_Mountain View, Missouri (West Plains / Willow Springs / Winona / Cabool / Summersville) ---- Spinal Decompression Doctor, Russell Schierling, presents another blog article on Spinal Decompression Therapy.

HERNIATED DISC
or
PIRIFORMIS SYNDROME?

Answering this question is critical because these are two very different problems that must be treated completely differently from each other --- yet can produce nearly identical symptoms.

But is this question being answered correctly the majority of the time?   I'll answer this with a quote from a recent research project from UCLA's Cedars Sinai Medical Center in collaboration with the Institute for Nerve Medicine.  The study was published in in a 2005 edition of the Journal of Neurosurgery: Spine.  "Most spine specialist consider Piriformis Syndrome to be extremely rare.  However, the authors conclude that although it is rarely diagnosed, it is actually a common cause of sciatica - possibly as common as the well known herniated disk syndromes."   "Rarely Diagnosed".  This is still true in my neck of the woods.  When you look at the VIDEO TESTIMONIALS of people I have treated with 20 - 40 year histories of Piriformis Syndrome, an almost universal thread is that none of them had ever as much as heard of PS until they came into my office.  Not that it would have mattered.  I am not convinced that doctors making the correct diagnosis is helping these people in any meaningful way.  If you have suffered with PIRIFORMIS SYNDROME, you know what I am talking about.

The Piriformis Muscle (piriformis means “pear shaped“) is a tiny muscle located deep in the buttocks, underneath the gluteal (butt) muscles.  This little muscle is the most well-known of a group of muscles known as the “Hip Rotator Cuff” and is frequently the source of pain in the butt and associated Sciatica.  I have had several people come to me for Spinal Decompression Therapy that actually had Piriformis Syndrome.  Yes, we saved them a lot of time, grief, and money.  Spinal Decompression Therapy does not help Piriformis Syndrome!

Piriformis Syndrome is a miserable condition in which the Piriformis Muscle becomes overly tight.  Although there are almost always underlying biomechanical issues to deal with (bow legged or knock knees, high / low arches, a history of PULLED MUSCLES around the pelvis, etc) this pathological tightness of the Piriformis is usually the result of FASCIAL ADHESIONS or TENDINOSIS. 

Piriformis Syndrome can be aggravated by bending, lifting, sitting, sports, and even driving (foot on the gas pedal).  Contrary to what your M.D. might tell you, there are no drugs or surgery that are effective for treating Piriformis Syndrome. I will warn you, in 20 plus years of practice I have never one time seen a person whose Piriformis Release Surgery actually worked.

Piriformis Syndrome is an extremely common condition, and is far more likely to be found in women than men (about 12-15 times more often).  Although I can only speculate on the reason for this, I suspect that it is a child-bearing issue. It probably also has to do with the naturally wider shape of a woman’s pelvis. This is the most likely explanation for my finding it much more frequently in women than men — even in women who have not had children. 


PIRIFORMIS SYNDROME CAUSES SCIATICA
As I stated earlier, Piriformis Syndrome is a major cause of sciatica (leg pain, numbness, tingling, or weakness, in any combination), hip pain, and buttock pain.  Because sciatica is so often involved, the problem is often misdiagnosed as a HERNIATED DISC, DEGENERATIVE DISC, or sacroilliac problem (sometimes chronic sacroilliac problems are related to problems in the Piriformis Muscle).

The SCIATIC NERVE is both the largest and longest nerve in the body, and at its largest point is about the thickness of one’s thumb.  The sciatic nerve originates in the low back (lumbar spine region) and angles toward the middle of the buttock.  It then extends down through the leg, passing just underneath the piriformis muscle.  Be aware that in as much as half the population, the sciatic nerve travels through the Piriformis Muscle, passes over the Piriformis Muscle, or splits in two and passes directly around the Piriformis Muscle. 

Be aware that much of what is called Piriformis Syndrome is actually a Piriformis Tendinopathy. See our TENDINOSIS PAGE for more information.   Usually this pain will be worse at the hip joint itself (lower, outer buttock region).

The symptoms of Piriformis Syndrome usually begin as a deep aching in what women like to refer to as their “hip” area.  This pain will be found along an imaginary line that runs from the very tip top of the butt crack, to the greater trochanter of the hip bone (the bony knob on the upper and portion of the outer or lateral thigh).

People most predisposed to chronic contracture and microscopic scarring of the piriformis muscle, are people who wear cruddy or improper footwear for their foot type (high-arched people wearing a “stability” or “dual-density” shoe), those with faulty spinal or lower limb mechanics, overweight or obese people, those with poor posture, people who spend too much time sitting, too much time on concrete, or not getting enough physical activity (or occasionally too much exercise — overtraining).  And of course, the biggie — just being female. 

Due to mechanical stresses causing chronic tightness / contracture, the Piriformis Muscle can actually become shortened over time.  This often results in microscopic scarring of the fascial sheaths that tightly surround the muscle itself.  Piriformis Syndrome is most commonly worse at rest (sitting or lying down) and is often (but not always) temporarily relieved by moderate activity (particularly walking or stretching).

Visit our MICROSCOPIC SCAR TISSUE & FASCIAL ADHESIONS page to understand the relationship of Fascial Membranes to Muscles.

For years, I did not really understand why I had such good clinical results with so many cases of buttock / hip pain and sciatica, while other seemingly identical cases were largely unresponsive to chiropractic adjustments.  Frequently these “problem” cases would get fantastic short-term results from their adjustment, but these results never seemed to last more than a few days at the most (and often no more than a few hours).  It was not until I started doing “TISSUE REMODELING” in 2001, that I truly began to understand what was going on. 

