Spinal Decompression

DDD can affect any part of the spine, although common sites are the lumbar (lower back) and cervical (neck) spine; thoracic DDD is very uncommon. Back or Neck pain is usually manageable with various conservative treatments options like surgical and non-surgical.

NON SURGICAL TREATMENT:

For acute or sudden neck pain, doctors prescribe pain relief medications such as acetaminophen, anti-inflammatory agents, and muscle relaxants. Temporary bed rest or a brace may also be suggested. Usually patients are encouraged to get up and gradually increase their activities of daily living.

Physical therapy is often prescribed, and usually includes stretching exercises to improve flexibility and extension exercises to help maintain the spine's natural curve. A hot/cold therapy and gentle massage can also be beneficial for neck pain. After acute symptoms subside (usually within two to three weeks), patients are encouraged to begin a daily exercise regimen. This may include low impact aerobics three times per week as well as daily neck exercises.

Injections: Steroid injections around the nerves exiting the spinal cord may be able to provide some pain relief.

Intradiscal Electrothermal Therapy : Intradiscal electrothermal therapy, or IDET, involves inserting a small catheter with a heated tip into the disk. The heat causes shrinkage of the disk and deadens the disk's nerve endings. This is not yet a generally accepted.

SURGICAL TREATMENT :

Patients who suffer from a herniated disc, ruptured disc, or degenerative disc disease, and have failed conservative therapy are often treated with an Anterior Cervical Discectomy and Fusion. An Anterior Cervical Disectomy and Fusion has been the gold standard of treatment.

Anterior Cervical Discectomy and Artificial Cervical Disc :

This procedure reaches the cervical spine (neck) through a small incision in the front of the neck. The intervertebral disc is removed and replaced with a small plug of bone or other graft substitute, and in time, will fuse the vertebrae. While Anterior Cervical Discectomy and Fusion remains the gold standard for treatment of cervical disc herniations and degenerative conditions of the cervical spine, the use of motion sparing techniques such as artificial disc placement are under investigation world wide.

Cervical Corpectomy :

This procedure removes a portion of the vertebra and adjacent intervertebral discs, which allows for decompression of the cervical spinal cord and spinal nerves. A bone graft, and, in some cases, a metal plate and screws, stabilizes the spine.

If you have been experiencing back pain, you have probably gone to see your primary care physician or an orthopedist. They have evaluated you and probably ordered you to get an MRI or an X-ray. That is common practice today in our current health care system. When you do the MRI or X-ray, it is usually followed up with a report that is sent to the referring doctor.

Many times the MRI or X-ray will say that there are bulging discs, facet hypertrophy, stenosis and other things. As important as those things are, it is even more important to understand whether or not they correlate with your symptoms.

If you are having lower back pain and butt pain, but the MRI says you have a disc herniation at L5-S1, it is probably not the cause of the lower back pain. The reason I say that is because the nerves that correspond to the L5-S1 dermatome area are located in the back of the leg and they control bladder and bowl movement. A significantly herniated L5-S1 disc would cause pain in the back of the leg and affect bowl and bladder function.

I am often asked what all of the findings mean. My answer generally is to first identify what if causing your back pain rather than reading thee MRI. While I think it is very important to get these imaging studies I place extreme attention in determining if the findings are what are really causing your problem.

For example, I have had patients whose MRI and X-rays actually show nothing, yet they are in incredible amounts of pain. So what good was the MRI in this case? By examining further and looking at a person's posture, muscle strength, muscle length, type of work, and type of recreational activities and habits, I can better diagnose what the problems could be.

Often people's pain originates from something that they do on a daily basis like their sleep position or the posture they assume while at work. Even though their MRI might read facet hypertrophy or stenosis, it could be one of the positions you are in daily that is making your problem worse and more painful.

This article is to help inform you that there is hope beyond just your imaging results. Even as bleak as you imaging results may be or sound, there is always something that you can change, modify or improve upon that can help you in the long run.

Even if you had a 7mm herniated disc at L4-5, a very large bulge, and had really bad numbness and tingling down the legs, you could still learn what positions to avoid, what positions to try and achieve, what stretches you can do comfortably and what strengthening exercises you could do to help provide some stability to the spine.

While MRI's and X-rays can be very helpful, I hope you can see that you have the opportunity to seek out additional advice and education on how to help improve the situation you are already in even if your imaging studies results don't paint such a great picture.

Oftentimes, we wonder if the intense, passionate attraction we have for a person is true love or not. We think it's true love but eventually realize that it was just lust; so how can we know that it's finally true love? Here are indications that you might be truly in love:

1. You think of him first before the I or me. You make him your priority. You think about his benefit before you do yours.

