Posts Tagged ‘healing’
Wednesday, February 16th, 2011
If you visit clinician be it orthopedic surgeon or a neuro-surgeon and complain of back ache you are more than likely to be advised to have a MRI.
Low back pain is a very common condition. The Need for diagnostic imaging for patients with low back pain has often been exaggerated. ‘Evidence indicates that routine imaging is not associated with clinically meaningful benefits but can lead to harms’, reports Annals of Internal Medicine.
Usually diagnostic imaging in this condition should be indicated only if low back pain is associated with progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying condition. This evidence-based recommendations from the American College of Physicians(ACP) and the American Pain Society (APS) appear to be grossly neglected. Routine imaging does not seem to improve clinical outcomes and exposes patients to unnecessary harms.
Overuse of imaging imposes severe financial burden on patients who already suffer lower productivity due to the menacing low back pain. Reducing unnecessary tests or ineffective treatments decrease the costs associated with low back pain. In addition to the direct costs imaging also causes additional expenses by leading to additional tests, follow-up, and referrals. It may also result in an invasive procedure of limited or questionable benefit.
The appropriateness of many of the low back imaging studies obtained in clinical practice has long been questioned. The ACP/APS low back pain guideline recommends selective imaging for patients in whom it is clinically indicated.
There are numerous factors that explain why routine imaging does not seem beneficial. Most lumbar imaging abnormalities are common in persons without low back pain and are only loosely associated with back symptoms. Although advanced imaging can detect more and smaller abnormalities, these abnormalities are not necessarily clinically relevant. This means a rapid MRI need not always be of greater practical value than radiography for evaluating low back pain.
Many abnormalities detected with advanced imaging are so common in asymptomatic persons that they could be viewed as normal signs of aging. The presence of imaging abnormalities need not mean that the abnormalities are responsible for symptoms.
Acute low back pain has a favorable natural history and the expected yield of routine imaging is low. Most patients show significant improvements in pain and function in the first 4 weeks; routine imaging is unlikely to improve on this. Imaging results rarely affect treatment plans. Thus they often have a low impact on clinical outcomes.
Routine imaging is associated with potential harms:
- Lumbar radiography and CT contribute to cumulative low-level radiation exposure. They may promote the development of cancer.
- The use of iodinated contrast in lumbar CT is associated with hypersensitivity reactions and nephropathy (disease associated with the kidneys).
- The average radiation exposure from lumbar radiography is 75 times higher than for chest radiography. This is particularly harmful to young woman because of the proximity to the gonads (sex glands). The amount of female gonadal irradiation from lumbar radiography is supposed to tantamount to having chest radiography daily for several years.
Most clinicians routinely order imaging for all cases of lower back pain even in the absence of a clear clinical indication though ACP/APS guideline suggests a trial of management without imaging in adults with no risk factors other than older age. The use of advanced imaging modalities like MRI and CT scans is skyrocketing. A large number of clinicians hastily jump to these modalities irrespective of any guidelines.
Patient expectations and preferences about diagnostic testing also add to the cause. They expect a clear diagnosis for their low back pain. Some attach a clinician’s decision to not obtain imaging with low-quality care. There are patients who think that their pain is not legitimate or important if the clinician doesn’t order for imaging. Wanting diagnostic testing is a frequent reason for repeated office visits for chronic back pain. There are ones who insist that they need imaging even after the physician explains that it would be unnecessary.
The potential solutions include:
- Clinicians should adhere to the ACP/APS recommendations on use of imaging so as to reduce overuse. Most patients do not need immediate imaging, and an initial trial of therapy before imaging is warranted in many cases.
- Advanced imaging should be reserved for serious situations, i.e. only when the results are sure to influence clinical decision making. Conditions like major trauma, severe neurologic compromise, or vertebral infection qualify for being imaged using an MRI or CT scanner. In the absence of strong risk factors for cancer and lack of neurologic signs, initial imaging with lumbar radiography and evaluation of erythrocyte sedimentation rate (ESR) is a reasonable approach.
- Patients should be educated about the pros and cons of imaging. Face-to-face information with patient hand outs, self-care education books, online materials, mass media educational campaigns help.
