Pinched Nerves - How to Determine If You Have One

spinal stenosis

Sciatica, everyone has probably heard of it but do you know what it really is? Most might say that it's a pain you get in your leg but do you know where it comes from? What confuses a lot of people and even doctors is that sciatica is not a diagnosis, I repeat that sciatica is NOT a diagnosis, in fact there are 10 reasons at least as to why you can get sciatica, so if you go to your doctor and they give you that diagnosis and hand you a pill, get them to think again. Sciatica by definition is pain experienced in the distribution of the sciatic nerve, the sciatic nerve consists of 5 nerves exiting your lower lumber (back) area and exiting your sacrum (pelvic area), these nerves join as one and is called the sciatic nerve. This runs down the back of your leg to your ankle and sometimes affects the sole of your foot. The sciatic nerve feels sensations and allows you to move the muscles in your leg. Sciatica is a symptom rather then the cause.

Here is a list of the 10 causes of sciatica pain:

1. Sacroiliitis - an inflammatory process within the sacroiliac joint (pelvis) can be due to infection, sprain of the joint (misalignment), or an arthritic condition.


2. Iliolumber Syndrome - inflammation or sprain of the iliolumber ligament, a big ligament that runs across the top of your pelvis used for bending and twisting.


3. Quadratus Lumborum Syndrome - heard of the QL muscle, this is a muscle in your lower back; it can get tight and painful and refer pain down your leg.


4. Trochanteric Bursitis - the bursa at the upper side of your leg is inflamed.


5. Ischialgluteal Bursitis - inflammation of the bursa in your buttock, when you sit it is aggravated.


6. Posterior Facet Syndrome - facet joints are a part of your vertebra, they can be misaligned or degenerated.


7. Meralgia Paraesthetica - a nerve entrapped that passes through your hip flexor muscle within your pelvic area, can be due to pregnancy, tumours and infection.


8. Disc Herniation - also known as a prolapsed disc or bulging disc these days, when you injure a disc in your lower back due to strain or misalignment.


9. Lateral Canal Stenosis Syndrome - degeneration or arthritis where the nerve passes through the spine causing symptoms.


10. Myofascial Syndromes - when muscles are tight around the lower back and pelvic area they can cause referring pain.

You can have one of those conditions occurring or you can have 3-4 at once occurring but until you get a proper diagnosis of your condition and the primary cause discovered you will not get better. Sciatica occurs when the function of the nerve is affected, weakness, numbness or pins and needles can be present in the legs with or without lower back pain. Certain treatments are affective with sciatica, such as chiropractic, acupuncture, and massage. What is also important is giving your body the nutrients it needs for tight muscles, inflammation and arthritic conditions, those include:

- Calcium and magnesium, a good mineral supplement with calcium and magnesium restores the balance back in your muscles and relaxes them, also prevents cramping.
- Fatty acids, a good fat supplement such as flax seed oil or a fish oil supplement is good for your joints and bones helping arthritis and joint problems
- Glucoseamine has been shown to help with arthritic conditions I also use it in my clinic to get stability within the ligaments and joints.

Lifestyle changes are necessary to help the condition and to prevent recurrence, such as stretching and exercises. First, get the problem professionally diagnosed, take supplements to support the condition and make changes in your lifestyle.

Lumbar Spine MRI

spinal stenosis

Lumbar spine MRI is a highly recommended scanning method for the detection of various lumbar or lower back spinal disorders. This technique employs highly sophisticated technology to produce clear and accurate images of the internal structures.

Ideal to Diagnose Lumbar Disc Abnormalities

Lumbar spine MRI is a procedure that can be recommended for all kinds of patients - the elderly, handicapped, obese and even pediatric patients. Degenerative disc problems such as sprain, strain, herniated disc or other lumbar spine problems can be detected by means of a lumbar spine MRI. These days, this method is may be sought after for disorders such as lumbar stenosis. This is a medical condition that ends up in the narrowing of the spine. Spinal arthritis, primarily seen among the aged people, is another lumbar spinal disorder that can be diagnosed through L-spine MRI.

Hi-Tech Scanning Method more Popular with Patients and Physicians

Latest technological advancements have brought forth a newer development in the area of imaging - the open AIRIS II system. Within minimum time possible, you can accomplish the entire scanning process done. The operation is completely quiet and for claustrophobic patients, the large open air gantry can potentially remove fears about the narrow tubes of the usual MRI machines. This scanning process covers large spinal areas and helps to detect the changes within the discs. Physicians can carry out the diagnosis process easily as this procedure gives detailed images of even the soft tissues.

Precautions

Lumbar spine MRI scanning cannot be performed on people having cardiac pacemakers or other metallic implants in the body. Before going for the scanning procedure, patients are advised to remove metallic objects such as ornaments, removable dental work, hairpins, and metal zippers. Otherwise, the strong magnetic field produced may interfere with these metallic objects while the scanning process is going on.

For any physical disorder, it is advisable to diagnose and treat before it becomes worse. Through lumbar spine MRI, detection and treatment of specific lower back spinal disorders is possible.

Foot Drop And Sciatica - Nerve Damage And Walking Better, Special Report

spinal stenosis

Do you suffer from foot drop?

Do you want to walk better again?

1.) Introduction

Foot drop can be a permanent condition. No, this is not always the case... Recovery depends on the potential for healing. Sometimes people have the opportunity to continue healing and others do not. If you suffer from foot drop, then we can feel your pain. That is why we are writing this free article to help. This free health information can help you walk better again. Read on for more information.

2.) Sciatica

What is sciatica?

Sciatica can refer to abnormal sensations in the leg. This can be discomfort, weakness, numbness or even tingling. Sciatica can be caused by injury or compression of the sciatic nerve. It is important to note that sciatica is a symptom of a greater medical problem, it is not its own medical condition. The sciatic nerve originates in the spine and runs down the back of each leg. It is a very important nerve because it controls muscles in the back of your knee and lower leg. It also provides sensation to the back of your thigh and lower leg, down to the sole of your foot. In some cases, the pain that is associated with sciatica is so severe that a person will be unable to move.

3.) Common causes of sciatica include:

•Slipped disc

•Degenerative disk disease (DDD)

•Spinal stenosis (narrowing of the spinal canal)

•A pelvic injury (such as a fracture)

•Tumors

Sciatica can cause weakness in the movement of your foot. Often times drop foot is caused by injury to the peroneal nerve. It is important to note that the peroneal nerve is a division of the sciatic nerve. Therefore, if you have sciatica, you can also have foot drop symptoms.

4.) Walking Better Again

If you have foot drop and sciatica, then you will want to talk to your local, licensed orthotist. These individuals are brace specialists. They can make you a special brace called an AFO that is low profile in design and can help support your foot and ankle, if you have foot drop. These braces are usually made of plastic and can be a great aid to you if you suffer from foot drop for any reason. There is also a device that is FDA approved, called the WalkAide. It can help many people with foot drop as well.

Note: For medical advice on bracing or the WalkAide, it is important to talk with your local, licensed orthotist. This is health information.

Frequently Asked Questions About Spinal Stenosis

spinal stenosis

Do your legs or back feel better when you are leaning over a shopping cart when walking? If so, you might have Spinal Stenosis.

What is Spinal Stenosis?

Stenosis is a narrowing of areas in the lumbar (back) called lumbar stenosis or cervical stenosis (neck) that causes pressure on the spinal cord or one of more of the spinal nerves.

Who Gets Spinal Stenosis?

It is most common in men and women over 50 years of age. However, it may occur in younger people who are born with a narrowing of the spinal canal or who suffer an injury to the spine.

What Causes Lumbar or Cervical Stenosis?

Narrowing of the spinal canal leads to stenosis. It can result from congenital conditions or be acquired.

When people are born with a small spinal canal, it is a condition called congenital stenosis. Sometimes people have a curvature of the spine known as scoliosis, which can put pressure on nerves. Either of these conditions can lead to stenosis of the spine.

Acquired conditions can also cause stenosis. The most common cause of spinal stenosis results from a degenerative process that is part of aging. As you age, your spinal structures change. Ligaments may thicken; bones and joints may also enlarge due to wear and tear over time, and spinal stenosis can occur.

When one vertebrae slips forward on the one below it, a condition called Spondylolisthesis results. This slippage can also result in stenosis of the spine.

Spinal Stenosis can also occur due to tumors in the spine.

Any of these processes can cause narrowing of the spinal canal resulting in stenosis.

What are the Symptoms of Stenosis?

Narrowing of the spinal canal can cause a number of symptoms. People often experience numbness, weakness, tingling, cramping, or pain in the back, buttocks, thighs, and calves or in the neck, shoulders or arms.

Symptoms from spinal stenosis are more likely to be present or get worse when you stand or walk upright. However, symptoms often disappear or lessen with sitting or flexing the lower back. You may notice that you feel better when you walk with a grocery cart; this is because the back is placed in a flexed position.

With more severe stenosis, people may have problems with bowel and bladder function and weakness of the foot.

Cauda equina syndrome is a very severe and rare condition. It is caused by severe narrowing of the spinal canal that compresses the nerve roots below the level of the spinal cord. With cauda equina syndrome, symptoms can include loss of control of the bowel and bladder functions and lower extremity weakness with loss of feeling in one or both legs. One may also experience numbness in the groin or area of contact if sitting on a saddle. Cauda equine syndrome is considered a surgical emergency.

How is Spinal Stenosis Diagnosed?

The diagnosis begins with a thorough medical history, and physical examination. Diagnostic testing including, x-rays, MRI and/or CT Scans can be done to identify the source of pain.

What are Treatment Options for Spinal Stenosis?

Non-Surgical options are usually prescribed for treatment of stenosis unless the person has severe or progressive nerve damage.

Medications such as non-steroidal anti-inflammatory drugs like Ibuprofen and Naproxen can be prescribed to reduce pain and inflammation.

