Spinal Decompression

What is a slip disc?

A disc is said to be slipped when it bulges or tears out of its protective ring of connective tissue. It is also called bulging disc, ruptured disc or herniated disc.

Slip Disc Treatment

The pain can most often be treated by addressing the causes that led to this condition.

1. Self treatment

Simple home treatment like hot and cold applications accompanied by rest can often relieve the pain caused by minor cases of slip disc. The patient may also take over-the-counter anti-inflammatory medication and pain killers like Tylenol and Advil. Simple exercises that strengthen and stretch the back may provide a lot of relief. Physiotherapy and massage may also help, if required. 95% of the people are cured by these simple steps.

2. Change in life-style

Overweight people may also suffer from slip disc. The excessive flesh around the waist causes strain on the lumber spine which supports the entire weight of the upper body. When the discs in the vertebrae come under pressure, they tear out of their boundary and press against the nerve roots. Obesity often occurs due to lethargic lifestyle and uncontrolled eating habits. Eating vegetables and fruits, taking physical exercises regularly and positive thinking can go a long way in reducing the weight and pressure upon the lower back.

Medicines

If the do-it-yourself efforts fail to treat the slip disc, the patient may take non-steroidal anti-inflammatory drugs and narcotic pain killers. This may be accompanied by muscle relaxants if the person is suffering from spasmodic pains in the back.

Injections

If the oral medicines do not work, patient may have to take steroid injections into the lower back area where the slipped disc has occurred. These injections generally have to be taken once in every three months. The medicines or injections should only be taken at the advice of the doctor.

Surgery

Surgery should be considered only as the last option when every other method has failed. It should be confirmed through tests that the slip disc will cause a potential damage to the nerve roots. Even in surgery, there are several options. You can consult the spine specialist which option will work best in your condition.

One of the many degenerative diseases that are evident in old age is Cervical Spondylosis. This condition attacks the cervical bones responsible for bending and rotating the neck by forming bone spurs or osteophytes. Sometimes, the condition is also termed as Neck Arthritis. The earliest clinical manifestations of the disease are headaches, neck pain and stiffness. Some people's disease manifestations, however, do not show clinical signs of development until it is elaborately diagnosed with a simple neck x-ray.

Severe cases of Cervical Spondylosis show neurologic and physiologic symptoms that may already alter body functions. Some of these severe manifestations include neck pain that is not relieved by drugs and other homeopathic remedies. Difficulty in swallowing, medically termed as dysphagia, can be dangerous and is observed when the developed osteophytes in the neck area compress the esophagus. Loss of balance may also be an issue when standing and moving about. Bowel and bladder incontinence can be disturbing as it affects excretion of toxins from the body.

Surgery can be the final option when the neck pain persists and radiates in the arms and back. However, some older people believe that this does not work up until advised by experts. Primarily, surgery is done if neurologic symptoms such as falling, weakness and numbness are observed. Your surgeon has the discretion of how to approach the spinal cord which has three areas: the front, rear and side. Usually, some portions of the cervical disc are excavated along with some osteophytes.

The type of surgery that will be used can vary depending on the underlying origin of pain and nerve damage including a narrowed spinal canal or a slipped disc. Here are each of the surgeries and overviews of each of the processes. Laminectomy is one of the most common procedures where a small incision is made at the back of the neck removing bone pieces contributing to spinal cord compression. Foraminotomy, on the other hand, is done by cutting a nerve root at the back of the neck. When a whole osteophyte or bone lump is removed, discectomy is performed.

A new kind of surgery, the Prosthetic Intervertebral Disc Replacement, is performed by removing a worn-out spinal disc and replacing it with an artificial disc to do the same function. This procedure has brought promising results to patients. However, there are still no data on how well it works on a long term basis.

The sciatic nerve, which is the largest nerve in the body, originates from your lower back and travels under the buttock muscles all the way down the legs and feet. When it is being pressed on, it gets inflamed or irritated which may give rise to painful symptoms. This pain is called sciatica.

Most people obtain relief from sciatic nerve pain without resorting to surgical treatments. In addition, they are able to return to their usual activities after a few weeks of having nonsurgical spinal decompression. Even more, many patients who underwent disc decompression experienced very good results.

Sciatic Nerve Pain

Sciatica is a painful symptom caused by an irritation of sciatic nerve. The pain is usually felt at the back of the thigh. Herniated disc, which is the most common cause, presses the nerve and cause it to get irritated or inflamed.

Symptoms

The pain from sciatica may vary from infrequent and irritating to severe and debilitating. Sometimes the sensation is like a jolt or electric shock. It may get more painful when coughing or sneezing. Symptoms may aggravate if you are sitting for a long period. Usually, only one lower extremity is affected.

Common symptoms of sciatica include:

• Pain in the rear or leg that becomes worse when sitting
• Burning or tingling sensation down the leg
• Weakness, numbness, or difficulty moving the leg or foot
• Constant pain on one side of the rear
• Shooting pain that makes it difficult to stand up

Herniated Disc

A spinal disc problem, herniated disc is the most common cause of sciatica. Spinal discs are pads of cartilage located between the vertebrae. Filled with a gel-like material, they maintain flexibility of your spine. The discs cushion your vertebrae to absorb stress when you move.

However, if the disc's outer covering tears or herniates, the gel may ooze and press on a nerve root. Constant pressure irritates the nerve and can cause swelling and inflammation and the symptoms will start to occur.

Nonsurgical Disc Decompression

Nonsurgical spinal decompression is a type of motorized traction that therapeutically helps in correcting disc-related problems. It works by gently stretching the spine, taking off pressure from spinal discs. The negative pressure of decompression retracts the bulging or herniated disc, eliminating the pressure from the affected nerves. The negative pressure also draws in nutrients, water, and oxygen into the disc to promote hydration and healing.

Using only drugs or injections to treat the chronic pain does not promise long-term relief. They only work to mask the pain instead of treating the cause itself.

Because spinal decompression therapy works directly on the cause of the problem, it offers long lasting relief in comparison to drugs and injections. Also, this treatment method is a safe alternative to drugs and surgery.

If a person is a good candidate for spinal decompression therapy, there is a good chance that he/she may get the real cause treated and experience long lasting relief from sciatica.

