Category Archives: Back Pain Info

Back Pain – SI Joint Dysfunction

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Sacroiliac joint pain

Sacroiliac (SI) joint pain has gained a lot of attention in the last ten years as an underappreciated cause of back pain with some studies indicating it is responsible for 15% to 40% of low back pain. The increased attention is due to the increasing knowledge of the SI joints intimate role in pelvic stability.  I hope more physicians consider SI joint pain in their differential after reading this article.

Pathophysiology

SI joint dysfunction due to inflammation within the joint itself is called sacroilitis. Pain from within the SI joint is common in rheumatoid patients and spondyloarthropathies.

The other cause of SI joint dysfunction stems from instability of the SI joint.  Many experts feel that SI joint pain is a component of a larger problem of pelvic instability (1). Pelvic instability has traditionally been underappreciated as a cause of low back pain, buttock pain, groin pain, and leg pain. Physical therapists and doctors of osteopathic medicine have been teaching these concepts for years but only relatively recently has this dissemination of knowledge trended towards mainstream thinking among medical doctors.

The SI joint complex (the SI joint and its associated ligaments) is the major support structure of the pelvic ring and is the strongest ligament complex in the body.  The complex consists of interosseous sacroiliac ligaments, iliolumbar ligaments, posterior sacroiliac ligaments, and the sacrotuberous and sacrospinous ligaments. The SI joints are two of the three joints involved in the stability of the pelvic ring.  The pelvic ring is the meeting place of the force vectors from the upper body and the lower extremities.  The third joint in the pelvic ring is the pubis symphysis. Pelvic instability causes pelvic rotation which can also cause twisting of the pubis symphysis.  Coupling this with its anterior location appears to provide an explanation as to why patients with SI joint instability can also experience anterior groin pain. Anecdotal evidence for this is seen when patients undergo a successful SI joint intra-articular injection relieving all of their posterior back, buttock, and leg symptoms but the patient still has groin pain. Groin pain is almost never eliminated by SI joint injections unless pelvic symmetry is corrected.

If the SI joints are unstable, it can lead to significant pain and discomfort over the SI joints as well as numerous referred areas.  If an individual affected by SI joint pain has pain only over his or her SI joint, he/she  should be considered lucky. Most often SI joint instability causes unnatural strain on the entire low back and pelvic region causing a sometimes confusing clinical picture. Pain referral patterns of SI joint pain are often confused with L5 or S1 radiculitis or radiculopathies.

Referral patterns of SI joint dysfunction (2)

SI joint dysfunction often presents with a confusing clinical presentation.

1.       Buttock pain 94%

2.       Lower lumbar pain 74%,

3.       Lower extremity pain 50%, with 28% of these lower extremity pains going distal to the knee

4.       Pain goes all the way into the foot 13%. Younger patients are more likely to refer pain distal to the knee.

5.       Groin pain 14%.

Most patients with SI joint instability also experience pain over the buttock region due to secondary muscle spasm of the gluteus muscles and piriformis complex.  Lower extremity symptoms are explained by the piriformis muscles natural tendency to spasm or tighten over the sciatic nerve whenever the SI joint is out of alignment.  This spasm of gluteus and piriformis muscles can cause a mechanical crowding or impingement of the sciatic nerve as it exits just below the SI joint (see figure 1. note the intimate association of the piriformis muscle, SI joint, and sciatic nerve).  Patients often complain of buttock pain and radiation of pain down to the knee and even down to the foot. Not all back pain and leg pains are due to a pinched a nerve from an intervertebral disk herniation.  SI joint dysfunction very closely mimics S1 or L5 radiculitis’ or radiculopathies because of the above described sciatic nerve irritation or impingement.

Groin pain and abdominal pain are not uncommon with SI joint instability.  Often times the groin pain is mistaken as a urologic problem like pudendal neuralgia, prostatitis,  genitofemoral neuralgia, or sterile epididymitis(1). This is likely either due to unnatural tension on the nerves and ligaments around the pubis symphysis or actual impingement of the pudendal nerve which lies between the sacrospinous ligament and sacrotuberous ligament. The distance between these two ligaments abruptly narrows when the Ilium and sacrum are out of alignment i.e. SI joint instability.

