The following is a video transcription of Dr. Bell’s Back Pain Solutions YouTube video.
Hi, this is dr bell, and in this video series, we're going to talk today about solutions to back pain and disc-related arthritis conditions.
Common Arthritis Symptoms
Some of the more common symptoms of arthritis are going to be pain, swelling and stiffness. Usually, the pain comes and goes when it's earlier in the condition, and you're not feeling it too often. It's not a major concern, so usually, it starts mild, but by the time a patient sees us here in the office, it's become a frequent occurrence. It will happen with even simple activities and especially strenuous activities or lifting. It's going to typically be hard to sleep, or there's going to be pain with sitting. But whatever the symptoms are, they're not going to go away on their own, no matter what type of services, treatments, or therapies you've tried.
What is the vertebral disc?
So the vertebral disc is a soft cartilage-type material that separates the bones of the spine, and it acts as a cushion for the discs, but it also allows space for the nerves to exit the spine. The interesting thing about the vertebral disc is there's not a great blood supply to it, and it typically dies off around the age of 12 to 14 years, so for most of your life, there's no direct circulation going through the disk, and that's why it can be damaged so easily. There is blood supply outside of the disc, but when there is damage to the disc, it can cause the fluid to essentially leak out or dry out. So there'll be various conditions that you can suffer from, but essentially once the damage is there, it can be tough to undo that easily.
How to Maintain Healthy Cartilage
So, of course, you want to maintain cartilage and keep it as healthy as you can throughout your entire life. Like I said earlier, the cartilage prevents the bones from rubbing together, but it also allows your spine to move and flex and bend so you can ambulate throughout life and so you can see here in the diagram on the right the very top disc is what a normal disc would look like.
Discs are sensitive to pressure.
As the disc breaks down, it starts to do what's called degenerate. It can start to thin slightly, but when it gets more pressure on it, it'll start to bulge, and then when the pressure gets extreme, it starts to herniate, and when the water is almost completely dried out, you might have heard of a term called bone on bone, and this is where the discs will be very thin, and you can actually see this happening on an x-ray. So as you can imagine, the discs are sensitive to pressure, and gravity isn't necessarily a friend to our spines, and what this diagram is showing you here is that the most neutral position, where there's the least amount of pressure on the disc is when you're lying flat or on your side. Normal pressure is considered standing, and then you can see as you bend forward with weights, it can double the pressure on the disc and you can see sitting increases the pressure on the disc, which we do a lot of in our modern society, and then if you're sitting with some sort of weight like this example looks like the little character is exercising, you can see that that increases the discs almost two and a half times, so again, it's very important that spinal posture is maintained, as well as reducing the pressure on the discs from lifting too much weight.
The Importance of an MRI Study
So one of the best ways to look at the disc itself is through an MRI study. You can see some thinning of discs or degenerated discs on X-ray, but the best way to view it is with an MRI. So bulge or herniation is what you can see here where the red arrow is at and to the right of that, you see sort of a dark line or a gray line going vertically or up and down, and that's where the disc is putting pressure on the spine, and this is very potentially a dangerous situation in some cases. Still, certainly, pressure on nerves is not a good thing. You can see muscle weakness. You can see pain. You can see spasms. You also potentially get numbness, tingling, or burning in your legs, arms, hands, and feet.
Don’t I have to be old to get arthritis?
When I started in practice 20 years ago, it was very rare to see younger people, and by younger, I mean people in their 40s and under with arthritis, but that's become a lot more common in the last five or ten years just because we sit so much. We live on our phones. We don't do a lot of physical activity or as much physical activity as we should, so you can get arthritis at any age, and statistically, about half of all patients that have arthritis are under age 65. A lot of this comes from your lifestyle choices, and so we can see some of the major causes being physical trauma injuries that you had, and this could even date back to when you were a child, and maybe you had a sports injury. Certain drugs and combinations of drugs can actually speed up arthritis or cause the development of arthritis. Diet is certainly a huge one. A standard American diet is largely inflammatory, and inflammatory foods can cause degeneration of all joints in the body, which is also related to inflammation from toxicity and autoimmune issues.
Nerve Pain VS Muscle Pain
There are a couple of ways you can self-diagnose yourself, if you will. There's a difference between nerve pain and muscle pain, and the way we separate the two is you'll typically see in nerve-burning, stabbing, electric shock-like pains. If it's a muscle issue, it's typically going to be tender to the touch. There'll be achiness either around the joint or in the muscle, and also, there will be stiffness in the joint. Often that stiffness will improve with motion or stretching those types of things.