Epidural steroid Injections can be prescribed for pain relief. These injections are also a very good option for those who are unable to undergo surgery due to other medical problems.

Physical therapy can be a viable option to help to maintain the motion of the spine, strengthen abdominal and back muscles. Aquatic or water therapy is also an excellent option for persons with spinal stenosis.

When Should Surgery Be Done?

Nonsurgical treatment is done initially to determine if it helps reduce the symptoms from spinal stenosis. However, surgery might be performed immediately when a patient has leg weakness and impaired bowel or bladder function. The effectiveness of nonsurgical treatments and the severity of the patient's pain will all play a part in determining whether or not to have spinal surgery.

The goal of surgery is to relieve pressure on the spinal cord or nerves and to restore and maintain alignment and strength of the spine.

Consult your physician if you have symptoms of Spinal Stenosis.

穢2012 Winifred D.Bragg, MD. All Rights Reserved.

Back Surgery and Its Different Types

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Are you suffering from severe back pain that hasn't relieved through non-surgical treatments such as physical therapy, medications and steroid injections? If other remedies have failed to provide relief from long-term chronic backache then surgery may be the only option for you.

However, the surgery cannot be considered as an initial treatment for back pain. In most cases, backache tends to be temporary and can be managed by using non-surgical approaches and self-care. Exercise, physical therapy, and acupuncture are usually successful in treating back and neck pain.

Unfortunately, there is no option left for chronic pain sufferers other than going under the knife.

Back surgery is usually recommended to only a small percentage of cases. In particular, surgical treatment for back may be recommended if a person has severe back pain caused by wear and tear; or pain that continues to worsen despite other treatments; has back instability from injury; has acute arm or leg pain caused by nerve compression in the spine; or has nerve problems.

Back Surgery Options

There are several different types of back surgery. The type you choose depends on your back condition.

Discectomy: Also called open discectomy it is the most common surgical treatment for a ruptured or herniated disc in the spinal canal causing the pressure on the nerve. In this type of procedure, a surgeon removes one or more of your affected discs through a small cut over the center of your back. This relieves the pressure on the nerves.

Spinal Disc Replacement: This procedure is relatively new and is still not widely used by the surgeons. Spinal disc replacement aims to restore disc height and relieve painful movement between two vertebrae. While performing a spine replacement, your surgeon will remove the degenerated or injured discs and replace them with artificial ones.

Laminectomy: This procedure involves the removal of parts of the bone, bone spurs, or ligaments overlying the spinal canal. In a laminectomy, a surgeon cut opens the back and removes or disrupts the lamina, a plate along the vertebra that covers the spinal canal, in order to enlarge the spinal canal to allow more space for the nerves to pass. This relieves nerve pressure caused by spinal stenosis.

Foraminotomy: While performing this operation, your surgeon will carry out a keyhole procedure to widen your foramina- the bony holes through which nerve roots exit the spine. This expanded space reduces pressure on your spinal nerves caused by the inter-vertebral foramen, thereby relieving pain.

Vertebroplasty: During this procedure, your surgeon will first make a small cut on your back. Then, using X-rays as guidance, he/she will slowly inject cement-like mixture into your compressed vertebrae to stabilize the spine and relieve pain.

In a similar surgical procedure, called kyphoplasty, a balloon-like device is inserted in an attempt to widen the compressed vertebrae before injecting the bone cement.

Spinal Fusion: Also known as spondylodesis, spinal fusion is the most common surgery for chronic back pain. This operation is aimed at treating broken spinal bones (vertebrae) and increasing the strength of the spine by fusing two or more vertebrae together.

In a spinal fusion, a surgeon joins two or more spinal bones together using metal hardware, including a bone graft, and special metal scaffolding made of rods, screws or plates.

A spinal fusion is typically done to treat spondylolisthesis (unstable spine), or spinal weakness or instability.

Spinal Decompression Therapy For Back Pain Cure

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Spinal Cord is the most important part of our musculoskeletal system. An unhealthy spine can result in a wide range of disorders and pain in the back. One of the most widely used medical treatments for its treatment is Spinal Decompression. It is practiced in two forms: Surgical and Non-Surgical.

The former form of treatment is pure medical and requires surgery of the back area for treatment and cure of back problems, whereas, the latter is an alternative form of back treatment. Non-surgical method is preferably a more simple way of treatment of spine-related problems. It involves the use of therapeutic and mechanical treatment of the problem.

In the recent past, non surgical form of treatment has gained importance in the cure of musculoskeletal disorders. It is a preferred form of alternative treatment for the cure of lower back pain, Sciatica, Herniated and/or bulging discs.

Non-surgical spinal decompression is a therapeutic treatment and is offered by many Chiropractic centers and spine care clinics across the world. It is also vital in the treatment of chronic back pains, Spinal Stenosis and Scoliosis.

There are many spine care centers across the world offering cure and treatment of musculoskeletal disorders and relief from pain through Chiropractic treatment and alternative methods of back pain relief. They prefer non-surgical forms of treatment using Decompression therapy beds for mechanical treatment of lower back.

Such treatments are also vital for maintenance of proper health and fitness of a person. Various chiropractic methods are useful in keeping backbone trouble and other chronic musculoskeletal issues in check. The form of treatment discussed in the preceding paragraphs employs the traditional chiropractic methods coupled with modern and sophisticated technology for therapeutic cure of back pain. In cases where medications, physical exercises or activities prove to be ineffective, surgery was considered the only solution left with the patients. But not anymore!

Will Disc Replacement Surgery Help in the Treatment of Cervical Radiculopathy?

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Disc replacement is a surgical procedure that is an option for treating cervical radiculopathy - a herniated disc in the neck area. The procedure has seen more success on the cervical region, but is also prescribed for the lumbar, or lower back area. Approved by the Food and Drug Administration (FDA) in 2004 for the lumbar region and in 2007 for the cervical region, disc replacement was developed as an alternative to spinal fusion, in which the vertebrae are fused together rather than replacing the natural cushion, or disc.

A herniated disc occurs when a disc becomes brittle from age and dehydration and the center or core of the disc pushes to the outer edges and flattens out, providing less padding between the bones. When a disc in either area of the spine is herniated, it comes into contact with nerve fibers stemming off from the spinal cord and causes pain, either in the back area or the arms or legs - depending on where the nerves are connected to the rest of the body.

Who Needs Disc Replacement Surgery

A herniated, ruptured or slipped disc requiring disc replacement can be recommended by a physician for three reasons, an injury to the back, degeneration caused by an aging body, or idiopathic reasons in which genetic, congenital or environmental condition predisposes a patient to severe back pain needing surgery. Artificial disc replacement surgery is indicated for the cervical region when a patient suffers from severe degenerative disc disease, in which the individual cannot tolerate the movement of the back.

When a patient's body does not respond to other forms of pain therapy including physical therapy, massage, specialized pain therapies including injections, blocks, radiofrequency electrical nerve stimulation, prescription medications and other treatments, surgery is an option. A disc replacement removes a disc and replaces it with a new one while preserving the motion of the spine at the level that it's used. Not all patients with a herniated disc need disc replacement. When a disc causes so much pain that the individual is not able to carry out work and leisure activities, even after trying several types of pain management techniques, this surgery may be indicated. Patients are carefully selected for disc replacement and not everyone is a candidate.

The Procedure of Disc Replacement

Several artificial discs have been developed since the FDA approval. One such disc is the LINK SB Charite III prosthesis developed out of Germany. The disc itself has two metallic plates have teeth in them to connect to the bone, and a rubber core made of polyurethane is between them. The core has a ring of metal around it so that it shows up in x-rays. During a disc replacement, the ruptured disc is removed by scraping it off of the bone. The vertebrae are held open by specialized tools to keep them separated, and the artificial disc is implanted. A potential benefit of replacing a disc is to preserve not only the movement at the site of the new disc, but to take pressure off of the lower portions that are adjacent to the damaged disc.

Please note that if you are feeling back pain and are told that you have a herniated disc, this does not necessarily mean that you need surgery. Follow doctor's instructions for healthy rehabilitation and have a good attitude about recovery and you may not need disc replacement.

The Right Orthopedic Back Brace For You

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If fashion is all about appeal and appearances, the orthopedic back brace on the other hand is for support and pain relief. Bad habits die hard. It is the same way with body posture. A lot of people may not see the bad impact because slouching is comfortable. It may vary from person to person, but it all boils down to back pains, weak muscles joints, a C or S-shape back and many more. Now what if all those worries can be addressed? It is a possibility by wearing orthopedic back braces.. They are posture back braces that are often used by individuals who are already experiencing severe discomforts. Yet, even this body supporter come in an array of functionality.

A Torn chanter belt is a type of orthopedic back brace that is used by people with pelvic fractures. Pelvic fractures result from intense injuries that use either low or extreme amounts of energy. Problems such as head, chest, and abdominal injuries associate with pelvic fractures. Fracture in the spinal column also come together with a pelvic fracture. The trochanter belt is buckled in front and worn like a regular belt around the waist. It can be worn on a regular basis in order to hasten healing on the fracture. If recommended by the physician one must even wear it even in their sleep. This belt will not be recognized like a body supporter because of its ordinary features.

Medical corsets are worn on the abdomen or stomach area where the spine needs to be aligned. It has metal stays which are bendable in order to adjust to the support specifically needed by the back. It has separate elastic and overlapping body bands which may vary in length depending on the physician's specifications. The elastic bands encircle the wearer's waist which has longitudinal panel edges. In adjusting medical corsets, they come together with a fastener in order to accommodate the size or shape of the person wearing it, though it is uncomfortable at the start but as time passes by it will be just a regular undergarment that you will get used to.

Lastly, hypertension braces are used for people experiencing spinal fractures or those who just came out from a spinal surgery. It has cruciform shape having four pads which includes sternal, pubic, and two side pads. This orthopedic back brace prevents excessive movement which helps the spine to recover.

