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Chiropractic care for herniated discs

Herniated disc treatment Beaverton Oregon

Chiropractic Care for Herniated Discs

A guest post by Dr. David Bennett, DC

A herniated disc can cause pain and can progress into other issues, such as sciatica. Seeking treatment for a herniated disc as soon as possible can help to minimize the pain experienced and prevent the condition from worsening. Many patients that suffer from herniated discs wish to find treatment options besides surgery. In some cases, chiropractic care may be an effective alternative.

What Is a Herniated disc?

To understand how treatment for herniated discs works, it is important to first understand what a herniated disc is. The discs between the vertebrae are composed of a harder outer layer called the annulus fibrosus and a gelatinous center called the nucleus pulposus. A herniation occurs when the annulus fibrosus is cracked and the nucleus pulposus begins to spill out. The disc is no longer able to properly cushion the vertebrae, which causes pain and can cause misalignments to develop.

Diagnosing a Herniated Disc

Not all back pain is caused by a herniated disc, so a chiropractor will start by evaluating the entire spine. A chiropractor will test the reflexes, look for signs of muscle weakening or deterioration, and test sensory functions along the spine. Depending upon the symptoms, a chiropractor may also order scan tests such as MRIs or X-rays. If a herniated disc is identified, the placement and severity of the herniation will be assessed to determine the best treatment options.

Determining the Proper Care

Chiropractic care is not always the most practical or effective way to treat a herniated disc. If a disc injury is causing issues with reflexes, mobility, or sensory functions, it may be necessary to undergo surgery. If a disc injury is associated with incontinence, a different treatment approach may also be necessary. Aside from these issues, however, herniated discs can generally be treated using chiropractic techniques.

Chiropractic Treatment Options

Spinal manipulation is the type of treatment that is most commonly associated with chiropractic care. Spinal manipulation can sometimes be helpful for treating herniated discs, as it can help to ease pain symptoms and can temporarily alleviate some of the pressure on the vertebrae. If pain sensations associated with the herniated disc are extreme, a chiropractor may recommend that spinal manipulation be performed while you are under anesthesia.

Flexion-Distraction Treatment

A flexion-distraction table can be used to stretch and cushion the spine so that the herniated disc or discs can be addressed directly. A gentle motion is used to push on the affected disc. This motion can help to reposition the leaked nucleus pulposus within the vertebrae. This may temporarily correct misalignments and alleviate pain.

If you suspect that you have a herniated disc, contact your local chiropractor to schedule an evaluation and begin treatment as soon as possible.

Author, Dr. David Bennett, DC, is a practicing chiropractor in Altamonte Springs, FL, and the owner of Physical Health and Rehabilitation clinic.

Our new table is here!

Chiropractic table | Low back pain treatment in BeavertonIntroducing our new Flexion-Distraction table from Hilllabs.com! Our chiropractor, Dr. Thompson, will be using this table for all of the usual treatments and adjustments he does in his routine chiropractic visits, but he will now have the ability to provide flexion-distraction therapy to patients with certain conditions.

Flexion-distraction is a method of adjusting the spine by gently stretching the lower back or neck as the table flexes. This movement creates space between specific vertebrae in the back or neck, which can reduce pressure on any pinched nerves, decrease the size of disc herniations, lessen the effects of stenosis (a narrowing of the space around the spinal cord and/or nerve roots), and forces vital nutrients into injured disc tissue to facilitate healing.

Conditions that can benefit from flexion-distraction treatment can range from neck and radiating arm pain to sciatica, stenosis, herniated discs, failed back surgery, and even the everyday mechanical back and neck pain that almost everybody has had at some point in their life.

Many people consider chiropractors to just be “back crackers.” Flexion-distraction therapy is just one of the many tools in our tool belt in addition to traditional manual adjustments (the twisting and “popping” that most people think of). A typical treatment plan at Catalyst will include education about your condition and what to do/what not to do to aid in recovery; adjustments to joints that aren’t moving well or are misaligned; soft tissue massage to relax tight muscles; and therapeutic exercises and stretches to stabilize affected area and make you more resilient to re-injury. Research is showing us that this type of multi-modal approach achieves superior results when compared to treatment involving just adjustments. Take spinal stenosis, for example. This is a condition that is commonly treated in chiropractic offices. In one study posted previously on the blog, stenosis symptoms responded better to flexion distraction therapy combined with an exercise program compared to flexion distraction alone. In another study, flexion distraction combined with typical therapeutic modalities (heat, e-stim, ultrasound), achieved larger reductions in pain and disability than the therapies alone. Studies like these are important because they show that there is not one silver bullet that works better than all other treatments, but it is usually a combination of treatments that achieves the greatest effect.

