Spine Health & Spinal Hygiene

Syringomyelia is a disorder in which a fluid-filled cyst/syrinx forms within the spinal cord. It is progressive, meaning that the cyst grows with time causing compression and damage to the spinal cord. The cyst usually begins in the neck/cervical spine but can develop in any area along the spinal cord. There are several possible causes; however, most are associated with a condition known as Chiari malformation. This is where the skull and neck come together, and either the skull is too small or shaped in a way that causes brain tissue to come out and settle in the spinal canal.

Syringomyelia Causes

Syringomyelia can be caused by or from complications of:

• Congenital disabilities like Chiari malformation
• Chiari type I malformation develops during the fetal developmental stage and causes the lower part of the brain or cerebellum to stick out from its standard location.
• Hemorrhage/bleeding
• Inflammation of the spinal cord from virus or bacterial infection like meningitis
• Spinal cord injury
• Spinal cord tumor

Symptoms

A damaged spinal cord disrupts communication between the brain and the body. Symptoms differ for every individual, but common syringomyelia symptoms include:

• Pain, stiffness, or weakness in the neck, arms, back, and/or legs
• Progressive numbness
• Headache/s
• Sensitivity to heat and cold
• Muscle atrophy, contractions, spasticity/tightness 
• Skin rash

Symptoms usually develop slowly, but exercise, coughing, or some form of strain can cause sudden onset.

Diagnosis

Physical and neurological exams are performed to determine loss of feeling or inability to move around normally, like walking. Diagnostic tests of the spine will include a CT scan with contrast dye and/or an MRI. Early detection can help before it progresses, causing further damage, and delaying treatment can cause irreversible spinal cord injury. It is recommended at the first sign of symptoms to contact a doctor.

Treatment

Some individuals who have syringomyelia may have no symptoms. These individuals can go about their everyday lives but are recommended to be cautious with neck and back strain. For individuals experiencing symptoms, the primary treatment objectives are to:

• Stop or control damage to the spinal cord
• Preserve function
• Prevent disability
• Treatment options include:
• Draining the cyst
• Surgical removal of the cyst
• Chiropractic and physical therapy could be included in the treatment plan to help the individual rebuild lost muscle strength and regain flexibility.

All too often, individuals with this disorder experience treatment delay/s because symptoms can be nonspecific or vague. Education is the key, and individuals can be diagnosed sooner by paying attention to the body's warning signs.

Body Composition

Does too much protein hurt the kidneys?

While protein restriction can be appropriate for treating existing kidney disease, research shows that high protein intake in healthy individuals does not disrupt or cause damage to the kidneys or kidney function. The amino acids in protein are more likely to be excreted through urine when not being used. However, there are certain risks associated with consuming too much protein, and it is recommended to keep track of protein intake. Eating more protein:

• Makes the body feel full longer
• Can help curb overeating
• Is essential for recovery and growth

When achieving daily caloric goals, maintaining a balance of nutrients like carbohydrates and healthy fats is essential for overall health.

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

Batzdorf, Ulrich. "Primary spinal syringomyelia. Invited submission from the joint section meeting on disorders of the spine and peripheral nerves, March 2005." Journal of neurosurgery. Spine vol. 3,6 (2005): 429-35. doi:10.3171/spi.2005.3.6.0429

Di Lorenzo, N, and F Cacciola. "Adult syringomyelia. Classification, pathogenesis and therapeutic approaches." Journal of neurosurgical sciences vol. 49,3 (2005): 65-72.

Fernández, Alfredo Avellaneda et al. "Malformations of the craniocervical junction (Chiari type I and syringomyelia: classification, diagnosis, and treatment)." BMC musculoskeletal disorders vol. 10 Suppl 1, Suppl 1 S1. 17 Dec. 2009, doi:10.1186/1471-2474-10-S1-S1

Naftel, Robert P et al. "Worsening or development of syringomyelia following Chiari I decompression: case report." Journal of neurosurgery. Pediatrics vol. 12,4 (2013): 351-6. doi:10.3171/2013.7.PEDS12522

Roy, Anil K et al. "Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management." Neurosurgical focus vol. 31,6 (2011): E15. doi:10.3171/2011.9.FOCUS11198

Spinal disorders and injuries could cause a nerve injury through compression or damage causing Neurogenic Bladder Dysfunction also known as Bladder Dysfunction. Neurogenic bladder disorder means an individual is having problems with urination.

Neurogenic involves the nervous system and the nerve tissues that supply and stimulate the organs and muscles to function and operate correctly. Neurogenic bladder dysfunction causes the nerves that control the bladder and muscles in urination to be overactive or underactive.

Symptoms

• Constant bathroom visits
• Control in urination is limited
• Complete involuntary urination
• Sudden urge/s to urinate
• The bladder is unable to hold urine
• The bladder fails to empty completely
• Overfilling of the bladder creates intense pressure causing accidental leakage

Nerves of the Bladder

The brain and spinal cord function as the headquarters with the spine as the body's highway that transmits and relays signals/messages to and from the bladder. In the low back, the spinal cord splits apart into a bundle of nerves called the cauda equina.

At the end of the lumbar spine is the sacrum this area is known as the sacral spine. The sacrum is the backside of the pelvis between the hip bones. The nerves in the sacral spine branch out and become part of the peripheral nervous system. 

These nerves provide and stimulate bladder sensation and function. When these nerves become compressed, inflamed, injured, or damaged in some way, organ dysfunction can present. This is when any of the symptoms listed above can develop and progress.

