Spinal Decompression

Prior to marijuana experiencing prohibition in 1937, it was a significant part of the US pharmaceutical market. It was commonly prescribed in the early 1900's, because at that time it wasn't on a controlled substance list.

After the Marijuana Tax Act of 1937, marijuana was not technically illegal but heavily taxed. Within 4 years, the US pharmaceutical market grew tired or paying the hefty taxes, so cannabis was removed from the market altogether. In the 1970's, it officially became a Schedule 1 narcotic, and illegal to prescribe.

Sixteen states have legalized marijuana medicinally, and for various conditions. California, for instance, has the most lax rules with what medicinal marijuana can be recommended and ID cards received. Forty six percent of CA voters actually said yes recently to outright legalization. Medical marijuana has been legal in CA since 1996.

In a recent survey of close to 2000 patients at multiple CA marijuana evaluation clinics, there was an interesting array of conditions patients maintained. Thirty one percent had chronic pain in the back, spine, or neck, with sixteen percent having a sleep disorder. Anxiety and depression amounted to thirteen percent. Eighty percent of these patients reported trying traditional medications (typically opioids) prior to marijuana.

The fact they were trying regular prescription medications could argue against faking, but even people faking can often bilk the system to get narcotic prescriptions. The patients were asked if they had used marijuana recreationally prior to receiving patient cards, with 40% saying yes. Interestingly, studies have shown that approximately 30% of narcotic patients divert their prescriptions (selling or trading them), with the percentage spanning all socioeconomic classes.

Most states now require evaluation of a patient's medical records and an in-person physical exam for the debilitating qualifying condition. For instance, if a patient has Crohn's disease in a state that has legalized cannabis for Crohn's, there should be some medical records for it. If not, a workup should commence for it to make sure the disease is present prior to approving for medical marijuana.

So it is not exactly clear how many medical marijuana patients are faking. Based on the CA survey, we do not have a clear number. Considering the sheer number of patients in the US who doctor shop for narcotics and become illegitimate patients, if it's any way equivalent the number may be over 20%. This is speculation.

One thing is certain though. Despite the illegitimate patients receiving ID cards, it is also apparent that medical marijuana represents a valid treatment than some of the more conventional existing treatments for numerous conditions. There are less side effects and often an ability to decrease the more harsh side effects of traditional medications by decreasing dosages.

Inflammatory conditions and diseases are most commonly treated with steroid injections. Doctors inject the steroid, usually cortisone or kenalog, into one or two locations of the inflamed area so the medication goes straight to the problem.

Like any other kind of medication, injections with steroids can have possible side effects.

繚 Pain

繚 Infection

繚 Bruising/bleeding

繚 Flushing in the face

繚 Allergic reactions

繚 Depigmentation of the skin

Some people will find that the actual injection itself is a little painful. If there is any post injection pain it will usually last up to 48 hours. An occurrence of infection after a steroid injection is quite rare, but experienced and qualified doctors will do everything they can to reduce the risk of infection. Facial flushing only occurs in about 5% of patients that undergo injections with steroids.

An allergic reaction to a steroid injection is very serious and can sometimes be life threatening. Skin depigmentation normally occurs if the steroid is injected into soft tissue rather than the joint, however, if the joint is closer to the surface then there is a possibility of depigmentation of the skin.

When inflammation is the primary cause of pain, steroid injections may abolish the problem to its entirety. In such conditions like arthritis, the injection doesn't usually provide a cure. The majority of injections with steroid are used to relieve pain temporarily, not permanently. Kenalog injections are often used to diminish allergies such as hay fever, as well as inflamed areas.

As with any other treatment, it is important to let the doctor know if the pain increases after the injection. Never overuse the steroid injected joint once it feels better because the inflammatory process may remain active. Side effects will vary among each individual. The more common side effects of these injections are:

繚 An increase in appetite and weight

繚 Higher blood sugar level

繚 Nausea

繚 Weakness in the muscles

繚 Thinning of the bones, better known as Osteoporosis

繚 Mood changes, anxiety, memory loss, and other psychiatric reactions

繚 Water retention

繚 Menstrual disturbances

Most of the side effects are rare when the steroid is injected around the joint. The primary side effects after this type of procedure are the basic increase of pain and swelling along with dizziness. Knee osteoarthritis and tennis elbow are very common conditions that involve steroid injections. Because inflammation is one of the first reactions to a bodily injury, injections with steroid have become more popular than before. It is a quick and easy temporary relief from the pain that hinders daily activities among many people.

Epidural steroid injections for pain management are one of the most common and most effective procedures performed to alleviate pain. They are utilized for relief of sciatica due to a disc herniation causing a pinched nerve, they're useful for spinal stenosis, and can be great in the neck as well to alleviate symptoms of radiculopathy.

How are epidural steroid injections different today than they were 20 years ago? One thing that has not changed is their effectiveness. Multiple studies have confirmed that epidural steroid injections for sciatica and radiculopathy maintain at least a 75% average effectiveness rate for pain relief. It may be one injection that does the trick so to speak, or maybe a full series of 3 injections. But the results from epidural started injections are sometimes as high in studies as 90%, which is similar to that seen with lumbar surgery for a disc herniation (without the risks).

Here are 3 ways the procedures for pain management have changed.

1. The standard of care with epidural steroid injections has changed with regards to how they are performed. The use of a real-time x-ray machine known as fluoroscopy has altered the way the epidural injections are performed. A landmark study over a decade ago showed that without the usage of fluoroscopy, injections into the epidural space missed approximately 30 to 40% of the time. If the patient is willing to undergo the procedure and except the small but real risks associated with it, they should be sure of getting the most accurate injection possible. Fluoroscopy allows the most accurate injection possible, so it has become pretty much the standard of care for doing them.

2. Transforaminal epidural steroid injections have become much more popular. Over the last 10 to 15 years, transforaminal injections for relieving pain have increased in popularity due to the fact that the steroid is placed closer to the area of the nerve root impingement. The theory is that with the steroid bathing the area of the pinched nerve and relieving inflammation, the amount of pain relief achieved with a transforaminal injection can be better. Therefore, the procedures popularity has increased exponentially over the older version, which is known as an intralaminar injection.

