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Non-Surgical Therapy Options For Ligamentum Flavum Hypertrophy

This article provides in-depth information on the definition, causes, signs, symptoms, and best non-surgical treatment options for hypertrophy of ligamentum flavum. CSC’s methods & technology can reduce ligamentum flavum hypertrophy. Call us before you opt for injections or surgery!

Hypertrophy Of Ligamentum Flavum Defined

showing ligamentum flavum hypertrophy

Ligamentum flavum hypertrophy is a condition in which the ligamentum flavum (LF) thickens due to stresses placed on the spine. With hypertrophy, ligamentum flavum (LF) increases in thickness (size). The thicker it becomes, the higher the risks of compressing the spinal cord or spinal nerves. In short, a thicker than average ligamentum flavum (LF) decreases the room or available areas a nerve root or the spinal cord has. Compression of spinal nerves or spinal cord can produce varying degrees of pain and even disability.

Contrary to the common belief, a hypertrophied ligamentum flavum (ligamentum flavum hypertrophy) is treatable non-surgically. Our award-winning center provides holistic therapies for ligamentum flavum through the combined efforts of our physical therapists and top-rated chiropractors in Kuala Lumpur.

This article will provide ample information about ligamentum flavum hypertrophy: what it is, how it gets damaged, and what your non-surgical treatment options are. Let’s began our review with the description of the ligamentum flavum.

What Is Ligamentum Flavum?top view of ligamentum flavum location in the spine

Ligamentum flavum (Ligamenta Flava or yellow ligament) is highly specialized. It is an extremely elastic ligament, which connects the spinal bones through its two laminae, articular joints (facets and pedicles) attachment points on each side of the spine, from C2-S1. But, what makes it unique is the fact that it functions as a muscle as well. The muscular function of LF enables the spine to realign following forward bending motions.

Ligamenta Flava (ligamentum flavum) is thin, broad, and long in the cervical spine or the neck. However, it is thickest in the mid-back and lower back regions of the spine. This highly elastic ligament serves to hold an upright posture, especially following flexion (bending) in the neck or low back. Its’ abundance of elastin affords the increased elasticity of this ligament. The thickening of ligamentum flavum is common among gym-goers and those involved in heavy lifting or repetitive movements. Ligamentum flvaum thickening is a common coause of backaches. To recoer from chronic backaches you need to have yur ligamentum flavum assess and treated.

The clinical significance or relevance of LF is that it can compress spinal nerves and the cord, damaging nerves and the spinal cord. A thickened or hypertrophied LF (ligamentum flavum hypertrophy) is the number one cause of spinal canal stenosis. A hypertrophied or thickened LF compresses the spinal cord because of the increase in thickness and buckling. LF buckling becomes increasingly common with progression. The buckling of LF (ligamentum flavum hypertrophy) is the main reason why many complain of increased pain during weight-bearing positions or when they extend the spine.

What Is The Function or Purpose Of Ligamentum Flavum (LF)?

chiropractic treatment of the spine

Elastin, which we will discuss in upcoming sections, provides ligamentum flavum (LF) significant elasticity. The elastic nature of LF is critical to the maintenance of an upright or a standing posture. LF is a ligament that functions much like a muscle. The muscular component allows it to have contractibility.

The contractile ability of LF assists in the proper realignment of the spinal joint after flexion or forward bending. The ligamentous characteristics of LF prevent excessive gaps or separation between the spinal bones. To understand these better, let’s look at LF attachments on the spine.

We mentioned that LF is attached to each spinal segment from C2-S1. Now, let’s see the actual attachment points. LF originates from the two lower surfaces (right lamina and left lamina) or the vertebra above and attaches downwards to the posterior upper margins of the vertebra’s right and left lamina below, as well as the articular facets (joints). The joint (spinal facet and pedicle) attachment prevents pinching or jamming of spinal joints as the body resumes an upright posture. Now, let’s see how these attachments occur.

As soon as LF originates from the lamina above, it separates into two sections on each side, a medial component and a lateral component. The medial element is the portion that attaches to the lamina below. The lateral component traverses in front of the joint (facets), connecting to the joint capsules of spinal joints or facets.

The articular component (spinal joint or facet portions) envelopes the entire joint capsule with its attachment to the vertebrae’s pedicle below. The articular facet (spinal joint) and pedicle attachments of LF prevent jamming or pinching joint surfaces and joint soft tissues due to its marked elasticity.

“We understand that may be more anxious about finding effective treatment options that are surgical or invasive. As such, we plan on discussing the non-surgical treatments first, before elaborating on Elastin, symptoms, or causes of thickening in spinal ligaments.”

Is It Possible To Treat A Thickened Spinal Ligament With Non-Invasive Conservative Treatment?

Our Doctors of Chiropractic will evaluate your MRI in our center by Mont Kiara

The short answer is YES. Conservative treatment of ligamentum flavum hypertrophy is effective when provided by a team with an expert understanding of the spine and associated conditions.

Chiropractic Specialty Center® uses specialized devices, methods, and care systems that are significantly superior to the traditional techniques of non-invasive treatments rendered by most chiropractors or physiotherapists. Our Chiro-zone and physio-zone work together to fix and repair your pain or injury.

Hypertrophy of ligamentum flavum is always present with associated conditions. Conditions such as herniated discs, facet arthritis, degenerated spinal discs, and bone spurs are all too familiar.

Surgical or steroidal medications have failed to provide patients the cure they need to live healthy, active lives. We have treated thousands of patients with hypertrophy of ligamentum flavum at our centers. In the vast majority of these cases, we have successfully reduced pain and increased functional capacity to a point where the patient can live a healthy, active life. In short, call us now if you want the best back pain treatment without injections or surgery in Malaysia!

Customized Chiropractic Combined With Physiotherapy For Ligamentum Flavum Thickening

CSC’s non-invasive conservative method of chiropractic and physiotherapy are further enhanced with care provided through breakthrough spine technology that others do not have. In short, we target the malfunction in spinal ligaments, as well as the secondary issues such as slipped discs, facet arthritis, and disc degenerations.

