Spinal Decompression

To solve the most complicated herniated disc and structural pain problems, three types of tissue must be specifically evaluated and repaired. These three are:

1. Passive Spinal Tissues including spinal discs, ligaments, cartilage and bones

2. Active Spinal Tissues including muscle and associated connective tissues

3. Control Tissues including both ingoing and outgoing nerves, the spinal cord and the brain and brainstem

Corrective procedures must be designed specifically for your condition to minimize the stresses on all these tissues and to optimize their function to allow your spine to be as close to normal as possible. Only then can you heal properly.

Water and nutrition must be supplied to all tissues of the body. The healthy spinal disc nucleus is 88% water. Degenerative discs are dehydrated and have abnormal function. You must begin with hydrating your body to achieve disc rehydration and reduction of musculoskeletal symptoms.

Muscle spasm prevents motion of the spine which will not allow spinal structural correction. Proper treatment will reduce these spasms and any accompanying adhesions and begin remodeling of scar tissue in old spinal injuries. This will reduce the soft tissue resistance to the structural improvement you need to make.

Then the disc must undergo alternate loading and unloading cycles to soften the hard dehydrated discs. This will temporarily remove the elastic energy from the disc so spinal change can occur. This will also aid in disc rehydration. Sometimes the use of a specially designed exercise chair such as a Pettibon Wobble Chair, will focus motion directly at the lowest spinal discs and magnify the healing process.

Spinal axial decompression may be required after the soft tissues have been prepared. Decompression is utilized to create motion throughout the spine. A unit such as the DRX-9000 Non-Surgical Spinal Decompression unit can be used for this procedure because of its' safety and comfort features.

The best spinal structural correction can only be accomplished with full spinal movement. This may require alignment of the upper body on top of the lower body using specific spinal adjustments. Most herniated disc treatment programs fail at this step and leave you with less than ideal results.

You may also use head and body weights to allow structural and postural correction of the spine. This helps strengthen the muscles of the spine,restores the normal lordosis and accelerates correction of the spine.

Once these steps have achieved most of the correction, the muscles must be strengthened to allow the curves to stabilize. As the muscles strengthen they will be better able to hold the new corrected curves.

Only then can the postural coordination patterning be programmed into your nerve system so it becomes correct and unconscious. Just like any new habit, it takes time for your body to get fully adapted to these changes.

Unless all three tissue types are fully addressed and allowed adequate time to adapt to the changes made there will be a tendency for the body to fall back into the same pattern and healing will be incomplete.

Spinal decompression has been an important part of my practice for some years now, and while it is a remarkably effective treatment for the vast majority of patients suffering from the symptoms of herniated and/or degenerated spinal discs, it is not an appropriate treatment for every patient with back pain. Sadly, the financial investment involved in providing spinal decompression services appears to sometimes influence doctors to recommend it in cases where it may not be necessary or indicated. No treatment is 100% effective, but when doctors are not as discriminating as they should be in what patients they accept, the results can be far from ideal. Even more concerning is the possibility that some patients may even get worse with this form of treatment when doctors prescribe it inappropriately for financial reasons.

Spinal decompression is an advanced form of spinal traction used in the treatment of disc-related back pain and related conditions such as sciatica. The primary difference between true spinal decompression and traction (and inversion) machines is that spinal decompression machines are set up to "trick" the spinal muscles into staying relaxed during treatment, allowing for greater changes in disc pressure than with regular traction, which has to fight the resistance of the muscles. As someone who previously used regular traction with my patients, I can attest to the fact that true decompression systems provide dramatically better results overall. Spinal decompression treatment provides excellent results for many people, but some fail to get any improvement at all, and others may even feel worse. I will attempt to explain the most common reasons for these treatment failures, and give suggestions for how to know when spinal decompression is and is not likely to help you.

Judging from my experience, the best patients for this form of treatment are the ones who have one or more bulging or herniated spinal discs and/or mild to moderate degeneration of the discs. Those patients who have previously had disc surgery still make good candidates for spinal decompression, provided they do not have any specific issues that would exclude them, such as metal implants in the spine, spinal instability, and/or some form of healing impairment at the site of the surgery. The large majority of patients who qualify under these criteria will typically get excellent results and be able to resume their daily activities without any major pain after going through the recommended spinal decompression treatment protocol.

While there are case reports that indicate complete disc ruptures can be treated with spinal decompression, in my experience, people with actual disc ruptures tend to not do very well with this form of treatment. It should be noted that even doctors sometimes incorrectly call a disc bulge or herniation a rupture. True disc ruptures (also called extrusions and sequestered discs), in which the inner gel of the disc is actually leaking out, are relatively rare, so it is good to find out for sure what your actual condition is. The simplest way to do this is to read the radiologist's report of the patient's MRI or CT scan. If you see terms like "extrusion" or "sequestered fragment", particularly when used in association with the words "large" or "severe", the patient may not be ideal candidate for decompression. This is not to say that decompression can't help in such cases, but the success rate for full disc ruptures is much lower than the success rate for bulges and herniations (which may also be referred to as "protrusions".

In addition to the importance of applying spinal decompression only in the appropriate cases, it is extremely important for the doctor or technician operating the machine to set the patient up properly for the treatment. It is very easy for a technician to get sloppy with setting up patients on the equipment, and this leads to ineffective treatment. Overall, because of the design of the better spinal decompression systems, even very poor patient set-ups rarely lead to patient injury, but mistakes in the use of the machine can definitely prevent the patient from getting the desired results and might cause a temporary flare-up in symptoms. To help avoid this problem, I recommend asking any potential spinal decompression provider you may be considering seeking treatment with about his or her training for the operators of the equipment. All operators of such equipment should have gone through a formal training program and should receive periodic re-training to help insure proper patient care.

One other consideration is the fact that some patients are not good candidates for spinal decompression treatment because of their inability or unwillingness to follow the recommended treatment protocol. In my experience, the primary reasons why a patient can't or won't follow the treatment recommendations are usually related to money and/or time.

A full spinal decompression treatment program that includes spinal decompression and other adjunctive treatments may seem somewhat expensive. In actuality, it is a much lower-cost treatment option than surgery for most people and has a statistically much higher success rate, so it can be a very good value, but nonetheless, some people try to cut down their costs by trying to reduce the amount of treatment. This can be a big mistake. In my experience, most people who complete the recommended decompression treatment protocol will get lasting relief and can safely return to their normal activities. Those who discontinue care prematurely will often relapse, and may suffer worse pain and worse damage to the disc because they resume excessively physically demanding activities before the disc has fully healed and stabilized.