Source: ‘Diagnostic Imaging for Low Back Pain: Advice for High-Value Health Care from the American College of Physicians’: Annals of Internal Medicine.
Source-Medindi
by Dr. Nithin Jayan
Read more: Does Routine Imaging in Low Back Pain – Do More Harm Than Good? http://www.medindia.net/news/healthwatch/Does-Routine-Imaging-in-Low-Back-Pain-Do-More-Harm-Than-Good-80842-1.htm#ixzz1Dylv7n6r
Tags: back injuries, back pain, back surgery, healing, herniated disc, Imaging, Lower Back Pain, pain
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Wednesday, January 12th, 2011
Often referred to as MENS (Microcurrent Electrical Neuromuscular Stimulation), proponents tout microcurrent therapy as the most effective form of electro-therapy available. The basis of their claims stem from the size of the wave length—rather the lack of size. Microcurrent is tiny, one-millionth the size of on amp in fact, which happens to be the same strength as the natural electrical current that flows through our bodies on a cellular level. When a cell is injured its capillaries dilate allowing excess blood proteins to enter which promotes bloating and pain commences. Multiple bloated cells in a given area of the body constitute visible swelling.
While swelling may be our body’s natural way of protecting a wound, it has many drawbacks that impede the healing process. When cells are damaged and swollen they become nearly impervious to our body’s natural electrical current. Without this electricity the cell is unable to oxygenate, absorb nutrients, eliminate waste, exchange ions, conduct protein synthesis and produce ATP (the protein that is chiefly responsible for giving us energy). Even the cells polarity may be askew, oscillating randomly. Only with time do the cells that can receive some electrical current heal. Those that are too damaged to heal die and are discarded by the body.
The problem with this natural healing process is the time it takes. Anyone who has ever had a sprained ankle or a torn ACL knows this. If only there was a way to speed things up.
With MENS there is a way.
Bombarding an injured area of the body with excess electrical current vastly increases the amount of electricity that penetrates the membrane of the damage cells—up to 500 percent some studies suggest. The more current that reaches the interior of a cell, the quicker it can expel waste, create ADT, process ions, and re-polarize. Only then can it absorb nutrients and oxygen and resume normal cell physiology.
More so than any other modality, microcurrent is effective at aiding and even speeding up the healing process. (Double-blind studies were conducted by Lerner and Kirsch). Although popular, TENS works best for temporary pain relief by occupying the nerve channels that transmit the pain signal. But because of the size of its wavelength (1000 times larger than microcurrent) it can’t penetrate the cell wall to aid in healing as MENS can. Ultrasound can penetrate the cell wall but its function is to excite liquids using vibrations. It has its own useful purposes.
To a medical professional (clinic, DME suppler, biller etc…) MEMS can represent a significant opportunity for additional revenue. Although it may be a little challenging to find a payer (private insurance and Medicare) that will approve microcurrent as a reimbursable device in and of itself, many microcurrent devices such as the InTENSity Select Combo or the InTENSity Micro Combo feature microcurrent combined with TENS, which is a reimbursable modality. Prescribe the patient this TENS unit for pain relief and he/she gets the needed bonus of microcurrent along with it.
No matter the desired outcome microcurrent definitely has some impressive history of positive outcomes. Athletes such as Joe Montana have used MENS to speed recovery and return to the game.
Tags: alternative pain management, Electric Muscle Stimulation, electro therapy, healing, injury, MEMS, microcurrent, swelling
Posted in Articles by Michael Harris | 1 Comment »
Tuesday, December 28th, 2010
This article is a repost from The Charlotte Observer. See the original article here.
North Carolina’s largest health insurer is coming under fire from surgeons across the country for implementing tougher restrictions on an increasingly common type of spinal surgery.
Blue Cross and Blue Shield of North Carolina’s new rules, which take effect Jan. 1, are designed to reduce overuse of spinal-fusion surgery, a costly and controversial procedure to ease patients’ lower back pain. The Chapel Hill-based insurer says it wants to ensure the surgeries are approved based on the latest medical evidence.
“We are not going to stop coverage, but we do want to make sure the ones being done are appropriate,” said Dr. Don Bradley, Blue Cross’ chief medical officer. “In some cases, we’re seeing technology being used when more conservative measures might be more appropriate.”