When a patient has an epidural steroid injection for pain management, the procedure involves placing a needle into the area around the spinal cord (or its remnant called the dural sac) and the nerve roots.

This needle can at times inadvertently enter into the covering around the spinal cord (called the dural sac) and cause some of the cerebrospinal fluid to leak out. This is an infrequent occurrence and typically the tiny little hole generated will heal up uneventfully.

There are also procedures such as a CT myelogram where the interventional radiologist will actually place the needle into the covering around the spinal cord to place dye. These tiny little holes into the covering which is called the dural sac will usually heal up uneventfully as well. After this type of procedure the nurses will typically have the patients lie flat for an hour or two to make sure.

A small percentage of the time, this little hole in the covering around the spinal cord does not heal up properly and cerebrospinal fluid (CS) continues to leak.

Symptoms of a post dural puncture leak are often times severe and problematic for patients. They may include severe headaches while standing upright, photophobia which is where exposure to light causes patients significant headaches and pain, or significant nausea and vomiting may result. The headaches that can result are referred to as spinal headaches and what is typically seen is that the headaches will subside when the patient is laying down and get very bad when the patient is either sitting upright standing or walking.This is due to gravity permitting more CSF to leak while standing upright.

One thing that should be made clear is that a person's body is very active in making cerebrospinal fluid. Studies have shown humans replace their CSF every 4 to 8 hours. This is good news, as a dural leak can cause a significant amount of cerebrospinal fluid loss and it's good to know that comes back so readily.

Initial treatment for a dural leak is to have a patient spend a few hours laying down in bed. This may entail bed rest for a full day, but thankfully patients usually do not need to be admitted to the hospital. If the bed rest does not take care of the problem, it may become necessary for a doctor to perform what is called an epidural blood patch.

An epidural blood patch is a procedure that is done as an outpatient by the doctor taking some blood from the patient's vein, and then re-injecting that blood into the spinal cord itself, through the dural sac. The blood then filters through the area and somehow attaches to the area of the leak and will often stop the leaking by sealing over that area.

This procedure can be done as an outpatient and is often extremely effective in association with bed rest after the procedure to alleviate the symptoms of an epidural leak.

It is typically very unusual for patient to end up needing a subsequent surgery to fix the leak. In extreme circumstances this may end up be coming necessary.

When a patient comes into the office and says, "Doctor I have a lot of back pain and the only thing that works is Oxycontin, I've tried everything else," how does the doctor know if the patient is legitimate or not?

Unfortunately there are few tools to objectively measure a patient's pain to know whether it is legitimate or if the patient is faking. Usually, patients are asked to give a pain score on the Visual Analog Scale which is pain on a scale of 0 to 10. There is also a scale which uses facial expressions for pain severity, which is great for children.

A widely held estimate is that 15 to 20% of patients are malingering (faking) their symptoms in order to obtain drugs illegitimately. They are either abusing them or selling them (or both), and faking an illness is the most effective way of obtaining their inventory. Another reason for faking is to obtain disability, which provides for a nice paycheck to patients while everyone else in society pays for it.

Opioids are now the second leading cause of accidental death in the US, only behind car crashes. While the Institute of medicine is reporting that pain is often undertreated, the Office of National Drug Control Policy reported that narcotic prescriptions are up 48% since 1999.

There are some well known red flags to patients who are "drug seekers". Patients who call in saying they are from out of town and cannot obtain their medical records from their previous pain doctor are suspicious. Also, if a patient states they do not have insurance and want to pay cash for their treatment may be utilizing their insurance at another pain doctor and trying to hide that by skipping their insurance plan payments.

Over 35 states have instituted statewide prescription registries, where doctors can see if patients are receiving narcotics from other doctors. There are a few problems with the system, including the delay in prescriptions registering, incomplete participation, and the fact the systems cover only that individual state. A nationwide system, signed into effect by President Bush in 2005, has not been fully implemented due to lack of funding.

About 80% of pain issues are handled by primary care doctors. And it can be very tricky. Even the best of tools available to fellowship trained, board certified spine doctors show that over 50% of the time an exact diagnosis evades medical specialists. Figuring out the pain generator can be elusive, hence figuring out whether a patient is faking can be tough to discern.

It's not just inner city drug addicts who sell or abuse their prescriptions. Retired folks do it, executives do it, and even legitimate chronic pain patients take too much of their medications, effectively abusing them.

So what to do? Well, there are no go-to methods for detection that are foolproof. A few helpful tools include urine or oral drug testing (screening), pain management agreements, and as mentioned the prescription registry monitoring system. Otherwise, keep your radar up for red flags.

It's no secret that pain management medications are a considerable problem in the United States, and the problem will not be going away anytime soon. We know from a recent study published by the Institute of Medicine that there are over 110 million people in United States suffering from acute or chronic pain, with a total annual cost of over $530 billion.

We also know from the same study that even though the cost of pain management in United States is well over $530 billion per year, the amount spent on research studies is between $200 and $300 million, which is less than 1/10 the amount of the cost of the problem. So it is obvious that more research needs to be performed to help find new ways of managing pain in United States.

Unfortunately one of the things that is being seen in numerous states now are onerously strict new pain management rules that are leaving patients without care at all. Unfortunately one of the stereotypes that gets thrown to pain management patients is that they are all drug seekers. In fact we know this is simply not the case, as there are certain patients who have conditions that are not amenable to either surgery or interventional pain management procedures any more.

Once a pain management doctor or a primary care doctor is duped by a few patients, it becomes very difficult and also very disappointing for that doctor to continue to prescribe pain medications not being able to delineate between real pain patients and fakers. So what may occur is that as states turn to more restrictive policies on prescribing pain medication, that physician may turn around and say "I'm just not going to prescribe any narcotics at all anymore".

In most states back in the 1980s, pain medications were under prescribed and patients were being undertreated. As a result of this there was a push to start treating pain appropriately, and this turned into a period of lax opiate prescribing which then caused a spike in overdoses. With the new statistics that are out for pain medication prescriptions showing a 100% increase over last five years across the country, a lot of states like Washington are now passing laws making it very difficult to effectively prescribe medications to patients in need.

