Anatomy of the spine
intervertebral discs are located between each vertebrae in the spinal
column. Of the vertebrae, there are 7 cervical (neck), 12 thoracic
(mid-back) and 5 lumbar (low back) discs. The discs make up approximately
1/3 of the spinal column. They have three main functions: (1) "Absorb
shock" from everyday wear and tear. (2) Allow movement of our
spinal column. (3) Separate the vertebrae.
The intervertebral disc is actually a type of cartilaginous joint.
Discs consist of an outer layer, annulus fibrosis, and an inner
nucleus pulposus, which is a soft, jelly-like, substance. The disc
is made up of proteins called collagen and proteoglycans that attract
water. Normally, discs compress when pressure is put on them and
decompress when the pressure is relieved. These discs do not have
a blood supply; therefore, they exchange nutrients by a process
called "imbibition". Imagine a sponge filled with water;
when that sponge is compressed, the water is forced out of the sponge.
When the compressive force is removed, the water is "sucked"
back into the sponge. This is precisely how discs stay healthy and
functional. Diseased discs can lead to degenerative disc disease
that can then lead to: arthritis, herniated discs, bulging discs,
facet syndromes, sciatica and spinal stenosis.
herniation describes an abnormal condition of an intervertebral
disc. Some refer to this condition as a "slipped", "ruptured",
or "blown" disc. Most of the time it is not known what
caused the disc to herniate, but it is thought to occur from repetitive
stress due to occupation, poor spinal posture, and/or natural processes
of aging and/or trauma.
A herniation begins when the inner nucleus pulposus bulges through
the annulus fibrosis, causing a bulging or protruding disc. This
bulge may push on a spinal nerve. This interferes with the natural
blood supply to the nerve roots and sets up a condition known as
intraneural edema. Basically, the nerve root microcirculation is
compressed and can progress to the point where the nucleus begins
to leak out of the disc. At this point the body begins to fight
back by launching an autoimmune response to the disc material (nucleus
pulposus). The reaction of this defense mechanism causes severe
inflammation and progressive deterioration of the nerve root. If
the herniation is located in the cervical spine (neck), the symptoms
can range from neck pain, with or without arm pain, to numbness
and tingling. Muscle weakness can be common as well. If the herniated
disc is located in the lumbar spine (low back), the symptoms can
range from low back pain, with or without leg pain, to numbness
and tingling. Muscle weakness is also common. This type of pain
and/or numbness in the legs or arms is referred to as a "radiculopathy".
This happens because the nerves that exit your spinal cord innervate
("attach to") the skin in your arms and legs. They are
responsible for sensation and for movement of the muscles in your
arms and legs. They are also responsible for the reflexive movements
as well. This is the reason some individuals with these conditions
experience extremity (leg/arm) pain / numbness / tingling and/or
weakness when they have a herniated or bulging disc. Be aware that,
some individuals with herniated discs may report arm or leg pain
only, with minimal neck or low back pain.
This pain is most commonly experienced at the outside of the thigh,
the lower leg and/or the foot. Shooting pain that radiates down the
leg is a common experience with herniated discs. Patients commonly
report an electric shock type of symptom.
This is the medical word for abnormal sensations such as tingling,
numbness, weakness or pins and needles. These symptoms
may be the result of a herniated disc and may be experienced in the
same regions as painful sensations.
Signals from the brain may be interrupted due to nerve irritation.
This can cause muscle weakness, usually of the ankle. Nerve irritation
can be tested by examining the reflexes of the knee and ankle.
Bowel or bladder problems
These symptoms are important because they may be a sign of Cauda
Equina syndrome. This condition is possibly caused by a herniated
disc. This is a medical emergency! You must see a medical doctor
immediately if you have problems urinating, having bowel movements,
or if you have numbness around your genitals. All of these symptoms
are likely caused by irritation to one of the nerves as a result
from a herniated disc.
of a herniated disc (either neck or low back) can be made from a
thorough physical examination including a detailed history, orthopedic
and/or neurological evaluation. Some disc patients will present
with an antalgic gait (lean away from the side of the disc lesion),
extremity pain/numbness/tingling (abnormal sensation) in addition
to neck or low back pain. Muscle weakness may be present in the
more chronic cases as well as areflexia ("loss of reflex").
