Spine Health & Spinal Hygiene

Introduction

The spine consists of soft tissues, ligaments, the spinal cord, nerve roots, and cartilage, forming an S-shaped curve with three regions: cervical, thoracic, and lumbar. Its primary functions are to keep the body upright, provide mobility, and support the upper body’s weight. Injuries or other factors can cause mild to severe pain-like symptoms that affect the spine’s three regions, leading to misalignment and disc herniation, which can cause further complications. Fortunately, non-surgical treatments like spinal decompression can restore the spine’s functionality by realigning the body and restoring the spinal discs. This article will discuss how disc herniation affects the spine and body and how decompression therapy can treat it. We work with certified medical providers who use our patients’ valuable information to provide non-surgical treatments, including spinal decompression, to relieve pain-like symptoms associated with disc herniation and prevent chronic musculoskeletal issues. We encourage patients to ask essential questions and seek education about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer

How Does Disc Herniation Affect The Spine?

Do you experience stiffness or tingling in your neck, shoulders, or low back? Do you have radiating pain that is similar to other musculoskeletal conditions? Or do you feel aches and pains during stretching? These symptoms are often associated with spinal disc herniation, as research studies revealed, where the nucleus pulposus within the spine displaces and compresses the spinal nerve or cord. This can be caused by poor posture, incorrect lifting of heavy objects, or excessive twisting and turning, leading to wear and tear on the spinal disc. Left untreated, this can cause neurologic compromise or activity limitation to the rest of the body, as additional research shows. The three spinal regions can all be affected by this condition, causing a range of issues such as: 

• Numbness and tingling in the arms, hands, and fingers
• Muscle weakness and stiffness in the neck and shoulders
• Gait disturbances
• Paralysis
• Cardiovascular abnormalities
• Back pain
• Muscle weakness in hips, legs, buttocks, and feet
• Sciatic nerve mimicry

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Herniated disc injuries and the time it takes to heal depend on the injury's cause, the severity, and where it occurred along the spine. Symptoms can last a few days to months. Chiropractic treatment, massage therapy, and decompression realign the spine and return the disc to its correct position. Still, the herniated disc signs it is returning to normal can take time as the rest of the spine and body adjust to the realignment.

Herniated Disc Signs It Is Returning To Normal

Most cases take a few weeks with healing time depending on health conditions, physical activity level, and age. However, in severe cases, a herniated disc can take up to several months to fully heal, but discomfort symptoms usually resolve sooner.

Expectations From a Healing Disc

• Resting the spine and taking it easy after the injury is recommended.
• Too much rest is not recommended as it can cause muscle stiffness.
• While the herniated disc is healing, a primary doctor may prescribe anti-inflammatories or muscle relaxants to help ease discomfort.
• A chiropractor and/or physical therapist can teach exercises and stretches to relieve pressure on nerves, loosen tight muscles, and improve circulation.

Signs The Herniated Disc Is Healing

• Most herniated discs cause significant pain in the back and neck from the nervous system, causing some of the muscles of the low back or neck to spasm to protect the area from further damage.
• Usually, the muscle spasms relax within the first days of the injury.
• After spinal decompression, neurological symptoms like the sharp, shooting pain down a nerve in the arm or leg are the first symptoms to go away.
• Then muscle weakness along the path of the nerve goes away.
• Numbness in the extremities can linger around longer.

Length of Time

• The wear and tear of adult spinal discs, combined with unhealthy posture habits, job occupation, previous injuries, etc., decrease blood circulation.
• This is why it can take some time to heal completely, as the entire blood supply needs to reset to optimal circulation.
• Nerve compression causing aches and pain sensations down the nerves can also take time.

Regular Activity

Returning to regular activities depends on the individual's case and condition. It is essential not to overdo things that can cause excessive loading of the spine before the disc has fully healed, which increases the risk of re-herniation and other injuries.

• Inactivity can slow the healing process and cause inflammation.
• Patients are encouraged to return to activities that generate gentle motion to stimulate the stabilizing muscles to function properly and increase blood circulation to the injured area.
• Individuals are recommended to:
• Learn posture improvement when walking, sitting, standing, and sleeping.
• Adjust sleep patterns.
• Incorporate anti-inflammatory nutrition during the healing process.
• Engage in light, gentle exercises.
• Keep the body hydrated.
• Avoid alcohol during the healing process.
• This provides a mechanical and biological environment that eventually becomes a personalized exercise physical therapy program.

DOC Spinal Decompression

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Díez Ulloa, Máximo Alberto. "Role of Microangiogenensis in Disc Herniation Healing." Journal of investigative surgery: the official journal of the Academy of Surgical Research vol. 34,6 (2021): 685. doi:10.1080/08941939.2019.1682725

Factors that influence recovery: Mayo Clinic. February 8, 2022. "Herniated disk." https://www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095

Factors that influence recovery: NHS. March 22, 2021. "Slipped Disc." https://www.nhs.uk/conditions/slipped-disc/

How to speed up healing time: American Academy of Orthopaedic Surgeons. January 2022. "Herniated Disk in the Lower Back" https://orthoinfo.aaos.org/en/diseases--conditions/herniated-disk-in-the-lower-back/

Keramat, Keramat Ullah, and Aisling Gaughran. "Safe physiotherapy interventions in large cervical disc herniations." BMJ case reports vol. 2012 bcr2012006864. 18 Aug. 2012, doi:10.1136/bcr-2012-006864

Stoll, T et al. “Physiotherapie bei lumbaler Diskushernie” [Physiotherapy in lumbar disc herniation ]. Therapeutische Umschau. Revue therapeutique vol. 58,8 (2001): 487-92. doi:10.1024/0040-5930.58.8.487

Swartz, Karin R, and Gregory R Trost. "Recurrent lumbar disc herniation." Neurosurgical focus vol. 15,3 E10. 15 Sep. 2003, doi:10.3171/foc.2003.15.3.10

Sleeping with a bulging disc can be challenging for the body to achieve the proper rest. And sleeping in an awkward position can add stress to the spine, making the bulge worse, which can cause tingling, numbness, pain, and digestive problems. This can disrupt the sleep cycle and prevent proper healing of the spinal injury.

Sleeping With a Bulging Disc

When sleeping, most back pain occurs in the lumbar or lower back, in one of two places where the spine meets the pelvis. Around 95% of lower back herniations happen in the L4-L5 spinal segment or the L5-S1 Lumbosacral joint. Any back pain can turn into a vicious cycle of:

• Inconsistent sleep
• Chronic pain
• Chronic fatigue
• Irritability
• Work/School performance
• Obesity
• Diabetes
• High blood pressure
• Immune system compromisation
• Mental health problems
• Depression

Sleeping with a bulging disc requires maintaining the ears, shoulders, and hips aligned to keep the spine aligned.

