself. "They aren't real doctors." and "What they do is the most ridiculous thing!"

Today, chiropractors receive a lot more recognition than they used to. After all, doctors of chiropractic get around the same number of college hours as any medical practitioner. There are several myths about what chiropractors do for their patients, but not everyone knows the actual reality in the art of spinal manipulations.

Top 10 Myths and the Reality

10. Chiropractors are not real doctors. There is way more to healthcare than narcotics and prescriptions. Just because chiropractors don't prescribe medication or remove any organs doesn't exempt them from the doctor status. They can offer their patients something that no other doctor can. Chiropractors have the same education on the human body as a medical practitioner. The difference between the two is chiropractors believe in natural healing rather than temporarily masking the pain with painkillers.

9. Chiropractic doesn't help children. Spinal manipulations can have an enormous impact on anyone's health, infants included.

8. Back pain is the only thing chiropractic is good for. The majority of chiropractors focus on correcting patients' overall health with spinal adjustments, not just the problem area.

7. Treatment is way too expensive. Most insurance plans cover chiropractic care, and even if it does cost a little bit out of one's pocket the end result is well worth it to have a healthy lifestyle.

6. Adjustments are uncomfortable. The adjustment is not painful. It's not any different than starting an exercise program for the first time and feeling a little sore afterwards.

5. An adjustment can cause a stroke. There hasn't been any research or scientific proof that a serious condition has occurred after an adjustment.

4. You have to keep going for adjustments forever. Nobody can make a person do anything. Adjustments create such a great lifestyle that people choose to keep going because it makes them feel good!

3. It is just a health trend that people follow. As the third largest form of ANY type of healthcare, chiropractic is the largest drug-free treatment in North America.

2. It can't be proven that it works. The research and science are there. The statistics for chiropractic results is off the charts.

1. It can't help with my problem. Think again. Maintaining normal nerve function is the absolute key to perfect health. Chiropractic focuses solely on the nervous system, which controls every tissue, organ, and cell in the human body.

For those people that would rather let their body heal the underlying problem rather than take narcotics to temporarily sweep the pain away, chiropractic is the best health treatment to choose.

To begin, I'll state my bias: I am a clinical somatic educator trained in methods of mind-brain-body training that address habituated reflex patterns triggered by stress (distress) and trauma. What I write is from that viewpoint: habituation or habit formation.

In my viewpoint, muscular activity comes either from voluntary behavior, from habitual learned behavior, or from involuntary reflexes. That means that movement, posture, and muscular tension come from either of these three general categories as responses controlled by the nervous system.

One category of involuntary reflex, the postural reflex, is largely learned, the learning built upon rudimentary primitive reflexes.

You can identify with the fact that stress and trauma leave impressions in memory and that those impressions might be associated with tension of one sort or another. The piece I'm adding, here, is that the memory of injury, if intense enough, can displace the familiar sense of movement position and control we have over ourselves, creating a kind of amnesia of the body, where we forget free movement and get trapped in tension. It's this kind of tension that conventional medicine tries to "cure" by means of manipulative therapeutics (including chiropractic and acupuncture), drugs, and surgery.

This article stands as a critique of those methods in contrast to an approach that deals with many musculo-skeletal problems in general, and back pain in specific, as maladaptive, stress-related disorders.

That this approach works better than the methods this article critiques remains for you, the reader, to see for yourself. I can't convince you, here (any more than I could be convinced before seeing for myself), but can only offer you a line of reasoning and... at the bottom of this page, a bit of evidence -- a link to a candid, two-minute video clip that shows the first moments of a client after a one-hour session of clinical somatic education.

So, I must appeal to your capacity to reason and to your intelligence and you must seek out the experience, for yourself.

We begin.

OVERVIEW OF THERAPEUTIC MODALITIES FOR BACK PAIN

First, I'll comment on drugs, then manipulative techniques in general, then surgery, then clinical somatic education.

