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Mountain View, Missouri (West Plains / Cabool / Winona / Summersville / Willow Springs) ---- Spinal Decompression Doctor, Russell Schierling, presents another blog article on Spinal Decompression Therapy.
“My Doctor Says that since I don’t have Leg Pain, I do not have a Disc Problem.”
Wow, have I heard this one a lot of times! This is a common misconception by doctors, PT's, and even chiropractors, who do not extensively deal with severe Spinal Disc problems such as DISC HERNIATIONS
, SPINAL STENOSIS
, or DEGENERATIVE DISCS
on a day to day basis. Much of this goes back to what doctors learned in school. If you have leg pain (SCIATICA
), you have a disc problem ---- if you do not have leg lain, your disc is not the problem. The same thing can be said of the relationship of the Spinal Disc to low back pain. I actually see a fair number of people who have severe buttock / leg pain, yet have no low back pain whatsoever.
Is it from the Disc, or is it something else?
Just like individual fingerprints, the reality is that no two bodies are exactly the same. Professors present lectures, and text books present anatomical pictures of the way that various structures in the body should
look. We know how different people look from one another on the outside. The truth is that because everyone is so different on the inside
, nerves are not always found exactly where one would expect them to be. In fact, when it comes to studying human anatomy, anomalies and anatomical variations are the norm. Discs can herniate
in any number of common (or very uncommon) patterns. When you throw in the phenomenon of ASYMPTOMATIC DISC HERNIATIONS
, the conundrum gets even bigger. You may be starting to understand why back surgeries can be such a crap shoot.
Another potential monkey wrench in the machine is that Sciatica is frequently
(about 40% of the time) caused by non-disc problems like PIRIFORMIS SYNDROME.
Like I insinuated earlier, Sciatica has the ability to manifest itself in an almost endless array of patterns.
- It can affect various parts of the leg
- It can skip parts of the leg, while affecting other parts.
- Sometimes it will cause problems below the knee, but not above the knee.
- Sometimes sciatica will not travel below the knee.
- Sometimes it might just stay in the buttock region.
- Sometimes a person might have terrible leg symptoms ---- and absolutely ZERO low back pain (fairly common).
- Sometimes people have lots of low back pain but no Sciatica-like symptoms in their leg (also fairly common). These people may or may not have a disc problem that can be verified on MRI (see the previous link on Asymptomatic Herniations).
The reality is that if you have dealt with enough disc patients, you come to expect the unexpected. Everyone is different. There are so many potential sources for low back / leg pain, besides those mentioned above, that the out-of-the-ordinary is about par for the course. What about the PIRIFORMIS MUSCLE
? What about the FACET JOINTS
. Sometimes simple VERTEBRAL SUBLUXATIONS
can cause "Scleratogenous Pain Patterns
" that mimic sciatica. What about SCAR TISSUE
---- particularly if found in the THORACOLUMBAR FASCIA
? Twenty-plus years experience in dealing with all kinds of back and neck problems has taught me to understand that there are numerous potential pain sources in patients struggling with chronic back or neck pain. Yes, we see lots of patients with the "typical" searing pain down the back of the leg when it is not a dull, nagging, ache. But we also see just about everything else.
A great deal of research tells us that much low back pain can actually come from the disc itself (as opposed to the HERNIATED NUCLEUS PULPOSUS
) pressing on a nerve. This is why so many of the MRI's that show one or more Disc Bulges, Ruptures, or Herniations, cannot always be trusted. What do I mean buy this? Doctors have known for years that OVER HALF THE ADULT POPULATION IS WALKING AROUND WITH DISC BULGES
---- that are not causing any symptoms at all! This is because many doctors have forgotten that the outer fibers of the disc (THE ANNULUS FIBROSIS
) actually have their own nerve supply (and potential pain source). Usually this type of pain is on or very near the spine's midline. Patients will typically describe this pain as a deep, nagging ache that can be sharp and severe if you move just right.
All of this is important to know. Why should you know this information? Because it can often times be difficult to trust your doctor to be looking out for your
best interests. What do I mean by this? Try explaining the fact that every study on back surgery is freakier than the study that came out before it. There is a steady stream of research telling us that SPINAL SURGERIES HAVE POOR OUTCOMES
. This is verified by viewing internet message boards, or talking to patients who have had back surgery. Why is it that SPINAL FUSIONS
----- the worst of the worst offenders ----- have increased nearly 1,600% since 2003; even though results are typically terrible? Why not ask your specialist who is recommending the surgery? Fortunately there is new technology available that has the potential to PUT A SOLID GOLD BRICK in your hands ----- without surgery or those nasty CORTICOSTEROID INJECTIONS that dramatically speed up the degenerative processes working on your spine. It's called Non-Surgical Spinal Decompression Therapy, and it could be just the thing for you. Because I see lots of desperate people looking for any glimmer of hope for their conditions, I run into a fair number of people who are not good candidates for Spinal Decompression Therapy
. Although many of these are people I am simply UNABLE TO HELP
, many I can
help ---- without
having to go through our SPINAL DECOMPRESSION PROGRAM
is an example.