Sleeping on The Back

Back sleeping done correctly is the best way to sleep for the spine's health. The important thing is to ensure the entire back is supported when sleeping. If there is a gap or space between the mattress and the back, the weight and gravity force the spine to lower in an unnatural way to fill the space. This can cause back muscle soreness, injury, and sciatica. A thin pillow, blanket, or towel can be used to fill the space, giving the spine the support it needs. Back sleepers can also benefit from a pillow or two under the knees to elevate the legs and help maintain the natural curve of the pine.

Sleeping on The Side

Side sleepers can try pulling the legs up toward the chest, and placing a pillow between the knees can provide relief when sleeping with a bulging disc. Pulling the legs up in the fetal position can relieve pressure on the discs. It is recommended to switch sides to keep the spine balanced. This helps maintain hip alignment, which helps keep the spine in a neutral position.

Sleeping On The Stomach

It is recommended to avoid sleeping on the stomach. This pulls the spine down into an unnatural curve that can cause and exacerbate back pain. For individuals that naturally stomach sleep, it is recommended to place a pillow under the hips and lower abdomen to prevent unnatural spinal positioning.

Chiropractic Relief

Utilizing the right sleeping position can provide pain relief and thorough rest. However, sleeping with a herniated disc is far from what is needed to get back to a normal healthy sleeping pattern. This depends on the location of the bulging disc, severity, and cause. A chiropractor can:

• Determine the cause.
• Relieve the pain.
• Help heal the bulging disc.
• Realign the spine.
• Maintain long-term relief without recurrence.
• Help the individual develop an optimal sleeping routine and positioning.

Body Composition

Sleep and Growth Hormone In Children

Growth, in all ages, is primarily controlled by growth hormone. The hormone is regulated by the hypothalamus and pituitary gland which plays an important role in sleep. Growth hormone has been found:

• It peaks during the beginning of deep sleep.
• There are multiple smaller peaks during the other stages of sleep.
• Those who have a delay at the beginning of deep sleep have delayed rises in growth hormone levels.

For children to grow they need to have proper levels of growth hormone. This means they need to have the proper amount of sleep for proper body composition. Research has found that increased levels of sleep resulted in less overall fat mass and a reduced percentage of body fat allowing their bodies to grow.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560878/

Desouzart, Gustavo et al. ‘Effects of Sleeping Position on Back Pain in Physically Active Seniors: A Controlled Pilot Study. 1 Jan. 2016: 235 – 240.

Kose, Gulsah et al. “The Effect of Low Back Pain on Daily Activities and Sleep Quality in Patients With Lumbar Disc Herniation: A Pilot Study.” The Journal of neuroscience nursing: Journal of the American Association of Neuroscience Nurses vol. 51,4 (2019): 184-189. doi:10.1097/JNN.0000000000000446

Sener, Sevgi, and Ozkan Guler. “Self-reported data on sleep quality and psychologic characteristics in patients with myofascial pain and disc displacement versus asymptomatic controls.” The International Journal of prosthodontics vol. 25,4 (2012): 348-52.

Many doctors/surgeons rely on the widely adopted lumbar spinal fusion. However, experts have asserted that lumbar total disc replacement or TDR should be made available and increased for treating degenerative disc disease and other spinal conditions. Individuals interested in total disc replacement, the ability to have it done, and if insurance will pay? What to know about TDR and fusion before deciding and moving forward.

Total Disc Replacement

Spinal fusion has been the traditional approach for relieving lower back pain. In this procedure, a bone graft is inserted between two or more vertebrae. This eliminates movement that causes pain or could be dangerous to the individual. Total disc replacement demands more on a technical level than spinal fusion. However, the worn-out, injured, or damaged disc is fully replaced, even a completely degenerated disc, with a metal and/or plastic one. Benefits from lumbar TDR surgery include:

• Shown to be a safe procedure with minimal complications
• Significant improvement in health and quality of life
• High rates of successful outcomes
• Mobility is preserved

Who Needs Disc Replacement?

Low back problems affect more than a third of the population. This can come from:

• Personal
• Work
• Sports
• Automobile injuries
• Aging
• All are risk factors

Fusion or Total disc replacement

Fusion reduces and eliminates motion around the affected area which also changes with the spine’s mechanics. It can also place increased stress on the surrounding segments. However, the lack of motion is to eliminate the pain. Total disc replacement does increase mobility, but it can’t fully relieve the pain.  It can relieve pain generated from the disc but not from other causes. TDR has been shown to:

• Provides motion preservation
• Reduces staying at the hospital
• Provides long-term durability
• Lower reoperation rates compared to fusion

Total disc replacement issues:

• The procedure is more time-consuming
• A lot of time making decisions
• A lot of time preparing

An example could be the patient has a narrow disc space. Looking at the X-rays of the discs above and below, the surgeon has to make sure they choose the right size. The narrow space needs to be mobilized back to a normal height that cannot be too high or too short. Finally, the surgeon has to make sure that the disc is anchored and fits properly.

Why Surgeons Still Choose Fusion?

Despite the benefits, there are reasons why surgeons still choose fusion.

• There are strict rules as to when TDR can be used. This means insurers are prone only to approve fusion procedures.
• The surgical technique is challenging. TDR surgery is a highly demanding procedure. Many doctors that have specialized in fusion for 20 years or more can be reluctant to perform the procedure.
• Complications and revision surgeries. Reoperations are sometimes necessary, but this happens in both fusion and TDR.

Individual Needs

Fortunately, most individuals with lower back problems never need total disc replacement. And those that do have severe pain/conditions are recommended to try non-invasive/surgical treatment. This ranges from:

• Chiropractic
• Physical therapy
• Massage

Imaging and lab tests will be required.

However, if an operation is necessary, ask questions about both procedures. If a surgeon insists that fusion is the only option, ask why total disc replacement is not an option?

Body Composition Testing

Protein and Weight Loss

Protein is one of three basic macronutrients found in food. Proteins are made up of smaller units called amino acids. There are 22 amino acids, with 9 of these being essential. This means the body needs them, as the body cannot produce them. These essential amino acids can be obtained by eating protein-rich foods like:

• Eggs
• Meat
• Fish
• Vegetarian/vegan options include:
• Nuts
• Seeds
• Beans
• Tofu

Generally, all the essential amino acids cannot be obtained from just one food. Therefore it is recommended to eat a variety of animal and plant-based proteins. Protein is in almost every structure and function of the body.