Of course, some people fail to follow treatment recommendations primarily because they have busy lives and are unwilling to spend the time on getting better. This type of patient tends to miss a lot of appointments and may go long periods of time between treatment sessions. Unfortunately, the success of spinal decompression usually depends on getting the recommended amount of treatment at the recommended frequency of treatments. The effectiveness and results are not as good when people don't make time for their appointments. What some busy people fail to realize is that if they don't set aside time to properly deal with their health problem, sooner or later that health problem will deteriorate to the point where it forces them to make time to get treatment, and this often occurs when they are at their busiest and treatment is least convenient. It is my recommendation to invest the necessary time in getting better, rather than do the treatment intermittently and not get the best results.

In conclusion, spinal decompression is usually an extremely effective treatment for people suffering with pain from bulging and degenerated discs, but it is important that doctors select patients for this treatment carefully and make sure that the technicians operating the equipment get refresher training regularly. Patients need to beware of trying to reduce their time and/or money investment through reductions in treatment and to take the responsibility to follow the treatment recommendations to allow for maximum correction and healing. In my experience, when patients are properly selected and the appropriate treatment protocols are followed, the vast majority of spinal decompression patients get excellent long-term results.

A Herniated Spinal Disc is such an unbearable form of back pain that only a good comedy show, like "Friends" could make it into something laughable. When Joey had his hernia, he was in such anguish; the jokes about his situation were way funnier because of our heightened sympathy towards him. Joey, of course, was not real. When we, or our loved ones are the ones going through the distress, laughter may lighten the situation, but it is not the right fix. Treatment is the right cure.

What Is Herniated Spinal Disc And Its Treatment Options?

A Herniated Spinal Disc happens when two vertebrae in the spine exert pressure on the cushiony disc that separates them. The effect is that the liquid center of the disc comes out. It hits nerves and it causes a lot of pain, which can radiate all the way to the other parts of the body. One might, as Dr. Luis Crespo MD says on the US Spine Care website, compare a herniated disc to the oozing jelly in a donut. But, I prefer to keep my appetite.

Ultimately, (and before another painful night) a herniated back needs to be dealt with quickly because living with back pain is not acceptable. It's just unbearable! However, for some, the treatment measures seem just as awful. The "S" word is especially frightening. Patients who go in for open back surgery take a long time to recover. So why not treat back pain with a soothing and much less painful treatment instead of a treatment that makes the pain worse before it gets better?

How Can Spinal Decompression Relieve Back Pain?

Spinal Decompression helps treat Cervical Herniated Discs in the neck, and Lumbar Herniated Discs in the lower back. In each treatment, the Spinal Decompression Machine pulls lightly on a very specific part of the spine, separating the two vertebrae and relieves the pressure on the disc. This separation gives more space for the bulge to slowly repair itself with every treatment.

I think it's a relief whenever fighting pain with more pain can be avoided. If a single surgery has a long and painful recovery period, using the same amount of time for a painless treatment might be a welcomed option. Spinal Decompression has cured thousands of back pain woes, and more people can benefit greatly from this treatment. Don't be like Joey and tough it out. Instead, make treatment something to look forward to. Why not make it more bearable.

The S-I joint is one of the most misunderstood areas of the human body. It has been the source of much controversy in the medical community for many years. Much of the debate relies on the fact that there are few reliable evaluation methods for the S-I joint.

Contrary to disc injuries, which can be evaluated using many types of diagnostic tools, examining the S-I joints has proved to be quite unreliable. Clinicians need to rely mostly on their experience rather than simple methods used to examine the low back. Most medical professionals do not acknowledge it as a source of pain and dysfunction. So patients leave a medical office with an incomplete evaluation and often times, an inaccurate diagnosis.

The S-I (Sacro-Iliac) joint is comprised of two bones; the sacrum and the ilium. You have two S-I joints (left and right). They are located basically where the spine meets the pelvis. Look for the two dimples in your low back. These two joints allow for very little movement overall as compared to other more prominent joints such as your hip or shoulder. The pelvic girdle is generally described as the two S-I joints, the pubic symphysis (pubic bone in front), the two hip joints, and the bottom two vertebrae (L4, L5).

What do you feel?

Pain located at or near the S-I joint on one side or both sides. Pain located in the low back, buttock, and/or groin area. Another common symptom of a S-I joint dysfunction is "sciatica". Sciatica is best described as a sharp, often shooting pain that begins in the buttocks and goes down the back of one leg. S-I joint dysfunction may also cause nerve irritation of the nerves that supply the groin or front of your thigh.

Other symptoms include:

o Weakness in one leg or both legs; difficulty standing on one leg and raising the other leg (like marching)

o Numbness and tingling in one leg (pins & needles)

o A burning pain located near the "dimples"

o Difficulty raising from a chair

o Muscle discomfort in the buttock, hip, or low back (over 30 muscles attach to the pelvis; from the hip, buttock, thigh, low back.

How does this happen?

S-I joint dysfunction is usually caused by an imbalance in the muscles of the hips and glutes and it can also be caused by a fall or other traumatic event, such as a car accident.

A condition known as "hypermobility" may also predispose an individual to S-I joint dysfunction. "Hypermobility" is best described as a condition in which the joints have too much mobility. This condition generally affects women more than men. Different hormone levels present in women, specifically "relaxin", can influence hypermobility. This hormone is released to prepare the body for pregnancy, and its level in the blood changes throughout pregnancy process. It basically causes the ligaments to "relax" and allow for more movement to occur in the pelvic girdle region.

The best treatment options

First of all, the evaluation is critical to the success of treating a S-I joint dysfunction. Most dysfunctions can be treated with manual techniques that generally involve "mobilizations", "manipulations", or "muscle energy techniques". These techniques must be applied by a skilled medical professional, such as a physical therapist. These techniques can prove to be quite helpful when utilized appropriately following a thorough evaluation.

Once appropriate manual techniques have been administered, a comprehensive exercise program must be implemented to address the following areas, specifically muscle imbalances:

o Lumbar stabilization program: strengthening abdominals and buttock muscles

o Improve flexibility in lower extremity musculature

Some cases may only need a detailed exercise program that addresses the muscle imbalances. You can learn more about how to identify and address your muscle imbalances by visiting http://www.losethebackpain.com

Some S-I joint dysfunctions may linger on for months and even years. Remember, if you are engaged in a current treatment plan with little to no improvement, seek other options. If you think you may have a S-I joint dysfunction, the first step is to find a healthcare professional who is skilled and experienced in addressing muscle imbalances.