To find out whether or not Spinal Decompression Therapy MIGHT BE A GOOD OPTION
for your particular problem, simply call our office at (417) 934-6337
to set up a free consultation with Dr. Schierling. He will look at your tests, discuss your history, and give you his honest opinion. If he can help you he will. If he cannot, he will try to provide you with the best options.
WHAT DO I DO NOW?
Equazcion at the English language Wikipedia
The reason I called my original website DESTROY CHRONIC PAIN
, is because that is really what I am about --- helping people who are in Chronic Pain get their lives back. Because I know what it is like to suffer with at least some small degree of CHRONIC PAIN
, I can empathize with others going through similar. Unfortunately, there are many people out there whose pain level makes anything I have ever experienced look like a frolic in the park. The following is one such story I recently received via email.
I've been scouring the internet for a long time looking for any kind of help I can get for my partner and love of my life. We live in the UK, so setting up a free consultation in your office is not going to be possible, but I was wondering if you could give me some advice?
Here's a bit about his medical history.
He broke his back when he was 17 (he is now in his 40's). He has had four spinal surgeries which have left him in constant agony. He is at the point where he wants to end his life as he cannot live like this anymore. I am doing everything in my power to try and find help for him!
- Surgery one - Spinal fusion - Failed
- Surgery two - Spinal fusion with steffi plates and bolts - Failed
- Surgery three - removal of plates and bolts and another fusion - Failed
- Surgery four - 2008, they removed part of his spine and replaced it with a steel cage - Failed
Now the doctors wont do anything except give him tablets and new pain medication. His surgeon is refusing any more surgeries.
His back is deteriorating and he is physically changing shape (he says it feels like his spine is splitting apart and the weight of the top half of his body is pushing out his stomach and feels like the spine is moving forward. He also feels that his pelvis is shifting and tilting forward). After all his latest MRI's and x-rays, the doctors are claiming there is no change.
I love this man deeply with all my heart and he now spends 97% of his time laying on his stomach on the living room floor. Walking causes him extreme pain, and sitting is practically impossible for him.
I am at a loss! I don't know what else to do and I was wondering if you could, by what I've told you, let me know if you think any of your treatments would work for him? I would be willing to sell my house to get us over to America - we are extremely poor at the moment as he cannot work, and I also suffer from a herniated disk and bilateral sciatica which limits how much work I can do. Or even if you could recommend any similar therapists in the UK. I know I shouldn't ask that as I don't want to take business away from you or anything of the sort, I'm just at a loss as to what else I can do to help him!
Eagerly awaiting your reply, and thank you so much for taking the time to read this.
Wow! Absolutely heartbreaking. I often weep as I read stories like this. The problem is that change the names, the dates, and stories just a little bit, and this sort of thing is common ---- way
too common! The first thing I can tell you is that it would do no good for you to sell your house. The solution is not coming to America. Although there are some people over there who can undoubtedly help you, as much as anything, you are going to have to help yourself while you are searching. I realize that this is going to be difficult, but it is your only real hope. If I or a family member were in your shoes, here is what I would do. Understand that I am not giving medical advice here or telling you to do these things. The information in this post is just that ---- information only
; and should not
be construed as medical advice or a diagnosis. Do not try any of this without first consulting your physician. Now that that's out of the way........
- YOUR SOLUTION WILL NOT BE PERFECTION: No doubt you already know this. With a problem like yours, I am not really sure how much better it can get; I just know that if you do the right things, it can get better.
- DO NOT GIVE UP HOPE / KEEP SEARCHING FOR ANSWERS: I completely believe that for every problem out there, someone somewhere has the solution. The internet is a great source for finding these answers. If you put all your trust in EVIDENCE BASED MEDICINE, you will likely never achieve the results you are looking for.
- UNDERSTAND INFLAMMATION: If you do not understand what INFLAMMATION really is (as well as what drives it), you have no real hope at finding a long-lasting solution to your problem.
- UNDERSTAND THE LINK BETWEEN GUT HEALTH AND OVERALL HEALTH: Inflammation is often driven by LEAKY GUT SYNDROME and visa versa. Understanding GUT HEALTH is critical to getting healthy enough for your body to begin to heal itself. The old adage from the practice of Natural Medicine is "Heal the Gut, Heal the Body".
- CONTROL YOUR BLOOD SUGAR: I just wrote about this the other day (HERE). No matter what sort of health problem you are dealing with, this is big-time critical! The really cool thing about eating a diet that controls Blood Sugar is that it is just a short leap to a GLUTEN FREE DIET. If you do not understand how much Gluten affects Inflammation, you have not been clicking the links.
- TRY INVERSION: Get a decent INVERSION TABLE and do what I call "hovering" (read the link). With the right kind of Inversion Table, you can actually do this on your belly if that is what is comfortable for you. You might even try Spinal Decompression Therapy, but finding someone to (gently) work on a person who has been through multiple spinal surgeries could be a challenge.