Over the past decade I have come to realize that Piriformis Syndrome is literally “epidemic” in the female portion of our society (see our PATIENT TREATMENT DIARY); with the medical community being largely mystified about what it really is, or how to treat it effectively.  Again, drugs and surgery do not constitute “effective treatment” for Piriformis Syndrome.  Never assume that a “Piriformis Release Surgery” will solve your problems, as many people who have it are worse.

As you have read on our Fascial Adhesions Page, scar tissue is normal, elastic tissue (think nicely combed hair here) that has been disrupted from its organized structure, into a balled-up and tangled wad of inflexible and hyper-sensitive, micro-gristle (think of a hair tangle that cannot be combed out).  This kind of microscopic scar tissue is not typically seen in the muscle itself, but in the fascia.  Fascia is the thin, but very tough, yellowish white membranes that cover muscles.  In my neck of the Ozarks, deer hunters call these membranes, “Striffin“.

Fascia is arguably the single most pain-sensitive tissue in the body!  Fascial Adhesions will cause pain and dysfunction.  Destroy Fascial Adhesions and Destroy Chronic Pain!

Because most of these scar tissues are in the fascia as opposed to the muscle itself, they do not image on MRI --- period.  It is my opinion that microscopic scarring of the Piriformis Muscle is the single most common cause of chronic, long-standing, Sacroilliac or buttock pain (the Sacroilliac Joints are the bony bumps that lie just up and lateral to the top of the butt crack).  It is also the most common cause of what I have for years referred to in the office as a “butt-based” sciatica.


PIRIFORMIS SYNDROME & YOUR FEET
If you have extra-high arches or “fallen” arches, or if you have abnormal lower body biomechanics of any sort; you probably need arch supports (orthotics).  We carry some nice, generic orthotics that will work for many people.  However, some of you will require custom orthotics.  Allow me to give you an example of why:

Although I have seen my fair share of Piriformis Syndrome patients with fallen arches or flat feet, as far as I can tell from clinical experience, high arches seem to be more related to Piriformis Syndrome.  The higher the arch, the more you get “pushed” onto the outside of your foot.  To see what this does to the Piriformis Muscle; stand up, put your hands on your upper buttocks in the area of the Piriformis Muscle.   Now, roll your weight out onto the outsides of your feet.  Notice how the Piriformis Muscle instantly becomes tight as a drum?  This is what is going on all day long if you have improperly supported high arches.  And there is only one company on the planet that I am aware of that specifically specializes in shoe inserts (orthotics) for people with high arches……. XF

The only custom orthotic company that I recommend for my patients is X-treme Footworks out of Idaho Springs, CO.  To find out whether your pain is Disc related, or Piriformis Syndrome, simply call us at (417) 934 6337 to schedule a free consultation with Doctor Schierling.  It is imprtant to differentiate Piriformis Syndrome from Disc problems because Piriformis Syndrome will not respond well to Spinal Decompression Therapy --- in fact, it will usually make it worse. 

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If you are considering Spinal Surgery, you might want to VIEW THIS PAGE FIRST!

_THE FDA HAS CLEARLY STATED THAT...
“All decompression tables that use the right amount of force and protocol will have the same positive results shown in the commonly used and quoted research done by various companies.”

What does this mean in relationship to today's Blog?  It means that most Spinal Decompression Tables are seriously caught up in marketing and pure hype (the reasons that many of these companies have been fined and forced to change their advertising)!   The combination of NEGATIVE PRESSURE with the computerized logarithms that together create the  pull & release pattern that separates SPINAL DECOMPRESSION THERAPY FROM TRACTION is is not unique to any one machine or table.  It can be replicated on almost any Spinal Decompression Machine.  What does this revelation mean to you, the consumer?  Only that your Spinal Decompression Protocol does not need to cost an arm and a leg.

 Although "Spinal Traction" (electric winch-like motors, hooked to belt-like devices) has been used by orthopedists and chiropractors for decades, about twenty years ago saw the invention of the first "Spinal Decompression Therapy" unit.  According to Wikipedia (and everything else I was able to find on the subject), the history of Non-Surgical Spinal Decompression Therapy started with VAX-D and is as follows:

Non-surgical spinal decompression was originally developed and pioneered by Dr. Allan Dyer, PhD, MD in 1985 and the first non-surgical spinal decompression table, the Vax-D was introduced by him in 1991.  This original device was controlled by a pneumatic system and gradually applied and released the traction force to reduce muscle guarding and spasm.  In 2004, Vax-D Medical Technologies introduced an enhanced version of this table called the G2 that replaced the pneumatic technology with more precise electrically driven components and also added an enhanced on board computer control system that instituted a logarithmic curve.

The thing that we are not being told about these earlier tables is that they were being sold for between $120,000 and $150,000.  Patients were being charged anywhere from eight to twelve thousand dollars to go through a series of Decompression Treatments.  With that kind of money available to Spinal Decompression Doctors, there were sure to be other players jump into the game.

Having seen twenty years worth of Spinal Decompression Equipment ads in various chiropractic publications, I can assure you that many Spinal Decompression Companies have come and gone.  One that product that has had some staying power is Axiom's DRX9000.  It is certainly not because the unit is inexpensive.  In today's housing market, I could buy a decent home here in Mountain View, Missouri for what one of these puppies costs!  Neither is it because it is a beautiful space saver.  Compared to the sleek VAX-D, the DRX9000 is a monstrosity whose 'traction tower' is literally covered with buttons, bells, whistles, computer screens, and all sorts of other "technology".  What the DRX unit has had going for it is some excellent marketing.  And the truth is, that is what this whole my-Decompression-Table-is-better-than-your-Decompression-Table thing boils down to.  Who spends the most dollars promoting their product.