2. He is always on your mind. Not a day goes by that you don't remember the person; wondering what he is busy with. Did the day go well?

3. You want to be with him for the rest of your life. You can't imagine life without your beloved.

4. You have passion for him. You want to hug and kiss your beloved.

5. When planning, you always include him in your plans, like when you plan for a house; you consider his favorite color, etc.

6. You are willing to sacrifice your life for his, without hesitation.

7. You want to get to know his family better. Does his mother want cats or dogs? What's her favorite hobby? What's her favorite food?

8. You strive to work hard for a living so you could ask her hand in marriage. You started saving for the future, planning about what type of car to buy, what architectural plan your house would be.

9. He is your best friend. You can tell him anything and he understands. Even if you don't tell him anything, he still understands. There are several instances that prove being a best friend to your beloved makes for a stronger relationship.

10. When asked why you love him, you find it hard to give a reason. You truly love a person, when you love him for what he is. You have no reasons why you do, you just do.

True love though is like a plant that needs to be watered and taken cared of. It should be nurtured until it has taken firm roots in the ground. It takes constant renewal and understanding. It needs some sunshine to grow. When you experienced going through life's challenges together, it would make your love stronger and sturdier. That would be the time that you can self-confidently proclaim to the world that what you have is true love.

Sadly, the vast majority of us are going to experience back pain at some point in our lives. Although many of us may be able to control this pain through over-the-counter painkillers or perhaps some light physical therapy and bed rest, there are going to be some of us that have back pain to the extent where we need to seek medical attention.

A common type of back pain or pinched nerve pain that is experienced is as a result of a slipped or herniated disc. These discs are gel filled material that exist between the vertebrae of our spine and allow the vertebrae to move independently of each other and also protect it from damage. Should these happen to crack or slip out of place, the pain that we experience can be extremely severe.

There are a lot of different ways that a slipped or herniated disc can be treated. These can include such things as physical therapy, bed rest, traction, spinal decompression, painkillers, surgery and natural forms of treatment. There may be times, however, whenever an epidural steroid injection is prescribed. What exactly is an epidural steroid injection, how is it administered and what can it do for you?

An epidural is a rather broad term that refers to an injection which goes into the epidural space in the spinal column. The epidural space is in the outermost part of the spinal canal and it lies outside of the dura matter which encases the spinal column. The injected steroids mimic cortisone and hydrocortisone which can reduce the inflammation that surround the affected nerves. This can give almost immediate relief to the pain that is experienced in this area and can help to keep the inflammation down for a considerable amount of time in order to allow for more effective pain management.

Unfortunately, the relief that is felt as a result of the epidural steroid injection is usually temporary. Also, the steroids that are injected can have side effects which may include weakened muscles, a decrease in bone density, and possible lowering of the steroids that your body produces naturally.

Be sure to discuss with your personal physician the pros and cons of epidural steroid injections for providing back pain and pinched nerve pain relief.

A modern chiropractor may specialize in a specific area only but may use a wide variety of methods and tools to address different general health issues and neuromuskuloskeletal problems. Most common methods include soft tissue therapy, dry needling, strength training, traction, functional electrical simulation, and nutritional recommendations. Alternate methods are sometimes used as a part of a holistic treatment approach.

There may be many forms of treatments involved in Chiropractic Medicine but the cornerstone of care remains to be chiropractic adjustment. This is to restore and maintain function of extremity joints and the spine.

Here are the different methods of diagnosis and care that chiropractic doctors most commonly use today:

Graston Technique

This is the latest technology in soft tissue therapy that entails deep muscle massage to relieve pain and tension along with reducing scar tissue formation. This is often applied in conjunction with chiropractic adjustments as it helps relax the muscles.

This offers a quick and effective way of treating various conditions like carpal tunnel syndrome, tennis elbow, plantar fasciitis, neck pain, back pain, rotator cuff syndrome, and fibromyalgia.

The great benefits make Graston technique a popular choice among athletes like those in NBA, NFL, AFL, NHL, MLB, and even PGA.

Digital Motion X-ray (DMX)

This is a modern-day diagnostic test that allows radiologists to visualize and evaluate all body joints in motion enabling doctors to specifically determine which ligament or soft tissue is damaged or injured. This enables recording of any joint in motion with real-time, full motion x-ray imaging.

Trigger Point Injections (TPI)

This is a famous option among patients with chronic pain. This is a procedure done by treating painful areas of muscles that contain the trigger points or the knots that tensed muscles form.