Knowing the right orthopedic back brace will help in the instant recovery of the patient. Regular consultation with the physician and following their prescriptions should also be kept in mind. The type of orthopedic back brace will only act as a support but the doctor will tell you what should be done.

Surgery of Conservative Pain Management Treatment for Symptomatic Lumbar Spinal Stenosis?

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In America, the most common reason for spine surgery in individuals over the age of 65 is lumbar spinal stenosis. What is it? Spinal stenosis represents a narrowing of the area available for the dural sac (spinal cord remnant) and the nerve roots emanating from it. Typically, there is plenty of room for both the dural sac along with the bilateral nerve roots coming out at every level of the spine. There is actually enough room for these to be bathed in cerebrospinal fluid and be comfortable.

As people age, arthritis sets in. Along with that arthritis in the spine, there can be an overgrowth of both the bone along with the soft tissues of the spine due to this. This overgrowth may start to impinge on the amount of space available for the dural sac and the nerve roots. If severe enough, pinching can occur, and patients may start to experience, back, buttock, and/or leg pain. This becomes a mechanical problem. Fortunately, most patients who have spinal stenosis do not have debilitating painful symptoms as a result.

Symptoms may result when the overgrowth causes reduced blood flow or nerve root excitement from inflammation. This can be in numerous anatomic areas. Symptoms are variable between patients depending on the area of pinching and the particular individual's reaction. Regardless of all this, it is the most common reason for surgery in people over the age of 65.

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

A recent review in Spine looked at over 10 high quality studies to determine the effectiveness of decompressive surgery for stenosis. The results overall showed that in patients who had failed conservative treatment for 3 to 6 months, surgery improved function, pain, and quality of life more than conservative measures. It did not, however, statistically improve walking ability.

These benefits were noted to decrease over time but not go away completely, even up to 10 years. Over ten year results were not established. These results were in place regardless of advancing age, obesity, lung issues, several levels, or other medical problems. Concomitant medical problems do increase the risks of complications, so they should be weighed against the benefits in deciding whether to have the surgery or not.

The results were similar among all the studies evaluated whether or not the patients had spondylolisthesis, which is one vertebra having slipped on another. The overriding factor is that it is a quality of life decision, and considerable conservative treatment should be attempted first.

The risks of surgery cannot be ignored in the patient population over the age of 65. At that point of failed conservative treatment, however, multiple studies now support the decision for a simple decompression procedure (laminectomy).

Back Ache: Holistic Treatments for Sciatic Nerve Pain

spinal stenosis

Sciatica is really an affliction where the sciatic nerve is undoubtedly affected and causes a real back ache as well as pains in the buttocks, legs and feet. The sources of sciatica number among piriformis syndrome, herniated disc, lumbar injury or possibly spinal stenosis. Even though there are several diverse approaches regarding treatment methods ones own doctor may perhaps recommend for sciatica, a lot of people opt for holistic treatment remedies in place of pharmaceuticals or over-the-counter medicines or even complex open back surgery.

The mixture of celery and potato juice provides superb respite from sciatica discomfort. However, the patient must drink no less than 10 ounces two-times every single day for it to be successful. This combination does not taste very good, so many people mix it with carrot and beetroot juice. Carrot and beetroot juice improve the flavor and are extremely good for you as well.

Celery or elderberry tea can also be beneficial for sciatica pain. Elderberries may be utilized in any tea as well as being a regular beverage alone. Elderberries include characteristics that stimulate and also relax the muscles as well as addressing some of the other symptoms characteristic of sciatica.

Garlic oil is actually beneficial for helping to deliver relief from various aches and pains. Additionally, it helps strengthen circulation within your body. A number of individuals acquire garlic nutritional supplements and other people choose to eat raw garlic cloves. One reason garlic is actually beneficial for sciatica pain will be the anti-oxidant properties it has. To get the most benefits from garlic in treating sciatica symptoms, it is vital to supplement your diet with vitamin B1 and other B vitamins while using garlic. A number of food products that give you natural sources of B1 are found in meats like liver, beef and pork, green vegetables like spinach, and a number of legumes like navy beans and soy beans. Whole grain cereals and breads are also good sources of B 1 and other B vitamins.

Some people rely on garlic milk as an outstanding home therapy for sciatica. Garlic milk is simply a mixture of a half a cup of milk infused with two crushed garlic cloves stirred in. Most claim that drinking this 2 times each day will provide effects in a 1 week. Not anyone can readily take garlic. For those who have bleeding ulcers or additional issues or take blood thinners, it isn't suggested that you take garlic.

Drinking water can also be fantastic as a holistic remedy for sciatica for the reason that it helps keep good circulation going within your body, which will reduce the discomfort.

Other essential keys to alternative sciatica treatment are a great diet with a lot of physical exercise. It is significant to maintain good overall well-being when using natural remedies for sciatica. Unless your sciatica is caused by a break in the spine, a herniated disk, spinal stenosis or tumor your best choice to treat your back ache may just be the natural approach.

For Chiropractors - Whiplash and Personal Injury Analysis - Penning's Method

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This analysis method is by far one of the most useful for determination of loss of range of motion that I have found. This is a great way to show pre/post x-ray changes in a quantifiable way, and to show how the care you provided helped your patients by improving ligament stability in the cervical spine.

To establish hypomobility or hypermobility of vertebral segments in the sagittal plane, Penning's Method is a one of your greatest methods. This is done with functional examination of the cervical spine in flexion and extension, using radiographic analysis.

If there is a loss of range of motion present, several factors may be found in your patient. You as the attending Cape Girardeau Chiropractor will need to understand these variable factors in order to ensure that the "validity of assessment" criteria have been met according to standards. Doing so will also best help your patient should a personal injury case enter the court room and you find yourself on the witness stand.

The intention of this article is to briefly explain and help Cape Girardeau Chiropractors use this method of functional radiographic diagnosis of the cervical spine during flexion/extension. This will hopefully allow you to better serve your patients and to have solid pre/post analysis. There has been much research done on this topic by Dr Liberti, D.C., as well as many other Doctors and Physicians, such as Dr. Pennings himself.

Completion of Penning's Method

Penning's Method is known by many to be the most widely accepted and utilized method for determining flexion/extension motion. To start the extension film is superimposed on the flexion film, with the C7 vertebrae matching perfectly. Next a line is drawn along one of the edges of the extension film, onto the flexion film. You then do the same with C6. A second line is then drawn. You can now measure an angle between these two lines and this establishes the degree of motion between the C6 and C7 vertebra. You follow this sequence for the rest of the cervical spine to determine the degree of motion between all of the vertebrae. The average values of segmental motion are written about by Dr. Penning: Functional Pathology of the Cervical Spine, 1968 pg 1-25. These values can be compared to determine the amount of dysfunction present in your patient's cervical spine. It should be fairly easy for you to find some examples of these drawings elsewhere on the internet.

To reiterate this is a very valuable method for determining abnormal or pathological conditions such as hyper or hypomobility of the cervical spine.

Penning Method of Radiographic Determination of Loss of Range of Motion:

As an example if the normal for C2-C3 was 12.5 degrees and your patient was 20 degress, your percentage of normal would be 160%. If normal at C3-C4 was 18 degrees and your patient was 15 degrees your percentage of normal would be 83%. This is straight forward, if you would like all the normal values, these can easily be found on the internet.

The percentage of normal is figured out by dividing the patient's values by Penning's established normal values. For example C3-C4 15/18 = 83%. This essentially represents 83% of normal motion at the C3-C4 joint had been maintained. On the other hand you see that 17% of normal motion was lost when compared to the normal value as determined by Penning.

If you look at the C2-C3 level you see that you have 160% of normal motion, or 60% more than normal expected motion at this level. This is clear as to how to read this!

*Values above 100 are HYPERMOBILE

*Values below 100 are HYPOMOBILE

NORMAL at 100% (Values within 10% of 100 are considered to lie within the standard deviation of what is accepted as normal.) So anywhere between 90-110% for all intensive purposed is considered normal.

Further Analysis of example patient:

The interpretation of the above example is as follows; multiple areas of abnormal joint motion and dysfunction are present. Cervical Joint Hypomobility or a loss of normal joint range of motion was found at C3/C4, and C5/C6 motor units. Cervical Joint Hypermobility was present at the C2/C3 motor units.

You can also see a compensatory minimal Hypermobility present at C6/C7, but this falls within the normal standard of deviation.

Restated there are two areas of diminished joint range of motion and one with excessive motion involving the cervical spine segments during flexion/extension in the sagittal plane.

As is obvious, these abnormalities exist within the joints of the cervical spinal column and this analysis has been established radiographically.

As goes without saying, in addition to substantiating loss of joint range of motion, a Cape Girardeau Chiropractor should be looking to further evaluate possible existence of any neurological deficit (either sensory or motor). By simply looking at the mechanical and structural aspects of a particular case however, much can be objectively gained, and you will be able to stand with confidence in saying that structural integrity has improved on this patient if post care analysis shows improvement on Penning's Method. Any degree of improvement substantiates improvement to the patient's ligamentous integrity and of course increased normal range of motion. These two things alone could prove invaluable, should you find yourself testifying in court. I will soon be writing a Part II of this article titled "Objective Scales of Prognosis for Chiropractors doing Whiplash and Personal Injury Cases." If you have found this helpful I am sure this will go a long way to giving you the objective findings you need in validating patient care. If you need any further help finding more information on this, any Cape Girardeau Chiropractic Clinic can feel free to look at the resource box in order to contact me with further questions.

Manual Spinal Traction - Treatment for Back Pain

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Manual spinal traction is not a new age, voodoo type of thing. It is a medically accepted form of therapy used to complement other forms of treatment for alleviating back pain resulting from injury and other medical conditions such as sciatica and lumbago. Contrary to popular belief, this method has been employed by physical therapists for more than a hundred years and is now widely practiced in the rehabilitative profession. It is basic, therefore, to arm yourself with information about spinal traction.