The result is typically that emergency rooms, specialists, or primary care doctors who are extremely busy decide that it's too much trouble to treat patients with the opiate medications and simply just stop prescribing them all together. The result? This will lead to an even worse problem where scores of patients now have no treatment for their pain, and end up having to seek out new providers who do not know them at all and have reason to be suspicious because it often times is unclear why that patient is having to seek out a new provider.

There is no doubt that with the onset of pill mills in United States and the growing epidemic of pain in this country there are a significant number of patients who are faking their situation. However, what could eventually happen is that with such strict rules regarding pain medication prescriptions that a significant amount of providers will just simply stop prescribing any narcotics, which will then leave a substantial amount of patients under treated again which was the problem back in the 1980s this event you let this problem to begin with.

What is Stenosis?

Spinal Stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and/or exiting nerve roots. Stenosis is from the Greek word meaning "a narrowing". Central canal stenosis is a narrowing of the channel in the center of each vertebra through which passes the spinal cord on its way down the spine. Foraminal stenosis is a narrowing of the channel on either side of the vertebra where the spinal nerve roots exit on their way to various parts of the body such as down the arms or legs. The vertebral foramen is a small opening or hole for the exiting spinal nerve root that is formed where the downward notch in the bone of a vertebra meets the upward notch of the vertebra below it. Spinal stenosis may affect the cervical, thoracic or lumbar spine. Lumbar spinal stenosis results in low back pain and can radiate down the nerves into the buttocks, hips, thighs, legs, or feet. Cervical spinal stenosis results in neck pain and can radiate down the nerves into the shoulders, arms, wrists, and hands.

What Causes it?

Although it is true that some individuals congenitally have larger or smaller canals than do others, the cause of the narrowing is usually a combination of 3 different degenerative factors present in varying degrees in different patients. First, when a disc herniates the bulge takes up space narrowing the nerve channel. Second, as the involved disc dries out and loses height (a process known as desiccation) it causes the vertebra to become closer together further narrowing the nerve channel. Third, as the stress on the joint compounds and osteoarthritis begins to result, bone spurs (osteophytes) form and ligaments thicken (hypertrophy) gradually narrowing the channel even further. These 3 factors in various combinations and degrees of severity compromise the space in the channel and conspire to compress (pinch) the spinal cord or nerve root. These 3 factors may also be referred to as Degenerative Disc Disease, the most common cause of spinal stenosis.

Spondylolisthesis and scar tissue formation as a result of prior surgical fusion are other factors that can contribute to spinal stenosis. Spondylolisthesis describes the anterior displacement of a vertebra or the vertebral column in relation to the vertebra below. Also, rarely, various bone diseases such as Paget's Disease or tumors in the spine are responsible for the narrowing. An MRI can rule in or rule out a wide range of possibilities rare though they may be.

A Non-surgical Solution

Spinal Decompression Therapy, first approved by the FDA in 2001, has since evolved into a cost-effective treatment for herniated and degenerative spinal discs, and the resultant spinal stenosis; one of the major causes of back pain and neck pain. It works on the affected spinal segment by significantly reducing intradiscal pressures. The vacuum thus created retracts the extruded disc material allowing more room for the pinched nerve, and will many times additionally increase the spacing between the vertebra as the involved discs are rehydrated, allowing even more room for the nerve. Furthermore, as the disc rehydrates its shock absorbing capabilities are restored reducing mechanical stress on the related structures (facet joints and supporting ligamentous tissues) slowing or halting the osteoarthritc damage. This is a non-surgical conservative procedure for patients suffering with bulging or herniated discs, degenerative disc disease, posterior facet syndrome, sciatica, failed back surgery syndrome, and non-specified mechanical low back or neck pain resulting in spinal stenosis.

1. Board Certified or Fellowship Trained Doctors

2. More services than writing prescriptions

3. Patients make an appointment

4. Mostly Insured Patients

5. Use of Narcotic Agreements and other Surveillance Methods

Comprehensive pain centers are considerably different from "pill mills". Unfortunately the two get linked together in the public's mind. Pill mills are pain clinics that are predominantly in the singular business of providing narcotic prescriptions. Because the country is in the midst of a narcotic prescription epidemic, pill mills have received a bad rap, and deservedly so. Unfortunately though, legitimate pain centers have been dragged down into that public perception as well.

Pain management clinics frequently have board certified or fellowship trained physicians who have received extensive training in both interventional pain treatment along with medication management. This is typically vastly different from pill mills, who tend to use physicians without specific pain training.

Pill mills typically just write prescriptions. In contrast, pain management centers usually provide more services, such as interventional treatments, physical therapy and chiropractic.

At a pill mill, patients are often able to simply walk in rather than making appointments. At the more legitimate pain centers, however, patients need to call and make an appointment. Usually if it's a new appointment with a referral, medical records are received from the referring doctor's office.

At typical comprehensive pain management centers, the patients have medical insurance and utilize it for their care. Pill mills often work outside the insurance system. This means either having patients with no insurance paying cash, or having patients with insurance simply not using it.

Comprehensive pain management centers utilize pain narcotic agreements, typically called "pain contracts." These contracts help to ensure patients comply with such treatment protocols as pill counts, urine drug screening, and pharmacy board prescription monitoring.

These 3 treatment protocols are a fantastic trio that helps prevent diversion. It is well known that over 20% of patients will divert their pain medications, and that diversion spans all socioeconomic and ethnic groups. Pill mills may not have these various surveillance tactics, and it works to the detriment of preventing the rising epidemic of narcotic abuse in the US.

These factors together differentiate pill mills from comprehensive pain management centers. By combining all of these services and qualities, the more modern pain centers can actually help patients cut down their amount of narcotics being taken. This may stem the tide of narcotic abuse, and also help transfer some of the medications being written to those of the non-narcotic variety.

"Ambulatory spinal unloading" is the "new kid on the block" when it comes to treatment of acute and chronic low back pain. It is so new that many care givers are not yet fully aware of it.

Anecdotally we know that relieving pressure on the discs via traction, non-surgical spinal decompression or inversion tables etc relieves the pain, we also know that continued activity opposed to inactivity is beneficial and everyone knows that stabilizing the spine and allowing strained muscles to relax and heal are critical to the healing process.

