Arthritis sets in as people get older. Along with the spinal arthritis comes potential overgrowth of the soft tissues and bone as a result. This may begin to pinch on the amount of space available for the nerve roots and dural sac. If it’s bad enough, people may start having buttock, back, and leg pain. This is actually a structural problem. Thankfully, most individuals with spinal stenosis do not have severe resulting pain.

Resulting symptoms can occur from this overgrowth leading to reduced blood flow or excitement of nerve roots from the inflammation. This may result in several levels being affected. They symptoms vary between individuals depending on the region of pinching and the person’s reaction. In spite of all this, lumbar spinal stenosis is the most common reason for spine surgery in individuals over the age of 65.

What if pain exists, should surgery be done? This question has been debated for decades since spinal stenosis really is a quality of life condition. It doesn’t kill anyone, and the severity of symptoms should guide treatment. If the symptoms do not improve despite nonoperative pain management for 3 to 6 months, a decompressive surgery may be considered. Some evidence has shown limited effectiveness overall for this surgery.

A recent Spine article looked at numerous high quality studies in the literature to determine how well laminectomy decompressions work for stenosis. The results showed that in those who failed nonsurgical measures, surgery helped with pain, quality of life, and function more than simply conservative treatment. It did not, however, statistically help with walking ability.

These benefits slightly decreased over the years, but did not go away completely, even up to a decade. Beyond a decade was not reviewed. These results continued despite obesity, older age, lung issues, or other medical issues. The addition of comorbidities raised the risks of complications from surgery, so they should be weighed into the mix to decide the benefits versus the risks and whether or not to proceed with surgery.

The results were similar among almost every study evaluated, including whether or not the patient had one vertebra slipped on another, known as spondylolisthesis. The main issue is it’s a quality of life decision, and substantial conservative treatment should be attempted first.

Surgical risks in this age range cannot be ignored, even though they are small. At that point when nonoperative treatment fails, however, a number of high quality studies support the decision for a simple lumbar decompressive laminectomy.

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Homeopathic remedies may actually be more effective than conventional treatments without having horrible side effects. Traditional medicine is designed to stimulate, kill, or inhibit. Homeopathic medications contain diluted substances and hit has been shown in research that these meds may reverse disease.

Acupuncture is about energy flow through the body in the form of chi. There are 12 meridiens and energy flows through them. The blockages of energy are alleviated through acupuncture.

Herbs can bring the body back into balance through normalization, rather than traditional medications which can promote imbalance.

Homeopathic remedies are often termed alternative medicines or techniques. However, as they become more mainstream, the term alternative will start shifting to conventional. Grouped together they are known as CAM, which is complementary and alternative medicine, with the boundaries between mainstream and CAM medicine becoming more blurred every year.

Holistic medicine, integrated medicine, alternative medicine, are all terms that refer to treatments that are non-conventional. Some people mistakenly assume this means they do not work. This is a falsehood. There is plenty of research to back up treatments such as acupuncture, chiropractic treatment, and reiki for instance.

Research has shown that alternative medicine in developed countries like the US is growing steadily and is now well over 40% utilization. Most individuals using alternative and complementary medicine choose to treat themselves, however, fifteen percent sought out treatment from a licensed holistic doctor.

Over 37% of US hospitals are offering holistic treatments, which is more than ever. There are a lot of traditional medical providers who criticize holistic medicine since for a lot of it there have not been big studies done. The research is mostly anecdotal, which is not Level I scientific evidence. This does not mean it’s “snake oil”, it just means more research is necessary for a significant amount of the alternative treatments.

For now, the incidence of alternative, holistic, and complementary therapies is on the steady rise. If it was all hocus pocus, would this be occurring so consistently?

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One of the standard reasons for legalizing medical cannabis is the condition of chronic pain. This is by far the number one reason in every state its been legalized. Why?

First off, let’s look at the substantial numbers for chronic pain. The Institute of Medicine had a recent research project showing that over one hundred million Americans suffer from some sort of chronic pain. The cost directly and indirectly is over five hundred billion annually between lost work time, medical care disability, etc. The statistic is truly mind blowing.

There are two well known types of treatment for chronic pain that exist in the US – traditional and alternative. Traditional includes those treatments that are mainstream, typically reimbursed by insurance, and have significant peer reviewed research backing up their usage. Also traditional treatments often have FDA approval for their use, but not always.

Alternative treatments are those not usually reimbursed by insurance, and may not have considerable research backing them up. This does not negate their potential assistance with chronic pain, particularly when used along with traditional treatments. It is just a way of categorizing the two. Some alternative methods including holistic, herbal, acupuncture, naturopathic, biofeedback, and some still include chiropractic and massage in this category. This is changing as more insurance companies cover them along with studies being done.

