Epidurals Can Provide Powerful Relief For Many Back Pain Related Conditions

In the treatment of back pain a conservative treatment approach is often followed prior to any invasive procedures.  These procedures can be in the form of chiropractic care, massage, physical therapy and in more painful conditions pain management, in particular epidural steroid injections.

The utilization of epidurals is most often employed when a person has back pain with referred pain in a distribution described as radicular in nature.  The term is used to describe an inflamed or irritated nerve root in the spine. This can create pain in the distribution of that nerve root as well as weakness and numbness.

This “radicular” pattern can be seen in both the legs and the upper extremities depending on where the irritated nerve root is. If it is in the lower back it is called lumbar radiculopathy and can affect the legs if it is in the neck or cervical spine it is called cervical radiculopathy and can affect the upper extremities or arms.  Epidural injections are used to deliver medication to the irritated and painful nerve roots.

In the utilization of epidurals for back pain there are certain conditions most frequently treated with this technique. They are as follows.

• Herniated Discs
• Spinal Stenosis
• Degenerative Disc Disease
• Sciatica
• Spondylosis

While epidurals steroid injections have been shown to be effective for the above conditions, it’s important to note that epidurals are not a long term solution. The medication used is a steroid and provides powerful local anti-inflammatory properties locally to the nerve. However, there is nothing curative about the procedure.

The Epidural Procedure

Epidurals are administered by injecting a medication in to the epidural space surrounding the spine. This is the areas where the injured nerve roots are.  Typically a local anesthetic is used in the form of lidocaine or some other medication and a longer lasting steroid. The steroid is used to decrease the inflammation irritation of the painful nerve and the anesthetic addresses the reflex muscle spasms and pain signals sent by the pain sensitive nerves.

The utilization of this procedure is primarily for the interruption of pain and to allow the patient to regain mobility and to participate in a more structurally oriented program of rehabilitation, returning them to work and back to normal activities of daily living.

There are different forms of epidurals and each is utilized to address a particular clinical outcome. The choice of which type of epidural you get is a combination of your clinical presentation, your exam and MRI findings and your doctor’s preference. The difference in these variations is primarily needle placement and the target of the procedure be it 1 or more nerve roots.

Types of Epidurals for Back Pain

Intralaminar Epidural- This may be the most common type of epidural and was utilized most frequently prior to the invention of the c-arm for x-ray guided injections. It entails numbing the skin and inserting the needle in the midline of the lower back between the spinous processes into the intralaminar space. This procedure puts a large amount of medication into the epidural space and can affect multiple nerve roots and both sides. Long term the procedure is limited in value, however it can provide good short term relief.

Transforaminal Epidural-This procedure requires a numbing of the skin again; however the needle placement is lateral and enters through the side of the vertebrae and is aiming primarily for one nerve root in one side. Some doctors prefer this approach because it is thought to be more specific and targeted. It is also utilized if scar tissue or hardware is present, because the needle cannot pass through these structures posteriorly. Again this procedure is good for short term and medium range pain relief, but is best if a multi-specialty program is initiated.

Caudal Epidural- The skin is once again numbed and the needle is then introduced near the tailbone. This approach introduces a catheter into the epidural space and a large bolus of steroid is introduced. This can be an effective approach is someone has severe spinal stenosis or arthritis and needle placement is difficult due to the increased amount of degeneration. Again short term relief is common, however long term benefits are still not typical.

Do Epidurals help?

In today’s climate of back pain treatment, epidurals are performed quite commonly. Studies have shown mixed findings related to their utilization. While they do in most cases provide temporary pain relief, they do not offer any long term benefits.  Most often epidurals are given in three’s. If pain relief is achieved to some degree another and often a third injection will be administered. If there is no relief after the first injection, most doctors will not perform a second.  Although some studies have shown better and longer lasting pain relief with more than one injection.

Epidural Risks and Side Effects.

Even with their pain relieving power, spinal injections may have some undesirable effects.  These side effects may include bleeding, infection, post-dural puncture headache, and nerve damage. There are also side effects related to the medications used for the procedure. These can include increased blood sugars, weight gain, arthritis, stomach ulcers, and a suppression of the immune system. The possibility of these side effects warrants a thorough evaluation by your doctor. If a patient is on blood thinners, has allergies to certain medications, is pregnant or is suffering from an active infection should use caution and let their doctor know of these risk factors.