3. The newest epidural steroid injections have been using steroid material that has less particulate matter than previously. There have been some complications noted with the steroid substances that have heavy amounts of large particulate matter. Therefore a lot of pain doctors are switching to steroid medications that have less amounts present. It's a little bit of a catch 22. You need to particulate matter to have the medication stay around for a while to achieve its anti-inflammatory effect. But you don't want too much or too large of a particulate matter that can cause potential complications. So epidural steroid injections are headed towards a happy medium with just enough particulate matter to keep the medication there for optimal effect with the least amount of complications.

Neurological MRI is helpful in detecting any kind of neurological disorder. These scans offer detailed images of the required body part from different angles and in different dimensions. Neurological MRI is a radiation free, painless and non-invasive procedure that can be carried out with minimum hassles to patients.

MRI Scanners with Superior Features

The AIRIS II MRI scanners are a new development in this specialty. With its patient-friendly design, these scanners greatly reduce the discomforts experienced by children, claustrophobic, physically disabled and obese people who have to undergo MRI. An AIRIS II MRI scanner is open on all sides and allows the patients to be examined in a completely relaxed and comfortable position. Almost all these scanners have an operating field with 0.3T strength and produce quality scanning images in better resolution and contrast.

Techniques Applied for Neuroimaging

Physicians depend mostly on MRI scans for getting precise scanning results that will help them decide on the most effective treatment. The magnetic and radio waves used in this system produce clear and detailed scanned images. When the patient is placed under the MRI machine, the protons of the particular area to be scanned will become capable of receiving and transmitting electromagnetic energy. The signals transmitted depend on the properties of each proton, including its mobility and homogeneity in the magnetic field. The computer processes these transmitted signals into two and three dimensional pictures.

Breakthrough Diagnostic Procedure for Various Neurological Disorders

MRI equipment for neurological purposes is recommended for the examination of major neurological conditions such as Alzheimer's disease, brain tumors, aneurysms, strokes and eye diseases. Most of the providers offer neurological MRI scanning facility in a patient-friendly and comfortable environment.

Bowen Therapy can be a highly effective treatment for back pain and sciatica. Although it is a form of bodywork, bowen affects the body differently. There is no kneading of the muscle tissue, or manipulation of the bones in any way.

The bowen 'moves' are gentle, short and quick generating neurological impulses that inform the body to enter a deep state of relaxation. This triggers the muscles, tendons and ligaments to relax, releasing any pinched nerves such as the sciatic nerve. Bowen is a holistic treatment, treating the whole body at once so it can help with other types of pain as well such as neck pain, shoulder pain, migraines, carpal tunnel, fibromyalgia, plantar fasciitis, etc.

Bowen therapy is so gentle it can be utilized on anyone including pregnant women, babies, children and the frail and elderly. A safe alternative for athletes as well as no drugs are required.

Bowen can be utilized as a complement or alternative to chiropractic, physiotherapy, massage, acupuncture, spinal decompression, osteopathy, active release technique, trigger point therapy, and massage therapy."

Research:

Amy Norman presented a Bowen study in 1998 at the University of North Carolina at Chapel Hill, Department of Physical Education, Exercise and Sport Science.

Practitioners rated the following results in their clients:

85% effectiveness in back pain with an average of 4.3 sessions
88% effectiveness in neck pain with 4.5 sessions
83% effectiveness in stress, tension with 4 treatments
83% effectiveness in their "other" category after 5.8 treatments

After receiving their treatments, clients reported the following results:

85% effectiveness with back pain
80% effectiveness for stress and tension
80% effectiveness with Fibromyalgia
95% effectiveness with TMJ
80% effectiveness with hip pain
75.6% for "other" conditions

Chronic back pain can be debilitating. A safe, gentle therapy such as bowen therapy may help alleviate the pain, allowing one to return to enjoying the activities and pleasures of everyday life.

Bowen therapy originated in Australia with the creator, Tom Bowen, Tom had an innate sense of how the body learns to heal itself, provided it was given the correct stimulus. That stimulus was the gentle procedures now known collectively as bowen therapy or the bowen technique.

Tom treated thousands of people with incredible results at his clinic in Australia. He especially enjoyed treating athletes and children and operated a special children's clinic. Tom Bowen's gift of bowen therapy is now practiced worldwide.

A disc bulge is not to be confused with a herniated disc. That said, a disc bulge can cause severe pain - it all depends whether the bulge impinges or irritates a nerve. If so, pain results. If you have back pain of any kind - visit your doctor. If it's determined you have a disc bulge, bulging disc treatment may include some or all of the following.

1. Rest

Rest takes off the pressure that activity places on your back. Often it's pressure that causes the disc to bulge. But, too much rest can weaken important muscles; therefore, at some point pain treatment may require additional treatment pursuits.

2. Exercise

Two common types of exercises include walking and yoga (as long as your doctor agrees). If you're looking to do yoga, look for teachers who have some training with yoga for back pain. With respect to walking, don't overdo it.

3. Physiotherapy

Physiotherapy is a type of therapy that has grown in popularity in recent years for treating all kinds of back discomfort and other injuries. Look for a physiotherapist who has training and experience treating your back pain condition.

4. Heat / Cold Therapy for Bulging Disc Treatment

Applying heat and then cold and so on to the painful area can help ease your pain. The cold reduces inflammation, and the heat loosens up soft tissue.

5. Anti-Inflammatory Drugs

This is a short-term fix, but can offer pain relief. Over the counter anti-inflammatory medication is Ibuprofen. Your doctor may prescribe nonsteroidal anti-inflammatory drugs as well for a stronger medication.

6. Surgery

Generally a last resort. The pain is usually extremely debilitating. Surgery always has risks attached to it. It`s rare to do surgery for bulging disc treatment.

You feel like you have tried everything under the sun to get rid of that back or neck pain. You aren't able to do the "normal" things you always could do, like cut the grass, exercise, play with your children, work in the garden, or just take a simple walk. Some days you say to yourself, "I would do anything to get rid of this pain!"

You feel like you have no choice and you may have to find a way to live with this pain for the rest of your life. You don't want to have surgery because you know after going through all of that there is no guarantee it will be any better. Well, you aren't alone. Millions of people around the world suffer with debilitating back and neck pain.