The typical history of SI joint dysfunction consists of lateral or bilateral low back pain almost always below the pelvic rim. Pain can also radiate into the hip, groin, pelvis, leg, and foot.  The most common location of pain is in the buttock with pain extending down to the knee. Females are much more affected than males though the ratio is unclear.  The mechanism of injury is a continuum from completely atraumatic events to more obvious trauma like motor vehicle accidents, childbirth, or falls. A little over one-third of failed back surgery patients suffer from SI joint dysfunction. In my practice, I often see patients who lose a substantial amount of weight and then develop SI joint dysfunction.  The etiology of this is unclear. Women who have had multiple births also seem to have a higher incidence of SI joint dysfunction.  The symptoms may be acute or may present as a remote or cumulative injury with chronic waxing and waning of symptoms with slow progression over time.  Patients often experience some degree of temporary relief with manipulation.  Patients must change positions frequently to avoid pain.  This is called “Theater Party Cocktail Syndrome”. Patient’s legs can also feel like they’re going to give out, but with objective testing of motor strength, no dysfunction is found. This is called a “Slipping Crutch syndrome”. Patients usually have a difficult time sleeping and getting out of bed in the morning can be excruciatingly painful. Continued movement after waking up tends to improve the pain.

There are many provocative physical exam maneuvers used to help establish the diagnosis of SI joint dysfunction. Going through each one of these provocative maneuvers is beyond the scope of this article.  It is important to note that the predictive value of provocative SI joint maneuvers in determining SI joint dysfunction is only 60%(4).  The conclusion of a recent study by Slipman et al(5), was that physical exam techniques can at best enter SI joint dysfunction into the differential diagnosis of a patient’s low back pain.  Of the alleged signs of sacroiliac joint pain, maximum pain below L5 coupled with pointing to the PSIS or local tenderness just medial to the PSIS (sacral sulcus) has the highest positive predictive value (PPD) at 60%(4).

Diagnosis

The gold standard for making a diagnosis of SI joint dysfunction is a fluoroscopically guided SI joint injection. Fluoroscopy is needed to accurately and consistently inject the sacroiliac joint.  Only 12% of patients had intra-articular SI joint injections when fluoroscopy was not utilized (3).  Also important is to anesthetize the entire SI joint complex.  In my experience as an interventional pain physician, this cannot be consistently done by palpation alone, especially in obese patients.  It is humbling to see anatomy change under fluoroscopic guidance. What you perceive with palpation is sometimes markedly different than the actual location of the structure that you palpate.  Also vitally important is that these diagnostic injections are followed up with another physical exam while the patient is in the recovery room. Sending a patient home, having them follow up in several weeks, and then determining if this “diagnostic” injection was successful has consistently been shown to be an inaccurate way of establishing a pathoanatomic diagnosis.

Treatments

There is no one specific treatment for SI joint dysfunction which helps all patients.  The treatment varies if the dysfunction is intra-articular (inflammatory), or if it’s a lack of stability. Conservative treatment should first be tried including the manipulation by a qualified physical therapist or osteopathic physician to restore normal motion and balance,  home self-correction exercises,  a walking program (avoid heavy axial loading maneuvers), and core strengthening exercises (Pilates, Yoga, or guided physical therapy). Some patients also benefit from a quality SI joint support belt.  If conservative therapy is not helpful then I recommend a diagnostic SI joint complex injection.  The injection should include the SI joint ( intra-articularly) and the supporting ligaments with pain relief lasting for the duration of the local anesthetic and achieving greater than 75% pain relief. If there is any question about the positivity of this diagnostic test,  it should be repeated.

Radiofrequency Denervation

If the diagnosis has been established by an intra-articular SI joint injection and pain relief using conservative therapy affords no long-term pain relief, then consideration for other treatments can be made.  Radiofrequency denervation of an SI joint carries about a 65% success rate for patients who have failed other conservative therapies and only mild instability around the joint. The procedure involves the neurotomy of the lateral branch nerves that lay over the sacrum and innervate the posterior SI joint. The advantage of SI joint radiofrequency is that it is a very safe procedure with almost no documented morbidity.

