Anatomy

The spine is made up of a chain of bones, called vertebrae , which are connected together by ligaments and muscles. The vertebrae cover and protect the spinal cord which carries sensory messages to and from the brain controlling all your body functions.

A disc separates each vertebrae and acts like a cushion, absorbing shock along the spine. The disc is a cartilage-like material made up of a jelly-like substance known as the nucleus, covered with many strong, fibrous outer layers called the annulus. These tissues do not have a rich blood supply like most other body tissues to nourish and replenish them; rather, disc tissue depend on a transfer of fluids, nutrients and oxygen from the bones (vertebral bodies) above and below them. This transfer of fluid depends on the difference in pressure between the inside of the discs and the surrounding vertebrae and blood vessels. This is why most disc nutrition and regeneration takes place when we lie down and the pressure inside the discs is reduced. This process is not very efficient, and slows down as we age, so that the disc is exposed to wear and tear exceeding its ability to heal and regenerate.

The discs are prone to injury and degeneration as we use our backs each day because they are compressed and torqued through sitting and standing, bending and lifting. Repeated injury weakens the annulus resulting in tears. With continued pressure inside the disc, the tears in the annulus may allow the disc to bulge like an old tire with a weak sidewall. Any internal damage to the disc may cause severe pain in the back. If all of the layers of the annulus break, the jelly-like nucleus will ooze out of the disc resulting in a disc herniation or prolapse. A bulging or herniated disc may press on (pinch) spinal nerves causing malfunctions which can be felt as weakness in your muscles, loss of sensation in the skin, or a tingling or burning sensation along the nerves and, of course, pain.

Repeated episodes of injury results in the degeneration of the disc which becomes stiff and dry causing it to lose its shock absorbing properties, and making it more prone to yet another injury. This process may continue until the disc is collapsed which increases the mechanical pressure on the bones and joints and may eventually lead to arthritis.

Spine

There are three sections of spinal vertebrae:

• 7 cervical vertebrae in the neck,


• 12 thoracic vertebrae to which the ribs attach, and


• 5 lumbar vertebrae in the lower back.

Each is section is numbered from top to bottom so that C1 attaches to the skull and L5 sits on the sacrum which is actually part of the pelvis.

Vertebra

An individual vertebra is made up of several parts. The body of the vertebra toward the front (anterior) is the primary area of weight bearing and provides a resting place for the fibrous discs which separate each of the vertebrae. The lamina covers the spinal canal, the large hole in the center of the vertebra through which the spinal cord passes. The spinous process projects backwards (posterior) and is the bump you feel when running your hands down your back. The paired transverse processes project sideways (laterally) and provide attachment for back muscles.

• There are four facet joints associated with each vertebra.



• A pair that face upward and another pair that face downward.



• These interlock with the adjacent vertebrae and provide stability to the spine.



• The vertebrae are separated by intervertebral discs which act as cushions between the bones.

Many patients with back pain, leg pain, or weakness of the lower extremity muscles are diagnosed with a herniated disc. When a disc herniation occurs, the cushion that sits between the spinal vertebra is pushed outside its normal position. A herniated disc would not be a problem if it weren't for the spinal nerves that are very close to the edge of these spinal discs.

What is the spinal disc?

The spinal disc is a soft cushion that sits between each vertabrae of the spine. This spinal disc becomes more rigid with age. In a young individual, the disc is soft and elastic, but like so many other structures in the body, the disc gradually looses its elasticity and is more vulnerable to injury. In fact, even in individuals as young as 30, MRIs show evidence of disc deterioration in about 30% of people.

Herniated Disc

As the spinal disc becomes less elastic, it can rupture. When the disc ruptures, a portion of the spinal disc pushes outside its normal boundary--this is called a herniated disc. When a herniated disc bulges out from between the vertebrae, the spinal nerves and spinal cord can become pinched. There is normally a little extra space around the spinal cord and spinal nerves, but if enough of the herniated disc is pushed out of place, then these structures may be compressed.