At Catalyst Chiropractic and Rehabilitation, your treatment is guided by the best available evidence combined with our chiropractor’s clinical experience in order to deliver you the most effective solution for your individual condition. Contact us today to get started on your comprehensive path to recovery.

Radiating arm or leg pain? Perseverance pays off

Pinched nerve Beaverton | Chiropractic treatment for sciaticaIf you have had neck and arm pain (cervical radiculopathy) or low back and leg pain (sciatica), you know that it can be debilitating. I see patients with these conditions often and here are some observations I’ve had over the years when treating them.

-It’s not as simple as a vertebra being out of place and causing a pinched nerve. The nerves in your arms and legs originate from the spinal cord at the level of your neck and your lower back, or lumbar spine. Those nerves exit the spinal column through gaps between each vertebrae, and that is where they can become pinched by either bulging discs or bone spurs. Disc bulges and bone spurs are much more complicated problems than a theoretical bone slipping out of place and pinching a nerve. In that scenario, the bone could be put back into place to take pressure off of the nerve and the pain would resolve quite rapidly. Don’t get me wrong, we do get some people better quite quickly. In the case of cervical radiculopathy or sciatica, though, it isn’t often that simple. Some people give up on treatment too soon because they want it to be that simple.

-Even though it is not just a bone out of place, a chiropractor can still help. Adjustments do more than just move bones. Adjustments can decrease the pressure inside the discs, which are soft and squishy and made mostly of water. Chiropractic adjustments can also relieve pressure on the pinched nerve by temporarily opening up the space where it passes between the vertebrae. Perhaps most importantly, adjustments affect the communication of pain signals from your arm or leg to your brain. In essence, getting adjusted can turn the volume down on the pain signal. Adjustments are just one tool in a chiropractor’s tool box. While they might not cure sciatica or radiating arm pain alone, they can help make the rest of your rehab more effective.

-If you end up needing surgery, doing it later rather than sooner shouldn’t affect your outcome. I’ve had patients give up after not seeing results after 1 or 2 treatments, only to consult with a surgeon and move forward with surgery. If the pain is caused by a bulging disc, and it is bearable and you aren’t progressively losing function in your arms or legs, it is safe to wait for surgery while you give conservative care a real chance at helping you. This study shows that even 1 and 2 years after the onset of symptoms, patients have a relatively equal chance of good surgical outcomes as those undergoing early surgical intervention. So when I recommend a trial of care lasting 4 weeks with 2 visits/week, I’m not doing it to pad my pocket book. In my experience, that is giving conservative treatment a fair chance before considering more invasive options. It’s enough time and enough visits to make a change, but not too much time that it could affect your surgical outcome if it comes to that.

If you or a loved one are suffering from cervical radiculopathy or sciatica, give conservative treatment a chance before doing anything more invasive. Contact us with any questions or to schedule a visit. (503) 526-8782

Why sneezes cause back pain

I remember several years ago I was watching Sports Center and the anchor reported that Sammy Sosa was not going to play that day due to back pain caused by a sneeze. It was reported in a way that made light of the subject, and I even got a good chuckle out of it. You may have laughed as well if this had never happened to you, but whether they make the headlines or not, sneezes often result in back or neck pain. As a chiropractor, I see this frequently and my patients are often embarrassed when they tell me how it happened. I believe sneezing is risky for two reasons:

1. When you sneeze you often turn your head in order to aim it away from people near you and to cover it with your arm or hand. Sneezing causes a very violent contraction of the diaphragm and many of the muscles that support the neck and spine. When creating such a violent contraction with your neck twisted, it is easy to see how a muscle could be pulled or even a joint in the spine sprained as the tissues are put under such intense stress.

2. Sneezing causes a rapid rise in intra-abdominal pressure. The pressure builds as all the air taken in during the “ahh” part of the sneeze gets restricted momentarily before the “choo” part. Raising intra-abdominal pressure also causes an increase in intra-thecal pressure, or the pressure inside the spinal canal, as well as the pressure inside the intervertebral discs, the soft cushions between each of your vertebrae. A sudden spike in pressure in these areas can cause a disc injury and/or a pinched nerve sensation in the back or neck.

One way to avoid injury when sneezing is to reduce the stress on your spine by slightly extending your neck and your lower back. As I discuss in the video below, we tend to bend forward when we cough or sneeze. Bending forward can place more pressure on the spine even when not sneezing, so it is best to avoid that position then next time you feel a tickle in your nose. See the video for more details. Until next time, take care and sneeze safely 🙂

-Dr. Thompson

 

Choosing the right mattress for lower back pain

Proper mattress selection for lower back pain

Which mattress is best for your back?