How is manual spinal traction done?

Spinal traction can be manual, mechanical, positional, sustained, and manual, but we will focus on the last type. All forms of spinal traction involve the use of force to pull apart the vertebrae, the individual thick bones that comprise the spinal cord. Manual traction is performed by the rehabilitation provider himself, using his body to apply force to the patient's body, unlike other forms of traction, which involves the use of mechanical devices like weights, pulleys, or halters.

How can traction relieve people of back pain and improve medical conditions?

When the vertebrae are drawn apart from one another, space is made more available for nerves to be able to travel more freely. At the same time, hydration and water inflow increase, making the spinal column stronger and more shock absorbent. This is the theory behind manual spinal traction, where the primary aim is to reduce or eradicate lower back, cervical, or radiating pain. At lesser intensities, spinal traction is also used to stretch the smaller spinal muscles constricted spasms or involuntary contractions due to restricted nerves.

What techniques are used to implement manual spinal traction?

Two common techniques are used for manual traction: cervical traction and lumbar traction. During cervical traction, the patient lies on his back on a stable medical table and the therapist uses his hands to support and reposition the head from side to side. Typically, this involves a smaller amount of force, around 20 to 30 pounds in all, while lumbar traction requires a greater force that is around half the patient's body weight. In lumbar traction, the therapist tugs at the patient's ankles or wraps the patient's legs over his shoulders and pulls across his thighs.

Can everyone undergo manual spinal traction?

Before a practitioner can subject any patient to any form of spinal traction, or any form of therapy for that matter, he has to carefully and thoroughly examine the patient first. Although traction has been seen as an effective treatment for back pain and degenerative diseases, not everybody is suitable to it. For starters, not everybody can endure the weight of physical force. For instance, pregnant women certainly should not subject themselves to any kind of forceful treatment, and so with others who are suffering from cardiovascular disease, hernia, and TMJ (temporomandibular joint disease). At the same time, patients who may have weakened spinal columns, such as those diagnosed with osteoporosis or rheumatoid arthritis, should not undergo traction.

Do All Rehab Clinics and Chiropractors Offer the Same Treatment?

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Chiropractors are generally perceived by the public as back pain experts. The fallacy is that although all chiropractors treat back pain not all chiropractors manage specific back pain conditions. In other words, some chiropractors may not treat a disc herniation or spinal stenosis (which involves damage to spinal joints, nerve tissue, disc tissue, reaction of muscle tone, change in posture, loss of strength and conditioning, change in nerve conduction and alteration in brain, psychological and behavioral response) but only manage an aspect of the pain. This is because some chiropractors only focus on removing what is termed spinal "subluxations" which is essentially areas of the spine that are fixed or immobile causing pain and stiffness. In spite of the fact that delivery of a spinal adjustment can help restore spinal joint movement which can reduce some level of pain, this may not be adequate in fully managing your spinal condition or injury. The same is true about a massage therapist delivering massage to a tense muscle tissue or a physiotherapist prescribing only strengthening exercise or only using ultrasound therapy or a family physician only prescribing pain relieving and anti-inflammatory drugs. Rehab clinics that offer multiple therapies under one roof may not mean you will be receiving coordinated and comprehensive spine care that is targeted to your condition.

Treatment of Back Pain and Spine Related Disorders:

A variety of providers have traditionally been involved in the treatment of back pain and spine related disorders. This includes family physicians, chiropractors, physiotherapists, massage therapists, physiatrists, orthopaedic surgeons, neurosurgeons, kinesiologists, acupuncturists and even personal trainers. This has resulted in what some have termed a "supermarket approach" where the patient or "consumer of healthcare" is left to sort out which of these approaches is best for his or her particular spinal or spinal related condition. Unfortunately, a patient's selection will be based on salesmanship rather than on science, cost effectiveness and clinical benefit.

The Challenge with Back Pain

Back pain is a common problem and affects 80% of the population at least once in a lifetime. There are hundreds of causes of back pain, from simple sprain/strains to spinal disc herniations, arthritis, fractures or even cancer. Diagnosis of your back pain condition requires a comprehensive examination sometimes followed with advanced imaging, like CT scans and MRIs. In some cases back pain is considered benign and self- limiting, meaning it will resolve without therapy over a course of a few days. This is typically seen in most cases of minor spinal sprain/strains caused by postural stresses. Your back or neck may feel stiff and achy from sitting too long at your desk or you may wake up with pain from improper sleeping postures. In these cases, stretching, hot baths and spinal stabilization exercises may be enough to assist with your recovery.

Back pain, however, may also result from more severe injury to joint tissue, disc tissue, muscle, bone or may be a cumulative effect of multiple injuries, dysfunctions and disease. Back pain may also be a consequence of referred pain from an internal organ such as the digestive tract, pancreas or gall bladder or may be a co-morbidity associated with another illness (most commonly depression, anxiety, diabetes, heart disease and obesity). In fact, back pain is now considered by the World Health Organization as a "chronic disease" because of its complex nature and the huge impact it has on our health, productivity, our economy and quality of our life.

Chronic back pain, as most chronic diseases, require a comprehensive treatment strategy and will not resolve with simple physiotherapy. Research supports the importance of planning and coordinating your treatment plan with a team of healthcare providers to achieve better outcomes

Back pain conditions have features that differentiate them from other health conditions. For example, diagnosis is challenging in many causes of back pain particularly when there is no lesion or injury detected by MRI, x-ray imaging or special tests. In many cases a lesion or injury like a disc herniation for example may not even be the cause of back pain. Additionally, most cases of back pain are multi-factorial, meaning back pain may involve many factors including psychological, social and neuropsychological factors. Management of back pain thus requires a high level of expertise that can respond to these multiple challenges. This high level of expertise necessitates an experienced spine care provider who can offer a clear diagnosis for your condition and provide a treatment strategy to directly address your condition. For instance for many back conditions, i.e. disc herniations and spinal stenosis, it is not enough for a health care provider to provide one intervention repeatedly like acupuncture, spinal manipulation or massage therapy. These interventions will only address a small component of the problem and therefore only offer temporary pain relief. Your condition may require a thought out plan that includes sessions of varying interventions or interventions from multiple experts for a particular period of time.

Look for a Spine Care Provider with the Following Necessary Skills:

• skills in diagnosis
• skills in the management of different patient populations
• wide range understanding of complex nature of spinal pain with psychological factors
• ability to detect and manage psychological factors
• appreciation in minimalism of treatment in spine care
• an understanding of the methods, techniques and indications of medical and surgical procedures
• a unique understanding of work related spinal disorders
• a unique understanding of motor vehicle accident related spinal disorders and injuries
• public health perspective and co-morbidity relationship with diabetes, hypertension, obesity, dementia and depression
• the ability to coordinate the efforts of a variety of providers; case management
• the ability to follow patients over the long term to monitor and treat re-occurrence and educate patients in self-management
• the ability to performance manage and assess outcome measures

The research is clear that some cases of back pain tend to reoccur and persist if a comprehensive solution is not delivered by expert in spine care. Due to its complex nature, a comprehensive approach is recommended to effectively manage back pain including emphasis on pain management; patient education, regeneration and repair; lifestyle modification, psychological factors and functional rehabilitation. This approach ensures long lasting restorative effects with fewer treatment visits and less overall costs.

Understanding The Root Cause of Sciatica Pain

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It is very important for a person to understand in detail about sciatica. The reasons, symptoms and causes differ from person to person. Due to this sole reason, the origination of sciatica changes accordingly. Sciatica pain is caused due to compression of nerve roots at the end of the spinal canal. Medical term for sciatica is Radiculopathy - a condition where a nerve root experiences pinching, compressed and irritated. Finding the exact root cause for the occurrence of sciatica will be helpful in providing the right treatment. Current article discusses about the common causes that elevate the pain.

Provided below are few of the important sciatica pain causing factors.

1. Degenerative disc disease:
Occurrence of degeneration in a disk is due to aging. One or more degenerated discs in the lower spinal region can cause irritation to the nerve root resulting in development of sciatica. Diagnosis for a degenerative disc carried out when a person is experiencing excessive micro-motion and inflammation. Proteins present inside the disc are exposed which is the root cause for inflammation and irritation. It is a natural aging process and requires attention in its early stage to prevent its growth.

2. Isthmic spondylolisthesis:
One or more vertebral body slips forward into another vertebral body (example: L5 vertebra slips to S1 vertebra). Due to this situation, a small stress is developed that causes pinching effect on the nerve root. When a combination of disk space collapse, a fracture and the slipping of vertebral body occurs, the pinching effect is elevated causing the development of sciatica.

3. Piriformis syndrome:
Irritation in the sciatica nerve is caused by piriformis muscle present at the rear. There is a chance that pinching effect is created by the muscle which leads to the development of sciatica. Though it does not represent true sciatica, the pain developed resembles the same as sciatica due to the irritation.

In order to overcome sciatica pain, it is important for a person to note down the symptoms experienced to find out the root cause of the problem. Based on this, a reputed spinal therapist will be in a position to provide treatment that comprises of medication and tailor made exercises. Diagnosis will also be helpful in finding out the root cause especially when patients opt for MR Neurography. Reducing the pain is an important factor to carry out regular activities in a day to day life without any trouble.

Spinal Stenosis - Causes and Treatments of Spinal Stenosis

spinal stenosis

A common back condition that can cause pain and suffering is spinal stenosis. This article will give a brief description of the causes and available treatments. Spinal stenosis is the narrowing of the spine. This can occur either in the upper of lower spinal or in both areas. This condition is the result of spinal degeneration that usually comes with age. The narrowing of the spine puts pressure on the nerves that branch out from the spinal column.

As these nerves are compressed the person may feel pain and numbness in the lower or upper back. This pain may radiate down the leg causing severe discomfort. Interestingly many people may have spinal stenosis and not experience any of the symptoms. These symptoms may occur when undue stress is place on the spine due to an injury or if the deterioration increases. The deterioration is also associated with osteoarthritis which is a main cause of the stenosis.