But some spine surgeons worry that the restrictions will limit care for thousands of patients and could set a new coverage standard among other insurers.
A coalition of surgeons representing nine medical associations, including the American Association of Neurological Surgeons and the North American Spine Society, wrote to Blue Cross this month, urging the company to reconsider.
The group also suggested various changes that would ease the new restrictions.
“If this intrusion into the physician-patient relationship goes unchallenged, other insurers will follow suit,” said Dr. John Wilson, a neurosurgeon at Wake Forest University Baptist Medical Center who is president of the N.C. Neurological Society and one of nine physicians who signed the letter to Blue Cross.
“It will be a progression of ever-more restrictive policies that will handcuff us as we try to treat patients,” Wilson said.
The surgeon groups requested a meeting with Blue Cross executives before the rules kick in one week from today to discuss the new policy. But the insurer responded in an e-mail message that because of the holidays, a meeting could not be scheduled until the third week of January.
Wilson estimates that he performs about 100 spinal-fusion surgeries a year. Only a small percentage of his practice’s patients would be ineligible for coverage under the new Blue Cross rules.
“Even if it’s just a few patients, if we’re limited in how we can help them, it doesn’t sit right with us,” he added.
The new spine-surgery rules come as Blue Cross faces increasing pressure to keep costs down and control premiums. The company announced plans in July to slash administrative costs up to 20 percent by 2014.
“The tendency is to label us as the big, bad insurance company,” Bradley said. “We understand folks rely on us to cover the things that should be covered. They also assume that we’re making decisions about appropriate care” to keep premiums affordable.
Blue Cross reports that it covered 3,593 spinal fusion surgeries last year, up 22 percent from 2007. The insurer paid $105 million in claims for the procedures last year, up 44 percent from 2007. The procedures require longer hospital stays and cost more than three times the amount of a simpler surgery, according to the Journal of the American Medical Association.
The new rules will require patients and physicians to get approval before spinal-fusion surgery. The insurer still will cover the surgery for some ailments, such as scoliosis, injury and tumors.
But Blue Cross won’t cover the surgery for degenerative disk disease. The condition is caused by aging disks and can cause debilitating back pain.
“We feel that to completely omit this as a covered procedure under any circumstance is overly restrictive,” the national group of surgeons wrote in their letter to Blue Cross.
The surgeries involve implanting rods and screws to repair vertebrae. JAMA reports that patients who had a complex fusion procedure were nearly three times as likely to develop a life-threatening complication and that the surgeries didn’t result in dramatically better outcomes.
But spinal implants have become a booming business for surgeons and medical-device companies since winning Food and Drug Administration approval in 1995. Minneapolis-based Medtronic is the biggest maker of spinal implants, accounting for about half of the $7 billion market last year, The Wall Street Journal reported.
Critics in Congress and elsewhere are calling for a review of Medicare’s coverage of the procedures. Spinal-fusion claims cost Medicare $2.24 billion in 2008, up nearly 400 percent since 1997 after adjusting for inflation, The Wall Street Journal reported.
Blue Cross has tried to work with physicians for several years to develop guidelines on the procedures, but it hasn’t stemmed the surge in the number performed, Bradley said.
“We have tried the kinder, gentler approach,” he said. “It’s unfortunate that it takes looking at each case each time, but other approaches haven’t really worked.”
A Blue Cross patient or surgeon could appeal any denial of coverage, and the process would include at least one review by a physician who isn’t employed by the insurer, Bradley said.
In late September, the company notified spine surgery practices across the state about the new rules. Before issuing the new policy, officials met with several spine surgeons in the Chapel Hill area and incorporated their input into the new rules.
In some cases, where doctors have tried physical therapy and other types of treatment, the only other option may be surgery, Wake Forest’s Wilson said. “To say you’re not going to cover them at all, you’re hurting some patients,” he added. “We don’t want there to be patients left suffering.”
Blue Cross continually reviews its coverage policies and makes adjustments based on the latest medical guidelines, Bradley said. But the new rules will take effect Jan. 1, despite the outcry from surgeons.