One such article that was decrying the marketing techniques techniques used by many Non-Surgical Spinal Decompression Clinics, and bashing the DRX9000 had this to say about other such Spinal Decompression Therapy equipment for this very reason.

Since this article was originally published, several similar devices — DECOMPRESSION STABLIZATION REDUCTION SYSTEM (DRS), ACCU SPINA SYSTEM, DRX9000, SPINE-MED, ANTALGIC-TRAK, and LORDEX TRACTION UNIT, and a less elaborate device called the TRITON DTS — have entered the marketplace. New devices typically cost from $80,000 to $125,000.

Now listen.  As far as I can tell, the problem is not that any of these machines is inherently bad or dangerous (except the Triton).  On the contrary, they all seem to work quite well and essentially do what they claim to do ---- with about the same success rates across the board (remember the FDA's statement at the beginning of this article).  If you look at our clinic's two Research Pages (HERE & HERE), you will see that the success rate for Spinal Decompression Therapy is in the 70% - 85% range, depending on whose studies you look at.  Fortunately, the body of research on this relatively new therapy is growing rapidly.

Even though there is nothing inherently bad about most other Decompression Therapy Tables, there are several features that set our table apart from the rest.  One of the most obvious has to do with patient positioning.  The DRX9000 is one of the least adaptable tables on the market because it allows patients to be decompressed only while laying on their backs.  The VAX-D is just the opposite, only allowing patients to be treated while face down.  The KDT Table is versatile and allows for an almost infinite number patient positions.  This is important for those patients who come in with various postural distortions.

Another great thing about Dr. Jay Kennedy, the Kennedy Technique, and the KDT Spinal Decompression Table is that it is not only safe and effective, it is significantly less expensive than the other tables listed above.  What does this mean to you, the patient?  Only that we can offer Spinal Decompression Therapy at a price that does not break the bank!  So when you see VAX-D, or DRX9000 ads telling you that their equipment is the only equipment on the market that has been proven to provide "True Spinal Decompression", just remember that this is not based in truth.  It is marketing ---- the kind of misrepresentation and hype that has been with us since the beginning of time!

Rather than try and tell you how effective our SPINAL DECOMPRESSION EQUIPMENT & PROTOCOL really is, I would simply suggest that you take a couple of minutes to check out our VIDEO TESTIMONIAL PAGE.   Great results speak for themselves!

If you are sick and tired of living with chronic pain and the inability to do the things you have always loved to do, simply pick up the phone and call (417) 934-6337.  We will make you an appointment for a free consultation with Dr. Schierling.  He will sit down with you and talk about your case, review your history, and go over your tests, x-rays, and MRI's.  He will determine whether or not YOU ARE A GOOD CANDIDATE for Spinal Decompression Therapy, and go over any and all details with you.  Isn't it about time you got your life back?  Call Dr. Schierling today. 

_It seems like every couple of years, someone comes running into my office asking me about the latest "research" on a brand new type of artificial disc.  Over the past twenty five years, I have seen so many of these products come and go that I no longer get too excited.  Most often these products are approved by the FDA amidst a Tsunami of media hoopla ---- and then a couple years later they are quietly pulled off the market ----- after using the American public as Guinea Pigs. 

It looks like it should be so simple.  "Hey Doc, why can't they just insert a rubber bushing in there where the disc should be?"  Let me explain to you a couple of reasons that these artificial discs have never worked well in the past, are not working well in the present, and will most-likely never work well in the future.

- HYDRAULICS
The disc is an avascular tissue.  This means that it has no blood supply.  When you think about the things that blood provides your cells (oxygen, nutrients, water) as well as the things it removes (toxicity, acidity, metabolic waste products), you will start to realize that for a disc not to have a blood supply is a big deal ---- a really big deal.  

So, if the disc has no blood supply, how in the world does it get the things into the disc that it needs to live, and then get rid of the waste products?  The ever-amazing Spinal Disc acts as its own pump.  If the disc is moving / functioning properly, everything works as it should. When the disc pumps, the blood-like exchange of nutrients, water, and oxygen ---- for waste products, takes place via the fluid that is pumped in and out of the disc.  And the Spinal Discs stay healthy!  But if the Spinal Discs do not move properly, bad things begin to happen, and the exchange taking place between the fluid and the ligamentous tissues of the disc becomes increasingly diminished.

- SPINAL COMPLEXITY AND PROXIMITY TO NERVES & SPINAL CORD
I will not belabor this point, but just understand that the spine and nerve system is complex.  No, that is a gross understatement.  The spine and nerve system are absurdly complex.  When surgeons go in and start cutting, chiseling, stapling, screwing, wiring, bolting, drilling, pinning, sawing, and who-knows-what-else, you not only end up with a boatload of SCAR TISSUE, you end up with a literal grab-bag of potential side effects and problems ---- frequently permanent!  I understand that there is a time and place for spinal surgery.  However, even some of the most respected Neurosurgeons in the business claim that these surgeries are about 500 times more common than they should be (HERE).

WHY WOULD YOU NOT TRY CONSERVATIVE METHODS LIKE SPINAL DECOMPRESSION THERAPY FIRST?
I ask this question every time I talk to a patient who has already had 2 or 3 spinal surgeries, but is telling me that they will do absolutely anything I tell them to if I could just help relive some of their pain.  You may have already heard this because its been in the news for the past several years, but several medical studies have confirmed that rehabilitation for low back pain works just as well as disc replacement surgery (read that again and let it sink in).  Recently, publishing in the British Medical Journal (BMJ), researchers added to the evidence for effective rehabilitation, stating that the results are similar to surgery but without the risks.  It's still a roll of the dice; the only difference is that if conservative methods do not work, you are not out anything but time and money (approximately 2-3% of the cost of a Spinal Fusion).  Spinal Decompression Therapy may not always work, but it's not going to ruin your life!

