What is a Degenerated Disc?
Houston Area Chiropractor Comments: A report from your doctor that you have a “degenerated disc” can sound scary until you realize that lots of people have degenerated discs and it does not mean surgery. It is important to understand how the disc works in the low back, how it is injured, and how it can be safely treated, to get the best results with your condition.
So what is a disc? A disc is nothing more than cartilage similar to the cartilage in your knee. Cartilage covers bones and connects them allowing a joint to be formed. Cartilage and ligaments are what make motion possible but they also restrain movements that are too large. In the case of the spine, there are 24 individual bones called vertebrae. The disc is a cartilage that connects each of these vertebrae.
The disc can be injured just like a knee or an ankle can be sprained. The injury will stretch the ligaments and cartilage and cause them to tear. Whenever the body is injured, inflammation follows which serves to begin the healing process. Damaged tissue is consumed and scars are laid down.
In the case of the disc, the degeneration is usually at the back portion of the disc, because that is the location of the original injury. The disc also contains a more watery center called the nucleus. When injury to the disc occurs, the joint does not move properly. Lack of movement can be just as detrimental as too much movement. With this lack of motion there is less movement of water, in and out of the nucleus. The nucleus then dehydrates and the disc begins to collapse under the weight of gravity.
You were likely shown an x-ray of the degenerated disc and told that the space between the vertebrae is smaller because the disc material is degenerating. An MRI or CT scan can also show the degenerated disc. However, it does not mean that you need surgery.
The body is meant to handle degeneration of the disc and many people do quite well despite what an MRI or x-ray may show. Other patients have a bulging of the disc along with the loss of height. This bulging, called a herniation, can press on the nerve and cause back or leg pain (sciatica).
If the pressure within the disc can be lowered, then it is possible to create a vacuum that draws the bulging disc away from the nerve. Decompression treatment uses this effect as a treatment for back pain and leg pain caused by a degenerated disc.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Headache Triggers and Causes
Clear Lake Chiropractor Comments: We often think headaches are caused by different stressful triggers. It could be long days at work, or staring at a computer screen all night, or the aggravation of a long commute in a traffic jam. Some of us get headaches after drinking red wine, or eating certain foods. While these triggers make headaches develop and worsen, they are not the underlying cause of the problem. Some people get headaches after exercise or working in the garden but these activities cannot be considered the cause-they are aggravating factors.
What is often overlooked is: why are your defenses no match for these minor life stressors? Why do you get the headache and your friend who has the same experiences does not? Even in the case of the flu you have to consider the strength of the person’s immune system more so than the virus. Older adults who get the flu tend to have a worse problem than someone younger.
In the same way you have to look at symptoms such as head pain. Serious causes such as tumors or strokes have to be ruled out, but these types of problems are very rare. Headaches are common in society today. Have you seen the pain reliever aisle at the supermarket recently? I think over-the-counter medications are one of the new ‘food” groups.
But consider common causes for headaches. Is there a spinal problem that causes the neck to go forward creating tightness and muscle tension? What is the underlying weakness that needs to be corrected? We rarely look at the causes of things. Our healthcare system is more concerned with covering up bothersome symptoms with medications. A more long-term and natural solution is to seek out the underlying cause of a problem and get it fixed. In many cases it is the spinal injury that is producing weakness that causes the headache. Getting these problems corrected can get you back in the game and improve your quality of life. Imagine a future where exercise will no longer be a headache trigger, but a way to further strengthen your body.
Pain is an expression by the body of a problem. It is a signal to your brain that something is wrong and action needs to be taken. Rather than masking the symptoms, why not consider consulting a doctor of chiropractic to see if there is an underlying spinal cause?
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com. or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Whiplash and Muscle Weakness
Houston Chiropractor Comments: Whiplash involves the stretching of nerves, muscles, and ligaments. The forces are so great during even low speed collisions, that the muscles cannot resist the forces. The injury of whiplash produces inflammation to repair the damaged tissues. During this time, fast movements of your head and neck will result in pain, so most patients become overly cautious and move their neck very little. Unfortunately over time, because of the lack of muscle use, you become weak. This sets up the difficult combination of both damaged ligaments and weak muscles. Now there is little strength and support for the neck. This may make you very vulnerable to a future injury. Even slight movements can produces flare-ups when the muscles are too weak. The patient may feel their head to be heavy. Sometimes patients’ injuries can be so severe that dizziness develops due to the asymmetrical muscle and nerve activity. This is called cervicogenic vertigo. If you get dizzy when you move your head, then you may have this condition.
