Archive for November, 2010

Many patients with low back pain have been told that they have a slipped disc that is pushing on a nerve. The problem is that discs can’t slip — they are connected to the vertebrae above and below them and are stuck in position. What can occur is the material in the center of the disc can bulge out or even stick out (herniation) and then press on a nerve nearby.

Disc bulges are extremely common and can be found in the MRI’s of patients that don’t even have any pain. Because of this, we generally don’t pay a lot of attention to a disc bulge as a possible pain generator for the patient. Disc herniations are entirely different. Instead of just bulging a little in the center, in a disc herniation, the inside of the disc becomes diseased and sticks out of the disc. Sometimes, it can be pressing on a nearby nerve or even the spinal cord causing pain to go into the arms or legs. For other patients, it is just sticking out and can cause low back pain without radiation into the legs.

Most disc herniations can be treated without surgery or injections. It is important to check the patient’s reflexes and strength to make sure that they are still a good candidate for non-surgical treatment. If the nerve damage is too extensive, it can indicate that the patient needs a referral to the orthopedist. Although it takes slow and consistent work, stabilization of the injury is possible. I should know — I have two disc herniations in my low back and lift patients for a living! If you need more information on treating disc injuries, feel free to email me at drerin@ducatchiropractic.com or ask at your next visit.

A recent study in coordination with 85,000 Blue Cross and Blue Shield beneficiaries showed that patients that consulted with a chiropractic physician at the first sign of low back pain saved about 40% in medical costs compared with patients that consulted with a doctor of osteopathy or a medical doctor. This cost savings added up to about $2.3 million for BCBS of Tennesee.

Low back pain is a significant public health problem. Up to 85 percent of Americans have back pain at some point in their lives. In addition to its negative effects on employee productivity, back pain treatment accounts for about $50 billion annually in health care costs-making it one of the top 10 most costly conditions treated in the United States.

The cost savings with doctors of chiropractic are the result of careful diagnosis through physical exam, reducing the need for expensive MRIs, CT scans and EMG testing. Doctors of chiropractic are also less likely to refer for surgical options or injections for their patients unless absolutely necessary. Although the patient may need to have several visits at the chiropractor, the total cost is small compared to $75,000 for a lumbar fusion surgery.

The reason this study is so important is because more insurers and HR departments are trying to cut benefits to chiropractic physician in hopes of reducing their premium costs. Now that we have proof that chiropractic benefits SAVE insurance companies and HR departments money, we need to inform them of the facts to protect access to affordable chiropractic care that allows patients to receive coverage for all chiropractic services including manipulation, soft tissue therapy, rehabilitative exercise and acupuncture. For more information or to print this study out for your HR department, click here.

Has your hand ever “gone to sleep” and not come back? Do you feel like your hand is weak or just doesn’t have the grip strength anymore? Or is your hand just numb and cold? These are signs that there is a nerve compressed between your spine and your hand.

The first type of compression that most patients think about is Carpal Tunnel Syndrome. Although this is a common type of compression, it is not the only cuase of hand numbness complaints. If you have true Carpal Tunnel Syndrome, you will only have symptoms in your 1st finger and palm and no other areas in your hand. Carpal Tunnel is common to people who do a lot of typing, flexing of their hands or writing with a pen.

If there is tingling in your 4th and 5th fingers, a more likely cause of the problem is a compression of the ulnar nerve (funny bone nerve) in either your shoulder, elbow or hand. This problem is common to people who rest their forearms on a desk or do a lot of cycling.

Sometimes the tingling is along the backside of your hand and the 3rd finger. This is caused by a compression of the radial nerve in your elbow or shoulder. This is probably the least common type of compression, but can occur in any type of patient.

In some patients, their entire hand is numb. This tells us that several nerves are compressed at once, most likely in the shoulder, but it’s important to make sure that they don’t have signs of stroke or any type of lesion pushing onto the nerves in the shoulder. We can check for this using various orthopedic tests and sometimes using x-ray to view the area.

Although there are many reasons for tingling or numbness in your hands, all of these causes can be effectively treated without surgery through chiropractic manipulation, soft tissue techniques such as Graston and strengthening exercises. However, with nerve injuries it is very important to seek professional care right away. The longer there is compression on the nerve, the greater likelihood of permanent damage.

If you have further questions, please email me at drerin@ducatchiropractic.com.

How do you know if you are healthy?  Are you okay as long as you aren’t in pain or having symptoms of being sick?  Are you healthy as long as your blood work is okay?  What about if your weight is within a healthy range?  Or blood pressure?  Reality is that all of these things are simply small parts of an overall picture of your health. 

Good health should always include several dimensions of your life including fitness, emotional health, internal health (blood work, blood pressure etc) and also physical health (flexibility, joint mobility, muscle balance etc).  If we focus just on one area (such as internal health for example) and feel as though you don’t have any health problems because your blood work came back normal, you may be in for a big surprise when you start developing rotator cuff disease because you didn’t pay attention to your physical health and fitness.  The same goes for if you focus only on physical health and have great posture/flexibility, but start having depression symptoms because you ignored your emotional health. 

In order to stay truly healthy, keep track of all aspects of your health at least yearly to make sure you are on the right track.  Go through a fitness test with your personal trainer.  Talk to a counselor or pastor about your personal goals and ambitions.  Have a yearly physical with your primary care physician to make sure your internal organs are functioning properly.  Keep your physical health on track by having a check-up with your chiropractor at least annually to make sure you aren’t showing signs of arthritis or muscular imbalances.  It sounds like a lot to keep track of, but if you simply address one area of your health every 3 months, it won’t be too difficult to fit into your schedule!