Antibodies

These proteins fight off any infections, bacteria, etc.

Repair, maintenance, and structural

Proteins are the building blocks of the body's muscles, bones, skin, and hair.

Hormones

Chemical messenger proteins are how cells and organs communicate. For example, Growth Hormone affects muscle gain and fat loss.

Enzymes

Not all proteins are enzymes; however, all enzymes are proteins. These proteins are catalysts or starters for chemical reactions in the body.

Transportation and storage

Some proteins carry molecules where they are needed. Like hemoglobin or the red blood cells carry oxygen to cells, then transport carbon dioxide away.

Not getting enough protein in one's diet can have serious consequences on the body's health. Without enough protein, the muscles can begin to atrophy or waste away, taking Lean Body Mass, strength, and energy away as well.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Salzmann, Stephan N et al. “Lumbar disc replacement surgery-successes and obstacles to widespread adoption.” Current reviews in musculoskeletal medicine vol. 10,2 (2017): 153-159. doi:10.1007/s12178-017-9397-4

Hopkins overview of Lumbar TDR (for consumers) https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement

“Comparison of Lumbar Total Disc Replacement With Surgical Spinal Fusion for the Treatment of Single-Level Degenerative Disc Disease: A Meta-Analysis of 5-Year Outcomes From Randomized Controlled Trials”, Zigler J, et al., Global Spine Journal, June 2018, PMC602295

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022955/

“Overview of Lumbar TDR” (for consumers); Johns Hopkins Medical Center https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement

Back or disc pain is becoming increasingly common for individuals of all ages. The spinal discs are prone to injury because of the extreme amount of pressure/stress placed on the lower back and neck. Fortunately, most cases of back pain heal on their own, while others can cause long-term chronic pain that can be difficult to manage, without proper treatment.

Different types of pain can be caused by problems with the spinal discs. The spinal discs are elastic sections of the spine that sit between the vertebrae. They are made up of materials called annulus fibrosus on the outside and a gel-like material called nucleus pulposus on the inside.

These discs are flexible, which allows for a range of motion to the spine and body shock absorption to increase comfort when in motion. When an individual visits a chiropractor, the practitioner will not know the exact cause of the pain, but only that it hurts around a certain area. Our spinal experts will help individuals understand the different types of ailments or conditions that could be affecting the spine. Then a customized treatment plan can be developed.

Disc problems

Spinal disc pain has two major sources of pain related to spinal discs: They are disc degeneration and nerve root pain. They are most common in the neck and the lower back. Individuals need to be informed of the difference to understand what is happening with the spine and potential treatment options to alleviate the pain and heal the problem.

Degenerative disc disease

Degenerative disc disease is when the spinal discs begin to dry out and deteriorate. The discs start to shrink and can tear, which leaves that segment with little or no cushioning. This can cause pain, as well as inflammation of the surrounding muscles and joints. Disc degeneration usually presents with low levels of consistent pain and occasional severe flare-ups.

A chiropractor can utilize spinal manipulation to restore alignment, function, and mobility of the affected joint. Massages stretches and exercises will help alleviate the tension in the surrounding muscles along with strengthening them for better support.

Nerve root pain

Nerve root pain does not take place within the disc but is usually caused by a bulging or herniated disc. This condition can be called a slipped disc or pinched nerve, affect the nerves that are in close proximity to the neck and lower vertebrae.

The pain can lead to numbness, tingling, and weakness along the path of the nerve, and radiate out to the arms and legs. A bulging disc is when the spinal disc progressively protrudes through a narrow opening.

This can irritate any nearby nerve roots causing inflammation and pain. If the disc herniates or breaks through then the outer protective material tears, letting the cushion/gel leak out and come in contact with the nerve root/s, which could also cause pinching and inflammation. Treatment for a bulging or herniated disc includes:

• Spinal manipulation
• Corrective exercises
• Physical therapy
• Massage
• Diet adjustments

These treatments can help realign the disc/s, moving them away from any nerves, and minimizing inflammation.

Proper Identification and Diagnosis

Spinal disc problems can be similar in their pain and symptoms. For example, degenerative disc disease can weaken the spinal discs to such a degree that nerve root pain follows creating a dual combination of pain. The conditions require various approaches and treatment methods often done in combination. However, they require a proper diagnosis to create a proper and custom treatment program for every individual. This will ensure the root cause of the disc pain is properly identified and handled. Call us to learn more.

Low Back Pain Treatment

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Browning, J E. “Chiropractic distractive decompression in the treatment of pelvic pain and organic dysfunction in patients with evidence of lower sacral nerve root compression.” Journal of manipulative and physiological therapeutics vol. 11,5 (1988): 426-32.

Degenerative disc disease is a condition where your spinal discs wear down that can lead to pain and discomfort. Everyone’s discs wear down with time, but not every person experiences pain from this process.

What are the 4 Stages

Two of the main components of the spine are the vertebrae and the discs. The discs sit between vertebrae to provide cushion, support, and flexibility. Each disc is made up of a soft inner layer and a tough outer layer. Over time, or due to injury, the discs can lose their integrity, begin to thin and even tear in certain cases. Compromised discs increase the likelihood of pressure on nerves and friction between the vertebrae.

Like many diseases, degenerative disc disease has several possible stages. As the stages progress, the negative symptoms become more pronounced.

Stage 1

The first stage of degenerative disc disease may go unnoticed by the individual but can be identified by a chiropractor or other medical professional. The loss of the natural curvature of the spine can indicate the beginning of degenerative disc disease. Pain may not be apparent, but extra pressure is being placed on the spine which can lead to more rapid aging of the spine, nerves, joints, etc.

Stage 2

The degradation of discs becomes more apparent in the second stage. They may look thinner, and it is common to see deformations in the bone, such as bone spurs. The curvature of the spine will become more unnatural and the spinal canal may become more narrow. Stage 2 is often where you will begin to notice some pain and discomfort.

Stage 3

Stage 3 is marked by a more extreme change in the posture and curvature of the spine, along with more pain and loss of mobility. Nerve damage is common and scar tissue typically begins to form. Discs are even thinner than before, which can sometimes cause even more deformation of the bones.

Stage 4

The final stage of degenerative disc disease is the most severe and is typically considered irreversible. Discs are at their thinnest or gone altogether. The flexibility of the spine is extremely limited and pain is often considerable. Nerve damage can be severe and the bones of the spine may even begin to fuse together.

