Wednesday, February 25, 2015

Degenerative disk disease - Spinal manipulation techniques - Neck bone spurs causing headaches?

Degenerative disc disease refers to any condition where the spinal discs are degenerating or degrading, often causing back pain. This interactive video provides information on spinal anatomy and how degenerative disc disease affects the vertebrae and spinal discs. It also gives an in-depth overview of symptoms associated with degenerative disc disease.

Spinal manipulation techniques
There are well over 100 types of adjustment techniques used by chiropractors throughout the world. Typically, chiropractors will focus on and utilize 8 to 10 different approaches in their practice.

Bone spurs in the neck could be causing your headaches:

Saturday, February 21, 2015

Articles on lower back pain, depression, and spinal manipulation

In the assessment of lower back pain, differential diagnosis utilizing a "triage" concept of classifying low back injuries into one of three categories helps to guide the doctor of chiropractic. Click below to read more:

It's not a surprise that most people suffering from chronic pain also experience depression, but did you know the reverse can be true as well? Check out the Depression Guide from Spine-Health:

Scientific evidence has indicated that spinal manipulation is a safe, mild-to-moderate pain reliever for lower back pain, neck pain and headache, and recent health care guidelines have listed it as a viable treatment option for symptoms that do not respond to self-care.

Wednesday, February 18, 2015

Understanding Low Back Pain (Lumbago)

Lumbago is the general term referring to low back pain, and the two terms are often used interchangeably.
The underlying causes of low back pain can be complex and are not always readily apparent. When determining the underlying cause of lower back pain, two main factors help guide the physician in making a preliminary diagnosis:
  1. The type of low back pain – meaning a description of how the pain feels, what makes it better or worse, when it occurs, and
  2. The area of pain distribution – meaning where the pain is felt, if it is confined to the low back, or if the accompanying leg pain is worse than the low back pain, or if the pain radiates elsewhere in the body.
This article is aimed at helping patients understand how physicians evaluate the area of pain distribution in helping to diagnose the source of a patient’s low back pain and determine initial treatment options.

Principles of Lumbago

Before discussing the specific types of low back pain, it is important to understand a few important principles.

    Pain does not always reflect the extent of damage. The severity of pain from low back problems is often unrelated to the extent of physical damage present. For example, a simple pulled muscle in the low back can cause excruciating pain that can limit one’s ability to walk or even stand, whereas a even a large herniated disc can be completely painless.
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    Diagnosis is often difficult. There are many anatomical structures in the low back that can cause severe lower back pain and/or pain that radiates into the legs and/or feet. These include:
    • Soft tissues, such as muscles, ligaments and tendons
    • Bones, which provide the structural building blocks of the spinal column
    • Facet joints, which allow the spine move
    • Discs (the outer rim of the disc, the annulus, can be a source of significant low back pain due to its rich nerve supply and tendency towards getting damaged)
    • Nerves, which branch out from the spinal cord in the low back and innervate the legs and feet
    All of the above structures are interwoven to make up the structure of the spine. During embryological development there is a great deal of overlap of nerve supply to all of these structures making it nearly impossible for the brain to distinguish between problems with one structure versus another. For example, a torn or herniated disc can feel identical to a bruised muscle or torn ligament.
    Diagnostic accuracy is important. Getting an accurate diagnosis as to the underlying cause of one’s pain is important if there are warning signs or “Red Flags” present. These would include weakness of the legs, significant numbness, loss of bowel or bladder control, fevers or chills or significant unexplained weight loss. If these symptoms are not present, then conservative treatment may commence without the need for obtaining an immediate diagnosis with an MRI.
Finally, it is important to note that - unlike many other medical conditions - the experience of low back pain tends to be different for many people. For example, two people can have the exact same condition, but for one it is incapacitating and for the other it is a mere nuisance. In fact, for most people a spinal abnormality (such as a degenerated disc that can be seen on an MRI scan) is painless. In addition, other factors – psychological, emotional, and financial - often contribute to and influence a person’s experience of low back pain.


Thursday, February 12, 2015

Back Care for Lower Back Pain

Since most episodes of lower back pain are self-limited, it is often advisable for patients to employ back care on their own early in the course of low back pain.

Back Care First Aid

In most cases, do-it-yourself back care for low back pain should center on a combination of:
  • A short course of rest, limited to one to two days
  • Pain medication, such as NSAIDs (e.g. ibuprofen) and/or acetaminophen
  • Application of ice and/or heat on the lower back to decrease inflammation.
Slow mobilization and gentle stretching is then an advisable form of lower back pain care, and the sooner a patient can return to his or her normal functional activities, the sooner the episode of lower back pain will usually get better.

Other Forms of Lower Back Care

Walking is often an excellent exercise for low back pain since it is gentle on the back and helps oxygenate the soft tissues in the back to stimulate a healing response. If walking is too painful, exercising in the water (water therapy or pool therapy) is usually tolerable. Such back care is typically beneficial for lower back pain because the water counteracts gravity and helps to support the patient’s weight in a controlled fashion.