The injection usually contains a local anesthetic with corticosteroid that renders the trigger point inactive that further results in alleviation of the pain.

Spinal Decompression

This is the non-surgical and drug-free method of treating chronic lower back pain, sciatica, herniated or bulging discs, degenerative disc disease, and even relapsed or failed back surgery. The method entails using a state-of-the-art technology to apply a distraction force to relieve nerve compression that causes pain.

Spinal decompression also works in the way that it causes the disc to heal through stimulating the cartilage to regenerate and causes the nutrient-rich blood to fill the disc spaces.

Kinesio (Sports Tape)

This is a latex-free therapeutic taping technique that is more popular among athletes. It is applied to the body in various ways over joints, muscles, tendons, and ligaments to support and stabilize the certain area.

Kinesio taping facilitates the natural healing process of the body while helping to reduce inflammation and alleviate the pain.

The goal in regenerative medicine is not simply to repair injured tissue. The human body repairs tissues, such as cartilage and tendons. But the human repair process routinely falls short, either failing completely or reaching a maximum of 70-80% strength with its repair. This may be enough to present functionality for a person. However, it often leaves cartilage defects unfilled, rotator cuff tendons weakly attached, or ACL tears unstable.

In recent years, there has been a shift with musculoskeletal injury and disease to regenerative capability. The United States put a man on the moon over 40 years ago, isn't it about time we figured out how to regenerate soft tissues? Amniotic fluid has emerged as a potential superior source of regenerative components.

In the body of an expectant mother, the amniotic membrane along with its fluid and cells acts as a biologic system whose primary function is to not only protect the fetus, but also aid in fetal growth and development. The fluid has been found to be a rich source of proteins, growth factors, and multipotent stem cells essential for fetal growth and development.

Along with these components, various proteins, cytokines, carbohydrates, phospholipids, and hyaluronic acids are present. The stem cells that are present are capable of differentiating into all three germ layers of the human body. That means they have the capability to differentiate into adipogenic (fat), osteogenic (bone), myogenic (muscle), endothelial (skin), neurogenic (nerve), and hepatic (liver) cell lines.

Research has shown than unlike embryonic stem cells, those seen in amniotic fluid do not over-replicate. That means they do not have the potential to form tumors as are seen from time to time with embryonic cells.

At this point amniotic fluid based stem cell treatments have been utilized for numerous indications. They have been helpful as a biologic dressing in a broad range of clinical applications such as a wound covering. In addition, they have been successfully utilized in spinal fusion and as a scar tissue barrier around the spinal cord.

Amniotic fluid stem cell based treatments also also show some promise for the treatment of cartilage defects, tendon and ligament tears (e.g. ACL, rotator cuff, Achilles), and osteoarthritis. Soft tissue overuse syndromes also have responded anecdotally well to treatments including plantar fasciitis, carpal tunnel syndrome, medial and lateral epicondylitis (tennis elbow).

Medicine has been waiting and hoping for an effective treatment that helps bolster the body's regenerative capacity. Amniotic fluid treatments continue to show promise as a potential holy grail.

Studies have shown that neck pain acupuncture works to ease the stress off our general neck area. While society is slowly learning to veer away from relying too much on over-the-counter remedies or prescription drugs, alternative forms of medicine are now becoming more popular. An increasing number of people are turning to more 'natural' ways to relieve common aches and pains.

Any kind of pain in the neck, however mild or severe the attack, can affect one's quality of life. Just like lighting, it can strike you in a flush. You can be fine one moment, and the next you'll be in a great deal of misery. Whatever kind of neck pain one may have can hinder individuals to fulfill their duties well. Many factors cause neck pain, but everyone at one point in their life will experience some kind of pain in the neck. When your neck muscles stay in one position for a long period of time, expect some discomfort in that area to happen. This condition can also be caused by sudden force, such as a being involved in a car accident. Sometimes, even neck pains bring along head aches with them, making people suffer even more.

Commonly, one's occupation has a direct impact on whether or not one experiences pain in the neck. Those involved in manual labor have higher incidence of pain in the neck, as compared to professionals who work in a typical office. But office workers beware, if one stays in a singular position or remain seated for long periods of time and forget to move around a bit, one can get neck pain as well. Twisting and bending your body frequently can also cause this inconvenience, and the level of pain can go up with age as our muscles and bones wear out.

Acupuncture is not exactly a science, but is an accepted means to relieve pain and provide therapeutic results by inserting fine needles into exact points in the human body. This practice originated from China, and is believed to have started during the Stone Age. Of course there were no needles then, but the concept of putting 'stones' on certain points of the body to relieve pain was born.