The good news is, spinal decompression therapy is a safe and pain-free procedure for lower back and neck pain. Spinal decompression is one of the most exciting medical treatments developed in many years, and has shown good statistical results for long term pain relief. It is also FDA approved.

Spinal decompression is a non-invasive, non-surgical technology that is able to provide real relief to millions of people who suffer with back and neck pain. This therapy is a form of traction that cycles through phases of distraction and relaxation, while also maintaining proper positioning. Spinal decompression is a term that describes the relief of pressure on one or many pinched nerves (neural impingement) of the spinal column. It gently relieves pressure that builds up on the discs that can indirectly cause spinal nerve pain that radiates into the arms or legs.

The patient is placed onto an instrument, they are belted in, and it separates their lower body from their upper body. During this procedure, the nutrient rich blood fills the disc space which fosters the healing response, causing the disc material to get sucked back into the joint space and the outer layer is made stronger by stimulating the cartilage to regenerate which in turn helps to prevent re-injury. It also allows for strengthening of the outer cartilage bands that hold the disc material in place, as well as aiding muscles and ligaments that can become weak and stretched during the bulging process.

Spinal decompression has been proven effective in relieving the following problems: pain associated with bulging and herniated discs, degenerative disc disease, sciatica, spinal stenosis (narrowing of the spinal canal), posterior facet syndrome, whiplash syndrome, and even relapse or failed back surgery, arthritis and other spinal conditions.

This therapy not only significantly reduces back pain in many patients, but also enables the majority of patients to return to more active lifestyles. Spinal decompression has great potential in treating a large number of people who might not otherwise be able to regain their health or ability to enjoy pain-free living without the restrictions and risks associated with back surgery.

Cervical radiculopathy typically causes patients to have arm pain that is consistent with the particular nerve root that is being compressed. The most common cause is from a cervical disc herniation, which is called a "slipped disc" in layman's terms. This pain may go into the shoulder area, down into the arm, or may extend all the way into the hand and fingers. The pain is typically burning and extremely irritating to patients. This article refers to treatment options for this diagnosis, not for other issues like tumors or fractures.

What treatment options are available? Here are ten, starting with the most radical.

1) Surgery. Neck surgery for a herniated disc causing radiculopathy is indicated if a patient is having motor weakness. It is unclear if motor weakness is watched for over 3 to 6 months if it will improve even after a successful decompression. If a patient undergoes unsuccessful nonoperative treatment for over six weeks and is still miserable, surgery is indicated as a quality of life decision.

2) Interventional pain management. Often times the disc herniation will go away by itself, by disintegration. One of the methods to avoid surgery in the meantime is an epidural steroid injection. It can bathe the nerve root in a soothing anti-inflammatory material and reduce pain, thereby making life tolerable while the piece of disc pushing on the nerve root slowly disappears.

3) Physical Therapy. PT can help a lot in patient suffering with radiculopathy. The patient may need an epidural injection first along with pain medication, but physical therapy can improve range of motion and decrease pain.

4) Spinal Decompression Therapy. This is a nonoperative intermittent traction treatment that is FDA cleared. It works extremely well for lumbar pathology and in addition has shown success in treating cervical radiculopathy. Typically the treatment entails 20 sessions.

5) Chiropractic Treatment. Cervical manipulation has been shown to be effective for neck problems and radiculopathy. The risks of cervical manipulation appear to be very low, with fatalities occurring less than one in a million times.

6) Narcotic Pain Medications. In acute situations, these can be extremely helpful. The pain from radiculopathy can be disabling, and these medications may allow the patient to be much more functional.

7) Non-narcotic pain medications. These include NSAIDS, acetaminophen, and neuromodulators like gabapentin. They can help just as much as narcotics for radiculopathy and should be first line treatment.

8) Muscle Relaxers. When patients have radiculopathy, muscle spasms are common. Helping settle those down may allow the overall pain scale for patients to drop.

9) Acupuncture. Acupuncture has been shown to be effective for a lot of neurologic and musculoskeletal issues, and radiculopathy is no exception.

10) Massage. This may help substantially with muscle spasms and relaxation.

Degenerative disc disease and the neck pain, back pain, and/or sciatica often associated with it is often misunderstood and even misdiagnosed. We will attempt to shed some light on one of the most misunderstood of all bad back conditions, offering a possible bad back strategy to help individuals struggling with the consequences of this "disease." The spinal column consists of seven cervical vertebrae, twelve thoracic vertebrae, five, sometimes six lumbar vertebrae, five, usually fused vertebrae forming the sacrum, and four very small bones making up the coccyx or vestigial tailbone. The spinal column is made up of a total of thirty-three vertebrae. Together, the vertebrae function to provide stability to the torso, and body as a whole, protecting the spinal cord from exposure and damage. Between each vertebral body is an intervertebral disc or IVD, and each IVD is made up of a fibrous bundle of tissue, fibrocartilage, which serves as a cushion of sorts, absorbing shock to the spine. The outer portion of the IVD is called annulus fibrosis and its surrounds a fluid filled center with the consistency of jelly, a mucoprotein gel, called the nucleus pulposis. The nucleus pulposis acts as a sort of shock absorber, keeping two adjacent vertebral bodies separate, while absorbing much of the impact to the spine. I have often used the example of a jelly doughnut to describe an intervertebral disc.

Over time, and as people age, the fluid filled center of the IVD, the nucleus pulposis, begins to dry up, it dehydrates. As the IVD dehydrates, the spine loses some of its shock absorbing ability. Additionally, and coincidentally with the dehydration of the IVD, the annulus fibrosis grows weaker and may begin to tear. This condition is called degenerative disc disease and, while some individuals with this condition remain asymptomatic or pain free, others will experience varying degrees of neck pain, back pain and/or sciatica depending on the level of the possible breakdown or pathology. In fact, as the annulus fibrosis begins to weaken and tear, the nucleus pulposis may bulge or extrude anteriorly or foreword, posteriorly or backward, or even laterally, pout to the side, possibly causing a nerve root impingement and, depending on the level, resulting in neck pain, back pain and/or sciatica.