Treatment: In most cases the doctor will begin with conservative measures to relieve the pain. This may include physical therapy, anti inflammatory drugs and/or a brace. Strengthening the back muscles and correcting muscle imbalance is a prime objective of the various treatments. Strong back and abdominal muscles give support to the spine relieving the pressure on the nerves.

For severe cases surgery may be necessary. Although only a very small minority of patients require an operation. In most cases non-invasive treatments will be all that is necessary.

One of the top rated programs is called the Lose The Back Pain System developed by therapists and doctors of the Healthy back Institute. This program has helped thousands by strengthening muscles and eliminating muscles imbalance. As someone who has suffered with a bad back and who has endured months of physical therapy and an operation, I can tell you there are solutions for your discomfort.

Chiropractor Adjustment Side Effects

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Though not all patients experience them, the side effects of chiropractic adjustments include soreness, a feeling of tiredness, and headaches. These side effects may present themselves within an hour of undergoing treatment, and they may last for as long as 24 hours after the chiropractic adjustment. It is normal for patients to experience some side effects after a chiropractic adjustment and such reactions are not cause for concern. Research has indicated that side effects are more likely to affect women, and that the side effects are more likely to affect a patient at the beginning of a series of treatment sessions when compared to patients at the end of a series of treatments.

Soreness

The most common side effect of chiropractic treatment is discomfort in the joints or muscles that were treated during the chiropractic alignment. Less frequently, patients will report an achy feeling in an area that was not directly manipulated during the adjustment. For many patients, the discomfort is quite mild and fades over the course of the next day. Some patients may prefer to treat the discomfort with ice packs or pain medication, but this is not necessary.

Fatigue

A percentage of patients that undergo a chiropractic alignment will experience increased fatigue in the hours after treatment. Patients that are worried about experiencing side effects after a chiropractic adjustment may want to schedule their appointments at the end of their workdays so they can take a nap if needed. Some patients report feeling fatigued after a session with the chiropractor, and then getting a renewed sense of energy. Either way, it is ideal for patients to be at home and have some free time to rest or work off any extra energy.

Patients that undergo a chiropractic adjustment, along with the use of massage or heat packs, may be particularly susceptible to fatigue after an adjustment. This is because massage and heat packs can make the patient more dehydrated. Drinking plenty of water before and after your chiropractic appointment may help reduce the feelings of sleepiness after surgery.

Headaches

If your chiropractic adjustment involved the muscles of the neck or realignment of the cervical portion of the spine, you may be more likely to experience a headache after treatment. The degree of pain is relatively low, and can be controlled with pain medication. Although headaches after chiropractic care are fairly common, they go away within a day.

Less Common Reactions

Less common reactions to chiropractic care include nausea and dizziness.

More serious side effects, such as stroke and bleeding have been reported.

Patients that are considering any type of medical care should research the potential risks and side effects of treatment. This includes the more natural, alternative methods of medicine, including chiropractic care. Being aware of the benefits and possible limitations of treatment can help you make a more educated decision with regard to treatment. If you feel that treatment of vertebral subluxations (vertebrae that have moved out of their optimal position) will improve your overall health and well being, contact a local chiropractic center to schedule an adjustment.

Is There Life After Back Surgery?

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You are facing back surgery and all sorts of doubts and fears are going through your head. You are probably wondering if there is life after back surgery. Will I be able to resume my normal life or never be able to do the things I did before my operation? Well the good news is yes there is life after back surgery. However you might want to consider if you even need back surgery.

Now first of all I am not a medical doctor, I am just someone who has gone through back pain, ruptured discs and the resulting surgery and physical therapy. Since my back surgery I have studied the prevention of back surgery as well as the side effects of surgery.

Unfortunately my experience with back surgery happened before I knew of all the dangers and the alternatives to surgery. Looking back I would not have had the operation without first trying some of the alternatives.

Also please understand that everyone's experience is unique and it is important to work closely with your doctor as you discuss the various options available to you. All that being said here are some key points of my back surgery and my life afterwards.

* The operation was a success, but I still had pain months after the operation.

* After two weeks of bed rest I had 8 weeks of physical therapy.

* After therapy I had some improvement and went back to work.

* I did some research I found a program called Lose the Back Pain.

* This program is tailored to each individual and I did notice improvement almost immediately.

* It has been four years since my surgery and physically I am in better shape than before my back operation.

* I still do the specific exercises outlined in the program, but also have added cardio and strength exercises.

I had my back operation at the age of sixty-two and now at sixty-six I am strong, fit and healthy. I keep my weight down, exercise 30 minutes four or five times a week as well as walk almost every day. For me my life after back surgery has turned out better than expected. I really did worry about the quality of my life and all the dangers of surgery. Because I have always been physically hoped I would be able to maintain an active lifestyle. My only regret is not trying alternatives like Lose the Back Pain program possibly if I had I could have avoided a lot of pain and time spent on my back.

What Are the Contraindications for Spinal Decompression Therapy?

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Contraindications to Spinal Decompression Therapy

Spinal Decompression Therapy is a revolutionary treatment involving intermittent traction which can help relieve, back pain, neck pain, arm and leg pain. Developed in the 1990's, it has grown tremendously in popularity as more and more patients realize the benefits of pain relief and surgery avoidance. It is highly effective (over 80%), low cost (less than 5% the cost of surgery), FDA cleared, and very safe with an extremely low risk profile.

There are some patients who are not candidates for spinal decompression however. Patients with chronic back pain or chronic neck pain who have sciatica or radiculopathy may benefit tremendously. Common problems that benefit include lumbar disc herniation, cervical disc herniation, facet syndrome, failed spine surgery, ruptured discs, degenerative disc disease, sciatica, and spinal stenosis.

Spinal decompression therapy has saved many people from spinal surgery. According to a recent study in the Journal of the American Medical Association, surgery is no more effective than non-invasive treatments, including chiropractic care, for patients with lumbar disc herniation causing sciatica.

However, if a patient has had a previous spinal fusion with instrumentation then spinal decompression is contraindicated. The key here is instrumentation. Spinal fusions without instrumentation are okay for the treatment. The concern is the unlikely event that the instrumentation may shift. For instance if a patient had a neck fusion with a plate the end result is typically no more radiculopathy and a solid fusion. However, at times the end result is no pain even though the fusion did not occur and the instrumentation is holding the bones together. The intermittent traction from the neck decompression, even though slight, could cause a screw to shift and the plate to move.

Another contraindication is pregnancy. Back pain and sciatica are very common during pregnancy. Chiropractic treatment and massage can be very helpful if done safely during pregnancy for back pain. Spinal decompression involves slight intermittent traction and there is a need to put a harness over the pelvis and abdomen region. In order to ensure the effectiveness of the treatment, the harness is secured snugly and therefore in pregnant women the treatment is not allowed because of the resultant pressure on the uterus.

Patients with significant spinal osteoporosis should not undergo lumbar decompression or cervical decompression. Since there is a baseline increased risk of vertebral compression fractures from the decreased bone density, spinal decompression may add to that risk. Patients who have severe osteoporosis may sustain fractures from simply getting up out of a chair or out of bed or sneezing. Patients with osteopenia, which is a slight decrease in bone density less severe than osteoporosis, are okay for neck decompression or back decompression in that regard.

These conditions are not indicated for spinal decompression. A comprehensive pain management center will have other options for pain relief in those patients which may include pain medications, interventional pain management, physical therapy, chiropractor treatment, acupuncture, or massage.

Degenerative Disc Disease - Non-Surgical Spinal Decompression Can Help

spinal stenosis

Millions of Americans suffer from severe back and neck pain as a result Degenerative Disc Disease. DDD as it is often referred to in the literature is not really a "disease" in the common sense of the word, but rather a term used to describe a process or condition that develops gradually and worsens over time. Use of this term indicates that the cartilage-like discs between the spinal vertebral joints are the primary cause of the symptoms, and that the degenerative changes are rather advanced. To some degree intervertebral discs lose their flexibility, elasticity, and shock absorbing characteristics as we age as do the other tissues in the body. Abnormal or excessive mechanical stresses or injuries of the past coupled with hereditary, developmental, and metabolic influences can rapidly accelerate this process.

As the involved disc dries out and loses height (a process known as desiccation) it causes the vertebra to become closer together narrowing the channels through which the nerve roots pass. A dry, hard disc can absorb less shock and is thus more easily torn resulting in a greater likelihood of herniation or bulge further compressing or pinching the nerves. As the stress on the joint compounds and osteoarthritis begins to result, bone spurs form and ligaments thicken (hypertrophy) gradually narrowing the nerve channels even further. These factors in various combinations and degrees of severity compromise the space in the nerve channels, a condition known as spinal stenosis (narrowing), and conspire to compress (pinch) the nerves.

Symptoms of Degenerative Disc Disease

The most common symptom of degenerative disc disease of the lumbar spine is low back pain (lumbalgia). If the cervical spine is affected, the most common symptom is neck pain (cervicalgia). When degenerative disc disease causes compression of the cervical nerve roots there may be shoulder pain, arm pain, and pain in the hand/fingers (neuritis, neuralgia, radiculitis), and may be associated with numbness and tingling (paresthesia). When degenerative disc disease causes compression of the lumbar nerve roots there may be butt pain, hip pain, leg pain, and pain in the foot/toes. This often is accompanied by muscle weakness in either the arm or leg.

