Spinal-Fusion

Is Spinal Fusion the Solution For My Low Back Pain

Spinal fusion is the extreme operation for back pain. Its aim is to lock a part of the spine and may be recommended for debilitating scoliosis, spine fractures or type IV of spondylolisthesis. But these reasons are rarely the motivations for the spine fusion.

It is largely considered and presumed that the degeneration of the disk and osteoarthritis, creating instability and inflammation, are the obvious cause of the low back pain, most of the time at the level of the the lombo-sacral junction. In this regard, the surgeon will remove the deteriorated disk between the vertebrae and stick the bones together. The purpose is to stabilise the hyper-mobile spine area and then the pain will logically disappear.

However, as we have seen in a previous blog, a majority of people in their middle age have degenerated disks and mostly free of pain. Reversely, a majority undergoing a spine fusion in the regard of a dehydrated disk resent more pain after the operation!

According to a study carried out at Oregon Health and Science University, half of the patients undergoing a spine fusion used opioids prior to be operated and only 9% ceased afterwards. Ironically, 13% used them after the operation while they did not before. Another study showed that hardly half of the patients after surgery reported a decrease of 30% of the pain and a third of improvement in function. In spite of this, the spine fusion remains very popular.

The problem is that if one part of the spine is fused and rigid, the forces applied to the lumbar spine during daily tasks are directed to other segments above or below this part, and this will lead to early degeneration of the other disks and create some osteoarthritis.

Instead of a spine fusion, it is largely admitted that an advanced rehabilitation is more appropriated, accompanied with behavioural therapy to reconsider low back movements.

chiropracticadjustment

Chiro Adjustment and Disc Bulge

Chiropractic adjustments are the treatment of choice to relieve a majority of back pain and disc bulge.

Most of people suffer from their back during their life. However, they have little idea of what is happening in their spine and what should be done to get some relief and heal properly. It is even common that they make mistakes damaging their condition.

Disc and Spine Lesions

It is important to know that most of people have a lesion such as disc degeneration or osteoarthritis and nonetheless, they do not resent any pain from it. A study published in 2015 in the American Journal of Neuroradiology has shown that a large majority not complaining from back pain show:

Thirty-three articles reporting imaging findings among 3,000 asymptomatic persons. Disk degeneration soared from 37% of 20-year-old individuals to 96% of 80-year-old individuals and disk bulge, from 30% of those 20 years of age to 84% of those 80 years of age. Interestingly, disk protrusion prevalence climbed from 29% of those 20 years of age to 43% of those 80 years of age. Annular fissure was surprisingly at 19% of those 20 years of age then to 29% of those 80 years of age.

Disc Bulge

Investigations showing spine degeneration are very common even with people not suffering at any time from their back, and are the norm after 65, likely part of normal aging. The medical profession picks to often the degenerative process as the explanation of the back pain that is most of the time asymptomatic. MRI and X-Ray are not good indicators of the cause. Between 5 to 10% of them will be diagnosed thanks to the spine imagery, most of the time invisible to them.

Ligament or muscle injuries and nerve irritation by some inflammation are common causes. This leads to muscle spasms and segment dysfunctions, reducing the range-of-movement and flexibility. As the vicious cycle, the inflammation remains irritating more the nerves and so, the muscles spasms.

Chiropractic Adjustment Mechanism

Chiropractic adjustments have shown to be highly effective and safe for back pain. Their aim is not to put a bone in place so that it is aligned. It is more a rapid mobilisation providing a short stretch, stimulating some receptors, and in response, the spasms release freeing up the joints, disc and segment. The chemical substances of the inflammation are taken away by an increased flow a blood and less irritating the nerves.

The spine is then more mobile and pain-free.

Orewa Chiropractor

What is Spondylolisthesis?

What is Spondylolisthesis?

It is a name derived from the Greek language: spondylos is a vertebra and listhesis means slipping.

When a vertebra slips forward over another vertebra, we call this phenomenon spondylolisthesis. The lumbar spine is the most common area of location. The complaint is usually pain or ache in the low back, buttocks and sometimes thighs. It may be accompanied by muscular tightness and/or weakness in the glutes and hamstrings. However, young individuals do not report any symptom in general, or rather some discomfort. X-Rays are the predominant investigation to diagnose its presence.  The scale grades it in a range of 1 to 4, according to the measure of the slippage.