To recover from the impacts of ligamentum flavum hypertrophy, you will need efficacious methods of treatment that combine targeted evidence-based strategies of chiropractic with focused clinical physiotherapy. In other words, the care you get must be targeted by systems and processes that target the ligamentum flavum damage. CSC’s methods of treatment meet the requirements for targeted damaged ligamentum flavum without surgery or injections.

CSC’s Three Physiotherapy & Chiropractic Centers In KL

We have multiple centers throughout the Klang Valley. For example, you can find a CSC center in Kuala Lumpur, Sri Petaling (Chiropractic and physiotherapy center near Taman Desa in Sri Petaling), Bandar Sri Damansara, and Desa ParkCity. CSC in Bandar Sri Damansara provides the most holistic spine and joint care from top-rated physiotherapists and chiropractors. Get treated by the best chiropractors and physiotherapists In Desa ParkCity & Sri Damansara are through CSC’s holistic Physiotherapy with chiropractic in Bandar Sri Damansara today

We are the best spine and joint treatment center in Malaysia. CSC’s physiotherapists and chiropractors follow the precise therapy and treatment protocols of NSD Therapy®. NSD Therapy® is the most comprehensive means of treating the spine without medication, injections, or surgery. But, for those who suffer from ligamentum flavum hypertrophy, we provide a proprietary method of physiotherapy, exercise, nutrition, and chiropractic discovered by our director Yama Zafer, D.C. (Doctor of Chiropractic). Yama Zafer, D.C., is an American chiropractor that has spent the better part of the last twenty years researching efficient means of non-invasive spine care. In addition to the care you get, we will advise you on daily activities.

For the gym-goers, we may even provide an in-depth explanation of how to avoid injury during their workout. So, the care you get from us includes lifestyle changes you will need to make for complete recovery. We will revisit treatment options after a thorough discussion on ligamentum flavum hypertrophy. So, let’s began with Elastin and the critical role it plays in ligamentum flavum.

What Is Elastin? How It Impacts Ligaments In The Spine?

herniated disc & ligamentum flavum thickening causing canal stenosis

Elastin is said to be 1000 times more elastic than cartilage. It is a protein in connective tissues such as ligaments, tendons, muscles, and spinal discs in basic terms. It enables our connective tissues to regain or “snap back” into position or their original shape after physical stress or stretch.

In addition to the skin, spinal discs, ligaments, tendons, or muscles, it is found abundantly in the heart. Blood vessels, lungs, and intestines also have elastin. Therefore, it is a critical protein in our bodies. How does elastin impact our spine?

As mentioned, elastin is highly elastic. The two primary structures with high elastin concentrations in the spine are the spinal discs and ligamentum flavum. In the spine, elastin is the bond that holds spinal disc fibers (annulus fibrosus) together. It prevents buckling or bulging of the spinal disc during load-bearing activates.

Prolonged sitting or axial loading will cause depletion or a decrease in elastin production in the spinal discs. When production decreases, the disc fibers that protrude in load-bearing activities do not snap back with rest. A reduced level of elastin in ligamentum flavum has a similar impact. A sufficient elastin level in ligamentum flavum prevents it from buckling into the spinal canal or neural foramina when extending the head and neck or the back.

Hypertrophy of ligamentum flavum results from traumatic injuries or repetitive activities that cause degenerative changes with the thickening of ligamentum flavum. A degenerated ligamentum flavum lacks sufficient levels of elastin protein. In other words, cord compression and nerve root compressions become increasingly common occurrences as the ligament thickens and degenerates.

The Elastin & Cartilage Roles In Ligaments That Surround The Spine

comparison view o normal and stenotic spinal canal

According to numerous research articles, a hypertrophied LF results from mechanical stresses in which elastin fibers fragment and calcify. Interestingly enough, several new pieces of research also indicate collagen deposition. In healthy LF, the elastin fibers form a complex meshwork. A meshwork is defined as a structure that is interlaced or interwoven.

When the spine is subjected to excessive stresses, elastin fibers’ meshwork is broken down and fragmented. The body responds to this fragmentation by increasing collagen content in LF.

The combined impacts of elastin fragmentation, collagen deposition (collagen Type IV), and the eventual calcification of damaged elastin and collagens are the leading factors in developing ligament flavum hypertrophy.

Chiropractic Specialty Center® provides the best spine and joint treatments in Malaysia. Our treatment programs include targeted care that fixes the actual damage. We will recommend nutritional supplements and vitamins for patients with damaged soft tissues in addition to the care you get.

What Causes Ligamentum Flavum Hypertrophy?

man holding back in pain

The actual cause of LF hypertrophy is related to elastin fragmentation, collagen type IV deposition, and calcification of elastin and cartilage. In this section, we will discuss the stresses and activities that accelerate LF hypertrophy. Hypertrophy of ligamentum flavum is an age-related disorder in which there is a decrease in elastin-to-collagen ratios in ligamentum flavum. Although often seen in the elderly, it can happen at any age. The leading cause is neglect of minor injuries.

The actual causative factor is still somewhat unclear. However, recent research has proposed links to inflammation and scar tissue as the main factors in elastin demise and collagen deposition. Repetitive motions or traumatic events cause inflammatory processes. Continued stresses and unabated inflammatory processes lead to the formation of scar tissues. A scar or scar tissue is the body’s response to repairing injured tissue. Scar tissue is a standard component of healing. It becomes problematic when there is a continuous build-up of scar tissues due to daily stresses or micro-traumatic events. An inflammatory process, by definition, is the body’s response to an injury or disease.

Inflammatory processes in ligamentum flavum are often the results of micro-tears (small, tiny tears). It could result from lifting heavy objects, playing aggressive sports, bodybuilding, or automobile accidents. Micro-traumatic events cause small rips and even microscopic tears that are often painless. But, continued stresses from micro-traumatic activities have a cumulative effect that leads to scar tissue or thickening of the ligamentum flavum.

So, the minor neck or back injuries we subjected our spine comes back to haunt us later in life. Therefore, to avoid such complications, years or decades then, tend to even the most insignificant spine injuries as early as possible. Prevention is better than cure. Ligamentum flavum hypertrophy is a preventable disorder.

