Health Update: Low Back Pain

What Causes Low Back Pain?

I can’t tell you how many times a day this question is asked! Obviously, there are MANY causes of low back pain (LBP) but you may be surprised about some of the following:

1. Trauma: Let’s start with the easy one – falling down, over lifting, twisting, pushing, pulling, bending over, sporting activities, work activities, sex, sneezing, raking, shoveling……OK, I could fill the page with possible injuries that can cause LBP so I’ll stop here. We’ve all sprained an ankle or a finger and based on statistics, most of us have also suffered from LBP as a result of a single event injury. These types of injuries include sprains (ligament injuries), strains (muscle/tendon injuries), disk injuries (tears, ruptures), and include many possible findings including subluxations (areas where vertebrae stop working well together or have shifted from their proper location). When there is radiating leg pain that travels below the knee, a pinched nerve may be involved, often caused by disk pressure or a combination of things.

2. Insidious or, “I don’t know what I did!”: Believe it or not, this is probably the most common cause of LBP we see as the majority of people can’t recall anything as causing their LBP. The “cause” in these cases often stems from a series of events that accumulate to a point where pain/swelling occurs, often hours or even days after several over-use activities may have been performed. Thus, more investigation into the activities that preceded the onset of LBP needs to be considered. We can usually uncover several possible culprits but we can’t ever be 100% certain that we’re right about the cause(s). In some cases, people will wake up with LBP, while others don’t have it until they’ve been active.

3. Biomechanical causes: This category might be involved in the 2nd category discussed but deserves a separate discussion because of the many possibilities. First, we are 2 legged / not 4 legged animals and that by itself puts a lot of pressure on our lower backs. In fact, 2/3rds of our weight is carried from the waist up and as a result, just bending over for a pencil can, “…throw the back out.” For example, a 180# person lifts about 120# of body weight just by bending forward! Another common problem is one leg being shorter than the other. It has been reported that 87% of us have unequal leg lengths and when the shift measures 7-9mm (about ¼ inch), the probability of back, hip, or sciatica pain is 2x greater. When the difference is 16mm, there is an 8x greater chance of having back trouble. The “fix” in this case can be quite simple as using heel lifts in the short leg shoe. Flat feet and ankle pronation can also create an unstable pelvis and can contribute to LBP so foot orthotics can also be very helpful in the management of LBP. Obesity (body mass index >30) has been identified as a risk factor for a lot of conditions including LBP and a weight management program can be highly effective.

4. Dangerous loading activities: It has long been known that jobs where 50-100# is lifted or carried, especially if frequently handled, have an increase in occurrence of LBP. Using proper lifting methods is very important in jobs like this!

Health Update: Low Back Pain

Low Back Pain
and Bone Density

So, what does bone density have to do with low back pain? The relationship between bone density and back pain is quite intimate. In fact, when the degree of bone density declines to the point of fracture, back pain becomes very real. The classic condition and cause of spinal pain associated with the loss of bone density is compression fracture.

Compression fractures occur when the strength of the bone decreases to a point where minor trauma and sometimes, no trauma whatsoever can result in fracture. Compression fractures affect the vertebral body (front of the spine) most often in the upper lumbar or lower thoracic spine but the pain associated with these types of fractures frequently radiates into the low back and pelvic region. In the elderly osteoporotic spine, these types of fractures usually do not result in spinal cord injury or nerve damage but this is quite the opposite when compression fractures occur in younger, normal bone density individuals. This is because when the bone is dense (or normal), the vertebral body basically explodes or bursts shifting some of the bony fragments back into the spinal canal where the spinal cord is located. When bone density decreases, there is no bursting of fragments – only collapse, resulting in pain but no neurological damage. Besides pain, another problem with compression fractures is that the once upright or vertical spine is now bent and angles forward shifting the patient’s weight to the front. This shift places yet more pressure on both the fractured vertebra and the surrounding vertebra which increases the risk of fracture to the surrounding adjacent vertebra. Therefore, multiple compression fractures are not uncommon when brittle bones occur from osteoporosis.