Prolotherapy

Another treatment for SI joint pain is Prolotherapy.  Prolotherapy works by stimulating an inflammatory cascade which leads to fibroblastic activity thereby strengthening the entheses of ligaments and tendons. Prolotherapy on SI joints usually requires very strong Prolotherapy solutions.  In my experience, hypertonic Dextrose Prolotherapy only relieves 20 to 30% of most patients’ pain.  More aggressive prolotherapy usually reduces pain by 50% or greater in roughly 75% of patients. The greatest advantage of Prolotherapy is that it provides a level of permanent relief.

SI Joint Fusion

If the patient fails radiofrequency and prolotherapy, the last treatment option would be a consideration for an SI joint fusion.  The outcome data on SI joint fusions is not highly favorable.  However, there are new minimally invasive SI joint fusions that have recently been approved by the FDA that appear promising. Patients with very diffuse pelvic pain and leg pains are not good candidates for fusion surgery.

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Treatment Guide for a Herniated Disc

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As we begin to age, the probability of dealing with a health complication is relatively high. From cancer to heart attacks and extreme pain – it seems expected to contend with one of these impediments to normal life. For instance, back pain which is a common health concern among Americans has affected millions marked by discomfort and inability to live life the fullest.

Though back pain is a common complaint, it has various types, symptoms and treatment methods. Most cases of back pain are attributed to a herniated disc. Based on the report of FamilyDoctor.org, “Herniated discs are most common in the lumbar spine–the part of your backbone between the bottom of your ribs and your hips. Discs are the soft “cushions” between the bones of the spine.” When your disc is pushed against a nerve, it begins to bulge and become very uncomfortable. Often referred to as a “slipped disc,” the pressed nerve can elicit pain in the back and leg, as well as numbness. Generally, the more you move, the more painful it becomes. Even the slightest movement from coughing or sneezing can bring on an excruciating muscle spasm.

Treament Procedures For Herniated Discs

If you suffer from a herniated disc, there are several treatments that you can undergo. First and foremost, maintaining a regular exercise rudiment is helpful. Although you have to consult your doctor before making a concrete action, stretching can mitigate the pain. Indulging yourself in Yoga or Pilates can help since the procedure improves your flexibility and blood circulation. You may also need to take in prescribed medicines or take a shot in your back bone.

Non-responsive? If so, spinal decompression therapy could help. Popularly known as one of the most effective and non-invasive treatments, spinal decompression therapy targets herniated discs, Sciatica as well as pinched nerves. It consists of lying on a table and being connected to a harness that is then hooked to a computer. The computer sends the signal that puts pressure to the spine stretching the discs apart to enable blood and oxygen to flow back into the spine. This is often referred to as a “vacuum effect,” since the pressure creates suction.

Though many would assume that spinal decompression therapy hurts, the treatment is 100% painless. For most patients, the effect is positive since it eases pain and relieves muscle spasm. The therapy triggers the disc to stretch and become flexible which marks the start of the healing stage. Much cheaper than spinal decompression surgery, this treatment requires the patient to undergo 4-5 sessions per week for a minimum of twenty sessions. By the end of the process, the majority feel as if they have either been cured or significantly helped.

The case of herniated discs is not an unusual problem for millions of people worldwide. It can be a frustrating experience since your mobility suffers. You no longer can take that daily walk or go swimming with friends – everyday becomes a sore day. With alternative treatments such as yoga or spinal decompression therapy, herniated discs no longer have to be your death sentence. Such treatments can significantly ease the pain, reduce the occurrence of symptoms and restore your confidence. Trust us, pain doesn’t have to be forever.

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Source by Blaise Breton

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Arthritis of the Hands and Wrists – Need for a Surgery

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Arthritis of the Hands and Wrists – Need for a Surgery

People whose hands and wrists are affected by arthritis are not always recommended by a surgery. They are usually treated with steroidal injections or non-steroidal anti-inflammatory drugs. A surgery is always the last resort as far as treatment for arthritis is concerned.

Only when the symptoms stop responding to the medications and injections and the severity of the symptoms become unbearable, would a doctor recommend a surgery. But finally, it is for the patient to decide whether or not to take up surgery as an option.