What Chiropractic Do for Degenerative Disc Disease?

Chiropractic care is a preferred treatment option for degenerative disc disease for a variety of reasons. Because it is gentle and non-invasive, chiropractic is much less likely to create undesirable side effects—which are common with prescription medications and surgery. 

Obviously, the earlier the stage of degenerative disc disease, the more successful treatment can be. But chiropractic can be helpful even in the most extreme cases of degenerative disc disease.

Chiropractic treatments may include:

Chiropractic Adjustments

One of the most effective ways to treat degenerative disc disease is to ensure the spine is in proper alignment. Loss of alignment, which can happen due to injury or just day to day life, puts extra stress on the spine which can accelerate the degradation of discs. Adjustments bring back alignment.

Spine Decompression

Spinal decompression uses gentle but firm pressure to bring space back between the vertebrae. Space allows blood flow to return and healing to happen. Decompression is an important treatment to complement adjustments.

Now is the Time for Treatment of Degenerative Disc Disease

The best time to seek treatment for your back and neck pain is right now. Our chiropractic team can help you feel better and live a healthier life. Please contact us now to learn more!

El Paso Chiropractic Clinic

The spine is made of bones called vertebrae, with the spinal cord running through the spinal canal in the center. The cord is made up of nerves. These nerve roots split from the cord and travel between the vertebrae into various areas of the body. When these nerve roots become pinched or damaged, the symptoms that follow are known as, radiculopathy. El Paso, TX. Chiropractor, Dr. Alexander Jimenez breaks down radiculopathies, along with their causes, symptoms and treatment.

The entire length of the spine, at each level, nerves exit through holes in the bone of the spine (foramen) on each side of the spinal column. These nerves are called nerve roots, or radicular nerves and branch out from the spine and supply different parts of the body.

Nerves exiting the cervical spine travel down through the arms, hands, and fingers. This is where neck problems affecting a cervical nerve root can cause pain, as well as, other symptoms through the arms and hands, one form of (radiculopathy). Another is low back problems that affect a lumbar nerve root. This can radiate through the leg and into the foot, another form of (radiculopathy, or sciatica), which creates leg pain and/or foot pain.

The spinal cord does not go into the lumbar spine and because the spinal canal has space in the lower back, problems in the lumbosacral region often cause nerve root problems and not a spinal cord injury. Serious conditions i.e. disc herniation or fracture in the lower back are also not likely to cause permanent loss of motor function in the legs.

• Cervical Spine - This nerve root is named according to the Lower spinal segment that the nerve root runs between. 
• Example - The nerve at C5-C6 level is called the C6 nerve root.
• It's named like this because as it exits the spine, it passes Over the C6 pedicle (a piece of bone part of the spinal segment).
• Lumbar Spine - These nerve roots are named according to the Upper spinal segment that the nerve runs between.
• Example - The nerve at L4-L5 level is called the L4 nerve root.
• The nerve root is named this way because as it exits the spine it passes Under the L4 pedicle.

Two Nerve Roots

Two nerves cross each disc level

Only one exits the spine (through the foramen) at that level

Exiting Nerve Root - This is the nerve root exiting the spine at a certain level

Example: L4 nerve root exits the spine at L4-L5 level.

Traversing Nerve Root - This nerve root goes across the disc and exits the spine at the level below.

Example: L5 nerve is the traversing nerve root at L4-L5 level, and is the exiting nerve root at L5-S1 level.

There is some confusion when a nerve root is compressed by disc herniation or other cause to refer both to the intervertebral level (where the disc is) and to the nerve root that is affected. This depends on where the disc herniation or protrusion is happening. It could impinge upon either the exiting nerve or the traversing nerve.

If The Traversing Nerve Is Affected

Lumbar Radiculopathy

In the lumbar spine, there is a weak area in the disc space right in front of the traversing nerve root, so lumbar discs tend to herniate or leak out and impinge on the traversing nerve.

If The Exiting Nerve Is Affected

Cervical Radiculopathy

The opposite is true in the neck. In the cervical spine, the disc tends to herniate to the side, rather than toward the back and the side. If the disc material herniates to the side, it will compress or impinge the exiting nerve root.

Radiculopathy & Sciatica

Nerve root goes by another name Radicular Nerve, and when a herniated or prolapsed disc presses on a radicular nerve, this is referred to as a radiculopathy. A medical physician might say there is herniated disc at L4-L5, which creates an L5 radiculopathy or an L4 radiculopathy. It all depends on where the disc herniation occurs (the side or the back of the disc) and which nerve is affected. And the term for radiculopathy in the low back is the ever famous Sciatica.

Radiculopathy

• A pinched nerve can occur at different areas of the spine (cervical, thoracic or lumbar).
• Common causes are narrowing of the hole where the  nerve roots exit, which can result from stenosis, bone spurs, disc herniation and other conditions.
• Symptoms vary but often include pain, weakness, numbness and tingling.
• Symptoms can be managed with nonsurgical treatment, but minimal surgery can also help.

Prevalence & Pathogenesis

• A herniated disc can be defined as herniation of the nucleus pulposus through the fibers of the annulus fibrosus.
• Most disc ruptures occur during the third and fourth decades of life while the nucleus pulposus is still gelatinous.
• The most likely time of day associated with increased force on the disc is the morning.
• In the lumbar region, perforations usually arise through a defect just lateral to the posterior midline, where the posterior longitudinal ligament is weakest.

Epidemology

Lumbar Spine:

• Symptomatic lumbar disc herniation occurs during the lifetime of approximately 2% of the general population.
• Approximately 80% of the population will experience significant back pain during the course of a herniated disc.
• The groups at greatest risk for herniation of intervertebral discs are younger individuals (mean age of 35 years)
• True sciatica actually develops in only 35% of patients with disc herniation.
• Not infrequently, sciatica develops 6 to 10 years after the onset of low back pain.
• The period of localized back pain may correspond to repeated damage to annular fibers that irritates the sinuvertebral nerve but does not result in disc herniation.

Epidemology

Cervical Spine:

• The average annual incidence of cervical radiculopathies is less than 0.1 per 1000 individuals.
• Pure soft disc herniations are less common than hard disc abnormalities (spondylosis) as a cause of radicular arm pain.
• In a study of 395 patients with nerve root abnormalities, radiculopathies occurred in the cervical and lumbar spine in 93 (24%) and 302 (76%), respectively.

Pathogenesis

• Alterations in intervertebral disc biomechanics and biochemistry over time have a detrimental effect on disc function.
• The disc is less able to work as a spacer between vertebral bodies or as a universal joint.