Summary

Epidurals can be a very effective procedure for some people on their road to recovery, however pain relief duration and intensity vary from person to person. Some people do experience long term relief while others none at all. The best plan of attack is to utilize this procedure as an opportunity to participate in other healing strategies to provide ling term relief and recovery. If you found this article helpful as always please share it on Facebook, Twitter or via email

Understanding the types of back surgeries can help you make an informed decision

Back surgery may be indicated in your particular condition depending on the particular problem that you have. While there are usually non-surgical options available, back surgery may be the treatment of choice for certain conditions, especially if conservative treatments have failed. For example if your pain is unrelenting, continues to reoccur, interferes with your social activities and/or your work activities or interferes with your sleep you may be a candidate for surgery.

For the most part there are a few specific sub-sections of back pain sufferers that may benefit from surgery. One group suffers from chronic unrelenting back pain and sciatica and typically has a condition associated with a disc, spinal stenosis, a fracture or a spondylolisthesis. The other group has advanced spinal arthritis and severe back pain but not sciatica. There is a severe narrowing of disc space and facet hypertrophy or overgrowth. In either case the probable outcomes may or may not be good, however research does show that surgery is typically more successful for leg pain then general back pain.

Below is a list of the common conditions that may respond to spinal surgery.

Herniated Disc

A herniated disc is a condition where the central portion of the disc (the nucleus) migrates outward through the out disc fibers (the annulus). The material can then compress or irritate the nerve and cause back pain and sciatica.

Spinal Stenosis

Spinal Stenosis is a condition where the spinal canal (the central portion that runs the length of the spine and houses the spinal cord and nerves) narrows. This is usually as a consequence of arthritic changes and a thickening of the ligaments and facet joints. This can cause compression on the spinal cord in the cervical and thoracic areas and a compression on the spinal nerves in the lumbar area, resulting in back pain and pain in the legs.

Spondylolisthesis

This condition can be either congenital or acquired. If someone is born with a spondylolisthesis it usually stems from a non-union of the posterior elements of the vertebrae. If it is acquired it is usually the result of severe degeneration and a slippage or a trauma causing a fracture. In both cases the vertebrae slips forward and can cause a pinching and narrowing of the areas where the nerves exit.

Spinal Fracture

A spinal fracture is a fracture in the vertebrae causing a collapse of the spine. This can be secondary to osteoporosis or from trauma.

Degenerative Disc Disease

This condition is a result of the wearing out of the disc and a breakdown of the disc material leading to narrowing of the disc space and arthritic changes taking places.

Now that we understand some of the conditions that may warrant surgery, let’s take a look at some of the most common surgical procedures.

Herniated Disc Surgeries

Laminectomy/Discectomy

In this procedure the posterior elements of the vertebrae are removed and the herniated disc material is taken out to take the pressure of the structures that are involved.

Microdiscectomy

This procedure is similar to the laminectomy/discectomy but doesn’t involve the large incision or the removal of the posterior elements to get to the disc. A smaller incision is made and the surgeon utilizes a microscope to locate the disc and perform the surgery. The thought is that by utilizing a smaller incision less tissue damage occurs and a smaller scar is left instead of an large incision.

Laser Spine Surgery

One of the newest and most popular surgeries is laser spine surgery. This technique involves the insertion of needle into the disc and through that needle laser energy is delivered to destroy the disc tissue and relieve the pressure on the nerves. This procedure has become more popular because of the shortened recovery time.

Spinal Stenosis Surgeries

Laminectomy

The primary issue surrounding spinal stenosis is that the spinal canal narrows due to excessive bone growth and ligament thickening. This procedure removes the posterior elements in hopes that more room will be created for the spinal structures affected.

Spondylolisthesis Surgery

Spinal Fusion-When a person has a slippage of one vertebra on another and a compromise of neural tissues a spinal fusion is often recommended. Non-surgical management can take a patient so far, but once pain and neurological deficits become progressive or unrelenting a fusion may be necessary. A fusion requires the surgical connection of two or more vertebra together. Usually pedicle screws, rods and bone graft either from a cadaver or the patient are utilized. The goal is to mechanically stabilize the area so that no further slippage can occur. Some advances have been made and certain proteins are now used to stimulate both growth at the surgical site, which has decreased the need for bone grafts.