What causes symptoms of a herniated disc?
When the herniated disc ruptures and pushes out, the nerves may become pinched. A herniated disc may occur suddenly in an event such as a fall or an accident, or may occur gradually with repetitive straining of the spine. Often people who experience a herniated disc already have spinal stenosis a problem that causes narrowing of the space around the spinal cord and spinal nerves. When a herniated disc occurs, the space for the nerves is further diminished, and irritation of the nerve results.

What are the symptoms of a herniated disc?
When the spinal cord or spinal nerves become compressed, they don't work properly. This means that abnormal signals may get passed from the compressed nerves, or signals may not get passed at all. Common symptoms of a herniated disc include:

• Electric Shock Pain
  Pressure on the nerve can cause abnormal sensations, commonly experienced as electric shock pains. When the compression occurs in the cervical (neck) region, the shocks go down your arms, when the compression is in the lumbar (low back) region, the shocks go down your legs.
  
  
• Tingling & Numbness
  Patients often have abnormal sensations such as tingling, numbness, or pins and needles. These symptoms may be experienced in the same region as painful electric shock sensations.
  
  
• Muscle Weakness
  Because of the nerve irritation, signals from the brain may be interrupted causing muscle weakness. Nerve irritation can also be tested by examining reflexes.
  
  
• Bowel or Bladder Problems
  These symptoms are important because it may be a sign of cauda equina syndrome, a possible condition resulting from a herniated disc. This is a medical emergency, and your should see your doctor immediately if you have problems urinating, having bowel movements, or if you have numbness around your genitals.

All of these symptoms are due to the irritation of the nerve from the herniated disc. By interfering with the pathway by which signals are sent from your brain out to your extremities and back to the brain, all of these symptoms can be caused by a herniated disc pressing against the nerves.

Degenerative Disc Disease

Degenerative Disc Disease (DDD) is not really a "disease" in the common sense of the word, but rather a term used to describe a process or condition that develops gradually and worsens over time. Use of this term indicates that the cartilage-like discs between the spinal vertebral joints are the primary cause of the symptoms, and that the degenerative changes are rather advanced. To some degree intervertebral discs lose their flexibility, elasticity, and shock absorbing characteristics as we age as do the other tissues in the body. Abnormal or excessive mechanical stresses or injuries of the past coupled with hereditary, developmental, and metabolic influences can rapidly accelerate this process.

As the involved disc dries out and loses height (a process known as desiccation) it causes the vertebra to become closer together narrowing the channels through which the nerve roots pass. A dry, hard disc can absorb less shock and is thus more easily torn resulting in a greater likelihood of herniation or bulge further compressing or pinching the nerves. As the stress on the joint compounds and osteoarthritis begins to result, bone spurs form and ligaments hypertrophy gradually narrowing the nerve channels even further. These factors in various combinations and degrees of severity compromise the space in the nerve channels, a condition known as spinal stenosis, and conspire to compress (pinch) the nerves.

How does Spinal Decompression Treatment help Degenerative Disc Disease?

Symptoms of Degenerative Disc Disease

The most common symptom of degenerative disc disease of the lumbar spine is low back pain (lumbalgia). If the cervical spine is affected, the most common symptom is neck pain (cervicalgia). When degenerative disc disease causes compression of the cervical nerve roots there may be shoulder pain, arm pain, and pain in the hand/fingers (neuritis, neuralgia, radiculitis), and may be associated with numbness and tingling (paresthesia). When degenerative disc disease causes compression of the lumbar nerve roots there may be butt pain, hip pain, leg pain, and pain in the foot/toes. This often is accompanied by muscle weakness in either the arm or leg.

How does Spinal Decompression Treatment help Degenerative Disc Disease?

Spinal Decompression Treatment

How does Spinal Decompression Treatment help Degenerative Disc Disease?