Spinal Decompression Treatment

In the past, a patient suffering from disc problems was usually given pain medications or injections, instructed to refrain from physical activities, referred for physical therapy, and when they weren't progressing they were sent for spinal surgery or simply told to learn to live it. Since 2001 when the FDA finally approved non-surgical spinal decompression therapy, there is new hope for those who suffer from degenerative disc disease. Spinal Decompression Therapy is a non-invasive, non-surgical treatment performed on a special, computer controlled table similar in some ways to an ordinary traction table. A single disc level is isolated and by utilizing specific traction and relaxation cycles throughout the treatment, along with proper positioning, negative pressure can actually be created within the disc. It works by gently separating the offending disc 5 to 7 millimeters creating negative pressure (or a vacuum) inside the disc to pull water, oxygen, and nutrients into the disc, thereby re-hydrating a degenerated disc and bringing in the nutrients needed to heal the torn fibers and halt the degenerative process. As the disc is re-hydrated the shock absorbing properties are restored and a normal life can be resumed.

Solutions For a Pinched Nerve

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One of the most common causes behind complaints of neck pain, shoulder pain, and back pain; a pinched nerve can cause excruciating pain until it is properly treated. After enduring intense massages, the next place that most patients turn to is a chiropractor.

The term pinched nerve means that a nerve has been compressed or forcibly stretched in some fashion. If the nerve originates in the neck or back, the condition can have symptoms of tingling, burning or numbness in either the back of the neck or behind the shoulder. This will also cause the muscles of the back to tighten in response, putting even more pressure on the nerves.

Realignment and Decompression

When you visit the chiropractor for a pinched nerve, you have two options available for you right away. The first, realignment, involves the manipulation of the bones surrounding the spinal column and those found within the affected area. The chiropractor will pop and stretch out those bones and muscles slowly and carefully, so that the pressure on the nerve will be eased.

Decompression is a non-surgical solution offered in some chiropractic offices as pinched nerve treatments. This involves a sophisticated multileveled table with proprietary biofeedback that manipulates the spine to form its own natural vacuum within it. This vacuum will ease the pressure from a pinched nerve, lower back pain and even a herniated disc.

Subluxation

A pinched nerve can also be the result of subluxation, a condition that occurs when a bone is partially pushed or pulled out of its usual position within a joint, like kneecaps, hips, fingers, elbows and shoulders. This is almost always caused by some trauma, like a direct blow to the joint affected, a fall, or by making a sudden twisting movement. This can happen to everyone, even during everyday activities.

The chiropractic treatment for a subluxation usually involves adjusting the joints and bones by twisting, pulling or pushing movements. Heat, electrical stimulation and ultrasound treatments are often used in conjunction with the manipulations to ease the threat to the ligaments, tendons, muscles, and cartilage that surround the joint. Care must also be taken so that no nerves or blood vessels are permanently injured during the treatment.

Herniated Disc

Pain that is thought to be the result of a pinched nerve might also be from a herniated disc. The bones that form the spine in a person's back are actually cushioned by small discs that literally act as shock absorbers. As we age, these spongy discs get drier and more brittle. Sudden trauma to the spine causes these discs to bulge or break open. When this happens it is herniated, and the bulging can cause nerves in the spine to become compressed.

A sure sign of a possible herniated disc is weakness or numbness in both legs or loss of bladder control in severe cases. Treatments include anti-inflammatory medication, heat and rest, depending upon the severity. A decompression table can also help restore the disc to its proper position.

Spinal Stenosis

This condition is caused by the narrowing of the spaces along the spine. When the space is reduced, the spine becomes compressed in a very painful way. The spaces are narrowed through arthritis or through the growth of bone spurs within the spinal column.

Spinal stenosis causes chronic lower back pain and can sometimes pinch the nerves that control muscle power and sensation in the legs. This is best treated through medication, manipulation or flexing of the spinal column and rest can restore some comfort. In extreme cases, surgery may be used to remove the spurs from the spinal column.

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Don't let a pinched nerve hamper your movements any more. If you suffer from severe neck, back or shoulder pain brought on by a pinched nerve, a visit to a qualified chiropractor is set you right in no time at all. Visit Chiropractic Center of Lakeland today to stay pain free!

The Most Effective Lower Back Exercises To Relieve Back Pain

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Despite what you might think, rarely is the cause of lower back pain at the site where it hurts. Most people and their therapists think it is. That's why they want to heat, rub, crunch, vibrate and slice the spot where it is most painful.

In fact you can tell how good a therapist is by watching where they go in the search for the cause of the pain. Just attacking the spot where it hurts sends out a big amber light.

Surprisingly, lower back pain is a merely a symptom that some of the bones in your lower back are out of alignment. Your immediate task is to get them back in alignment. Do that and there's a good chance the pain will go away.

When the vertebrae move out of alignment, ligaments, tendons and muscles are stretched beyond their pain threshold. The nucleus of discs is squeezed out and the disc collapses. Often the nucleus hits the spinal cord. That's when the pain really starts. You can't sneeze or cough without it feeling like there's a red hot poker being jammed into your back. You can't bend over the basin to brush your teeth. You can't bend down to put your socks on.

So what causes the vertebrae in your lower back to move out of alignment?

Answer! If the pelvis has moved out of alignment, it's highly likely the bones above it have moved out of alignment as well.

Treat the pelvis as the foundation for the bones that are above it and consider this analogy. If the foundation of your house moves then the walls will crack. You can patch up or paper over the cracks, but you'll probably have to continue to keep patching and papering until kingdom come. The solution is to underpin (and square up) the foundation so it can't move.

So the precondition for a spinal column that's in alignment is a pelvis that's in alignment.

So what causes the pelvis to move out of alignment?

Answer! Tight calf, hamstring, buttock and hip flexor muscles.

Which brings us back to the question of what are the best exercises to relieve lower back pain?

Answer! Flexibility exercises that impact on the alignment of the pelvis, particularly exercises that loosen off tight calf, hamstring, buttock and hip flexor muscles.

But that's not the full story. You also need to strengthen the whole musculo-skeletal ecosystem by regularly going to the gym and working out - or if you're averse to lifting weights start on a regular and systematic strength training program at home that includes situps, pressups, squats and the Superman back arch.

It makes sense to have a body strong enough to keep the bones of your spinal column in correct alignment.

Interestingly one of the best predictors of risk of lower back pain is the ability to do pressups. While you're doing pressups the muscles of your trunk are all being strengthened, front, back and core.

If you're looking for targets for situps, pressups and squats, 20 of each is good, 30 is better and 40 is best. Build the Superman back arch up to a couple of minutes of gentle ups and downs without your chest or legs touching the floor.

The last piece of the lower back exercise jigsaw is some relaxing exercises to settle the spinal column down, exercises where you lie on your back with both legs bent at 90 degrees and the lower legs supported by an ottoman. This is known in the trade as the static back exercise and lying in this position for 20 minutes will bring temporary relief from back pain, and over the weeks and months assist the vertebrae to gradually get back into better alignment.

Another relaxing posture using the ottoman is lying on the floor with one leg on the ottoman and the other outstretched on the flood for 20 minutes - then change legs. This is the supine groin stretch. Over 20 minutes the hip flexor muscles will gradually relax and over the weeks and months allow your vertebrae to move back into better alignment.

If you're diligent you'll spend a couple of hours on the floor each evening while you watch TV, read a book or just drift off with the faeries doing the flexibility exercises and the relaxation exercises.

The strength exercises you can do after you've been for a walk, shuffle, jog, swim, cycle... in the morning.

Now just as Rome wasn't built in a day, your lower back pain wasn't caused in a day. For most people it happens over decades, due to a poor sitting posture and lack of strength and flexibility exercises. Being 20 or more Kg over weight doesn't help matters.

Neither will back pain be cured in a day. Depending on how far out of alignment your pelvis and the bones above it are, it may take a couple of months for you to experience real relief and up to a year before you can say, 'I no longer have lower back pain.'

But the good news is that if you start doing something now, there's an 80% chance for 80% of people that they will get themselves back to 80% of good nick within a year. If you've got back pain them's good odds.

In the meantime stay tuned, highly tuned and make an immediate start on a serious strength and flexibility training program.

Spinal Arthritis is One of the Most Painful and Difficult to Treat Forms of Arthritis

spinal stenosis

The modifications of different illnesses create one of the toughest challenges for consultants, analysts, and patients. As an example, we frequently hear through the mass media that scientists are looking for the cures for assorted sicknesses. Each of these forms of the illness cause different symptoms and treatments, and would therefore need different cures. Similarly, numerous kinds of arthritis exist, for example psoriatic arthritis, reactive arthritis, and rheumatoid arthritis. Another variety of this devastating illness is spinal arthritis.

Spinal arthritis, or spinal stenosis, involves the tapering of the spine, manifesting itself through stress on the spinal nerve as well as on the roots of nerves. This illness sometimes involves 3 regions of the backbone : the canals at the nerves' base that expand from the spinal nerve ; the openings between the backbone's bones, through which nerves exit the backbone and then continue to other body parts ; and the tube in the middle pillar of bones, through that the roots' base and the backbone continue. This tapering can include either a big or minuscule area of the backbone. The subject of spinal arthritis may feel aches or a scarcity of sensation in the shoulders, neck, or legs.

Spinal arthritis sufferers are most frequently ladies and men who are over 50 years of age. Nonetheless , younger folk who experience an injury to their backbone may also experience spinal arthritis. In addition, those that are born with tapering of the spinal channel could also become inflicted with this illness.

Spinal arthritis sufferers of every age may experience no symptoms, because of the tapering of the area in the spinal channel. However , if this narrowing puts stress on the nerve roots or spinal nerve, sufferers might endure cramps, absence of sensation, aches in the legs and arms, and weakness. Also, if the chiselled area in the backbone presses down on the nerve base, sufferers of spinal arthritis may experience discomfort sealing down their leg. They should right away engage in bending exercises, reinforcing exercises, stretching the lumbar region, and sitting.

When a victim of spinal arthritis isn't experiencing tremendous or worsening nerve organisation, then the doctor might prescribe either anti-swelling drugs that have no steroids, such as aspirin, and ibuprofen, to lower swelling and reduce aches, or drugs like Tylenol, to reduce discomfort.