What are Symptoms Of Ligamentum Flavum Hypertrophy?

back pain illustration

Ligamentum flavum hypertrophy symptoms can vary depending on the severity of the condition and location of hypertrophy or thickening. The initial hypertrophy stages are relatively asymptomatic (cause no pain), but its progress can rapidly become severe and even disabling.

Ligamentum flavum hypertrophy in the low back (lumbar spine) produces sciatica-like symptoms. Sciatica is descriptive of symptoms of pain (leg pain) along the course of the sciatic nerve. The sciatic nerve emerges from the lower lumbar segments and provides nerve innervations to the buttocks, thighs, legs, and feet.

A hypertrophied LF in the lumbar spine (low back) can produce pain in the lower back, buttocks, or nerve pain impacting the thighs, legs, and feet. In addition to leg pain, most will also complain of numbness, tingling, or burning sensations. In severe cases, weakness and foot drop may result. Foot drop is a condition that occurs from nerve damage.

Prolonged compression of the spinal nerves or spinal cord can compress, injure, and even kill nerves that control the bowels’ functions, bladder, reproductive organs, and legs. Yes, a severely hypertrophied ligamentum flavum can cause sciatica, impotence, paralysis, or loss of bowel and bladder function!

To give you a better understating of the symptoms associated with degeneration or thickening of ligaments in the lower back, we have provided a detailed list below:

A lumbar or low back hypertrophied ligamentum can cause symptoms or pain in one or both sides of the lower body. As mentioned earlier, it can also cause bowel and bladder issues or dysfunction in reproductive systems and organs. We have provided a detailed list of musculoskeletal symptoms for your review below:

  • Back pain or leg pain that worsens with staining or sitting and is relieved by lying down
  • Pain in the buttocks; pain can be constant or intermittent, on one or both sides
  • Leg pain: the result of pinched spinal nerves or the thecal sac (housing of the spinal cord)
  • “Pins and needles” sensation in the back, buttocks, or lower limbs
  • Numbness in the buttocks, legs, feet, or toes
  • Pain upon bending at the waist or when standing for a period
  • Pain and discomfort when rising from a seated position
  • Varying degrees of back pain or leg pain with sudden movements, coughing, or sneezing.
  • Leg pain that is more severe than back pain, or leg pain alone – i.e., without any pain in the back
  • Discomfort or pain when turning in bed during sleep, severe enough at times to wake patients up from a nap or sleep.
  • Inability to walk due to weakness or pain in the legs.
  • Incontinence
  • Impotence, infertility
  • Paralysis of one or both legs as the condition progresses

What Symptoms Are Present When Ligamentum Flavum Hypertrophy Is In The Neck?

man holding neck in pain

Thickening of Ligamentum Flavum (LF) can occur at any point in the spine. We have already covered the most common site: the lower back. Now, let us look at the second most commonplace, or the neck, for ligamentum flavum hypertrophy. The neck is the second most common site for LF overgrowth, but it is critically dangerous.

A severely thickened or hypertrophied LF in the neck can cause severe spinal canal stenosis or myelopathy. Severe canal stenosis in the neck can cause severe symptoms due to myelopathy. Myelopathy is severe compression of the spinal cord that often results from trauma, degeneration, hypertrophy, or congenital disabilities. Symptoms of malfunction can be present from the neck down to the feet. It can cause paralysis from the neck down.

Earlier, we mentioned that the ligamentum flavum was thinnest in the neck. We also said that it was the longest as well. Both statements are true. In addition to what was discussed, the neck portions of LF have the highest levels of elastin. Higher elastin levels are needed to provide better stretchability and retraction of this ligament during forward-bending or backward tilting of the head and neck.

Poor posture, text neck, slip-disc in the neck, spondylosis, and subluxation damage to the ligamentum flavum lead to varying degrees of pain or symptoms.

Ligamentum Flavum Issues In The Lumbar & Lumbo-Sacral Motion Segments

A motion segment is the union of two or more contiguous vertebrae in the spine. The L4-L5 motion segments from when the inferior two facets of L4 vertebrae connect with the superior paired facets of the 5th lumbar or L5.

The three most common lumbo-sacral sites for ligamentum flavum hypertrophy are:

  1. L2-L3 Motion segment
  2. L3-L4 motion segment
  3. L4-L5 motion segment
  4. L5-S1 motion segment

Ligamentum Flavum Disorders Of The Neck

The three most common sites for ligamentum flavum hypertrophy in the neck are:

  1. C4-C5 motion segment
  2. C5-C6 motion segment
  3. C6-C7 motion segment

The C5-C6 motion segment is by far the most mobile of all neck segments, and as such, it is the most common site for bulging discs, herniated discs, facet hypertrophy, bone spurs, and ligamentum flavum disorder. Patients with Eigentum hypertrophy in their neck will often present with a C4-C7 disc bugle or spondylosis. Contact CSC today to get more information on neck pain treatments for the ligamentum flavum.

We have provided a list of the most common symptoms of the cervical spine below:

Cervical spine hypertrophy of the ligamentum flavum produces symptoms when the spinal cord or spinal nerves are pinched. In most cases, the symptoms gradually develop over a period. However, there are scenarios where symptoms are not felt in early or even moderate stages of hypertrophy. As such, most are diagnosed in moderate or severe stages. In almost all cases, there will be some level of associated spinal disc damage. The most common spinal disc damage in patients presenting with a hypertrophied LF is degenerative disc disease, bulging discs, herniated discs, extruded discs, or fragmented spinal discs.