The Need for a Surgery: Hands or wrists that are affected by arthritis can make the hands and fingers look deformed and unimpressive. But, a surgery is initially done not to improve the look, but to alleviate the joint pains and stiffness thus, improving the function.

The overall aim of the surgery is relief from pain and an increased overall function of the joints. Let us take a brief look at each of the different surgeries.

Carpal Tunnel Release: The median nerve is responsible for the movement of the thumb and for the transmission of the information from the thumb to the brain. When this nerve is squeezed, the thumb suffers the most with immense pain and numbness.

When the pain stops responding to other treatments, a surgery of the carpal tunnel would be necessary. The ligament of the carpal tunnel would have to be moved as it is responsible for applying the pressure on the media nerve.

A patient can go home soon after the surgery is done and the bandages would stay for two weeks. During this time, it is necessary to keep the fingers and thumb moving in order to avoid the scar tissue from jamming the joints.

Dupuytren’s Contracture Fasciotomy: A scar tissue in the palm and the fingers can cause the fingers to curl towards the palm. This is due to the formation of contractures. A surgery is required to cut these contractures and enable finger stretching.

This surgery would require the patient to stay overnight at the hospital and would take almost 12 weeks before one gets to use the hand fully.

Trigger Finger Release: In patients who suffer from arthritis, the finger sometimes would bend normally but wouldn’t return back into a normal position and will remain curled. The tendon that surrounds it would have to be operated upon in order to release the finger.

This involves a minor surgery and the recovery would take 15 days.

Tendon Repair: In patients who suffer from rheumatoid arthritis, there is a possibility that the hands’ tendons are ruptured. A tendons’ rupture can either lead to problems with finger straightening or bending.

The surgery would involve replacing the damaged tendons with healthy ones from the unaffected fingers. If the rupture is the resultant of a rough bone, then the bone has to be either smoothened or removed to prevent the problem from repeating.

The recovery period is nearly 3 months during which time the hand should be properly rested in order to heal.

Ganglion Removal: Synovial fluid is essential to avoid friction in the synovial joints during movement. Inpatients, who suffer from arthritis, there is every chance that the synovial fluid would leak from the joints allowing the formation of ganglion cysts, usually formed at the back of the wrist.

A surgery (in very rare cases) would be required to draw the leaking fluid in order to prevent the cyst formation.

Knuckle Joint Replacement: Rheumatoid arthritis can leave the hands severely deformed and decrease their functionality completely. In such severe cases, artificial knuckles would have to be implanted in order to restore the hand flexibility.

The recovery from this surgery takes a while and it can be sometime before the hand can be used normally once again.

Thumb Joint Surgery: Rheumatoid arthritis can severely damage the thumb joint and it is not easy replacing this joint. Instead, a surgery would stiffen the damaged joint thus, completely disabling the movement of the joint. Dis baling the joint would relieve a patient from pain.

In a few cases, the joint is removed and the space is either allowed to fill with naturally forming materials or an artificial joint may be used.

Wrist Joint Surgery: Wrists affected by rheumatoid arthritis cause severe pain and either a fusion surgery or a replacement surgery of the wrist would become essential.

Based on the severity of the symptoms, the surgery would either restrict the movement of the wrist (fusion) or the affected joint would be replaced. The latter surgical option is still not being used vividly.

A surgery for arthritis of the hands and wrists can be very useful for alleviating the pain associated with the affected joints. The only matter of concern with a surgery would be the recovery time, otherwise, there are not too many serious complications that arise.

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Source by mohammed

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Cold Laser Therapy For Arthritis Knee Pain Sufferers

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A common serious type of arthritis is rheumatoid arthritis, which initially manifests as sore or stiff joints in the knees, feet, elbows, and hands. Typically, the stiffness will start in the same joint on both sides of the body. Gradually the patient of arthritis feel a sense of fatigue and flu-like symptoms, accompanied by aches and pains as well as joint inflammation. Now if the pain is felt in any joint of the body following a repetitive action, this might be indicative of another type of arthritis called Osteoarthritis. Such as an individual who has been a professional athlete for years may someday feel some pain in his/her knee without any evident cause. Standard imaging tests like X-rays may uncover wear and tear in the cartilage of the knees, which weaken the joints and cause increasing pain.

