Back Pain: Intervertebral Disc Conditions

The term ‘disc’ is short for the ‘intervertebral discs’, the spongy cushions that separate the block-like bones (vertebrae) of the spine. These discs have a number of important functions including shock absorption, keeping the vertebral column stable and giving the vertebrae ‘pivot points’ to allow movement. 

A disc is made of two parts: the elastic outer shell (annulus fibrosis) and the jelly-like contents (nucleus pulposis). It can handle quite a lot of pressure without damage, but certain types of pressure can damage the shell and push its contents out. 

Symptoms of disc problems

The symptoms of a damaged disc can vary according to its location and severity. Many people who show evidence on scanning of damaged discs have no symptoms. This means that, most commonly, there are no symptoms at all. However, general signs may include:

• Back pain
• Pain radiating down the legs
• Worsening pain associated with bending over or sitting down for a long time
• Worsening pain associated with activities like coughing or sneezing
• Numbness or pins-and-needles in an arm or leg.

Risk factors for disc problems

Some people are more susceptible to disc problems than others. Risk factors include:

• Obesity
• Poor muscle tone
• Lack of regular exercise
• Cigarette smoking
• Advancing age
• Poor posture
• Incorrect lifting techniques.

Often, however, there is no recognisable risk factor present.

Types of disc problems

Common disc-related problems include degenerative disc disease, ruptured (or ‘slipped’) disc and sciatica (nerve pain).

Degenerative disc disease

The discs of a young child are plump and moist, but the water content reduces with age until the discs are comparatively thin and hard. As a result of this, friction between the bones is thought to increase, resulting in growths called bone spurs around the discs.

In many cases, these age-related changes cause no problems, but some people experience a painful condition called degenerative disc disease. The most common symptom is back pain caused by holding the same position (either sitting or standing) for too long. It’s among the most common causes of chronic back pain in older people. 

Ruptured disc

The term ‘slipped disc’ suggests that a disc has moved out of position, but this is not accurate. The discs are held firmly in place by various structures (including ligaments, muscles and the vertebrae themselves).

Terms like ‘ruptured’, ‘herniated’ or ‘prolapsed’ describe the situation better, as the real problem is not that the entire disc ‘slips’, but rather that a crack in the tough outer shell of the disc allows the soft jelly-like contents to ooze out. When this material comes into contact with other structures, especially the spinal nerves that run nearby, this can cause pain and alter nerve function. 

The most common site for a ruptured disc is the lower back, and chronic lower backache can be a symptom. As we get older, the risk of rupturing a disc declines because the discs dry out and the contents are less able to ooze through any cracks.

Sciatica

Sciatica is nerve pain from the sciatic nerve that runs from the spine into the buttock and down the back of the leg. A common cause of sciatica is a ruptured disc. The spinal cord normally has room to slide up and down inside the spinal column whenever the body moves. However, a bulging disc can protrude into the spinal column and press against the spinal nerves, hampering its movement and causing pain. 

Diagnosis of disc problems

Diagnosis of disc problems involves:

• Taking a medical history (to determine risk factors and predisposing conditions)
• A physical examination.

Other investigations are carried out if surgery may be required.

Treatment for disc problems

The majority of disc problems will resolve regardless of treatment. Bed rest is occasionally best for initial management of severe sciatica, but most people can keep active with some restrictions according to the level of pain. Good pain control and allowing the person to move is often a good approach. 

Some common treatments include:

• Heat treatment
• Regular massage
• An exercise program designed to improve strength and flexibility
• Non-steroidal anti-inflammatory drugs (NSAIDs) or steroids
• Pain-relieving medication
• An injection of anti-inflammatory steroids into the region of the disc
• Uncommonly, in severe cases of ruptured disc, an operation may be needed to trim the protruding bulge (laminectomy)
• Also uncommonly, in severe cases of degenerative disc disease, an operation may be needed to remove the disc and fuse together the two vertebrae on either side.

Remember, most disc problems resolve without specific treatment. 

Self-help for disc problems

Given time and the right conditions, a ruptured disc can heal itself. Ongoing maintenance can reduce the risk of disc problems in the future. Be guided by your doctor or health professional, but general suggestions include:

• Try not to sit still for long periods of time.
• Avoid lifting heavy objects.
• Remember that movements such as bending and twisting (especially at the same time) can increase pressure on your damaged disc.
• Work on increasing your abdominal strength. Strong stomach muscles help to support the back. People who work hard on their abdominal muscles probably have much less recurrence of back pain over the long term, but only if they keep doing the exercises.
• Pay attention to posture while sitting, standing and walking.
• Flexibility exercises, performed regularly, can improve mobility and help reduce muscle tension and back pain.
• Include a gentle program of back-strengthening exercises.
• Yoga is recommended by some practitioners as an excellent form of strengthening and stretching for people with back problems.