Vertebral Fracture Surgery

Vertebroplasty

This surgery is utilized primarily after a person has suffered a spinal fracture from osteoporosis. A cement like substance is injected into the vertebra to relieve pain and stabilize the fracture.

Kyphoplasty

This procedure is done in 2 distinct steps. In the first step the surgeon inserts a balloon into the vertebra in an effort to restore height and shape to the vertebra. The second step involves the injection of the cement like substance to stabilize the fracture.

Disc Pain Surgeries

Intradiscal Electrothermal Therapy

(IDET) Is a procedure where a coil is inserted into the disc and heated. The premise is that the heat will reconfigure the collagen fibers and strengthen them. Many patients have a long recovery after this procedure and recent studies are not favorable.

Spinal fusion

Much like the spondylolisthesis surgery the fusion is performed to stabilize the spine. In this case it is performed when a disc is severely degenerative and the recommendation is to remove the disc and fuse the spine. The goal is to remove the painful disc and create a more stable environment.

Disc Replacement Surgery

This procedure is an alternative to a standard discectomy. Here an artificial disc is placed in the space where the damaged disc used to be. The goal here is to restore disc height and overall spinal movement.

As with any surgery spinal surgery has extreme risks. If you are considering surgery please make sure to exhaust all of your non-surgical resources and have a long discussion with your doctor so that you are fully informed

Lower back pain often hits when we get a little older. One of the reasons for this is that we begin to lose water throughout our bodies and as tissues become less hydrated the ones that have the lowest natural blood supply tend to be affected the most like our joints and  the intervertebral disc.  The disc loses its blood supply early in life and needs a constant exchange of fluid to remain healthy and hydrated. As the cartilage structure of the disc becomes less stable the disc begins to deteriorate. This condition is called degenerative disc disease.

The disc can begin this early degeneration and never cause pain. That’s because the disc for the most part is not pain sensitive except for the very outer 1/3^rd. The degenerative process doesn’t create inflammation early on so the first signs of this may be seen on x-ray, showing a decrease in disc height or an MRI on the T2 image showing a darker disc.

The pain associated with this condition usually comes in the later stages. Once the disc becomes more fragile it begins to lose elasticity and the inner material that is inherently higher in water content and thus much softer can begin to migrate through the small cracks and fissures that occur secondary to the disc breaking down.  The lack of general disc health and breakdown also makes the disc more susceptible to irritation and injury when we overdo it or are involved in an accident. This can lead more pain and inflammation.

Another issue that occurs with disc degeneration is that as the disc loses height the joint of the spine (facet joints) become compressed. This can lead to the facets becoming a secondary source of pain. A disc herniation or a bulging disc doesn’t have to be present for the disc to be painful. A condition known as internal disc disruption is pain felt from the disc alone and can be a tremendous source of back pain.  As cycles of pain begin secondary to a degenerative disc we begin to also lose stability in and around the affected areas.

This can lead to further deterioration and a cycle of degeneration begins. If this process goes undetected or untreated it can lead to advanced arthritis in the spine. As the forces on the facet joints and vertebral bodies becomes excessive they respond by thickening and enlarging, this is the precursor to spinal stenosis.

Treatments for Degenerative Disc Disease

Like most spinal conditions treatments vary from person to person. There are non-surgical and surgical options for degenerative disc disease. Below I will outline a few of the most common and what the treatment goals are.

• Chiropractic Care-The goal with spinal manipulation is to keep the spine moving properly. Manipulation restores motion to the vertebral joints and through this motion the active pumping mechanism that nourishes the disc is optimized. Manipulation also helps to decrease muscle spasms and break up scar tissue in the facet joints. Another benefit is that as joints move they stimulate synovial fluid production and this helps keep the facet joints healthy.

• Exercise- As with any musculoskeletal condition exercise and strengthening can provide great relief and prevention. Keeping the spine flexible and the core muscles strong can help in stabilizing the spine and ensures normal movement occurs throughout the spine and trunk. The benefits of a well thought our rehabilitation program cannot be overemphasized.

• Medications- As with pretty much every medical condition there is a pharmaceutical answer. With pain the drugs do nothing to fix the problem only to mask the symptoms and this is often much needed. Managing the pain can help you do the more active treatments that are going to make a difference in the long run.