So who is more at risk for osteoporosis? The usual predictors include age, (older than 65), gender (female), race (Asian or Caucasian), low body weight, and previous fracture. Others include smoking, previous use of corticosteroids, a family history of fracture, excessive alcohol use, and rheumatoid arthritis. Additionally, vitamin D deficiency, thyroid or parathyroid increased function, and celiac disease (gluten intolerance) as well as poor balance (repeated falls), muscle weakness and a DEXA (dual-energy X-ray absorptiometry) T-score of -1.1 to -2.4 (osteopenia) or -2.5 or greater (osteoporosis) are also important predictors of brittle bone disease or osteoporosis. To best determine your risk using these factors, go to FRAX (www.sheffield.ac.uk/frax) developed by the World Health Organization (WHO) to determine your 10-year fracture probability (do not just use of the T-score on the DEXA scan).

Video: Bone Density Screening

From a treatment standpoint, it depends on the age of the patient, the degree of osteoporosis, and whether fracture has already occurred. In the younger, osteopenic person (that is, no fractures have occurred yet but bone density is low), non-medication approaches such as weight bearing exercise, no smoking, calcium / vitamin D supplementation, and minimize the other risk factors described above may be the proper choice. For others already with fracture, medication (bisphosphonates such as Actonel, Boniva, & Fosamax) may be appropriate. Further, injecting a cement into the bone (called kyphoplasty) may be appropriate for some.

We realize you have a choice in healthcare providers. If you, a friend or a family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Health Update: Low Back Pain

What Can I Do To Reduce My Risk For Low Back Pain?

Low back pain (LBP) can have many causes such as genetics, acquired abuses, body type (especially obesity – body mass index or BMI greater than 30), gender, as well as cultural aspects that predispose one to acquire low back trouble.  So, the question remains, “what can I do to reduce my risk for developing low back pain?”

The answer, like the cause is – you guessed it – multifactorial.  Since we can’t change our genetics, we’ll have to accept that one.  But, we can change our BMI by keeping our weight to a reasonable amount.  In an April 2010 study from Norway, 60,000 men and women provided BMI information and 20.9% of the men and 26.3% of the women indicated they had chronic low back pain. The authors found a direct relationship to a high BMI and an increased prevalence of LBP.  Similar results attributing obesity to LBP were also reported in a meta-analysis published in January 2010 in the American Journal of Epidemiology (2010; 171(2):135-154).

So, what is, “…a reasonable amount of weight?”  When using the BMI, a BMI of 18.5 to 25 is considered “normal,” while 25-30 is described as overweight and greater than 30 represents obesity.  We should also mention anything LESS than 18.5 is considered underweight and that’s not good either as many nutritional needs of the body are compromised and too little weight can negatively affect bone health leading to osteoporosis and a myriad of other problematic health issues.

You may be wondering what a body mass index or BMI is, as its quite important and is quickly gaining respect in the medical world.  In fact, it has been suggested to include the BMI along with the other “vital signs” pairing it up with blood pressure (BP), pulse, breathing rate, height, weight, and temperature.  The BMI is a formula of height and weight and it’s a rough calculation of our total body fat, which is related to the risk of disease and death.  However, according to the National Heart, Lung and Blood Institute (NHLBI) it’s a little more complicated than that as people with greater muscle mass (such as a body builder) will have a higher BMI, suggesting they are overweight. At the other end of the spectrum, older individuals who have lost muscle mass may be still be overweight but their BMI will not reflect that.

The NHLBI reports 3 factors of importance when defining obesity and its many negative health effects, including the increased prevalence of LBP.  The 3 factors are: 1) The BMI; 2) The waist measurement; 3) The presence of other negative health factors including: high BP, high LDL-cholesterol, low HDL-cholesterol, high triglycerides, high blood sugar, a family history of heart disease, physical inactivity and smoking cigarettes.  If you have a waist size greater than 35” for woman, greater than 40” for men, AND 2 or more risk factors, simply put, you MUST lose weight!  Even a small weight loss of 10% (such as 30# if you’re 300#), will help lower your risk of developing diseases associated with obesity such as heart disease, high cholesterol related diseases, stroke, certain types of cancers and type 2 diabetes.