Spinal Decompression Therapy is a non-invasive, non-surgical treatment performed on a special, computer controlled table similar in some ways to an ordinary traction table. A single disc level is isolated and by utilizing specific traction and relaxation cycles throughout the treatment, along with proper positioning, negative pressure can actually be created within the disc. It works by gently separating the offending disc 5 to 7 millimeters creating negative pressure (or a vacuum) inside the disc to pull water, oxygen, and nutrients into the disc, thereby re-hydrating a degenerated disc and bringing in the nutrients needed to heal the torn fibers and halt the degenerative process. As the disc is re-hydrated the shock absorbing properties are restored, and in many cases some of the lost height is restored as well, improving any spinal stenosis.

Arthritis

Spinal Arthritis / Osteoarthritis

The Primary Cause of Disability

According to the Centers for Disease Control (CDC) arthritis is #1 of the top 10 causes of disability in the United States. The #2 cause is back or spine problems followed by #3 heart trouble. Arthritis of the spine combines the risk factors of the top two groups - and with its attendant pain upon motion, discourages exercise which contributes to eventual heart disease. Lack of exercise and often associated obesity, also epidemic in this country, contribute to heart as well as back troubles. A diagnosis of spinal arthritis begins a slippery slope that is not to be ignored.

There are hundreds of types of arthritis that share similar symptoms including inflammation, joint pain, and progressive damage of joint surfaces over time. Most back pain patients suffer from a "wear and tear" type of arthritis known as osteoarthritis, the most common type of arthritis, which comes from the Greek word osteo meaning bone. Arthro is from the Greek word for joint and itis of course means inflammation so any inflammatory condition of a joint is correctly termed arthritis. This means that technically even a stubbed toe that becomes swollen and painful could be called early arthritis. On the other end of the spectrum, the joint damage that occurs in the final stages of rheumatoid arthritis, an autoimmune disease, is also one of the hundreds of types of arthritis.

How does Spinal Decompression Treatment help Osteoarthritis / Degenerative Joint Disease?

Degenerative Joint Disease / Osteoarthritis (OA)

Osteoarthritis (OA) is also known as degenerative arthritis or Degenerative Joint Disease (DJD). When applied to the spine, use of the term DJD generally implies multiple osteoarthritic changes found at multiple vertebral levels. Any joint in the body is potentially subject to abnormal or excessive mechanical stress or injury that could result in damage to the cartilage and bone although the weight bearing joints of the spine, hip, and knee are most common.

To some degree this affects approximately 80% of people over the age of 65 in the United States. Old injuries, poor health habits, a weakened immune system, and/or hereditary factors can contribute to the development of osteoarthritis. Osteoarthritis is not a disease in the sense that a patient can "catch it" in the same manner that one could catch malaria or pneumonia, but is rather the body's natural response to abnormal or excessive mechanical stress over time coupled with hereditary, developmental, and metabolic influences. It is not necessarily a disease of the old because many younger people can have abnormal or excessive mechanical stress too, and not all older people do.

How does Spinal Decompression Treatment help Osteoarthritis / Degenerative Joint Disease?

What causes Osteoarthritis?

One would at first assume that abnormal or excessive mechanical stress on a joint would result in a wearing down or loss of bone. In fact, over time quite the opposite is true. Initially the cartilage does wear down, but as the joint surfaces become less well protected by cartilage the bone beneath may be exposed and damaged, with re-growth leading to a proliferation or increase in cellular growth called hypertrophy. In much the same way that excessive stress to the skin on the palm of the hand due to excessive use of a shovel or a rake soon results in an overgrowth of skin referred to as a callous, the excessive stress to a joint results in a build up of bone referred to in general as osteoarthritis and more specifically as spondylosis, arthrosis, sclerosis, stenosis, bone spur or osteophyte, etc. depending somewhat upon location and degree of severity, and somewhat upon the preference of the reporting physician. This is the body's natural response to excessive or abnormal mechanical stress.

How does Spinal Decompression Treatment help Osteoarthritis / Degenerative Joint Disease?