If stronger treatment is required corticosteroid injections can be given into the remotest of the membranes covering the nerve roots and the spinal nerve, this will lower swelling and treat pointy agony that spreads down a leg, or down to the hips. Anaesthetic shots, and nerve blocks, can be given nearby the nerve that is influenced, to momentarily reduce agony.

Doctors frequently counsel physical treatment or exercises to increase stamina, continue the backbone's motion, and fortify back and belly muscles. This could help to make the backbone steadier. Aerobic activity is also a choice if the patient isn't in too much discomfort.

When treatment not concerning surgery is ineffectual, surgery becomes a choice. The target is to reduce the nerves' pressure or spinal nerve, and to re-establish and sustain the backbone's arrangement and strength.

Today, spinal arthritis remains one of the most devastating sorts of sicknesses that folk can have. Luckily, doctors and analysts continue to enhance its treatment, to relieve its victims' discomfort.

Spinal Stenosis and Finding the Right Lawyer

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Spinal stenosis is the condition where one or more spaces between the bones (vertebrae) of the spine narrow, causing either the spinal cord or nerves that branch from the spinal cord to become compressed. Usually, spinal stenosis occurs in the lumbar region of the spine (lower back) or cervical (neck) region of the spine but it can also occur in the thoracic region (middle back).

Symptoms
Depending on the affected area of the spine, symptoms can include (1) pain, numbness, and weakness in the legs, buttocks, calves, and pelvic region if the condition occurs in the lumbar region or (2) pain in the neck region or tingling, weakness or pain the shoulder and arms if the nerve compression occurs in the cervical or neck region.

It is common for those with spinal stenosis to not be able to sit or stand upright for extended periods of time and may feel better by bending or leaning forward to relieve some of the pressure on the compressed nerves. Severe symptoms can include difficulty walking and challenges with balance may be as well as an inability to control his or her bowel movements, or difficulty urinating.

Causes
Spinal stenosis usually affects the elderly where the vertebrae become enlarged and the space between the bones where nerves are located is decreased. However, other causes include back injury such as a slipped or herniated disk, tumors, birth defects, and abnormal destruction and re-growth of bone.

Diagnosis
To diagnose spinal stenosis, a physician will take a medical history and perform a physical examination to assess where the pain is located and any limitations in movement. Then, X-Rays will be taken and possibly an MRI (magnetic resonance imaging), a CT Scan (computerized tomography), bone scans and tests using injections of contrast dyes called Myelograms.

Treatment
Typically, non-surgical treatment only relieves the symptoms. This includes pain medication, non-steroidal anti-inflammatory drugs (NSAIDS), physical therapy, corticosteroid injections to relieve swelling and inflammation and rest.

Surgical treatment treats the underlying cause. These typically include laminotomy or laminectomy, discectomy or fusion where a surgeon widens the spinal canal to provide more room for the spinal cord or trims, cuts, or fuses bone or disk material to provide more space for the nerve and relieve compression.

Were you injured at work?
Spinal stenosis can be work related. If you slip and fall at work and suffer a direct trauma to your neck or back, it could lead to nerve compression in the back or it could lead to a herniated disk that can lead to spinal stenosis. Also, heavy lifting and repetitive bending at work can aggravate an already existing back condition like spinal stenosis and make surgery necessary.

Attorney's Fees
The majority of attorneys who handle these types of cases do so on a contingency basis. This means that you do not have to put out any money up front or cover any costs or expenses. If you recover anything, your attorney is paid from that recovery amount. If you get nothing, your attorney gets nothing.

4 Exercises to Relieve a Slipped Disc

spinal stenosis

Herniated disc or slipped disc occurs when a disc in the spin between the vertebrae ruptures and compresses against one of the spinal nerves, causing pain, tingling sensation and numbness. There are many methods to treat slipped disc with anti-inflammatory medication and physical therapy the most common ones. Exercises are also an excellent and effective method to help relieve pain. While exercises can help, it can also possibly aggravate the condition if it is overdone.

Clasp hand stretch

Hand clasp stretch exercises will help to prevent stiffness of the shoulders due to a slipped disc. This is due to the disc causing the shoulders to haunch forward, causing stiffness over a period of time. Hand clasp stretch will also help to reduce and relieve muscle tension. Standing up straight, slowly stretch your hands and reach for them behind your back, clasping them together. Holding firmly in this position, pull the shoulders behind and you should be able to feel a light stretch at your chest area. Hold this position for ten seconds and release your hands. Repeat this exercise five times.

Back flexion

Back flexion exercises will stretch the upper portion of your body, namely the neck and the lower back. This will help to relieve muscle tension caused by a slipped disc. Lie down on a flat surface with your feet flat on the ground. Bring up both knees towards your chest and wrap your arms around the knee. Lift your head up slowly and curl your body together like a ball. This will cause you to feel stretch at your spinal area and hold for 10 seconds and slowly release back to the starting position. Repeat this exercise for five times.

Hamstring stretch

Stretching the hamstrings can help to relieve muscle tension on the lower back. Lie down on a flat surface on your back near a wall. Lift either one of your legs up and place the other on the wall, pulling your buttocks inwards until they touch the wall. There should be a light stretch felt at the back of the thighs and the lower back. Hold this position for a minute and release and back to the starting position. Repeat this exercise five times.

Crunches

Crunches will help to strengthen core muscles in our body which in turn will reduce pressure on our spine and lower back. Lie on a flat surface and place your hands behind your head. Slowly lift your shoulders off the floor and make sure that your lower back does not leave the floor. Hold this position for five seconds and recover back to the starting position. Repeat for ten times.

Exercises when done properly can help to relieve back pain due to slipped disc. Results will not show immediately. The exercises have to be done consistently and religiously over a period of time to see results. By following the above exercises, relief from pain should be obtained.

Herniated Disc Surgery - What Can You Expect?

spinal stenosis

Most people with a disc herniation do not get herniated disc surgery. However, if your doctor or medical back specialist recommends herniated disc surgery, then it's something you may decide to do.

Keep in mind that disc surgery is not a sure thing. There is no guarantee it will work.

The type of surgery you have will depend on the exact nature of your disc herniation. Typically your surgeon will be able to tell you the type of procedure after reviewing your MRI.

3 herniated disc surgery procedures are as follows.

1. Open Discectomy (OD)

As you know by now, the reason a disc herniation can hurt so much is the leaking fluid from your disc presses or irritates a nerve. That hurts. A discectomy removes the leaked fluid that contacts or irritates the nerve. Patients are put under with general anesthesia for this procedure.

2. Endoscopic Discectomy

An endoscopic discectomy, removes leaked fluid from the disc herniation that contacts the nerve. However, this procedure is different from the open discectomy in being much less invasive. An open discectomy requires at least a 3 cm incision and peeling muscle from the spine.

An endoscopic discectomy, on the other hand, makes a tiny incision and uses an endoscopic probe with a video recorder attached, through which tiny surgical instruments are inserted to remove the excess disc fluid that herniated. An endoscopic discectomy is much less invasive than an open discectomy. You can go home the same day.

3. Percutaneous Discectomy

This procedure is performed when a disc hasn't ruptured or herniated, but instead bulges resulting in pain. The procedure is done with a needle-like instrument called a cannula that removes tissue from inside the bulging disc to relieve pressure. This procedure is used less often than an open discectomy, but is much less invasive than an open discectomy. Patients remain awake during this procedure.

Recovery Expectation from Herniated Disc Surgery

Some patients enjoy immediate herniated pain relief upon waking. Others' pain goes away over several weeks following the surgery.

If you have an OD, you'll be directed to take it very easy for several weeks. Absolutely no lifting or twisting.

Complications?

Most ODs are successful to some degree. However, as with any surgery, there are potential complications of bleeding and infection. In the case of a discectomy specifically, there is a slight chance of fluid leaking into the spinal canal.

Two Different Chiropractic Opinions on How to Care For Your Back and Neck Pain

spinal stenosis

Just like many other professions, within the field of chiropractic there are different opinions on how to treat health problems. The result is that patients may see different results and pay different costs.

While musculoskeletal chiropractors address relief of symptoms, traditional chiropractors concern themselves with structural correction of a patient's problems.

Musculoskeletal chiropractors, who are also known as symptom relief chiropractors, primary focus on relieving symptoms such as back pain or headaches. These professionals treat problems through manipulations to the spine to decompress joints, free fixations and reduce pain. Other important information to know about musculoskeletal chiropractors includes:

• Electrotherapies such as ultrasound or laser acupuncture are often used to relieve pain


• The length of treatment and frequency of adjustments are most often determined by a patient's symptoms, along with insurance coverage


• Treatments periods are usually shorter


• Long-term corrective care is not addressed by a symptom relief chiropractor. This is because even though a patient may initially feel better, the root cause of their problem has never been corrected. As a result, their spine remains structurally misaligned and degenerates, causing damage and dysfunction to discs and joints

A traditional chiropractor works toward subluxation and structural correction of the spine. A subluxation is a misaligned vertebrate that interferes with nerve impulses in a patient's body. Nerve impulses are the electrical impulses from the brain which regulate body functions and keep individuals alive.

There are three basic types of subluxations:

1. Physical, that include slips and falls, accidents, repetitive motions and improper lifting


2. Emotional that are a result of grief, anger or fear


3. Chemical causes from alcohol, drugs, pollution or poor diet

A patient may have subluxations without any form of pain or discomfort. Over time subluxations can start to show it's symptoms. Chiropractic examinations are important to identify and locate the problem before it grows into something more serious.

Other important information a patient should know about a traditional chiropractor includes:

• Traditional chiropractors want patients to see relief, but their primary focus is on removing nerve interferences and restructuring a patient's spine to its most stable biochemical position. This is accomplished through a rehabilitation program that includes adjustments and spinal exercises
  


• The length of correction and frequency of adjustment is dictated by the severity of a patient's misaligned vertebra


• Even though symptoms may have ceased, a patient's spine may not be its maximum corrected position. Consequently, adjustment schedules are kept intense to allow structural correction in the shortest amount of time


• The progress of patients is monitored through posture patterns, X-rays and spinal readings until the misalignment is corrected

Since subluxations are silent and research shows they begin at birth resulting in dysfunction and dis-ease, the traditional chiropractor recommends families to be checked, especially children. Because of this the traditional chiropractor will work out fair and equitable payment plans so families can afford care, regardless of insurance coverage.