• Pain Management- As with medications spinal injections are not healing in nature. They do allow for temporary relief so again you can do more productive treatments and are not limited by pain. In some cases relief may last for long periods of time, however getting into an exercise or rehab program is highly recommended because even though the pain is gone, the degenerative process continues. Pain Management typically consists of things like spinal epidural, facet and SI joint injections when dealing with degenerative disc disease.

• Spinal Surgery- There is a lot of debate as to whether surgery is a viable treatment option for disc degeneration. Most think it has no value when there is no leg pain present. However, if the spine is severely damaged and degenerative a spinal fusion may be recommended and should always be a last resort. The goal with this type of surgery is to fuse the damaged joint with the goal of eliminating the pain.

So as you can see degenerative disc disease can be quite painful and affect your life dramatically. Because it is a chronic condition some form of maintained care is often needed. If you found this post helpful please share it on Facebook or Twitter and don’t forget to sign up for our newsletter.

In this article we discuss how to find the best mattress for back pain.

If you have back pain you owe it to yourself to find the best mattress you can to help support your back. So you can get a good nights sleep.

Having lower back pain by itself can be a life changing experience, however not sleeping on the right mattress can make matters worse.  In this article we are going to discuss how to find the best mattress for back pain.  The simple fact is a poor quality mattress or a mattress that is not suited to your body type can create a poor sleeping environment by not providing adequate support, causing an over stretching of ligaments and muscles and contributing to more lower back pain.

The ideal scenario is finding a mattress that not only provides support to the spine but is also comfortable and suited to your own individual sleeping habits. This is not an easy task, because being uncomfortable during a bout of back pain is one thing, but more often poor sleeping habits contribute to structural issues that can cause back pain in the future. So choosing a mattress that is both comfortable to you when you don’t have pain and one that also supports your back and allows you to get the rest you need when you do have pain can be frustrating, but it can be done.

Best Mattress For Back Pain

As I just mentioned the perfect mattress does exist, it just isn’t the same for everyone. The ideal mattress allows the person a restful night sleep and doesn’t create morning aches and pains. If you are a back pain sufferer then it is very import ant to choose a mattress that not only is comfortable, but also provides the support your injured spine needs. When researching mattresses you want to understand the mattresses construction. In a standard mattress the coils or springs within the mattress provide support to the spine and the rest of the body and depending on the type of mattress the configuration and volume of springs can be different.  Another factor is the actual cushioning on the mattress, which can vary. Most mattresses have padding that ranges from about 7 inches to 18 inches and both of these factors can play a role in your individual comfort.

The ideal mattress will provide good and solid support for the spinal curves to maintain proper alignment and decrease the amount of stress on the back. By supporting the spine properly the supporting muscles and ligaments of the spine avoid overstretching contributing to that morning stiffness and muscle soreness that can occur in the morning.

The fact is unlike other aspects of medical research there is not a lot of clinic information about mattresses.  There are some studies out there that show that a medium-firm mattress can provide better support and relief from back pain then a firm mattress.

The key for anyone choosing a mattress is to create a fine balance between spinal support and sleeping comfort. You have to be comfortable enough to get the rest you need otherwise what is the point in having your back supported? Hard mattresses can make you sore and stiff, because they are unyielding to your body’s natural curves and can create areas of pressure that can lead to soreness.  A medium-firm mattress may be more desirable because your shoulders and hips are able to sink down a little creating a more natural posture. If you need a firmer mattress to support your back a little more in the padding or even a pillow-top addition can help make it more comfortable.

As a back pain sufferer it’s extremely important to have a good supportive mattress, however many people don’t know when a mattress is past its prime. If you can see sagging areas in your mattress it is most likely time to get a new one.  Below are a few helpful tips to utilize when mattress shopping.

• Don’t let price be the biggest factor when choosing a mattress. This is an investment for you and a purchase you will have for years to come. Higher quality coils, memory foam mattresses and quality padding does cost more, but the overall health benefits outweigh the cost. There are good mattresses however that don’t come with a high price tag. There are a lot of mattress stores out there nowadays and price wars are common. Use the competitive marketplace to your advantage and compare brands store to store.

• Don’t fall victim to a claim that a certain mattress has any medical backing. There are no definitive studies out there and if there are studies about a particular mattress the manufacturer most likely funded the study. The data may be compelling and even valid to a degree, but  as always use your best judgment.