People end up with chronic pain for many reasons. It may be a peripheral neuropathy without a surgical answer, or a failed back surgery that only helped alleviate 20% of a person’s pain. An individual may have rheumatoid arthritis or scleroderma, that encompasses diffuse pain that may or may not be helped by narcotics.

One ubiquitous issue that is seen with chronic pain is narcotics. Most patients, if they are legitimate hard working individuals, despise taking narcotics. They hate having to take more to get the same pain relief (tolerance), and want to be productive, pain free, and able to stay away from a mind altering and addictive substance to do it.

It is not horrible to see such a substantial number of chronic pain folks turning to an alternative pain relief method, medical marijuana. The only really bad part about it is when faking patients start using it (think the young male faking back pain to get cannabis). The amount of times this happens is a small number of the total.

With the large amount of individuals in the US suffering from chronic pain, and the number of reasons as to why these folks got to that situation, means the applicant pool for medical cannabis cards will be substantially bigger than for the other reasons. Supplying them with a non-addictive option that is natural and allowed legally will open up a path of hope and optimism than continuing the bad situation of opiate despair and addiction.

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Here are five of the more considerable evolutions (or regressions) in pain management treatment that we have seen:

1. Refinement in pain management interventions. Over the past few years, there have been some improvements in pain procedure technology that have allowed physicians to get better results. One of these is transforaminal epidural injections. The initial type of epidural injection that was established was called intra-laminar injections. Now pain doctors are able to accurately place their needle into the area where the nerve root travels, getting the pain medication more accurately where it is needed. A second improvement is with radiofrequency ablation machines. When they were first established, they were only able to treat 2 anatomical areas at a time. Now they can do 4, decreasing the patient procedure time.

2. Biologic treatments. Regenerative therapy is not just on the horizon, but is becoming reality. There are now injection materials that contain a number of regenerative ingredients, including hyaluronic acid, stem cells, and specific cytokines. This will hopefully show to be helpful in treating arthritis, soft tissue and cartilage injuries, and disc problems.

3. Disk treatments have reduced in numbers. As literature has been produced showing that intradiscal electrothermy and percutaneous discectomies have suboptimal results, their use is going down. Along with this, there is some initial data showing that diskography may promote disk degeneration. So its use is going down too. The disc is a true treament enigma. Surgery is a roll of the dice half the time, and interventional nonsurgical pain management treatments are a question mark as well. If there is one area along that could use a better therapeutic option, it is degenerative disk disease.

4. Performing vertebroplasty and kyphoplasty. These treatments are done as an outpatient, and do not entail incisions. They take about forty five minutes, and can have very extremely quick pain relief for individuals with spine compression fractures. More pain physicians are learning how to do these procedures.

5. Comprehensive pain management centers. As more literature is produced showing the benefits of multiple specialists treating patients, comprehensive pain centers are becoming more common. This has benefited individuals substantially by having more medical providers with varied training backgrounds lining up for the benefit of the individual. Patients can end up necessitating fewer narcotics and becoming much more functional.

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Clinical research out of UCSD shows a dose effect may occur, with higher marijuana doses actually increasing pain rather than helping. The UCSD study consisted of capsaicin injections into the forearms of healthy volunteers. Capsaicin is known as pepper cream and is rubbed on to the skin to produce a numbing response with pain relief. But in this study it was injected under the skin, where it becomes painful.

After injecting the capsaicin into the forearms, the study participants smoked cannabis at three doses. The low dose did not help, while the medium dose relieved pain significantly. However, the high dose made the pain worse. What occurred?

The first issue is that no one really knows how marijuana works for chronic pain. Sure, it is understood that there are receptors for the cannabinoids of marijuana in the brain and throughout the body. But what happens exactly once the cannabinoids are attached to those receptors is a mystery. It is well understood that smoking marijuana increase heart rate by 7 to 12 beats per minute. But how does the brain receiving cannabis tell the nerves not to send pain signals?

Some studies have shown that THC (marijuana’s active component) has good pain reduction for cancer patients. Cancer patients would fall into the chronic pain category in reality, but most states with legal medicinal marijuana have a separate category for cancer. Numerous studies have shown that medical marijuana works well for chronic painful issues like cancer, but not well for acute pain issues like sunburn.

Having stated that, there has been a study looking at cannabis in conjunction with opioids for post-operative pain medication requirements. The study showed a decrease in opioid requirements as cannabis intake increased. However, that study did not go over a 15mg THC dose. Would a higher dose have made the opioid needs increase as a counter-intuitive effect?