Disc replacement surgery involves removing DEGENERATIVE DISCS or HERNIATED DISCS and replacing them with Titanium or Stainless Steel endplates and a polymerized core whose purpose is to "try" and act like the soft and pliable Nucleus Pulposus of a Spinal Disc.  As you might imagine, neither bone nor hardened metals have the ability to act similarly to the jelly of the nucleus!

More risks?  Another recent study published in the prestigious British Medical Journal (BMJ) stated that the risks of Disc Replacement Surgery are "enormous", including:
•A re-operation rate of 5-10%,
•Vascular injury rate of 5-10%
•Possible amputation due to vascular injury
And that's in the first year!  As time goes on, the problem gets worse.  When questioned, most doctors will admit that even "successful" Spinal Fusions only last about a decade before wearing out the discs above and below the surgery!

GULP! 
Other well known risks include: allergies to the material the fake disc is made from,  breaking the fake disc, failure for the whole mess to actually fuse once the fake disc is implanted, slippage can occur that will dramatically alter biomechanics, and on and on and on.  This does not even get into the problem of repeat surgeries.  When two vertebrae are fused, there is abnormal motion (too little) at the fusion.  However, there is also now abnormal motion at the discs above and below the fusion site (too much motion).  Unfortunately, abnormal motion is the chief cause of DISC DEGENERATION.  This is why Spinal Fusions (which themselves create seriously abnormal mechanical function of the disc) actually create the need for repeat Spinal Surgeries ---- fusions at the levels both above and below the surgically altered discs.  Which itself creates further abnormalities of motion.  It's that vicious cycle again!  But hey, if you're a Spinal Surgeon, it's great job security!

Then there is a significant chance of nerve or spinal cord injury, as well as the common surgical risks associated with anesthesia and infection.  If you think that the threat of infection is not real with a fusion (plates, pins, wires, and screws are implanted in your spine), go online and see what the medical community is saying about the infection rate for people who are having stainless steel or titanium implanted permanently into their bodies!  My brother (an MD) thought he was going to have to have a Spinal Fusion, and the thought terrified him.  Why?  The threat of infection when metal is surgically implanted into the human body.


SPINAL DECOMPRESSION THERAPY FOR THOSE SUFFERING WITH CHRONIC SEVERE SPINE PAIN
Why should a person with chronic low back pain consider Spinal Decompression Therapy for their low back or neck? Our experience as well as the experience of millions of patients world-wide prove that Spinal Decompression Therapy is a great alternative to surgery for many chronic low back or neck pain patients.  It carries almost no risk, and typically patients START SEEING RESULTS EARLY IN THE PROGRAM!   In short, surgery not only misses the root problem, it often messes people up and leaves them wondering what to do and where to turn.  Don't be "that person".

If this blog hits pretty close to home, my best suggestion for you would be to call Tracy and set up an appointment for a free consultation with Doctor Schierling.  If you are a candidate for Spinal Decompression Therapy, he will tell you.  IF YOU ARE NOT, he will tell you that also.  Call (417) 934-6337 today.

What criteria do I use to determine if someone is a candidate for Spinal Decompression Therapy?  This is a great question.  And contrary to what some might think, just because you're alive and have a wallet, does not make you a candidate.  So, what exactly are the criteria?  When you sit down with me in my office so that we talk face to face, we will go over your history and tests.  It is there that I begin to get an idea of whether or not Spinal Decompression Therapy could possibly benefit you.  In order to make this determination, I have to first find out things like......

-How long have you had your back problem?
-Is it getting progressively worse?
-Do you have a family history of back problems?
-Did you injure your back?
-If so, how and when?
-Describe the pain.
-What makes the pain worse?
-Do you have trouble sitting?
-Do you have trouble sleeping?
-How has this problem affected your life?
-What have you done to ease the pain?
-Has it helped?
-Have you been on NARCOTIC PAIN RELIEVERS?
-If so, how long?
-Have you been on ANTI-INFLAMMATORY DRUGS?
-Have you had STEROID INJECTIONS?
-If so, how many?_
-Have you taken Muscle Relaxers?
-What have your doctors actually diagnosed you with ---- SPINAL STENOSIS, BULGED or HERNIATED DISCS, DEGENERATIVE DISCS, FACET SYNDROME, SCIATICA, or something else?
-Have you been through Physical Therapy?
-If so, how much / how long?
-What did it entail?
-Have you been to a Chiropractor with this?
-Have you been to a specialist?
-If so, was it a Neurosurgeon, Orthopedic Surgeon, Physiatrist, Psychiatrist, etc?
-Have you been to a "Pain Clinic"?
-If so, what did they do for you there?
-Has a physician recommended that you need spinal surgery?
-Have you had any X-rays taken?
-Have you gone through any Advanced Diagnostic Imaging (CT Scans, MRI's, Discograms, Meylograms, etc)?
-What does your MRI, CT Scan, or X-ray look like --- what did these tests reveal?
-How much DEGENERATION is present in your Spinal Bones and Spinal Discs?
-What are your expectations for SPINAL DECOMPRESSION THERAPY?
-If you were accepted as a patient, are you doing things that would sabotage a SPINAL DECOMPRESSION PROTOCOL and prevent you from getting better?
-Do you smoke?
-Are you diabetic?
-What is your daily activity level?
-Are you willing to do the exercises and other things that go along with OUR DECOMPRESSION PROTOCOL in order to get better?
-Are you overweight?
-If I accept you as a patient, are you willing to work at dropping some weight if that is what is required for you to get better (I WILL HELP YOU)?