Here is a list of symptoms for thickened ligaments to watch out for:

  • Mild cases are often asymptomatic (no pain). However, it can cause stiffness in the neck.
  • Neck pain, upper back pain, or mid-back pain
  • Shoulder pain, arm pain, elbow pain, or wrist pain
  • Carpal tunnel-like sensations
  • Weakness in shoulder, arms, wrists, or hand
  • Burning sensation in the neck, upper back, or upper extremities
  • Pins and needles sensations in the upper extremities, neck, or upper back. It can even cause pins and needles in the legs and the feet in moderate or severe cases.
  • Poor coordination of legs, arms, wrists, or hands
  • Unable to balance or walk with a shuffling gait
  • Loss of bladder (incontinence) and bowel functions are interruptions or complete loss of sexual or reproductive systems.
  • Chest pain, difficulty breathing, heart issues, lung problems, and digestive issues
  • Earaches, migraines, dizziness, vertigo, tinnitus, or blurred vision

To conclude, hypertrophy of ligamentum flavum in the neck can be crippling or worse. Your goals should be to seek centers, clinics, or hospitals that provide non-invasive therapy solutions for neck pain. However, most hospitals recommend a surgical intervention as they lack the non-surgical experts needed for a non-surgical recovery.

Should Chronic Back Pain, Chronic Neck Pain Patients Avoid Steroid Injections?

Back pain, neck pain, and hypertrophied LF are mechanical conditions that result from accumulated daily stresses. Chronic neck pain and chronic back pain patients will always have some degree of damage or thickening in LF. Steroidal injections are an orthopedic surgeon’s favorite injectable.

They love to inject patients with steroids even though it has limited application and many harmful impacts. Perhaps the love for the injectable such as steroids stems from their years of training, education, and research centered around invasive methods.

Steroid injections for neck and back pain are useless as it only addresses the inflammatory nature of a health condition. However, the poking of a rather large needle in the spine, passing through the Ligamentum Flavum (LF), can harm more than it can help. As mentioned, in almost all chronic back pain or chronic neck pain cases, LF is hypertrophied with scar tissues. Piercing a hypertrophied (scared) LF will only add more scar tissue to an already hypertrophied ligamentum flavum, but what is even worse is the steroid itself.

While piercing the LF with a large needle can harm and create more scarring, the steroid itself is even more detrimental. The U.S. National Library of Medicine has over 60,000 published research articles that allude to steroid injections’ side effects.

“We will cover of these findings to help you understand why we oppose the steroid injections for chronic neck pain & chronic back pain or in-patient with LF hypertrophy below:”

  • Our ligaments, tendons, muscles, cartilage, joints, and bones all have living stem cells. These stem cells are needed to regenerate and repair following damage or injury. According to published research, steroid injections harm the living stem cells in your body.
  • When injected, cortisone (steroid) crystallizes. The crystallization of steroids in tendons leads to weaknesses in their supportive and protective abilities or functions.
  • Steroid injections have been found to deplete bone and cartilage densities, increasing your risks of arthritis and osteoporosis. For arthritic and osteoporotic patients, steroid injections can progressively increase the rate of progression.
  • According to an article from The Lancet in 2010, patients injected with steroid injections have a slower rate of recovery when compared to physiotherapy. What is worse is the fact when the injection is repeated. Perhaps, this is why some orthopedic surgeons limit the number of injections to three times within twelve months. However, many consider this as three-too-many.

Why Should You Avoid Surgery For Ligamentum Flavum Hypertrophy?

spine surgery in operating theater during surgery

Spine surgery should be the last option. Spinal canal stenosis is a common condition in chronic neck pain and chronic back pain patients. The most common cause of spinal canal stenosis is hypertrophy of the ligamentum flavum. The second most common cause of spinal canal stenosis is a slipped disk.

The third most common cause is bone spur or osteoarthritis. Having said that, the vast majority of chronic neck pain and back pain patients present with varying degrees of all three types: hypertrophied LF, slipped disk, and bone spurs. To complicate matters, multiple segments are involved in more than 90% of cases.

Spine surgery has never been touted as a cure, and those that claim it as a cure are enormously mistaken. A cure is a 100% reversal of a health condition. You cannot obtain 100% normal function when parts are cut, screwed, plated, or caged. It is just that simple. However, there are scenarios when spinal surgery becomes a necessity. Surgery on the spine for LF, spurs, a slipped disc, or spinal canal stenosis should be opted for when targeted non-invasive conservative measures have been exhausted. Surgery on the spine becomes necessary when a patient presents with a bowel or bladder function loss.

Pain in the back or neck, pain down the arms, and even weakness in the legs or arms can be effectively treated non-surgically. Our advanced methodology can resolve even foot drop and mild incontinence issues through targeting research-based methods of treatments.

What Is The Best Non-Invasive Conservative Treatment For Neck Pain, Back Pain, Slipped Disc & Spinal Canal Stenosis?

NSD Therapy methods and systems of care for ligamentum flavum hypertrophy

Chiropractic Specialty Center® uses a proprietary spine care system through an integrative approach backed with breakthrough spine-specific technology. This system of treatment is termed NSD Therapy®. NSD Therapy® (Non-Surgical Decompression Therapy) is provided through clinical physiotherapists’ collaborative efforts (physical therapists) and our researched-based doctors of chiropractic medicine. In short, NSD Therapy® is the combination of physical therapy, chiropractic, physiotherapy, rehabilitation, nutrition, and lifestyle changes. It is the most compressive non-invasive form of spine care.

The physical therapy component of NSD Therapy® includes soft-tissue mobilizations, gentle osseous manipulations, trigger point therapy, and myofascial release. Physical therapy treatments in NSD Therapy® are the manual procedures rendered. The physiotherapy aspects of NSD Therapy® are provided through medical devices specifically for the spine. With physiotherapy, some of your treatments are delivered through modality-assisted therapeutic measures. We may recommend one or all of the following physiotherapy treatments after assessing you: ultrasound therapy, high-intensity laser therapy, interferential current therapy, shockwave therapy, the RxDecom®, and Spinercise®.

The chiropractic treatment rendered in our centers for chronic neck pain, back pain, a slipped disc, spinal canal stenosis, and ligamentum flavum hypertrophy is through the Activator methods. We do not use the traditional rotatory spine adjustments, which can further aggravate patients with chorionic conditions. Our Activator method of chiropractic treatment is specific to facet joints (spinal joints). In addition to using the Activator treatments, our chiropractors will use proprietary methods involving chiropractic manipulations specifically for elongating soft tissues that include LF.