Traditional Treatment for Back Pain
So in this slide, we're looking at the traditional or Western approach to back pain and arthritis, and typically that'll start with a visit to your MD or your primary doctor, if you will, and the usual initial course of care will be some sort of medication, most likely a pain reliever or an NSAID like Advil or Motrin. After a few months or years of trying that, maybe the next step would be an x-ray or MRI, which is usually a screening tool to see if there's anything going on, and then, of course, that's when we'll find that there's some arthritis or some sort of problem happening and depending on how long that process has been allowed to go on that will determine the severity of or how bad the arthritis is. Generally, that will lead to the next step of visiting or getting a referral to a neurologist or an orthopedist, and at that point, there'll be some sort of steroidal injection administered and, since we're talking about back pain here in this presentation, that could be an epidural injection directly into the spine. There are other forms of injections you can do, and once that wears off, then typically, there sometimes might be physical therapy, but generally, it's going to be a discussion of surgical intervention.
Are we doing the right thing by only treating symptoms?
So the one question that I've pondered a lot, and maybe it's something you've pondered as well, but if we're only treating symptoms or if I'm only getting treatment for my symptoms is the right thing for me or are we doing the right thing by taking this type of approach. So is traditional medicine on the right track for back pain and arthritis, and chronic conditions? I would argue that that is not the case simply because by the time we're treating symptoms, it's usually already too late. We have to address the underlying cause of the problem, and by addressing the cause then, the symptoms go away on their own by doing that, we can eliminate a lot of treatments that have harmful side effects or have just simply no results at all.
Do cortisone injections work?
So once pain medications have stopped working or the problems become worse in a traditional Western medical approach, a cortisone injection will be the next step along the path. These are sometimes called epidural injections or steroid injections, or cortisone injections. Those will be the three terms that you'll commonly hear. They're a very powerful class of drugs that produce an anti-inflammatory response. It can reduce swelling, but the big problem that we see with cortisone injections is in limiting the body from causing further damage because it is intended to stop inflammation. It's intended to stop the pain. That will also be a potential area for re-injury because your brain won't pick up the signal that your activity is causing pain. By eliminating the pain response, you don't know when to stop, so that's why you can actually re-injure yourself or cause a worsening condition with cortisone injections.
The Startling Statistics of Spinal Surgery
So hopefully, you're sitting in our office today watching this presentation in the waiting room because you're hoping to avoid spinal surgery. But today we're talking about back pain and arthritis and if surgery is something that you have to undergo, the statistics aren't very great in terms of longevity or the long-term ability for it to provide you relief. Approximately 20 to 40 percent of all spinal surgeries will fail. 29.2 percent statistically will have no change after six months, and about half of patients with failed surgery were misdiagnosed, which meant that they had the wrong surgery so a lot of times because of the immobilization of the spine or the fixation of the spine, which is what you can see here in these two x-ray pictures that do cause weakening of the bone, but it also can cause excess pressure on the discs right above the surgery and so very commonly within about a decade or so there's usually a need for a second surgery to fix the effects from the first surgery.
Safe, Effective, and Natural Back Pain Relief
So our goal is to help patients avoid surgery and if it's not necessary, then Of course, that's what we'd love to help you with. There are always going to be cases where surgery is necessary, but if you do, in fact, qualify for one of our programs here in the office, our therapies are safe, effective, and natural.
Some of the services we offer are disc decompression, chiropractic care, trigger point injections, regenerative medicine, functional medicine and also therapy, rehab, and exercise.
We were one of the early adopters of disk decompression. We've had these machines in our office since 2005, and the purpose of these machines is to decrease the pressure on the disk and increase the fluid flow to the disk so the disk can rehydrate, but also relieve the pressure on the nerves. By doing all of this what decompression will help do is restore motion to the spine, and of course, you can imagine that would also reduce pain, discomfort, swelling, etc.
Our practice started in 2001 with chiropractic care, so we do believe strongly in chiropractic care. We're now an integrative practice, so we offer medical services, chiropractic services, and massage therapy, but chiropractic care pressure on the nerves can influence the ability of your brain to transmit and receive information. This is what chiropractors are taught in school and so when we have spinal problems, we can have issues where the health of the body through the immune system, which is run by the nerves that, can also be affected, so chiropractic philosophy isn't really just about pain which it's of course very effective at reducing muscle spasms pain and inflammation but the bigger picture of chiropractic care is that by keeping your spine in alignment and getting a regular adjustment that allows your body to heal itself. It allows the body to be able to do that more easily because there's less pressure on the nerves.