Various scientific studies involving neck pain acupuncture have proven that it can actually work better than prescription medicine, or massage. People commonly go to get a Swedish or Shiatsu massage when they experience pain in the neck, or pop a pill to relieve the pain. It is proven that people who received acupuncture for neck pain experienced faster relief, and got less neck pain 'attacks' in the future. This breakthrough study will sure make many folks reconsider their mode of treatment, especially if they get neck pains frequently.

Neck pain acupuncture can truly be an alternative solution for many people, especially those who go through chronic neck pain. Chronic neck pain sufferers can go through extended bouts of suffering, with some reaching well over 3 months. Imagine having that constant pain in the neck, literally. Some medical clinics, spas and massage centers already offer "pain in the neck" acupuncture services at friendly rates, but check with friends who've had similar treatments for referrals on the best places to go to get the treatment. And of course, it's always important to consult one's physician first before embarking on alternative treatments.

We all have these little jelly donuts between the bones of our spine. Okay, they're discs, but they're actually built much like a jelly donut. These discs are made of cartilage on the ouside and a jelly like substance on the inside. The disc's job is to absorb shock to the spine. Sometimes, due to an abnormal force, or a long term stress, part of the cartilage gets torn and the jelly starts to leak out.

This causes a herniation of the disc
The jelly pushes out because there's less support on one side of the disc. Faulty posture or too much pressure on one side also pushes the jelly to the weaker side. This looks much like what happens with a bubbled tire.

This bubble causes you pain because it compresses the nerve around the injured disc.

In extreme cases...
The disc tears completely causing the jelly to rush out. This leads to the need for surgery, known as a discectomy. This procedure removes the leaked jelly and eases the irritation to the nerve. This is a procedure you'd hope to avoid.

How to avoid a herniated disc
We always talk about the importance of training using core exercises. This situation is no exception. Any deep core exercises and stretching helps improve your posture while taking stress off your spine. If you still find yourself with a herniated disc you'll need the right care to get you out of pain.

How we care for a herniated disc
Our first goal is to get you out of pain. Once we get you comfortable we begin strengthening the muscles around the spine. This takes the stress off the nerve.

It's important to remember once the wall of the disc is compromised it can't be repaired only supported. So you'll need to be stronger to compensate for it. This way you can keep the jelly where it belongs.

Summary:

* The discs that absorb a shock to your spine are like jelly donuts, cartilage on the outside, jelly on the inside.
* A tear in a disc happens much like a blown tire. An abnormal force or long term stress cause the disc to bubble
* The tear cannot be healed, but the muscles around it can be strengthened to relieve the pain and pressure.

Don't panic! Though our spine is situated on our backs, most of our back pain complaints are not usually associated with spine damage. As a matter of fact, back pain, together with headache, belongs to the most frequent complaints of adults.

The most common signs of serious medical problem caused by back pain are the lack of control of bowel and bladder as well as the weakness in the legs. If you're not experiencing these symptoms, nor were you involved in an accident that could have caused damage to your spine, most probably, your back pain is caused by muscle spasms.

Like what you experience after working out in the gym for the first time, muscle spasms on your back may be secondary to improper posture, strains of physical work or because of wrong sleeping positions. Pregnant women may also experience back pain because of the weight of the child. Sometimes, even the cold weather may trigger tenderness on your back.

Under the said circumstances, back pain usually subsides in a few weeks' time. However, if the pain is really distracting, several over-the-counter medicines are available to lessen the throbbing. The usual types of pain relievers are as follows:

Acetaminophen

This is said to be one of the safest over-the-counter pain relievers and is recommended for children and pregnant women. Acetaminophen, or paracetamol in the British Commonwealth and some Asian nations, is available in several brand names like Tylenol, Datril, Liquiprin, Tempra, etc. It is less powerful than aspirin and ibuprofen and does not have an anti-inflammatory effect. This is very effective for treating mild pains caused by muscle spasms and fevers. Acetaminophen users seldom experience side effects, although overdose is known to cause liver failure. This is seriously fatal, especially to children, so we must always follow the directions on how to consume acetaminophen.

Aspirin

This is one of the pain relievers that usually have side effects. It is very effective, though, in treating arthritis because of its anti-inflammatory properties. Usual side effects are upset stomach and ringing in the ears. The fatal Reye's syndrome on children is also said to be caused by aspirin. To avoid these side effects, children who have chicken pox or flu should avoid taking aspirin. Acetaminophen is safer. Also, if aspirin will be used to lessen aches, say back pain, it should be taken only when it hurts.