How Effective Is Chiropractic Care For Ligamentum Flavum Thickening?

Chiropractic care is best for any type of spine, joint, and sports injuries. However, for you to benefit from chiropractic care, it must be targeted and condition-specific. Chiropractic is similar to other professions. It has those who are mediocre, average, above average, and best. Of course, getting treated by the best chiropractor will have greater benefits.

FInding the best is not difficult. All you have to do is to call us,; we are the best chiropractic center in Kuala Lumpur.

Ligamentum flavum hypertrophy is a common finding in patients with neglected spine issues. Those with chronic neck and back pain or long-standing sciatica-like symptoms often develop a hypertrophied ligamentum flavum. Moreover, hypertrophy of ligamentum flavum is rarely a condition that causes pain by itself. There is always an associated or co-condition present. Therefore, the care you get must target the ligamentum flavum and all its related disorders.

Chiropractic treatment for ligamentum flavum is helpful. However, not all chiropractors are knowledgeable on treatments of ligamentum flavum. To benefit from chiropractic, you must do your homework and go to the best chiropractor. Get care from an excellent chiropractor is the best thing you can do for chronic neck or back pain. If you live in the Klang Valley, contact Chiropractic Specialty Center®. Chiropractic Specialty Center® has treated over 20,000 spine & joint patients. We are the premier physiotherapy and chiropractic center in Kuala Lumpur, Malaysia. Our methodology and specialized technology can help even when competing centers fail. Dr. Zafer is an American chiropractor with 25-years of clinical excellence. In our opinion, he is the best chiropractor in Kuala Lumpur, Malaysia.

Chiropractic Specialty Center® offers comprehensive treatment for spinal muscles. ligaments & spinal discs at our physio and chiro-zones.

Our physio-zone and chiro-zone offer evidence-based treatment with precision. In the chiro-zone, you will be assessed for all the therapies you will get in our center, including those given at our physio-zone. In addition to treatments provided by our chiropractors and physiotherapists, our team will give you home exercise, as well as advice or supplements. Nutrition, spinal rehabilitation, and lifestyle changes will also be needed. Our clinical teams will customize a specific plan for your nutritional needs, rehabilitative needs, and any modification of your lifestyle or activities. If you are seeking the best non-surgical spine center for ligamentum flavum hypertrophy, we are it. No other practice in Malaysia offers the same level of spine care that we provide.

Chiropractic Combined WIth Physiotherapy & Breakthrough Technology To Repair Ligamentum Flavum Hypertrophy

canal stenosis caused by ligamentum flavum thickening & hypertrophy

Chiropractic Specialty Center® is Malaysia’s premier non-surgical center for conservative treatments of the spine and joints. If you have been diagnosed with a slipped disc, bone spurs, arthritis, spinal stenosis, we are your best choice; call us today.

We are the best center in Malaysia that treats ligamentum flavum hypertrophy through non-surgical means. The best advice we can give you is to call us and start your care. The sooner we start your treatment, the better. We can treat ligament issues without surgery or injection. All we ask from you is to maintain consistency during your care. Inconsistent treatments or those who stop the care too early will hamper your recovery. Call our center today to start your treatments. Ligamentum Flavum Hypertrophy is treatable and reversible through our methods and technology with consistent therapy programs.

This Post Has 33 Comments

  1. Benedict J. Marciano, MD

    Do you have NSD Therapy clinics in the East San Francisco Bay Area in California> I require my multi-level moderate to severe mid-Lumbar (worst at L3-4, based on MRI). Also, I have foraminal stenosis due mostly to Ligamentum Flavum, epidural lipomatous. MRI also showed facet hypertrophy and disc bulging. Symptoms include moderate achy/diffuse LBP, mild to moderate right shooting pain in the buttocks. Also suffer from leg pain, weakness, numbness, and tingling coming from L2-L3, L4-5 & L5-S1. Tinginglin is the greatest in toes (both sides). No pain with Valsalva, no claudication symptoms, no acute progressive weakness or bowel & bladder issues or incontinence, but occasional bowel urgency. Thank you1 com

    1. Yama Zafer, D.C.

      Dear Dr. Marciano,
      Thanks for posting on our blog. I will respond to your question through email shortly.

    2. Margaret McDonald

      Hello. I have multiple degenerative disc diseases and ligamentum flavum hypertrophy. Do you have any offices in the Tampa Bay, Florida area?

      1. Dr. Yama Zafer, D.C.

        Dear Margaret,
        Please accept my apologies for not replying sooner. Unfortunately, at present, we are only located in Malaysia. We do not have any centers in the United States.

    3. Bp singh

      I am suffring from lingament flames d10 d11 on 20 years I am 56 year old present I am on wheel chair legs pain no movement. stesses right hand weakness left shoulder pain

      1. Dr. Yama Zafer, D.C.

        Dear Bp Sing,
        Thanks for posting a question. Hypertrophy of ligamentum flavum is a leading cause of spinal canal stenosis (shrinkage of the spinal canal). I suspect that you have a moderate to severe case of spinal canal stenosis resulting from a ligamentum flavum thickening. However, canal stenosis or ligamentum flavum hypertrophy at the D10-D11 will not cause issues in the shoulders, arms, or hands. Canal stenosis resulting from hypertrophy of Ligamentum flavum at D10-D11 can cause problems from mid-back down to your toes.

        In your specific case, I suspect the issue to be related to an injury. Therefore, I encourage you to call our Bukit Damansara center at 03 2093 1000 to set up a consultation. You will need to bring all diagnostic imaging (MRI, CT & X-rays). Let us assess you and review your imaging to see if our methods of spine care can get you feeling better.

        Your shoulder and arm symptoms are possibly due to a neck and upper back problem. We can assess that as well.

        Hope this helped

  2. Anjanireddy

    Sir, I am suffering from degenerated disc disease involving c3-4,c4-5. I also have ligamentum flavum hypertrophy at c4-c5. What is the solution, sir, as I am in pain daily?