Symptoms of Osteoarthritis

Osteoarthritis (Degenerative Joint Disease) is characterized primarily by stiffness and a deep aching pain in the joints. The loss of flexibility, or stiffness, and pain tend to be worst in the morning (until the patient "loosens up") and improves with movement during the day until evening when activities slow down (and the patient "stiffens up"). Pain that awakens the patient during the night is also often an indicator. Frequently there is localized tenderness when pressure is applied to the joint or affected area of the spine.

How does Spinal Decompression Treatment help Osteoarthritis / Degenerative Joint Disease?

Degenerative Arthritis of the Spine

"Degenerative" means that the osteoarthritic changes develop gradually and worsen over time. Osteoarthritis is the most common form of arthritis and the leading cause of chronic disability in the United States. As the stress continues and accelerates the joints may lose normal contour and abnormal amounts of fluid may build up inside the joint along with pieces of floating debris. Early on, a patient may only experience joint aches after physical work or exercise, which fades and then returns as the affected joint is used or overused. As the cartilage between the bones gradually thins, the patient increasingly experiences pain upon weight bearing, including walking, standing, and sitting as well as many other movements in between.

As a result of the patients attempt to avoid certain movements because of the pain, regional muscles may atrophy and ligaments may become more lax while other muscles may spasm in an attempt to limit the abnormal motion and reduce the pain, all resulting in further stress to the involved joints thereby accelerating and worsening the process. Now, the joint pain and stiffness occurs after periods of inactivity such as while sitting for long car rides or watching a long movie. Later, the pain often becomes substantial even at complete rest or with very little movement. This is the degenerative cycle in action - where everything makes everything else worse in an accelerating downward spiral of pain and disability. Spinal Decompression is designed to break this cycle.

How does Spinal Decompression Treatment help Degenerative Arthritis of the Spine?

Osteophyte

An Osteophyte, often called a Bone Spur, describes osteoarthritic changes that are a projection of bone that develops and grows along the edges of joints at the attachment points for ligaments and tendons. The evidence of these bony deposits can be found on an x-ray. These are frequently found on the edges of the bodies of the vertebra where the spinal disc attaches to the bone, an area known as the end plate of the vertebra. The adjacent picture shows lumbar spinal osteophytes although cervical osteophytes and thoracic osteophytes are also common. The body's production of osteophytes is a futile attempt to stop the motion of the arthritic joint and deal with the degenerative process. It never completely works. Hips, knees, and the joints of the fingers are other common locations in which to find these bone spurs.

How does Spinal Decompression Treatment help Osteophytes?

Arthrosis / Facet Arthrosis

Arthrosis is a term commonly reserved for osteoarthritic changes of the facet joints of the spinal vertebrae. Bones of the spine articulate (attach together) anteriorly by inter-vertebral discs and posteriorly by left and right paired facet joints (facet refers to the fact that they are flat surfaces just like the facets of a diamond are flat surfaces). The facet joints are also termed zygapophyseal joints.

Biomechanically, facet joints assume a prominent role in resisting load forces, and their importance is well established. Facet joints resist most of the inter-vertebral shear force, and share with the discs in resisting the inter-vertebral compressive forces. Excessive or prolonged stress can result in degenerative osteoarthritic changes referred to as facet arthrosis. Moreover, as discs at the anterior of the joint degenerate they dry out and lose height (a process known as desiccation) changing the facet joint angles at the posterior of the joint and placing additional stress on the facet joints. This abnormal motion coupled with the loss of shock absorbing capability of the thin, dry disc adds even more stress to the facet joint accelerating the arthrosis, and placing stress upon the posterior supporting ligaments as well.

How does Spinal Decompression Treatment help Facet Arthrosis?

Arthropathy / Facet Arthropathy

From the Greek arthro for joint and pathos for suffering usually implies that the arthritic changes of the joint are rather advanced and have begun to impinge upon the adjacent nerve root or the spinal cord itself by narrowing the channel through which the nerve exits. This narrowing is referred to as spinal stenosis.

How does Spinal Decompression Treatment help Facet Arthropathy?