But until ambulatory spinal unloading came along there was no way to offer a low back pain suffer the full treatment. This new treatment modality for low back pain allows sufferers the ability to regain mobility, flexibility and activity in a pain free or pain reduced environment, allowing discs to rehabilitate, muscles to realign and mend and damaged nerves to heal.

Ambulatory spinal unloading dramatically reduces the degenerative cycle and dramatically increases the rejuvenative cycle of the spine and is without a doubt one of the most beneficial and cost effective, non-invasive treatment modalities for acute and chronic low back pain available today.

Ambulatory spinal unloading can be used to extend the benefits offered by stationary treatments as well as chiropractic and physiotherapy treatments or can be used as a pre surgery bridge or a post surgery protection/prevention tool.

Typical indications for this new treatment modality are most forms of low back pain that have been caused by; degenerative disc decease, herniated or bulging disc, nerve impingement, stenosis, facet syndrome, spondylolisthesis, lumbar vertebrae compression fracture, sciatica, lordosis etc and for many "undiagnosable" causes of low back pain.

While it is common for traditional doctors to recommend spinal surgery to treat severe back problems, it is usually not the ideal treatment option. Several accounts have been recorded of patients experiencing pain after back surgery. This is known as Failed Back Surgery Syndrome or Post-Surgical Back Syndrome.

Spinal surgery can almost guarantee that no future back surgery is needed for an operated disc, however, the surgery can cause complications with new discs. These complications, if not caused by malpractice, are often due to recurrent herniated discs or scar rediculopathy. Another probable cause is the slow adjustment of the body with the change in anatomy caused by either the surgery or the injury. Failed Back Surgery Syndrome is characterized by lower back pain, which in some cases is worse than the pain before the surgery, incapacitation, nocturnal cramps, and distal paresthesia.

Rehabilitation and pain management are the usual treatments for Failed Back Surgery Syndrome depending on the degree of pain. A second back surgery, however, is not recommended as treatment.

Several alternative methods of treating spinal problems, which are of equal, if not greater effectiveness than surgery are also available. One of which is spinal decompression therapy, which uses a machine, the DRX9000, that applies a gentle pulling force that decompress the injured discs and vertebrae and results in relief of back pain. It works by elongating the spine to release the pressure from the compressed discs or vertebrae and allows healing to begin as oxygen and nutrients enter the injured portions.

Spinal decompression holds several advantages over surgery, the most important being the lack of side effects since it is just a very simple, and safe procedure that uses high-class technology.

Another advantage is the faster treatment time compared to surgery as it is non-invasive. No incisions were made, therefore, there is no healing process to be worried about. Finally, based on research, spinal decompression has been proven to be more effective than surgery in terms of relieving pain. A proof of this is the fewer amount of analgesics (pain killers) needed to be taken after the treatment as to when surgery is performed.

At any one point in time, 1% of the US population is suffering from a lumbar herniated disc. The condition typically occurs when a piece of the intervertebral disc squeezes out from its confines and pinches on a lumbar nerve root. Think of a jelly donut with a tear in the outer portion, and some jelly squeezes out.

The compression of the nerve root may spark up inflammation around the area, and that is what creates pain going down one's leg called radiculopathy, or sciatica. Sciatica is often a burning, searing pain that is extremely painful and disabling for patients.

Epidural steroid injections for herniated disks are very popular treatments, and often work well to give pain relief and avoidance of surgery. But who does well with them? There are 2 types of epidural injections done currently. The first, an intralaminar epidural injection, involves steroid medication being placed just under the bone in back of the spine. These do work, but one of the current options is a transforaminal epidural steroid injection (TESI), where the pain doctor places the needle into a more specific area where the nerve root is actually being pinched as it exits the spine.

Since the problem is the pinched area, that is where the steroid medication works well. A new study out of Australia (Ghahreman, Pain Medicine 2011) looked at transforaminal injections for lumbar radicular pain from a herniated disc. The findings were very interesting. They round that transforaminal epidural steroid injections worked well for disc herniations that did not have severe nerve root compression, but small to moderate compression.

The theory behind their results was that with small to moderate compression, the body produces an inflammatory response for which steroids work well. The success rate in these instances was 75%, which is consistent with numerous other studies on the benefits of epidural injections overall for herniated disc with sciatica.

If the compression is severe, the results in the study were only 26% effective. The authors theorized that in those instances an inflammatory response was not as prominent so the steroid injection was not as successful. If in fact that is the case, in instances of severe compression a higher consideration towards surgery should be given. Especially if an individual has muscle weakness from the compression.

At any rate, epidural injections are an excellent treatment to try and avoid surgery with a low risk profile. It just appears they work better for disc herniations that are present but not in the severe category.

Even though back and neck problems are commonplace, it is a good thing that generally they can resolve on their own. In reality, the usual result of spinal pain symptoms is most favorable with or without treatment.

It is challenging to determine which treatments are or are not successful because of the body's natural tendency of spine-related pain to improve; i.e. the pain often subsides on its own regardless of whether you received any form of medical intervention. However, even with the body's natural ability to heal itself and get you out of pain, many people with back or neck pain experience pain that persists, gets worse, or comes and goes. If you are reading this article, chances are that your back or neck pain problem falls into the classification of not getting better by itself. The following is a list of the more common pain situations:

• Chronic back or neck pain problems that persist for more than three months.


• Back or neck pain flare ups that occur from time to time over the course of several years.


• Back and neck pain for which spinal surgery is recommended.


• Back or leg pain that persists even after having spinal surgery. This type of pain is known as failed back surgery syndrome.

The aforementioned classes of pain do not resolve themselves right away and can become frustrating for you and those near you. Getting the proper information about your back or neck pain problem is your most important resource for improving your spinal health.

Many times, the appropriate timing and implementation of treatment options is the key for you to get over your pain problem with success. For instance, you may see an improvement with physiotherapy treatments that include electrotherapy, ice, and heat in conjunction with an exercise program. In some cases, you might also receive spinal decompression.