• If possible try out a particular brand before investing in it. Some manufacturers like Tempurpedic allow you to try it in your home as part of a trial process. If you don’t want to go that route call around to some area hotels and ask what types of mattresses they use. One chain that I frequent has replaced all of their beds with sleep number beds. This is a great way to try out a mattress prior to buying one. You can also ask friends and family members what they have, and if they have a brand you may be interested in head on over and test it out. A  good 15-20 minutes should be enough to see if a mattress is comfortable enough for you.

• Look for reviews about the mattress or company you are purchasing from. Look at their policy on returns, warranties, delivery options etc. You can find a lot of this online in forums and back pain support groups.

Once you find a great mattress there are a few things you can do to make sure it lasts and gives you the support and comfort you need for many years to come. One simple thing you can do is rotate the mattress so that it gets worn evenly. You may also want to flip it over if it doesn’t have pillow top to ensure an even wear.

As an effective strategy for managing lower back pain choosing a mattress is a key strategy and taking things slow and not getting drawn into the hype is important. Another important thing you can do is ask your spine specialist. Many doctors who deal with back pain regularly more than likely have been asked the question hundreds of times and in most cases they have done some research of their own and can often give you a good recommendation.

No matter what the cause of your back pain is, find the best mattress for back pain can be a challenge. Utilizing the tips outlined in this article hopefully will put you closer to finding that ideal mattress to help relieve your back pain.

Suffering from lower back pain in early pregnancy is common, however there are some things you should know.

Lower back pain in early pregnancy is a relatively common occurrence. For many women it may be the first signs of early pregnancy as the body begins to change in anticipation of the months to come. These lower back pain symptoms may be experienced quite differently from women to women as the pregnancy begins to unfold.

For those who have never given birth before, your body is adjusting to a completely new condition. Often the lower back pain is less intense for 2nd and subsequent pregnancies. As ligaments begin to stretch and the uterus begins to get ready for the process the initial lower back pain can be  similar to what you experience during a heavy monthly cycle.

For many who know they are pregnant however, this begins to worry them and the health of the baby is a primary concern. In addition to the lower back pain and increased level of nausea, frequent urination and a general feeling of lethargy can also accompany the symptoms.

More often than not the lower back pain in early pregnancy begins in the 3rd week for most women. At this point unless a pregnancy is planned or being monitored many women will not even be aware that they are pregnant. It is usually after a women is aware of the pregnancy that the concern of the increased lower back pain can turn to worry. Usually it is a normal sign that things are beginning to change, the uterus is expanding and the tethering ligaments in and around the pelvis become stretched. This tension leads to over all tension on the connective tissues that connect into the back muscles and am general uncomfortable feeling begins to occur.

As with anything as fragile as a pregnancy it is very important to consult with your doctor and report all symptoms. In most cases as outlined above this is a normal process. The concerns usually increase if the lower back pain in early pregnancy is associated with any blood or discharge of any kind, general malaise or feeling ill or any other abnormal symptoms. The process of carrying a baby is very stressful on the body and can cause a lot of discomfort for some women. There are some things you can do during this process to minimize your lower back pain.

1. Many women find it helpful to visit a chiropractor skilled in treating pregnant women. Spinal manipulation can ease the tension on the spine and pelvis and as relaxin a pregnancy hormone is released in body the chiropractor can provide gentle relief while they keep the hips, pelvis and spine moving properly.

Even early on in pregancy lower back pain can cause alarm

2. Another gentle and often soothing treatment is pregnancy massage. Many massage therapists specialize in prenatal massage and gently apply massage techniques to the pregnant mother, soothing and relaxing tense muscles and helping relieve pain.

3. Acupuncture can also be used to relieve lower back pain in early pregnancy. A skilled acupuncturist can apply a gentle program of acupuncture to relax and soothe the pain, as well help your overall general well being.

Hopefully these techniques can help you if you suffer from lower back pain in early pregnancy. Home remedies such as gentle stretching and exercise can also aide in lower back pain relief. As can heat and ice therapy. The more natural you can keep the treatments the better, you don’t want to take any unnecessary medications while you are pregnant. As always please consult your physician prior to taking any advice including ours, we wish you a healthy and happy pregnancy and as always if this post was helpful please share it on Facebook.

Finding sciatica nerve pain relief can be frustrating, but don't give up hope. We found some great options.