We also realize you have a choice in who you choose for your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.                            
                                                                              
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN!  FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597

Health Update: Low Back Pain

Would Traction Help My Back Pain?

Traction is a common form of treatment for patients with low back pain.  By definition, traction is the “act of pulling a body part.”  That basically means traction can be applied to an arm, leg, finger, toe…..virtually any body part that one can get a hold of.  Here, the focus of traction is being applied to the lower part of the spine and the primary objective is for pain relief and restoring function.  Traction “works” by applying a force that separates and increases the space between joints.  It also stretches the surrounding soft tissues, including ligaments, joint capsules, muscles and tendons.  Spinal traction can be applied manually (with the hands) or by a device with either the use of complicated computerized equipment or, by a gravity assisted means such as using the body’s weight and gravity as the traction force.

Common conditions of the spine for which traction is often utilized include low back sprains and strains, disk herniations (“slipped disks”), and spinal stenosis.  Spinal stenosis occurs when there is a narrowing of the hole or canal through which a nerve root exits the spine or where the spinal cord travels, often caused by arthritic spurs.  Hence, it is most common after the age of 60 years old.  Traction has been shown to improve circulation, reduce inflammation, and by movement of the joints, it may also reduce the nerve’s excitability, resulting in pain reduction.

The “dose” of traction from a clinical experience standpoint, is determined by patient comfort.  It must “feel good” to be safe.  Remember, too much of anything changes it from being beneficial to being potentially harmful.  Therefore, when determining the dose of traction for the first time, we advise the patient to pay careful attention to the way they feel during the time traction is being applied. Often, it feels good at first but may become uncomfortable as time passes. If there is sharp pain, radiating pain (such as down a leg), or, if it is just not comfortable, traction should be discontinued and the recovery time should be reported.

A “typical” dose is 10-15 minutes of time, and the traction force can be continuous or intermittent, kind of like turning on a water faucet and leaving it running vs. turning it on and off.  With intermittent traction, we can vary the time that the force is applied such as 30 seconds on and 10 seconds off.  Generally, the total treatment time can be longer with intermittent traction (such as 15 minutes) compared to continuous traction, where 10 minutes may be utilized.  The traction weight or force can be gradually increased, depending on tolerance and individual patient response to the prior weight.

The Cochrane Report found traction is most effective for cases of sciatica or nerve root pressure creating leg pain. Also, it’s best when used in conjunction with other treatment approaches.  In a chiropractic setting, manual traction (where the doctor uses their hands to apply the force) is often utilized along with side to side or figure-8 movements to achieve better results.  Spinal manipulation, muscles massage, myofascial release techniques, exercise training for both stretch and strengthening purposes and patient education such as teaching proper bend/lift/pull/push techniques are often utilized to achieve the most satisfying results when managing patients with low back pain.

We realize that you have a choice in where you choose for your health care services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.      
                                                                              
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN!  FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597.

Health Update: Low Back Pain

Why Does My Back Always Hurt?

Low back pain is a very common problem affecting 80-90% of all of us at some point in our lifetime.  Why is that you ask?  There are many reasons. One of the biggest reasons is that we are 2-legged animals carrying 2/3rds of our weight above our waist.  Studies have shown deterioration or arthritis occurs much sooner in us vs. our 4-legged animal counterparts. A 180 lbs man carries roughly 120 lbs above the waist.  This means, every time he bends over, in order to stand upright, he needs to lift 120 lbs PLUS whatever he is lifting.  Hence, the argument of, “…but I only bent over to lift a pencil and my back went out,” seems on the surface as impossible but in reality, the man in our example is lifting the pencil plus 120 lbs. Now, let’s add to that the point that a 5 pound weight equals 50 pounds when held out in front with the arms stretched out straight.  Now, if that’s not bad enough, now, let’s assume all of this is happening from a bent forward position, with a twist at the waist, with out stretched arms, while lifting a 20 pound object.  Get the idea?  It’s amazing our back doesn’t get injured every day as we lift 2 bags of groceries into the far end of a car trunk, or, when lifting our 30 pound child in and out of a car seat, height chair, or when they are screaming and pushing away from us as we try to lift them!