The importance of treatment integration should involve chiropractic. Chiropractic is only appropriate in certain cases. You can improve the odds of having a good outcome from chiropractic if you include psychological preparation for chiropractic treatment especially if you have never been to a chiropractor nor have any knowledge of what a doctor of chiropractic does. You can also increase your chances of success by arming yourself with the right information about your situation should you wish to avoid drugs or surgery.

During the course of chiropractic treatment, a complementary rehabilitation program will follow and include exercise, psychological evaluations, physiotherapy, and, sometimes, a referral to a doctor of medicine for surgical consideration.

Keep in mind that there is an alternative to drugs or surgery to get rid of back or neck pain.

You may have heard the term "slipped disc" used to describe a low back injury. Discs do not actually "slip". Rather, they may herniate or bulge out from between the bones. A herniation is a displaced fragment of the center part or nucleus of the disc that is pushed through a tear in the outer layer or annulus of the disc. Pain results when irritating substances are released from this tear and also if the fragment touches or compresses a nearby nerve. Disc herniation has some similarities to degenerative disc disease and discs that herniate are often in an early stage of degeneration. Herniated discs are common in the low back or lumbar spine.

What causes discs to herniate?

Many factors decrease the strength and resiliency of the disc and increase the risk of disc herniation. Life style choices such as smoking, lack of regular exercise, and inadequate nutrition contribute to poor disc health. Poor posture, daily wear and tear, injury or trauma, and incorrect lifting or twisting further stress the disc. If the disc is already weakened, it may herniate with a single movement or strain such as coughing or bending to pick up a pencil.

How do I know if I have a disc herniation?

Herniated discs are most likely to affect people between the ages of 30 and 40. Disc herniations may be present without causing pain. The most common symptom will be pain in the area of the herniation that may radiate across the hips or into the buttocks. You may also experience numbness or pain radiating down your leg to the ankle or foot. If the herniation is large enough, you may notice weakness with extension of your big toe and you may be unable to walk on your toes or heels. In severe cases of lumbar disc herniation, you may experience changes in your bowel or bladder function and may have difficulty with sexual function.

How is a disc herniation treated?

Mild to moderate disc herniations can usually be treated conservatively with stretching, exercise therapy and chiropractic care. More advanced cases will often require some form of spinal decompression, such as traction or mechanical decompression, in conjunction with chiropractic care.

Occasionally, a herniation may be severe enough to warrant surgical intervention. These cases are usually reserved as a last resort when other forms of therapy have failed to relieve pain, or if there is significant compression of the spinal cord or nerves.

How will this effect the rest of my life?

When I was first injured it seemed I was destined to be in a wheelchair forever. Over time, actually about 8 months, I began to see some noticeable differences in my range of motion and pain level. Today over 12 years later I live a very active life and don't feel as if I have to stop being an active dad. Although even this long after my injury I have some pretty rough days. There are times when I get the electric shock pain down my legs or can't get up. I've learned over the years when this happens "Don't Panic", for me I just return to regular chiropractic check ups, routine stretching, and get my diet back on track. Your back pain can be used as a barometer to alert you that you're getting over stressed or not exercising as regular as you should. I highly recommend you find a doctor or therapist you trust to give you good advice or treatment. Ultimately you will have to make the decisions as to what works best for you but know there are lots of options other than surgery. And you can get back to a normal active life even in severe cases.

Coccydynia is pain in the coccyx, the tailbone, which can cause a great amount of discomfort and limit mobility. Sometimes, this pain is not taken seriously by general practitioners but it is important to learn the cause if the pain persists. In some cases, the cause is obvious as pain develops after a fall or injury. A pilonidal cyst also creates pain in the coccyx and since there is often a visible abscess, diagnosing the problem is simple. 

Other causes of coccydynia are more complex and require a thorough examination and diagnosis. One of the first goals is to rule out the possibility of cancer as a cause of the pain. Before deciding upon a plan of treatment, it is important to distinguish coccyx pain from low back pain or other causes not related to the coccyx. 

Diagnosing Coccydynia

• History and Physical must be completed.


• CT Scan (Computerized Tomography)


• MRI ( Magnetic Resonance Imaging)


• Dynamic X-rays -this means x-rays taken when sitting and standing. A comparison may show a coccyx that dislocates when the patient sits, causing pain. 

Treatment Of Coccydynia

Falls

• Use a cushion or well padded seat to relieve pressure on the coccyx when sitting. Several new devices have been developed which are far superior to rubber donuts or foam pads. Many can be found on the internet when doing a search for 'coccyx cushions'. This cushion may be necessary for an extended period of time.


• Rest and avoid re-injury.


• Anti-inflammatory medications, such as ibuprophen and naproxyn, are helpful.


• Corticosteroid or local anesthetic injections may dramatically relieve persistent pain. 

Unstable Or Dislocating Coccyx

• Rest and avoid re-injury.


• Corticosteroid injections are helpful.


• If pain persists and corticosteroids are unsuccessful, the coccyx may be removed surgically. 

Childbirth

• Rest often allows the coccyx to return to its normal position.


• If this fails, treatment as for Unstable or Dislocating Coccyx is appropriate. 

Repetitive Strain

This is due usually to long periods of rowing or bicycle riding.

• Rest - avoid activities that caused the pain.


• Anti-inflammatory medications, such as ibuprophen or naproxyn relieve discomfort. 

Misaligned or Long Coccyx

• Injections of corticosteroids are often helpful.


• Surgery is not recommended. 

Boney Spur or Spicule On Coccyx

• Local injection of corticosteroids and/or local anesthetic have been helpful.


• Surgery has been successful.

 
Muscle Spasms Of Gluteus Maximus Muscle

• Physical therapy and massage have been effective in relieving spasm. 

Piriformis Syndrome

• Physical therapy


• Stretching exercises


• Injections of Corticosteroids Locally 

Pilondal Cyst

• Surgical removal is necessary as infection reoccurs repeatedly. 

Coccyx pain and the associated difficulty with sitting and movement can be most miserable and memorable. Sufferers who gain relief are always anxious to avoid any recurrence whenever possible.  

Stem Cell rich injections are now available for patients dealing with painful conditions. This represents a potential breakthrough in pain management for patients dealing with back, neck, arm, and leg pain.

