Spinal decompression

Presented by:Life in Motion Chiropractic

& Wellnesswww.lifeinmotionchiro.co

m

• Back Pain Overview • Back Anatomy• Back Injury Risk Factors• When to Seek Help for Back Pain• Treatment Options• Spinal Decompression Therapy

Back Facts…• About 85% of Americans

experience back trouble by age 50.

• Back problems are the most frequent cause of activity limitations in working-age adults.

The Spinal Column• The human spinal column is the center

of postural control.• It is built to provide stability and at the

same time allow flexibility. • These two seemingly incompatible

functions of support (inflexibility) and movement (flexibility) are at opposite ends of a spectrum of movement, and this fact is one reason the spine is so vulnerable to injury.

The Spine - Disc Nutrition• Located between the vertebrae in

our backs are discs which act as the shock absorbers for the spine.

• Discs begin losing blood supply by age 20.

• We feed our disks by moving fluids into and out of them through mechanical compression and decompression (one reason to move about while at work).

The Spinal Column7 cervical (neck) vertebrae

12 thoracic (middle back) vertebrae

5 lumbar (low back) vertebrae

Sacrum (fused vertebrae)

Coccyx (tailbone)

Spinal Components

Facet Joint

Spinal Cord

Vertebra

Disc

Herniated disc materialpressing on nerve

Nerves

Back Injury Risk Factors• Acute (traumatic) back

injury may occur due to:

• slips, trips and falls

• auto accidents

• sedentary lifestyle (with occasional lifting)

• heavy and/or awkward loads

• improper lifting technique

Where is the Stress?

• Facet Joints: bear 20% of weight

• Discs bear 80% of weight

• Neural Foramen• Anterior Longitudinal

Ligament• Posterior Longitudinal

Ligament

Back Injury Risk Factors• Chronic back injury may

result from poor posture and/or improper lifting technique combined with repetitive lifting.

• Additionally, genetics and overall physical fitness may affect spinal health.

Back Pain - When to Seek Help• For common back strain, give home remedies a try for

72 hours.• In rare cases, back pain can indicate a serious

problem - seek medical attention if:– you have weakness or numbness in either leg;

– you have a fever along with back pain;

– you notice new bladder or bowel control problems;

– your pain increases with lying down; or

– you have a history of significant chronic disease, such as osteoporosis, cancer or diabetes.

Radiation of Back Pain• LBP may radiate into – groin – buttocks– upper thighareas that share an interconnecting nerve

supply• Source of somatic referred pain is a

skeletal or myofascial structure of the lumbar spine

• Source of visceral referred pain is within a body organ

– ovarian cysts may refer pain to low back– cancer of head of pancreas can present

as low back pain becoming excruciating at night Damage to specific nerve root

– pain may radiate along the nerve down the lower extremity

• Lumbosacral radiculopathy often manifests as sciatica

Medical Interventions• Less than 5% of back pain is caused by

serious diseases (e.g., cancer or infection) or by anatomical problems that require surgery.

• Surgery is almost always elective, possibly providing faster relief of symptoms but may have little effect on long term outcomes.

• Non-specific pain could originate with the muscles, ligaments, facet joints or discs and it is generally impossible to be certain of the exact cause.

From: Cherkin, Dan. Measuring Health Care Quality: Low Back Pain and Associated Treatment Outcomes. Center for Health Studies, Group Health Cooperative of Puget Sound.

Medical Intervention• In a small fraction of cases, the pain

will move down the leg into the foot, usually as a result of a disc herniation; however, only about 2% of persons with back pain undergo surgery.

• Most herniated disc symptoms abate without surgery and have been found to be surprisingly common even in non-symptomatic adults.

From: Cherkin, Dan. Measuring Health Care Quality: Low Back Pain and Associated Treatment Outcomes. Center for Health Studies, Group Health Cooperative of Puget Sound.