In order to further appreciate why the lower back is so vulnerable to injury, some basic understanding of anatomy is needed.  When we’re born, the back is made up of 33 segments of which 5 fuse by the time we’re about 18 years old to make up the sacrum (bottom of the spine) and 4 fuse to make up the coccyx (tail bone), leaving 5 lumbar (low back), 12 thoracic (mid-back) and 7 cervical (neck) vertebra.  These are stacked up on top of each other like building blocks and are connected to each other by a shock absorbing disk in the front and two smaller facet joints in the back, acting like a tripod.  In the low back, we’re supposed to bear about 80% of our weight in the front and 20% in the back but, if our abdominal muscles are a bit out of shape and the pelvis rotates forwards, the curve in the low back increases and overloads the back of the vertebra (facets) making them vulnerable to injury.  The disk becomes injured when we bend/lift/twist. This can tear the outer tough fibers of the disk, allowing the central more liquid-like material to leak out.  If this happens, the leaking or "herniated disc" can put pressure on the nerve that exits the spine and travels down our leg.  If the pain pattern includes the back of the leg, it’s commonly referred to as “sciatica.”

OK, enough about anatomy.  What can we do to reduce the chances of having periodic low back pain? Obviously, staying in shape is very important. Certain muscles of the body must be tight to keep us upright or standing.  These muscles need to be stretched on a regular basis. For example: the hamstring muscle.  We’ve all had to perform hurdler types of exercises and remember how tight they feel!


We realize that you have a choice in where you choose for your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.  

FOR A FREE NO-OBLIGATION CONSULTATION CALL  732-984-9597  OR VISIT US AT ADVANCED-WELLNESS.NET

Health Update: Low Back Pain

I Slipped a Disc – What Is That Exactly?

“I was digging a hole in my garden and hit a rock with the shovel. After clearing the dirt from around the rock, I bent over and reached into the hole. I couldn’t get a good grip on the rock and had to twist my body to get my arm under it. As I started to move the rock, I felt something ‘give out’ in my low back and felt immediate low back pain, but it wasn’t terrible. Like a fool, I gave it another try but this time, the pain in my back was really sharp when I twisted to reach under it. Then, it felt like a knife stabbing me when I tried to stand up. Since then, I can’t stand up straight and pain is shooting down my left leg.”

The intervertebral disk is like a shock-absorber located between each vertebra in our spine extending from the tail bone to the upper neck. When healthy, your disks truly do function as shock absorbers. There are two parts to the disk – the inner part (called the nucleus) which is the liquid-like center and the outer part (the annulus), which is tough, laminated and rubber-like whose job is to hold the nucleus in the center of the disk. The annulus has concentric rings which look similar to the rings of an oak tree trunk and the strength of these laminated rings is due to the fibers crisscrossing, creating a self-sealing, secure border for the nucleus center. In spite of this great anatomical structure, our disks degenerate and can crack or tear allowing the more liquid-like nucleus to leak out of the annulus creating the classic “slipped disk” (technically referred to as a herniated or ruptured disk). When the herniated disk presses into the nerve that goes down the leg, pain is felt along its course and can radiate all the way to the foot. There are five vertebrae and disks with a pair of nerves that go into each leg and depending which disk ruptures, pain will follow a different course down the leg, which is why we ask you if you feel the pain more in the back or in the front of the leg. When the disk tears prior to both disk herniation and leg pain, low back pain occurs because the nerve fibers that are normally only located in the outer third of the disk grow into the central portion of the disk, making it generate more pain.