“We always listen to providers,” he said. “It’s unlikely we would not implement this. But if there’s new data that says our criteria are incorrect, we’ll be open to that.”
Tags: back pain, back surgery, decompression, discs, healing, herniated disc, Lower Back Pain, spinal fusion
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Friday, October 29th, 2010
If you were to do a search online for the “SR 500” you would likely come up with some links to a Yamaha motorcycle. You would also find the SR 500 is the given product name for a certain type of back brace, however, the SR 500 is no normal brace. Normal braces—or braces that are “common” on the market—are constriction braces. This means exactly what the term implies…they constrict. They are designed to cinch tight around the abdomen to immobilize the area. The theory is less movement less pain.
This simple logic has been the “backbone” of back bracing theory for hundreds of years. Then in the mid 1980s a new kind of treatment started to take hold in America—spinal decompression. By the late 1990s decompression therapy had made significant advances in technology and popularity. It was about that time that a Korean Medical company asked the question: Why can’t there be a brace that produces some of the same effects as decompression therapy?
The result of that question led to the world’s first ever decompression brace. I’ll spare you the details of exactly how it evolved, but evolve it did to what is now known as the SR 500. So let’s take an inside-out look at the SR 500. What makes it unique? What makes it a “decompression” brace?
First of all, the SR 500 is not a constriction brace. It does not immobilize the spine. When properly adorned, it actually promotes healthy movement. This helps avoid muscle atrophy which is a known side effect of the constriction back brace.
What the SR 500 does is expand vertically. In order to obtain a decompression effect, the designers created unique air chambers or cells made of a rubber bladder-like material that, when filled with air, expand upward. As they expand they cause the overall profile of the belt to grow from just 4 inches in height to over 7 inches in vertical height. As it does it lodges up under the rib cage pushing upwards and down against the pelvic girdle pushing downwards. The result is an unloading of the lumbar spine as the weight-bearing forces are offset. As this occurs, something quite magical takes place inside the spine. Discs that have been “compressed” due to an injury (such as a herniated or bulging disc) or due to a long life of poor health and poor posture (results are disc degeneration) can now “decompress.” That means they can distract or facilitate back into their original space and shape. As they do they reabsorb any lost fluids and begin to heal.
The decompression effect achieved by the SR 500 is a scaled down version of the decompression achieved on a decompression table at a qualified chiropractor’s office. Decompression tables use computer guided micro movements to target and adjust specific discs for short periods of time while the patient is on the table. This pinpointed effect has produced thousands of positive results for chronic back pain sufferers. The SR 500 offers the chance to continue decompression into the home between visits or after the therapy ends. It serves as a perfect supplement to the table treatments and it has helped speed the recovery of many patients. It has even allowed many patients freedom from pain killers and the elimination of the possibility of spinal surgery.
Included with the SR 500 is a hand pump that has a built in pressure gauge to insure proper inflation, a owner’s manual and a laundry bag. The SR 500 is 100% machine washable. The brace also comes with a rigid front and rear panel for those individuals who need more spinal stability in the initial stages of healing.
The design behind the SR 500 is patent protected and is available by prescription only. Medicare and private insurance companies reimburse for the brace. Visit your doctor, chiropractor, physical therapist or other care provider to inquire about obtaining your own SR 500. You may want to visit www.spinalrehabsolutions.com first and print off some information to show your provider in case he/she is not familiar with this type of brace.
Tags: back brace, back injuries, back pain, back surgery, chiropractics, decompression, discs, distraction, Durable Medical Equipment, healing, herniated disc, Lower Back Pain, pain, spinal brace, spinal decompression, Spinal Rehab Solutions, spine, sr 500
Posted in Articles by Michael Harris | 10 Comments »
Monday, September 27th, 2010
See if this sounds familiar: Man is in pain. Man goes to doctor. Doctor prescribes pain medication. Man feels better. Prescription runs out. Pain comes back. Man goes back to doctor. Man gets prescription renewed. Man does this many more times. Man eventually gets surgery and fixes source of pain, has a full recovery. Man no longer needs pain meds for pain, doctor discontinues prescribing them. But man still needs pain meds…because he is addicted. Man resorts to obtaining pain meds illegally. Man eventually gets caught and suffers public humiliation. Man goes to rehab and finally becomes free of his addiction.