Pathogenesis - LUMBAR SPINE 

• The two most common levels for disc herniation are L4-L5 and L5-S1, which account for 98% of lesions; pathology can occur at L2-L3 and L3-L4 but is relatively uncommon.
  Overall, 90% of disc herniations are at the L4-L5 and L5-S1 levels.
• Disc herniations at L5-S1 will usually compromise the first sacral nerve root, a lesion at the L4-L5 level will most often compress the fifth lumbar root, and herniation at L3-L4 more frequently involves the fourth lumbar root.

• Disc herniation may also develop in older patients.
• Disc tissue that causes compression in elderly patients is composed of the annulus fibrosus and and portions of the cartilaginous endplate (hard disc.)
  The cartilage is avulsed from the vertebral body.
• Resolution of some of the compressive effects on neural structures requires resorption of the nucleus pulposus.

• Disc resorption is part of the natural healing process associated with disc herniation.
• The enhanced ability to resorb discs has the potential for resolving clinical symptoms more rapidly.
• Resorption of herniated disc material is associated with a marked increase in infiltrating macrophages and the production of matrix metalloproteinases (MMPs) 3 and 7.
• Nerlich and associates identified the origins of phagocytic cells in degenerated intervertebral discs.
• The investigation identified cells that are transformed local cells rather than invaded macrophages.
• Degenerative discs contain the cells that add to their continued dissolution. 

Pathogenesis - CERVICAL SPINE

• In the early 1940s, a number of reports appeared in which cervical intervertebral disc herniation with radiculopathies was described.
• There is a direct correlation between the anatomy of the cervical spine and the location and pathophysiology of disc lesion.

• The eight cervical nerve roots exit via intervertebral foramina that are bordered anteromedially by the intervertebral disc and posterolaterally by the zygapophyseal joint.
• The foramina are largest at C2-C3 and decrease in size until C6-C7.
• The nerve root occupies 25% to 33% of the volume of the foramen.
• The C1 root exits between the occiput and the atlas (C1)
• All lower roots exit above their corresponding cervical vertebrae (the C6 root at the C5-C6 interspace), except C8, which exits between C7 and T1.
• A differential growth rate affects the relationship of the spinal cord and nerve roots and the cervical spine.

• Most acute disc herniations occur posterolaterally and in patients around the forth decade of life, when the nucleus is still gelatinous.
• The most common areas of disc herniations are C6-C7 and C5-C6.
• C7-T1 and C3-C4 disc herniations are infrequent ( less than 15 %).
• Disc herniation of C2-C3 is rare.
• Patients with upper cervical disc protrusions in the C2-C3 region have symptoms that include suboccipital pain, loss of hand dexterity, and paresthesias over the face and unilateral arm.
• Unlike lumbar herniated discs, cervical herniated discs may cause myelopathy in addition to radicular pain because of the anatomy of the spinal cord in the cervical region.
• The uncovertebral prominences play a role in the location of ruptured discs material.
• The uncovertebral joint tends to guide extruded disc material medially, where cord compression may also occur.

• Disc herniations usually affect the nerve root numbered most caudally for the given disc level; for example, the C3 – C4 disc affects the fourth cervical nerve root; C4- C5, the fifth cervical nerve root; C5 – C6, the sixth cervical nerve root; C6 – C7, the seventh cervical nerve root; and C7 – T1, the eighth cervical nerve root.

• Not every herniated disc is symptomatic.
• The development of symptoms depends on the reserve capacity of the spinal canal, the presence of inflammation, the size of the herniation, and the presence of concomitant disease such as osteophyte formation.
• In disc rupture, protrusion of nuclear material results in tension on the annular fibers and compressıon of the dura or nerve root causing pain.
• Also important is the smaller size of the sagittal diameter, the bony cervical spinal canal.
• Individuals in whom a cervical herniated disc causes motor dysfunction have a complication of cervical disc herniation if the spinal canal is stenotic.

Clinical History - LUMBAR SPINE

• Clinically, the patient’s major complaint is a sharp, lancinating pain.
• In many cases there may be a previous history of intermittent episodes of localized low back pain.
• The pain not only in the back but also radiates down the leg in the anatomic distribution of the affected nerve root.
• It will usually be described as deep and sharp and progressing from above downward in the involved leg.
• Its onset may be insidious or sudden and associated with a tearing or snapping sensations of the spine.
• Occasionally, when sciatica develops, the back pain may resolve because once the annulus has ruptured, it may no longer be under tension.
• Disc herniation occurs with sudden physical effort when the trunk is flexed or rotated.
• On occasion, patients with L4-L5 disc herniation have groin pain. In a study of 512 lumbar disc patients, 4.1% had groin pain.
• Finally, the sciatica may vary in intensity; it may be so severe that patients will be unable to ambulate and they will feel that their back is "locked".
• On the other hand, the pain may be limited to a dull ache that increases in intensity with ambulation.
• Pain is worsened in the flexed position and relieved by extension of the lumbar spine.
• Characteristically, patients with herniated discs have increased pain with sitting, driving, walking, couching, sneezing, or straining.

Clinical History - CERVICAL SPINE

• Arm pain, not neck pain, is the patient’ s major complaint.
• The pain is often perceived as starting in the neck area and then radiating from this point down to shoulder, arm and forearm and usually into the hand.
• The onset of the radicular pain is often gradual, although it can be sudden and occur in association with a tearing or snapping sensation.
• As time passes, the magnitude of the arm pain clearly exceeds that of the neck or shoulder pain.
• The arm pain may also be variable in intensity and preclude any use of the arm; it may range from severe pain to a dull, cramping ache in the arm muscles.
• The pain is usually severe enough to awaken the patient at night.
• Additionally, a patient may complain of associated headaches as well as muscle spasm, which can radiate from the cervical spine to below the scapulae.
• The pain may also radiate to the chest and mimic angina (pseudoangina) or to the breast.
• Symptoms such as back pain, leg pain, leg weakness, gait disturbance, or incontinence suggest compression of the spinal cord (Myelopathy).

Physical Examination - LUMBAR SPINE 

• Physical examination will demonstrated a decrease in range of motion of the lumbosacral spine, and patients may list to one side as they try to bend forward.
• The side of the disc herniation typically corresponds to the location of the scoliotic list.
• However, the specific level or degree of herniation does not correlate with the degree of list.
• On ambulation, patients walk with an antalgic gait in which they hold the involved leg flexed so that they put as little weight as possible on the extremity.