Sleeping on the wrong mattress can cause or worsen lower back pain. Lack of support from a mattress reinforces poor sleeping posture, strains muscles and does not help keep the spine in alignment, all of which contribute to low back pain.
Sleep comfort is also sacrificed if a mattress does not match one’s individual preferences. A mattress that provides both comfort and back support helps reduce low back pain, allowing the structures in the spine to really rest and rejuvenate during the night.
Choosing the right mattress can be difficult. The following practical guidelines are designed to help patients with low back pain choose the best mattress for both back support and sleep comfort:

  1.  Personal preference should ultimately determine what mattress is best. There is no single mattress style or type that works for all people with low back pain. Any mattress that helps someone sleep without pain and stiffness is the best mattress for that individual. Patients with low back pain should choose the mattress that meets their standards for comfort and support and allows them to get a good nightís sleep.
  2. Understand and inquire about the physical components of the mattress. The coils or inner springs of a mattress provide the support. Different mattresses vary in their number and arrangement of coils. Padding on top of the mattress comes in many different thicknesses. Mattress depths typically range anywhere from 7 to 18 inches deep. Choosing the number of coils, type of padding and mattress depth should be determined by individual preferences.
  3. Find a mattress with back support. A good mattress should provide support for the natural curves and alignment of the spine. The right amount of back support also helps the patient avoid muscle soreness in the morning. While there is not much clinical data about mattresses, one study found that medium-firm mattresses usually provide more back pain relief than firm mattresses.
  4. Achieve a balance between back support and comfort. Overall comfort while sleeping on the mattress is equally important as sufficient back support. Sleeping on a mattress that is too firm can cause aches and pains on pressure points. A medium-firm mattress may be more comfortable because it allows the shoulder and hips to sink in slightly. Patients who want a firmer mattress for back support can get one with thicker padding for greater comfort.
  5.  Know when it’s time to get a new mattress. If an old mattress sags visibly in the middle or is no longer comfortable, it is probably time to purchase a new one. Putting boards under a sagging mattress to keep it from sagging in the middle is only a short-term fix for the sagging; a new mattress is still needed.

Some Considerations

  • Shop for the best value and quality of the mattress, not price. Mattresses with more coils and thicker padding tend to be higher quality and also more expensive; however, a higher price does not guarantee that the mattress is more comfortable or more supportive. Mattress stores often have sales and promotions, so it is a good idea to comparison-shop for the best price after finding the right mattress.
  • Be aware of mattress advertising gimmicks. Claims that a mattress is orthopedic or medically-approved should be viewed skeptically. There has not been extensive medical research or controlled clinical trials on the topic of mattresses and low back pain. The individual must determine whether or not extra features on a mattress make it more comfortable or supportive.
  • Give the mattress a test-run before buying. To sample mattresses, people can try sleeping on different makes and models in hotels or at other peopleís homes before going to a mattress store. When shopping at the store, shoppers should lie on the mattress for several minutes to decide if it is a good fit. If two people will be sleeping on the mattress, both should test it at the same time to make sure they have enough space and are both comfortable on the same style of mattress.
  • Purchase mattresses from stores and companies that are trustworthy. Consider the customer service offered by the mattress store, such as delivery options, warranty, and removal of old mattresses and the store’s return policy. Look for mattress stores where customers can return a mattress if they are not satisfied with the quality or comfort after sleeping on it for a significant amount of time (i.e. a couple of weeks to a month).
  • To help preserve the quality of a new mattress, it should be repositioned every six months to ensure that the mattress is evenly worn. This includes rotating 180 degrees and flipping the mattress lengthwise on a regular basis. The Better Sleep Council advises against putting a mattress on a box spring/foundation that is not made to go with the mattress, as this may decrease the life of the new mattress.

Where does whiplash pain come from?

sore neck?

When the cervical spine (neck) is subject to whiplash, there is usually a combination of factors that contribute to whiplash pain in the neck and back, and ultimately need to be addressed individually by a chiropractor, who maintains a “holistic” view of the patient’s whiplash pain. This article explains how chiropractors approach treating neck pain, back pain, and/or other whiplash symptoms, and help patients prevent chronic whiplash pain.

Whiplash Pain Management for Joint Dysfunction

Joint dysfunction from whiplash occurs when one of the joints in the spine or limbs loses its normal joint play (resiliency and shock absorption). A chiropractic technique called motion palpation gently moves the joint in different directions and assesses its joint play. When a joint develops dysfunction, its normal range of movement may be affected and it can become painful.

