cervical disc herniation

[CenteredHealth]

Looking at the bomechanics of the cervical spine is also highly effective in treating cervical dics herniations. Without getting in to the probable dysfunctions of the upper cervical spine (C0-C3) which always cause compensatory motions in the mid to lower c-spine, let us look at the typical pathological dysfunctions of C5-C6.

Typically what one will find on inspection is that C5 has sheared itself anterior on C6. This is evident on palpation, but also when asking the patient to extend his/her neck. On active neck extension one will not find segmental movement throughout the c-spine but rather you will see a hinging at the C5 level that we called 'Pez Head' (named after the Pez candies dispensers). This anterior displacement of C5 will bias the C5 disc posteriorly. Also, please keep in mind that the individual vertebral bodies are able to rotate upon eachother. So, another typical dysfucntion of C5 is that of being rotated either to the right or left coupled with side bending. Remember that vertebral rotation increases intradiscal pressure and will contribute to disc herniation as well as side bending which will bias a disc herniation to one side (i.e. side bending left will bias a disc herniation right).

Biomecnahics according to Fryette's Laws states that the typical cervical spine (C3-C7) has what is called Type II motion, in which mobility is depenedent upon the facet joints, and dysfunctions will be rotated and side bent to the same side. Again in keeping with C5, the typical dysfunction will be either FRSL or FRSR, meaning that C5 is flexed, rotated and sidebent to the right or left. This dysfunction will bias the C5 disc posterior and to either the right or left side depending on the side of rotation and side bending.

Begining to adjust these mechanics will make a world of difference to the patient, as it will decrease the protective neural responce, decrease sympathetic tone throughout the cervical spine, decrease protective muscle spasm, improve cervical mobility, decrease paresthesias, decrease radiculopathy, improve blood flow, improve strength, etc.

Correcting these mechanics even has the potential for eliminating the disc herniation all together. It has been confirmed for me via MRI imaging.

Of courese I would integrate this work with an appropriate stretching regieme, modalities as necessary and neuromuscular re-education.

[jesspt]

Correcting these mechanics even has the potential for eliminating the disc herniation all together. It has been confirmed for me via MRI imaging.

I think I'd like to see a reference for that, if you've got it handy. Or, are you talking about strictly personal experience?

[CenteredHealth]

I think I'd like to see a reference for that, if you've got it handy. Or, are you talking about strictly personal experience?

Hi Jess. Again thank you for challenging my posts, I find it refreshing.

The majority of information that I spoke of in this post comes form Osteopathic Medicine. For information regarding biomechanics and osteopathy I will refer you to Fred Mitchell and Harrison Fryette. There are many others, but I believe this is a good start.

Regarding a disc herniation repairing, are you to say that it is not possible? If the body can overcome Cancer, can it not repair a herniated disc? The body has an amazing ability to heal itself, which can see on a daily basis. Remember homeostasis? Unfortunately Western Medicine has partially forgotten this concept. Anyway...

The disc herniation... I have been privileged to work with many people suffering from disc herniations, and of them all there are two that stick out in my head because fortunately for us they had both pre- and post-treatment MRI imaging. The results were undeniable and life changing. The doctors were amazed, the patients themselves were amazed and yes, even I was amazed.

Every now and then something comes along in your life that takes everything you thought you knew and throws it out the window. They were beautiful experiences to live through as they completely expanded and deepened my understanding of the human body.

Thanks Jess, looking forward to your reply.

[sharileedahl]

No matter where we are in the world, things get a little emotional when we talk about evidence based practice!!!
There are a couple good discussions regarding the same subject under the tag "ebp".

Personally, I feel there is something very important to remember. I agree that evidence-based practice is extremely important. To validate what we do to insurers, funders, clients, other professions...... That is the reason that I read the amount of research that I do.
BUT...research has to start somewhere. It will start based on a case study or even purely a therapist's intuition.
I love citing research when talking about treatment plans but I am also very interested in learning more about the fascial system and myofascial release....bit of a contradiction really. But...it just makes sense to me. And once I learn a little more, apply a little more maybe I (or someone else who actually wants to do research) can make it make sense to other people?? (Or I'll figure out I was wrong!)

To ask someone to provide research to back up what they do is fine. But I don't think we can totally discredit everything they have to say if they can't.
Example: According to research, not too long ago I would have to have people doing VMO setting exercises and taping for PFPS and nothing else. My gut (and my eyes) were telling me something else so I had people work more on gluts, body awareness... And (yahoo) now in the past couple years I'm actually seeing research backing that up.
I would be surprised if there isn't anyone out there that has done something treatment wise that just makes sense to them then later (maybe months or years later) gets the pat on the back from a research article that tells them they are on the right track.
So yes....read research, critically evaluate it, use it where you can, let it optimize your treatment but remember not everything has been studied yet. Your unproven theories might be the outcome of the next body of research.