Conventional treatment methods for back pain patients are a large healthcare expense. Some conventional approaches focus only on the symptoms rather than the primary source of the pain. Once the source of the back pain is corrected, a patient may experience long-term relief. The following types of treatment methods are the most commonly used.

Occasionally, bed rest is prescribed for back pain patients. The downfall of this treatment method is that patients may be more likely to develop depression and experience other negative effects.

Another common treatment method for back pain is physical therapy. Certain exercises can improve the general function and strength of the spine, but may not address the primary cause of a patient's back pain.

Oral and injectable pain medications will normally function by temporarily decreasing inflammation, muscle spasm and pain. This treatment method will only alleviate symptoms, but seldom does it deal with the primary cause of pain.

One treatment method introduced over 2,500 years ago is called acupuncture. It is a form of treatment where by needles are inserted into various parts of the body, such as in ankles, knees, or fingers for the treatment of back pain.

A treatment method that attempts to correct the primary source of back pain is surgery. Some patients report significant relief of pain after surgery, but the risks involved make this option a last resort for many.

A commonly used technique is called traction. Manual traction can be performed by a therapist, utilizing their weight to change both the force and direction of pull. Auto traction is when the patient controls the traction forces by grabbing and pulling on the end of the traction table. There are other forms of traction available such as bed rest traction, underwater and gravitational traction.

A relatively new treatment method for the relief of chronic low back pain is called non-surgical spinal decompression. A highly recognized device called the DRX9000 True Non-surgical Spinal Decompression System™ [http://axiomworldwide.com/drx9000.aspx] is designed to provide pain relief for compressive and degenerative injuries of the spine. Through the application of spinal decompressive forces to these injuries, patients have found relief from their back pain problems.

While back pain is a common and debilitating condition, patients today have more treatment options than ever before.

This article is not intended nor should be used as a substitute for professional medical advice. Consult your physician before considering any medical treatment method available.

Piriformis Syndrome is caused by spasms or tightening of the piriformis muscle which irritates the sciatic nerve causing sciatic type pain. A differential diagnosis must be made to determine the cause of the disorder. A bulging or herniated lumbar disc protruding causes pressure on the sciatic nerve resulting in pain, numbness and tingling in the affected extremity, called sciatica. Treatment for a lumbar disc problem and sciatica is quite different from that needed to clear up the pain associated with Piriformis Syndrome. Anatomy of the Piriformis Muscle The piriformis muscle is connected to the sacrum, the triangular shaped bone at the base of the spine, and to the greater trochanter, the bump of bone at the top of the hip bone (femur). It is one of the muscles that is an external rotator of the hip, meaning it helps turn the leg and foot outward. The sciatic nerve runs under and sometimes through the piriformis muscle on its way out of the pelvis. The muscle can squeeze and irritate the nerve, leading to the symptoms of sciatica.

Treatment of Piriformis Syndrome

• The RICER regimen should be implemented for at least the first 48 to 72 hours after injury.
  
  
  
  • This consists of Rest, Ice, Compression, Elevation, Referral for medical evaluation.
  
  
  • This regimen may not be implemented soon enough as symptoms don't always appear for a day or two.
  
  
• After diagnosis, treatment will be started and an ice pack or ice massage may help reduce inflammation.
• Rest is usually recommended and, at least, a two or three week break from all sports or activities that cause pain.
• Anti-inflammatory medications like ibuprophen and naproxen are helpful in treating the pain and inflammation caused by the nerve irritation.
• Corticosteroid injections with an anesthetic medication may be injected into the piriformis muscle.
• Oral cortisone may also be prescribed to reduce the sciatic nerve inflammation.
• Heat Packs ease muscle spasms and reduce the inflammation.
• TENS is helpful and, sometimes, a low voltage current to the area is combined with a cold application.
• Ultra-sound Treatments provide deep heating and are ideal preparation for deep massage.
• Deep massage and specialized soft tissue mobilization may be useful.
• Custom foot orthotics can help with both treatment and prevention. Gait correction can reduce the use of the piriformis muscle, allowing the muscle to relax and begin to heal.
• A Botox injection may be used which actually paralyzes the piriformis muscle, causing it to relax, taking pressure off the sciatic nerve. Both types A and B botulinum toxin have been used. The injection is done using either Ultra-sound or a CAT 9 (computerized axial tomography) for guidance. Both toxins are effective and pain relief usually lasts for more than 3 months.
• During this time, a stretching program may be started which may correct the problem.

Exercise and Stretching Once the pain has been decreased, the next treatment phase will begin. The goal is to regain the strength, power, endurance and flexibility of the muscles and tendons that were injured. Physical therapy will involve:

• Stretching of the gluteal and piriformis muscles


• Stretching exercises will target the piriformis muscle but may also focus on the hamstrings and hip muscles to reduce pain and increase range of motion.


• Strengthening the core muscles of the back and abdomen will help reduce strain on the piriformis.

Surgery Surgery is a last resort and there are 2 methods of relieving the spasms in the muscle:

• The piriformis muscle is cut where it attaches to the greater trochanter (the boney bump on the top of the leg bone at the hip).


• The other method is to cut through the piriformis muscle itself to relieve pressure on the sciatic nerve.

After surgery, physical therapy may be prescribed for 4 to 6 weeks. Ultra-sound, massage, and electrical stimulation will help the healing process, which takes up to 3 months.

Prevention of Piriformis Syndrome
The more you can do to prevent this syndrome, the better off you will be. The most important things to remember are:

• A thorough and correct warm-up to prepare the muscles and tendons for activity. Without a warm-up, muscles are stiff and there is reduced blood flow to the hip area, making it more injury-prone.


• Let muscles rest and recover after any strenuous activity.


• Strengthening and conditioning the muscles of the hips, buttocks, lower back will help prevent this disorder.


• Keep muscles and tendons supple and flexible through a structured stretching routine.

Vertebral augmentation is a confusing term. It is an outpatient procedure that is used to treat spinal fractures, called compression fractures, that often occur from osteoporosis and are painful in a lot of cases. The vertebral body, when fractured, will often lose height, and patients often have significant pain with decreased ability to function.

The term augmentation refers to injecting a substance into the fractured bone to augment the vertebra and alleviate pain. The original procedure that was invented and still performed is called a vertebroplasty. The vertebroplasty procedure injects bone cement under pressure which fills the crevices and interstices of the bone for stabilization and hence pain relief. The only problem is with the pressure of cement injection, the liquid cement may go where it's not supposed to prior to hardening.