Potential Causes of Neurogenic Bladder Dysfunction

Spinal Cord Injury/s are a common cause of neurogenic bladder dysfunction. The spinal cord does not have to be severed to cause paralysis below the injured part of the spine. If the spinal cord gets bruised or there is improper blood flow, the spinal cord's ability to send nerve signals can become inhibited. Cauda Equina Syndrome happens when the nerves spinal roots become pinched or compressed. It is rare, but it is a serious medical condition that requires immediate medical attention. Causes of cauda equina syndrome include:

• Low back disc herniation
• A tumor in or near the low back
• Spinal fracture
• Infection
• Spinal stenosis which affects the spinal canal
• Trauma like an auto accident, personal/work/sports injury
• Spinal condition from injury or present from birth

Treatment

The treatment depends on the cause or causes of neurogenic bladder dysfunction. A primary physician could call upon a bladder specialist like a urologist, nephrologist, or urogynecologist to collaborate and coordinate the treatment plan. If the dysfunction is caused by a nerve root compression, a spinal procedure (discectomy) is performed to decompress and relieve the pressure on the nerves.

Nutrition and Fitness During These Times

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*

Seasonal Affective Disorder is a form of depression that has to do with the changing of the seasons, specifically when fall begins to. It affects around 10 million Americans during the fall and winter seasons. Back pain can be a symptom of the disorder. For most individuals, the condition follows a pattern:

• It starts with lethargy or lack of energy
• Craving carbohydrates
• Heavy low mood

These are typical symptoms for many dealing with the condition. The individual can experience aches and pains throughout the body, but especially the back. Recent studies have shown how various forms of depression, like Seasonal Affective Disorder, can present with pain, specifically back/spinal pain. Many individuals play it off as the blues, but research has found, depression can have a much more significant impact on an individual's quality of life. The exact cause is still unknown. But research is finding a connection related to the level of sunlight an individual receives throughout the day.

Research has shown there could be a biochemical imbalance in the brain when there is less daylight during fall and winter. As the seasons change from summer to fall individuals can experience a shift in circadian rhythms that can cause them to disrupt their regular daily routine. However, Seasonal Affective Disorder is more common for individuals living where the daylight lessens and has been shown to affect women more than men and young adults.

Depression and Back Pain Connection

Depression can present with pain symptoms and the pain can enhance the depression. Headaches, Body aches, and especially backaches are common symptoms of depression. Research has shown that individuals with severe depression can actually feel a more intense level of pain.

Physical symptoms like back pain or headaches can be the only or the beginning symptom/s of seasonal affective depression. As research continues to grow as to how the nervous system interacts with the body, pain symptoms have been found to be connected to biological mechanisms connected with stress, anxiety, and depression.

Living a sedentary lifestyle, with little or no physical activity and regular exercise can be another cause for Seasonal Affective Disorder. Depression itself can cause fatigue that restrains individuals from exercising and working the core muscles for optimal spinal strength and health.

This added stress on the spine's discs, joints, and ligaments, makes the body more susceptible to low back pain, muscle strains, illness, and injuries. Pain can wear an individual down impacting mood and overall health.

Symptoms

The difference between Seasonal Affective Disorder and chronic depression is that Seasonal Affective Disorder is limited to the same time of the year during the time of less light, and winter months. Symptoms of Seasonal Affective Disorder can be the same as those associated with depression. They are:

• Feeling Low/Depressed
• Weight gain
• Increased appetite
• Craving sugar and carbohydrates
• Sleeping all-day
• Consistent drowsiness
• Hopelessness
• Loss of interest in enjoyed activities

Symptoms can also be related to low levels of Vitamin D, which is associated with anxiety and depression for individuals with fibromyalgia. Seasonal Affective Disorder can be related to chronic pain conditions the way depression can. Some individuals with chronic fatigue syndrome can also present with symptoms of Seasonal Affective Disorder.

Treatment

Diagnosis for Seasonal Affective Disorder requires an individual to experience at least two years of symptoms that become worse at a specific time of the year. And the depressive episodes have to significantly be worse than the non-seasonal episodes of depression. There are four types of treatments, that can be used individually or in combination. They are:

Medication

Medications used to treat the disorder are known as Selective Serotonin Reuptake Inhibitors or SSRIs.

Psychotherapy

Cognitive-behavioral therapy/CBT is a form of psychotherapy that is effective for the disorder, as well as other conditions. It relies on techniques that identify negative thoughts and work on ways to not dwell on the negative and focus more on positive things and thoughts.

Lightbox Therapy

Diminished sunlight when fall and winter arrive can be replaced with regular exposure to a bright, artificial lightbox. Individuals sit or stand in front of the lightbox when they get up on a daily basis. This is done when fall begins and goes on until spring. The lightbox filters out ultraviolet rays and requires around 20 to 60 minutes of exposure to 10,000 lux of cool-white fluorescent light.

Vitamin D

Low levels of vitamin D were found in individuals with Seasonal Affective Disorder. Talk to a doctor about the proper level of vitamin D that should be taken through supplements.

The Pain and Backaches

Understanding how pain and depression are interconnected treating both conditions as part of an integrative treatment plan can include:

• Chiropractic care for releasing muscle tension
• Psychological counseling
• Relaxation therapy
• A light aerobic exercise program that stimulates serotonin levels and releases endorphins to relieve depression and pain.
• Low-dose antidepressants can reduce depression symptoms and back pain. They work to inhibit the reuptake of neurotransmitters like serotonin and norepinephrine that is associated with a person’s mood and the way they perceive pain.

What Works

Everyone is unique, which means that different treatment plans and combinations of treatment plans may have to be tried out before finding the optimal one. A significant factor is not settling with the pain and just accepting it. Healing can be a unique and complex experience. The objective is for the individual and doctor to work collaboratively.

Depression And Chronic Pain 

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