Don't get me wrong, there are many others that could be put on this list. The thing is, since most health problems have at least some degree of COMMON ORIGIN (and HERE), they naturally must have to at least some degree, a COMMON SOLUTION
- TRY COLD LASER THERAPY: COLD LASER THERAPY is awesome because like most of the other bullet points above, there is absolutely no potential for it to make you worse.
as well. Begin by radically changing your diet (HERE
) to decrease Inflammation, and see what happens. And never stop searching for answers. Oh; one more thing. See if there is a Functional Neurologist in your area who has been trained by DR TED CARRICK
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WHAT IS NEGATIVE PRESSURE?
WHY IS IT SO CRITICAL IN
SPINAL DECOMPRESSION THERAPY?
Mountain View, Missouri (West Plains / Willow Springs / Cabool / Winona / Summersville) ---- Spinal Decompression Doctor, Russell Schierling, presents another blog article on Spinal Decompression Therapy.
If you look at very much information about Non-Surgical Spinal Decompression Therapy, you will notice that the number one goal of the process is to achieve something called "Negative Pressure
" inside of the Spinal Disc. Negative Pressure is critical because it is what allows the jelly center (the Nucleus Pulposus) to be 'sucked' back inside a stretched or torn Annulus (the ligamentous rings that keep the jelly center in place). What are some of the ways that you can aid this process on your own?
For one, get to and maintain your optimal weight. When you carry extra weight --- particularly ABDOMINAL FAT
---- there is an incredible amount of mechanical pressure that is exerted on the Spinal Discs. I am also a big advocate of using an Inversion Table. Many people get relief from their disc symptoms by using Inversion Therapy. Just make sure that you do it the right way (HERE
). For severe cases of HERNIATED DISCS
, Spinal Decompression Therapy is a logical choice if your goal is to avoid surgery. Spinal Decompression Therapy gently pulls on your low back, creating Negative Pressure inside of the Spinal Discs. Think of Negative Pressure as a vacuum. As the pressure inside the disc decreases, something has to fill that void. The herniated portion of the disc is allowed to be pulled back under center.
With the proper amount of time, nutrition, and OTHER FACTORS
, the majority of these discs can heal without SURGICAL INTERVENTION
. For more on this topic, you can READ THIS
THE COMMON CAUSES OF SCIATICA
Everything You Ever Wanted to know about Sciatica,
But were Afraid to Ask
Do You Have Any of These Painful Symptoms of Sciatica?
- Burning sensations that run from your butt into your leg?
- Electrical shock-like sensations that shoot down your leg?
- Gnawing, aching, cramping-like pain in your thigh or calf?
- Pins and needles sensation (many people refer to this as numbness and / or tingling) in your butt, thigh, leg or feet?
All of these are indicative of SCIATICA
. But you need to understand that
sciatica is just that ---- pain caused by irritation and INFLAMMATION
of the sciatic nerve. The sciatic nerve is both the longest and
the largest nerve in the body (as big around as your finger in the buttock region). It begins in the lower back, as the lower spinal nerves exit your spinal cord and join together to form one large nerve. The sciatic nerve, supplies your lower body with sensation and muscle function, and is always a symptom of an underlying problem. What Causes Sciatica?Although the symptoms manifest essentially the same way and can look virtually identical to each other, there are numerous different causes of sciatica. Some of these are Disc-related and some are not. The list includes things like......
How Can I Tell What is Causing My Sciatica?
- Injury or direct trauma to the sciatic nerve.
- SUBLUXATION or misalignment of the spinal bones.
- If pain starts in the buttocks, it could very well be PIRIFORMIS SYNDROME and not a Spinal Disc problem. If your problem is Piriformis Syndrome, it will not respond favorably to Spinal Decompression Therapy.
- SPINAL DEGENERATION
- DISC BULGES / DISC HERNIATIONS
- Degenerative Arthritis of the spine, causing SPINAL STENOSIS (narrowing of the "tube" that houses the spinal cord or the "window" from where the spinal nerves exit the spine).
- Spinal Tumors
There are many different ways that doctors try to determine what is causing your back pain. Bear in mind that most of these methods are not as effective as you might imagine. As I have discussed previously (HERE
), study after study after study has shown that doctors cannot determine the exact tissue that is causing the pain less than 25% of the the time (Gulp!).
Which Sciatica Treatments Are Best?
- Physical Examination: This involves your doctor pushing, pulling, and stretching your back and legs to determine exactly where the sciatic nerve irritation is coming from.
- Neurological Examination: This helps doctors determine which disc is injured, and how severely injured it might be.
- Spinal X-ray: Although doctors cannot see a disc herniation with an X-ray, it does allow them to see if any signs of disc space narrowing or Spinal Degeneration is present.
- Electrical Diagnostic Tests (NCV): This can show diminished speed of nerve transmission from your back to your leg. I will warn you that this test is not only miserable to have done, in my opinion is it's not the best test out there. Most of the time you have to be really really bad for for the test to show that you have a problem. Many people who are suffering with a great deal of sciatic pain are surprised when this test comes back negative.
