Page 12 - The Connection Warren-Watchung Edition September 2012

PAGE 12 THE WARREN-WATCHUNG CONNECTION SEPTEMBER 2012
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 wide-
ly used and accepted means of practice within
the medical community. A recent trend in medi-
cine is utilizing a multi-specialty or “team”
approach for safer, faster and more effective
treatment outcomes for acute or chronic spinal
pain. A typical multi-specialty team includes a
medical physician (physiatrist, pain management
physician, orthopedist or neurosurgeon), chiro-
practic physician and physical therapist. True
multi-specialty care allows the patient to conve-
niently access a wide range of services that may
be used individually or collectively to successfully
treat their condition in a single facility.
Performance Rehabilitation & Integrated
Medicine 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
complicated ranges of motion by allowing the
spine to bend, twist and turn in various direc-
tions. 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 pres-
sure on the spinal nerve. This increase in disc
pressure is commonly called “slipped disc” or
more accurately a herniated disc. When the her-
niated material presses on a spinal nerve it is
commonly called a “pinched nerve” or radicu-
lopathy.
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 incorporates advanced
computer technology to calculate and apply log-
arithmic 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. Traditional 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 & Integrated
Medicine is a premier, comprehensive and multi-
disciplinary office dedicated to treating acute
and chronic spinal pain through non-surgical
procedures. We have invested in the most inno-
vative and cutting-edge technology and com-
bined it with the best physicians available.
Recently, three of Performance Rehabilitation’s
physicians have been named to the prestigious
‘America’s Top Physicians’ list by Consumer’s
Research Council of America, for their related
specialties. Performance Rehabilitation &
Integrated Medicine 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)756-2424.
www.theconnectionsnj.com