The augmentation procedure differs a bit. Once the instrument is carefully placed into the compression fracture under xray guidance, a balloon is introduced into the fracture area and expanded. This creates a bony void as the fracture fragments are pushed away. Once accomplished, cement is then injected under low pressure into this bony void, stabilizing the fracture just like a vertebroplasty does. The vertebral augmentation procedure is often referred to as a kyphoplasty.

The procedure may or may not allow for some height to be restored to the fracture. This has not been borne out in the literature yet to matter for resultant clinical benefit. Both the vertebroplasty and vertebral augmentation procedures have been shown in the literature to both have excellent results with small risks (although these risks are very real).

Prior to undergoing the procedure, it may be prudent for a patient to try a spinal brace or other nonsurgical methods of pain relief.

It is truly remarkable what fluoroscopy has done for the field of interventional pain management. Fluoroscopy is a fancy term for the x-ray machine that allows real-time images during treatment.

Fluoroscopy has allowed more accurate needle placement as well as allowing the field of pain management to venture into new treatment avenues. During pain management procedures, doctors can now inject contrast material and see exactly where their needle is on a real-time basis, as opposed to the traditional way of getting just a regular x-ray.

Studies have shown in the past that epidural injections performed without fluoroscopy have upwards of a 30 to 40% miss rate which in effect is a huge disservice to patients. Therefore, a lot of pain doctors consider a fluoroscopy machine to be the standard of care during epidural injections. If you are a patient receiving an injection, don't you want the optimal chance of successful placement?

New procedures that have come about over the last decade or so that have benefited from fluoroscopy include spinal cord stimulators, vertebroplasty, and minimally invasive lumbar discectomy. When a pain doctor is in a tricky area for an injection, injection of dye may reveal whether or not needle placement is correct. It also saves time as you can see right away in real time whether or not you can go ahead and inject the final medication. You can also see with fluoroscopy fairly well whether or not the needle is located inside of a vascular structure.

Fluoroscopy machines can be moved in multiple different directions which can be extremely helpful if the patient has scoliosis or other aberrant anatomy. It also can be varied with its intensity which can be extremely helpful if the patient has a lot of excessive tissue to go through. As patient size increases the image quality goes down and the newest fluoroscopy machines are extremely good at optimizing the quality of the images generated.

Studies have shown that if an individual stands over 6 feet away from a fluoroscopy machine, well over 90% of the radiation dissipates by the time it reaches that distance from the machine. This is not to say the fluoroscopy is not amidst potentially harmful radiation, and anyone is going to be in the room where procedures are being done should wear lead both on their torso and thyroid.

There are practitioners who tend to over utilize fluoroscopy during procedures. Radiation training for staff is extremely important. With the new procedures made possible fluoroscopy and the increased accuracy allowed with the technique, usage of fluoroscopy is now similar to a cell phone, what would we do without it?

Epidural cortisone injections represent an excellent treatment option for pain management patients suffering from spinal nerve irritation, which is also termed radiculitis.

The injections work well for leg pain coming from herniated discs along with radiculitis coming from the various different types of spinal stenosis, including foraminal, central, and lateral stenosis. Also, epidural injections work well for radiculitis coming from disc problems. Can epidurals work well for back pain? Yes they can, but mostly they are for leg pain problems.

Cortisone spinal injections are really meant to get patients "over the hump". Cortisone puts "water on the fire" so to speak, allowing patients into rehab more comfortably and hopefully work and play with their kids and socialize. The cortisone doesn't fix anything but they can temporarily do well with pain control.

Until we come up with something better, predominantly cortisone is injected. How well does it work?

It works by neural membrane stabilization along with blocking phospholipase A2 activity, and inhibiting neural peptide synthesis.

Local anesthetics by themselves have been shown to produce a prolonged dampening effect of the dorsal horn and c-fiber activity. This may provide excellent pain relief by themselves without cortisone.

Fluoroscopic guidance is the current standard of care with epidural cortisone injections. Multiple studies have shown upwards of a 35% improper placement outside the epidural space without fluoroscopy.

Here are the different types of injections along with some facts on each:

1. Caudal epidural injections - Indications include when it's tough to get to the other approaches with intra-laminar or transforaminal approaches. Usually administered in post-surgical patients when transforaminal technique is not possible. There are also indications for a caudal injections with pelvic pain. These injections are least technically demanding. Need a larger volume to hit the targets, usually 10 milliliters are needed to reach L5-S1 and over 20 milliliters are need to reach above L4-5. The miss-rate without fluoroscopy for caudal epidurals is 40% according to the literature.


2. Interlaminar Epidural Cortisone Injections - This type of injection allows for administration of medication to higher lumbar levels. One of the biggest downsides to interlaminar variety is that it has the highest incidence of dural tears which may lead to headaches (5%). Advantages include being fairly technically simple. It does require physicians being familiar with the "loss of resistance" technique. It also allows for delivery of medication to areas higher in the spine than the caudal route. Frequently these injections are performed blind, without fluoroscopy, and this is a disservice to the patient. Research shows 30% misplacement without it.


3. Transforaminal ESI - The indication for TESI is for radicular pain, with the rationale being delivering the drug in maximum concentration and closer to the site of pathology. There are multiple studies demonstrating the efficacy. Disadvantages include very rare events of bad things happening. These injections are technically the most demanding, and there is a slight risk of direct nerve trauma. A study by Weiner in 1997 showed that these injections may be surgery sparing. There was a 46% rate of achieving complete pain relief. Multiple studies have shown that 2/3 of patients have been able to avoid surgery with these interventions. A 2010 study by Bogduk et al was a prospective randomized blinded study looking at transforaminal epidurals with cortisone plus anesthetic, versus anesthetic alone versus saline in the epidural space. The study also looked at intramuscular injections without epidural injection. Well over 50% of patients received over 50% pain relief for the epidural injection with cortisone and lidocaine. Twenty five percent of the patients ended up pain free completely. The other groups achieved between 7% and 21% pain relief, so much less.

Even if you have only just started taking over  the counter painkillers for back pain, it will be to your advantage to look into spinal decompression. Unfortunately, acetaminophen is one of the most common medications used for backaches.  At the same time, it is also widely known for causing heart attacks and other types of cardiac damage. 

On the other and, if you use painkillers that include ibuprofen, you will most likely suffer from stomach damage. Regardless of the painkillers that you use, every single one causes kidney damage. 

By contrast, if you go for computer guided spinal traction, you will not need to worry about ingesting drugs that will cause permanent damage to your body. Instead, your spine will be gently realigned in order to create an optimal shape.  As spinal tissues readjust and heal, you will no longer feel pain. In many cases, this relief can last a lifetime.