    1. Yama Zafer, D.C.

      Thank you for posting your question. We can certainly help! Our neck and back pain treatments are through the combined efforts of our chiropractors and physiotherapists. In your case, we will also use advanced therapy devices to fix and repair as much of the damage as possible. The care we will provide can eliminate your neck pain and any pain that runs into the upper back, shoulders, or arms.

      Thickening of ligamentum flavum and degenerative disc disease are two conditions that co-occur in the neck or back. They arise from repeated injuries to the spine. Surgeons recommend surgery, but they can be addressed through non-surgical methods. Our center offers the best non-surgical treatment for degenerative disc disease, slipped discs, spondylosis, neck pain, and back pain. Also, we provide advanced methods of treating hypertrophy of ligamentum flavum. I would encourage you to visit our center. Please call us on 03 2093 1000 to schedule an appointment. Please bring all your X-rays and MRIs. Let me and my team assess you.

    2. Yama Zafer, D.C.

      Dear Anjanireddy,
      Please forgive us for replying late. Spinal disc degenerations in the neck combined with hypertrophy of ligament flavum lead to compression of the spinal cord and nerves. These can become quite serious, as they are progressive in nature. Spinal disc disease and thickening of ligamentum flavum are difficult conditions to treat. As such, you will need focused treatments that are specialized through therapy devices, chiropractic, physiotherapy, and targeted rehabilitation. We have treated thousands of patients with similar conditions successfully. Please contact our center at 03 2093 1000 to learn about our services. We will be glad to answer your questions when you call. Also, our team members can help schedule a one-on-one consultation with one of our clinical team members.

  3. D Chandra Sekhar

    Sir, do you have any branches in India?

    1. Dr. Yama Zafer, D.C.

      Dear Chandra,
      I am sorry, but as of now, we only have centers in Malaysia. Hopefully, one day we will expand to India and the Indian subcontinent.

  4. Ann Reggio

    I’m 77. I have all of the above. Do you have any office near the Lancaster, Pennsylvania, Downingtown, Pennsylvania, Reading Pennsylvania areas

    1. Dr. Yama Zafer, D.C.

      Dear Ann,
      Thanks for posting, but unfortunately, we do not have any offices in your area. And we wouldn’t know who to refer you to in Pennsylvania.

      1. Jaykaran singh

        Do you have any centers in India where we can go for treatment?

        1. Dr. Yama Zafer, D.C.

          Dear Mr. Jaykaran Singh,

          Unfortunately, we don’t have any centers in India. The nearest one to you is in Kuala Lumpur, Malaysia.

    2. K.Ramu

      I am also having the same back problem with pain shooting down my buttocks and legs. What can be done? Please advice.

      1. Dr. Yama Zafer, D.C.

        Dear Mr. Ramu,

        Back pain due to nerve impingement and impairments arising from a slipped disc, facet, and ligamentum flavum hypertrophy is treatable without surgery or injections. However, there aren’t many centers with adequate technology or skill sets to provide the needed conservative treatments.

        In short, patients with multi-faceted issues (problems arising from two or more events in parallel) need personalized treatment plans focusing on root causes. In your instance, you will need highly specialized treatment through manual and therapy devices specialized for full recovery, and we can help. Our center is the leading non0-surgical clinic for the spine and joints; we have helped thousands recover. Give us a call today and schedule a consultation with one of our non-surgical spine specialists.

        I hope this helps, do contact us on 03 2093 1000 or Whatsapp us at +(60)17 269 1873 for more information.

  5. America zaza

    I had fusion surgery seven years ago for c4c5, and now I have ligament flavum thickening on c5c6 . Can you help me?

    1. Dr. Yama Zafer, D.C.

      Dear America,

      Patients with cervical fusions can be treated for pain and stiffness, which are common after surgery. We will not be able to provide you with the same level of care as we would for persons without fusions. Spinal fusions limit our ability to provide comprehensive care. However, we can provide treatments to help with the pain and stiffness you might be experiencing. I hope this helped.

  6. Meni

    I read your website about spine issues related to ligamentum flavum hypertrophy.

    I am 31 years old; I had an accident and injured my neck (the soft tissue of my neck ). I started to have symptoms about three mounts ago. Now years after the trauma is causing severe chronic neck due to degenerative changes, including damage to my ligament flavum (hypertrophy and buckling of ligamentum flavum).

    My ligamentum flavum hypertrophy involves the C3-C4 segments of my neck, causing compression of my spinal cord and nerves from the center to the left.

    MY symptoms include neck pain, pins & needles, and tingling in the legs and hand. The pins & needles started last week. I am also experiencing pins & needles in my trunk, along with pain in the chest.

    Moreover, my blood pressure increased with the systolic pressure ranging between 170 and 190m, but it is lower now, fluctuating between 110 and 130.

    I like to find out if my condition is treatable without surgery, as I am not looking forward to neck surgery. Also, is there a way to help repair my Myelomalacia without getting surgery?

    1. Dr. Yama Zafer, D.C.

      Dear Meni,

      Thanks for posting your question about our neck pain treatment for soft tissue damage to spinal discs, spinal cord, and spinal soft tissues (muscles & ligaments).

      Ligamentum flavum, also known as the yellow ligament, is a highly specialized soft tissue that functions as a ligament with a contractile ability like a muscle. Its’ ligament function is to connect spinal segments, while the muscular or contractile capabilities of the ligamentum flavum help assist with the extension of the spine (neck or back) when returning to an upright position from a bent or flexed posture or position.

      Damage or hypertrophy of ligamentum flavum is typically seen among active gym-goers (deadlifts, free weight workouts, and intense leg press exercises), whiplash injuries as seen in sports injuries or car accidents.

      Gym workout involving free weights or heavy lifting, especially with poor mechanics, is the leading cause of ligament flavum hypertrophy in the lower back. Hypertrophy of ligamentum flavum in the neck is almost always associated with a whiplash-like injury.

      Whiplash is an acceleration-deceleration injury caused by hyperflexion and hyperextension of the neck. Acceleration-deceleration injury of the neck results from a forceful and sudden snapping movement of the head and neck—such injury damage the neck’s soft tissues, including the ligamentum flavum.