- MRI of Low Back: MRI's allow doctors to visualize the spinal discs to see if there are herniations blocking or pinching the sciatic nerve. I typically do not require an MRI to begin Spinal Decompression Therapy. HERE is one reason why. The previous link is another.
Sciatica treatment depends on what the underlying cause is. If your problem is Piriformis Syndrome
, we will always tackle it as a separate issue as it does not respond to Spinal Decompression Therapy. If your problem involves one of the BIG FOUR
, the most effective forms of sciatic nerve treatment include things like: The truth is, your Sciatica is Likely Caused by One or More of the Common Causes.
Your prospects for getting better largely depend on the cause and severity of your underlying
underlying condition, how long it’s been there, as well as your general health and fitness level. The good news is that for the majority of those suffering with chronic sciatica, there is help available. Call us today at (417) 934-6337
to set up your free consultation with Dr. Schierling.
Mountain View, Missouri (West Plains / Willow Springs / Winona / Cabool / Summersville) ---- Spinal Decompression Doctor, Russell Schierling, presents another blog article on Spinal Decompression Therapy.
ICE -vs- HEAT
It's All About the Blood Vessels
Remember when you ruptured your disc? You were bending over trying to get your boat hooked up to your hitch when BAM
--- you felt a stabbing pain in your low back that took you to your knees. In the months since that time, you have had a set of X-rays, a CT Scan, and an MRI of your lumbosacral area. Your doctor told you that you have a DISC BULGE
at the L5 disc, and that it is pinching a nerve. This is not news to you because you can feel the constant dull ache in your leg. That is, until you move wrong and it runs through your leg like an electric shock of pure pain that the doctor called SCIATICA
. The doctor wrote you prescriptions for four different medications and then told you to use a heating pad several times a day.
You are not doing well at all, and want to know if you are doing things the right way. Of course the medications are not helping you get better. They are masking the symptom so that you can live with it while it is supposedly healing. Unfortunately they are not doing a very good job of doing even that. But the medications are another topic for another day. What I want to discuss with you right now is
the difference between using ice and heat, and when one is better than the other.
IF I HURT MY BACK DO I USE ICE OR HEAT?
Allow me to take you through the progression of a back injury. When you bent over to jockey with the ball hitch on your truck (you are hitching up your boat), you felt something give in your back. Some soft tissues (like muscles) have a rich blood supply. Some, like TENDONS
have a very poor blood supply. Arterial blood comes from the heart / lungs loaded with oxygen. The oxygen is transported out of the blood vessel and into the body's tissues at the capillary level. Capillaries are so small that only one red blood cell at a time can pass through without creating a traffic jam. Because they are so small and fragile, when you injure tissue, you actually injure (tear) the capillaries that supply blood and oxygen to said tissue.This causes leaking of fluid into the tissue itself (swelling). The group of Immune System chemicals (INFLAMMATION) that are released due to this tissue injury, attract fluid (swelling) to the area.
It is important to remember that swelling and inflammation, while intimately related to each other, are not
synonymous terms. Although Inflammation is necessary for the healing process to take place, too much of it is bad news as far as pain is concerned. This is why you need to use ice --- even if it does not immediately help with your pain.Ice is a vasoconstrictor ---- it closes down the smallest blood vessels in the torn tissue so that less fluid and chemicals leak out. The result is less swelling and Inflammation --- and hopefully less pain. If you are going to use heat for your back, I almost always recommend a "global" heat. In other words, don't put the heat pack on your low back because that will attract fluid (swelling) to that area. Instead, get in a bath, shower, jacuzzi, etc. The larger the area you heat, the less chance of swelling a local area.
YES, YOU CAN HAVE DISC DEGENERATION AT AGE 33
Hello Dr. Schierling,
I have been struggling with severe low back pain for a while now. Neither chiropractic adjustments nor physical therapy have helped me much. My doctor finally suggested that I have an MRI. Although I do not have Herniated Discs, they told me that I have something called "Spondylogenic Spondylolysis". He said that most doctors refer to this as DJD (Degenerative Joint Disease) or DDD (Degenerative Disc Disease). How can this be? I'll admit that I weigh a bit more than I should, and do not get as much exercise as I would like, but come on..... I mean; how in the world does this happen? I just turned 33 a couple of months ago. I saw your DESTROY CHRONIC PAIN website. Would your scar tissue treatment help me? What can I do?
Wow! These kinds of letters break my heart. Why? Mainly because the vast majority of similar problems are almost 100% preventable!
DJD is not a disease in any real sense of the word (HERE
). It is a problem caused by abnormal joint motion over time. For this sort of degeneration to be occurring at such an early age, it probably means that this individual has had underlying injury / SUBLUXATION
for years (it turns out he was in a severe MVA
back in high school).The good thing is that this person can likely be helped by non-surgical Spinal Decompression Therapy. Of all the different problems
that we help via SCAR TISSUE REMODELING
, Degenerative Lumbar Discs are not at the top of the list. However, they are at the top of the list of the "Best Responders" as far as Spinal Decompression Therapy is concerned. If you get a couple minutes, check out our VIDEO TESTIMONIALS
Mountain View, Missouri (West Plains / Willow Springs / Winona / Cabool / Summersville) ---- Spinal Decompression Doctor, Russell Schierling, presents another blog article on Spinal Decompression Therapy.