Spondylosis

Spondylosis is a term referring to osteoarthritic changes of multiple spinal vertebra at the level of the spinal inter-vertebral discs. The term was coined from the Greek spondyl for vertebrae and osis meaning "condition of." Use of this term indicates that the facet joints at the posterior of the vertebrae are not necessarily involved. If severe, it may cause pressure on nerve roots with subsequent sensory and/or motor disturbances, such as pain, paresthesia, or muscle weakness in the limbs.

As the space between two adjacent vertebrae narrows as a result of disc degeneration, compression of the nerve root emerging from the spinal cord results in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, and hand/fingers or severe pain in the lower back, butt, hip, leg, and foot/toes often accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in myelopathy, characterized by global weakness, gait dysfunction, loss of balance, and loss of bowel and/or bladder control. The patient may experience a phenomenon of tingling or numbness (paresthesia) in the arm/hand or leg/foot because of nerve compression and/or inhibited blood flow. If vertebrae of the neck are involved it is labeled cervical spondylosis. Lower back spondylosis is labeled lumbar spondylosis.

How does Spinal Decompression Treatment help Spondylosis?

Hypertrophy

A term indicating a thickening or an overgrowth usually reserved to describe a thickening of the ligaments which help hold the spinal bones together, although sometimes used to describe early bone changes and as such means much the same as sclerosis.

Living tissue responds to biomechanical stress through hypertrophy (technically, an increase in the size of cells) or hyperplasia (technically, an increase in the number of cells). As an example, excessive or prolonged stress to the skin of the hands or feet results in a hypertrophy of the skin known as callous formation. Spinal ligaments, specially the ligamentum flavum along the posterior aspect of the spinal canal, respond to stress by thickening in the same way. The problem with this is that there is little ''extra'' room along the spinal canal. If one tissue is thicker than it should be another is being compressed or pinched.

How does Spinal Decompression Treatment help Hypertrophy?

Sclerosis

Sclerosis is from a Greek word meaning hardness. (Most patients are familiar with the term arteriosclerosis meaning a hardening of the arteries). For back pain sufferers sclerosis is a term used by the radiologist to describe areas of increased density or whiteness found on X-ray or MRI examination indicating that calcium is building up in areas of excessive stress to form osteoarthritic bone. This early stage of osteoarthritis is seen as a sclerosis upon radiographic examination. Early changes to the facet joints would be termed a facet sclerosis, a more advanced stage a facet arthrosis. Early changes to the bodies of the vertebra where the disc attaches would be termed end plate sclerosis, and with continued stress eventually become osteophytes (bone spurs).

How does Spinal Decompression Treatment help Sclerosis?

Spondylitis / Spondylopathy

Spondylitis is an inflammation of a vertebra. Any similar disorder of the spinal column may also be called spondylopathy.

Pott's disease is a tuberculous disease of the vertebrae marked by stiffness of the vertebral column, pain on motion, and tenderness on pressure. As the vertebrae collapse the spinal cord is compromised and paralysis can result.

Ankylosing spondylitis is an autoimmune disease involving the spine and sacroiliac joints (joints in the pelvis).

These are rare findings and not the usual cause of spinal pain. An X-ray or MRI can quickly rule out these and other such conditions. Bone scans are another method of bone imaging used to detect bone abnormalities.

Spinal Decompression Treatment

How does Spinal Decompression Treatment help Osteoarthritis / Degenerative Joint Disease?

Spinal Decompression Therapy reduces the biomechanical stress or ''wear and tear'' on the vertebra / disc / vertebra joint complex that is the primary cause of the formation of osteoarthritic bone damage. With less joint stress the deterioration of cartilage and the inevitable build up of bone (osteoarthritis) that leads to pain, and can lead to disability, is eliminated or slowed and the body can begin the process of repairing itself. That, in conjunction with advice from the doctor in developing good health habits including advice on nutritional supplements, proper water consumption, proper stretching and strengthening exercises, proper use of ice and heat, ways to relieve postural stress, weight loss, etc. can mean the difference between an active, vibrant life style and spending the final years of your life shuffling along behind a walker.