Muscle Dysfunction from Whiplash Injuries

When joint dysfunction develops, muscles are affected by becoming tense and overactive or inhibited and underactive. In either case, these muscles can develop trigger points that may necessitate whiplash treatment involving muscle relaxation or stimulation. Trigger points are areas of congestion within the muscle where toxins accumulate and can irritate the nerve endings within the muscle and produce pain. This whiplash pain can occur in the muscle itself or can be referred pain (perceived in other areas of the body). The muscle can also send abnormal neurological signals into the nervous system, which can then cause disruption of the ability of the nervous system to properly regulate muscles in other parts of the body, leading to the development of faulty movement patterns.

Faulty Movement Patterns and Whiplash Pain

It is thought that the intense barrage of pain signals from a traumatic whiplash injury to the cervical spine can change the way the nervous system controls the coordinated function of muscles. The disruption of coordinated, stable movement is known as faulty movement patterns which cause increased strain in the muscles and joints, leading to neck pain and back pain. They can involve the neck itself or can arise from dysfunction in other areas of the body such as the foot or pelvis. Instability is also considered part of faulty movement patterns. There are two types of instability that can occur in whiplash: Passive—the ligaments of the neck are loosened, making it more susceptible to whiplash pain; and Dynamic—the nervous system disruption causes a disturbance in the body’s natural muscular response to common, everyday forces. Instability can cause even mild, innocuous activities difficult to perform as they often exacerbate the whiplash pain.

Whiplash Pain from a Herniated Disc

The force of whiplash can cause injury to the discs between the vertebrae, and small tears can develop. If the gelatinous middle of the disc seeps out, it can irritate the nerve endings in this area. This is known as disc derangement. Occasionally, the gel can seep all the way out and press on a nerve root exiting the spinal cord behind the disc, known as disc herniation. A herniated disc may involve whiplash pain in the neck as well as sharp, shooting pain down the arm and possibly neurological symptoms such as numbness, tingling and muscle weakness.

Chiropractic Treatments for Whiplash

Each case of whiplash is different so it’s not possible to generalize about the chiropractic whiplash treatment. Chiropractors commonly employ different chiropractic treatments for whiplash, often including:

  • Manipulation
  • Muscle relaxation and/or stimulation
  • Various exercises
  • Ergonomic and lifestyle changes.
Preventing Chronic Pain from Whiplash

After sustaining whiplash injuries, it is fairly common for people to suffer from chronic neck pain. Chiropractors can detect certain factors in a patient’s history and chiropractic exam to better determine patients who may be more susceptible to chronic pain from a whiplash injury. This process will identify when aggressive preventative measures should be taken for patients who may be at a greater risk of developing chronic neck pain from whiplash injuries.

Research update: Which neck pain treatments work?

Which chiropractic treatment works best for neck pain

Research shows chiropractic care relieves both chronic and acute neck pain

Manipulation, or chiropractic adjustments, of the neck are a polarizing topic. There are some in the medical profession who denounce it as unnecessary and unsafe. On the other hand are the millions of chiropractic, osteopathic, and physical therapy patients who have benefitted greatly from cervical spine (neck) adjustments. The good thing is that as the chiropractic profession advances, more and more research is coming out to give scientific backing to the millions of personal anecdotes of successful treatment of neck pain with chiropractic care. There is already a plethora of evidence regarding the safety of chiropractic adjustments to dispute the claim that it is unsafe. Thankfully there is also mounting evidence, such as the study above, to prove that it actually works. The great thing about this paper is that it is a systematic review. In the hierarchy of scientific evidence, the systematic review is the top dog. What I find significant are two things in particular:

  1. It found a moderate-strong recommendation through a search of 41 high quality random trials that both chronic and acute neck pain respond well to chiropractic adjustments. This is significant because it has long been believed (I don’t know why) that only acute neck and back pain respond well to manipulation. This search found that chronic neck pain may even be more likely to improve with treatment.
  2. It’s not all about the adjustment. It lists other common treatments of neck pain, which can all be performed our chiropractor in Beaverton, Oregon! Even more awesome is that it lists which ones have shown good evidence of effectiveness and which have not. Many of you may recognize these therapies and have received them on multiple occasions, and it may surprise you that some of them are not effective! You’ll be happy to know that those therapies found in the “Weak Recommendation” or “No recommendation” are not therapies that we use much at Catalyst Chiropractic and Rehabilitation. The ones we use the most, and excel at, are those in the moderate-strong recommendation categories. They are not flashy, fancy, gimmicks, but they are tried and true methods that will get you out of pain and keep you feeling better for the long term.

Please contact us if you have questions about how we can help you find relief from your acute or chronic neck pain. 503-526-8782