Osteoarthritis commonly affects the joints of hips, back, neck, and fingers. Swollen or misshapen fingers joints are telltale signs of the disease. In severe cases, affected patients may find it difficult if not impossible to perform even simple activities such as walking, sitting down, or standing up. In such conditions, joint replacement surgery may be the only course of action. A common approach to treating severe arthritis in the knees is the cold laser therapy or use of knee braces, either off-the-shelf or custom-made. Off-the-shelf types of knee braces may not fit perfectly but are less expensive, whereas custom-made types are more expensive and are devised to fit both your knee and your specific condition.

While cold laser therapy or the prescription drugs may help alleviate pain, they are seldom able to eliminate it completely. New medications and remedies however, are now available to manage the painful symptoms of arthritis. In addition to standard and usual medications, physicians may prescribe creams and ointments for oral application. NSAIDs are often the prescription of specific choice for a majority of doctors.”diagnosis: a preface to an autopsy”
“To confess ignorance is often wiser than to beat about the bush with a hypothetical diagnosis.”
“Being a reporter is as much a diagnosis as a job description” Rheumatoid arthritic patients are usually given biologics or anti-rheumatic medications, which can be injected at regular intervals to improve the patient’s condition and to lessen the pain. Another technique that has been known to effectively reduce the progression of the disease is doing regular arthritis knee exercises, including swimming, cycling, and walking. Regular work out programs will help improve or restore joint function. These work outs need not be rigorous, as even simple steps can do wonders to the joints. Strenuous work outs that may further damage or aggravate the joints must be strictly avoided.

In extreme severe cases, knee surgery and chemotherapy may be necessary. Alternative methods of treatment such as acupuncture and magnetic pulse therapy have also become popular these days, owing to the many users who attest to their efficiency.

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Source by ihtesham

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Back Pain Caused by Allergies

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Back Pain problems are developed in many different ways. If your back pain is caused by an allergy, then it is more difficult to deal with. This is a very common problem. If left untreated it can cause very severe back problems.

Finding The Cause

To find out what is causing the allergic reaction is an important step for a person dealing with back pain caused by allergies. The worst time of year for allergies is springtime. To help determine what you can be allergic to, you can have a doctor do a few tests.

These are various allergies that you could have:

House dust, house dust mites, animal dander, yeasts, bee/wasp stings, and certain drugs and foods can also cause allergic reactions. Eggs, milk, shellfish, nuts, dried fruits, and certain food dyes can cause food allergies.

Lower Back Pain And How To Deal With It

What is going to happen next is that there are steps that need to be taken to tell what is the best treatment for the person who has the intolerance to the allergens. There are some very effective options, but it will depend if the back pain is acute or chronic.

What happens with sudden acute low back pain, is it comes on all of a sudden and you don’t know where it came from. Chronic lower back pain is the recurring type and can last for a couple months to even longer in some cases.

Typically, drugs are the first step in the treatment plan. There are prescription and non-prescription drugs that are available for people who are suffering back pain caused by allergies. Depending on how serious and how long a person has been suffering will determine what drug to take.

You could take anything from Advil to NSAID’s (non-steroidal anti-inflammatory drugs). These are commonly used to help alleviate all types of back pain.

Now when you get to the prescription drugs there are risks in taking some of them. You can have possible side effects, drug interactions with other medications you may be taking, so be careful.

Always read the labels of the medication you are taking even the ones prescribed by a doctor. This will ensure that you have as little cause for an allergic reaction as possible.

To increase your nutrition, you can also take supplements and vitamins. It is important to have a good diet as well.

There is treatment for people who are dealing with back pain caused by allergies. Talk to your doctor and you will get proper treatment for the condition that you are suffering from. Take care of yourself so that the back pain does not become permanent.

Don’t suffer anymore from back pain. Just think how good it would feel to be back pain-free. You can get your FREE report now. Discover information on arthritis low back pain and lots more.

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How To Identify Lower Back Pain Symptoms?

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The first step to kill any kind of pain and particularly back pain is to understand its true cause. What could be the possible reason of your lower back pain symptoms is the pain mild or severe? Since how long are you facing the pain? These questions could help you introspect into getting some critical answers with the help of which your back pain could be cured at an early stage itself.