The back pain complex caused by degenerative disc disease is generally the result of inflammation, instability, a reduction in the vertebral spacing intervals and/or nerve root impingement. Neck pain, back pain, and/or sciatica may also be due to several of the above consequences together as the spine at a given level fails. It has been demonstrated that proteins in the disk space may cause a great deal of inflammation, thus resulting in chronic pain at the level affected. Instability caused by weakening of the IVDs, and possibly of the anterior and posterior longitudinal ligaments, often results in pain due to micro-motion and the resulting nerve impingement. Furthermore, the pain resulting from instability may be muscular as well. On occasion, the para-vertebral muscles, as well as other core muscles, will spasm as the musculoskeletal system attempts to adapt and adjust to the instability. The degeneration of the discs over time and as we age will bring adjacent vertebral bodies closer together, also resulting in nerve impingement. Degenerative disc disease may result in pain as an aging disc becomes then and the space between vertebral bodies narrows. As spacing decreases the nervous may be compressed does causing inflammation and pain. Depending upon the level of impingement, an individual may experience tingling or numbness in the buttocks, legs, and even the feet and toes. Additionally, the nerve impingement may result in neck pain, back pain, and/or sciatica. The amount of actual pain may vary from mild to completely debilitating and disabling. Pain levels may vary with periods of almost no pain and other periods of acute and debilitating pain.

Degenerative disc disease, as noted above, is an often misunderstood and misdiagnosed condition. In spite of the fact that it is one of the most common "bad back" conditions, and one of the leading sources of neck pain, back pain, and/or sciatica, it is not a disease. Degenerative disc disease is actually an age-progressive phenomenon and the normal part of aging. There are measures that when taken may offset, and even delay many of the consequences of this phenomenon, but ultimately, as we age, the spine ages with us. In many instances sitting actually worsens the pain while standing, as long as it is not in one spot and for a prolonged period of time, it helps to alleviate the pain.

Ultimately, the most effective course of action is an individualized and supervised program of stretching and exercise to strengthen the para-vertebral muscles, as well as the remained of the core muscle group. It is crucially important that anyone with this "disease" strengthen the muscles that support the spine. Degenerative disc disease is as common as it is because of inactivity, obesity, and a sedentary lifestyle. Only by implementing a daily activity and exercise routine can one hope to offset the effects of aging as related to this condition. Through daily exercise to strengthen the muscles supporting the spine, combined with ice for inflammation, and the proper shoes for heel cushioning, so important when you must be on your feet for prolonged periods, one can alleviate and ultimately eliminate neck pain, back pain, and/or sciatica associated with degenerative disc disease.

Spinal decompression therapy is composed of several methods. All treatment techniques employ several approaches and various equipment are utilized to decompress the spine, increase the room in between the vertebrae to enable enough blood and oxygen to flow continuously and to decrease the tension and pressure on the spinal column and disc. Spinal decompression is advised for people struggling from extreme lower back discomfort, sciatic nerve pain and various spine and disc ailments which can be degenerative in nature or due to postural abnormalities.

Spine decompression options involve the newest procedures of utilizing spinal decompression units and inversion tables. The question would be: Which one would be the most effective method of treatment? And which can you choose?

Employing a spinal decompression device like the ones located in a medical professional's clinic can be an extremely effective approach to decompressing spinal column simply because the equipment is computerized and can approximate the total amount of traction needed to get the ideal results. The treatment is called as spinal decompression treatment. It's popular just like inversion treatment which makes use of an inversion table.

An inversion device is used in inversion therapy which is an additionally strategy of treating spinal compression through inversion. Inversion, or hanging upside down employing the inversion device gives a particular overall amount of traction to the spine enabling it to decompress. They are both excellent possibilities for the treatment of spinal compression however each one has its own negatives as well.

Spinal decompression therapy and the device used are extremely expensive. You can spend a few hundred bucks for an inversion machine, or you can invest hundreds and thousands of dollars for the computerized decompression therapy in a medical doctor's clinic. The other advantage of using a home inversion machine is the potential to use it day-to-day or several times per day if necessary.

Your decision amongst these two should now depend on your needs and your budget. Reviews on the internet will additionally help you determine which one is more efficient nonetheless statements can be confusing so it will be considerably better to talk to your medical professional and ask him or her which therapy and therapy equipment is best for you.

Aging brings about several changes in the human anatomy, as our bodies become more susceptible to wear and tear. A common condition that arises because of aging is called Degenerative Disc Disease, and it is a condition that can also be passed on genetically.

Degenerative Disc Disease, however, is neither a real disease nor does it mean that the condition's symptoms worsen over time. Degenerative Disc Disease is the degeneration of the lumbar discs in the spine due to inflammation or damaging of the outer rings of the disc, which prevents it from resisting force and motion. The degeneration of the discs results in spinal compression as vertebral bodies move closer to one another.

The lumbar discs act as shock absorbers between the vertebrae of the spine. They oppose a great amount of force in multiple planes of motion to protect the spine and vertebrae. Their degeneration commonly causes chronic lower back pain and at times severe back pain, which is felt more when sitting rather than when standing. Activities such as bending and lifting worsen the pain. Other symptoms also include pain, numbness, and tingling of the legs.

Non-surgical spinal decompression is one method of treating Degenerative Disc Disease. Spinal decompression is a non-surgical, cost-effective, and non-invasive way of treating Degenerative Disc Disease and other chronic spinal conditions. This treatment proceeds by using a machine, the DRX 9000, which applies a gentle force that decompress the injured discs and vertebrae, and therefore, provides immediate and gradual back pain relief. Decompression works by elongating the spine in order to release the pressure from the injured discs and vertebrae.

In treating Degenerative Disc Disease, decompression reduces the pressure in the disc space and restores homeostasis (balance) on the discs, thereby reducing and eliminating painful symptoms and allowing healing to take place as oxygen and nutrients enter the injured discs. An advantage of treatment by spine decompression therapy is being able to control the rate of decompression through the machine. As a result, the patient does not endure excess stress compared to other decompression treatments. This is also ensured by the fact that the treatment incorporates rest in between the slow and gentle process of stretching the spine.

Spinal decompression has proven to be a more effective way of treating Degenerative Disc Disease than traditional spinal surgery, and fewer analgesics (pain killers) are required to be taken after the therapy.