Two of these three approaches, drugs and manipulation, are best for temporary relief or for relief of new or momentary muscle spasms (cramp), not for long-term or severe problems.

The third, surgery, is a last resort with a poor track record (estimated by one physical therapist at 15% success rate).

You can get a comparison chart of common modalities here.

DRUGS

Drugs can provide temporary relief or for relief of new or momentary muscle spasms (cramp), but can't provide a satisfactory solution for long-term or severe problems. They generally consist of muscle relaxants, anti-inflammatories, and analgesics (pain meds).

Muscle relaxants have the side-effect of inducing stupor, as you have found if you've used them; they're a temporary measure because as soon as one discontinues use, muscular contractions return.

Anti-inflammatories (such as cortisone or "NSAIDS" - non-steroidal anti-inflammatory drugs) reduce pain, swelling and redness, and they have their proper applications (tissue damage). Cortizone, in particular, has a side effect of breaking down collagen (of which all tissues of the body are made). When pain results from muscular contractions (muscle fatigue/soreness) or nerve impingement (generally caused by muscular contractions), anti-inflammatories are the wrong approach because these conditions are not cases of tissue damage. Nonetheless, people confuse pain with inflammation, or assume that if there's pain, there's inflammation or tissue damage, and use anti-inflammatories to combat the wrong problem.

Analgesics tend to be inadequate to relieve back pain or the pain of trapped nerves and, in any case, only hide that something is going on, something that needs correction to avoid more serious spine damage.

MANIPULATIVE TECHNIQUES

Manipulative techniques consist of chiropractic, massage, stretching and strengthening (which includes most yoga and Pilates), most physical therapy, inversion, and other forms of traction such as DRS Spine Decompression.

Most back pain consists of muscular contractions maintained reflexively by the brain, the master control center for muscular activity and movement (except for momentary reflexes like the stretch reflex or Golgi Tendon Organ inhibitory response, which are spinal reflexes). I put the last comment in for people who are more technically versed in these matters; if these terms are unfamiliar to you, don't worry. My point is that manipulative techniques can be only temporarily effective (as you have probably already found) because they don't change muscular function at the level of brain conditioning, which controls tension and movement, and which causes the back muscle spasms.

Nonetheless, people commonly resort to manipulative techniques because it's what they know -- and manipulation is the most common approach, other than muscle relaxant drugs or analgesics, to pain of muscular origin.

SURGERY

Surgery includes laminectomy, discectomy, implantation of Harrington Rods, and surgical spine stabilization (spinal fusion).

Surgery is the resort of the desperate, and although surgery has a poor track record for back pain, people resort to it in desperation. There are situations where surgery is necessary -- torn or ruptured discs, fractures, spinal stenosis; situations where surgery is inappropriate -- bulging discs, undiagnosable pain, muscular nerve impingement; and situations where surgery is sometimes appropriate -- rare cases of congenital scoliosis. (scoliosis -- curvature of the spine -- is more commonly a functional scoliosis, the consequence of muscular tensions around the ribs and spine, rather than the result of deformed growth).

SOMATIC EDUCATION

Most back disorders are of muscular (neuromuscular) origin - and correctable by clinical somatic education (which is not about convincing people that 'things are not so bad, and live with it' or 'understanding their condition better' - but a procedure for eliminating symptoms and their underlying causes, and for improving function). Severity of pain is not the proper criterion for determining which approach to take. The proper criterion is recognition of the underlying cause of the problem.

In the case of back pain, the underlying cause -- chronic back tension -- causes muscular pain (fatigue), disc compression, nerve root compression, facet joint irritation, and the catch-all term, arthritis -- all through strictly mechanical means.

Degenerative Disc Disease, for example, is no more a disease of the discs than is excessive tire wear and breakdown from an overload of weight over a long period of time. There is no such thing as Degenerative Disc "Disease".