Today, few people realize just how dangerous painkillers really are. 

As may be expected, when you are in pain, you will feel driven to make it stop as quickly as possible. While you may need to take painkiller to relieve back pain, you should also take steps to solve the actual problem. Regardless of what you may think of certain kinds of therapy, you should at least do what you can to try out the least invasive ones. 

In particular, if you try spinal decompression, you may just find that it will solve all of your back pain issues.

If you have any interest in inversion therapy, you probably already know about inversion tables and benches. What you may not know is that inversion chairs/recliners also exist. The most obvious difference between an inversion chair and table is that the chair doesn't allow you to hang freely during inversion, since you are in a sitting position. Unlike inversion boots and tables which allow full, 90-degree, inversion, a typical inversion therapy chair only allows an inversion of about 70 degrees. So why would anyone pick an inversion chair over an inversion table, you ask?

Most of the people who choose to go with the chairs are either afraid of falling to the ground or have really painful ankles which would make hanging upside down by the ankles extremely uncomfortable. Recliners have several safety belts including one that goes over you lap making you feel more secure. In addition, doctors often advice individuals who have certain back problems and heart problems to use chairs for inversion therapy.

Contrary to popular belief, just because the chair doesn't allow 100% inversion doesn't mean that the degree of spinal decompression will be affected. That's because the degree of spinal decompression depends as much on the amount of weight below the lower back during inversion as it does on the angle of inversion. Therefore, whether you use a chair or a table, the amount of weight below the lower back will remain the same. The prices of inversion recliners are just about the same as those of inversion tables. For this reason, price isn't really a factor to consider when choosing between inversion tables and chairs.

Obviously, one of the most notable disadvantages of an inversion recliner is that you can only invert to about 70 degrees. Though this will not affect the degree of decompression, you may not receive the full benefits of inversion therapy. Secondly, it is nearly impossible to perform back strengthening exercises while sited. Thirdly, being strapped to a chair by the ankles isn't exactly the best experience. For most people, it feels as if they are being held against their will thus they may end up having a panic attack.

In conclusion, if you are a perfectly healthy individual, you would be better off using an inversion table or bench. This way, you can enjoy a wider range of inversion therapy benefits for roughly the same price. If you are a little nervous about using an inversion table on your own, try visiting a gym and using an inversion therapy table under the supervision of a certified trainer.

Back ache is a very common problem nowadays, and almost every individual faces lower back pain at least once in a life time. It can be caused by a number of factors, and can affect your life to quite an extent. The best cure to back ache is care.

Here are some tips for reducing the back ache:

1. The best way to sleep is on your side with your knees bent. You can use a pillow under your head to support your neck. You may also put a pillow between your knees.

2. If sleeping position doesn't reduce pain, try adjusting your sleeping surface. The choice of the firmness of the surface varies from person to person. Choose the one that suits you the most.

3. In case you have to stand for long periods, rest one foot on a low stool to relieve pressure on lower back. Switch your foot every 5 to 15 minutes. If case you have to stand with both feet firmly placed on ground, for example in case of a security guard, place both your feet inline with your shoulders.

4. While sitting (in your office) maintain a good posture by keeping your ears, shoulders and hips in a straight line, with your head up and stomach pulled in. Keep your lower back and feet supported, elbows at sides, shoulders relaxed and wrists straight. Don't forget to stretch occasionally.

5. Wear flat shoes and low heels.

6. Exercise regularly. An inactive life style can also lead to lower back pain.

7. If you sleep on your back, you can place a pillow under your lower back.

8. Heating pads can help relax painful muscle spasms. Use heat for 20 to 30 minutes at a time. Massage can also be helpful in most of the cases.

9. Remember, lower back pain can be caused by using your back muscles in activity they are not used to, like lifting heavy furniture or twisting your body. It can also lead to a disc slip, a condition knows as herniated disc.

10. Push rather than pull when you must move heavy objects. Don't lift by bending over. Instead lift by bending your knees and squatting to pick the object. Avoid twisting your body while lifting.

Just follow the above mentioned easy tips to cure your back ache. In case you don't feel any relief, please seek medical help immediately.

Spinal Stenosis is a medical condition that is found mostly in elderly people. The spinal canal, which stretches from the bottom of the head to the top of the pelvis, might become narrow and the spinal cord and nerves get compressed. This causes low back pain, pain or numbness in legs, thighs and buttocks, and sometimes loss of bladder and bowel control in severe cases.

The spinal canal consists of a number of vertebrae aligned together like a stack. The spinal canal may be divided into cervical spine (in the neck), thoracic spine (the mid back) and lumbar spine (the lower back). The spinal cord passes though the spinal canal. There are nerves coming out from the spinal cord and between the openings (known as foramen) in vertebrae, spreading out to the whole body. The nerves from spinal cord in the cervical region control the arms the nerves from spinal cord in the lumbar region control the legs. Spinal Stenosis is more common in cervical and lumbar spine. Lumbar spinal stenosis causes pain and numbness in legs whereas cervical spinal stenosis can cause pain and numbness in arms, shoulders and legs.

The foremost reason for narrowing of the spinal canal is a gradual degeneration of the spine with age. The gradual changes in bony and soft tissues of the spine may result in spinal stenosis. Osteoporosis or a tumor can also put pressure on the spinal cord and nerves. Arthritis can settle in with age and also affect the spine. This can cause cartilage wear and tear between the bones on the joints of the vertebral column. The discs between the vertebrae might bulge out or ligaments can also thicken in some cases. This cramps the space available for spinal nerves and spinal tissues, resulting in pain and numbness in lower back or legs. Such arthritis only worsens with time and if not treated promptly, can result in loss of bladder and bowel control. If one vertebra slips forward on another, that can also cause spinal stenosis.

Treatment for spinal stenosis depends on the severity of the condition. It is always advisable to start with a non operative course. Medication needs to be taken to reduce inflammation and pain. Some medications meant for nerve pain are particularly helpful. Physiotherapy can also be tried as a treatment option. Application of hot and cold packs can also help. Steroid injections for the lumbar spine can provide relief but should be taken in moderation. A corset can be worn to support the abdominal muscles.

If there is no improvement with these treatments or if the patient experiences loss of bladder and bowel control, it is better to opt for surgery to avoid damaging the spinal tissues permanently. Generally, Lumbar Decompression Surgery is needed to remove whatever might be cramping the nerves in the spinal canal or vertebral foramen. A small portion of vertebra may be removed so that spinal tissues are freed. If the number of restrictive structures to be removed is much, it can cause spinal instability. In such a case, a spinal fusion is required to attach the vertebrae together. This surgery can successfully eliminate the pain and numbness in legs.

