Chiropractic Care Can Help Lumbar Radiculopathy!

The following is a copy of an article from Mark Studin DC, FASBE (C), DAAPM, DAAMLP. It shows the latest research on chiropractic care for treating disc pain.

Back and Leg Pain (Lumbar Radiculopathy) as a Result of Disc Herniation and the Long Term Effect of Chiropractic Care

The term "herniated disc," has been called many things from a slipped disc to a bulging disc to a ruptured disc. To a doctor who specializes in disc problems, the term is critical because it tells them how to create a prognosis and subsequent treatment plan for their patient. To clarify the disc issue, a herniated disc is where a disc tears and the internal material of the disc, called the nucleus pulposis extends through that tear and is always from trauma, or an accident. This differs from a bulging disc that is a degenerative "wear and tear" phenomenon where the internal material or nucleus pulposis does not extend through the disc because there has been no tear, but the walls of the disc have been thinned from degeneration and the internal disc material create pressure with thinned external walls and the disc itself "spreads out" or bulges..

There are various forms and degrees of disc issues, but the biggest concern of the specialist is whether nerves are being affected that can cause significant pain or other problems. The problem exists when the disc, as a result of a herniation or bulge is touching or compressing those neurological elements, which is comprised of either the spinal cord, the nerve root (a nerve the extends from the spinal cord) or the covering of the nerves, called the thecal sac.

There are 2 concerns that doctors consider, first is the structure that we have just discussed and the second is what has the herniation of the neurological element caused. In this scenario, there are 2 problems, the spinal cord or nerve root. If the disc has compromised the spinal cord, it is called a myelopathy (my-e-lo-pathy) where you have a compression of the spinal cord and problems with your arms or legs and an immediate visit to the neurosurgeon is warranted for a surgical consultation.

The second problem is when the disc is effecting the spinal nerve root, called a radiculopathy and is a very common problem. A doctor of chiropractic experienced in treating radiculopathy has to determine if there is enough room between the disc and the nerve in order to determine if a surgical consultation is warranted or if they can safely treat you. This is done by a thorough clinical examination and in many cases an MRI is required to make a final diagnosis. Most patients do not need a surgical consultation and can be safely treated by an experienced chiropractor.

While herniations can occur anywhere, it was reported in the US Chiropractic Directory in 2010 that 95% occur in the lower back, who stated "The highest prevalence of herniated lumbar discs is among people aged 30–50 years, with a male to female ratio of 2:1. In people aged 25–55 years, about 95% of herniated discs occur at the lower lumbar spine (L4/5 and L5/S1 level); disc herniation above this level is more common in people aged over 55 years."

It was reported by Aspegren and co-researchers in 2009 that 80% of the chiropractic patients studied with both neck and low back (cervical and lumbar) disc herniations had a good clinical outcome with post-care visual analog scores under 2 [0 to 10 with 0 being no pain and 10 being the worst pain imaginable] and resolution of abnormal clinical examination findings. Anatomically, after repeat MRI scans, 63% of the patients studied revealed a reduced size or completely resorbed disc herniation.

A study by Murphy, Hurwitz and McGovern in 2009 focused only on low back (lumbar) disc herniations and concluded that "nearly 90% of chiropractic patients reported their outcomes to be either "excellent or good...with clinically meaningful improvement n pain intensity in 74% of patients." The researchers also concluded that the improvements from chiropractic care was maintained for 14 1/2 months, the length of the study indicating this isn't a temporary, but a long-term solution.

It was reported in Journal Manipulative Physiological Therapy 1996 that 78% percent of the low back-lumbar disc herniation patients were able to return to work in their pre-disability occupations, which is the result of the 90% of all low back-lumbar disc herniation patients getting better with chiropractic care as discussed above.

These are the reasons that chiropractic has been, and needs to be considered for the primary care for low back-lumbar disc herniations with resultant pain in the back or legs. This study, along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to herniated discs and low back or leg pain. To find a qualified doctor of chiropractic near you, go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.