• Neurologic Examination:

• The neurologic examination is very important and may yield objective evidence of nerve root compression (We should evaluate of reflex testing, muscle power, and sensation examination of the patient).
• In addition, a nerve deficit may have little temporal relevance because it may be related to a previous attack at a different level.
• Compression of individual spinal nerve roots results in alterations in motor, sensory, and reflex function.
• When the first sacral root is compressed, the patient may have gastrocnemius-soleus weakness and be unable to repeatedly raise up on the toes of that foot.
• Atrophy of the calf may be apperent, and the ankle (Achilles) reflex is often diminished or absent.
• Sensory loss, if present, is usually confined to the posterior aspect of the calf and the lateral side of the foot.

• Involvement of the fifth lumbar nerve root can lead to weakness in extension of the great toe and, in a few cases, weakness of the everters and dorsiflexors of the foot.
• A sensory deficit can appear over the anterior of the leg and the dorsomedial aspect of the foot down to the big toe

• With compression of the fourth lumbar nerve root, the quadriceps muscle is affected; the patient may note weakness in knee extension, which is often associated with instability.
• Atrophy of the thigh musculature can be marked. Sensory loss may be apparent over the anteromedial aspect of the thigh, and the patellar tendon reflex can be diminished.

• Nerve root sensitivity can be elicited by any method that creates tension.
• The straight leg-raising (SLR)test is the one most commonly used.
• This test is performed with the patient supine.

Physical Examination - CERVICAL SPINE

Neurologic Examination:

• A neurologic examination that shows abnormalities is the most helpful aspect of the diagnostic work-up, although the examination may remain normal despite a chronic radicular pattern.
• The presence of atrophy helps document the location of the lesion, as well as its chronicity.
• The presence of subjective sensory changes is often difficult to interpret and requires a coherent and cooperative patient to be of clinical value.

• When the third cervical root is compressed, no reflex change and motor weakness can be identified.
• The pain radiates to the back of the neck and toward the mastoid process and pinna of the ear.
• Involvement of the fourth cervical nerve root leads to no readily detectable reflex changes or motor weakness.
• The pain radiates to the back of the neck and superior aspect of the scapula.
• Occasionally, the pain radiates to the anterior chest wall.
• The pain is often exacerbated by neck extension.
• Unlike the third and the fourth cervical nerve roots, the fifth through eighth cervical nerve roots have motor functions.
• Compression of the fifth cervical nerve root is characterized by weakness of shoulder abduction, usually above 90 degree, and weakness of shoulder extension.
• The biceps reflexes are often depressed and the pain radiates from the side of the neck to the top of the shoulder.
• Decreased sensation is often noted in the lateral aspect of the deltoid, which represents the autonomous area of the axillary nerve.

• Involvement of the sixth cervical nerve root produces biceps muscles weakness as well as diminished brachioradial reflex.
• The pain again radiates from the neck down the lateral aspect of the arm and forearm to the radial side of hand (index finger, long finger, and thumb).
• Numbness occurs occasionally in the tip of the index finger, the autonomous area of the sixth cervical nerve root.

• Compression of the seventh cervical nerve root produces reflex changes in the triceps jerk test with associated loss of strength in the triceps muscles, which extend the elbow.
• The pain from this lesion radiates from the lateral aspect of the neck down the middle of the area to the middle finger.
• Sensory changes occur often in the tip of the middle finger, the autonomous area for the seventh nerve.
• Patients should also be tested for scapular winging, which may occur with C6 or C7 radiculopathies.

• Finally, involvement of the eighth cervical nerve root by a herniated C7-T1 disc produces significant weakness of the intrinsic musculature of the hand.
• Such involvement can lead to rapid atrophy of the interosseous muscles because of the small size of these muscles.
• Loss of the interossei leads to significant loss of fine hand motion.
• No reflexes are easily found, although the flexor carpi ulnaris reflex may be decreased.
• The radicular pain from the eighth cervical nerve root radiates to the ulnar border the hand and the ring and little fingers.
• The tip of the little finger often demonstrates diminished sensation.

• Radicular pain secondary to a herniated cervical disc may be relieved by abduction of the affected arm.
• Although these signs are helpful when present, their absence alone does not rule out a nerve root lesion.

Laboratory Data

• Medical screening laboratory test (blood counts, chemistry panels erythrocyte sedimentation rate [ESR]) are normal in patients with a herniated disc.

• Electro diagnostic Testing

• Electromyography(EMG)is an electronic extension of the physical examination.
• The primary use of EMG is to diagnose radiculopathies in cases of questionable neurologic origin.
• EMG findings may be positive in patients with nerve root impingement.

Radiographic Evaluation - LUMBAR SPINE

• Plain x-rays may be entirely normal in a patient with signs and symptoms of nerve root impingement.

• Computed Tomography

• Radigraphic evaluation by CT scan may demonstrate disc bulging but may not correlate with the level of nerve damage.

• Magnetic Resonance Imaging

• MR imaging also allows visualization of soft tissues, including discs in the lumbar spine.
• Herniated discs are easily detected with MR evaluation.
• MR imaging is a sensitive technique for the detection of far lateral and anterior disc herniations.

Radiographic Evaluation - CERVICAL SPINE

• X-rays

• Plain x-rays may be entirely normal in patients wit han acute herniated cervical disc.
• Conversely, 70% of asymptomatic women and 95% of asymptomatic men between the ages of 60 and 65 years have evidence of degenerative disc disease on plain roentgenograms.
• Views to be obtained include anteroposterior, lateral, flexion, and extension.

• Computed Tomography

• CT permits direct visualization of compression of neural structures and is therefore more precise than myelography.
• Advantages of CT over myelography include better visualization of lateral abnormalities such as foraminal stenosis and abnormalities caudal to the myelographic block, less radiation exposure, and no hospitalization.

• Magnetic Resonance

• MRI allows excellent visualization of soft tissues, including herniated discs in the cervical spine.
• The test is noninvasive.
• In a study of 34 patients with cervical lesions, MRI predicted 88% of the surgically proven lesions versus 81% for myelography-CT, 58% for myelography, and 50% for CT alone.

Differential Diagnosis - LUMBAR SPINE

• The initial diagnosis of a herniated disc is ordinarily made on the basis of the history and physical examination.
• Plain radiographs of the lumbosacral spine will rarely add to the diagnosis but should be obtained to help rule out other causes of pain such as infection or tumor.
• Other tests such as MR, CT, and myelography are confirmatory by nature and can be misleading when used as screening tests.