      Thank you for submitting a link to your MRI video with your posted comment. Although our technical web team has removed the YouTube link you provided, I can assure you that I studied them carefully. Here are my findings based on the limited views I had of your cervical MRI video:

      • Moderate to severe thickening of ligamentum flavum that compresses the spinal cord posteriorly on the left.
      • Spinal cord compression dorsally on the left (back of the spinal cord on the left side) with signs of Myelomalacia (softening of the spinal cord).
      • Retrolisthesis of C3 on C4 may have resulted from injuries to anterior and posterior spinal ligaments.
      • Mild to moderate disc bulge at C3-C4
      • Degenerative disc disease at multiple segments

      Myelomalacia is a condition that softens and damages the spinal cord due to injury, hemorrhagic infarcts, or cervical myelopathy. In your comment, you mentioned a traumatic event that I suspect resulted from a whiplash-like injury. In such an instance, the head and neck forcefully extend and flex forward and backward, damaging the ligaments (including the spinal discs & ligamentum flavum), muscles, and spinal cord.

      Discussion on your specific conditions:

      The severity of damage and thickening in your ligamentum flavum on the left side of C3 and C4 leads me to believe that you suffered from a whiplash-like injury. Sudden and forceful injuries of the neck that damage the ligamentum flavum will certainly injure the spinal cord, spinal discs, spinal joints, and the remaining ligaments and muscles of the neck. Based on what I can see, there are signs of damage to all structures, most notable in the spinal cord, ligamentum flavum, and supportive soft tissues at C3-C4 spinal segments.

      In addition to ligamentum flavum hypertrophy and cord softening, you have slipped vertebrae (retrolisthesis of C3-C4). Your third cervical segment (C3) appears to have slipped backward on your fourth cervical segment (C4). The backward slippage of a vertebra known as a retrolisthesis or spondylolisthesis results when the connecting ligaments are weakened due to degenerative condition or torn following an injury. The degenerative causes of retrolisthesis (spondylolisthesis) are typically seen in the elderly and, as such, may not apply to you.

      X-rays of the cervical spine combined with your MRI are critical for accurately evaluating the injuries you sustained. Therefore, one of the first things you will need to do is get a comprehensive assessment of your neck’s stability with x-rays. I encourage you to get a complete cervical spine series (Davis series) to assess your cervical stability before proceeding with any form of treatment.

      The Davis series consists of 7 views:

      1). AP open mouth
      2). AP lower cervical
      3). Left oblique cervical
      4). Right oblique cervical
      5). Neutral lateral view of the cervical spine
      6). Flexion lateral view of the cervical spine
      7). Extension lateral view of the cervical spine

      However, if you are not able to do a Davis series or if you are worried about the radiation exposure, I would recommend the minimum four views below:

      1). AP cervical
      2). Neutral lateral view of the cervical spine
      3). Flexion lateral view of the cervical spine
      4). Extension lateral view of the cervical spine

      The most critical view needed for you are the side-views of your neck:

      * Neutral lateral view of the cervical spine
      * Flexion lateral view of the cervical spine
      * Extension lateral view of the cervical spine

      These three side-view x-rays or lateral x-rays are needed to assess the stability of your neck. More importantly, they are essential in planning your treatment.

      Is it possible to get you better without neck surgery?

      Yes, it is possible to get you better without surgery. However, the non-surgical treatment will need focused holistic therapies and consistency. Holistic means comprehensive; in other words, every aspect of your conditions must be identified and treated for you to get better. If you live in Malaysia, please contact our center on 03 2093 1000 to schedule an appointment with us. We will need to assess you in person thoroughly. During your consultation, we will discuss the possibility of getting your neck treated without surgery.

      I hope this helped.

      1. Martha

        I learned a lot from reading your website. Thank you for the information. I receive no treatment, just drugs from Drs, and I’ve been in pain for 20 years. Is it too late for me? Thanks, Martha from California.

        1. Dr. Yama Zafer, D.C.

          Dear Martha,
          Thanks for posting your question and praising our published content on our blog and website pages. Hypertrophy of ligamentum flavum is a relatively common finding in patients with chronic neck and back issues. It often results from excessive loading, improper bending, injuries, or poor posture.

          Unfortunately, most doctors do little for patients with thickening ligamentum flavum. Like you, many take medication to help with daily symptoms. Specialized & advanced methods of chiropractic treatment combined with physical therapy can help. The good news is that it is never too late to get the joints, ligaments, and spinal discs of the spine treated, including the ligamentum flavum. The aim of focused therapy is two folds:

          1- To repair the damaged tissues as much as possible non-surgically
          2- To prevent progression as thickening of ligamentum flavum is a progressive condition and a leading cause of spinal canal stenosis, foraminal stenosis, and disability in the longterm

          I advise you to find a non-surgical center that offers chiropractic combined with physical therapy service (physiotherapy). The best therapeutic modalities that help include EWST Shockwave therapy, high-intensity laser therapy (HILT), and focused spinal decompression. Spinal decompression therapy should not be confused with DTS decompression as it is mainly a traction device. A better spinal decompression therapy device is the RxDecom® or comparable units. To dos & don’ts of ligamentum flavum include:

          • Avoid bending and twisting activities, stretches, or therapy methods
          • Avoid physiotherapy, physical therapy, and chiropractic treatments or therapy processes that incorporate twisting of the spine
          • Do take breaks from sitting every 30 minutes and avoid sitting with a forward-leaning posture
          • Start strengthening pelvic floor muscles with Kegel exercises, squats, and planks if your condition is stable

          I hope this helped, and should you have any additional concerns or wish for more information, please WhatsApp our main center in Bukit Damansara (Kuala Lumpur, Malaysia).

  7. Richard Lanier

    Howdy, My wife has this condition primarily L3-L4 and L4-L5 and additional mild issues L1 through L-3. The orthopedic doctor prescribed McKenzie exercises, pain meds, and, if necessary, an injection and down the road surgery. I think it’s a bad idea! Proper exercise is the best approach. Is there anyone you know of in Tallahassee, Florida, she could go to?