Piriformis Syndrome is a condition in which irritation of the sciatic nerve causes pain in the buttock, radiating down the leg. The main difference between Sciatica and Piriformis Syndrome is the cause. Sciatica is due to pressure on the sciatic nerve from a bulging or herniated lumbar disc. With Piriformis Syndrome, the irritation of the sciatic nerve is due to spasms or tightening of the piriformis muscle, resulting in pain. The piriformis is a small muscle located deep within the hip and buttocks region. It connects the sacrum, which is the 'tailbone' or lower end of the spine, to the top of the femur, the hip bone. The piriformis muscle aids in external rotation, turning out, of the hip, leg, and foot. The sciatic nerve usually passes underneath the piriformis muscle but, in approximately 10% to 15% of people, it travels through the muscle. In both cases, spasms and tightening of the muscle irritate or pinch the sciatic nerve, causing painful symptoms. Symptoms of Piriformis Syndrome

- Pain deep within the buttocks
- Pain becomes worse with sitting, climbing stairs, performing squats.
- Sitting is often difficult and the patient can't sit flat on a seat.
- Sufferers tend to sit with their weight off the painful buttock, which is tilted up off the seat.
- Sciatica type pain radiating from buttock down thigh, calf, possibly to foot
- Numbness and muscle weakness may develop in affected limb.

Causes Of Piriformis Syndrome Contractions and spasms of the piriformis muscle cause the pain and pressure on the sciatic nerve. The most common reasons for this are:

- Improper stretching or warming up before exercising
- Overly-strenuous exercises
- Prolonged sitting - sometimes sitting with a wallet or pressure causing object in the hip pocket
- Exercising on a hard surface, like concrete
- Exercising on uneven ground
- Increasing exercise intensity or duration too quickly
- Exercising in worn or poorly fitting shoes
- Excessive running or bicycle riding, unless accompanied by lateral strengthening and stretching exercises
- A fall onto the buttocks

Diagnosing Piriformis Syndrome A differential diagnosis must be made to determine the cause of the sciatica pain. It includes:

- Complete History and Physical Exam
- Checking to see what movements cause pain
- Evaluating sufferer's posture and gait
- Past history of any injuries or arthritis
- Review patient's exercise habits
- Evaluating muscle strength and reflexes, any other spine conditions
- Lab work may be done to rule out arthritis or infection
- X-rays of the lower back and pelvis, lumbar spine and hips
- A MRI (Magnetic Resonance Imaging) to give a detailed picture of the spine and soft tissues
- Neurography is like a MRI but it examines nerves for irritation. This is often helpful in diagnosing Piriformis Syndrome.
- A Bone Scan will show injuries, inflammation, or infection.
- The most accurate method of diagnosing the syndrome is a diagnostic injection into the muscle with the help of a fluoroscope. An anesthetic is injected into the piriformis muscle and if the pain subsides, the diagnosis is confirmed.

This would have no effect if the cause of the sciatica was pressure on the sciatic nerve from a lumbar disc.

Spinal decompression therapy is a non surgical treatment for chronic lower back pain caused by degenerative disc disease, herniated disc or other deformities of the disc. This treatment is also adopted for pain in the neck, arms or legs and involves reducing the load to the spine. Spinal decompression therapy is otherwise called Vertebral Axial Decompression (VAX-D). In the early days, major surgeries were the only relief for chronic lower back pain. Now we can avoid surgeries by making use of spinal decompression therapy. This therapy has an FDA approval for lower back ailments. This treatment is adopted for treatment of conditions such as pain in the lower back, buttocks, and hip with or without numbness in the foot or leg.

Spinal decompression therapy is meant for patients suffering from back pain due to herniated disc for more than four weeks. Those having recurring back pain even after back surgery, which is more than six months old, can also make use of spinal decompression therapy.

Medical researches have supported decompression therapy as recent studies have proved it to be safer and more effective than spinal surgery. Sciatica, spondylosis, degenerative disc disease, herniated discs, soft-tissue spinal stenosis, and facet arthropathy are caused by compression of discs. Spinal decompression therapy offers the best treatment for these conditions.

A bulging or herniated disc can cause excruciating pain in the lower back portion. This can be returned to the normal condition using spinal decompression. Spinal decompression lengthens the bulging disc by placing traction. This activity helps the disc absorb the nutrients required to heal the disc. This is done by producing a negative pressure inside the disc. Thus the pain and discomfort produced by the bulging disc is eliminated.

The cost for spinal decompression therapy is only about 10% that for lumbar surgery, which makes it an economical option. It is ideal therefore to opt for spinal decompression therapy for a more effective and safer treatment involving minimum cost and in minimum time.

What is sciatica? Sciatica is one of the most difficult conditions for medical practitioners, even those experienced in treating back pain and sciatica patients, to identify and treat. Sciatica often presents itself as a tingling and/or numbness, not unlike the feeling one may experience with a pulled hamstring muscle, the biceps femoris at the back of the leg. The sensation may be dull, almost an ache, with periods of tingling and/or numbness occurring during certain activities. The tingling and/or numbness experienced, if not treated, may develop into a full-blown chronically acute phase with pain shooting across the buttocks and radiating down the leg. Sciatica may affect one or both legs, usually one, beginning as a pain radiating from some point in the lower back, the lumbar spine, then across the gluteal muscles (the buttocks), and finally down the back of the leg. In advanced cases, sciatica reaches all the way into the feet and toes, causing discomfort and an eventual loss of feeling.

Interestingly, sciatica is not a specific condition, it is simply a catch-all medical term applied to a constellation of symptoms in order to describe a state the back pain sufferer is in. In this case, sciatica is used to describe a patient's complaint of pain radiating across the buttocks, down the leg, and into the feet and toes...along with the associated tingling and/or numbness. Sciatica may be caused by a number of conditions, from stress and trauma at a specific location on the spine, the lower back or lumbar curvature, to a more generalized condition such as obesity or pregnancy. There are a number of other conditions associated with sciatica, all requiring varying degrees of medical intervention and treatment. Some of the conditions likely to present with sciatica are:

1. Osteomyelitis: An infection of the bone or bone marrow. Osteomyelitis may be debilitating and in extreme cases may even cause death. It is difficult to diagnose and may go undetected for a long time unless appropriate blood tests are ordered and the medical practitioner is well trained in infectious diseases affecting the bones.