For decades the gold standard in pain management treatment has been steroid injections for spinal or extremity pain issues. These cortisone injections work well with excellent results over 75% of the time. However, steroid injections do not alter the course of arthritis or soft tissue injury. They simply offer pain relief for a finite time period and then need to be repeated usually. In addition, there are significant limitations on the frequency with which corticosteroid injections may be performed due to potential adrenal gland problems and blood sugar issues. Most pain doctors recommend no more than once every few months for injections, and if multiple joints are being injected the total amount of steroid going into the body can add up quickly.

For a long time, the holy grail for arthritis and soft tissue injury has been to find a cell regenerating injection substance which both relieves pain and helps regenerate bone or soft tissue. Steroid injections only help with the pain relief portion. The non-steroidal, anti-inflammatory, stem cell injections that are processed from amniotic fluid have the potential for cartilage and soft tissue regeneration along with offering pain relief.

The regenerative effects have been shown in both the laboratory as well as in animal studies. Cartilage defects have been able to be filled with real cartilage. What is seen now is that cartilage defects typically are filled in with pseudo-cartilage, which is also known as fibrocartilage. This is not nearly as durable long term as native types of cartilage.

The non-steroidal stem cell therapy product is made from the amniotic fluid of live donors, and is neither fetal nor embryonic. The stem cells that come in the substance are not pluripotent, meaning they are not capable of differentiating into all cell types. However, they are capable of differentiating into most cell types, including, bone, muscle, and cartilage, which is the most important for orthopaedic and pain management injections.

The human amnion derived allograft has been used over 4000 times in the US over the past few years. Indications have included soft tissue injections, spinal fusion enhancement, wound healing, degenerative joint disease, joint injections, and injection around the spinal cord as a scar barrier. Adverse events with this potentially regenerative medicine substance have been minimal and results have been encouraging.

At this point in time, regenerative medicine injections are becoming more and more popular. Larger research studies need to be done, so for now the anecdotal excellent results are enough to spur its popularity.

So many people forget, or can not figure out how, to effectively stretch their largest muscle in their body - their back. What is the best way to do so? In my opinion, and according to many others, the best way to stretch your back is by inverting on a machine call an inversion table.

Why is an inversion table better than using some of the other back stretching tools (you know, the ones that look like a half-circle that you essentially lie down on, stretching your back the opposite way of bending over)? Simply put, because inverting effectively uses gravity to reverse the same force that has been pulling you and your back down and out of joint each and every day, even in your sleep. Don't get me wrong, the other back stretching machines are good, and I strongly encourage you to use them as well, but if I had to pick just one, then it would be the inversion table.

Inversion therapy does the following to help reduce back pain. Inversion therapy will help your back decompress as gravity pulls your back in the inverse as it normally does, effectively taking pressure of the discs and allowing them to widen. When this happens, the disc and soft tissue will rehydrate, essentially filling up with good nutrients which in turn reduces nerve and sciatic pressure, realigns your back, and relaxes those tense back muscles.

In addition, inversion therapy will also help you with many other benefits (such as increased oxygen flow to your brain, increased blood circulation to your heart, and helps recover height that is lost over time (the average person will shrink a few inches in their lifetime to due gravity).

So, while other back stretching machines are good for you, they will not do as many or the same things that an inversion table will, which is why I would strongly recommend the inversion table if you had to choose just one.

If you are suffering from a herniated disc, you should consider therapy as a possible remedy. A type of disc problem involves the rubbery cushion between the individual vertebrae of your spine to push out through a crack of the tougher exterior of the disc.

Symptoms usually include a numbing or tingling sensation that begins in one leg and can extend from the buttocks down to the knee. In some cases, the pain can extend from the buttocks all the way down to the ankle and even the foot. Pain can also be present in the front of the thigh, and a person can have severe and even extreme muscle spasms due to a herniated disc.

There are many types of herniated disc therapy. One form of therapy that is used by chiropractors is non-surgical spinal decompression.

Non-surgical spinal decompression involves the use of a mechanical traction device that is operated by an on-board computer. This device regulates the angle and force of disc distraction, which limits the body's natural ability to generate muscle spasms. Non-surgical spinal decompression helps to reduce intradiscal pressure, which reverses nerve impairment, reduces loading of the spine, and enables damaged spinal discs to heal themselves over time.

A type of mechanical traction that is used in non-surgical spinal decompression is inversion therapy. This involves the patient hanging upside down in order to achieve relief from a herniated disc. This therapy works by alternating between 15 one-minute decompression and relaxation cycles to reduce the pressure on the herniated disc and to allow the tougher exterior of the disc to heal.

There are several versions of therapy, including range-of-motion (ROM) decompression. Range-of-motion decompression involves the chiropractor adjusting the patient's spinal posture while the decompression is taking place. This allows the decompressive pulling forces that are applied during the spinal decompression to reach into the spinal areas and tissues. These are areas that are often not affected by basic linear decompression.

Spinal decompression through inversion therapy is a popular herniated disc therapy because spinal decompression does not have the risks associated with surgery, anesthesia, or injections, yet can be quite effective in providing relief from a herniated disc. Therefore, spinal decompression is considered to be a safer herniated disc therapy option as compared to surgery or injections. Additionally, spinal decompression is an FDA-approved therapy and is generally less expensive than surgery or injections.

Non-surgical spinal decompression therapy is a herniated disc therapy option you should consider if you have any of the following conditions:

- Numbness
- Tingling
- Radiculopathy (sensory and motor disturbances that cause severe pain and muscle weakness within the neck, back, arm, shoulder, or leg)
- Spondylosis (degenerative osteoarthritis of the joints between spinal vertebrae and the openings within the vertebrae)
- Lower back pain
- Sciatica (numbness, weakness, pain, or tingling within the leg due to pressure or injury on the sciatic nerve)
- Disc hernia
- Disc protrusion
- Spinal injuries
- Foraminal stenosis (narrowing of the small canal in the spine)

Therefore, if you are suffering from any of the aforementioned symptoms, you may have a herniated disc and need to seek therapy in order to obtain long-term relief. Non-surgical spinal decompression is an FDA-approved therapy option you should consider, as it can provide the relief you are seeking without the need for surgery or injections.