Spinal Stenosis

• Patient with spinal stenosis may also suffer from back pain that radiates to the lower extremities.
• Patients with spinal stenosis tend to be older than those in whom herniated discs develop.
• Characteristically, patients with spinal stenosis experience lower extremity pain (pseudoclaudication=neurogenic claudication) after walking for an unspecified distance.
• They also complain of pain that is exacerbated by standing or extending the spine.
• Radiographic evaluation is usually helpful in differentiating individuals with disc herniation from those with bony hypertrophy associated with spinal stenosis.
• In a study of 1,293 patients, lateral spinal stenosis and herniated intervertebral discs coexisted in 17.7% of individuals.
• Radicular pain may be caused by more than one pathologic process in an individual.

Facet Syndrome

• Facet syndrome is another cause of low back pain that may be associated with radiation of pain to structures outside the confines of the lumbosacral spine.
• Degeneration of articular structures in the facet joint causes pain to develop.
• In most circumstances, the pain is localized over the area of the affected joint and is aggravated by extension of the spine (standing).
• A deep , ill-defined, aching discomfort may also be noted in the sacroiliac joint, the buttocks, and the legs.
• The areas of sclerotome affected show the same embryonic origin as the degenerated facet joint.
• Patients with pain secondary to facet joint disease may have relief of symptoms with apophyseal injection of a long-acting local anesthetic.
• The true role of facet joint disease in the production of back and leg pain remains to be determined.
• Other mechanical causes of sciatica include congentenial abnormalites of the lumbar nerve roots, external compression of the sciatic nerve (wallet in a back pants pocket), and muscular compression of the nerve (piriformis syndrome).
• In rare circumstances, cervical or thoracic lesion should be considered if the lumbar spine is clear of abnormalities.
• Medical causes of sciatica (neural tumors or infections, for example) are usually associated with systemic symptoms in addition to nerve pain in a sciatic distribution.

Differential Diagnosis - CERVICAL SPINE

• No diagnostic criteria exist for the clinical diagnosis of a herniated cervical disc.
• The provisional diagnosis of a herniated cervical disc is made by the history and physical examination.
• The plain x-ray is usually nondiagnostic, although occasionally disc space narrowing at the suspected interspace or foraminal narrowing on oblique films is seen.
• The value of x-rays is to exclude other causes of neck and arm pain, such as infection and tumor.
• MR imaging and CT-myelography are the best confirmatory examinations for disc herniation.
• Cervical disc herniations may affect structures other than nerve roots.
• Disc herniation may cause vessel compression (vertebral artery) associated with vertebrobasilar artery insufficiency and be manifested as blurred vision and dizziness.

• Other mechanical causes of arm pain should be excluded.
• The most common is some form of compression on a peripheral nerve.
• Such compression can occur at the elbow, forearm, or wrist. An example is compression of the median nerve by the carpal ligament leading to carpal tunnel syndrome.
• The best diagnostic test to rule out these peripheral neuropathies is EMG.
• Excessive traction on the arm secondary to heavy weights may cause radicular pain without disc compression of nerve roots.
• Spinal cord abnormalities must be considered if signs of myelopathy are present in conjunction with radiculopathies.
• Spinal cord lesions such as syringomyelia are identified by MRI, and motor neuron disease is identified by EMG.
• Multiple sclerosis should be considered in a patient with radiculopathies if the physical signs indicate lesions above the foramen magnum (optic neuritis).
• In very rare circumstances, lesions of the parietal lobe corresponding to the arm can mimic the findings of cervical radiculopathies.

Hydration: There is no denying that a healthy diet is integral to overall wellness and staying hydrated is absolutely vital. Every organ, every cell in your body contains water. In fact, when you don’t drink enough water and keep your body properly hydrated, it does not function as it should.

The health of your spine and back depends heavily on whether you are properly hydrated. In fact, if you don’t drink enough water plain, pure water, it could affect your back, causing pain and limiting mobility.

Hydration

Overview Of Spinal Construction

To understand water’s role in spinal health, you first need to understand how the spine is constructed. The row of bones that make up the spine are called vertebrae. Between each vertebrae is a disc. This disc works like a shock absorber so as you bend, flex, and move about the disc provides a buffer so the bones do not rub together.

Each disc is comprised of two parts. The center of the disc is the nucleus pulposis. It is made up mostly of water. The nucleus pulposis is surrounded by a tough, flexible ring that contains a gelatinous substance. It protects the inner area which is the cushion for the vertebrae. Two factors that further complicate the rehydration of the discs are aging and sedentary lifestyles.

How Water Is Good For Your Back

As you go about your daily activities, each time you move, the spine compresses the disc, squeezing out the water within. Even walking or sitting upright can cause this as gravity causes the spine to compress. When the disc does not have adequate water, the result is pain and lack of mobility as well as increased risk of spinal injury.

When you are not properly hydrated your body cannot replenish the water in the discs, causing them to remain compressed. Beverages like soda are not adequate for effective hydration. You need to make sure that you drink enough water every day.

For years we were told that 8 eight ounce glasses of water a day was the rule for proper hydration, and that works for many people. However, an article in the Harvard Health Letter suggests that the body can be properly hydrated with 30 to 50 ounces of water a day. The article goes on to suggest that water can also be found in foods like spinach, watermelon, soups, and lettuce are also good sources for hydration.

Spinal Problems Caused By Dehydration

When the body is dehydrated the discs remain compressed instead of refilling. When that happens the overall function of the spine is compromised. Your constant back pain may actually be caused by dehydration. When the discs cannot refill they can’t do their job. This leads to immobility and a compromised range of motion.

Hydration also plays an important role in how the cerebrospinal fluid moves and works. While it does require more than water to function properly, water does play an important role. When the body is dehydrated this fluid cannot move as it should which can even affect brain function.

On a larger scale, when the body is dehydrated it begins to retrieve water from other parts of the body so it can reroute it to the vital organs and sustain life. The extremities are the first places it pulls water from and the spine is another. When it deprives the spine of water in order to supply the organs then you remain in a constant deficit which can cause pain and mobility problems.

How The Spine Rehydrates

As the body rehydrates itself, it does not assign the spine as a priority. The vital organs take precedence so the spine basically gets what is left over. If there is already a deficiency present, then there is nothing left over to rehydrate the spine.

When there is adequate water in the body, normal activity and movement aids in the rehydration of the discs. The most significant rehydration occurs while you sleep though. When you lie down and rest your body is best able to initiate the process of rehydrating your spinal discs via osmosis.

Chiropractic care is another way to adjust the spine and encourage the refilling of the discs. That depends, of course, on proper water intake. Be good to your spine; it’s the only one you have.