Stress Fracture

Most of the time, it is developed during the childhood although it can be present at birth (it said then congenital) or in the adulthood after an accident or repetition of movements. The very common cause of spondylolisthesis is a stress fracture during the growth. The recurrence of backward movements like bridges put serious load on the parts of the vertebra not strong enough to cope with this charge, and they “crack”. The sports often implied are gymnastics, dance, judo and martial arts, rugby, soccer and weightlifting. The stability of the spine is then modified and creates severe tensions around.

Degenerative Spondylolisthesis

The degenerative process is another cause of spondylolisthesis. The slippage can be forward, that we call anterolysthesis, or backwards, retrolysthesis. This happens after 40 or 50 mostly due to genetical history or heavy lifting during working time life. The nerves which go through between the vertebrae may be impinged by the narrowing of the canals (holes), and then pain, numbness, weakness are resent in the lower limbs. The perimeter of walking is reduced and to open the canals, the individual feels the need to sit to “open” the canals and relieved the nerves from the pressure.

Treatment of Spondylolisthesis

Spondylolisthesis can be “silent” which means that the person does even not know about their condition and does suffer from it. In the opposite, the symptoms can be severe and may demand a surgical operation before significant compression of the nerves. Regarding ache, stiffness and tensions, chiropractic adjustments are recommended but not in regard of the slipping vertebra. At Orewa Chiropractic, our chiropractor has long experience over sport injuries and degenerative spinal conditions and assists the patient in reducing the level of ache/pain and increasing the flexibility of the spine. Visit us.

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young male holding his back in pain

Chronic Low Back Pain Case

Sue, a 45 year-old lady, came to Orewa Chiropractic referred by a GP to evaluate and manage her complaint of chronic low back pain. She had been suffered for about one year, and the symptoms were worsening. She originally slipped and fell on a wet surface at home, landing on her right hip. X-rays were unremarkable.
The pain varied from 4/10 to 9/10 at its worst. She was very active prior to the accident but, since she had very little physical activities. Rising from a chair, putting shoes on and turning over the bed were painful and cleaning and gardening impossible. Driving or walking more than 15 minutes were excruciating.

Examination of Chronic Low Back Pain:
The lumbar spine was reversed sitting, but the arch increased standing contrarily. The gait was very short with little strength around the hips.
Lumbar paraspinals and gluteals were tight and tender with moderate pressure. The range-of-motion was considerably restricted at the lumbo-pelvis junction.

Management of Chronic Low Back Pain:
We started the course of chiropractic sessions per week including adjustments and muscular release techniques. After 3 weeks, Sue was more mobile, dealing better with daily activities, sleeping deeper and walking for 15 minutes with little hindrance. The chiropractor prescribed then specific stabilisation exercises of the lumbar spine and hips. After further 4 weeks, Sue complained of intermittent ache, 4/10 at worst. Most activities were pain free except gardening. She started more advanced strength, mobility and endurance exercises, and still receiving adjustments weekly.

After 12 weeks, Sue were back to her previous life, free of chronic low back pain and enjoying all the physical activities that she loved and being much more positive about her life. She visited her chiropractor monthly to receive adjustments until the end of the year to settle down the progress.

mattress-topper-1

How To Choose A Mattress

How to choose your mattress?

We spend 200,000 hours in our bed, roughly one third of our life and the quality of our sleep is essential for our mood.

Each night we turn something like 40 times, so we don’t sleep in one position.

You may think your bed is too old and it’s time to change it. In the bed store, try this:

  • Lie on your back and pass your hand under your lower back arch. If there is no problem, the mattress could be to firm. It should provide a good firm support but with enough softness so that your musculature is able to release.
  • Turn on your side and push down the mattress with your elbow. If it’s too deep, it may be too soft. You may think it’s comfortable, but your back won’t like it, especially if you have been suffered from it.
  • Lie on your favourite position and try to feel your muscles, between your shoulder blades and pelvis are released.