Lumbar Structural Pathology and Degenerative Cascade

• In all individuals, there is natural, progressive degeneration of the motion segments over time

• This results in anatomic, biochemical, and clinical sequelae

• Although lumbar motion segment degeneration is not a normal process, it may not be painful

Three phases of Three phases of degenerationdegeneration

DysfunctionDysfunction

InstabilityInstability

StabilizationStabilization

Sources of LBP• Damage to several

structures in the low back can result in severe pain– vertebrae– thoracolumbar fascia– ligaments– joints

specifically the sacroiliac joint

– discs– muscle

Deyo RA, Weinstein JN. N Engl J Med. 2001;344:363-370.

• Exercise (stabilization training)• Soft tissue mobilization• Complementary measures (physical therapy

modalities, acupuncture, CogB Therapy, massage or biofeedback therapy)

• Spinal manipulative therapy• Spinal Decompressive Therapy

Conservative Treatment Options

The Diagnosis• A diagnosis is made by matching your back and leg pain

symptoms with a good clinical history and data from the;– General Physical Examination – Range of Motion Evaluation  – Orthopedic Examination – Muscle Strength Testing  – Postural Evaluation – X-rays, – Labs, – Advanced Diagnostics (MRI, CT, NCV, etc)

Non Surgical Spinal Decompression• Safe, Effective and Affordable

• Based on more than 15 years of medical research

• Effective for treatment of Disc Herniations, Degenerative Disc Disease, Lumbar Facet Syndrome and Sciatica

• Several studies suggest upwards of an 86% success rate

• Decompression produces a negative intradiscal pressure of up to -200mm Hg to pull the extruded material back towards the center of the disc

• Reoxygenates, rejuvenates, rehydrates and provides nutrition to the damaged discs

• Reduces local scar tissue and adhesions

Decompression, Reduction and Stabilization Science

• Decompression relieves pressure placed on the nerves from herniated discs or compressive forces.

• Decompression relieves pain by drawing areas of disc herniation back into the center of the disc where it belongs.

• Decompression creates a vacuum that draws the bulging and herniated disc material back into the disc space to relieve nerve pressure.

• Decompression can help stabilize the ligaments that hold the disc in a normal position to reduce the likelihood of future problems.

Treatment Protocols• A hot pack will be applied and myofascial release performed on the

paraspinal muscles prior to commencing decompression.• Treatment parameters are determined based upon exam and MRI

findings to target the damaged lumbar disc.• Initial treatment of two weeks of daily treatment, followed by three

sessions a week for two weeks, concluding with two sessions a week until condition is resolved or maximum improvement has been made.

• Interferential therapy with cold packs are applied after decompression to consolidate paravertebral muscles and prevent inflammation.

• Patients are examined every 10 visits to monitor progress.

• If the patient has not improved by 50% after 10 treatments then a comprehensive evaluation is performed so that appropriate changes in the care plan can be made.

• If the patient has not improved 50% after ten treatments consideration will be made for the appropriateness of:

Facet nerve block injections

Trigger point injections

Refer for surgery• A strengthening and rehabilitation program lasting between 4-6 weeks will begin when the

patient has seen a 75% improvement in pain and function to help strengthen the paravertebral and lumbar core musculature.

• Some patients will require an ongoing care program that may include the use of tens, cold packs, exercise, relaxation training, walking techniques, and posture techniques.

• 6 weeks after the end of treatment the patient is seen for evaluation and follow-up

Treatment Protocols – Cont.

You are ultimately in control of your destiny• Large disc herniation does NOT always need surgery• Neurologic loss is NOT an absolute indication for surgery• Small disc bulge is NOT always normal• Interventional pain management works but not 90% of

the time• Surgery does not have an 80% success rate• Conservative treatment is reversible. Surgery is not.

Back Pain Summary• Chronic LBP is something that can be

overcome with proper guidance• Progress is focused on targeting

treatment at the mechanisms that produce pain rather than ameliorating the symptoms

• Biopsychosocial approach is critical for the successful management of chronic LBP

• Spinal Decompressive Therapy is a promising new treatment for chronic back pain and should be considered before surgery.

Life in Motion Chiropractic & Wellness6139 Route 96 –

Suite 1Farmington, New

York14425

(585) 953-0200

3111 Winton Rd. South

Rochester, NY14623

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