Yes, it's a long list of questions.  But my reputation is on the line.  I do not want people starting this program who are not likely to get better!

Spinal Decompression Therapy is a revolutionary treatment that involves providing intermittent traction to problem areas of the spine.  This therapy HAS BEEN SHOWN EFFECTIVE in relieving back pain, neck pain, as well as arm and leg pain (SCIATICA). Developed about 20 years ago, it has grown tremendously in popularity as more and more patients not only realize the therapy's benefits, but are also becoming increasingly aware of just how many SPINAL SURGERIES ARE ACTUALLY FAILING.  Non-surgical Spinal Decompression is effective, backed by RESEARCH, low cost (less than 3% the cost of most spinal surgeries), FDA cleared, and very safe with an extremely low risk profile.

WHO MIGHT BENEFIT?
Patients with chronic back pain, chronic neck pain, or leg pain may benefit tremendously.  Some of the most common problems that may be helped by Spinal Decompression Therapy include

• LUMBAR DISC HERNIATION
• CERVICAL DISC HERNIATION
• FACET SYNDROME
• FAILED SPINAL SURGERY
• RUPTURED or BULGED DISCS
• DEGENERATIVE DISCS
• DEGENERATIVE DISC DISEASE
• SCIATICA
• 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 more conservative treatments, including CHIROPRACTIC CARE, for patients with LUMBAR DISC HERNIATION causing SCIATICA.

However, there are some patients who are simply not good candidates for Spinal Decompression Therapy. The truth is, not everyone is going to be helped by this therapy, and if I know up front that it will not help you with your specific condition, I will tell you.  No hard feelings, but if I am not confident that we can help you, I will tell you so.

I have had distraught parents call the office wanting me to use Spinal Decompression Therapy to straighten their child's scoliosis.  I have had people want to use Spinal Decompression to help with butt and leg pain that I ascertained was PIRIFORMIS SYNDROME --- usually a simple fix ---- but not usually a problem for Non-Surgical Spinal Decompression.  I recently had a patient who wanted me to do Spinal Decompression on her neck in regards to a "unique" problem she had dealt with for over a quarter century.  Her problem turned out to be FASCIAL ADHESIONS.  However AMAZING the results of Spinal Decompression Therapy may be for some people, it is not indicated for every person or every back problem.

The bottom line is this; if, after I evaluate you, I feel that Spinal Decompression Therapy will help you, we will move forward.  If I do not think it will help you ---- or if I think your problem would be better helped by another approach (or even another doctor), I will try and help you set up an appointment with them.   I have been in practice in Mountain View, Missouri for over two decades.  I have worked hard to build a good reputation.  Good results speak for themselves, and if I do not think that we can achieve good results with your specific problem, I will tell you up front.

On occasion I might do with you what I did with George Lawler.  George and his wife Dr. Martha are dear friends that I have known since my earliest days in practice.  I told George that because his back was so messed up with so many different problems at multiple levels, and because he had tried just about every conceivable treatment there is to try without any real long-term benefit, I honestly had no idea whether I could help him or not (I was leaning toward "not").  After discussing all of this, George wanted to give it a go.  So I started a DISC PROTOCOL with George, both of us realizing that it might prove to be just like everything else he had done over the previous 18 years.  Instead, the results were nothing short of one of God's Miracles (SEE GEORGE'S VIDEO TESTIMONIAL HERE). 

Some of the problems that would keep you from being a good candidate for Spinal Decompression Therapy include.....

• Pregnancy (Although it is not a "problem", being pregnant disqualifies you for Spinal Decompression Therapy.  While highly unlikely, the stretching could cause uterine contractions)
• Severe Osteoporosis (While I might not be able to actually decompress these patients initially, our WHOLE BODY VIBRATION THERAPY is backed by a significant number of studies that show marked improvement in bone density.)
• Cancer / Spinal Tumors
  
• Aneurysms
• Certain Rare Disease Processes
  
• Certain Spinal Surgeries (Having pins, plates, wires, and screws in your spine might disqualify you as a Spinal Decompression Therapy patient, but it might not.  Come in a talk to me ---- and bring your X-rays and tests.  We will look at them and go from there.)

If you have read the RESEARCH and feel that Spinal Decompression Therapy is the one thing you have not tried, but need to ---- call us today.  Tracy will schedule you for a completely free, no-obligation consultation with Dr. Schierling.   We will sit down together and go over your previous history and test results, and figure out whether you are a good candidate for Non-Surgical Spinal Decompression.  Our phone number is (417) 934-6337.

To understand Facet Syndrome, we need to first understand just a little bit of spinal anatomy.  Each spinal joint is made up of the disc, as well as the vertebrate above the disc and below the disc.  But we cannot stop there.  On the back side of each vertebrae are two joints.  The technical name for these is "Zygapophoseal Joints", but we will simply call them facets. 

Facet Syndrome is a condition in which these small joints in the back of the spine degenerate and subsequently cause pain. The facet joints are found at every vertebrae on both sides of the spine, and provide as much as one fourth of the twisting stability in the low back.  Facet joints also prevent individual vertebra from slipping over the vertebrae below. A small capsule surrounds each facet joint providing a nourishing lubrication for the joint.

Each Facet Joint has a rich supply of tiny nerve fibers that can cause terrible pain when the joint is injured or irritated.  Inflamed facets can trigger neurological reflexes that can lead to severe muscle spasms.