Many people suffer from back pain, in fact statistics show that most people do at some point in their lives. As debilitating as back pain can be sciatic nerve pain can be even more so. Finding sciatic nerve pain relief starts with understanding what the sciatic nerve is and identifying the most common causes of sciatic nerve pain.

Anatomy of  The Sciatic Nerve

The sciatic nerve is actually a combination of several nerve roots. Starting at the 4th Lumbar vertebrae or L4 all the way to the 3rd Sacral Nerve or S3. This combination of nerves comes together to form to sciatic nerve. The sciatic nerve has the jb of supplying the feelings of sensation as well as motor control or movement to the leg.It joins the spinal cord with the lateral thigh, posterior thigh and hamstrings as well as the lower leg including the calves and the feet. When irritation of the sciatic nerve occurs severe pain, numbness or weakness may occur in the affected leg.

Different Types of Sciatic Nerve Pain

There are many different variations of sciatic nerve symptoms that a person can experience. The location, they sensation and the severity of the symptoms be much different from person to person. There are some common patterns however, that may help you identify whether or not you are suffering from a sciatic nerve issue.

Sciatic Nerve Pain can have the following characteristics:

• It can be in one leg or both

• It often starts in the lower back or buttock region and radiates down the back of the upper leg and into the calf and/or foot.

• Sciatica is usually experienced as a sharp intense pain that is well localized along the distribution of the nerve.

• Common words used to describe sciatica are burning, singing, shooting and sharp.

• Cramping of the sciatic nerve innervated muscles also often occurs

• Sciatic nerve pain is often worse with standing or sitting and feels better with motion or activity in some cases.

Other symptoms that may also be present include severe numbness or tingling and hypersensitive skin along the distribution of the nerve.

In most cases sciatic nerve pain is as a result of irritation to the sciatic nerve and more often than not will subside with rest and non-surgical intervention like chiropractic, exercise or spinal decompression if a disc injury is involved. More severe sciatic nerve pain may need to be addressed with a spinal epidural or anti-inflammatory medication to deal with the chemical aspects of the pain.

If more serious symptoms are present it may be as a result of a more serious problem. Symptoms like loss of bowel and bladder control may be indicative of a more serious problem called cauda equina syndrome. Symptoms like severe foot drop and loss of feeling in the legs may also be indicative of a more serious underlying problem. These symptoms may involve severe nerve damage and if you experience them you should seek immediate medical attention.

No matter what your sciatic pain levels are treatment in most cases some form treatment  is necessary,raging from home therapies to surgery depending on the nature of the symptoms and the severity of them. Below are some of the most common treatments for sciatic nerve pain relief.

Non-Surgical Treatments for Sciatic Nerve Pain Relief

The array of non-surgical treatment options for sciatic nerve pain relief is quite broad.The goal of these treatments is to calm down the inflamed nerve and allow the healing process to take place. Each of these treatment options can be done in isolation or in combination to effectively relieve sciatic nerve pain. Best practices dictates that these treatments be combined with an effective exercise program.

Heat and Ice

The application of heat and ice is probably the easiest home therapy you can utilize for your sciatica. Heat increases blood flow to the injured area and helps remove toxins from the injured area. The application of ice decreases inflammation and helps to soothe the affected area. The utilization of this remedy is especially effective in the early stages of a sciatic nerve pain episode.

Pain Medication

During an episode of sciatica over the counter pain medications or prescription medications may provide temporary relief, while the healing process takes place.Non-Steroidal anti inflammatory medications like ibuprofen or an oral steroid dose can help reduce the inflammation associated with sciatic nerve pain. However, you should always consult your doctor when taking any medications.

Chiropractic Care

Chiropractic care has also been shown effective in managing sciatic nerve pain. Manipulation is a well recognized treatment and by increasing motion and helping improve flexibility in the spinal joints the healing process can take place. Other treatments like laser therapy and inferential treatments often employed by chiropractors can also aide in sciatic nerve pain relief.

Epidural Steroid Injections

If the sciatic nerve is severely inflamed sometimes the best treatment option is to inject a steroid medication directly to the affected area. This is accomplished with an epidural and can be done as part of a comprehensive sciatic nerve pain relief program. These injections are temporary, however with severe sciatica the pain relief may be a welcome reprieve no matter if it is temporary or not. If epidurals are applied as part of a more comprehensive program, they can often be very effective.