Finally, it’s good to know that we should change our bed every ten years. The mattress made with springs will lose some of their properties sooner than latex ones.

Don’t hesitate to ask more information to your chiropractor.

Pillow

How to Choose a Pillow

How to Choose Your Pillow

We spend one third of our life sleeping, something like 200,000 hours in our life.

Thousands of New Zealanders could be needlessly suffering from disrupted sleep due to bad pillow choices at bedtime.

According to the Massey University Sleep Wake Centre 37 per cent of New Zealand adults aged 30 to 60 are sleep-deprived.

A number of studies have shown that proper selection of a pillow can significantly reduce neck pain, upper and lower back discomfort, headaches, shoulder and arm pain and restlessness.

It would also improve quality and duration of sleep. Chiropractors at Orewa Chiropractic believe that more education around pillow and bed selection could lead to better quality of life.

It is important to choose a pillow that is of material and a shape that suits your sleeping position.

Choose the filling.

Today the choice is vast. There are now pillows on the market made from memory foam (developed by the NASA) or natural latex/bamboo which has been shown very effective for neck pain suffers and improving sleep quality. However they can be a significant initial investment.

Polyester filling, less expensive than down and memory foam, tends to provide good support and hold its shape reasonably well. However, it is also the least durable of these materials.

Consider your sleep position.

The way you sleep will affect the height of your pillow; different positions require different types of support.

Back and stomach (not recommended) sleepers may want to choose a flatter pillow that helps keep the natural curvature.

If you sleep on your side, however, a higher pillow, which fills the gap between head and neck, is generally a better choice. We have all a different neck, with different width of the shoulders, that’s why there isn’t a standard “best of the World” pillow.

The point is having the cervical spine (neck) aligned with the rest of the body spine, not allowing any tilt of the head. It doesn’t need anything contouring the neck or with a specific edge, sometimes quite uncomfortable. Orthopaedic or ergonomic aren’t necessarily a reference.

Take special needs into account.

You’ll find plenty of specialty pillows on the market tailored to specific situations. For example, people with allergies might think about a pillow with a cover and filling that are specifically formulated to keep away dust and mites.

If you snore, consider a pillow shaped to position your head and neck in a way that will prevent your airway from becoming compressed.

If you are in any doubt, get in touch with chiropractors at Orewa Chiropractic. We will be more than happy to point you in the right direction.

knuckles

Why Do Knuckles Crack?

What is it that makes that popping sound when you crack your knuckles? If you think it’s vacuum cavities forming in the synovial fluid of the joint, give yourself a gold star: a team of researchers led by the University of Alberta Faculty of Rehabilitation Medicine have confirmed that that is precisely what it is. How? By pulling the fingers of a test subject inside an MRI machine. “We call it the ‘pull my finger study’ — and actually pulled on someone’s finger and filmed what happens in the MRI,” said Professor Greg Kawchuk of the Faculty of Rehabilitation Medicine. “When you do that, you can actually see very clearly what is happening inside the joints.” The idea for the study came from Nanaimo chiropractor Jerome Fryer, who approached Professor Kawchuk with a theory. Rather than beat around the bush, they decided to take a direct look using magnetic resonance imaging. “Fryer is so gifted at it, it was like having the Wayne Gretzky of knuckle cracking on our team,” Professor Kawchuk said. Fryer’s fingers were inserted, one at a time, into a tube attached to a cable; this tube slowly pulled on each finger until the knuckle cracked. And, in each instance, it was absolutely the formation of the bubble in the synovial fluid that was associated with the popping sound, occurring within 310 milliseconds. “It’s a little bit like forming a vacuum,” Professor Kawchuk explained. “As the joint surfaces suddenly separate, there is no more fluid available to fill the increasing joint volume, so a cavity is created and that event is what’s associated with the sound.” “The data fail to support evidence that knuckle cracking leads to degenerative changes in the metacarpal phalangeal joints in old age,” the study concludes.

Clinic

Florence House,
16 Florence Ave, Orewa

Contact Info

09 426 4545
office@orewachiropractic.co.nz

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