Of all the non surgical treatments used to treat back pain, spinal decompression care is one popular name. It is also particularly effective when it comes to treating back wounds. It's also an FDA authorised measure to eliminate the back pain.

This alternative cure of back pain is used to cure numerous back conditions. It is used to cure prominent and herniated disc. It has also been found you can treat sciatica and pinched nerve fibres with spinal decompression therapy.

Spinal decompression treatment works on the principle of reducing stress on the spinal discs. As a result of it, the back stiffness gets relieved. Often, compression of the spinal discs is what leads to back pain which is due to strain on the vertebrae. You must always remember that bones may experience a high level of pressure on account of factors like slumped posture, inaccurate standing, sitting or sleeping. Such pressure could in turn compress the spinal discs and cause lots of back pain.

This alternative cure decompresses your spinal discs to relieve you from back trouble. The patient is strapped to a transportable table that causes a mild distraction force while moving. This immediately affects the painful parts of your body. A computerized control is used to maneuver this force. And, the strength of the force is controlled relying upon the patient's condition and wishes.

The force is applied on the spine to tug it to elongate the spine, to make space between your backbones. The empty space is utilized by the compressed discs to fall back into their place. When you are taking the treatment sessions of this Spinal decompression, you are asked to take correct rest as well. This is to make sure that you do not take any pointless stress. These treatment sessions are also accompanied by cold and heat therapy for more satisfying results and especially in case when the patient is under great discomfort.

The number of sessions needed to relieve back pain may alter from patient to patient, dependent on the severity of the problem. However, it is often said that 28 sessions could treat the problem fully. These sessions could be administered in a timeframe of one to two months. A single session is of roughly 30 to Forty minutes.

Spinal decompression treatment could help you get rid of sciatica and other types of back trouble, successfully. But, before you decide to go for it, it's better to know about all its pros and cons. Since, it's a natural care, there are extraordinarily rare odds of any complications and that's the positive thing about it. But the disadvantage is that it can take quite some time for this care to supply results.

Spinal decompression is a wonderful alternative treatment for those that are on the lookout for a method to treat sciatica naturally or different types of back trouble. Just give it a try.

Spinal Decompression therapy is an exciting modern healthcare treatment for back and neck pain due to a variety of conditions.  There is a great deal of research to support the effectiveness of spinal decompression in relieving pain and symptoms.  Many doctors, clinics, marketing companies, and equipment manufacturers really go overboard when praising the benefits of decompression however!  Arrogant and over the top decompression advertisements give spinal decompression a bad reputation that it doesn't deserve.  Healthcare providers need to make sure their spinal decompression advertising and marketing isn't making promises they can't keep.   

Don't get me wrong, I have seen first hand evidence that spinal decompression works.  I have seen many patients steer clear of the path of drugs and surgery thanks to spinal decompression and conservative chiropractic care.  Although I believe in spinal decompression, I also know it has limitations.  Spinal decompression is not a magic cure all.  It is not an instant, guaranteed fix for herniated discs or back pain.  Marketing decompression as if it is, is simply unethical.  While that may seem obvious, we always need to be aware of the message our spinal decompression marketing is sending.  

I understand most healthcare providers don't design their own marketing.  Most simply pay someone else to design and run it.  That is still no excuse for not critically analyzing your advertisements and they statements they make.  The doctor or healthcare provider is ultimately the person responsible for the contents of their advertising.  When it comes to state board regulations there is no passing the buck.   How often have you come across a spinal decompression ad that makes bold statements about curing this or that condition?  How often have you read an ad that you KNEW violated state board rules or other regulations?  More importantly, are you running these ads yourself?  Even though an ad may be effective in generating new patients, it can still be potential trouble. 

For example, about a month ago while traveling for a seminar I came across a simple and well designed decompression ad.  It was very compelling and ended with a strong offer and a call to action.  I had no doubt it was a very effective ad.  My problem was with the headline, which read something to the effect of: "Spinal Decompression can eliminate your back pain due to herniated or bulging discs . . . without drugs or painful surgery!"    I've also come across a few ads flat out stating that spinal decompression is a non-surgical CURE for back pain.  These types of ads can land a practice in hot water.  It is also my personal opinion that these ads are both dishonest and unethical.  You may not share my concerns, but look at what these ads are really saying to the prospective patient. 

Let's look at the first example ad.  The ad states that spinal decompression CAN eliminate back pain. It doesn't say it might, or that it is a possibility.  It states that it CAN.  Now we could split hairs here and debate the meaning of "can".  Some would argue that the usage of "can" simply implies that decompression has the potential to eliminate back pain.  I would agree it's a possibility, but I don't want my state board, or a court interpreting the meaning of my advertising content.  I think a much better choice would be statement like "spinal decompression may be able to help relieve your pain and symptoms . . . without drugs or surgery".  This may not be as eye catching as the original headline, but it conveys the same message and does so ethically.  There is no promise.  There is no statement left for loose interpretation.  Written this way the ad simply states that spinal decompression MAY be an option.  Without directly stating so, the ad also indicates to a reasonable person that spinal decompression is NOT always an option and it is NOT always effective.  

Another concern with that first example ad is the word "eliminate".  Is it really ethical to be talking about ELIMINATING pain or symptoms?  A statement like that can lead to false expectations on the part of new decompression patients.  Patients will come in expecting elimination of their pain and symptoms, when the honest to goodness truth is we have no idea whether treatment will be effective.  Wouldn't the word "reducing" or "relieving" be a much better choice than "eliminating"?  As you can see, you should choose your wording carefully when you advertise.  Changing one or two words in the copy of an advertisement can lead to a potential problem.  Although a mistake may be an honest oversight or miscommunication between the advertiser and provider, it doesn't excuse the doctor from any liability.  

The second type of ad I mentioned were those overly confident ads that boast spinal decompression can cure back pain or herniated discs.  Yes, these ads do exist.  I have seen them with my own eyes.  I still cringe when I read them.  A healthcare provider shouldn't be advertising that they can cure anything with spinal decompression.   These types of ads are flat out unethical and illegal.  They are a disservice to the prospective patient because they make statements that simply aren't true!  I usually give these doctors the benefit of the doubt and assume they simply haven't carefully looked at what their ads are saying.  