References:


1. http://www.uschirodirectory.com/index.php/patient-information/item/242-cervical-and-lumbar-disc-herniations-and-chiropractic-care

2. Donald Aspegren, DC, MS, Brian A. Enebo, DC, PhD, Matt Miller, MD, Linda White, MD, Venu Akuthota, MD, Thomas E. Hyde, DC, and James M. Cox, DC. Functional Scores and Subjective Responses of Injured Workers with Back or Neck Pain Treated with Chiropractic Care in an Integrative Program: A Prospective Analysis of 100 Cases, Journal Manipulative Physiological Therapy 2009;32:765-771

3. Magnetic Resonance Imaging and Clinical Follow-Up: Study of 27 Patients Receiving Chiropractic Care for Cervical and Lumbar Disc Herniations. Journal Manipulative Physiological Therapy, 1996 Nov-Dec; 19(9): 597-606

4. Murphy D R, Hurwitz E L, McGovern E E, A Nonsurgical Approach to the Management of Patients with Lumbar Radiculopathy Secondary to Herniated Disc: A Prospective Observational Cohert Study with Follow-Up, . Journal Manipulative Physiological Therapy, 2009, November (32) 9: 723-733


The Glastonbury Chiropractor is located in central Connecticut- CT Spine and Disc Center specializes in patients who suffer from sciatica, disc degeneration, bulging disc or herniated disc in the lumbar spine. Call our chiropractic office at 860-633-8756 to schedule an appointment and to see if you are a candidate for non surgical spinal decompressionAdditional Reading Resources:

• Lumbar Radiculopathy Article
  
• Find A Chiropractor
  
• Chiropractic and Spinal Decompression
  
• What is Non Surgical Spinal Decompression: FAQ's
• Research about Non Surgical Spinal Decompression

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It’s EXTREMELY Important To Educate Yourself On Your Back Condition!

Nowadays, anyone can google what symptoms they have and learn more. Let’s say, for example, you have an L5 radiculopathy (you may know this because one of your doctors diagnosed this), or let’s say you have disc and facet degeneration at L4. Get on the internet, do some research, go to the library, ask around.

Keep in mind there’s a lot of junk out there on the web, and you can get the wrong diagnosis or bad advice, but educating yourself is very important.

I recently spoke to someone who said she saw a surgeon she was referred to by her primary care doctor. This surgeon told her she needed surgery right away (by the way all he did was read the MRI; no exam was even performed). This individual, the patient, said “I’d like to get another opinion or think it over before I do anything.” Before she left the surgeon replied, “be careful on the road, if you get in an accident you could be paralyzed.” Pretty unbelievable and scary night!

There are good and bad doctors of all types just like there’s good and bad politicians, or chefs, or truck drivers, but the bottom line is be educated so you make the right decisions with your health.

The person in the story I described above may be rare, but you better believe crazier things have happened. If you don’t feel comfortable with your doctor, find another.

At CT Spine and Disc Center, our chiropractors will do the necessary tests needed and look at any MRI’s, x-rays, etc … and ask the right questions and give you the honest answers you need. In fact, numerous patients have told us that they have never had such a thorough exam before.

So educate yourself so you know what your options are and make the right decision regarding your spine health.


CT Spine and Disc Center is located in central Connecticut- Specializing in patients who suffer from sciatica or radiculopathy, disc degeneration, bulging disc or herniated disc in the lumbar spine. Call us at 860-633-8756 to see if you are a candidate for non surgical spinal decompression

Additional Reading Resources

Symptoms of Lumbar Radiculopathy

Treatment options for low back pain

Surgery for your Back???

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Specific Symptoms Associated With A Lumbar Radiculopathy

Pressure on nerve roots L1-L3 are often associated with pain above the knee. Also one may have decreased sensation in the anterior thigh.

The pressure and radiculopathy most commonly affects the L4, L5, and S1 nerve root levels.

Someone with pressure at the L4 level most often have weakness in the quadriceps muscle, pain in the low back and or front of the leg, and a decreased knee (patellar) reflex.