It is quite common for Facet Joints to wear and deteriorate.  When facet joints become worn or injured, the cartilage surfaces may become thin to the point they no longer exist.  The bone in the joint underneath can produce an overgrowth of bone spurs and an enlargement or thickening (hypertrophy) of the joints similar to that seen in both SPINAL STENOSIS & DISC DEGENERATION. When that happens, we say that the joint has arthritic changes, or osteoarthritis ---- which can be a source of considerable back pain.

Prolonged, uncorrected dysfunction and accumulated trauma can cause the joint surfaces to become compressed together preventing proper motion. This condition is often referred to as a Facet Syndrome. The fluid lubricant within these joints requires proper and complete joint motion to keep it circulating. Therefore, a Facet Syndrome can cause degenerative changes to occur by starving the cartilage of much-needed oxygen and nutrients due to loss of joint motion.  If not dealt with, the degenerative changes in the facets progress to full-blown Facet Syndrome.  Degeneration can progress to the point it is totally irreversible.

FACET JOINTS:  In the picture on the left (taken from above), you can see the two oblong surfaces on either side of of the bottom, back portion of the Central Canal (the large hole in the middle).  These are Facet Joints.  There are two more on the bottom portion of the vertebrae as well.  In the picture on the right (a side view with the vertebrae facing right), you will notice the bone that sticks up higher than the rest, as well as the bone that sticks down below the rest.  These are Facet Joints.  While the square vertebral bodies stack on top of each other like blocks, the lower Facet Joints of one vertebrate articulate with the upper Facet Joints of the vertebrate below it.

_

SYMPTOMS OF FACET SYNDROME
The symptoms of a facet syndrome generally include deep, achy pain in the neck or low back. The pain is often near the center of the spine and is more pronounced on one side of the spine than the other. The pain is often made worse by bending toward the affected side or extending you back backward. It is also extremely common to experience stiffness in the involved region of the spine in the morning that actually improves with activity or stretching.  Symptoms of Facet Syndrome are often aggravated by prolonged sitting, standing, or staying in any one position for very long.  This is why people with Facet Syndrome will sometimes almost kill themselves with activity ---- it's the only time they do not hurt!

Non-Surgical Spinal Decompression  provides relief by separating the vertebrae and discs in a gentle, rhythmic fashion.  Although we typically think of this as being effective for the Spinal Discs, including things like DEGENERATIVE DISC DISEASE or HERNIATED DISCS, it is equally as effective for the Facet Joints.   As the vertebrae are separated, pressure is slowly reduced within the facet joints. Decompressing spinal joints can drastically reduce pain and dysfunction.  Also, the separation creates a NEGATIVE PRESSURE within the joint capsule that pulls much-needed oxygen, nutrients and fluids into the injured joint space allowing healing to begin.  It also pulls out metabolic waste products that can build up and cause cellular toxicity.

For more information, call Schierling Chiropractic, LLC, to check on availability and see if you QUALIFY FOR A FREE CONSULTATION.  The phone number is (417) 934-6337.

__The sciatic nerve is made of of the individual spinal nerves that exit the spinal cord from between the vertebrae of your low back and pelvis.  These nerves join together to form the longest and largest nerve in your body ---- the sciatic nerve.  It is as big around as your finger!  This nerve travels all the way to the feet.  The term "Sciatica" is used to describe irritation pinching, or INFLAMMATION of the sciatic nerve. 

Sometimes these "irritations" are actually caused by a pinching of the nerve.  This is commonly caused by a HERNIATED or RUPTURED DISC in the lumbar spine.  However, it is also frequently caused by DEGENERATIVE DISCS or SPINAL STENOSIS.  The pressure or irritation leads to several different symptoms that include radiating leg pain, burning, and/or numbness and tingling. This pain can be characterized as either  being sharp and severe or a dull nagging ache (or even both).  It is one of the single most common problems that I have treated over the past twenty years in practice.

If HERNIATED or BULGING DISCS are the cause of the problem, it's the herniated jelly center of the disc (Nucleus Pulposus) that pushes out and compresses or pinches the nerves.  Sometimes you will see Sciatica diagnosed or referred to as a "radiculopathy ".  This is really just a fancier name for Sciatica (the same thing can be seen in the arms when nerves in the neck get pinched or irritated).  Sciatica occurs most frequently in people between 30 and 50 years of age. On many occasions this condition slowly develops as a result of SPINAL DEGENERATION.

Rarely does this condition require surgery.  In fact, unless there is a rare sort of problem or traumatic injury, the majority of people who experience sciatica get pain relief with conservative treatments --- without the side effects of surgery.  NON-SURGICAL SPINAL DECOMPRESSION THERAPY, along with CHIROPRACTIC ADJUSTMENTS, COLD LASER THERAPY, and CEREBELLAR REHABILITATION are frequently effective for the underlying causes of sciatica ---- especially when utilized in concert with each other.

One or more of the following sensations may occur as a result of sciatica:

• Pain in the buttocks or leg that is worse when sitting
• Burning down the leg
• Numbness down the leg
• Weakness in the leg, or difficulty moving the leg or foot
  
• Frequently the leg pain is slightly worse than the back pain.

While everyone wants to be rid of the pain, your treatment goals should involve actually addressing the disc herniation.  This involves treatments that will re-hydrate and nourish the Spinal Discs and nerve roots, as well as to strengthening the disc to prevent re-injury. This is where SPINAL DECOMPRESSION THERAPY comes in.

WARNING   WARNING    WARNING...........
Symptoms that may constitute a medical emergency include progressive weakness in the leg or a serious loss of bowel control or an inability to pee. If either or both of these occur, seek immediate medical attention!

Oh, and do not confuse PIRIFORMIS SYNDROME (sciatica caused by an injured, chronically overstressed, or SCARRED muscle in the buttock ---- the Piriformis Muscle) with sciatica that is caused by HERNIATED DISCS or DEGENERATIVE DISCS.  Although Piriformis Syndrome is not always associated with sciatica, more often than not, it is.