Some Very Important Things To Remember

In the present times, four out of five adults face Back pain symptoms and most commonly lower back pain symptoms. Lower back pain can be mild or severe. It is important to understand that most of the times these pains are periodical and may not last continuously for days. They keep re-occurring over a period. In most of the cases, lower back pain occurs due to damage or over exertion of certain ligaments in the spine. Therefore, it is important to observe these pains to determine their true nature. The most commonly faced problem by the doctors is that they fail to determine the true cause of this pain and provide an effective curative solution. One must understand that back pain being of a complex nature, the doctor may choose to observe and study these pains carefully and over a period before prescribing strong medication. However, you are your best judge. Therefore, your observations also play a vital role and could help your physician in back pain diagnosis. Some of the common symptoms to lower back pain are:

1. Persistent aching or stiffness in the hips or waist area
2. Pain encountered after long hours of sitting or standing.
3. Pain encountered during back movements. For e.g. while bending, walking, or performing any kind of sport.
4. Pain during while getting up from the bed in the mornings.
5. Pain while moving hands. For e.g. while shaking hands.

The above points are the most common symptoms and the most ignored symptoms of back pain. Ignorance of these back pain symptoms in most of the cases is the common reason of chronic pain. Lower back pain symptoms if attacked at an early stage can be cured with proper medical attention, care and the right back pain diagnosis. One the other hand, one must also understand that there is no need to get panicky as soon as you encounter back pain. With advancement in the scientific field, there are a number of treatments available, which can cure back pain. It is just important to be optimistic.

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Source by Apurva Shree

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Herniated Disc – A True Pain in the Back!

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So you have back pain, and you have been diagnosed with herniated disc. What is most important to get you back on the road to recovery as soon as possible?

Although back pain can occur for many different reasons, one of the most common occurrences of serious back pain comes from a herniated disc. In between the vertebrae of our spine there exists small pockets of fluid which helps the vertebrae to move independently of each other. When one of these discs becomes bulged or perhaps even ruptures, it is commonly known as a herniated disc. Not only can it cause severe pain for the person that is suffering, it can be a life altering event which may have long-term implications. Once you have one of these herniated discs, what can be done to help the situation?

Your doctor may tell you that there is a chance you may need to have surgery if your herniated disc doesn’t improve over time. Don’t let that discourage you, because the fact of the matter is, there are a number of different treatments that can take place if you have a herniated disc. A lot of it has to do with your own personal condition and how it is affecting you. It may also be a matter of the position of the disc in your spine that would determine the best course of treatment. For most individuals, however, the severe pain that comes whenever the disc is first ruptured typically goes away to a certain extent after a week or two. With just rest and taking it easy for a little bit, you may be able to actually overcome a majority of the symptoms within a couple of months. For those that are truly suffering from the pain of a slipped disc, however, a couple of months can almost feel like a lifetime.

There may be some things that can be done in order to speed along the process and to make sure that your healing time is as reduced as possible. More than likely, your doctor is going to give you some medication that will help to mask the pain that you are feeling. Unfortunately, this doesn’t do much to help with the problem, it simply makes it easier for you to be able to endure it. Other forms of therapy such as hot and cold compresses, electrical stimulation and traction may also be recommended in order to help with the difficulty. The traction does help with stretching your back and relieving the pressure so that you can start recovering and eliminating a lot of the pain. If you happen to have a rented traction device, it is wise to use if soon before retiring to sleep at night for the most benefit.

There are also some other things that you can do such as specific stretching exercises or other forms of exercise which will greatly help to reduce the pain that you are now feeling. It will also help to shorten the length of time that you will be experiencing the difficulty. These important steps will put you back on the road to health in the shortest amount of time possible.

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Source by Verona Raymond

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Herniated Disc Causes and Relief

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What is a herniated disc?

You’ve probably heard people say they have a “slipped” or “ruptured” disc in the back. Sometimes they complain that their back “went out”. What they’re most likely describing is a herniated disc. This condition is a common source of back and leg pain.

Discs are soft cushions found between the vertebrae that make up the spinal column (your backbone). In the middle of the spinal column is the spinal canal, a hollow space that contains the spinal cord. The nerves that supply the arms, leg, and torso come from the spinal cord. The nerves from the neck supply the arms and hands, and the nerves from the low back supply the butt and legs. The discs between the vertebrae allow the back to move freely and act like shock absorbers.