Somatic education is a discipline distinct from osteopathy, physical therapy, chiropractic, massage therapy, and other similar modalities.

As such, it isn't a "brand" of therapy or treatment, but a category or discipline within which various somatic "brands" or approaches exist. Examples of "brands" include Trager Psychophysical Integration, Aston Patterning, Rolfing Movement, Orthobionomy, Somatic Experiencing, Feldenkrais Functional Integration, and Hanna Somatic Education.

The prime approach of somatic education, through various methods according to the 'brand' or school of somatic education, is to retrain the nervous system to free muscles from being in an excessively contracted state. The general category of training is movement education, where it is understood that the function of muscles is movement and training movement trains muscle tension.

In the abstract, what distinguishes somatic education from manipulative practices is the active participation in learning by the client. The instruction comes from outside; the learning comes from within, and what the client learns during sessions (in terms of sensory awareness and control of muscles and movement) is what produces the improvements, and not what a practitioner does to the client, per se. As education, it deals with memory patterns, which show up as habitual patterns of muscular activity: tight muscles and familiar patterns of coordination and control. Deeper-acting somatic disciplines, such as Feldenkrais Functional Integration and Hanna somatic education, deal with more deeply ingrained and unconscious habit patterns formed by injuries and stress.

More concretely, somatic education uses movement and positioning to enable the client, by delilberate effort and practice, to gain access to muscles out of voluntary control, and thereby to recapture control from conditioned reflexes triggered by injury or stress and to improve quality of movement and physical comfort. Sensory awareness techniques are a large part of the process, as are controlled breathing, controlled pacing of movements, and coordination training.

Most forms of somatic education are "enriching" in nature, as they improve movement and sensory awareness, but gradually and with practical limits as to predictability of a specific outcome. They are often successful in the alleviation of pain, where more conventional therapeutic methods -- manipulation, stretching, strengthening, drugs, surgery -- are less successful. However, the gradualness of and unpredictability of improvements make them impractical as methods to be used in a clinical setting, although they are often used as an adjunct to those conventional methods.

A clinical approach to somatic education is so distinguished by the ability of practitioners to predict with a high degree of reliability and number and kind of sessions required to resolve a specific malady and to achieve resolution efficiently.

The specific advantage seen in clinical somatic education by referring physicians is that, while being effective in the relief of muscular pain and spasticity, it has the specific virtue of teaching the client an ability so to control the muscular complaint that there is little chance of a future return of the problem.

For a technical comparison between somatic education and chiropractic (as an example of a manipulative approach), see below.

Shin splints can be devastatingly painful and if not handled properly, can actually cause micro stress fractures in the legs.The athletes and exercise enthusiasts that are usually troubled with these injuries are joggers and runners, soccer players, rugby and football athletes, lacrosse players and almost every sport or athletic activity that entails running for prolonged periods of time.

The best treatment is always practicing prevention. The following steps should be performed daily to prevent injury.

1. Always keep the body hydrated. You should drink anywhere from one to 2 L of water every day.


2. The muscles all the leg should be stretched several times throughout the day.  Especially for games. The following muscles should be stretched: the quadriceps, hamstrings, calves and the tibialis anterior muscle. They should be stretched first thing in the morning, before and after practices and games and at night time before you go to bed.


3. A healthy diet consisting of lean meat, chicken and fish as sources of protein and plenty of vegetables either fresh or frozen.


4. A good multi-mineral and multivitamin should be taken daily, as well as 2 g of fish oil.  A calcium and magnesium supplement is also recommended to help prevent muscle spasms.


5. A good running shoe should always be worn and make sure that they take care of any issues of excessive aversion or inversion.


6. Having and using common sense is a major factor. If your legs are feeling tired, sore or achy take this as a sign that your body needs a rest and take off a few days


7. And if you are suffering from fatigue and injury seek the proper medical attention from your chiropractor, podiatrist, physical therapist or medical doctor.