WHAT SHOULD I TAKE FOR MY BACK PAIN?
Hey Doc, what can I take for my back? It's killing me!
" Unfortunately, there are no medications that can effectively address the underlying causes of back pain ---- particularly the severe back pain caused by HERNIATED DISCS
, DEGENERATIVE DISCS
, or SPINAL STENOSIS
In order to determine which ones were the most effective, a recent issue of the Cochrane Review
looked at the medications which are most likely to be prescribed for back pain. For those of you who follow current medical research, the results were not surprising. Although studies like this should lead medical doctors to change the manner in which they prescribe medications for their back pain patients ---- I'm not holding my breath. The study was a Meta-Analysis. This means that although they did not do any new research, they actually looked at numerous similar studies over a period of many years. What drugs did they study?
The Back Pain Medications:
- NSAID’s (Non-Steroidal Anti-Inflammatory Drugs) include drugs such as aspirin, ibuprofen (Motrin and Advil) and naproxen (Aleve)
- Another class of NSAID’s called Cox 2 inhibitors (Celecoxib aka Celebrex). Vioxx was one of these drugs, and was pulled years ago because it was killing people.
- Acetaminophen (Tylenol)
- Muscle Relaxers
What Did the Experts Determine?
- NSAIDs work in the short-term, but they aren’t really better than plain Tylenol. They also have numerous side effects.
- NSAIDs are more effective than a placebo, but with more side effects
- COX-2 inhibitors (a different kind of NSAID) do spare the GI tract; but they don’t work better than the traditional NSAIDs (by the way, newer research is saying they do not spare the GI tract)
- There wasn’t one individual NSAID that worked better than others
- It is not necessary to combine an NSAID with a muscle relaxant. This doesn’t provide greater symptom relief but it does increase the negative side effects
This does not even touch on the issue of Corticosteroids, which not only have a terrifying array of side effects, but actually work to rapidly degenerate collagen-based tissues (Spinal Discs, ligaments, tendons, cartilage, bone, muscles, etc...). This is why doctors who routinely give STEROID INJECTIONS, should warn patients that even if it helps with their pain, they cannot have very much of it because it eats the Spinal Discs. Unfortunately, these warnings are not given as often as they should be, and if they are, doctors never seem to mention why corticosteroids are dangerous.Listen folks, you already know that these drugs are not effective for what you are dealing with. The dirty little secret is that you doctor knows it as well. If you are struggling with chronic low back pain, at least think about trying something different than the same old same old. We will sit down and talk. I will review your test results. If I think I can help you, I will. Unfortunately, at least half of those who I consult with are not GOOD CANDIDATES for our Spinal Decompression Program.
- Expensive prescription drugs do not work any better than Over The Counter cheapies like Tylenol, Advil, Motrin or Aleve.
- All NSAID’s are about the same in regards to relieving back pain ---- and are no better than Tylenol (which, if you ask people who suffer with back pain, is not effective).
- Muscle relaxants are not good for back pain patients as they do not improve outcomes, but do increase the numbers of side-effects.
But those who are tend to get excellent results. Make sure to watch a couple of the Testimonial Videos on our Homepage.
It's a question that I am asked all too frequently. "
ASYMPTOMATIC DISC HERNIATIONS
Fact or Fiction?
Image by Mansuper
BOTH HAVE A HERNIATED L5 DISC
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If you want an excuse to operate on a pitcher’s throwing shoulder, just get an M.R.I. World's foremost sports surgeon, Dr. James Andrews after doing shoulder MRI's on 31 healthy big-league pitchers visiting him for other reasons, and then finding that 90 percent of them had both cartilage and Rotator Cuff abnormalities.
| |Like Dr. Andrews in the quote above, many of you have found out the hard way that MRI examinations are not all they're cracked up to be. Oh; most people already realize that x-rays will not show a Disc Herniation. But they are typically under the impression that an MRI will show anything and everything that might be wrong with you. But if you have followed my DAY TO DAY BLOG,
you are aware that this is frequently not the case.
Spend any significant time researching Disc Herniations, you are likely to have heard of "Asymptomatic Disc Herniations
". Buckle your seat belts and hold on to your hats because this is going to start getting interesting. Depending upon whose research you believe to be the most accurate, between 35% - 75% of the adult American population has Asymptomatic Disc Herniations. What does this mean? Only that the majority of U.S. adults are walking around with Disc Bulges / Disc Herniations ----- but have no idea because they do not have back pain or leg pain (SCIATICA
FUN FACTS ABOUT DISC HERNIATIONS
- Herniated Discs are not necessarily painful --- in fact much of the time they are "asymptomatic".
- The majority of Herniated Discs are asymptomatic (they cause no pain).
- Surgery is rarely needed to fix most cases of Herniated Disc.
- SPINAL SURGERY frequently means poor outcomes for Herniated Discs.