The disc is made up of two main sections. The outer part (the annulus) is made up of tough cartilage that is comprised of series of rings. The center of the disc is a jelly-like substance called the nucleus pulposus. A disc herniates or ruptures when part of the jelly center pushes through the outer wall of the disc into the spinal canal, and puts pressure on the nerves. A disc bulge is when the jelly substance pushes the outer wall but doesn’t completely go through the wall.

What do you feel?

Low back pain will affect four out of five people during their lifetime. The most common symptom of a herniated disc is “sciatica”. Sciatica is best described as a sharp, often shooting pain that begins in the buttocks and goes down the back of one leg. This is most often caused by pressure on the sciatic nerve that exits the spinal cord. Other symptoms include:

• Weakness in one leg or both legs
• Numbness and tingling in one leg (pins & needles)
• A burning pain centered in the low back
• Loss of bladder or bowel control (seek medical attention immediately)
• Back pain with gradually increasing leg pain.

(If you have weakness in both legs. Seek immediate attention.)

How do you know you have a herniated disc?

Your medical history is key to a proper diagnosis. A physical examination can usually determine which nerve roots are affected (and how seriously). A simple x-ray may show evidence of disc or degenerative spine changes. An MRI (magnetic resonance imaging) is usually the best option (most expensive) to determine which disc has herniated.

Why do discs herniate?

Discs are primarily composed of water. As we become older (after the age of 30), the water content decreases, so the discs begin to shrink and lose their shape. When the disc becomes smaller the space between the vertebrae decreases and become narrower. Also, as the disc loses water content the disc itself becomes less flexible.

While aging, excess weight, improper lifting and the decrease in water in the discs all contribute to the breaking down of discs, the primary cause of a herniation or bluge is uneven compression and torsion that’s placed on the discs.

This uneven pressure is caused by imbalances in muscles that pull the spine out of it’s normal position and then your body is forced to function in what I call a physical dysfunction. Every human being develops these dysfunctions over time and eventually they cause enough damage to create pain.

The best treatment options

When it comes to treating a herniated disc, there are traditional treatments such as ice/heat, ultrasound, electrical stimulation, cortisone injections, anti-inflammatory medications and even surgery. While these may deliver some relief, it will usually be temporary if at all.

But the major problem with these traditional treatments is that they can’t fix or heal a herniated disc as they do not address the actual cause of the problem. For example, even if you were to have a surgery and get some pain relief, the fact is the dysfunctions that caused the disc to herniated in the first place are still there and if not addressed, they will continue to place uneven pressure and strain on the discs and sooner or later you will likely have another problem with that disc, or others.

Without identifying and addressing the underlying cause of the problem, which is the physical dysfunctions caused by imbalances in muscles, you will likely continue to suffer with this condition and the continuous flare ups for years.

Unfortunately, most doctors, chiropractors and physical therapists don’t spend time or focus on identifying the physical dysfunctions that are responsible for the condition so most people end up jumping from one useless traditional treatment to the next and suffer for months or years unnecessarily.

If you have been diagnosed with a herniated disc, or are wondering if your back pain may be caused by a herniated disc, either way you must identify and address the physical dysfunctions that are causing your pain.

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Source by Dr. Robert Duvall, Dpt, Atc

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How to Tell if you have Rheumatoid Arthritis

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There are actually two major varieties of arthritis the osteoarthritis and rheumatoid arthritis both involve pain such as Knee Pain, swelling and stiffness in the joints. How do you know if you have osteoarthritis or rheumatoid arthritis? What differentiates rheumatoid arthritis is the inflammation of the smooth, moist synovial membrane which lines the interior of the joint. The membrane gets inflamed, sore and swollen. The hands and feet are the most affected joints.

Another difference is the fact that rheumatoid arthritis scarcely develops in the hips or spine which is most common on osteoarthritis. Nonetheless, the neck or cervical spine can be involved. This can result in severe outcomes. Rheumatoid arthritis can be activated by a viral infection or stress. It’s an autoimmune disease which means that the body’s immune system seemingly and incorrectly attacks its own tissue. This is what leads to the inflammation or arthritis knee pain.