Other causes of back pain

There are many other causes of back pain, so see your doctor if pain is strong. Important other reasons for back pain include:

• Muscular pain – probably even more common than disc rupture. It is usually localised to the back, without the pain spreading to the legs and very likely to fix itself without specific treatment
• Fracture – especially in elderly people, or those with osteoporosis
• Malignancy – some cancers can present with back pain. See your doctor if you have strong pain, night pain, have experienced weight loss or any other symptoms you are worried about.

Where to get help

• Your doctor
• Physiotherapist
• Osteopath

Things to remember

• Intervertebral discs are spongy cushions found between the vertebrae of the spine.
• Common problems include degenerative disc disease and ruptured (or ‘slipped’) disc.
• Risk factors for disc problems include obesity, advancing age, lack of exercise and incorrect lifting techniques.

This article originally appeared on www.betterhealth.vic.gov.au

What Does a Osteopathic Manual Therapist Do?

Soft Tissue Manipulation

The practitioner uses soft tissue manipulation in many different ways. In general, they use it to evaluate the condition of tissues and to help the body’s fluids (such as blood and lymphatic fluid) flow smoothly. Keeping fluids flowing smoothly reduces harmful fluid retention and makes the body’s immune system more effective. Fascia is tissue found in all parts of the body. It connects all of the body’s structures at both superficial and deep levels. Practitioners evaluate the fascia to find areas of restriction, and then use soft tissue manipulation to make sure the length and tension of the fascia are properly balanced. Throughout the treatment, manual osteopaths keep checking on the state of the body’s tissues. If one technique isn’t working to correct a restriction, they use another approach instead. Above all, manual osteopaths try to restore health without over-treating.

Osteopathic Articular Technique

Osteopathic Manual Therapists use this technique to reduce muscle spasms near a joint, ease neurological irritations around a joint, make joints more mobile and to reduce pain and discomfort.  The articular technique involves gently moving 2 joint surfaces.  Before doing this, manual osteopaths carefully prepare the soft tissues around the treatment area.  They also move the patient into a position that will minimize, or eliminate the energy and force needed to perform the manoever.  Many patients find this technique less forceful than joint manipulations.

Cranial Osteopathic Manual Therapy

This is a very gentle osteopathic technique, and it requires the most experience to use effectively. To learn this technique, Manual osteopaths undergo intensive training. Through this training, their hands become sensitive to the cranial mobility and develop great precision in utilizing cranial techniques. Manual osteopaths use this gentle technique to assess and treat the mobility of the skull and its contents. They may also use it to assess and treat the spine, the sacrum, and other parts of the body. The goal of this technique is to adjust the body’s physiology by restoring balance to the circulation of the blood and other body fluids. Manual osteopaths do this by treating the body’s inherent biorhythm. They are able to feel this rhythm in the patient’s head, spinal cord, and in the sacrum and the rest of the body. Manual osteopaths use the biorhythm to assess the patient’s condition, and they may modify it during treatment.

Visceral Manipulation

Osteopathic Manual Therapists use visceral manipulation to treat organs and viscera of the body, including the lungs, heart, liver, spleen, kidneys, stomach, pancreas, intestines, bladder and uterus. Patients may feel pain in one or more of these organs, or the viscera may be less pliable than it should be. Manual osteopaths gently move the structures themselves and the fascia (connective tissue) that surrounds them to restore full movement.

Most patients treated with visceral manipulation feel only the gentle pressure of the manual osteopath’s hand, but the corrections are powerful enough to improve the mobility of an organ, improve blood flow, and help the organ function more effectively.

The above (and many other) osteopathic manual techniques and approaches are used in a coordinated and rational fashion to slowly adjust the patients anatomy and physiology towards normal, so that the patient’s body can heal itself.

This article originally appeared on nmoc.ca

 

10 Ways Your Body Changes When You Start Drinking Enough Water

The research is clear: Staying hydrated is one of the healthiest habits you can adopt. Here are all the ways your body—and brain—get better when you chug, chug, chug.

You'll have more energy

The cells throughout your body need water to function, which is why we can all use tips on getting more water into your diet. "Water is a basic need for cellular health," says Ronald Navarro, MD, orthopedic and sport medicine surgeon at Kaiser Permanente South Bay Medical Center in Harbor City, California. "Cells contain water and are surrounded by water. In dehydration, cell membranes become less permeable, hampering the flow of hormones and nutrients into the cell and preventing waste products that cause cell damage from flowing out." When that's happening throughout your body, your energy is sapped, and fatigue can take over, according to a review of hydration research published in the journal Nutrition Review.