While it may seem intuitively obvious that addressing weak neck muscles are important to a full recovery, few patients will do them unless prompted and explained by their doctor. Specific muscles need to be strengthened in a way that does not cause further damage to the ligaments. If the muscles are tight in certain areas, then stretching or deep tissue massage, or trigger point therapy, can help to loosen areas and decrease pain.
But the most important thing you can do on a daily basis is to keep exercising. Studies have shown this to be effective in whiplash treatment when there is a mechanical neck disorder. A specific exercise program can be prescribed by a doctor of chiropractic. Special attention should be made to your posture and x-rays, and how specifically you were injured. Only in this way, will the treatment be effective and not risk further trauma.
Exercises such as rolling the head around the shoulders should be avoided since the neck is not a ball and socket joint like the shoulder. In some directions, the joints will have excessive laxity and the muscle exercises should be done in the neutral position versus at the end range or limit.
Because the ligaments are so badly damaged in whiplash, it’s important to maintain the supporting muscles (both strong and flexible), to keep the spine stable and pain free.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com. or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Designated Doctors In The Texas Worker’s Comp System
Clear Lake City Chiropractor Comments: Recently I was asked again to co-chair a conference in Dallas, Texas to help teach all types of doctors (medical, osteopathic and chiropractic) how to become Designated Doctors in the Texas Dept. of Insurance, Division of Worker’s Compensation. The course was co-sponsored by the American Academy of Disability Evaluating Physicians (AADEP) http://www.aadep.org/ and the Texas Council of Chiropractic Orthopedists (TCCO) http://www.texascouncilofchiropracticorthopedist.org . The Designated Doctor Training Seminar is designed to provide doctors and other health care providers with methods of determining maximum medical improvement (MMI) and of calculating the appropriate impairment rating using the AMA Guides, Fourth Edition, to follow the Texas Department of Insurance, Division of Workers’ Compensation (Division) approved core curriculum for doctors seeking full authorization to perform the new functions of the DD under HB7 and for health care providers performing ROM, sensory, and motor testing for those doctors, to fulfill the MMI and impairment rating requirements per the new Rules of the Division to introduce the use of ODG and MDA and to introduce the issues involved in determining causality.
The 2005 legislature made significant changes in the Texas workers’ compensation system with HB7. The TDI Division of Workers’ Compensation has new Rules that require the Designated Doctor to have completed new training in order to be and stay on the Designated Doctor lists. In addition, the Designated Doctor role was expanded in HB7 to include determining and resolving issues regarding MMI, the impairment rating, return to work, causality, and treatment.
While there is a substantial amount of material to cover over a 2 day period, the course went very well. Being able to be well versed in the AMA’s Guides to the Evaluation of Permanent Impairment, Fourth Edition takes time and a concerted effort. As always, the seminar was well received with many interesting questions and discussions. To all doctors who wish to be on the approved doctors list with TDI-DWC, study the AMA Guides and take the course and you will have a good understanding of how to help the injured workers in Texas.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com. or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Are Physical Therapists Like Chiropractors?
Clear Lake City Chiropractor Comments: This is a fairly common question that I get asked in my office. While the simple answer is no, physical therapists do have some similarities in treatment to chiropractors. First and foremost, each individual practitioner in each profession treats in his/her own unique way so the comments below are generalities.
Doctors of Chiropractic (DC’s) diagnose, treat and prevent mechanical disorders of the musculoskeletal system which affect the nervous system and therefore one’s general health.
Chiropractors aim to maintain, restore, maximize and develop one’s functional ability through specific spinal adjustments, physical modalities and rehabilitative or therapeutic exercises. Physical therapists use rehabilitation therapy and general mobilizations, usually under the orders of a doctor, to help restore a patient to their pre-accident or illness status. Chiropractors use a holistic approach to treatment that focuses not only on the physical, but the psychological, social and emotional well being of the individual through diagnosis, treatment and intervention. The chiropractor then will typically give the patient home based exercises and stretches to prevent a reoccurrence after care is completed.
Chiropractic doctor’s practice combines aspects from both alternative and mainstream medicine. Most chiropractors work with the patients other doctors to coordinate the necessary care of the patient based on the diagnosis that we determine thru our own specific examination. Depending on the specialty of the chiropractor, he/she may have a more nutritional, neurological, sports or in my case orthopedic type of practice.