So now for the important question, “…what can I do for it?” When you visit our office, we will ask you about how you injured your back. Often, the cause of a herniated disk can be the accumulation of multiple events over time. It certainly can happen after one major event, like our example of lifting a rock out of a hole, but that is usually the “straw that breaks the camel’s back” and not the sole cause. Many researchers have reported it is rare for a healthy disk to herniate. Rather, disk degeneration with tears already present sets up the situation where a bend plus a twist, “…finishes the job.” The orthopedic and neurological examination will usually clearly identify the level of herniation. Chiropractic treatment often includes traction types of techniques, some form of spinal manipulation or mobilization, extension exercises, physical therapy modalities like electric stimulation, low level laser, or ultrasound, and ice therapy. Core / trunk strengthening and posture management are also commonly applied and, proper bending/lifting/pulling/pushing techniques are taught. We realize that you have a choice in where you choose for your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597

Health Update: Low Back Pain

Back School 101:  3 Ways To Prevent Making Your Back Pain Worse


Chiropractic care for patients with low back pain (LBP) not only includes spinal manipulation or adjustments but also patient education in regards to heat/ice, performing daily activities and exercise.

Heat vs. Ice: This topic is controversial, as often, patients will be told by their friends and family to use the opposite of what we may recommend to our patients. In general, when pain is present, there is inflammation… so use ice to reduce swelling and pain. When heat is inappropriately utilized during this inflammatory phase of healing, vasodilation or, an increase in blood supply to the already swollen injured area often results in an increase in pain. The use of heat may be safely applied later in the healing process during the reparative phase of healing, but as long as pain is present, using ice is usually safer and more effective.

Daily Activities: Improper methods of performing sitting, bending, pulling, pushing, and lifting can perpetuate the inflammatory phase, slow down the healing process, and interfere/prevent people from returning to their desired activities of daily living, especially work. Improperly performing these routine activities is similar to picking at scab since you’re delaying the healing process and you can even make things worse for yourself.

Exercise: There are many exercises available for patients with low back pain. When deciding on the type of exercise, the position the patient feels best or, the least irritating is usually the direction to emphasize.

More specifically, for those who feel a reduction in pain when bending forward (referred to as "flexion-biased"), flexion exercises are usually indicated. Examples of these include raising a single knee to chest, double knee to chest, posterior pelvic tilts, sitting forward flexion, and hamstring stretches.

When bending backwards results in pain reduction (referred to as "extension-biased"), standing and bending backwards, performing a sagging type of push-up ("prone press-up"), laying backwards on large pillows or on a gym-ball are good exercises. The dosage or duration exercises must be determined individually and it is typically safer to start with 1 or 2 exercises and gradually increase the number as well as repetition and/or hold-times. If sharp/"bad" pain is noted, the patient is warned to discontinue that exercise and report this for further discussion with their chiropractor. It is normal and often a good sign when stretching/"good" pain is obtained at the end range of the exercise.

We recognized the importance of patient education in our approach to managing low back pain cases, and look forward in serving you and your family presently and, in the future.
                                                        
YOU MAY BE A CANDIDATE FOR OUR LOW BACK PAIN PROGRAM.  FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597 OR VISIT US AT ADVANCED-WELLNESS.NET

Health Update: Low Back Pain

What Do Consumers Say Works Best?
            
              We know that many people, in fact about 80%, hurt their back at some point in life.  In a recent survey by Consumer Reports (CR) (see the May 2009 issue), over 14,000 subscribers had low back pain (LBP) but no surgery to treat it in 2008.  More than half reported severe daily activity limitations for at least one week and 88% reported their LBP recurred throughout the year.