Sound crazy? Think it is unfathomable that our great medical system could aid in the addiction of an otherwise upstanding man? See Rush Limbaugh.
The truth is hundreds of thousands of individuals are hooked on narcotic pain medications every year. And who can blame them? Pain hurts and so do withdrawal symptoms.
In the last few decades a different thought trend has emerged for dealing with pain. Appropriately called “alternative pain management,” this trend has grown into an industry providing many products and services that thousands of chronic pain sufferers rely upon on a daily basis.
A new study by David Eisenberg, M.D found that total visits to alternative medicine practitioners jumped 47% from 427 million in 1990, to 629 million in 1997 which easily topped the 386 million visits to primary-care doctors.
Here is your quick rundown on the top trends in alternative pain management.
TENS
Tens stands for Transcutaneous Electrical Nerve Stimulation. Transcutaneous (trans-kyoo-tey-nee-uhs) means “through, or by way of the skin.” TENS sends electrical impulses via electrodes or conductive garments to occupy the nerve pathways with a more comfortable sensation which overrides the pain. TENS recently was recognized by the American Society of Anesthesiologists’ Task Force on Chronic Pain Management as an effective mode of pain relief. (Read full article here.)
Chiropractics
Despite its growing acceptance even within “mainstream” medicine, Chiropractics still has its doubters. Yet it has far more advocates. Golfers and other pro sports individuals will often employ a private Chiropractor. The practice has been growing in popularity here in the U.S. since the early 80’s.
Decompression
Usually administered by a specialized Chiropractor, decompression is very effective for disc-related back pain sufferers. The patient is harnessed on a table and a computer uses micro movements to slightly expand the amount of space between the vertebrae.
Visceral Manipulation
This is practice of “massaging” internal organs and the membrane that supports them. When an organ is damaged the membrane that holds it in place can stiffen forcing the surrounding organs to move around it. Visceral manipulation has helped thousands with ailments ranging from lower back pain to heart and lung problems.
Acupuncture
Got pain? Fix it by sticking dozens of needles in you. Sounds fun doesn’t it? Acupuncture dates way back to ancient China. It works by altering the senses of the nerves surrounding the area in pain. Reviews have been mixed as with most alternative approaches. Some swear by it, others get nothing out of it.
Yoga
Combining the art of meditation and stretching, yoga is the ultimate heal-yourself approach to dealing with pain. There is no shortage of believers either. But like most alternative approaches, science can’t find any solid evidence to back up the claims of the thousands who swear by it.
There are many other alternative approaches to managing pain in addition to these front runners. If you are in pain it may be in your best interest to try some of these remedies first before accepting a potential addictive regimen of pain killers. Who knows, you may even be able to avoid a surgery and improve your overall health. And good health is the number one preventative medicine to keep you out of pain in the first place!
Tags: acupuncture, back brace, back pain, chiropractics, decompression, discs, DME, DMEPOS, Durable Medical Equipment, Electric Muscle Stimulation, electro therapy, healing, herniated disc, HME, Home Medical Equipment, TENS, visceral manipulation
Posted in Articles by Michael Harris | 2 Comments »
Wednesday, September 15th, 2010
The following is a repost. Click the link at the bottom to read the full article.
All back pain is not created equally. The way pain in the back presents itself can be a clue to what kind of problem exists and therefore what to do about it. A proper assessment is crucial in order to begin relief and training to prevent recurrence of the cause.
Pain in the low back that does not radiate to the legs or buttocks is called lumbago. This pain will be described as an ache that may become sharp with certain movements. The pain can start suddenly or gradually and often the actual cause of it may not be known. Generally, lumbago is thought to be caused by overusing a weak back. Lifting, gardening, cleaning the house or other seemingly innocent physical chores may be enough to bring on lumbago. Sudden onset lumbago may be caused by a disc injury, muscle strains or spinal joint misalignment or irritation. Gradual onset lumbago may be caused by many things like postural problems, weak muscles or muscle imbalances, sacroiliac joint problems or poor sitting positions at work or while driving and spinal misalignment. Treatment can include heat if the pain is not of sudden onset or has continued for more than three or four days, spinal realignment such as a chiropractic adjustment, rest and massage. Lumbago can go away only to return sometime later. If this happens, an exercise program with a trainer is recommended to strengthen the back to prevent the problem in the future.