Physical therapists (PT’s) on the other hand practice in different settings such as outpatient clinics, inpatient rehabilitation facilities, extended care facilities, skilled nursing facilities, hospices, education and research centers, occupational environments and fitness centers. Care is typically directed by the diagnosis and orders of a doctor, though some PT’s are currently allowed direct access.
Chiropractic doctors and physical therapists are both currently using evidence based research to expand their knowledge and further help our patients. Hopefully in the future DC’s, PT’s and other providers of physical medicine will work together for the greater good of our patients with all providers knowing the strengths and limitations of their care.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com. or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
A Natural Solution To Back Pain
Houston Back Doctor Comments: Getting your health back after a spine injury can be problematic if you do not approach it holistically. What is meant by holism? In general it is caring for the person as a whole vs. individual parts, and using techniques that assist different bodily systems. It can be treating the mind as well as the body. It is well known that depression is an important risk factor for back pain.
When dealing with a mechanical spinal problem, the doctor needs to consider the condition of the disks and ligaments, scar tissue, muscle strength, posture, movement, and alignment. A simple prescription, while effective at reducing pain, is not a good solution in the long run. For example, the scar in muscles that is formed after injury when NSAIDs (ibuprofen) are used is much weaker. The patient needs to also consider the side effects of stomach or gastrointestinal bleeding that can come with long-term use. Leaving joints problems to sit for years while masking the pain, will just make future rehabilitation more difficult and less effective.
Pain is a signal for your body to avoid certain movements and can be very protective. While muscle pain is expected during rehabilitation, if there is ligament or joint pain, then you’re pushing it too hard.
Exercise and stretching without attention to joint injuries, will also not work over time. It’s hard to maintain exercise when there is joint pain. Chiropractic care can keep the spine and other joints flexible while you also approach the other aspects of spine function with specific exercises and stretching.
Maintaining a healthy body weight is also part of any holistic approach. If you’re overweight, this adds tremendous stress to your spine. In some cases it may be important to first get your weight down, before commencing an exercise program, or weight training.
In addition to proper weight control you have to also consider sound nutrition in terms of vitamin and mineral consumption. Most patients need to do better at eating green leafy vegetables, fresh fruits and other nutritious foods. One has to avoid harmful fats, and chemicals/preservatives that are often present in highly processed foods. Supplements such as manganese and glucosamine chondroitin may help joint health. Although there are few studies on how effective these supplements help, the downside or side effects are quite minimal.
As a doctor of chiropractic, I can advise you on integrating a holistic approach with spinal joint care, strength training, flexibility, and sound nutrition.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com. or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Slipped Disc – What Is That Exactly?
Clear Lake City Chiropractor Comments: “I was digging a hole in my garden and hit a rock with the shovel. After clearing the dirt from around the rock, I bent over and reached into the hole. I couldn’t get a good grip on the rock and had to twist my body to get my arm under it. As I started to move the rock, I felt something ‘give out’ in my low back and felt immediate low back pain, but it wasn’t terrible. Like a fool, I gave it another try but this time, the pain in my back was really sharp when I twisted to reach under it. Then, it felt like a knife stabbing me when I tried to stand up. Since then, I can’t stand up straight and pain is shooting down my left leg.”
The intervertebral disc is like a shock-absorber located between each vertebra in our spine extending from the tail one to the upper neck. When healthy, your discs truly do function as shock absorbers. There are two parts to the disc – the inner part (called the nucleus) which is the liquid-like center and the outer part (the annulus), which is tough, laminated and rubber-like whose job is to hold the nucleus in the center of the disk. The annulus has concentric rings which look similar to the rings of an oak tree trunk and the strength of these laminated rings is due to the fibers crisscrossing, creating a self-sealing, secure border for the nucleus center. In spite of this great anatomical structure, our discs degenerate and can crack or tear allowing the more liquid-like nucleus to leak out of the annulus creating the classic “slipped disc” (technically referred to as a herniated or ruptured disc). When the herniated disc presses into the nerve that goes down the leg, pain is felt along its course and can radiate all the way to the foot. There are five vertebrae and disks with a pair of nerves that go into each leg and depending which disc ruptures, pain will follow a different course down the leg, which is why we ask you if you feel the pain more in the back or in the front of the leg. When the disc tears prior to both disc herniation and leg pain, low back pain occurs because the nerve fibers that are normally only located in the outer third of the disc grow into the central portion of the disc, making it generate more pain.