    Her Husband

    1. Dr. Yama Zafer, D.C.

      Dear Mr. Lanier,
      You are correct; surgery and injections are not the way forward. The best means of treating your wife is through focused therapies that target the L3-L4 and L4-L5 spinal discs. Also, McKenzie exercises may not be suitable as it causes the discs and ligamentum flavum to buckle more, causing more issues later. I am not aware of any clinic in Florida that can offer the same treatments that we do. But, I am confident that the great Sunshine State has many clinics that provide therapies similar to what we provide. You should start calling around integrative centers that combine chiropractic and physical therapy.

      In the meantime, it would be good to have her ice her lower back for 15-minutes every two to three hours to decrease inflammation. She will also need to avoid the following:
      1). No bending or twisting at the waist
      2). Avoid any exercises that put her spine in a rotated position
      3). Avoid sitting for longer than 45 minutes
      4). Avoid sitting with a forward-leaning posture

      I hope this helps.

  8. Vinu Patel MD

    Hi Doctor Yama,
    My daughter is a chiropractic doctor in Indianapolis, Indiana, in the US. She has suggested that I contact you. I have had pain in both ankles for eight weeks. The pain worsens after walks or if I stand for 10-15 minutes.

    I am a retired pain management physician. I have had Epidural steroid injections twice, but it has not helped. X-rays and MRIs have been taken. The MRI shows canal stenosis, disc bulge, facet hypertrophy, and ligamental hypertrophy. What is your advice for me?

    Vinu Patel MD

    1. Dr. Yama Zafer, D.C.

      Dear Dr. Patel,

      Spinal disc bulges in the presence of facet and Ligamentum Flavum hypertrophy are leading causes of foraminal and central canal stenosis. The pain you are experiencing is possibly the result of compressed exiting and traversing nerves. Steroid injections may not be the best option. Therefore, you should look for integrative centers offering physical therapy with chiropractic. However, they should avoid stretching hamstrings, bending, twisting, or McKenzie exercises. I would encourage a course of non-rotatory chiropractic and physical therapy combined.

      I have emailed you the therapies and treatments you need. I hope it helps

  9. Jai Sehrawat

    Respected sir, is collagen intake harmful to patients with ligamentum flavum hypertrophy? And if so, which supplements should we take in ligamentum flavum hypertrophy?

    1. Dr. Yama Zafer, D.C.

      Dear Jai,

      Collagen should not harm you, but you should get with your medical providers before you start taking any supplements. However, supplements alone are not sufficient to undo the effects of ligamentum flavum hypertrophy. To recover from aches and pains caused by ligamentum flavum hypertrophy, you will need a clinical team that targets and addresses the root causes of a thickened ligamentum flavum. A suitable treatment for patients with ligamentum flavum disorder is NSD Therapy®. NSD Therapy® service is a combination of chiropractic, physiotherapy, and rehabilitation that targets problematic segments in the spine. And in such an instance, you can start with supplements prescribed by your medical provider as an adjunct to focused treatments.

  10. Basit

    I am 38years old and have back pain with tingling and numb foot. I recently had an MRI of the Lumbar spine; below is my report; kindly assist.

    The highlights of my MRI findings are as follows:
    Multilevel ligamentum flavum hypertrophy and facet arthropathy. At L4-L5 level, mild central bulge causing minimal thecal sac indentation and minimal left lateral recess stenosis.

    1. Dr. Yama Zafer, D.C.

      Dear Basit,

      Thanks for posting a question. I suspect you have had back problems for some time, even if you had no symptoms. Back pain resulting from spinal disc bulges and herniations is treatable without surgery, even if it presents with hypertrophy of ligamentum flavum and facets (facet arthropathy).

      Spinal joint arthritis (facet arthropathy) and thickening of ligamentum flavum (hypertrophy of ligamentum flavum) is all too familiar in patients with chronic back problems. When facet arthropathy, ligamentum flavum issues, and slipped discs (bulges and herniation) present together, they will cause some degree of the canal and foraminal stenosis (shrinkage in the size of the spinal canal and the openings between vertebra (lateral recesses).

      Your surgeon may recommend surgery, but you should start with an effective conservative treatment program. Surgery should be considered only if conservative measures fail. Given your current situation, you require price treatments for your joints, spinal discs, and their associated soft tissue. In other words, you need therapy from centers and clinics with experience. Chiropractic Specialty Center® is one of the best places for patients similar to you, as we have the skillsets, therapy techniques, and integrative solutions, with a success rate of over 95%.

      To recover, you should get treated through the combined efforts of chiropractors and physiotherapists. The best non-surgical treatment for you is the NSD Therapy® methods, an integrative back pain treatment in KL through therapy devices combined with personalized care through physiotherapy and chiropractic. If you live in Malaysia, you can WhatsApp us to book a consultation.

  11. meni

    thank you for your attention and comment .
    I can share with you my symptoms for at least 15 mounts .
    problem with long walking (pain in legs after and weakness in 2 legs.
    I have neck pain but in the last year it was less chronic neck pain (but before i have the problem with lower extremity i have a chronic neck pain for 6 years .
    I was have a trauma to the neck , but this was crash head in the backstroke swimming (to the wall of the pool ) in 2010.

  12. meni

    what do you think (my ossification or hypertrophy LF in my case ]
    it is caused by trauma (I was accident in a swimming pool hit my head on a wall when I 20 (it is happened because the coach teach me technic swimming backstroke (don’t warning me their is no FLAG to see when the end of the pool end (for swimmer of back stroke )
    of course after trauma life with degeneration increase stress on the facet joint (causes facet arthritis)
    I m very be a ware from 2016 to my problem with the disc in the neck (after first MR ) .
    so i use a good ergonomic lifestyle,low impact exercise, and chin tuck (but I m not accepted to get chiro manipulation because i think this will be dangerous (but get some exercise like chin tuck, and also some stretches, prevention .
    but all of this not prevent from i get the LF buckling in c3-4 .
    I share with you the link for 1 minute
    (what is situation now 22 to 23 and u can also see image from 2016 .
    MY MJOA score it is 16 points .

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