So there you have it seven steps to preventing and taking care of major injury from shin splints.

The answer, almost always, is YES.

As some of you may know, I ruptured a disc in my lower back when I was 13 years old. We were playing a running & dodging game at recess, and after a quick cut to the side, my back and legs suddenly seemed to stop working and I hit the ground.

Many years later I saw x-rays of my lumbar spine, and it became clear what had happened back then on the playground: I had damaged my 2nd lumbar disc.

The evidence was easy to see. My entire lumbar spine looked great, except for L2. That disc was dramatically thinner than the rest of them, the vertebrae above & below were thickened and misshapen, and there were large, hooked bone spurs (osteophytes) surrounding that joint.

Your spine is made up of 24 bony vertebrae, and in between each of them is a disc. The discs perform 3 functions:

1. They act as ligaments, by holding the vertebrae and spine together.
2. They act as shock-absorbers, by carrying the downward weight (axial load) of your body while you're upright.
3. They act as pivot points, allowing the spine to bend, flex and rotate.

The disc itself is designed like a jelly danish. The outer rim (annulus) is tough and fibrous, while the "jelly" center (nucleus pulposis) is about the consistency of toothpaste. It's when the nucleus starts to protrude through the layers of the annulus that problems start. When a damaged disc bulges outward, the "bubble" can compress or irritate spinal nerve roots, which can cause the numbness, radiation pain, weakness and tingling associated with disc injury. This most commonly happens in the cervical or lumbar spine.

The good news is, many disc injuries (even old ones) can be dramatically improved without surgery. Don't get me wrong -- we can't replace damaged disc material, or remove osteophytes. What CAN help is to rebuild the muscular support system around the damaged joint, fine-tuning it to take over the job of the disc. Traction, McKenzie exercises, core stabilization, joint mobilization and flexibility training can all help make your disc injury a non-issue. Even more importantly, good spinal maintenance can help keep your pain from coming back.

If you're in pain, don't despair -- for the huge majority of patients, there IS life after a disc injury, if you get the right therapy. A good chiropractor or physical therapist can equip you with the tools you need to keep your spine happy and healthy for a long time.

Spinal stenosis is a term used to refer to a narrowing of the spinal canal.

When the narrowing occurs in the center of the spinal canal it may press upon the spinal cord. If thenarrowingoccurs on the side of the spinal canal it may press upon the nerves - this may result in either what are termed lateral recess stenosis or foraminal stenosis depending on whether the stenosis is in the lateral aspect of the spinal canal or in the neuroforamen where the nerve exits. Both of these sub-types of spinal stenosis may affect the nerve in the region.

Spinal stenosis is one of the most common causes of back pain for Americans. In fact, approximately 70% of people with spinal stenosis have back pain. This may range from intermittent discomfort to severe and disabling spinal arthritis pain.

Many of those suffering with spinal stenosis experience what is termed, neurogenic claudication. This results in pain or weakness in the legs as a person attempts to walk a long distance. Eventually, the distance a personis able towalk is severely limited. As a result, these people may be disabled.

One of the common signs of neurogenic claudication is called the "grocery cart sign", i.e., when a person with significant neurogenic claudication walks a distance, they begin to feel the symptoms into their legs. When this occurs they may simply sit down for a few minutes and the symptoms may resolve. However, many people will simply bend forward and lean on the cart to obtain relief. The effect of leaning forward on the cart opens the spinal canal and provides more room for the spinal cord or nerves. Even a small amount of additional room can have a significant impact on the distance/duration these people can walk.

There are many causes of spinal stenosis but the most common cause is simple aging. As we age, our spine degenerates and a condition known as spondylosis develops. Spondylosis is the medical term for spinal degeneration or arthritis.

Spondylosis may occur in the lower back and is termed, lumbar spondylosis. It may also occur in the neck and is termed, cervical Spondylosis.