Caudal Epidural Steroid injection procedures are performed to relieve low back and radiating leg pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica, and herniated discs.

In this procedure the patient lies face down on the table and a cushion is placed underneath the stomach area for comfort and to arch the back. The pain physician then uses a fluoroscope (x-ray machine) to find the small opening at the base of the sacrum called the sacral hiatus.

A local anesthetic is then used to numb the skin and all of the soft tissues down to the surface of the sacral hiatus. The pain physician then guides a needle through that anesthetized track and into the epidural space. The needle is carefully inserted about 1 to 2 cm.

Once inside the sacral hiatus space a contrast or nonallergenic iodine base solution is injected. This solution helps the pain physician to see the diseased and painful areas using the fluoroscope. A steroid and anesthetics mix is injected into the epidural space bathing the painful area and medication. The needle is removed.

The tiny surface wounds is covered with a small band aid. In some cases it may be necessary to repeat the procedure as many as three times for the patient to feel the full benefit of the medication. However, many patients feel significant relief from only one or two injections.

If a patient has a disease process at numerous spinal levels, a caudal injection may help significantly. The reason is it can bathe numerous levels with the steroid medication giving the patient the best chance of pain relief success with a multi-level problem.

Arm and leg pain and their associated joint pains can be caused by many different factors. Sometimes, pain in your extremities can be caused by an obvious injury. However, surprisingly most arm and leg pain are usually not caused by direct trauma. Instead the pains are often the result of other pains that originate in other parts of your body - far removed from the arms or legs. This pain concept is named 'referred pain' and can be difficult to understand.

Our muscles, joints and bones are all intertwined with one another. This means that an injury or pain in one area can often travel to other parts of the body.

Understanding Referred Pain

As osteopathy is a holistic manual therapy, it's perfect to assess whether the origin of your pain is localised to one particular area, or if it actually originated in a separate area before travelling to your arms and legs.

It can be difficult to recognise pain in your central nervous system. This is often because it is referred to your extremities. You therefore think that 'a sore foot' is a sore foot, when it's actually a sign that another part of your body is experiencing pain. Where some doctors may fail to notice this, osteopaths are acutely aware of this phenomenon and try to locate all connected sources of pain. A pain in your arms or legs may allow your osteopath to uncover and treat pains across your whole body. In such cases, your osteopath is not only helping you rid the pain in your legs and arms, but also the pain in your neck, shoulders and/or other areas of the body. Now that's a good thing.

In the quest to find the true source of your pain, your osteopath not only looks locally, but also centrally. For example, a pain in your neck joints may cause referred pain to your wrist. Logically you would think that your wrist is the sole area that requires treatment. However this would be of little benefit, as the source of your problem is in the neck. Your neck therefore requires treatment, which would then eliminate your wrist pain.

For the source of the pain to be identified, your local joints may also be checked for any joint pain. In most cases, pain in your extremities may be a result of referred pain from various sources in the body.

Your Osteopathic Assessment

During your osteopathic assessment, your osteopath will ask you questions to either confirm the signals your body is indicating, or ask questions to help provide a better understanding of your health across other areas. Your osteopath will ask some routine questions such as whether your pain started after a local injury, if the pain began slowly at a particular spot, or if you noticed pain in the back, neck or the spinal region a few days before your leg and arm pain started. It's important that you answer these questions as honestly as possible. The answers to these questions will help your osteopath understand whether your pain is due to a recent injury or whether the origin of your pain is due to the resurfacing of an old injury. This will also allow your osteopath to understand whether the source of your pain is local or central. To further confirm, your osteopath will perform a physical examination.

Apart from making these observations, your osteopath will also look at the spinal patterns and the nerve relationships to get to the source of any central pain in your body. They will test different parts of your body, especially the areas where you feel the most pain, to look for any kind of muscle tightness or loss of strength.

After a full assessment, your osteopath is best able to diagnose the true origin of your pains and recommend the best course of action.

Stress can be a serious condition if it remains untreated. It can cause anxiety attacks, heart disease, or general pain and stiffness. One of the best options to relieving stress is chiropractic adjustments. Stress can significantly be reduced with the help of a chiropractor. With spinal manipulations and a good diet, the body will be able to adapt better to stress.

Stress knots in the body can drastically hinder the way one performs their daily activities. The body tries to compensate for the pain the muscle is causing, but in return the body starts to become uncomfortable and extremely tight. When a condition arises in the neck, if it isn't treated, it can then form down the shoulders and into the low back.

The biochemical and physiological aspects of the human body receive a lot of attention from chiropractors. When the body has prolonged tension in the muscles, regardless of the location, it can lead to behavioral and personality changes. A spinal manipulation benefits the spine and surrounding muscles. This technique removes the irritation in the nerves and releases tension in the muscles allowing the body to properly adapt to the daily stresses in life.

A spinal adjustment sends certain signals up to the brain that turns off the stress response. The human body can actually handle stress very well if it's given the chance. Routine chiropractic adjustments, a healthy diet, and moving well will keep the body in tip top shape to deal with daily stresses.

Managing stress with chiropractic care helps to improve reflexes, joint and muscle movement, and range of motion. Some people are so prone to stress that the joints and muscles must be retrained so the individual doesn't hold stress and tension in their body. For greater results, spinal adjustments may be combined with massage therapy.

A few tips and helpful hints to reduce any physical stress and tense muscles are:

Take a quick five minute stroll whether it is inside or outside. Continuous movement helps prevent muscle restriction.

Change the scenery. Sometimes all it takes is little break to chit chat with someone or just look at the window. Observing others, or "people watching", is a quick way to get the mind off any stressful thoughts.

Simply close your eyes and imagine being anywhere in the world. Take a few deep breaths and re-group your thoughts to positive images

Stress can definitely bring out the worst in some people. Chiropractic care is an important and natural way to rid stress and tight muscles.

In the 10 years between 1997 and 2006, interventional pain treatments went up by 235% in the Medicare demographic. There is building evidence that early imaging and injection treatments result in better outcomes. The results have been very promising.

When looking at neck and back pain causes, there are really 3 main categories: 1) Disc Degeneration 2) Disc bulges/herniations and 3) Facet Degeneration

When imaging studies are obtained, one of the main reasons is to exclude non-degenerative pain problems such as tumors, compression fractures, or neural disorders.

