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THE BERNARDS-RIDGE CONNECTION
JUNE 2013
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BACK PAIN BOTHERING YOU?
Non-Surgical Herniated Disc Treatment
A conservative “team” approach often yields excellent results.
By: Dr. Ron Spiaggia, D.C.
Non-surgical herniated disc
treatment is a widely used and
accepted means of practice
within the medical community.
A recent trend in medicine is uti-
lizing a multi-specialty or
“
team” approach for safer,
faster and more effective treat-
ment outcomes for acute or chronic spinal pain.
A typical multi-specialty team includes a medical
physician (physiatrist, pain management physi-
cian, orthopedist or neurosurgeon), chiropractic
physician and physical therapist. True multi-spe-
cialty care allows the patient to conveniently
access a wide range of services that may be used
individually or collectively to successfully treat
their condition in a single facility. Performance
Rehabilitation and Sports Injury Center affords
this benefit to all of our patients thus eliminating
the back and forth of seeing different doctors in
different offices.
Many patients with herniated discs will present
with neck or back pain and radiating pain into
the arms or legs. It is common for the patient to
complain of weakness in the extremity, as well as
electric shock pain, burning or numbness. A
spinal disc is a soft cushion that exists between
spinal joints. The disc acts as the “shock
absorber” of the spine. It provides for many com-
plicated ranges of motion by allowing the spine
to bend, twist and turn in various directions. Any
impairment or loss of structural integrity of the
disc, from spinal trauma, poor posture, weak
spinal core muscles or obesity can weaken the
disc and eventually cause the disc to fail. When
the disc fails the inner component of the disc
(
nucleus) migrates through the outer component
of the disc (annulus) and exerts pressure on the
spinal nerve. This increase in disc pressure is com-
monly called “slipped disc” or more accurately a
herniated disc. When the herniated material
presses on a spinal nerve it is commonly called a
“
pinched nerve” or radiculopathy.
To truly appreciate the benefits of multi-specialty
care in the treatment of herniated discs, it is
important to understand how the patient is
simultaneously experiencing multiple conditions.
First, there is an acute inflammatory reaction that
is occurring at the site of the herniated disc,
which is creating an irritant to the affected nerve
resulting in pain and/or numbness and tingling.
Physicians will commonly prescribe anti-inflam-
matory medication to mediate this reaction and
decrease the patient’s discomfort levels. For less
severe cases, a short-term application of oral
anti-inflammatory medications, such as a Medrol
Dose Pack (Methylprednisolone) or Naproxen will
help reduce inflammation and pain around the
disc and nerve. More severe cases may require a
local injection of Cortisone to the damaged
structures. This is commonly called an Epidural
Injection. Spinal injections are usually quite effec-
tive in reducing the acute pain, however the
results may be temporary unless the underlying
structural problems in the discs and muscles are
identified and treated.
Second, to obtain long term relief from herniat-
ed discs, the healthcare provider must address
the increased disc pressure which is causing the
migration of the inner nucleus
of the disc onto the nerve root,
as discussed above. Spinal
Decompression Therapy (DRX)
has been proven to be the most
effective non-surgical means to
reduce disc pressure. DRX incor-
porates advanced computer
technology to calculate and apply logarithmic
decompressive forces to elongate the spine. It is
this technology which drastically reduces disc
pressure without causing muscle spasm. The
overall goal of Spinal Decompression Therapy is
to create and sustain an environment of negative
disc pressure, thus “vacuuming” the herniated
nucleus back into the annuals of the disc. Tradi-
tional traction does not utilize this technology
and thus has not been proven to reduce disc
pressure.
Lastly, a comprehensive, non-surgical protocol
must include a regimen of physical therapy to
address the aberrant muscular and biomechani-
cal components of the herniated disc syndromes.
It is widely accepted in physical medicine that
weak “core” postural muscles or spinal instabili-
ty is a major cause of herniated disc syndromes.
Instability in the spine results in unwanted exces-
sive movements which lead to tissue and struc-
tural damage to both the muscles and spinal
discs. A skilled therapist will asses each patient’s
problematic region and create a therapy pro-
gram that is unique to his or her own physical
tolerance and capacity in order for the patient to
develop proper joint stability and flexibility.
Strong, stable and flexible spinal structures are
much less likely to develop problems.
It is imperative that the patient understand that
a true comprehensive treatment plan must
address each area of spinal dysfunction, as
described above. The real advantage to a
“
team” approach for non-surgical treatment is
the synergistic benefit each specialist provides to
the patient. Simply stated, since most patients
present with multiple components to their prob-
lem, it makes the most sense to address each
issue concurrently in order to achieve fast, effec-
tive and long standing relief for the patient.
Some of our most successful cases have included
patients who have previously failed individual
therapies, even including spinal surgery.
Performance Rehabilitation is a premier, com-
prehensive and multidisciplinary office dedicat-
ed to treating acute and chronic spinal pain
through non-surgical procedures. We have
invested in the most innovative and cutting-
edge technology and combined it with the best
physicians available. Recently, three of Perform-
ance Rehabilitation’s physicians have been
named to the prestigious ‘America’s Top Physi-
cians’ list by Consumer’s Research Council of
America, for their related specialties. Perform-
ance Rehabilitation allows you to consult with
medical and chiropractic physicians, pain man-
agement specialists, physical therapists, massage
therapists, spinal decompression specialists, and
more - all under one roof. To learn more about
our state-of-the-art facility, please visit us on-line
at www.performancerehabnj.com or call for
more information at (908) 899-0788.
www.theconnectionsnj.com
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