X-rays can be helpful in identifying degenerative changes of the
vertebra, but MRIs are the "gold standard" to identify
the exact nature of the lesion. When the disc is herniated in the
lumbar spine (low back), and it is compressing the spinal nerve
roots causing pain and numbness down the buttocks, thigh and leg,
it is often referred to as sciatica.
treatments for herniated disc includes physical/chiropractic therapy,
epidural Injections, surgery and pain killers such as non-steroid
anti-inflammatory medication (NSAID's).
Please keep in mind that NSAID's have an inherent risk of gastrointestinal
(GI) ("stomach" and "intestinal") disorders
such as: perforation, ulceration and hemorrhages. The New England
Journal of Medicine reported that it has been conservatively estimated
that 16,500 NSAID-related deaths occur every year in the United
States, and conservative calculations estimate that approximately
107,000 Americans are hospitalized every year due to NSAID related
GI complications. The number of deaths reported in the same study
due to AIDS was 16,685. In addition to gastrointestinal disorders,
drugs such as VIOXX have been known to cause serious cardiovascular
(CV) events such as: heart attacks, strokes and heart failure. There
have been similar complaints from other NSAID's such as: Bextra
Non-surgical spinal decompression
Spinal Decompression offers to treat the root cause of the diseased
or pathological disc based on the anatomical and physiological principles
of Non-Surgical Spinal Decompression.
Non-Surgical Spinal Decompression relieves pressure from the disc,
which, in turn, relieves pressure from the nerve.
Research has shown that Non-Surgical Spinal Decompression can create
a negative pressure within the disc causing a "vacuum effect".
This vacuum effect can "suck" the disc material back inside,
thus relieving the pressure from the nerve.
According to the FDA 510k papers, the definition of decompression
is unloading due to distraction and positioning, and
additionally, unweighting due to distraction and positioning.
This is important because the unloading of the injured
area creates positive changes in the microcirculation of the disc
and nerve roots.
Therefore, Non-Surgical Spinal Decompression for herniated discs
is based on the following principles.
- Decompression of the involved disc creates a negative intradiscal
("within the disc") pressure which, in turn, creates
- a vacuum effect which reduces ("sucks in") the size
of the herniation, and which then takes pressure off the involved
- Reduction or elimination of extremity (leg/arm) pain and/or
numbness, while at the same time
- The pumping motions, due to Non-Surgical Spinal Decompression,
called, "imbibition", allows nutrients to be exchanged
at the level of the disc and inflammation around the nerve root
to be dispersed resulting in reduction or elimination of low back
Epidural injections ("injection within the epidural space
of the spinal cord") with corticosteroids, lidocaine or opioids
have no proven benefit in treating neck or upper back symptoms.
In the instances that people find improvement, the effects are often
temporary and require repeat injections, and several per year are
not uncommon. There is also an increase in risk in contracting a
spinal infection that can lead to meningitis. In fact, the results
of a randomized, double-blind trial, published in the June 2003
issue of the Annals of Rheumatic Diseases indicated that an epidural
steroid injection was no better than an epidural saline ("salt
water") Injection (i.e. placebo) for sciatica. These findings
are consistent with those of another definitive trial presented
at the last American College of Rheumatology meeting.
Given that there have been advances in spinal surgery, the outcomes
can still be very unpredictable. In failed back surgery, post-operative
pain syndrome is a very disabling and troubling reality of surgical
intervention. According to the 2002 Johns Hopkins White Paper on
Low Back Pain and Osteoporosis * by John P. Kostulk,
M.D. and Simeon Margolis, M.D., PhD., surgery "is not the treatment
of choice for most people with back pain." The report goes
on to say fewer than 5% of people with back pain are good
candidates for surgery. "Surgery ought to be used when
all other measures have been explored, and only if it appears that
there is a strong probability that it will improve the condition."
An article in Spine reviewed the outcomes and complication rates
for surgical intervention in degenerative disc disease. Complication
rates were as high as 55% and included: hematoma, neurologic adjacent
segment degeneration, infection and hardware/instrument-related
issues. Another study determined the effects of single-level (2
vertebrae) and 2-level (3-4 vertebrae) spinal fusion success rates
reported 53% with "good" and "fair" results
with single- level fusion and no "good" results with 2-level
Having read about the possible side effects relating to these traditional
treatments, you might want to consider the drugless, non-surgical
approach that Non-Surgical Spinal Decompression has to offer.