Pain in the lower back and or buttocks which radiates down one or both legs is called sciatica. Sciatica is not a condition, it is a symptom which can be caused by a long list of problems which cause pressure on the sciatic nerve, which extends from the lower spine and pelvis into the legs and all the way to the toes. Causes include inflammation, disc bulges, disc herniation, piriformis muscle syndrome or something less common, like tumors, bony growths or infection. Sciatica can be accompanied by…[read full article here]
Tags: back pain, back surgery, discs, healing, herniated disc, Lower Back Pain, nerves, neurological disease
Posted in Reposted from another source | 3 Comments »
Wednesday, August 25th, 2010
If you are one of the millions of Americans suffering from disc-related back pain it is important for you to understand the difference between the three major types of disc dysfunction and how to treat them.
A disc can suffer damage from an isolated incident such as a fall or a car accident, or it can gradually weaken with age. Either way, the result is most likely severe pain.
This is because discs are in such close proximity to a slew of delicate nerves. One slip, bulge, break or squeeze from the adjacent disc and you can experience pain that will stop you in your tracks, most likely in the form of sciatica pain (the nerve that goes through your buttocks and down your legs).
Here’s a summary of everything you ever needed to know about your discs but never knew you needed to ask:
- A healthy disc has a fibrous outer shell with a jelly-like, squishy substance in the middle called the nucleus. It is that center substance that gives the disc its shock absorbing traits and keeps the vertebrae from rubbing against each other.
- A bulging disc is when, most likely through an injury, the disc is over compacted (squished) between the two vertebrae it protects, forcing the nucleus to push against the fibrous shell with such force that it actually bulges the wall of the shell.
- A herniated disc is when the nucleus actually penetrates the fibrous wall spilling out into the inter-vertebra cavity. This is also called a ruptured disc.
- Disc degeneration is not necessarily caused by injury although an earlier injury may be the partial cause. Degeneration is a much slower onset and is due to age, poor health and poor posture. All these combined gradually wear the disc down. The disc loses its height and elasticity. As it loses height it begins to allow the vertebra to touch and rub. This in itself can be painful and will likely result in osteophyte formations (bone spurs on the outer rim of the vertebrae). Signs of early disc degeneration are referred to as disc thinning.
No matter your disc ailment, believe it or not there is something you can do. Discs can heal if given the opportunity. That opportunity is in the form of added space. All of the above ailments are caused by either a onetime violent squeeze on the disc or a life time of squeezing from gravitational effects. Either way the disc’s natural residing area was compromised forcing it to flatten. With no room to spare in the inter-vertebral disc space, the disc, or parts of it, is forced out. Or in the case of degeneration, cell by cell, over time the disc dissipates.
Give the disc back its original space and the disc will reassume its original shape…and heal! Well, most likely. Extremity of the injury or the advancement of the degeneration may be deterring factors…as will age and patient’s overall health.
How do you give a disc more space? Depends on who you ask. A spinal surgeon is likely to tell you it can be done through surgery (by cutting off the herniation or carving into the vertebra to create more room) or not at all (in which case they may recommend a spinal fusion of the two vertebrae in question thus totally eliminating the need for the disc).
A chiropractor will tell you otherwise—particularly a chiro who specializes in decompression therapy. Modern decompression therapy involves computer guided micro adjustments that can target the specific disc in question. The adjustments expand or stretch the two vertebrae thus creating more inter-vertebral disc space. The result is the disc distracts back into its place and begins the healing process. Full distraction is accomplished over the course of 15 to 30 sessions. These sessions may be augmented with a decompression brace.
Of course, it should go without saying that exercise and good health can make a huge difference in both preventing disc problems in the first place, and in helping them heal. This is especially true with degenerative disc disease. If your core muscles, (the ones responsible for lower spine support) are kept strong, natural weight-bearing forces are kept off the discs to begin with thereby sparing your discs the wear and tear that promotes degeneration.