It may seem that it is very easy to accidentally cross over into the world of unethical and dishonest spinal decompression advertising.  This may be true, but it is also just as easy to prevent this from happening.  Here are10 easy tips to ensure your spinal decompression marketing is both effective and ethical:  

1. Be Informed.


2. Accept responsibility


3. Curb your enthusiasm


4. Don't Promise Anything


5. Use Common Sense


6. Put yourself in the Prospective Patient's Shoes


7. Patients Before Profit


8. Your Competition is not a Role Model


9. Be Consistent


10. Control Costs  

1.  Be Informed

Know your state laws and any other applicable rules and regulations. Ignorance of the law is no excuse.  Do your homework and make sure your spinal decompression marketing is in full compliance.  Don't leave any grey areas which are open to interpretation.  

2.  Accept Responsibility

You already know this, but it bears repeating. Ultimately the doctor or provider is responsible for the advertising they run.  Don't expect a marketing firm, a media outlet, or anyone else to accept responsibility for your mistakes.  In the end YOU as a healthcare provider are responsible for the content of your advertising.  It is YOUR license and reputation which are on the line.  Market ethically or don't do it at all!  

3.  Curb Your Enthusiasm

We both know spinal decompression is great.  As healthcare providers we are convinced spinal decompression can help our patients.  It is important to remember to keep our passion and confidence in decompression in check.  Communicate your confidence in decompression, but remember that nothing is guaranteed.  This leads us to tip number four.  

4.  Don't Promise Anything!

Do yourself and your patients a favor: don't make any promises you can't keep.  Do not advertise that spinal decompression can definitively cure, stop, or eliminate anything.  If you want to state that spinal decompression may be able to do these things, I think you are treading in much safer waters!  

5.  Use Your Common Sense

I have faith that we all possess at least some degree of common sense.  Use it! If something seems like a grey area or a bad idea it probably is!  Stop and think about the impact any given form of advertisement is going to have on you and your practice before you run it.  Try and visualize both the positive and potential negative impacts of an advertisement before committing.  Following tip number six well help here.  

6.  Put Yourself in the Prospective Patient's Shoes

It is easy to assume others know what we are trying to express in our advertising.  We see the benefits of spinal decompression everyday so we have a biased point of view.  One of the best ways to critically evaluate your spinal decompression marketing is to look at each and every ad from an outsider's point of view.  Pretend you are a prospective patient who knows nothing about spinal decompression.  Take a look at your advertisements and interpret them from an outsider's point of view.  What does your marketing say?  Does it make promises?  Can the ad be misunderstood and taken too literally?  It is often beneficial to enlist the help of a friend or relative with this step.  

7.  Patients Before Profit

This one is simple.  Remember the main goal is to help patients and improve quality of life.  The goal is not make as much money as possible.  Profit is a factor in the equation, but it shouldn't be the driving force behind your marketing.  One of the fastest ways to start marketing unethically is to market only to make money.  Focus on bringing in patients into your practice that you want to help.  When you market with the end goal of helping people get out of pain and back to enjoying a better quality of life you will be amazed how profit falls into place.  Your spinal decompression will be ethical and you will still make money.   Position yourself as a doctor who truly cares about your patients and those patients will reward you.        

8.  Your Competition is not a Role Model

Never rely on your competitor's advertising to tell you what is legal and ethical.  Just because Dr. Jones down the street at XYZ Clinic gets away with it doesn't meet it is acceptable.  Focus on tips 1-7 and let the competition say what they will!  

9.  Be Consistent

Make sure your spinal decompression advertising and marketing maintains a central theme and message.  At the very least make sure your different advertisements don't contradict one another.  Don't tell patients one thing in one and something totally different in the next.   Maintaining consistency is key.  If your ads are sending mixed messages, your audience may dismiss them as unethical junk that tells them what they want to hear rather than the truth.  

10.  Control Costs

What do costs have to do with ethical marketing?  Nothing leads to unethical marketing faster than when a doctor overextends their marketing budget.  Think of it as the familiar old saying, "Desperate times call for desperate measures".  Panicked doctors who spent too much on advertising often say and promise things they normally wouldn't.  When that expensive advertising they can't afford doesn't work, the situation is often even more critical.  These individuals may begin to use questionable marketing ethics in effort to bring in more patients.  Never put yourself in this position.  Set a marketing budget that is affordable.  Know this budget and stick to it!  

The preceding tips are  ten easy ways to ensure your spinal decompression marketing is ethical.  Unfortunately many spinal decompression providers market with questionable ethics.  This is both bad for their profession and a disservice to the patient.   Healthcare providers owe it to their patients to market truthfully.  Hopefully I have demonstrated that spinal decompression marketing can be both effective and ethical.  Follow the advice above, stay humble, and use your common sense.  Whenever I run an advertisement I think of something my father would tell me when I was a teenager: "Don't let your mouth write a check your butt can't cash!"  That advice still applies today!  

1. I use shoe pads because they make wearing my shoes very comfortable. I am an upcoming nurse and will have to be standing around all day during clinicals, so I need the extra support and relief. I had to experiment with several different brands and models before finding the right style. After finding the right model, my work days were much more enjoyable.

2. The good really outweighs the bad when it comes to shoe pads. These things do not cost that much money for the amount of good that they can do. Unless you get yours from a doctor, they shouldn't cost you anymore than twenty bucks for two of them. Usually they don't even cost over ten, but there are some brands that are not that expensive.

3. I wear gel pads because they last. Yep, they are unlike any other form of support for a pair of shoes. Some shoe brands come with a little added support inside the sole, but these layers often give way to the wear and tear of everyday use. The tough plastic material of which the gel pads are made of, have lasted much longer in my experiences.

4. They make me taller. I hate to admit it, but wearing gel pads makes me taller. I actually double up on each shoe in order to make myself look a little bit taller. My girlfriend is just a smidgen taller than I, so the gel pad actually levels out heights out a bit.

5. Lastly, they are simply exciting, Yes, I am about to explain why I think these innovative objects are exciting. They come in so many different shapes, sizes, colors, and contents, that they really are fun to experiment with. You never know which ones will give your feet the most relief. I am always tempted when I see a new one.