Safety of lumbar and cervical epidural injections and nerve blocks has been shown in many studies, with a complication rate of

Transforaminal injections into the cervical spine entail risk higher than lumbar due to 1)Tortuosity of the vertebral artery 2) Direct injection possibility into the spinal cord and 3) Injection potential into the microvasculature surrounding the spinal cord.

It's unclear whether these injections in the cervical spine are that much better and with the increased risk, it may be better just to stick to regular cervical epidural injections. The contrast used to elucidate correct placement may end up in one of these vessels, causing potentially serious complications.

The most common complications seen in back and neck procedures are 1) Pain and 2) Needle misplacement. As mentioned, transforaminal cervical epidural injections are questionable with their safety profile. It's debated where some studies show them to be safe, while others display an unfavorable safety profile.

Patient Selection for ESI

Injections are of value to patients with both spinal stenosis and painful disc herniations. With spinal stenosis, one may see a situation where the stenosis is chronic and the patient is functional, however, an acute exacerbation makes it intolerable. ESI's may put the situation back to baseline.

Injections are not a permanent cure, and surgery is an option for stenosis or herniations. One injection may not do the trick, it may take a series of injections with a repeat of the series every few months.

If a series works and then wears off it does not mean it was a failure, simply it ran its course.

ESI's can achieve pain relief, lower operative rates, and less medical cost, especially in those over age 65. Acute problems and leg/arm radicular pain respond the best. Disc herniations have an overall efficacy response (61%) better than stenosis (38%). Interestingly, though, with stenosis the degree of the problem is independent of the patient response to the injection. For patients with multilevel spinal stenosis, injections may be a godsend as it can prevent a multi-level surgery with increased risk.

It is natural for people to have morning breath. Who does not? But we do not want people to think that we always have "morning breath," right? After brushing, we want to maintain that fresh, minty breath, but oftentimes we cannot. We wonder why others can. We must be doing something wrong. Here are some pointers in maintaining the freshness of your breath.

1. Drink lots of water.

A dry mouth emits foul odor. Drinking now and then would prevent this. You could also take in candy to stimulate the salivary gland to produce saliva leaving the mouth moist. Fruit juice could take the place of water. Water; however, is the best liquid because it cleanses also the system of waste products.

2. Brush every after meal.

The standard method is to brush twice a day, but brushing after every meal would ensure that there are no food remnants left inside crevices. Brush the molars gently with circular strokes and up and down strokes at the front teeth. Bacteria thrive on bits of food left inside teeth crevices.

3. Do not eat spicy foods and condiments.

Spicy foods like pepper, ginger, onions, could dry up the mouth that can lead to halitosis.

4. Do not smoke.

One of the main causes of bad breath is smoking. The odor of cigarette causes bad breath.

5. Do not drink alcohol.

Alcohol breath is never pleasant. The odor is sickeningly "fruitish." Who would like to smell that kind of breath?

6. Gargle with soda water.

Soda powder dissolved in water and gargled is a good odor remover. If you cannot avoid drinking alcohol and smoking, then gargle with soda water afterwards.

7. Floss at least once a day

Food remnants found in between the teeth are not all removed by brushing. Flossing will eliminate all these tiny bits of food. When these are not removed, bacteria would proliferate and would cause halitosis.

8. Select the correct toothpaste

Your mouth and teeth should not "reject" it. Even if it is alleged to be the best in town, if it does not suit you, then find another. Your toothpaste should not make your mouth dryer.

9. Drink calcium-containing drinks.

Dairy product like milk is one good source of calcium. Other sources of calcium are cereals, tuna, and salmon. Citrus fruits would also provide vitamin C for the gums.

10. Visit your dentist regularly

"Prevention is better than cure, "as the cliche goes. To avoid decay, cap tooth. Have that tooth cured before the hole becomes bigger. An infected tooth is a good haven for bacteria.

You should remember that what you are trying to prevent is the accumulation of bacteria, which would cause bad breath.

According to Merriam-Webster's online dictionary, sciatica is defined as pain along the course of a sciatic nerve, especially in the back of the thigh caused by compression, inflammation, or reflex mechanisms.

The sciatic nerve is an ensemble of several nerve roots that join together and create the longest and largest nerve in the body. Generally, symptoms of sciatica are pain in the buttock and leg that worsens when sitting, burning or tingling sensations that run down the leg and/or weakness, numbness or distress while moving the leg or foot.

Sciatica is usually a secondary symptom to a primary problem. Due to the fact that sciatica is commonly a symptom, the primary concern must always be addressed in order to obtain relief from sciatica.

In general, primary conditions include lumbar spinal stenosis, herniated or slipped disk in the lower back region, pregnancy, piriformus syndrome or trauma to the sciatic nerve. The most common of these conditions is a herniated disk. There are many methods used in relieving sciatic nerve pain due to herniated or slipped disk.

1. One form is the extension exercise method. Extension exercises should always be done gently with caution, because most patients are unable to tolerate the positions required. While in the prone position (lying on the stomach), prop the upper body up by using the elbows while keeping the hips on the floor. Hold this press up position for five seconds, then gradually increase the movement to thirty second intervals. Ten repetitions is recommended. For the patient whom is unable to tolerate the prone position, a similar method can be used by standing and arching the back slowly, with the hands placed upon the hips.

2. Another common approach to relieving sciatic nerve pain is a minimally invasive procedure known as epidural steroid injection (ESI). An ESI is a common type of injection used to relieve certain types of lower back pain, such as sciatica. The solution is injected into the epidural space, which is the space between the covering of the spinal cord and the spinal canal. What is generally injected is a strong, long lasting anti-inflammatory steroid known as Cortisone. Cortisone begins to take effect several days after injection and lasts several weeks to several months depending upon the individuals tolerance.

3. Additionally, sciatic pain from a herniated or bulging disk can be abated using the spinal decompression therapy procedure. Spinal decompression therapy is a process where forces are applied to the spine. This technique promotes the elongation of the spine as well as improving disk hydration. Thus relieving pressure on the nerves and intervertebral disks.