Spinal Decompression Therapy

Spinal Decompression is an advanced form of traction with a sophisticated computer device. The device allows for a specific amount of distraction force to be applied to the spine while decreasing the chances of the bodies own reflex protective mechanisms kicking in. The treatment can be very effective in decompressing the nerve from conditions like bulging discs, herniated discs and spinal stenosis.

Spinal Surgery

In severe cases of sciatic nerve pain that are unresponsive to the above treatments, occasionally surgical spinal nerve decompression is the only alternative. Spinal surgery is a last resort, however for properly selected patients it can be very effective for sciatic nerve pain relief.

No matter what the cause or severity of your sciatic nerve pain, we want you to be well informed about your options. Hopefully this short article has helped and gets you on the road to recovery. If you found this article helped please share it on Facebook or Google + and help others find sciatic nerve pain relief.

Lower left back pain can be serious, always check with a physician to determine the cause of your pain

If you are suffering from lower left back pain there are a few things you need to know and what to look for to determine the possible the cause and severity of your pain. The first question is typically how long have you been suffering. A gradual onset versus a more acute onset can often give some insight into the cause of your lower left back pain. Below are some of the of the more common causes.

Herniated Disc or Bulging Disc

Often times a disc can herniate or bulge causing an intense pain in the lower back and potentially the legs. If the disc herniation has occurred to the left of the midline the pain can be referred into the left side of the lower back. This pain can be sharp at times or my be experienced as a deep dull ache. Either way depending on the location of the protruding disc material it may also include pain in the the upper buttock area or even down into the legs.  Disc injuries are often associated with muscle spasm as well, because the inflammation can irritate the exiting nerve and cause the back muscles to go into spasm. Treatments for a disc injury can include rest, anti-inflammatory medication, exercise, spinal injections, spinal decompression or even surgery depending on the severity.

Facet Joint Pain

If you have an irritated facet joint on the left side it can also lead to lower left back pain. The facet joints are the joints that connect each vertebrae together in posterior portion of the vertebral body. The facets allow movement by gliding upon each other. Each joint is surrounded by a capsule and the joint has lubrication that keeps it moving smoothly. When a facet joint stops moving properly or becomes injured or arthritis it can start to irritate the nerve called the medial branch. This can lead to pain  referred in to the left lower back or even into the upper buttock or thigh area depending on what facet joint is affected. Treatments for facet joint pain may include chiropractic manipulation, physical therapy, facet joint injections or specific exercises and stretches.

Muscle Strain

Another common cause of lower left back pain can be a simple muscle sprain or strain. A muscular injury to the left lower back muscles can occur with improper lifting, twisting or a sudden jolt or trauma such as a sports injury or auto accident. This type of pain often feels like a deep burning or dull sensation and can limit range of motion or movement. A muscle strain can be very limiting with regards to motion, however it is better to keep the range of motion as full as possible without stresses the muscle to the point of pain. Treatments for muscle strain include heat, ice, massage, gentle manipulation and rest. Rehabilitation should start as soon as it is tolerated to ensure the muscle does not heal in a shortened fashion.

These are just a few of the more common causes of lower left back pain. There are other conditions that may be more serious like kidney issues or other internal organ dysfunction. It is always important to consult a physician to get to the bottom of the problem once and for all and to initiate a treatment plan that is both safe and effective.

Spinal decompression is often confused with traction. It is a treatment for neck pain and back pain and is given to give relief from pain caused due to compression on one or many pinched nerves of the spinal cord. Spinal decompression can be achieved both with surgical intervention and non-surgical intervention. It is especially used to treat chronic pain conditions such as sciatica pain, spinal stenosis, disk bulge, disk herniation, degenerative spondylolisthesis, etc.

Non-surgical spinal decompression:

Non-surgical spinal decompression is a much more sophisticated form of manual traction which was used by physical therapists and chiropractors decades ago. It helps to relieve back pain by gently changing the force and positioning of the spine. The decompression helps to take off the pressure from the spinal disc which is a gel-like cushion in between the bones of the spine. When the pressure is removed water, oxygen and other nutrients freely reach the disk so that it heals.