So remember when choosing a chiropractor, choose based on your health goals either temporary relief or maximum correction. Ask your chiropractor what their goals are. Ask them whether they have a wellness program that will continue care to prevent an injury from coming back. And finally, ask whether your family should be checked for subluxations that exist but may not be causing any pain. The choice is yours.

Back Pain - Caused by Muscle Damage or Nerve Compression?

spinal stenosis

Back pain can be a tricky phenomenon to diagnose or treat effectively. On the one hand, nearly four out of every five people will have an episode of back discomfort sometime throughout their lives, either an acute flare-up or a chronic condition. But on the other hand, some people with disc herniation, subluxations, and other disorders may never feel pain caused by those conditions. This indicates that a person's pain perception systems may have as much to do with back pain as an actual injury.

In fact, doctors have understood for years that it is not just the disc disease, injury, or arthritis in the joints of the spine that leads to pain. Much more likely is that accompanying muscle spasms cause feelings of discomfort or soreness at or near the site of an injury. But some people who have had a herniated disc for years may never feel any severe pain. Thus, it seems that it is not until the spinal muscles reflexively react to a disorder that pain results in many people.

Furthermore, neck and back pain is most often caused by an acute feeling of discomfort that may go away after a few days or a week of rest. Neck pain responds much the same to such rest. In these cases, it is the muscles that develop a sprain or spasm and lead to the soreness in the first place. With some time off to rest, the muscles are able to relax and stop the spasms, repair the strain or tear, and the pain is eliminated.

Pain and numb sensations caused by nerve damage or compression, however, may lead to a much more severe and chronic condition. Sciatica or spinal stenosis can be caused by compressed nerve roots, and extremely painful sensations may be felt from the lower back all the way down through the hips to the knees and feet, depending on the site of the nerve pressure.

Healing for nerve damage and compression may take longer and be much more involved, as well. First, compression of the discs may have to be reduced, either through spinal decompression treatments, surgery, or other therapies. Then, the nerve pathways much be reeducated through spinal flossing and by practicing proper movement habits to prevent future injury.

Even after this is done, though, muscle damage and spasms may still be present. And if nothing else, there may be severe muscle weakness and lack of endurance in the spinal and abdominal muscles that support the spine. All of these issues must be addressed once the cause of the nerve pain is eliminated and once the back pain sufferer learns to move properly with minimal discomfort.

The good news is that the vast majority of causes of back and neck pain is an acute problem that lasts only for a few days or weeks. Muscles can relax and begin healing fairly quickly once the reason for the disorder is eliminated or reduced. And even for people suffering from chronic nerve conditions, much can be done to reduce discomfort, learn pain-free movements again, and build up muscle endurance to prevent future injury.

Home Exercises for People With Spinal Cord Injuries

spinal stenosis

There are a few exercises you can do at home that will keep you tone. They target arms(biceps/triceps), shoulders, lats, legs(quads) and abs. Theses exercises can be done while sitting in your wheelchair or lying in bed using inexpensive items such as dumbells, exercises bands, and ankle/wrist weights.

BICEPS.
The most basic movement for arms is the bicep curl. There are many variations, but for our population, the seated dumbell curl is what we will do. Depending on your hand function, you can perform this with either dumbells or wrist(ankle) weights that wrap and velcro around your wrists. There are 2 ways to do these, 1st.... with your arm(s) hanging down at your side, palms facing in towards your body, curl your arm up, be sure to keep your upper arm from shoulder to elbow in a fixed position As you bring the weight up,(if possible) rotate your wrist so it ends palm up. This rotation has an affect on the bicep muscle. The 2nd way i like, if your wheelchair has armrests, simply use it as a base of support under your elbow. This will prevent any upper arm/ shoulder movement and really isolate the bicep muscle. 10 reps, 3-5 sets

TRICEPS.
The tricep is the muscle in the back of the arm. This muscle is often affected by Spinal Cord Injury. If you have function of tricep, there are a few ways we can train this muscle from a wheelchair and lying down. A few require should function, one does not. Lets look at ways from a seated position which also require shoulder movement..

1- With a dumbell or wrist wrap weights, raise your arm(s)straight overhead. Bending at the elbow, lower the weight to behind your head, then raise to full extension again. This can be done each arm individually, or both hands holding one dumbell.
2- Lying down flat on your back, raise one arm straight up towards the ceiling, lower the weight to the side of your head. Keep your elbow pointed upwards. It is basically the same as movement #1, but lying down.

The 3rd movement requires NO shoulder involvement. For this exercise you will need an exercise band. Place an exercise band either over the top of a a door or even over the back of your neck, as if u had a rolled up towel over you. With your elbow either at your side or planted on your armrest, press downwards towards the floor. Pause at full extension, then slowly release back to start. 10 reps, 3-5 sets

FOREARMS.
To perform this movement, you need to have some hand function to grip and hold a dumbell, as well as wrist control.

Place your arm(s) on your thighs with your hand extended slightly further than your knees.

With your palms facing up, roll your wrist down, then up. If you have good finger control, you can open your hand on the downside of movement and roll the dumbell so only your fingers are griping. Then roll your hand closed and then your wrist up.

This can also be done with your palms facing down. This will work the topside of the forearm. 10 reps 3-5 sets

SHOULDERS.
SIDE RAISES- This movement will work the shoulder muscle. Again, depending on your hand function, you can use dumbells or wrist (ankle) weights.

Hold the dumbbells with your palms facing in and your arms straight down at your side. This will be your starting position. Raise your arms out to the side, with just a slight bend, to just past shoulder level. Slowly return to starting position. 10 reps 3-5 sets

PRESSES- The seated dumbbell shoulder press is one of the best shoulder exercises for developing all heads of the shoulder.

Hold one dumbbell, or wrist weight, in each hand at shoulder height using a pronated grip. With the elbows pointed downward and to the sides. Press upwards towards the ceiling. Stop just short of full extension, then slowly lower to starting position. 10 reps 3-5 sets

ABDOMINALS...
CRUNCHES- Core strength is extremely important to people with spinal cord injury. Having a good strong core with not only allow us to feel good, it will aid in getting in and out of bed, sitting up, reaching, bending over to pick something off of the floor, dressing, etc. Depending on your level of injury, theses should be done daily. Start your day off with crunches before you even get out of bed.

Lying on your back, bend your knees up to approximately a 45 degree angle. You can place a bolster, exercise ball, chair, or even a pile of pillows under your legs for support.

The movement begins by curling the shoulders towards the pelvis, then back down to flat. Do this movement nice and slow. he hands can be behind or beside the neck or crossed over the chest.

DO NOT pull on your neck, simply place your hands back there.
When performing a crunch the lower back should not leave the floor.
Start with 2 sets of 25 reps..That should give you a good burn.

SEATED SIDE BENDS- This exercise I found to be very beneficial. Being in a wheelchair, we cannot always reach things and need to stretch to get to them. Without core strength, we would fall over. This movement requires you to be in your wheelchair, at a table, and you will need a towel. Depending on your ability, you may need the aid of someone in case you go to far and cannot get back to center.

Place the towel on the table. Pull your chair sideways to the table and place your closest arm on the towel.
Lean as far as you can, as if you were reaching for something across the table, then come back to center.
This can be a tough movement, so find your range to where you wont get stuck.
Spin around and work the other side as well.

This can also be done facing the table. Place both hands on towel, arms extended forward. Lean forwards, then back to sitting up. Find your range and build on it.

BACK...
LATS- The lat (Latissimus Dorsi) is a muscle of the back. Pulldowns are the most basic exercise for this muscle. To perform this exercise, you will need either an over the door pulley, or an exercise band. If a pully is used, some sort of resistance will need to be on the opposite handle. You can wrap ankle weights to the handle.

Start with your arm extended upward, palm forward. Slowly pull downward. Be sure to keep your elbows pointed out to the side. Stop when your arm is just past 90'. Slowly control the movement back up.

The further outside of the shoulder your hand is to start, the more the lat muscle is focused on. When your hand is above the shoulder, you will use more bicep muscle to pull down.

This exercise also incorporates shoulder and bicep muscles. 10 reps 3-5 sets

LOW BACK/HIPS...
BRIDGING- Bridging is great for maintaining strength in the low back. Pelvic bridging is also a great exercise that strengthens the paraspinal muscles, the quadricep muscles at the top of your thighs, the hamstring muscles in the back of the thighs, the abdominals and the gluteal muscles. This is an exercise that not many with an spinal cord injury can do. If you can, it is a great movement. If you have any movement or strength in your hip and low back areas, you should give this a try. Even the slightest movement can be built upon. You will need the aid of someone to sit on your feet and support your knees in place.

Lie flat, knees bent and feet flat on the floor about 6 inches apart.

Push your hips towards the ceiling, hold at the top for a few seconds, then slowly lower back to start.

3 sets 10-15 reps

LEGS...
Quadriceps- This exercise will strengthen the quads. The quadriceps is a large muscle group, stretching from hip to knee, which makes up the front of the thigh. You can perform this movement with nothing, or if you have strength, you can add ankle weights for resistance.

From your sitting position, extended your leg out as straight as you can, hold for 3 seconds, then slowly back to start.

10reps 3-5 sets

Having a Spinal Cord Injury wreaks havoc on our body. Able bodied people can get away with not exercising more so because at least they are moving, walking, bending, etc. We pretty much are stationary and muscle will quickly atrophy with non use. We NEED to exercise whatever functional muscles we have. If you have the hope of recovery when a cure comes along, you need to have as much muscle tone as possible.