How much water do you need to boost energy? Depending on who you ask, the exact amount varies. Dr. Navarro points to the most agreed-upon recommendation of six to eight 8-ounce glasses of water daily. This could change though, depending on the climate you live in and the type of lifestyle you lead. "Some adults may need more or less, depending on their overall health, including if they have certain illnesses, take specific medications and more. It also depends on how much they exercise and the level of intensity, and how hot and dry the weather is," he explains. If you're interested to know how much water your body is hankering for, talk to your primary care doctor.

Your memory will improve

Your brain is hugely dependent on fluid to work properly. All those synapses and neurons need liquid to fire properly. According to research published in the European Journal of Clinical Nutrition, one of the most reliable predictors of decline in memory and mental performance is dehydration. And yet, according to Dr. Navarro, some polls estimate that upwards of 75 percent of Americans suffer from chronic dehydration. And that number worsens in summer: "We see the rate of dehydration increase in the summer and fall when temperatures are higher and perspiration is more pronounced," he says. If you're concerned you're among the dehydrated masses, here are the signs of dehydration.

Your focus will increase

Ever feel like you have no control over your attention span? Your mind just wanders no matter how hard you try to focus on the task at hand? Drink a big glass of water and watch what happens: According to researchpublished in the journal Nutrients, mild dehydration interferes with brain processing and breaks down the ability to focus. Just like sleep, maintaining a healthy diet, making time to sweat it out in your favorite workout class or log miles on your nearby running path, water is one of the most essential needs of your body. In fact, since we're made up of so much water, it makes sense why we would constantly need it to replenish, cleanse and feed our system.

You'll be stronger and faster

Ever feel sore during a workout, even though you didn't exercise the day before? You can check out these home remedies for sore muscles, but you should also know that those aches and pains or the difficulty you experience when trying to lift a heavier weight or push through that extra mile can be due to dehydration, and not your lack of strength. Research suggests that even a 2 percent drop in hydration can cause significant losses in strength and motivation while increasing feelings of fatigue. Dr. Navarro says that when we take in the right amount of water for our bodies, our muscles become more relaxed, which increases energy and maximizes our performance.

You'll slim down by eliminating mindless snacking

Ever find yourself eying the ice cream in your fridge late at night or taking a sampling of your kid's Goldfish, even though you know better? Instead of thinking you have hunger pains, reconsider that you're simply thirsty. Dr. Navarro says that more often than not, people mistake hunger for thirst, and that if you downed some water instead of those junk foods, you would feel just as full. "Proper hydration can serve as an appetite suppressant and help with weight loss or weight management," he notes.

Your digestion becomes reliable

Though there's no magical number of times you should move your bowels, it's definitely true that your bowel movements can offer real insight to your health. And if you struggle with consistency and often feel bloated or uncomfortable, you probably need to chug that water bottle ASAP. "People who drink enough water usually have regular bowel movements. Hard bowel movements or constipation can be a sign that you aren't getting enough water," Dr. Navarro says.

Your skin is more radiant

Ever go for a spa treatment—like a massage or facial—and your therapist makes a point to remind you to drink some water instead of the champagne you're eyeing? That's because skin can benefit greatly from hydration and for some, clear up your skin or make it look younger. (If you're looking for more ways to beautify your skin, try these tips.) "Our skin, the largest organ in our body, relies on water to produce new cells and give us that glow. Our skin also needs water do its job of regulating the body's temperature," Dr. Navarro says. No question: According to research, our skin contains 30 percent water which adds to plumpness and elasticity—vibrancy, in other words.

You'll need fewer calories

JENIFOTO/SHUTTERSTOCKWe're always looking for simple ways to cut calories, right? A new study involving more than 18,000 adults from the University of Illinois found that when people increased their daily water intake by one to three cups (on top of the four they drank on average), they ate less: Their food intake dropped by as much as 205 calories a day. In other words, drink a couple more glasses of water each day and you could shed two pounds a month—no dieting or extra time at the gym required!

According to Dennis Cardone, DO, chief of primary care sports medicine at NYU Langone Orthopedics, drinking water before—and during—meal fills you up faster, displacing the desire and need for additional calories. "Drinking water before and during a meal can decrease appetite and assist in weight loss," he notes. Choosing foods with a high-water content will also help: Many fruits and vegetables have a high water content, so they can provide additional ounces of water without you having to drink anything. Dr. Cardone recommends watermelon, cucumber, tomatoes, grapes and cherries.