2. Tumors on or near the spine: Tumors, particularly tumors or abnormal growth (e.g., scar tissue) affecting the nerves or nerve roots as they exit the spinal canal and intervertebral foramen, will sciatic nerve pain or sciatica.

3. Degenerative Disc Disease: Once again, degenerative disc disease is not a disease any more than sciatic nerve pain, called sciatica, is a specific condition. Degenerative disc disease is a breakdown of the IVDs, the intervertebral discs, and is usually a consequence of aging combined with the any or all of the 5 principal factors affecting the spine as we age.

o Excess weight and/or obesity

o Muscle weakness

o Muscle Imbalance

o Inadequate nutrition and diet

o Inadequate hydration or dehydration

4. Herniated (i.e., ruptured) or bulging disc: This condition may be particularly problematic if the herniated disc or bulging disc is protruding posteriorly (to the back) and into the spinal canal, or impinging on the nerve root at the intervertebral foramen, thus placing pressure on the spine and/or nerve root; and, sciatica is the result in many instances.

5. Piriformis syndrome: We will cover the piriformis syndrome and how it relates to sciatica in depth in a subsequent video and article. Recent research has demonstrated that this little-known syndrome, at least in the lay community, may be a factor in as many as eight out of ten sciatica cases. The piriformis muscle works particularly hard in runners and others who are physically active, often resulting in RMI or repetitive motion injury.

6. Spinal stenosis: This is a narrowing of the spinal canal and/or intervertebral foramen. In fact, any narrowing of a structure can be defined broadly as a stenosis. The stenosis, the narrowing affects and/or obstructs the pathway for nerves, thus exacerbating pain...in this case creating the sciatic nerve pain associated with sciatica.

7. Spondylolysis: In layman's terms, it is a stress fracture at the back of the vertebra, the vertebral body (the front part) breaks away from the back part of the vertebra (everything else). In osteological terms, the break occurs at the pars interarticularis of the vertebra, usually at the fifth lumbar vertebra, the last vertebra before the lumbar spine articulates with the sacrum or tailbone. This is usually associated with spondylolisthesis, the next contributor to sciatic nerve pain.

8. Spondylolisthesis: Usually associated with spondylolysis in younger back pain and sciatica patients but may present without spondylolysis in older adults. Spondylolisthesis is the result of an anterior (forward) shift in the vertebra body, in fact the entire vertebra when spondylolysis is absent, or the vertebral column in relationship to the remainder of the vertebral column below. There are a number of reasons why this condition may occur but in younger patients it is usually found with spondylolysis. We will discuss this condition in depth in a subsequent article and video but suffice it to say that any change in the overall structure of the spine, particularly at the lumbar curvature, will create sciatic nerve pain.

9. Trauma: Trauma and stress go hand in hand when it comes to back pain and sciatica. Trauma may be localized, meaning the spine will take the brunt of the stress at a specific location, or it may be generalized and affect several levels simultaneously. The better equipped we are in terms of muscle strength, muscle balance (or imbalance), and the other factors affecting spine health, the better equipped we will be to handle appropriate levels of stress. The IVDs are remarkably resilient and very strong but if the discs undergo change as a result of any of the 5 factors listed above, or the traumatic event is profound enough, damage to the spine may occur; and, sciatica may be the outcome. In this case, a medical practitioner should always be the first step in any bad back treatment strategy.

In reality, any one of the factors above, or several of the above mentioned conditions together, may cause low back pain and sciatica. Sciatica is, once again, the presentation of a specific type of pain. The actual condition causing the sciatic nerve pain may be any of the above or a number of other conditions not discussed here; these are some of the main ones.

Your medical practitioner may refer to sciatica as radiculopathy, particularly lumbar radiculopathy, because sciatica originates in the lumbar curvature or lumbar region of the spine. This has become a catch-all, in much the same was sciatica has; and, both are used when a more appropriate designation should be applied. But for now, understand that if your medical practitioner refers to sciatica and/or lumbar radiculopathy, he or she is usually referring to pain radiating from the lumbar region of the spine, at times across the buttocks, down the back of the leg, and even into the feet and toes. We will discuss sciatica in much greater depth in upcoming articles and videos.

If you are looking for a program that will burn fat and build muscle this is the exercise routine for you. This workout is designed to work your entire body at the same time.

The problem with most exercise regimens is that they break up the body into compartments. On Monday they have the work your legs, your back on Tuesday, your chest on Wednesday, your shoulders on Thursday, and biceps and triceps on Friday. And of course they will mix in a bunch of exercises throughout the week end 60 minutes of cardio four to six times a week.

My problem with this type of workout schedule is that there are not many physical activities that you will do in the course of the day that does not require you to use your body as an entire unit. That is why my programs require the use of your whole body.

Here was the program:

• Jog for five minutes as a warm-up


• 25 Hindu push-ups


• 35 jump squats, holding a dumbbell in each hand, if possible, for extra resistance


• Sprint 40 yards as fast as you possibly can


• 30 V-ups


• 30 Burpees


• One minute of mountain climbers


• 35 jump squats, again holding a dumbbell in each hand and possible


• Sprint 25 yards as fast as you can


• Bear crawl for 50 yards


• 20 reverse push-ups


• 50 jump squats, holding a dumbbell in each hand and possible. If you can do more than 50 jump squats continue till you reach value.


• Walk for 10 minutes as it cool down.

So there you have it. By high-intensity entire body exercise routine that will burn fat and build muscle.

Of course, before you do this exercise routine please consult your doctor.

Arnold Chiari (pronounced key-are-ee) Malformation is a rare malformation of the brain located in the area where the brain and spinal cord connect. This malformation occurs when the cerebellum is too large to fit within the confines of the skull.

When the cerebellum is over-sized, the cerebellar tonsils are forced to extend down into the spinal cord canal through the small opening in the base of the skull. As the cerebellar tonsils elongate, they may restrict or cut off the normal flow of cerebro-spinal fluid of the brain and around the spinal cord as well as apply pressure to the brain stem and the top of the spinal cord. This condition is usually a congenital abnormality but there have been a few reported cases of spontaneous development due to trauma.

According to the Duke Center for Human Genetics, "The affected regions of the brain are the lower brainstem and cerebellum. The lower brainstem controls breathing, swallowing, balance, the vocal cords, eye movements, and sensation and movement of the arms and legs. The cerebellum's most important function is to coordinate body movements."

