Thursday, January 6, 2011

Happy New Year!

In my first blog report of the 2011 year I would like to begin a series of posts that will help educate my readers. It is often that I have patients come to my clinic after they have failed to get relief from other facilities and it’s my belief that this is usually due to a lack of a proper diagnosis. Since the lower back is the most common problem I will focus on the symptoms and diagnosis of the lumbar spine. Hopefully this information will help you understand all the possible scenarios of the lumbar spine. With this information you will have plenty of material that will help you ask the proper questions to your doctor. The topics that I will cover in the next few weeks will include the following:

1. Normal Anatomy & Disc Degeneration
2. Disc Injuries (Slipped Disc)
3. Sciatica (Leg Pain)
4. Vertebrae & Sacroiliac Subluxation
5. Facet Syndrome
6. Short Leg Syndrome
7. Spondylolithesis
8. Scoliosis
9. Transitional Vertebrae

If you have lower back pain, you are not alone. Lower back pain with or without leg pain, afflicts 1 out of every 3 Americans. The pain in the leg is called sciatica and may occur in the buttock, thigh, leg, ankle or foot and represents irritation of the longest nerve in the body – the sciatic nerve. This nerve starts in the lower back where it is formed from the union of five nerve roots that come from the spinal cord. Most authorities state two basic sources of lower back pain – the intervertebral disc and the facet joints. There are many reasons why these structures create pain and will be covered in this series.

Part 1
Figure 1 shows what a normal spine looks like. (A) Notice what a normal disc looks like. (B) Shows the normal facet articulations and (C) shows the opening where the nerve exits the spine.

Figure 2 shows what degeneration looks like. (A) Points to a degenerated disc which reduces the size of the hole where the nerve exits the spine (B)

The nerve that comes from the spine must pass through the narrowed opening then travels down the leg. Therefore, narrowing of the disc with misalignment of the joints causes pressure of the nerves by narrowing this opening. The loss of the disc height is called disc degeneration while misalignment of the joint is called a subluxation. Treatment of the back must be directed toward relieving the disc narrowing and the subluxation. Disc degeneration is sometimes referred to as Arthritis but this is a poor choice of term. Arthritis is not always the cause of pain but can be reaction from the body when disc height is lost and subluxation of the joint is present.
That’s why treatment with pain killers or anti-inflammatories doesn’t get rid of the problem. Your doctor needs to concentrate on reducing the pressure on the nerve.

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