So now for the important question, “…what can I do for it?” When you visit our office, we will ask you about how you injured your back. Often, the cause of a herniated disc can be the accumulation of multiple events over time. It certainly can happen after one major event, like our example of lifting a rock out of a hole, but that is usually the “straw that breaks the camel’s back” and not the sole cause. Many researchers have reported it is rare for a healthy disc to herniate. Rather, disk degeneration with tears already present sets up the situation where a bend plus a twist, “…finishes the job.” The orthopedic and neurological examination will usually clearly identify the level of herniation. Chiropractic treatment often includes traction types of techniques, some form of spinal manipulation or mobilization, extension exercises, physical therapy modalities like electric stimulation, low level laser, or ultrasound, and ice therapy. Core / trunk strengthening and posture management are also commonly applied and, proper bending/lifting/pulling/pushing techniques are taught. As long as you have not lost bowel or bladder control, you are better off seeing if conservative care can relieve your pain before looking at surgical options.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Headaches from Forward Head Posture
Clear Lake Area Chiropractor Comments: John Q. Public has been trained to believe that headache is a problem in the head and headache treatment and relief comes in a bottle.
While it’s true that pain medications can bring relief for a pounding headache, they rarely get at the actual cause of the problem. You have to also consider the long-term problems that can occur when you take these types of pills for years or even decades. Some long-term complications include stomach bleeding, liver and kidney problems. Plus there is the problem of not actually correcting anything and instead masking the symptoms. Pain pills are not one of the five food groups.
For many patients, the problem is not one in the head, but may have a spinal cause. Let me explain how this works…. Normally, the neck is balanced over the shoulders in an upright manner. Some people, however, they develop forward head posture where the head protrudes out away from the shoulder girdle-it looks like the bad posture your mother told to avoid. It is the slouching or turtle problem- your neck should now come out of the front of your chest. This type of posture is often seen in computer operators and others who bend over to do their work. Whiplash injuries can also create this forward head posture by disrupting the natural curve of the neck.
Over time the muscles at the back of the neck become tight and start to tug and pull at the base of the skull. This can cause head pain. Sometimes it’s a dull ache with a burning type of pain full of tension. In other patients, the headache may be more throbbing and to one side. The important thing is to address the actual cause of the problem. This is where chiropractic care is key. By correcting the forward head posture, the head is more balanced over the shoulders. Many patients will report less tension in their shoulder and upper back muscles which were really working over time.
At Beecher Chiropractic Clinic, I try to get at the cause of headaches. Usually it’s not a lack of pills in the diet, and in most patients simply correcting their posture can bring relief. Only a comprehensive examination of the full spine will determine if the cause of your headaches is spinal, and whether chiropractic will be the best option for you to regain your health.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
The Truth About Neck Pain and Chiropractic Treatment
Neck pain is a very common complaint that chiropractic has been found to be very effective in treating. There are many causes of neck pain including posture related (such as a forward head carriage) and repetitive strain (such as long static holding of awkward positions). These two causes are very similar as the head weighs approximately 15 pounds and when held in a forward translated position for a lengthy time frame, the muscles fatigue and begin to ache. This is similar to holding a baby in your arms for a long time frame. We soon find ourselves moving the baby to the other arm or against our chest due to the gradual increasing strain placed our upper quarter muscles. Hence, we must similarly change the forward head position when we are working at the computer, listening or talking (especially if the person is not directly in front of you), reading a book, cooking, and so forth.
Another cause of neck pain is trauma. This could be from a car accident, a slip-and-fall injury, sports injury, and more. These injuries are highly variable as no two injuries or accidents are the same and, there are a wide variety of neck sizes in both length and girth and hence, the same trauma may hardly result in an injury in one person and greatly injure a smaller, more petite person. Your doctor of chiropractic will ask you about the “mechanism of injury” as that can give us clues about which tissues are injured. For example, in a motor vehicle collision, if the impact occurs from the side verses the rear end of the car, the tissues in the neck are stretched differently and the management/treatment may vary accordingly.