SEE OUR VIDEO TESTIMONIALS ON SPINAL DECOMPRESSION THERAPY

If you are wondering if Spinal Decompression therapy might be the answer to your chronic Sciatica, call us at (417) 934-6337 to set up a free, no-obligation consultation with Dr. Schierling to FIND OUT IF YOU ARE A CANDIDATE.

WHAT IS STENOSIS?
The word, "stenosis" automatically implies that you are dealing with a tube or canal.   Stenosis simply means that this tube or canal, for whatever reason, is getting smaller.  Thus, Spinal Stenosis is the name given to the condition of calcium deposition involving the spinal bones and ligaments that affect (shrink / compress) the Spinal Canal. 

The picture on the left is from the legendary anatomy textbook, Gray's Anatomy.  The other is a simple drawing.  Note that in these pictures, the spinous processes are opposite each other.  They are both top views of a Spinal Vertebrae.  In both pictures, you can see the rings (ligament layers) that make up the outer disc's Anulus Fibrosus.  The Annulus is what holds the jelly center of the disc (the Nucleus Pulposus) in place.  Notice how the Central Canal in the picture below is smaller (stenotic).

Now, look at the big hole in the middle ---- just (behind) the disc?  This is the Spinal Canal (sometimes called the Central Canal).  When you stack the 24 spinal vertebrae on top of each other, all of these large "holes" line up with each other to create a long tube.  This tube (the Spinal Canal) is where the Spinal Cord is housed.  

___ HOW COMMON IS SPINAL STENOSIS:
Believe it or not, in the United States, one of the most common reasons for Spinal Surgeries in the over-60 crowd is Spinal Stenosis of the lumbar spine (low back). Current estimates by the American Association of Neurological Surgeons (AANS) put the number of elderly suffering with Spinal Stenosis at almost half a million people and growing rapidly.  Right now nearly one in five Americans is over 60 ---- so the number of people struggling with Spinal Stenosis will continue to grow as our population ages and gets increasingly heavier.

SPINAL STENOSIS DEFINITION:
According to the most common definition, published in a 1976 issue of the medical journal Clinical Orthopedics, Spinal Stenosis of the low back is caused by narrowing of the Central Canal. This causes nerves to be pinched, which leads to unrelenting buttock pain pain, limping, lack of sensation in the legs, altered sensation in the legs, numbness, tingling, diminished strength, and decreased physical activity. Although there are several types of Spinal Stenosis, there is only one that we will deal with here, as it is the one that responds to Spinal Decompression Therapy.

DEGENERATIVE SPINAL STENOSIS:
By far, the most common type of Spinal Stenosis is Degenerative Stenosis. The truth is, if you live long enough, you will probably end up with at least a small degree of Degenerative Spinal Stenosis.  It is a degenerative narrowing of the Spinal Canal (Central Canal) and nerve root canals (Intervertebral Foramen).   And in similar fashion to DEGENERATIVE DISCS, is characterized by bone and ligament calcification / thickening in the spine. This calcification results thickening of supporting ligaments, which cause a subsequent narrowing of the Central Canal.  As you might imagine, this causes compression of spinal nerves and nerve roots ----- and sometimes, even the Spinal Cord itself.  All of this creates the "Perfect Storm" that can cause the myriad of symptoms that we discussed in the previous paragraph.

WHAT CAUSES DEGENERATIVE SPINAL STENOSIS?
Degenerative changes in the vertebrae and surrounding spinal structures (ligaments, discs, tendons, bones, cartilage, etc) is affected by age.  However, if you read the piece on DISC DEGENERATION, you are already aware that age is often times an all too convenient scape goat.  The biggest reason people get Spinal Stenosis is mechanical dysfunction over time.

As the body weakens and dehydrates with age and / or injury, bones and ligaments hypertrophy (they "thicken" or get slightly bigger).  This is due to a buildup of calcium deposits as the body tries to stabilize itself.  However, despite this hypertrophy, the bones themselves become less dense (osteoporosis) and the discs of the spine can lose their height as well as their fluid.

The discs compress, causing tilting, slippage and rotation of vertebral bodies (SUBLUXATION). This results in compression of the pain-sensitive thecal sac that surrounds the Spinal Cord.  It can also cause compression of the Spinal Nerves as well.  In some cases, bone spurs form in the Intervertebral Foramen (Foraminal Stenosis).  This can cause compression of Spinal Nerve Roots as they exit through the Intervertebral Foramen and travel through the lower back, buttock, and  down the legs.  This typically leads to chronic low back pain and intermittent numbness and weakness in the legs (SCIATICA SYMPTOMS).

CALCIFICATION OF LIGAMENTUM FLAVUM:
If you have ever had a chance to look at a spine taken from a cadaver, you will notice a huge difference from the model spines seen in doctor's offices or science classrooms.  Model skeletons or model spines show you the bones only.  While this is great for learning anatomy, it does not give one a very lifelike picture of what the spine actually looks like or how it really functions. 

To say that the spine is held together with ligaments is a gross understatement.  The spine is literally "mummified" in ligaments ---- inside and out!  Yes, interestingly enough, some of these ligaments are on the inside of the Spinal Canal.  The ligament that runs the entire length of the back part of the Spinal Canal is called Ligamentum Flavum, while the ligament that runs the entire length of the front of the Spinal Canal (against the vertebrate and discs) is called the Posterior Longitudinal Ligament.  Simply understand that the Spinal Cord sits in the Spinal Canal, but never touches the bones or discs.  It touches these and other ligaments.