              Many indicated their sleep, sex life, and weight management all suffered as a result of LBP.  What is important about these findings is that once you have LBP, you’re probably going to have repeat episodes.  It’s the chronic, recurrent nature of LBP that makes it one of the most costly conditions to the injured employee, the employers, fellow workers, insurance companies, and the health care system in general.  Of interest, most of the 14,000 LBP sufferers indicated they had tried 5 or 6 different treatment approaches.  When rating the degree of helpfulness of each type of care and, their overall satisfaction with the various health-care professionals, the hands-on therapies were the top rated, with chiropractic leading the list at 59%.  Physical therapists (PT) were next at 55% though later in the article a “very helpful” rating for PT was reported at 46% vs. massage therapy at 48%.  Acupuncture was listed at third with 53%, specialty physicians at 44% and primary care physicians were rated the lowest at 34%.  Medications by prescription “helped a lot” in 44% and about 22% were helped by over the counter medication.  It is ironic that other reports have indicated that only about 15% of people with LBP go to chiropractors when research, consumer satisfaction as indicated here, and all of the international guidelines have recommended that chiropractic be considered as one of the first approaches in the management of non-surgical LBP.  What is the hesitation?

              Other interesting points in the article include that most of the LBP sufferers that elected not to seek treatment (about 35%) did so because of cost concerns or the belief that professional care would not help. Both research and the majority of the 14,000 who tried chiropractic said it helped and a LBP case was reviewed emphasizing this point. The case example emphasized the value of periodic chiropractic treatment for a worker in a heavy physically demanding job and the benefits he received from a treatment every few weeks, indicating this approach, “…is able to keep his back pain to a minimum.”  Another important point was that 44% of the 14,000 consumers reported exercise was helpful, and this represented the top placed self-help measure.  Moreover, 58% indicated they wished they had included more exercises to strengthen their back in the past year.  Chiropractic management of back pain and other musculoskeletal conditions includes exercise training during the care rendered for LBP.

              The article concludes with caution about back surgery, and references a separate CR survey completed in 2006.  They reported 60% satisfaction in about 1000 LBP consumers that had surgery in the prior 5 years compared to hip or knee replacement satisfaction at 82%. Additionally, more than 50% reported at least one problem during recovery, 16% had no improvement at all, while 8% were worse. The recommendation of obtaining at least 2 opinions was suggested prior to under going surgery, preferably one from a non-surgeon.

              Therefore, if you, a loved one, or a friend have not yet utilized chiropractic for LBP management, the time is now as all the evidence points to chiropractic as yielding the highest level of satisfaction and activity restoration for LBP sufferers.  This recommendation may be one of the most important acts of kindness that one can give to another person.

Health Update: Low Back Pain

Chiropractic Care For
Low Back Pain :
 What Does the Research Say?

There has been a debate for years regarding the use of spinal manipulation and its benefits in the treatment of low back pain.  Since the founding of chiropractic in 1895, the initial reaction against the early pioneer chiropractors resulted in doctors of chiropractic (DC’s) being incarcerated for “…practicing medicine without a license.”  But chiropractors kept forging ahead and because of obtaining good results and helping millions of people, by 1971, Medicare adopted coverage for chiropractic – a first in chiropractic’s history.  In 1975, the US Department of Health, Education, and Welfare invited an international group of health care provider types (MD’s, DC’s, DO’s, etc.), to share with each other at the National Institute of Health, and determine what the “current” research status of spinal manipulative therapy was at that time. Recommendations for future needed research resulted and the proceedings were published in: The DHEW Publication No. (NIH) 76-998 “The Research Status of Spinal Manipulative Therapy.” That landmark gathering stimulated a plethora of research that was to follow over the course of the next 30+ years and continues today.  Due to the overwhelming positive benefits of chiropractic published in many research studies, by the late 1980’s, most insurance companies included coverage for chiropractic care.  Today, many chiropractors practice in multidiscipline health care centers that include DC’s, MD’s, and PT’s others. The following list of research studies has had a significant impact in vaulting chiropractic to its current accepted status in the health care system:

1)    Meade TW, Dyer S, Browne W, Townsend J, Frank AO. British Medical Journal 1990 (Jun 2); 300 (6737):1431-1437.
 www.chiro.org

2)    Manga P, Angus DE, Papadopoulos C, Swan WR. A Study to Examine the Effectiveness and Cost-effectiveness of Chiropractic Management of Low-Back Pain. 8/1993; Ontario, Canada.  www.chiro.org/LINKS

3)    Bigos S, et. al., 1994, Agency for Health Care Policy and Research (AHCPR). www.ncbi.nlm.nih.gov