An individual with L5 symptomatology often has pain in the low back and or pain on the side of the leg, as well as a decreased medial hamstring reflex, weakness of the antherior lower leg muscles, and sometimes sensory loss on the outer calf.

S1 radiculopathy often creates pain in the low back, and or pain down the back of the leg or pain in the foot. The Achilles reflex may also be affected as well as sensation on the lateral foot and calf muscle strength.

Symptoms other than pain may include numbness and tingling, or burning pain. Also, most symptoms usually occur on one side of the body as the left nerve roots exit the spine on the left side of the low back and the right nerve roots exit on the right side. Sometimes pressure can be more central creating irritation to both nerve roots. This will often give bilateral symptoms.

One must keep in mind that depending on which nerve fibers have pressure on them and how severe that pressure is often determines your symptoms. If symptoms persist or get worse, see a professional right away.

If you have specific questions about a lumbar radiculopathy or sciatica or have tried various treatments with no real success, call our office at 860-633-8756 to find out if we may be able to help.

Additional Reading Resources:

• Treatments for Sciatica: Low Back & Leg Pain Relief
  
• Causes of Sciatica and Lumbar Radiculopathy
  
• Is Your Low Back Pain And/Or Leg Pain From A Lumbar Radiculopathy
  
• Understanding Non Surgical Spinal Decompression: FAQ's
  
• Research about Non Surgical Spinal Decompression
  

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What is Causing My Sciatica??

Sciatica or a lumbar radiculapathy is when pressure is put on one or more of your lumbar nerve roots. The nerve roots in the lower lumbars form together to make the sciatic nerve which travels down the leg. It gives off numerous branches that go to various parts of the leg – your toes, muscles, blood vessels, etc. Hence the term sciatica. It’s the general term for pain going from the lower body down the leg.

So what’s causing the pressure? The main pressure is from inflammation in the area. This is usually caused by a disc injury, trauma, facet irritation, arthritic changes, or stenosis. A disc bulge for example may put pressure on a nerve inflamming the nerve, causing pain or another symptom. The facet joints, which are the joints that exist just behind where the nerve roots exit off the spinal cord, can get irritated from a disc bulge can create inflammation which closes in on the nerve root.



In fact many things can cause irritation and inflammation in the low back. This is why so many people have experienced a severe episode or two of back pain. Even a severe strain or muscle spasm can create significant pain. A irritation to muscles in the low back or buttocks can cause radiculopathy or sciatica. Remember the nerve roots exit out of hole called foramen and form together into the sciatic nerve. Therefore spasm, muscle inflammation and strain of one or more of the muscles located in this region can cause problems. Also, the sciatic nerve, before it travel down the leg, goes through two heads of the piriformis muscle which is located in the buttocks.

Another common cause of pain is a spinal misalignment. A trauma to the low back, maybe a car accident or a fall, or a sports injury can cause a shift of the spine. Muscle spasm, poor posture, and heavy lifting are a few other causes of misalignments or subluxations.

Someone can even have a specific misalignment called a spondylolesthesis which is a shift of vertebrae forward or backwards on the one below it. This is often more severe and can be from a trauma but also one may be born with it or it happens because of severe lumbar degeneration.

These are the many causes of your back and leg pain. The next blog post I’ll cover treatment options for individuals currently suffering from lumbar radiculopathy.
If you have specific questions about a lumbar radiculopathy or sciatica or have tried various treatments with no real success, call our Glastonbury CT office at 860-633-8756 to find out if we may be able to help.


CT Spine and Disc Center is located in central Connecticut- Specializing in patients who suffer from sciatica, disc degeneration, bulging disc or herniated disc in the lumbar spine. Call us at 860-633-8756 to see if you are a candidate for non surgical spinal decompression


Additional Reading Resources:

• How does spinal decompression work ?
  
• How does Drx9000 spinal decompression work?
  
• Is your Lower Back Pain or Leg Pain the result of a radiculopathy?
  
• Learn how chiropractic manipulation can be extremely valuable on your pathway to health and relief of pain
  
• Understanding Non Surgical Spinal Decompression: FAQ's
  
• Research about Non Surgical Spinal Decompression
  

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