Herniated Disc | El Paso, Texas

What is a Herniated Disc?

Herniation of the nucleus pulposus (HNP) occurs when the nucleus pulposus (gel-like substance) breaks through the anulus fibrosus (tire-like structure) of an intervertebral disc (spinal shock absorber).

A herniated disc occurs most often in the lumbar region of the spine especially at the L4-L5 and L5-S1 levels (L = Lumbar, S = Sacral). This is because the lumbar spine carries most of the body’s weight. People between the ages of 30 and 50 appear to be vulnerable because the elasticity and water content of the nucleus decreases with age.

The progression to an actual HNP varies from slow to sudden onset of symptoms. There are four stages: (1) disc protrusion (2) prolapsed disc (3) disc extrusion (4) sequestered disc. Stages 1 and 2 are referred to as incomplete, where 3 and 4 are complete herniations. Pain resulting from herniation may be combined with a radiculopathy, which means neurological deficit. The deficit may include sensory changes (i.e. tingling, numbness) and/or motor changes (i.e. weakness, reflex loss). These changes are caused by nerve compression created by pressure from interior disc material.

Progression of Herniated Disc 

The extremities affected are dependent upon the vertebral level at which the HNP occurred. Consider the following examples:

• Cervical – Pain in the neck, shoulders, and arms
• Thoracic – Pain radiates into the chest
• Lumbar – Pain extends into the buttocks, thighs, legs

Cauda Equina Syndrome occurs from a central disc herniation and is serious requiring immediate surgical intervention. The symptoms include bilateral leg pain, loss of perianal sensation (anus), paralysis of the bladder, and weakness of the anal sphincter.

DIAGNOSIS OF A HERNIATED DISC

The spine is examined with the patient laying down and standing. Due to muscle spasm, a loss of normal spinal curvature may be noted. Radicular pain (inflammation of a spinal nerve) may increase when pressure is applied to the affected spinal level.

A Lasegue test, also known as Straight-leg Raising Test, is performed. The patient lies down, the knee is extended, and the hip is flexed. If pain is aggravated or produced, it is an indication the lower lumbosacral nerve roots are inflamed.

Other neurological tests are performed to determine loss of sensation and/or motor function. Abnormal reflexes are noted as these changes may indicate the location of the herniation.

Radiographs are helpful, but Computed Axial Tomography (CAT) or Magnetic Resonance Imaging (MRI) provides more detail. The MRI is the best method enabling the physician to see the soft spinal tissues unseen in a conventional x-ray.

RADIOGRAPHIC EVIDENCE OF HNP

The findings from the examination and tests are compared to make a proper diagnosis. This includes determining the location of the herniation so treatment options can be reviewed with the patient.

Written by Edgar G. Dawson, MD; Reviewed by Howard S. An, MD

Subluxation is when a joint shifts out of alignment, which can happen to any joint in the body. Spinal subluxation indicates a misalignment of one or more portions of the spinal vertebrae. It is common in the spine from all the reaching, bending, twisting, and flexing the body goes through. Spinal subluxations, if left untreated, can cause disc degeneration, permanent nerve damage, neurological conditions, and chronic pain symptoms. A subluxation chiropractor will realign and decompress the spine combined with massage therapy to relax the muscles and restore mobility and function.

Subluxation Chiropractor

Some subluxations don't cause any problems or pain, but that doesn't mean they aren't affecting the back and body. A spinal subluxation can cause long-term problems by:

• Advancing the disc degeneration process.
• Gradually pushing, pulling, and/or compressing nerves.
• Causing the body to compensate through unhealthy postures.
• Delaying nervous system responses and signal transmissions.

Symptoms

While some spinal subluxations may not be symptomatic, the majority of them are and include:

• Muscle tightness, weakness, or spasms around the back.
• Back aching and pain.
• Neck aching and discomfort.
• Headaches.
• Limited mobility.
• Digestive issues.
• Tingling or pain in the arms or legs.

Causes

Common causes include:

• Unhealthy postures.
• Sleeping in awkward positions.
• Sitting or standing for long periods.
• Lifting objects improperly.
• Wearing a heavy bag on one shoulder for an extended
• Heightened stress levels can cause the back muscles to tighten, which can cause subluxations.
• Automobile accidents, falls, or other traumas.
• Playing contact sports.
• Edema
• Hyperemia - lack of blood circulation.
• Atrophy
• Fibrosis

Effects

Research shows that spinal subluxations can affect many facets of the body. Long-term effects may include:

• Sleep problems
• Low energy
• Brain fog
• Mood swings
• Anxiety and depression
• Digestive issues
• Respiratory problems
• Bone spurs
• Spinal arthritis

Chiropractic Care

When the spine is out of alignment, it can cause issues throughout the body. Changes in one area affect the rest of the body. A subluxation chiropractor looks at the spine's neurological and mechanical components and aims to reset everything back into its proper position. Similar to the way a massage helps the mind and body relax and de-stress, a spinal adjustment helps by:

• Increasing circulation
• Relieving discomfort and pain
• Releasing tension
• Improving mood
• Reducing stress levels
• Improving sleep function
• Increasing energy levels

When the spine is properly aligned, the body can operate at its full potential.

Adrenal Dysfunction

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Brian S. Budgell, Reflex effects of subluxation: the autonomic nervous system, Journal of Manipulative and Physiological Therapeutics, Volume 23, Issue 2,
2000, Pages 104-106, ISSN 0161-4754, https://doi.org/10.1016/S0161-4754(00)90076-9. (https://www.sciencedirect.com/science/article/pii/S0161475400900769)

Green, J D et al. "Anterior subluxation of the cervical spine: hyperflexion sprain." AJNR. American journal of neuroradiology vol. 2,3 (1981): 243-50.

Meyer, S. “Thoracic spine trauma.” Seminars in roentgenology vol. 27,4 (1992): 254-61. doi:10.1016/0037-198x(92)90004-l

Neva MH, Häkkinen A, Mäkinen H, et al. High prevalence of asymptomatic cervical spine subluxation in patients with rheumatoid arthritis waiting for orthopedic surgeryAnnals of the Rheumatic Diseases 2006;65:884-888.

Nourollahi, Maryam, et al. "Awkward trunk postures and their relationship with low back pain in hospital nurses." Work (Reading, Mass.) vol. 59,3 (2018): 317-323. doi:10.3233/WOR-182683

Vernon, Howard. "Historical overview and update on subluxation theories()." Journal of chiropractic humanities vol. 17,1 (2010): 22-32. doi:10.1016/j.echu.2010.07.001