- Herniated Discs do not typically get "more herniated" with time (however, they do end up DEGENERATING).
- Although the pain may go away after a period of months or years, Herniated Discs do not resolve on their own.
- Herniated discs cannot be seen with an x-ray.
- Herniated Discs can happen without an overt injury.
- Herniated Discs can happen due to compensation caused by an abnormally rotated pelvis.
- Medical treatment is not necessary for most herniated discs.
- Many disc-like conditions are misdiagnosed (i.e. PIRIFORMIS SYNDROME)
In fact, according to the research I am about to show you, if I rounded up 100 people with an average age of 45, with no history of low back pain; and were to do MRI's of the lumbar spine on all of them, the results would be as follows.
- 35% - 75% would have Disc Bulges
- Just under 40% would have Disc Protrusions (Disc Herniations contained within the Annulus)
- Just over one in ten would have Disc Extrusions (Disc Herniations where the Nucleus Pulposes is actually leaking out of the Annulus) --- severe Disc Herniations.
How do I know all this? Not only have I learned a thing or two over the two plus decades I have been taking care of patients, but there are numerous scientific studies on the subject that encompass nearly six decades. Let's take a couple of minutes to look at just a few of them. I want you to note that some of the variations between studies has to do with the fact that there are no hard and fast definitions for terms like Disc Herniation, Disc Bulge, Disc Rupture, etc. These terms are often used interchangeably with each other and have the potential to create some confusion.
ASYMPTOMATIC DISC HERNIATIONS
Image by Magnus Manske
Image by User: Tonbi_ko
In one of the first studies of its kind, George Washington University Medical Center Orthopedist, Dr. S.W. Wiesel started the ball rolling with a study published in the September 1984 edition of the medical journal Spine
(The Incidence of Positive CAT Scans in an Asymptomatic Group of Patients
). "In order to study the type and number of CAT scan abnormalities of the lumbar spine that occur in asymptomatic people, 52 studies from a control population with no history of back trouble were mixed randomly with six scans from patients with surgically proven spinal disease, and all were interpreted by three neuroradiologists in a blinded fashion. Irrespective of age, 35.4% were found to be abnormal. In the over 40-year-old age group, there was an average of 50% abnormal findings.
" At least 35% abnormalities in asymptomatic individuals.
Six years later, in the March 1990 edition of the American Volume of The Journal of Bone and Joint Surgery
, renowned orthopedic surgeon Scott Boden, also working at GWU Medical Center, followed up with a paper titled, "Abnormal Magnetic-Resonance Scans of the Lumbar Spine in Asymptomatic Subjects. A Prospective Investigation
". In it he said that, "We performed magnetic resonance imaging on sixty-seven individuals who had never had low-back pain or sciatica. The scans were interpreted independently by three neuro-radiologists who had no knowledge about the presence or absence of clinical symptoms in the subjects. About one-third of the subjects were found to have a substantial abnormality. Of those who were less than sixty years old, 20 per cent had a herniated nucleus pulposus. In the group that was sixty years old or older, the findings were abnormal on about 57 per cent of the scans: 36 per cent of the subjects had a herniated nucleus pulposus and 21 per cent had spinal stenosis. There was degeneration or bulging of a disc at at least one lumbar level in 35 per cent of the subjects between twenty and thirty-nine years old and in all but one of the sixty to eighty-year-old subjects.
" At least 35% abnormalities in asymptomatic individuals.1994 saw yet another study published on this topic. Dr. Maureen Jensen's "Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain
" published in the July 14 issue of the New England Journal of Medicine
. In this study we learned that, "Thirty-six percent of the 98 asymptomatic subjects had normal disks at all levels. 52 percent of the subjects had a bulge at at least one level, 27 percent had a protrusion, and 1 percent had an extrusion. Thirty-eight percent had an abnormality of more than one intervertebral disk. On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions. Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.
" Over 50% of asymptomatic individuals had Disc Bulges.
In 1995, Volvo's 'Clinical Sciences Study of the Year' (The diagnostic accuracy of magnetic resonance imaging
) was published in the December issue of Spine
. The present study has presented evidence that.... asymptomatic patients show a high incidence rate of disc herniations (76%). Individuals with minor disc herniations (i.e., protrusion, contained discs) are at a very high risk that their magnetic resonance images are not a causal explanation of pain because a high rate of asymptomatic subjects (63%) had comparable findings.
I must make note of the fact that this study also found that a whopping 85% of the asymptomatic subjects had class 3-5 DISC DEGENERATION
on MRI as well. At least 75% of asymptomatic individuals had Disc Herniations.