Attacks typically come on abruptly. You wake up one morning with pain and stiffness in the small joints of the hands and feet. It’s possible you’ll experience pins and needles sensations, tiredness and have a general feeling of being ill. There can even be a low grade fever. The initial signs and symptoms are often quite mild though. The early morning stiffness lessens during the day. However, within a few days severe symptoms can appear.

There are numerous self-help methods which are utilize to treat arthritis. However , there is no known prevention or treatment. However, the signal to pay your doctor a visit is once the pain and rigidity in the joints turn out to be so severe that may limit movement and interfere with normal activities. For the reason that disease gets worse, it makes agonizing pain which you cannot disregard. Furthermore, the joints become inflammed and deformed; the muscles may begin wasting away and red painless lumps known as rheumatoid modules may appear under the skin. You may even experience chest pain and difficulty in breathing.

Your self-help measures ought to include regular, moderate exercise, getting enough rest on a firm mattress and maintaining your weight at a healthy level. Considering that arthritis tends to restrict mobility, swimming can be advantageous especially if you can do so in a heated pool. Making use of heat to the joints can give a calming relief. Diabetics and persons with poor circulation need to stay away from utilizing heat.

If you at some point need the help of your doctor, he will most likely advise specific blood-tests, x-rays and examination of joint fluid for diagnosis. The results of these tests give the doctor a measure in which to determine the severity of the disease. Once you’ve been diagnosed with the disease, you’ll likely need constant care from your physician, yet individual cases do differ. Surgical procedure is an alternative for a small number of patients. Despite the fact that there is absolutely no cure; control is essential and accessible for most patients.

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Source by Angel Rymes

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Rheumatoid Arthritis & Ayurveda

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Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. Rheumatoid arthritis can also cause inflammation of the tissue around the joints, as well as other organs in the body.

The disease usually begins gradually with fatigue, morning stiffness (lasting more than one hour), widespread muscle aches, loss of appetite, and weakness. Eventually, joint pain appears. When the joint is not used for a while, it can become warm, tender, and stiff. When the lining of the joint (synovium) becomes inflamed, it gives off more fluid and the joint becomes swollen. Joint pain is often felt on both sides of the body, and may affect the wrist, knees, elbows, fingers, toes, ankle or neck.

Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease & is a progressive illness that has the potential to cause joint destruction and functional disability.

In some patients with rheumatoid arthritis, chronic inflammation leads to the destruction of the cartilage, bone, and ligaments, causing deformity of the joints. Damage to the joints can occur early in the disease and be progressive. Moreover, studies have shown that the progressive damage to the joints does not necessarily correlate with the degree of pain, stiffness, or swelling present in the joints.

According to Ayurveda, Rheumatoid arthritis is compared as “Ama vata”. It has been described as

”  Sa Kashtaha Sarvarogaanaam yadaa prakupito Bhavet |

Hastha paada shiro gulpha trika jaanu uru sandhishu ||

Karoti sarujam shopham yatra doshaha prapadyate |

Sa desho rujate atyatham vyaviddha iva vrishchkaihi ||  “

This means ” If the disease “ama vata” (rheumatoid arthritis)  becomes chronic the joints (sandhi) of hands  (Hastha), feet (paada) ,  ankles and elbow (gulpha) , low back (trika) , knee (jaanu), and hip (uru) become inflamed and painful. The pain in affected joints resembles the pain of a scorpion’s sting.”

A detailed description of the causative factors, pathophysiology, symptoms, treatment principles and diet & lifestyle modifications for treating ‘Amavata’ have been clearly explained in Ayurveda, thousands of years back.

The strength of Ayurveda in the area of spine and joint treatments is globally appreciated. Since it addresses the root cause of the issue the results are fantastic.

CHARAKA offers a very effective treatment methodology based on the classical texts of Ayurveda. The treatment comprises of Detoxification, rejuvenation through Ayurvedic Panchakarma therapy, administration of researched medicines internally.

If patient can come for the treatment in early stages, even total cure is also possible.

For further information:

E-mail: [email protected]

Web: http://www.charaka.org

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Source by dr m chandrashekhar

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