“Cauda Equina Syndrome: When NOT to See Your Chiropractor”

Your Doctor of Chiropractic can help you with a myriad of health problems. Numerous studies have proven both the efficacy and safety of chiropractic treatment as a cure for lower back pain, neck pain, whiplash and many other issues.

This article however, explains a particular situation “When NOT to See Your Chiropractor.”

Cauda Equina Syndrome
There is a fairly rare, but very serious condition known as “Cauda Equina Syndrome.” Thankfully, very few readers will have direct experience with this condition. But it is nonetheless important to discuss because if you ever develop these symptoms or know someone who does, you’ll know the quick action to take to avoid serious complications.

Horse Anatomy
The last several nerve roots come off of the spinal cord as strands resembling a horse’s tail, thus the Latin term “Cauda Equina” (Horse’s Tail). Cauda Equina Syndrome refers to pressure of these nerve rootlets that branch off of the terminal end of the spinal cord.

Symptoms of Cauda Equina Syndrome
These are the tell-tale signs you have Cauda Equina Syndrome. You can have one or all.

• Weakness of legs
• Atrophy (loss of muscles girth) of legs
• Numbness, pain or tingling into legs or feet
• Numbness and or anesthesia (total loss of sensation) around the anus
• Loss of bowel or bladder control

 

Cause of Cauda Equina Syndrome

There are several conditions that can cause Cauda Equina Syndrome:

• Large disc herniation in lumbar spine
• Spinal Stenosis
• Spondylolisthesis Grade III or greater
• Fracture/Dislocation of lumbar vertebrae
• Tumor

 

Complications

If not treated properly and in time, permanent irreversible paralysis could occur. Therefore, going to your chiropractor or general medical physician when you have these symptoms only further delays proper care.

 

What to Do if You Have These Symptoms
You should immediately report to an emergency room for an examination and MRI and/or CT scan. Once the cause of the syndrome is found, proper treatment may commence.

 

 

Cause of Lower Back Pain: Spinal Stenosis

Spinal Stenosis is a common cause of lower back pain and sciatica. It is most often found in older patients in their 60’s and older.

Stenosis means a restriction or blockage of a hole or opening. When doctors refer to “spinal stenosis” they are most often talking about stenosis or blockage of the central spinal canal. The central, canal is the large opening in the spinal bones that provides a bony “tube” that houses and protects the spinal cord.

The Cause of Spinal Stenosis
The central canal may become reduced in size due to:

• Disc bulge or herniation
• Bone spur of vertebral body
• Bone spur from facet arthritis

Symptoms of Spinal Stenosis
No matter what the cause, the symptoms of central spinal stenosis are the same. The textbook example is back and/or leg pain that is aggravated by walking and is relieved by short periods of sitting, after which time the person can walk for a period of time before the pain increases again. Sufferers of spinal stenosis must take frequent breaks on a walk.

As the condition worsens the amount of time the patient is able to walk gets shorter and shorter. Eventually spinal stenosis sufferers stop going for walks, shopping, etc.

Diagnosing Spinal Stenosis
The history of pain while walking relieved by rest is a big clue. A physical exam is necessary to determine the extent of neurologic function.

Two things must be documented and monitored for treatment:

1. How long the patient can walk before he or she must sit
2. How far down the pain travels; buttocks, back of thighs, calves, etc

An MRI is the most conclusive test to accurately diagnose stenosis and to determine the severity and cause, i.e. bone spur versus disc herniation.

Spinal Stenosis Treatment depends on:

• The cause; disc vs. bone spur
• The severity

For more information on spinal stenosis and a possible treatment go to: http://www.spinediscrehab.com/drx9000.htm

Cause of Lower Back Pain: Facet Syndrome

Back Anatomy

The spine has 2 sets of joints: A large joint between the large weight bearing part of the spine which is held in place by the disc and a smaller pair of joints in the back of the spine that guide movement.

It’s the latter joints that this article will address.

The smaller paired joints in the spine are called “facet” (fuh-set) joints. These joints are designed to help guide movement within the spine.

Cause of Facet Syndrome
Facet syndrome is a cause of chronic back pain that results from prolonged stress on the facet joints. It is a form of osteoarthritis of a specific joint. Work injuries, accidents, subluxation, prolonged poor posture and disc disease all contribute to facet joint malfunction. Continued malfunction over time results in the breakdown of the cartilaginous facet joint linings. In time, the bones react by forming spurs in an attempt to fuse the joint shut.

Symptoms of Facet Syndrome
The hallmark of facet syndrome is a deep aching pain that is aggravated by sitting and leaning backwards or twisting at the waist. The pain is usually located within an inch or two of the midline of the spine. It may occur just on one side or it can be on both. Facet syndrome does not ordinarily cause radiating pain (sciatica).

Diagnosing Facet Syndrome
A thorough physical examination of the spine must be done. A simple maneuver where the patient’s back is extended over the doctor’s hand as a fulcrum (Kemp’s test) will usually cause reproduction of the pain. Oblique (angled) plain film x-rays will show characteristic signs of facet joint narrowing, irregularity and often spurs. A loss of disc height is often found at the same level. Advanced imaging like an MRI is not usually required.

For more detailed information and a video tutorial on facet syndrome follow this link.

Is Your Disc Bulge ‘Focal’ or ‘Diffuse’? and Why it Matters…

The spine is made of 26 interlocking bones held together and made flexible by “discs” between each spinal bone.

Disc Function:
The disc is a flexible, yet very strong structure that bears the brunt of our weight by absorbing shock. Discs allow movement between the vertebrae or spinal bones. The discs also act as spacers to allow enough room for sensitive and important nerves to pass from the spinal cord to the rest of the body so that your brain can control and communicate with distant organs and tissues.

Disc Anatomy
A disc has 2 parts:
1. Annulus–outer fibrous tissue
2. Nucleus–inner gel substance

Disc Damage
When a disc is injured by acute trauma or by long-standing physical stresses, the outer fibers are weakened and allow the disc to bulge outward. The annulus may bulge or protrude in a small discreet area called a “focal” disc bulge or it may bulge across a wide portion of the disc, which would be called a “diffuse” bulge.

Focal bulges by their smaller and more localized nature cause more discreet neurologic symptoms like pain. Because the bulge is small or focused to only one area, the nerves involved are fewer.

Diffuse bulges however, take up more space and can cause more varied symptoms. You could one sided or both sided pain, you could have pain that appears to be coming from a different level altogether because of pressure on the spinal cord itself and not just a discreet nerve.

Obviously if you are going to pick and choose your bulge, you’d opt for a focal one. Unfortunately back pain sufferers have no choice. The “take away” point here though is if you know what type you have, it will help you to understand what your likely recovery is.

It’s also crucial for your doctor to take this into account to determine what treatment methods to use to cure your lower back pain and sciatica.

Learn what can be done to repair damaged discs and relieve the pain without surgery here:http://www.spinediscrehab.com/