Back Pain and Ruptured Discs

Herniated DiscLow back pain problems occur in 60-80% of people at some time in their lives. Much of this relates to lumbar disc disease, either protrusion (bulge) or rupture.

The disc is a layer of cartilage and fiber, about a quarter inch thick, that acts as a cushion between two vertebrae. It assists in twisting and bending movements, and prevents the deterioration of bone that would be caused by friction between bones. The discs make up 25% of the height of the spine. Their shrinkage causes most of the loss of height as people get older.

Discs are subject to injury and wear. CT and MRI studies, but not x-rays, will visualize disc problems. Ruptured discs, with entry of material into the spinal canal, are most common in people between 30 and 50 years of age. They are very painful, due to pressure on spinal nerves and release of inflammatory molecules from the disc itself and from white blood cells trying to dispose of damaged tissue. The pain may require narcotics for relief. Non-steroidal drugs are often effective, and should be used first.

Risk factors for herniated discs include driving motor vehicles, sedentary activities, inactivity, vibration, smoking, history of pregnancy, obesity and tall height. Extremes of lifting or pulling heavy weights also lead to low back injury. Flexion of the spine is the motion most responsible for causing disc rupture. Therefore, in all physical activities it is important to keep the spine straight, and especially NOT to bend the spine while lifting.

Surgery is often performed to remove part or all of the herniated disc, especially when lower lumbar disc rupture, usually the L4-5 disc, compresses a sciatic nerve root, causing debilitating pain to radiate down the leg.

The natural history of ruptured discs, however, reveals that they often heal themselves without the need for surgery. Effective non-surgical treatments include epidural steroid injection, acupuncture, exercises, and physical therapy including ultrasound and electrical stimulation. In a one-year trial, 90% of patients had satisfactory recovery without surgery.

Other studies reveal that low back pain is often related to abnormalities in the cervical spine, even in the absence of neck symptoms. Treating the cervical spine will improve low back pain over half the time. In my own experience, cervical chiropractic has been effective.
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Hillary Clinton’s Fracture May Serve as Osteoporosis Warning

Secretary of State Hillary Clinton’s unfortunate fall last week meant a fracture and subsequent surgery Friday to repair the break in her right elbow.

It’s not clear if this was just a nasty fall or if Clinton has any underlying conditions such as osteoporosis that contributed to the fracture. Her spokesperson declined to comment about whether she’d received any such diagnosis after the accident.

Regardless, for many women who are roughly the same age as Clinton this is the kind of accident that often serves as a wake-up call that they should get themselves screened for the bone-weakening condition osteoporosis and its precursor, osteopenia.

Clinton, 61, reportedly fell in the State Department basement as she was on the way to a meeting and heading to her car.

But for about 10 million Americans who have osteoporosis in this country — roughly 8 million of whom are older women — a broken bone is often the first, and only, warning of osteoporosis.

“There are no symptoms until the first break, so you’ll know if you get a simple fracture from a simple fall,” ABC News medical contributor Dr. Marie Savard said this morning on ABC’s “Good Morning America.” And she added that the drop in hormone production that accompanies menopause signals an increased risk for the condition.

“All post-menopausal women are at risk,” Savard said. “The older you are, the more at risk you are.”

But not everyone who is at risk for osteoporosis knows it — possibly due to the incorrect stereotype that only frail, old women experience the condition. As a result, only about 20 percent of women who have a telltale fracture from osteoporosis — most often in the spine, hip or wrist — ever get properly diagnosed and treated.

Click here to read the rest of this story at ABC News.

For more information about integrative treatment of osteoporosis and DXA bone densitometry testing at IPM, Click here.

Fun facts…

Magnesium, muscles and mortality.

A small segment of the population have genetic mutations that cause them to have very low levels of magnesium, which can cause altered heart beats, seizures, and involuntary muscle contraction.

In addition, it has been estimated that up to 60% of critically ill patients have low levels, and this is associated with increased mortality.

It is very easy to supplement magnesium, which is often given along with calcium in a balanced formula. Natural Calm + Calcium is an excellent powdered calcium and magnesium formula. IPM also carries Magnesium Citrate in 500mg capsules.
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