When cervical spondylosispresses upon the spinal cord, it is termed cervical spondylotic myelopathy (CSM); when the cervical spondylosis affects a nerve to the upper extremity, it is referred to as cervical spondylotic radiculopathy (CSR); and, when both the spinal cord and a nerve are associated with cervical spondylosis, it is referred to as cervical spondylotic myeloradiculopathy (CSMR).

Unfortunately, there is no cure for spinal stenosis and it is a progressive disorder. However, there are many treatments available that provide relief including physical therapy, chiropractic, pain injections and surgery.

Regardless of the treatment selected, it is important for those with spinal stenosis to stay active and exercise to maintain strong core muscles which support the spine.

For those who do not respond to conservative treatment, surgery may be required. The goal of surgery is to resolve the neurogenic claudication and the back pain. Typically, a simple decompression of the spinal stenosis will relieve the back pain and the neurogenic claudication. A spinal fusion is rarely necessary.

One of the most advanced and well-tolerated treatments of spinal stenosis uses minimally invasive spine surgery techniques. Using small camerascalled endoscopes, specially trained spine surgeons can remove the spinal stenosis using only very small incisions. Many innovative surgeons also use laser spine surgery techniques as well because the laser has the unique ability to vaporize areas of stenosis that would otherwise require more tissue removal to resolve.

Minimally invasive spine surgery is typically performed on an out-patient basis with no hospitalization required. It is performed using the small endoscopes or very small tubular retractors. Each of these techniques has their own indications but the result is resolution of the spinal stenosis through very small incisions designed to protect the overlying muscles of the spine. This minimizes any scarring and there is virtually no blood loss.

These types of surgical procedures do not require general anesthesia so patients with heart conditions who may not otherwise be able to tolerate a spinal procedure are not excluded.

Laser spine surgery offers the additional benefits of ablating the nerves to the small joints that may be an additional source of back pain. The lasercan also safely decompress painful discs.

All of these techniques are performed in a single setting so that all the sources of pain are addressed in one procedure.

Today, some innovative minimally invasive spine surgeons are also using adult stem cells derived from the patient's own bone to further minimize any scar formation. These adult stem cells, not embryonic stem cells, play an important role in down-regulating inflammation and reducing pain.

Left untreated, spinal stenosis can severely affect the ability to walk.

However, today's advanced minimally invasive spine procedures can typically resolve the spinal stenosis and prevent progression during a simple out-patient procedure without the need for general anesthesia or spinal fusion.

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Sciatica Treatment:

Treatment for musculoskeletal injuries typically is rendered according to the basic mnemonic RICE.

• Rest


• Ice


• Compression


• Elevation

The question is for a musculoskeletal injury, is ice better than heat? There is no hard and fast answer, as research has been unclear for a definitive answer.

The thinking is as follows. For an acute injury, such as an ankle or low back sprain/strain, ice is better. An injury sparks up increased blood flow to the area, which brings in inflammatory mediators and increases swelling. Ice can slow down the blood flow, and along with the elevation minimize the resultant swelling and pain. Ice can also provide a bit of a numbing effect for pain control. Ice treatment is also called cryotherapy.

Be careful not to apply ice continuously, as it can damage the skin. A good rule of thumb is 20 minutes on, 20 minutes off and to place a towel on top of the skin to prevent direct contact.

After the initial 48 to 72 hours of injury treatment with ice, the current recommendation is to switch over to heat. One of the first phases of healing is the inflammatory phase, for which adequate blood flow is necessary to bring in those substances.

Plenty of medical providers recommend at that point alternating ice and heat for both pain control and assisting in the healing process. After physical therapy, ice is recommended to prevent significant inflammation and throbbing along with pain. After a few hours, for instance when going to bed later on, heat may assist with relaxing the affected body part and allow one to fall asleep easier.

This is the current thought process for ice and heat treatment with a musculoskeletal injury. When used in conjunction with physical therapy and possibly chiropractic treatment, ice and heat can be very effective modalities.