A few years later, a group of prominent Swiss researchers, led by Dr. Weishaupt of Zurich's Orthopedic University Clinic's Department of Diagnostic Radiology, got their hands on 60 hospital employees with no history of back pain. The research team ran all of them through MRI's of the lumbar spine. Even though the paper's conclusion infers that MRI is a wonderful tool for diagnosing back pain in the under-50 crowd, reading between the lines leads one to a different conclusion. 40% of the volunteers had "Disc Protrusions
" even though they did not have back pain. Even more amazing was that almost 1 in 5 of the test subjects had a "Disc Extrusion
" (severe Disc Herniation). The results were published in the December 1998 issue of the journal Radiology
. Almost 20% of the asymptomatic individuals studied had 'severe' Disc Herniations.*INCREDIBLE STUDY
*In Y-2K, Dr. Michael Raskin (M.D. / Attorney) got into the mix with a paper he published in Applied Radiology
. In the paper, whose topic pertained to the difficulty of accurately diagnosing personal injury clients, he exposed one of the dirty little secrets that hundreds of thousands of people on SSI Disability have known for years --- essentially that back injuries are easily faked. "Asymptomatic individuals with "abnormal" MRI--Recent literature has shown that many anatomical abnormalities of the back, including disc bulges and disc herniations, are quite common in people without back pain. Even prior to magnetic resonance imaging (MRI), the high incidence of disc abnormalities in the lumbar spine of asymptomatic individuals was quite well known. In 1956, a study using postmortem examinations of the entire spine showed a 39% prevalence of posterior disc protrusions. In 1968, a study using myelography in 300 asymptomatic individuals demonstrated lumbar disc abnormalities in 24%. Using computed tomography (CT), a 1984 study reported the prevalence of herniated discs in asymptomatic individuals to be 20% in those under the age of 40 years and 27% in those over the age of 40. Since MRI became a clinically available diagnostic imaging tool in the mid 1980s, multiple studies have confirmed that more than half of adults without symptoms have significant disc bulges or disc herniations. Furthermore, the prevalence of [asymptomatic] disc herniations increases with age.
" We have known that there is a huge prevalence of asymptomatic Herniated Discs since 1956.A study published one year later in the journal Spine came to similar conclusions. According to the University of Washington's Department of Radiology, "Back pain is the second most common symptom-related reason for clinician visits in the United States. Up to 84 percent of adults have low back pain at some time in their lives.
" But despite this, as well as the incredible numbers of MRI's being done here in the United States, the authors concluded that, "Many MR imaging findings have a high prevalence in subjects without low back pain. These findings are therefore of limited diagnostic use.
" Read the previous two sentences.
And what if you are one of those people who has already had a back surgery? The scientific literature speaks to you as well. Just a little bit over a year ago, a group of six researchers working at Vanderbilt University Medical Center in Nashville, Tennessee, concluded their study on post-surgical asymptomatic Disc Herniations by saying that, "Nearly one-fourth of patients undergoing lumbar discectomy demonstrated radiographic evidence of recurrent disc herniation at the level of prior surgery, the majority of which were asymptomatic..... Clinically silent recurrent disc herniation is common after lumbar discectomy. "
Their findings were reported in the December 2011 issue of Spine
. This was not new information.
A 1995 offering, this time by Dr. RD Fraser and his team from South Australia's Department of Orthopedics and Trauma, Royal Adelaide Hospital, had this to say in that year's March edition of Spine
. "The findings of this study indicate that long-term improvement of a patient's symptoms after treatment of disc herniation may occur with or without resolution of the herniation. This and the similar findings in the different groups is consistent with the 10-year clinical results after the treatment of disc herniation reported by Weber.
" This was the conclusion after looking at groups that were treated in various ways for herniated discs, and noticing that after a decade, 37% of the people in the study still showed herniated disc on MRI. Interestingly enough, there was no rhyme or reason for who hurt and who did not simply by looking at their MRI. Between 25% - 37% of post-surgical asymptomatic patients showed Herniated Discs after their surgeries.
BUT WHY DOES IT MATTER?
Great question. Why does
it matter? Who really cares if you have Disc Herniations as long as they don't hurt? Let me give you a couple of examples. For one, research is now saying that if you have Asymptomatic Disc Bulges, they will likely not stay symptomatic forever. This is good to know. It may behoove you to check out the Top Ten Ways to Fix Your Own Back Problem
on my THORACOLUMBAR FASCIA POST
. No, I am not suggesting for one second that you need to rush out and get an MRI. I am saying that knowing this information could prove invaluable at some point in your life. Let me give you another example --- one that I see several times a week in my clinic.Let's say that you start having all the SIGNS OF A HERNIATED DISC.
After trying several things that did not help you, you had an MRI. The MRI showed that you have DJD
at three levels of the lumbar spine and two with DISC HERNIATIONS
. Your doctor wants you to do CORTICOSTEROID INJECTIONS
, and when that doesn't work, he wants you to visit a Spinal Surgeon. Even if you do not happen to be the sharpest knife in the cupboard, you know one thing ----- you know that people that have SPINAL SURGERIES
don't usually do worth a flip. All you have to do is ask them. BE WARNED: If you do not realize what it really means that most Disc Herniations are asymptomatic, and that it is often quite difficult to correlate one's symptoms with what the MRI shows, you will be taken advantage of.