There is a lot we know about medical marijuana for chronic pain, and a lot of unanswered questions. The more studies that come out, the better marijuana’s use for chronic pain can be aligned with specific dosing towards the condition for which it is utilized.

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All of these issues may lead to pain in the same region, therefore, delineating the exact pain cause may take some significant mental consideration. A thorough history and exam of the patient is critical to ruling in or out some of the potential diagnostic sources.

The difficulty with SI pain is finding the individuals whose exam and history match true SI joint symptoms, and then the diagnosis can be confirmed by a positive response to an anesthetic block inside the joint.

A significant amount of time more than one anesthetic block will be necessary into the SI joint to definitely rule int the joint as the pain generator. Once this diagnosis occurs, the additional treatment options may begin. At times patients will obtain relief for a while from the anesthetic blocks themselves, or it could just be short term. Should the pain block not work after a while, a radiofrequency neurotomy has been shown to work well. Pain physicians typically debate the exact techniques that are best for the joint.

The SI joint is not the easiest joint to get into for interventional techniques. Fluoroscopic assistance is crucial, as the joint is jagged and irregular. The entry into it may take an unusual angle. Knowing the exact entry point with the real time x-ray can make the difference between a successful procedure with a happy patient versus a missed joint and a patient remaining in pain.

Along with the interventional pain efforts, additional treatment options include physical therapy, anti-inflammatory medication, chiropractic treatment, and potentially acupuncture and massage. It may take a combination of efforts including both traditional and alternative medicine to help the patient improve.

There really is no great surgical option for SI joint pain. There is a new procedure for fusing the joint, but no long term data is available yet regarding its effectiveness. For the time being, it’s best to avoid operative intervention and treat the problem with outpatient techniques such as the radiofrequency technique mentioned.

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A significant amount of research has been done over the past few decades showing laser treatments for musculoskeletal problems to be effective, non-invasive, and safe.

Animal studies have shown laser therapy may help with recovery after acute injury and reduce edema (swelling) along with increasing tissue of healing wounds. In animal studies, healing rates of injured tendons in animals have shown substantial improvement too.

One substantial finding was that wounds treated with laser displayed elevated tensile strength, and wounds on the other side not treated with laser showed benefit too. This was deemed to be due to a general effect on the body of having the laser treatment with some type of tissue growth factor being released into the blood. More research is necessary in this area to separate out exactly which factor is being released.

In human studies along with animals, laser treatment has been shown to facilitate collagen production which enhances tendon healing. Laser irradiation on a daily basis has been shown to decrease wound inflammation by 20-30%. This occurs partly by decreasing the amount of prostaglandins in the region, which are components of inflammation.

Low energy photon laser therapy has shown clinical indications for shoulder tendonitis, heel spurs, rheumatoid arthritis symptoms. One of the proven effects involved the improvement of local microcirculation, which enhances wound healing. In animals, this could explain why broken bones treated with laser healed quicker than controls.

Small scale human studies of patients with osteoarthritis in either the knee or spine displayed over a 90% excellent pain relief with low level laser therapy.

Studies in individuals with rheumatoid arthritis undergoing laser therapy have displayed that 2/3 of individuals benefit, which potentially gives it substantial advantages over steroid injections and NSAIDS. For low back pain, low level laser treatment has shown excellent results for pain emanating from a number of anatomic areas with low side effects. Compared to control group, laser was doubly effective and also came back only half the time.

Used along with chiropractic treatment, lasers may provide great results for a wide range of painful conditions such as tendonitis, osteoarthritis, rheumatoid arthritis, and even post-surgical scarring problem regions. Compared with surgical treatment, laser therapy is outpatient, low cost, and does not promote scarring.

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To understand how chiropractic helps pregnant women, it’s necessary to understand the anatomy of the pelvis and uterus. The pelvis is essentially a bony ring, with two sacro-iliac joints in the back, and the pubic symphysis in the front. The uterus sits inside this bony ring, and is tethered to the pelvis by three main sets of ligaments: the Broad, Round, and Uterosacral Ligaments.

As the baby and uterus grow, stress is placed on these ligaments, distorting the structure of the pelvis, lower-back and mid-back. In addition, the shift in the pregnant woman’s center of gravity, coupled with significant weight gain, causes even more stress on these areas, and on the surrounding musculature.
To top it all off, pregnancy induces the release of a hormone called relaxin. The function of this important and powerful hormone is to allow the ligaments which connect the pubic bones to relax and separate, thus allowing for delivery of the baby. However, the effect of relaxin is experienced throughout all the ligaments of the body, and is lifelong.