4)    Meade TW, Dyer S, Browne W, Frank AO. Randomised Comparison of Chiropractic and Hospital Outpatient Management for Low Back Pain: Results from Extended Follow up.  British Medical Journal 1995 (Aug 5);   311 (7001):   349–351  www.chiro.org/LINKS/

5)   Luo X, Pietrobon R, Sun SX, Liu GG, Hey L. Estimates and Patterns of Direct Health Care Expenditures Among Individuals With Back Pain in the United States. Spine 2004 (Jan 1);   29 (1):   79–86.  www.ncbi.nlm.nih.gov/

At our clinic, we are most appreciative to have the opportunity to provide care to our patients and strive to make the experience highly satisfying.  If you, a family member or a friend requires care, we sincerely appreciate the trust and confidence shown by choosing  Advanced Wellness in Marlboro, New Jersey.

Dr. Cilea is president of Advanced Wellness, an integrated practice that offers chiropractic care, physical therapy, pain management, acupuncture and massage therapy.  To find out if you are a candidate for their customized treatment approach call 732-719-8148 or visit www.advanced-wellness.net.

What is spinal decompression therapy?

Spinal decompression is a non-invasive, non-surgical treatment for certain types of chronic back pain.  Mechanical decompression works by slowly and gently stretching the spine, taking pressure off compressed discs and vertebrae. Spinal decompression is one of the most exciting medical treatments developed in many years, since it demonstrates good statistical results for long term pain relief.

The most common spinal condition treated with decompression treatment is a herniated disc. Spinal compression can cause disc herniations to expand, putting pressure on surrounding spinal nerve roots Decompression treatment takes the pressure off these damaged discs so that the disc bulge will shrink back closer to its original size.

Degenerative disc disease is also a common condition treated with decompression therapy. Loss of disc height can be exacerbated by spinal compression, causing the vertebral bodies to move closer together. This can cause nerve compression and other forms of common back pain. Decompression eliminates the overwhelming pressure on degenerated discs reducing or eliminating painful symptoms.

Facet joint syndrome is yet another condition treated with spinal decompression. Facet syndrome causes pain due to arthritic changes in the vertebral bones. Decompression helps to create more space between the vertebrae, hopefully reducing painful symptoms.

In order to determine if you are a candidate for spinal decompression a thorough history, exam and review of diagnostic tests including MRI’s will be necessary.  Once accepted a typical decompression program is 4 to 8 weeks in duration.  Over this period 12 to 20 treatment sessions are performed.  Each treatment session is approximately one hour long and includes any necessary physical therapy services.

A spinal decompression program may be covered by health insurance plans.  Each plan must be verified and discussed with patients on an individual basis.  It is important to choose a practice that has both expertise in spinal decompression and utilizes the most advanced spinal decompression technology.  The DRX 9000 and the Vax D are the industry leaders in this technology.

Dr. Cilea is the president of Advanced Wellness.  Advanced Wellness has been a leader in spinal decompression in Central New Jersey with over a thousand patients treated over the past 5 years.  They utilize the DRX 9000 technology.  To learn more about spinal decompression visit www.AdvancedDRX.com or call 732-984-9594 for a free consultation.

Back pain to be concerned about

90% of Americans will suffer an episode of back pain in their lifetime. It is important to determine when medical action is needed. Back pain can be categorized into radiating and nonradiating or centralized back pain. Non radiating back pain is often caused by spinal misalignment, muscle spasms or facet irritaion. This type of pain is often uncomplicated and can be resolved fairly quickly with conservative hands on therapies. Radiating back pain is often more complex and can be more serious and chronic. Many times the radiation is caused by a herniated disc or nerve related issue. It is important to seek medical care to get a proper diagnosis so the appropriate treatment can be performed. A very serious condition called cauda equina syndrome is a medical emergency and is associated with bowel or bladder issues in conjuction with back pain. Back pain that lasts more than a few days will only create bigger problems down the road in the future so don't ignore the signs.