Muscles Get Trigger Points
The immune system can work a lot better, so when there are long-standing issues with muscle spasms or spinal misalignment, or even degenerated or herniated discs a lot of times this will cause tension in the muscles. It'll cause abnormal pulling and pressure in areas that really aren't supposed to be there, and when this happens in the muscle, this is called a trigger point. So you can feel these sometimes on your back. A lot of people will say there's a knot in my back. It'll feel like gristle on a steak. It can be kind of a hard nodule. You can actually feel these, so it's really important that the trigger points are kept to a minimum because they are at the nerves' endings. There's typically a nerve attached to it, so it can be painful. It can cause a lot of pain with motion and movement, and it also gets mistaken many times for fibromyalgia, so that's definitely a diagnosis you don't want to have.
Trigger Point Therapy
So trigger point therapy is something that we offer not only through our medical department but also through our massage therapy program as well. Trigger point therapy is something that works great with our decompression and our chiropractic program because trigger points, once they're there, those knots are very hard to get get rid of. Trigger point therapy is an injection of a local anesthetic typically where we are using lidocaine which is non-steroidal. It's a very simple injection. It's only injected just a half inch or so below the surface of the skin so it's something that's minimally invasive, but it does help the muscles relax. It does give you some relief after the procedure for a few hours. What we find is it does help your body hold the chiropractic adjustment longer. It also allows decompression to do a better job because when muscles contract, it can actually put compression or compressive pressure on the spine. Of course one of the nice benefits is that it's a very quick way to get you relief when we're trying to do therapy that can take several weeks to accomplish its goals.
You might have heard of regenerative medicine. This is a newer branch of medicine that's sprung up in about the last ten years. We added regenerative medicine in 2014 to our practice when we added our medical team. Regenerative medicine focuses on science and research and what stem cells do inside of our body and so anytime we have a regenerative medicine procedure as part of a care plan the goal is to help stimulate the body's inborn repair response. This happens through stem cells which signal your body to heal but what will happen is the root of the wear and tear will be reduced. We will also be looking at helping to restore the cushion and stability to the joint. Regenerative medicine is a great option if you're looking to avoid surgery.
We’ve been helping people get relief for over 20 years.
So we've been at this for about 20 years, having started with traditional chiropractic care in 2001. II feel we're very good at what we do and our services because they're safe, non-invasive and we've had a long time to get it right. I know that from a patient's perspective that what I would want you to know is that we know what you're going through with the services that we've added and the things that we've tried throughout the years. We have a plan that can solve your problem and help end your suffering. We're not traditional medicine. Most of our patients come to us because they were failed by traditional medicine and that's where our niche is at and that's what I feel we do a very good job at. We look at our job as to get you better and to help you get your life back because the one thing that we cannot get back in life is time. It's the most precious commodity we have and so if we can do anything to shorten that time period for you and to end your suffering that much quicker that's huge. I think for someone's quality of life but also if we cannot help you we're going to tell you that as well because again we don't want to be another failure for you and we will be honest with you if we can't help you. We'll tell you who your best option would be so you can find the relief that you need.
We never use RX drugs or cortisone.
So we are a non-traditional office for most intents and purposes. We do blend some western medical techniques with chiropractic techniques along with some eastern medical philosophy as well so there are a lot of tools that we have where we don't have to prescribe drugs or cortisone to patients. We'll use typically a combination of disk rehabilitation with decompression, chiropractic care, trigger point injections, regenerative medicine, laser therapy, functional medicine and massage therapy. Your consultation process will determine what combination or care plan that we need to develop for you and those are all customized per patient for individual patients. Once we determine what your needs are that'll determine what our course of care is going to be with you.
So if you're suffering from back pain and you would like to speak with us about the natural solutions that we offer for back and neck pain please give us a call at 951-225-4419 and we can get you booked for a consultation at the earliest appointment that we have available. We also would welcome spouse, friends or family members that you may know that are also suffering from back pain. Feel free to have them watch this presentation or have them give us a call and they can certainly come in as well. If you'd like to get them some help or if you’d like more information you can check us out at our website www.growwithvitality.com. You can also check us out on social media on Facebook and Instagram at Vitality Integrative Wellness. So that's it for a presentation today on back pain and we look forward to seeing you in the office very soon!