This explains why moms-to-be feel so much pain and discomfort, especially in the lower back. In addition, a misaligned pelvis can result in torque being place on the uterus through it’s ligamentous attachments, which often results in malpositioning of the baby, into a transverse position. The goal of a chiropractor throughout a woman’s pregnancy is to help keep the pelvis and spine balanced and properly aligned. This allows for the most comfortable pregnancy, and it ensures proper function of the nerves which exit the spine. There are various techniques specifically designed for adjusting pregnant women, as well as pillow systems which are designed to provide your tummy maximum comfort while lying face-down.

Chiropractic can lessen discomfort and make pregnancy more enjoyable. It can also help to promote a safer and easier birth, by helping to balance the uterus, which encourages the baby to be in a proper head-down position. Seek Dr. Carissa Hang, a chiropractor in San Diego who has vast experience adjusting pregnant women at New Century Spine Centers when considering chiropractic treatment during pregnancy.

Learn more about chiropractors in San Diego. Request a free DVD where you can discover all about spinal decompression therapy and what it can do for you.

A chiropractor is a health professional who has trained and studied for several years in order to be able to provide natural health care for many problems that affect the nervous system. They do not believe in medications or surgeries to relieve problems, but believe that in balancing the nervous system, the body can heal itself.

On the first visit to the chiropractor they will talk with you about your medical history and then find out what treatments you have already tried or are trying for any health condition that you have. They will then analyze your spine and identify areas where there are subluxations that may be causing problems.

If you know that you have already developed a herniated disc, then they will also take a look at that and suggest a method of treatment for it. This plan should include chiropractic care that can reduce the pain from the herniation and work on coaxing the disc back towards its normal location. Several sessions are likely to be needed, but you should notice pain relief after the first session.

Getting over a herniated disc will take some time, there is no quick fix. Through chiropractic care, you can reduce the recovery time and the associated pain. This allows the nerves around the disc to calm down, but it will take time for the problem to resolve itself.

If the chiropractic professional deems it appropriate to do so, they may also suggest some gentle exercises for you to do in order to strengthen the area of the back that has been affected by the injury. They may also attempt to discover what is causing the condition and offer posture or other advice to overcome the problem.

You can get chiropractic for herniated disc treatment through a qualified and experienced chiropractor. They are able to offer you natural care that can provide you with great relief from the condition and help reduce your recovery time. There are local chiropractors in your area, so stop suffering and be proactive about your health care today.

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When you go to your first appointment, you should expect to be filling out paperwork, talking with the doctor about your problem, and giving your medical history. You may get an x-ray or make an appointment for an MRI. These pictures show the doctor what is truly going on with your skeleton. The doctor may also give you a physical examination and explore the area where you are having pain. He may have you do some range of motion tests as well. After your thorough examination, the doctor may or may not do any adjustments for you. He may decide to wait until he can see the results of your x-rays or MRI scans. You may also be given suggestions you can do at home before the next visit like applying ice packs or avoiding certain tasks.

At your follow up visit, the doctor will discuss the results of your x-rays with you and talk about a possible course of treatment. Some ailments only need one visit to help you feel better. Other conditions may require two or three visits per week for a week or two. If you have a very serious condition, you may end up needing a longer course of treatment that will taper off in frequency as your condition improves. The doctor will begin treatment with adjustments to decrease your pain and increase your movement abilities.

Manual adjustments are done by applying pressure to your spine using either the doctor’s hands or small devices. Most adjustments cause no pain or discomfort. The adjustments that are a little uncomfortable only last for a few seconds.

The chiropractor will reassess your progress every few treatments. If you are showing steady improvement, it is likely that you can reduce the frequency of your visits until you only go in as needed. Once you are feeling an improvement in your pain, you may do some sessions to correct the underlying problem. The spinal adjustments at this point are trying to increase your mobility so you don’t need to worry about re-injuring yourself. If you do experience a flare up or recurrence of your problem, you’ll easily be able to increase your sessions briefly until you feel better again.

The next part of your treatment works on strengthening the soft tissue that surrounds the area that was affected by your injury or pain. By strengthening this tissue, you will have proper functioning of the muscles and joints of this area. Once the pain is gone or at least stabilized, you may get supportive care, or maintenance. This can be as frequent as once a week for serious issues to once every few months for minor issues. This helps the patient remain on a healthy course of action to prevent re-injury.

Since you may need frequent visits at the beginning of your care, be sure to check with your insurance company to see what might be covered. Many do cover chiropractic care, even if only a portion of what you need. You can also ask the chiropractic office to find out if you have coverage on your policy, as they do this type of thing daily.

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