4. A not so difficult remedy in achieving relief from sciatica due to pregnancy is to lie on the side opposite of the pain. For added comfort, place a pillow between the legs. Also, avoid heavy lifting and standing for long durations. If avoidance of standing cannot be obtained, try elevating and resting one foot on an object.

5. Flexion exercises are generally the best approach in treating sciatica from lumbar spinal stenosis. Flexion exercises are exercises that involve forward bending. Bending forward increases the size of passageways that will in turn relieve irritation. An example of a Flexion exercise is the double knee to chest exercise. While lying on the back with both knees bent, gradually raise the knees to the shoulders and hold for five to ten seconds. Slowly lower the knees back to the floor. This exercise can also be done one leg at a time.

6. Acupressure is an alternate remedy that can be used in easing sciatic pain due to piriformus syndrome. Acupressure is the application of pressure on the pressure points of the body. A self administering acupressure technique is to lie down in the supine position (on the back) with knees slightly bent. Next, place the hands into fists and then lie on the knuckles. The knuckles should be positioned on the muscles on both sides of the spine. The body weight on the knuckles will aide in the releasing of the lower back muscles, which activates several acupressure points. While in this position, breathe deeply and slowly. Ten repetitions of breathe is recommended. For additional relief from sciatica after acupressure is performed, lie down and place the knees to the chest. This position aides in the releasing of the gluteal muscles.

7. A Transcutaneous Electrical Nerve Stimulation (TENS) unit is used for the relief of nerve related pain ailments, such as sciatica. The electrical current produced prevents pain signal transmissions to the brain.

8. Hot and cold compresses are considered a popular method in obtaining relief from sciatica. Hot compresses are generally applied if inflammation is not the culprit of the discomfort. Stiffness and soreness are indicators of little inflammation. Cold compresses are applied if inflammation is the culprit. Swelling is an indicator of inflammation.

9. Hydrotherapy is a relaxing yet effective sciatic pain relief method. One method is simply filling a bath tub with warm water, preferably to the chest area. Soak in the water for twenty minutes to several hours. If the sciatic pain is too intense to remain in a tub, then take a hot shower for about twenty minutes.

10. Non-steroidal anti-inflammatory drugs (NSAIDs) are beneficial in the reduction of inflammation and pain associated with sciatica. Some common forms are ibuprofen and naproxen.

Millions of Americans suffer back pain daily. In the majority of cases, pain occurs when muscles or ligaments stretch, strain or tear. In some instances, patients experience pain due to a bulging or displaced disc. Many medical experts agree that reparative surgery, such as bulging disc surgery, is not the only viable option available to resolve this condition. Professionals estimate 90% of persons afflicted with this injury, heal with alternative treatments within 6 months.

Bulging Disc Definition

Between each vertebra lies a shock-absorbing cushion known as a disc. The disc consists of a gel like substance covered by a tough outer layer. Under certain circumstances, the disc can shift backward, putting pressure on spinal nerves, which results in pain. A disc may tear or rupture causing leakage of the cushioning inner fluid, also contributing to pain. The irritated area becomes inflamed, further contributing to symptoms.

Health care providers uses various terms describing the condition including:
Black, Herniated, Collapsed, Prolapsed, Degenerative, Ruptured, Slipped, or Protruded Disc

A bulging disc can occur anywhere along the spine. Symptoms vary according to what location of the spine is affected. Generally, patients experience back pain, numbness or tingling in an extremity, muscular weakness, diminished reflexes or paralysis.

The event is the result of excessive spinal straining, twisting motion, age or obesity. Health care providers make a definitive diagnosis based on an individual's symptoms and by using a CT or MRI scan. Physicians treat the cause and the symptoms using various options before considering intervention with bulging disc surgery.

Medications

In order to reduce inflammation, irritation and mild to moderate pain, health care professionals prescribe a combination of over-the-counter or prescription anti-inflammatory medications with bed rest along with heat/ice applications or topical ointments. Muscle relaxant medications minimize the effects of painful muscle spasms created by the irritation and tension.

Physical Therapy and Exercise

Physical therapists treat and educate patients to obtain spinal endurance, flexibility and strength.
Physicians often recommend patients consult with a physical therapist, which use numerous treatment methods to alleviate the spinal pressure and subsequent pain associated with bulging discs.

Chiropractic

Chiropractors, like physicians, formulate treatment based on symptoms and diagnostic testing, which may include x-rays, CT or MRI scans. The practitioner acquires a patient's medical history, list of symptoms and diagnostic test results. They test muscle tone, reflexes and nerve function to determine the location and severity of the condition.

Chiropractors are highly trained professionals who treat improper spinal alignments that impinge upon health and physical function. Similar to physical therapists, chiropractic treatment requires numerous sessions incorporating hot/cold treatments, electrical stimulation, and exercise. A chiropractor's skill and knowledge includes spinal manipulation and methods of traction to realign the spine.

Many individuals prefer chiropractic care because remedies involve non-invasive methods without the use of medications.

Decompression Traction System

Traditional traction methods involved wearing a harness attached to a weight system. Weight increments increased gradually in an attempt to stretch the spine, alleviating pressure.

Modern decompression traction, or DTS, consists of a fully-clothed patient lying on a table in a desired comfortable position. Harnesses and weight are still utilized, but under a carefully controlled computer-generated environment. A computer program initiates gentle stretching and release cycles. The amount of force exerted increases gradually and then allows a period of relaxation, inhibiting muscles from resisting and attempting to spasm.

Acupuncture and Acupressure

Acupuncture is an ancient form of Chinese medicine that involves placing fine needles into various parts of the body to stimulate natural healing processes. Traditional acupuncturists use extensive evaluation and testing techniques to determine ailment locations.

Acupuncturists, chiropractors and physical therapists commonly use acupressure. The method involves applying concentrated deep massage directly to the tissues involved in the condition by using the thumbs and fingertips.

Time

Effective healing from any type of injury requires time. Numerous methods enhance the healing process without the need for bulging disc surgery.

Neck pain is a common illness from which almost all of us suffer at least once in a lifetime. We often hear complains of neck pain from our colleagues, friends, relatives, etc. in our daily life. Neck pain has been known by a medical term "cervical spondylosis". This mainly occurs due to the degeneration of joints in our neck. As we grow older the bones in our body starts degenerating and that's why cervical spondylosis is common in people with over 60 years of age. Cervical spondylosis is basically a form of arthritis, but it rarely leads to disability.