Non-surgical spinal decompression technique is used to treat:
Sciatica pain: this pain ranges from mild-to-severe and is caused when there is compression in of the nerve roots located in the lower back. This leads to numbness, weakness, tingling sensation that radiates to the legs.
Bulging or herniated disk: When the normal cushion or gel-like padding between the vertebrae of spine ruptures due to degeneration or any other reason, the disk pushes out and put pressure on nerves. This eventually leads to symptoms of pain, numbness, weakness, tingling sensation etc. Spinal stenosis: When the pathways of nerves constrict and become narrow or clogged then they compress the nerves and ultimately lead to spinal stenosis. Trauma or injury: Motor vehicle accident or any other job-related or other accident may impact on the nerves or lead to injury to the nerves.
Spondylolisthesis: When one vertebra slips forward or is displaced, compression occurs and leads to back pain symptoms.
Piriformis syndrome: When the Piriformis muscle develop spasms and compresses and irritates the nerve then decompression treatment can be used. Degenerative disk disease: due to degeneration, normal wear and tear may occur and it may compress the nerve roots, resulting in back pain.

All these conservative decompression techniques do work in most cases, but if your pain persists for more than 6 weeks and if non-surgical treatment fails and movement becomes unbearable then you may consider surgical intervention for spinal decompression.

Surgical spinal decompression procedures are:
Microdiskectom or microdecompression: This surgery is used to treat lumbar herniated disks. In microdecompression, a portion of the disk that is compressing the nerve is removed so that extra space is created and the nerve heals. Spinal fusion: this procedure is performed when a disk wears out due to degeneration and is considered the last resort. In this two or more vertebrae are fused or joined together. Laminectomy: this involves surgical removal of herniated disk. It is an invasive technique where a small portion of the vertebrae bone is removed and this alleviates pressure on the pinched nerve. It is also known as open decompression surgery. Diskectomy: This involves surgical excision of diseased disk.

Your doctor will decide whether you need a surgical or non-surgical spinal decompression technique. But usually invasive techniques are used when all other conservative measures failed. Nonsurgical spinal decompression involves very little risk and for this therapy doctors generally treat with electric stimulation, ultrasound or heat and cold therapy. As no anesthesia or post-operative care is involved, the risk is very minimal.

The most common risks involved in surgical spinal decompression are infection, bleeding, blood clots, nerve or tissue damage, or allergic reaction to anesthesia. It is also not sure whether your back pain symptoms will be alleviated or not.

However, there is very little literature available which supports non-surgical spinal decompression therapy, it still has a large following and many clinics swear by it.  With the latest advancement in techniques related to diagnosis, instruments, and new procedures a lot of improvement has been done in the existing treatments for spinal decompression.

Diagnosing modic changes

Modic changes can only be seen on a magnetic resonance imaging, an MRI. Modic changes were first described and separated into 3 different types of changes by Dr. Michael Modic in 1988.

Normal bone consists of an internal scaffolding of bone, called trabeculae. In the hollows between the trabeculae is red bone marrow, which produces blood cells.

• In Modic type 1 the trabeculae are fractured in many places, the trabeculae are shorter and broader and the “scaffolding” pattern is unstructured and uneven. The marrow is substituted by serum, the same clear liquid that is inside a blister.

• In Modic type 2 changes the trabeculae are also fractured in many places, but are shorter and broader and the “scaffolding” pattern is unstructured and uneven. With Modic type 2 changes the marrow is substituted by visceral fat, the same kind of fat we have on our hips and bellies.

• Modic Changes type 3 are rare, and it is bone scar tissue.

Researches in this most recent study wanted to determine if bed rest was more suitable for patients with lower back pain who also had modic changes in the spine as opposed to exercise.  Below is an excerpt from that study in the April 2012 issue of Clinical Advisor had this to say about this topic.

To determine which treatment strategy would work best for people with persistent LBP and Modic changes, the investigators randomized 49 such patients to a 10-week course of two hours of daily rest and the option of using a flexible lumbar belt, and 51 patients to exercise therapy once a week for 10 weeks.

No statistically significant differences were found between the two groups on any outcome measure, including pain, disability, general health, and global assessment, after 10 weeks or one year. The study authors speculated that because LBP did not improve more with rest than exercise, Modic changes themselves might not be causing pain, two hours of rest per day might not have been enough, or some types of Modic changes might respond better than others to rest.

So as you can see from this study it appears it really doesn’t matter which option you take, it seems to produce the same outcome, however long term studies have not shown either is better, you should still consult with your physician to determine whether or not one approach may be better for your particular circumstances.

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