How do I know this? For starters, look HERE
. Because there is big money in Spinal Surgery, it is not hard to grasp the fact that astounding numbers of people are having surgeries for problems that are not even the source of their pain! This is one of the reasons that before I start Spinal Decompression on anyone who's Sciatica originates in the butt / hip instead of the low back, I make good and sure that they are not dealing with PIRIFORMIS SYNDROME
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SPINAL DECOMPRESSION THERAPY
SETTING REALISTIC EXPECTATIONS
Mountain View, Missouri (West Plains / Willow Springs / Winona / Cabool / Summersville / Thayer) ---- Spinal Decompression Doctor, Russell Schierling, presents another blog article on Spinal Decompression Therapy.
One of my duties to the Chronic Disc patients I treat is to help set realistic expectations for their recovery. Expectations are critical. Because spinal pain ---- most particularly the severe, debilitating lower back or neck pain associated with SCIATICA
caused by HERNIATED DISCS
, SPINAL STENOSIS
, or DEGENERATIVE DISCS ----
can present a challenge for any physician to treat, you need to turn to someone who is both knowledgeable and trustworthy. I strive to be both.
Although it would be easy to take advantage of desperate people who are in pain, I have to turn about half the people I consult with away because I ALREADY KNOW
that theirs is not a problem that Spinal Decompression Therapy is going to help. Sometimes patients need to see a specialist. Sometimes they do not have a disc problem. Sometimes they need to be treated in a completely different manner than Spinal Decompression Therapy ---- particularly if they have a disc-mimicking
problem like PIRIFORMIS SYNDROME
. Bottom line: If I can help you, I will help you. But if yours is not a problem that will benefit from Spinal Decompression Therapy, I will tell you that as well ---- and try to get you to someone who can
Ask anyone who has been on the medical merry-go-round with spinal problems. Pain pills, CORTICOSTEROID INJECTIONS
and SPINAL SURGERIES
don't work for the long haul, and are known to have an extremely poor track record as far as dangerous and even deadly side effects are concerned. Not only is this borne out in the peer-reviewed scientific literature, but just look at the Online Support Groups for people with debilitating spinal pain ---- people that have already been through one or more Spinal Surgeries and are being told their only solution is more surgery. Or better yet, ask someone you know who has been down this route. Few of them are jumping up and down and shouting halleluiah because their surgeries or trips to the Pain Clinic were a rip roaring success.
Even though a person's severe pain may have just started, it is critical to understand that the underlying cause
of that pain has most likely been there for decades --- slowly progressing. As much as I wish that I could sprinkle a bit of pixie dust on your back side and make you well overnight, treatment for severe disc problems takes time. Even the medical community admits this. There is no way to avoid this fact. And even though I have had patients with long-standing spinal pain see massive improvements almost overnight (we once had a post-surgical case respond to their Spinal Decompression 80% after his very first treatment), most respond slowly. While many patients report a slow and steady improvement with each treatment, the truth is sometimes people respond erratically to treatment. Better one day, and worse the next ---- three steps forward and two steps back. (The patient who responded 80% on his first treatment? He took a month and a half to reach 100% improvement.)Although our STANDARD DISC PROTOCOL is 24 sessions over a period of approximately two months,
some patients may take more treatment than that. Especially if they have severe degeneration. Although I will often put a person on the Spinal Decompression Table to see how they will tolerate the treatment, or to find out which position will be the most comfortable, "Trial Sessions
" of a few treatments do not provide us with valuable information as to how well patients will respond over the long haul. I know this because most of my Spinal Decompression patients see the majority of their improvement during the last half of their treatment schedule.If you are tired of living with Chronic Pain that is affecting your ability to do all of the things that you love the most, call Tracy at (417) 934-6337. Schedule a free, no-obligation consult with me; Dr. Russell Schierling. I will go over your history and tests and determine whether or not you are a GOOD CANDIDATE for Non-Surgical Spinal Decompression Therapy.
My goal is to provide you an exit strategy ---- a way to get off the medical merry-go-round and get your life back.
SPINAL DECOMPRESSION THERAPY
MONEY BACK GUARANTEE
hat's right; here at Schierling Chiropractic, LLC, we offer a money back guarantee on our Spinal Decompression Therapy Protocols. If I accept you as a patient (HERE
), I am so confident that Spinal Decompression Therapy will be the solution to your disc problem, that your acceptance as a patient automatically confers you a money back guarantee.
If you get through the first two weeks of your Decompression Protocol at Schierling Chiropractic, LLC (every weekday ---10 sessions) and there is absolutely no improvement in your condition, you will be offered a refund of half the cost of your Spinal Decompression Protocol (minus any credit card or financing fees). You do not have to accept it --- I have had patients who do not start coming around until the third or fourth week ---- but it will be offered.
Although I would love to 'guarantee
' you that I can help every single person's unique disc-related problem(s), unfortunately I have run into a few people whose situation was too far gone ---- they did not respond. Although our Spinal Decompression Protocol has saved many people from spinal surgery, spinal surgery is, unfortunately, always a possibility when dealing with severe spinal problems. Who else is offering this sort of deal on their Spinal Decompression Therapy program? No one I know of.
For complete financial information, go HERE