Tags: back injuries, back surgery, healing, herniated disc, Lower Back Pain, pain, spinal decompression, spine
Posted in Articles by Michael Harris | 17 Comments »
Friday, July 16th, 2010
More than 80% of Americans will have back pain at some point in their life — whether from injury, overuse, or as a result of the degenerative process that accompanies aging. Chronic low back pain is frustrating, not only because of the severe pain but also because it can be difficult to effectively treat.
A particularly common cause of this pain is a herniated disk, also referred to as a “slipped disk.” The usual conventional medical solutions have been anti-inflammatory medications, muscle relaxants, injections, physical therapy, and surgery, all of which take an extended amount of time to take effect and which may not work for everyone. Recently, a novel type of treatment has been gaining favor. It is a non-surgical, non-invasive treatment for herniated disks called spinal decompression.
Your spine consists of bones, called vertebrae, each of which is stacked one upon the other. The vertebrae are separated from each other by rubbery discs that act as shock absorbers.
The disks are constructed like hard donuts filled with a jelly-like material in the center. Over time, the strong fibrous cartilage (the donut shell) can weaken, allowing the jelly-like material (nucleus pulposus) to bulge. If it’s a mild bulge, it is not painful. However if the bulge extends out far enough, it can irritate nerves and lead to pain. But more seriously, a disc can herniate- explode through the shell causing disc material to pour out and press on spinal nerves. This can cause excruciating pain and significant nerve damage.
One of the first devices used for spinal decompression was approved by the FDA in 1995. Because spinal decompression requires special expertise and expensive equipment, few physicians have offered this treatment — but the procedure is becoming more commonly available.
Here’s how it works…the patient lies on a comfortable table made specifically for decompression, comfortably strapped down with a pelvis and torso harness that looks like a girdle. “It is a high-tech traction device,” Dr. Wei explained. “It works by slowly and comfortably creating traction by pulling and holding for one minute. Then, intermittently, it releases. It is believed that this creates a negative pressure, or a vacuum within the disk, which then sucks back the bulging or herniated disk material which was displaced,” he goes on to explain. With less pressure inside the disk, and therefore less on the spinal nerves, pain often diminishes and might even go away – sometimes altogether. To maintain the benefit, however, numerous sessions may be required.
The theory is that this technique also allows nutrient and oxygen-rich fluid to travel to the area where there is less pressure, stimulating the healing process. Most patients either sleep or listen to a CD during the treatment, Dr. Wei added. Each session takes about 30 minutes and a typical treatment program may take between 20 to 30 sessions.
Critics contend that there are no long-range, well-designed studies looking at efficacy over time, but there has been some research on the treatment and the results are promising. In one study published in Neurological Research (2001), researchers reported that a spinal decompression therapy called VAX-D produced a success rate of 68.4%, compared with 0% for a placebo therapy in treatment of chronic low back pain. Another study demonstrated that a similar device called the Spina internal disc decompression unit or IDD had an 86% response rate. And… a recent study from a team of researchers at the University of Illinois and Rome found a 71% success rate for treatment of herniated disk and other causes of low back pain using spinal decompression, with “success” defined as a reduction in pain to 0 or 1 on a scale of 0 to 5.
Dr. Wei noted that some people get much benefit from spinal decompression while others do not. He emphasized that it is not an option for everyone. “It’s contraindicated for a person who has metal implants in the spine or who has had a spinal fusion,” he warned. And it is not recommended for patients who have spinal instability or who have severe untreated osteoporosis. It’s better for people with a single-disk herniation than those who have multiple herniations. Also, people who are morbidly obese and/or who smoke probably won’t find much relief from spinal decompression.
The procedure is thought to be safe, though there is not a lot of hard science data supporting its efficacy. If you do decide to seek out this form of treatment, it’s safest and best to do so with the recommendation of your rheumatologist, who can help you determine whether it might work in your situation.
Source: freelance blogging
Tags: discs, distraction, healing, herniated discs, Lower Back Pain, spinal decompression, traction
Posted in Reposted from another source | 2 Comments »
Tuesday, July 6th, 2010
Check out this new slide presentation called
I put together. It’s informative and entertaining. I call it “infotaining!”