Ibuprofen

This is usually prescribed for arthritis and is very effective for pain and fever. Ibuprofen brands like Advil, Motrin, Nuprin, etc. are available as over-the-counter medicine. This pain reliever also causes upset stomach but has no other fatal side effects. It is said to be impossible to commit suicide with ibuprofen overdose. Ibuprofen, however, costs a little higher compared to other pain relievers.

Naproxen

This is another type of over-the-counter medicine that is efficient for back pain. Its advantage over the other pain relievers is that it has a longer effect. Usually, consuming naproxen twice a day is efficient enough. Because it also causes stomach upset, children and adults over 65 years of age should avoid taking naproxen.

Topical Pain Relievers

Salicylates are the usual components of topical pain relievers. These are the same components present on aspirin and are very effective when absorbed by the skin. Bengay is an example of a topical pain reliever. It contains methyl salicylate that causes the soothing and menthol effect.

Back pain caused by muscle spasms usually subsides in a few weeks. However, if the pain is intolerable despite the intake of pain relievers, or some side effects are being experienced, a visit to the doctor is not a bad idea. Most people usually suffer a lot from worrying than the actual illness itself, so if it would ease your nerves, consult a doctor. Just don't be surprised if he or she prescribes you with the said pain relievers mentioned above.

As the number of pain management patients in United States continues to increase, pain itself is turning into big business. It is often times helpful for patients to receive an injection to avoid or delay surgery, or to allow individuals the ability to participate in physical therapy. Focal injections can also decrease the need for opiate pain medications.

Let's look at a few different types of injections and how well they work. The first type is soft tissue injections in the extremities. An example of this would be an injection of steroid medication into the shoulder area that is called the subacromial bursa. Impingement syndrome is one of the most common diagnoses seen in medicine today, and a subacromial injection can permit patients increased function of their shoulder and significant pain relief.

Another type of soft tissue injection example would be one for tennis elbow. This is a condition around the elbow that involves inflammation and pain of the tendon insertion on the outer part of the elbow. Injections of steroid work very well for this region, and often times the doctor will place small holes in the bony region to enhance blood flow and healing of the area.

Another type of injection performed in the extremities is a nerve block. Let's use an example of a supra-scapular nerve block which is a nerve that can become compressed around the shoulder region. Injecting steroid medication around the area of compression may allow a patient to participate in physical therapy along with providing excellent pain relief and may help the patient avoid surgery.

Additional examples of extremity nerve blocks will include a lateral femoral cutaneous nerve block, an ankle block, or a carpal tunnel injection. Occipital nerve blocks are utilized for occipital neuralgia. Occipital neuralgia may be a significant cause of migraine headaches, and blocking the nerves in this area may provide months of pain relief. If that works well, the pain doctor may move on to a radiofrequency ablation which may provide pain relief for over a year.

When it comes to interventional spinal injections, there are a few different types. These can be grouped into 3 different categories. The 1st are injections in or around the facet joint. Pain doctors may inject medication right into the joint or potentially around the joint which is called a medial branch block. The evidence for medial branch blocks is strong and can give weeks to months of pain related along with acting as a diagnostic injection. A subsequent procedure when that injection wears off called a radiofrequency ablation may allow patients to receive pain relief for over a year.

The next category of injections are referred to as epidural steroid injections. Evidence for these injections is strong, and there are currently three different types used by pain doctors. The first is known as interlaminar injections, which is the oldest type and has been done since the 1960s. Transforaminal epidural steroid injections are the newest type performed and allow the pain doctor to get fairly close to the area of the pinched nerve with steroid medication. The last type of epidural started injection is called a caudal injection, and works very well in situations where steroid is needed to work on multiple areas of compression.

The last category of spinal injections involves procedures to remove scar tissue. This is called an adhesiolysis and may be performed under a fiber-optic camera guidance. This is the least used of the interventional procedures.

Other procedures performed by pain doctors should be placed into a category termed exotic. These would be such things as superior hypogastric plexus blocks, sympathetic blocks, and Botox injections for neuromuscular conditions.

Lastly, one of the more exciting procedures in pain management they are spinal cord stimulator's. These are permanent implants that can help provide electrical stimulation around the spinal cord and decreased pain in situations where there is no solution to caring the painful problem.

As the years go by in pain management, technology continues to improve and it is a very exciting field presently. More research is necessary to keep up with the amount of pain issues in this country and keep coming up with new solutions to help those in need.