Hypertrophy, thickening, and calcification of these spinal ligaments (particularly the Ligamentum Flavum) can reduce the space available to the Spinal Cord and Spinal Nerves.  Ligaments tend to stiffen with age and injury, and can "buckle" into the Central Canal.  This creates additional areas of compression and pain.  Degenerative Arthritis (sometimes referred to as Degenerative Disc Disease (DDD), Degenerative Joint Disease (DJD) or DISC DEGENERATION) will often compound the problem by increasing the stiffness and inflexibility of the ligaments and joints.  In addition, Spinal Discs tend to dehydrate with age.  None of this is a good thing.

_I could not resist putting up this video.  All I can say is Amazing!  It is a video interview of Encino California's Dr. Bruce Shannahoff (a true expert in Non-Surgical Spinal Decompression Therapy), being interviewed by one of his patient's families.  The gentleman that Dr. Shannahoff is treating (Al Podrid) looks to be between 85-90 years old --- maybe older.  At the 3:00 minute mark of the video, Dr. S will show you one of the worst Lumbar MRI's I have ever seen in my life!  It is an amazing example of Lumbar Spinal Stenosis.  If someone with problem's like Al's can get better with non-surgical Spinal Decompression Therapy, there is hope for just about anyone!  Thank you Podrid family for this awesome video!

_Anything that encroaches on the Intervertebral Foramen (IVF) will compete with the nerve for space.  As you can imagine, it is not a good thing for the nerve to be pressed or encroached upon.  It's pretty easy to understand that the nerve needs a certain amount of room as it comes through the bony window we call the IVF.  When the nerve does not have the room it needs to stretch and move, it can become "pinched" or severely irritated.  As you can also imagine, this is not a good thing either.  How does this happen?  Follow along as I walk you through the process.

As the Spinal Discs bear loads, the pressure pushes the nucleus outward in all directions.   If there is a weak spot in the disc's outer Annulus, its most inner layers (near the Nucleus) begin to tear.  As they tear, the jelly center (The Nucleus) begins to push its way toward the outside.  Bear in mind that Disc Herniations rarely happen in the front part of the disc.  Because people tend to lean forward (not backward) and bend side to side, the pressure tends to push the nucleus toward the back of the disc.  This is where discs tend to rupture --- to the back and just lateral of the midline ---- where the spinal cord and spinal nerves are.

Full-blown Disc Herniations rarely happen all at once.  Much more common is a Progressive Disc Injury (diagram below).  As the disc is continually stressed, the annulus continues to tear just a little bit more; allowing the nucleus "slip" a little bit more ---- always creating a little bit bigger bulge and putting a just little bit more pressure on the nerve. But then it heals some, and might even feel better for awhile.  In other words, it's not an "all-or-none" proposition.  It is usually a process where a disc goes from normal to ruptured over time ---- even though the terrible pain might have come on all at once.  

And while you will hear terms bantered around such as "Slipped Disc," "Herniated Disc," Ruptured Disc," "Prolapsed Disc", etc, the question to ask is whether the disc is Contained or Non-Contained.  As long as the Nucleus is at least mostly contained within the Annulus, there is a strong possibility that conservative measures such as Spinal Decompression Therapy can help you avoid surgery.  But if the Nucleus slips completely outside of the Annulus ---- a "Non-Contained" lesion......   Unfortunately, you might have a surgical problem on your hands.   Unless your neurosurgeon says otherwise (AND MAYBE EVEN AGAINST THEIR WISHES), as long as you do not have severe leg weakness and / or loss of bladder or bowel function, you might want to consider Spinal Decompression Therapy!

_PIRIFORMIS SYNDROME:
One quick word about Piriformis Syndrome.  Piriformis Syndrome is literally a "pain in the butt" that can sometimes mimic a disc problem ---- even though it is caused by a problem with a muscle.  If you have little or no low back pain but lots and lots of buttock pain (or chronic Sacroilliac pain), this might very well be your problem ---- especially if you are female (notice the relationship of the Piriformis Muscle and the Sciatic Nerve in the picture below).  To understand the difference between a Herniated Disc and Piriformis Syndrome, please take three minutes and visit www.DestroyPiriformisSyndrome.com. 

This MRI is a lateral view of a person facing to your left.  The ling white line is the spinal cord.  The white areas on the left of the MRI are discs.  The fact that they are white indicates that they have water in them ---- a good thing.  Notice the circled area of one of the discs rupturing into the spinal cord.  The one below it is rupturing as well.  The disc is not white.  It is gray, fading to black.  This is indicative of a disc that is dehydrated.

You can see the same thing in this MRI of the L4 Disc.  Notice how it is not only bulged, but is thinning as well.  This is called SPINAL DEGENERATION.  Note that the healthy discs are white on MRI, but the herniated discs are much darker, depending on their degree of degeneration.  This is a really good MRI to study.  It shows the progression of disc problems.  It starts with a normal disc at the L1-L2 disc, and ends with a Stage III Disc Herniation at L5-S1. 

Have you been diagnosed with a Herniated Disc?  Maybe you have the Three Cardinal Signs of a Herniated Disc.  Whatever the case, DO NOT under any circumstances consent to spinal surgery without a second opinion.  Check out the internet message boards on the subject.  Visit the online support groups for people suffering from Failed Spinal Surgery Syndrome (FSSS).  Or better yet, talk to people you know who have had spinal surgery.  Ask them how they have done.  I promise you that over half of those you interview would not do it again ---- even if you paid them! 

Call us today (417) 934-6337 to set up a free consultation with Dr. Schierling to see if Spinal Decompression Therapy MIGHT BE RIGHT FOR YOU  and your specific problem.