Tags: back surgery, decompression table, discs, distraction, healing, herniated disc, Lower Back Pain, spinal brace, spinal decompression, spine
Posted in Articles by Michael Harris | No Comments »
Friday, June 4th, 2010
As a durable medical equipment (DME) provider you no doubt already know about the therapeutic benefits and the market demands for electrical therapy devices. You may even be aware of the various devices on the market and what purpose each serves. But do you know how each device works and why?
Understanding the science behind the specific functions of each type of electro therapy device will help you to choose the best solution for your patients, which will improve the end user’s experience, which will in turn lead to customer satisfaction, referrals and more sales.
So here we go, one by one:
TENS
T.E.N.S. is an abbreviation for Transcutaneous Electrical Nerve Stimulation. Transcutaneous (trans-kyoo-tey-nee-uhs) means “through, or by way of the skin.” TENS sends electrical impulses via electrodes or conductive garments to occupy the nerve pathways with a more comfortable sensation which overrides the pain. More specifically, according to Wikipedia, the high and low frequencies of TENS activate receptors in the spinal cord and the medulla. Further, high frequency TENS reduces excitation of central neurons that transmit nociceptive (pain) information, reduces the release of excitatory neurotransmitters and increases the release of inhibitory neurotransmitters (GABA) in the spinal cord, and activates the main “end” receptors centrally resulting in the blockage of pain. Low frequency TENS also releases serotonin and activates serotonin receptors in the spinal cord, releases GABA, and activates the main end receptors to reduce excitability of nociceptive neurons in the spinal cord.
EMS
E.M.S. is an abbreviation for Electrical Muscle Stimulation. Whereas TENS targets the nerves and is primarily for pain relief, EMS is more for aid in healing via direct muscle stimulation. It sends electric impulses to elicit muscle contraction and relaxation by mimicking signals normally coming from the central nervous system. Studies have shown EMS to be beneficial for the prevention of muscle edema and atrophy by increasing blood circulation. Positive results have also been shown for the adaptation (training) of skeletal muscle fibers, help in relaxing muscle spasms, maintaining or increasing range of motion or joint mobility, prevention of venous thrombosis (blood clots due to inactivity) immediately following surgery and for general muscle strengthening and toning.
IF
I.F. stands for Interferential. It crosses two slightly different, medium-frequency alternating currents to create a third, much stronger and deeper sub frequency current ideal for deep tissue stimulation. It has both healing and pain relief benefits. Its unique current is able to pass through skin, fat and bone—which are poor conductors of current flow—to target the fluid inside the cells of the damaged area. It changes the fluid in such a way that excess sodium ions are able to cross the cell’s plasma membrane and be actively transported out of the cell by activating the Na/K+ pump which then controls the concentration of sodium and potassium ion within the fluid that surrounds the cells. This occurrence forces displaced fluid to exit the swollen cell which eliminates edema. Inflammation is also reduced as the blood proteins that were trapped in the extra-cellular fluid are removed when the sodium imbalance is corrected and oxygen flow increases to the cell. Oxygen removes bradykin (a blood flow restrictor) and histamines (a chemical substance involved in edema and inflammation) thus speeding the cell’s recovery. Oxygen also removes prostaglandin—a natural pain substance of the body. To obtain IF frequency, electrode placement should be in an “X” pattern, with the point of intersection located directly over the affected tissue area.
HVPG
H.V.P.G. is an abbreviation for High-Voltage Pulsed Galvanic Current. Galvanic is another word for direct current (DC). Unlike low-voltage, alternating current (AC) that is found in TENS, EMS and IF, galvanic is best suited for major tissue trauma including bleeding and swelling. It quickly increases blood circulation while reducing edema. Like TENS, it stimulates the nerves, which aids pain relief. It also helps relax muscle spasms and is ideal for diabetic-induced neuropathy. It is unique in its application using a large dispersive pad which is placed in a neutral area on the body to ground the current while smaller “active” pads are placed over treatment area.
Tags: alternative pain management, DME, Durable Medical Equipment, Electric Muscle Stimulation, electro therapy, EMS, healing, High Voltage Pulsed Galvanic Current, HME, Home Medical Equipment, HVPC, IF, Interferential, nerves, TENS
Posted in Articles by Michael Harris | 6 Comments »
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