Other causes of neck pain include a “slipped” or herniated disk. A herniated disk is like a jelly donut where the jelly leaks out and presses against a nerve that travels down the arm. Symptoms often include pain, numb, tingling, burning, weakness, or combinations of these sensations down the course of the nerve. When this occurs, the person is usually quite specific about where the pain is traveling such as, “…it goes down my arm to my ring and little finger.”
Another cause can be related to natural aging process involving the “wearing out” process of the disk, joints, and muscle/ligament attachments. The term, “osteoarthritis” is commonly associated with these findings and is often blamed for neck pain, but this is controversial. First, osteoarthritis (OA) takes years to develop and many people have a significant amount of OA but literally no pain or symptoms while others with only a little x-ray evidence of OA present with an abundance of pain.
So, how do chiropractors manage all of these causes of neck pain? A thorough history, examination, and locating the positions of pain production verses pain relief are “key” to the successful management of patients with neck pain. For one patient, traction/stretching types of manual adjustment techniques work best while for the next, this may not be tolerated at all, which is why we “pre-position” the patient prior to administering an adjustment.
Other treatment considerations may include exercise instruction, physical therapy modalities (electric stimulation, ultrasound, etc.), the use of ice/heat or changes to your work station. If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.
We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and we look forward in serving you and your family presently and in the future.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
“Conservative” Treatment for Neck and Back Pain – A Chiropractic Perspective- Part 4 – Exercise
As a practicing chiropractic orthopedist, I am regularly asked what the difference between me and an orthopedic surgeon is. The simple answer is that I look for a conservative treatment option while the surgeon looks for a surgical treatment option. The term “conservative treatment” is used to describe any treatment option that does not involve surgery. This may be as simple as reassuring you that it is not a serious problem, and recommending that you just watch and wait. However, people with recurring back or neck problems should consider preventive measures. This includes learning how to protect your back and neck and exercising to strengthen your back and neck. Conservative treatment approaches include the use of:
Exercise
Exercise is vital to recovery and to maintaining a healthy spine. Consider it part of long-term health management and risk reduction. Regular exercise is the most basic way to combat back and neck problems. However, if you already have an injury or damage to your spine, talk to your doctor of chiropractic before you start an exercise routine, to make sure the exercises you choose are effective and safe for your particular case.
Why exercise? Scientific studies show that people who exercise regularly have far fewer problems with their spine. Exercise helps strengthen the muscles in your back that connect to your spine. Exercise can reduce your risk of falls and injuries. It can also strengthen your abdomen (your belly), arms, and legs, which reduces back strain. Stretching reduces risk of muscle spasms. In addition, weight bearing exercises help prevent loss of bone mass caused by osteoporosis, reducing your risk of fractures. Aerobic exercise, the type that gets your heart pumping and pulse rate up, has been shown to be a good pain reliever as well. The natural chemicals of the body that combat pain — called endorphins — are released during exercise and actually reduce your pain.
Exercises will help maximize your physical abilities including:
- Flexibility — exercises that increase flexibility help to reduce pain and make it easier to keep your spine in a healthy position. Flexibility exercises are helpful for establishing safe movement. Tight muscles cause imbalance in spinal movements, which can make it easier to injure your spine. Gentle stretching increases flexibility, eases pain, and reduces the chance of re-injury.
- Stabilization — “core” muscles are the muscles located closer to the center of your body and act as stabilizers. These key muscles are trained to help you position your spine safely and to hold your spine steady as you perform routine activities. These muscles form a stable platform, which allows you to move your arms and legs with precision. If the stabilizers are not doing their job, your spine may be overstressed by daily activities.
- Coordination — strong muscles need to be coordinated. As the strength of the spinal muscles increases, it becomes important to train these muscles to work together. Learning any physical activity takes practice. Muscles must be trained so that the physical activity is under control. Spine muscles that are trained to control safe movement help reduce the chance of re-injury.
- Conditioning — improving your overall fitness level will help you recover from spine problems. Fitness conditioning involves safe forms of aerobic exercise. The term aerobic means “with oxygen.” When using oxygen as they work, muscles are better able to move continuously, rather than in spurts. Examples of aerobic exercise include:
- Swimming laps
- Walking on a treadmill
- Using a cross country ski machine
- Using a stair stepper
If you decide you want some extra conditioning, always check with your doctor of chiropractic before beginning a program on your own. It is important that you choose an aerobic activity you enjoy. This will help you stick with it, so you reap the long-term benefits that come with a well-rounded exercise program.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