Sitting upright (e.g. in an office chair, driving) will often aggravate low back pain, since this position loads the back three times more than standing. Sitting in a reclining position, however, relieves pressure on the lower back and is often the most comfortable position for patients experiencing an episode of back pain in the lower back (lumbar spine).

When to Seek Lower Back Care from a Medical Professional

If the lower back pain symptoms do not start to abate within one to two weeks, medical attention should be sought from either the patient’s primary care doctor or chiropractor. The assessment of the patient begins with a history of the patient’s low back pain and includes questions such as:
  • Where is the back pain?
  • Is there more low back pain or more leg pain?
  • How long has the pain been present?
  • Does anything make the lower back pain better?
  • Does anything make the low back pain worse?
  • What back pain care has been tried?
  • Have there been other episodes of lower back pain?
A physical exam will also be done to assess the patient’s nerve function and motion in the lower back. Sometimes diagnostic studies (such as an x-ray) will be recommended to better assess the anatomy of the patient’s spine and determine the specific type of back care.

Initial Back Care and Lower Back Pain Help

Combining the information from the patient’s history, physical exam, and diagnostic studies, the health provider will then recommend a course of back care for the lower back pain. Generally, conservative (non-surgical) treatments for the low back pain will be recommended first.

If conservative back care fails, back surgery may be a reasonable option to try to cure the lower back pain.

Further Reading: Lower Back Pain Treatment

Tuesday, February 10, 2015

Conservative vs Surgical Care for Lower Back Pain

For most people, any episode of lower back pain will tend to get better within two weeks to three months. During this time period that an episode of back pain is resolving, or if the back pain is chronic, it is important to consider the appropriate course of conservative (meaning non-surgical) treatment in order to:
  • Reduce pain and spasm
  • Provide conditioning for the back
  • Assist in managing issues frequently associated with back pain, such as sleeplessness or depression.
Treatment options are considered "conservative" when they are non-invasive (such as medication) or markedly less invasive (such as injections or chiropractic manual manipulation) than surgery.
As a general rule, surgery for lower back pain is considered if conservative back treatment fails and the lower back pain and/or leg pain persists for an extended period of time, or if the patient is unable to maintain a satisfactory ability to function in everyday activities.

There are a few exceptions to this general rule. Conservative treatments are not the first option of choice if:
  • The patient loses bowel or bladder control, or develops progressive weakness in the legs - these symptoms constitute a medical emergency and require immediate surgery. However, surgical emergencies for back pain are extremely rare and most episodes of lower back pain can be treated nonsurgically. For more information, see When Back Pain May Be A Medical Emergency.
  • The patient has lower back pain, but an anatomical cause of the pain cannot be identified, surgery is not advisable and conservative treatments are the only recommended course of action. For more information, see What to Expect from Spine Surgery for Low Back Pain.
The length of time that conservative treatment should continue varies widely. Here are two general rules to help provide some context for patients:
  • In general, the more pain and dysfunction a patient experiences, the earlier surgical treatments will be considered.
  • The morbidity (e.g. incidence of post-operative discomfort) or extent of the surgery must also be considered, and therefore a microsurgery (small surgery using microscopes) will be considered much earlier than a much more extensive fusion operation.
In This Article:
For a more complete discussion of the role of back surgery, see Back Surgery and Neck Surgery Overview.
At the onset of lower back pain it is generally advisable to try one or two days of bed rest to decrease muscle spasm and allow the back to rest. More extensive bed rest seems to be counterproductive because it leads to further deconditioning (weakening) of the muscles that provide critical support for the spine.

In addition to initial bed rest, either one or a combination of several conservative treatment options is often recommended in order to alleviate pain and rehabilitate the lower back. To review nonsurgical treatments, see Back Pain Treatment: Non-Surgical Options for Pain Relief

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Saturday, February 7, 2015

How to treat your lower back pain

In the US, lower back pain is one of the most common conditions and one of the leading causes of physician visits. In fact, at least 4 out of 5 adults will experience it at some point in their lives. Take an in-depth look at the common causes of lower back pain and the treatment options available.

Featured Article:
Lower Back Pain Treatment

Sunday, February 1, 2015

What You Need to Know About Osteoporosis

Osteoporosis is sometimes called the "silent disease." Most people don't know they have osteoporosis until it has progressed, often to the point of fracture, usually in the hip, wrist, or spine. The good news is that osteoporosis is largely preventable and treatable. Learn what causes osteoporosis, who is at risk, and what can be done to prevent its development. 

The Definitive Guide to Osteoporosis

Osteoporosis is a thinning of the bones that causes them to become porous and fragile. It affects women more than men, is associated with aging, and progresses more rapidly after menopause. Learn more...

Osteoporosis In Men
Osteoporosis is generally considered to be a disease that primarily affects post-menopausal women. However, incidence of osteoporosis in men is substantial, with an estimated 2 million diagnosed and 12 million at risk for developing the disease. Learn more...

Diagnosing Vertebral Compression Fractures
Vertebral compression fractures (also called spinal compression fractures) due to osteoporosis are not straightforward to diagnose. Learn the adverse effects and risks involved with missed or late diagnosis. Learn more...