You'll run cooler

When we exercise, our bodies cool off by sweating," says Dr. Navarro. "As we perspire, we lose necessary body fluids. If we do not replace these fluids, we become dehydrated. This makes it difficult to sweat and cool down, which can result in a heat injury," he explains. In hot weather, it's important you know the signs of heat stroke. If you're looking for easy ways to stay hydrated during exercise, check out this trendy solution from SMITH + STARR. Co-founders Chelsea Alexander and Fallyn Smith, were inspired to create a bag that offers a hydration solution, so they wouldn't have to lug around a water bottle while commuting in their home city, San Francisco, or while going hiking or camping. Their bag, The Conway, is the first ever cross-body handbag that doubles as a hydration pack. It looks like a bag you'd take while running errands or while out with your friends, but it contains a removable water pouch that holds 17 ounces and a tube for easy hydration right from the shoulder strap.

You'll be in a better mood

Even dropping 1-2 percent below optimal hydration can start wrecking your mood, according to research from the University of Connecticut. That's barely low enough to feel thirsty, and yet at that level of dehydration the moods of the women in the study soured and they were more likely to experience headaches and fatigue. So drink up, says Dr. Navarro: If you get tired of drinking good 'ole fashioned H20, consider upping your hydration game by making your 'brew' sparkling or flavored. Water with bubbles offers the same benefits of regular water, and added fruit can make the negative, tasteless sensation of water more interesting.

this article originally appeared on rd.com and was written by Lindsay Tigar 

Manual Osteopaths: Your Ally in Complete Health Care

Osteopathy is a form of drug-free non-invasive manual (therapy) medicine that focuses on total body health by treating and strengthening the musculoskeletal framework, which includes the joints, muscles and spine. Its aim is to positively affect the body's nervous, circulatory and lymphatic systems.

This therapy is a unique holistic (whole body) approach to health care. Osteopaths do not simply concentrate on treating the problem area, but use manual techniques to balance all the systems of the body, to provide overall good health and wellbeing.

Dr. Andrew Taylor Still established the practice of Osteopathy in the late 1800s in the United States of America, with the aim of using manual 'hands on' techniques to improve circulation and correct altered biomechanics, without the use of drugs.

What does osteopathy treat?

Osteopaths treat more than you think. Many patients present with complaints of aches in the head, back, neck, and heel/ foot pain; sciatica; shin splints; tennis elbow and repetitive strain injury. Other patients suffer from asthma; arthritis; digestive problems; carpal tunnel syndrome; whiplash and postural problems.

Osteopaths also deal regularly with patients who have been injured in the workplace, at home or while playing sport.

What are the qualities of Osteopathy

The philosophy of Osteopathy is what sets it apart from other (manual therapy) disciplines. The key principles are based on all parts of the body functioning together in an integrated manner. If one part of the body is restricted, then the rest of the body must adapt and compensate for this, eventually leading to inflammation pain, stiffness and other health conditions. When the body is free of restrictions in movement, Osteopathic treatment assists the body with pain minimisation, reduced stress and greater mobility providing the body with the opportunity to heal itself.

Osteopaths use a broad range of gentle hands-on techniques including soft tissue stretching, deep tactile pressure, and mobilisation or manipulation of joints.

In some cases, Osteopaths can complement the advice given by GPs. For example, people who suffer from arthritis are often prescribed medication by their GP. In addition to that, Osteopaths can ease the pain caused by joint and muscle stiffness, by improving joint mobility and the flow of blood to the joints, and show arthritis sufferers how to prevent causing injury to themselves...

Benefits of Osteopathy

Osteopathic treatment in itself is not 'preventative'. Osteopaths respect the body's natural ability as a self-regulating mechanism and only intervene when pain or discomfort is present. The benefits of osteopathy are the general improvement in mobility and structural stability of the body. In turn, other systems of the body such as the circulatory, nervous and lymphatic systems function more effectively and for a number of general conditions, minimal treatment is required.

Osteopathy and sleep

A key indicator of pain or discomfort is lack of sleep or restless nights. An effective osteopathic treatment outcome often reflects the first signs of recovery with a good night's sleep. Poor sleep patterns only serve to magnify the body's inability to function adequately and reduce our psychosomatic (Psychosomatic illnesses are those in which physical symptoms are caused or aggravated by emotional factors) ability to cope with pain.

Osteopathy and the nervous, circulatory and lymphatic systems

Osteopathic treatment positively affects the nervous, circulatory and lymphatic systems, to deliver a more balanced body and better health overall. This combined with good dietary and /or exercise prescription can enhance a patient's well being and often leads to a positive approach to individual health responsibility.

This article originally appeared on medicalnewstoday.com and was written by Christian Nordqvist