Cervical spondylosis results more in women than in men. There is no specific cause of neck pain known, until now, but it occurs due to one or more disorders or diseases that exist in the structures of the neck. As we grow with time, vertebrae and discs develop some degree of degeneration that affects the closely located nerves, muscles, and ligaments. These body structures due to irritation tend to develop pain that results in cervical spondylosis. Cervical spine is made of circular bones (vertebrae) that lie in regular pattern one above the other. Each vertebra is separated from other through an intervertebral disc that acts as a shock absorber and provides flexibility to spine. Nerves extend from the spinal cord, passes from the vertebrae, to shoulders, neck, arm, and upper chest. Thus, the degradation in vertebrae eventually leads to pain in interconnected nerves and muscles.

Causes:

Cervical spondylosis mainly results due to chronic wear on the cervical spines. Everyday wear and tear may start degradation of these vertebrae. People who are very active in work or in sports may be more likely to have cervical spondylosis. The causes of neck pain may vary from one person to the other, but some common causes are:

• Injury, muscle problem, or trapped nerve in between vertebrae.
• Wrong postures while sitting or sleeping
• Malfunctioning of small joints present in the neck
• Hypertension, hyper-flexion may also result in neck pain
• Travelling, household activities, and office jobs

Risk Factors:

The major risk of cervical spondylosis is aging. People having age above 60 are at more risk. Other risk factors include:

• Overweight and less physically active
• Doing a job that includes pulling heavy weight and that involve excessive movement of muscles.
• Injury of the neck in late past
• Spinal cord injury in recent past
• Disease such as Osteoporosis or Arthritis

Symptoms:

Symptoms of cervical spondylosis may differ individually and can vary from mild to serious. Some usual symptoms that indicate cervical spondylosis are:

• Pain in neck and shoulders
• Difficulty in movement of neck and head
• Neck stiffness, especially when you wake in the morning
• Frequent headaches, especially in the back of the head
• Numbness or weakness in the shoulder and arms

Treatment:
One can prevent the pain by adopting a better lifestyle, correct sitting postures, and exercising. However, treatment of cervical spondylosis includes:

1) Non Pharmacological Treatments

• Physical therapy by using stretches
• Massage therapy by using acupuncture
• Cold pack and heat therapy to alleviate neck pain
• Cognitive Behavioral Therapy: If pain is severe and has impact on quality of life. This technique is also called as talk therapy which helps to understand the cause and measures to prevent pain

2) Pharmacological Treatments:
The drugs Non-steroidal anti-inflammatory (NSAIDs) such as Aspirin, Ibuprofen can help to relieve from pain. If the pain is severe, kindly consult to the doctor.

Preventive Measures:

• Prevent from cold exposure and violent exercise
• Maintain comfortable posture while sitting or doing daily activities

Low bone density or osteopenia in medical term is a problem that commonly affects women, particularly in their middle ages and certainly after menopause. Its bone mineral density is lower than normal peak. It is estimated that 40% of all postmenopausal Caucasian women have low bone density and proportion of these women will go on to develop osteoporosis, with a high risk of bone fractures.

Bones constantly recycle themselves to maintain their strength. Old bone is absorbed by the cells in body called osteoclasts in a process known as resorption. New bone growth by cells called osteoblasts replenishes the old. The osteoblasts construct new bone material to maintain bone strength. Low bone density takes place when old bone is taken up than new bone deposited, resulting to thinning of bone or low bone density and in severe cases, may result to osteoporosis, a disease characterized by low bone mass and structural deterioration of bone tissue that leads to bone fragility and an increased fractures of hip, spine, and wrist.

The association between bone density and low back pain is quite intimate. The classic condition and cause of spinal pain associated with the loss of bone density is spinal compression fracture. All bones lose strength over time and the lumbar vertebrae, particularly in postmenopausal women, can be fractured or compressed from a fall or even from the stress of lifting or everyday activities. The bone strength decreases to a point where slight trauma and sometimes, no trauma whatsoever can result in a fracture.

A compression fracture is a complete bone break that disrupts the bone tissue and collapses the affected bone. Most commonly, the site where compression fractures occur can be found on the spinal vertebral body. Pain from a vertebral compression can be severe and it may show no symptoms and only be discovered when x-rays of the spine are done for other reasons. Over time symptoms such as back pain, loss of height, and kyphosis or stooped over posture may occur. A person may experience less pain during bed rest due to the fact that sitting and standing puts weight on the vertebra and can cause pain.

Studies have shown that the likelihood of incurring additional vertebral fractures is increased once an individual has already experienced one, even if that person does not have low bone density. Research also suggests that around 20% of older women who experience spinal fracture will experience another such fracture within a year.

The normal effects of aging in relation to decreased bone mass and decreased strength and elasticity of muscles and ligaments is unavoidable. However, such effects can be slowed by keeping the muscles that support your back strong and flexible by exercising regularly, using proper body mechanics in lifting and moving, maintaining proper body weight, maintaining a proper posture, avoiding smoking, and receiving regular chiropractic care.

Most cases of low back pain respond to chiropractic treatment. A chiropractor can accurately diagnose and effectively treat most types of low back pain. DEXA (dual-energy X-ray absorptiomery) scan is used in some cases to predict brittle bone conditions. A DEXA T-score of -1.1 to 2.4 indicates osteopenia while 2.5 or greater indicates osteoporosis. A DEXA scan can also help to identify if you are at risk, before it becomes a problem.

A newer bone imaging technology has been developed. FRAX is a computer-based algorithm that provides the 10-year probability of fractures in men and women on the basis of classic risk factors alone or by integration of classic risk factors with bone mineral density, which is measured by DEXA.

Proper diagnosis will help figure out whether a chiropractic adjustment would be beneficial as a part of back pain treatment. A lot of doctors regularly refer people with severe back pain to chiropractors. A patient can go directly to a chiropractor as referral from a doctor is not actually required. The key to such health concern is early identification and intervention. Receiving chiropractic treatment helps in the prevention of low back pain from low bone density.