The symptoms of Chiari vary with each individual and are quite extensive. Most commonly, Chiari patients have some or all of the following symptoms:

• Headache in the back of the head that may radiate behind the eyes and into the neck and shoulders.


• Disordered eye movements, vision changes.


• Dizziness, autonomic symptoms (orthostatic intolerance, NMH).


• Muscle weakness.


• Unsteady gait.


• Cold, numbness and tingling in the extremities.


• Chronic fatigue.


• Tinnitus (ringing, buzzing or watery sounds in the ears).


• Sleep apnea.


• Speech impairment.


• Hearing loss.


• Gastrointestinal problems, irritable bowel syndrome, frequent urination.


• Lack of gag reflex, difficulty swallowing.


• Symptoms are exacerbated by exertion, and especially by leaning the head backward or coughing.


• and the list continues beyond the symptoms listed above...

Some patients with Chiari have no visible symptoms. For these patients, careful monitoring by a neurologist or neurosurgeon is all that is needed. These patients may live a full life with no adverse effects appearing. Other patients with the adult onset variety of Chiari Type-I will begin to exhibit symptoms in their late 20's or 30's. For most people who are exhibiting symptoms, surgery is the only option available to help stop the progression.

Generally, the surgery is meant to decompress the area of the brain that is being squeezed. Surgery to correct the malformation may not be able to reverse any neurological damage that has already been done. Once the pressure has been relieved, the patient may see some of their symptoms lessen or disappear.

The long-term effects of the surgery are still being studied. However, surgeons will not guarantee that symptoms will disappear after the surgery, or that symptoms, either old or new, will not return in the future. The main goal of the surgery is to attempt to prevent the patient from worsening from their current neurological status. For some patients, a second decompression surgery will be needed some years after the first surgery was completed.

As a person living with Chiari, I can not stress enough the importance of finding and staying with a neurosurgeon that specializes in dealing with Chiari. This is a complex disease. Receiving the wrong medical advice can be extremely detrimental to your health. To find qualified medical care near you, I suggest that you join a Chiari support group and ask the other members for their help and guidance.

The support group that I belong to and rely on is very active and is filled with helpful, sympathetic, and concerned group members. The members have been where you are now and are eager to share their stories and advice.

Studies have determined that the most common causes of recurring low back and neck pain are problems related to the spinal column. Unlike musculoskeletal ailments, degenerative disc diseases can cause intolerable back pain that can render one completely immobile and bedridden. Thanks to spinal decompression treatment, there is a new ray of hope for people suffering from chronic back pain. The question that often arises is as to how many spinal decompression treatments are required before a patient gets relief. This would largely depend on the condition of the patient. Treatment sessions last about 30 to 45 minutes, and frequent sessions may be essential to ensure the best results.

Effective Non-surgical Treatment for Back Pain

Spinal decompression is a non-surgical, traction based treatment for almost all kinds of major back pain. It is an advanced modality which constitutes a specifically designed table connected to a computer controlled workstation that can be programmed to effectively decompress structures in the spine that cause major pain and discomfort.

This decompression traction therapy decompresses the inter-vertebral discs and facet joints within the spinal column with a gentle stretching and relaxing motion. This causes a vacuum effect within the disc, which draws back displaced disc material to relieve pressure on nerves and replenish the spine with essential nutrients, fluids and oxygen to aid in the healing of the damaged disc. Spinal decompression also helps strengthen the spine and provide stability.

Spinal decompression is an FDA approved treatment. Safe and gentle, it quite effective in relieving chronic pain symptoms such as tingling, burning and dull sensations. Patients experience notable improvement in their medical condition in as few as 3 to 4 visits with hopefully, full relief by the end of the treatment program. The total number of sessions required would vary among patients, depending upon the severity of the condition. In most cases, physicians recommend about 2 to 3 visits per week with each session lasting about 30 to 45 minutes.

Spinal decompression treatment works best for patients diagnosed with the following medical conditions:

• Nerve Compression
• Lumbar Disorders
• Lumbar Strains
• Sciatic Neuralgia
• Herniated Discs
• Injury of the Lumbar Nerve Root
• Degenerative Discs
• Spinal Arthritis
• Lumbar Instability

It is equally effective for patients who have not had much success with back or neck surgery.

Pain Relief through Maximum Therapeutic Benefit

Spinal decompression treatment has great therapeutic benefits and in most cases, patients do not require follow-up treatment. The cost depends on the number of sessions and duration of the treatment. This is one of the factors that cause patients to ask the question: how many spine decompression sessions are required before relief? Most health centers recommend a package of therapies for the best results. As with any comprehensive pain management or rehabilitation program, your physician may recommend home exercises along with modifications in some daily activities for long-term pain relief. Periodic visits to the doctor's office would help physicians evaluate improvements in your spinal health and reduce the possibilities of recurrence.

At any one point in time, cervical radiculopathy from a pinched nerve affects millions of Americans. It involves a burning, searing type of pain that goes down an invididual's arem, resulting from a "slipped" disc in the neck pushing on an a person's nerve root in the cervical spine. Can it cause permanent nerve damage?

The answer is yes. If you take your finger and push on a nerve root of the neck while a person is awake, it will not hurt. That would be an impossible experiment to perform, but the point is that neck radiculopathy does not come from nerve roots being compressed. It comes from the inflammation that is sparked up by the pinching.

The inflammation elicits pain and it often travels through the region where that nerve root has its path for supplying sensation. For various cervical nerve roots, that may be part of the forearm, or part of the hand. These regions supplied vary slightly between individuals, and not all patients are similar to a textbook drawing.

If a neck disc herniation is pinching a nerve root, eliciting inflammation, and ending up with radiculopathy pain, it may also lead to numbness or pins and needles. These symptoms are painful and annoying to patients, but do not mean surgery is required. With these issues the surgery becomes a quality of life decision.

If conservative treatments do not work, surgery has about a 95% chance of alleviating pain. Even a successful surgery may not take away the numbness. A large amount of individuals have numbness that simply will not go away, even if the surgery was technically done perfect. Most people don't care as long as there is no more pain.

This is tough to predict, and is not the surgeon's fault of the surgeon. It's the person's body's fault. If an individual develops muscle weakness from the cervical nerve root being compressed, and it does not get better over 2 months, surgery should be considered. The reason is that the longer the neck muscle weakness persists, such as a bicep weakness, the higher the chance it will not improve after an operation. Even if the operation is performed perfectly.

Epidural steroid injections into the neck may allow individuals to avoid surgery. They may allow two things by reducing the inflammation around pinched nerve roots. They may relieve pain, and maybe permit the muscle weakness to to get better.