SPINAL DISC: AN ALL TOO FAMILIAR SOURCE OF NECK PAIN AND BACK PAIN
Spinal Disc is the most overlooked structure in patients that suffer from neck pain or back pain. In the spine, the importance of the spinal disc is only second to the spinal cord and spinal nerves. Therefore, the spinal disc has a greater importance than the joints, muscles or ligaments. The clinical teams of Chiropractic Specialty Center have the expertise and technology to repair, rejuvenating and even reverse some of the spinal disc damage without medication, injections or surgery!
The clinical importance of the spinal disc is either ignored and even misunderstood by most. So, the vast majority of patients that suffer from a spinal disc disorder continue to suffer needlessly. In our centers, spinal discs are rightly at the very center of the treatments our spine patients get. We understand that fixing neck pain and back pain is not possible until you repair and fix the damaged tissues of a spinal disc.
Our Targeted Holistic Methods of Spinal Disc Treatment is Better
In short, our clinical teams consider the spinal disc as a source of pain was. Unlike others, we will not ignore it, but rather provide targeted treatments aimed
at improving its function. Our centers offer you a holistic treatment, which is geared towards identifying and correcting all spinal disc related issues. Meaning, we will assess every aspect of your neck or back pain and render appropriate care to all tissues in need. In other words, we will treat muscles, ligaments, joints and of course your spinal discs.
We wish that most centers followed our advice and treat spinal disc patients holistically. But, unfortunately, most are just concentrated on the soft tissue. In other words, many centers focused their attempt solely on muscles and ligaments. Some were overzealous when it came to muscle and soft tissue works. And as such, many that suffered from a spinal disc disorder were made worse. We have had many neck pain and back pain patients that presented to us after their condition was made worse through aggressive soft tissue or joint manipulations in other centers.
If you suffer from a spinal disc condition: aggressive joint manipulations by chiropractors, osteopaths or Chinese Medical Practitioners can make your condition worse. Thus so, the importance of having the spinal disc ruled out as a cause before treatments. However, many centers are ill equipped or unable to detect spinal disc issues, especially if it is an early spinal disc problem. Hence, we encourage anyone with back pain to visit one of our centers and have their spinal disc thoroughly evaluated by an experienced clinical team with strong analytical and clinical background on spine and spinal disc. Our chiropractors and physiotherapists in Malaysia have the skills, knowledge, and understanding to accurately diagnosis and identify the cause of your condition.
WHAT IS THE BEST TREATMENT OPTION FOR SPINAL DISC PROBLEM?
This section of our website was set up to help neck and back pain sufferers identify, detect and understand spinal disc disorders. We know that many live far from our centers, but yet they need help. So, please use the information contained on this page to help you understand the essential details of a spinal disc. Keep in mind that this page is not meant to diagnose your condition, it merely provides you with information so you can understand the health issues you may be experiencing. Call or visit one of our centers with questions or concerns. We are here to help you live a healthy active life.
We also ask all our visitors to share this page on their social media as many suffer from treatable back and neck issues. Help us get this important information to them before they choose a treatment center. The information in this section will help all identify the right centers from the rest.
Our centers have the experience and the technology to treat, repair and even reverse severe spinal disc disorders. Our treatment of choice for those that suffer from a spinal disc disease is NSD Therapy. Please visit our NSD Therapy section on this site to get information about the best and most efficient non-operative spinal disc treatment: NSD Therapy.
The Human Spinal Column and its Relations to the Spinal Disc
Function of the Spine
Spinal Discs are highly specialized structures. Nothing in the human body is as unique as the spinal disc. It is a complex structure that carries out essential functions. Healthy active lifestyle is impossible without having a healthy spinal disc. Let’s look at some of the functions that our spinal discs carry out on a daily basis.
Spinal cord and nerve roots Many internal organs
Point for Attachment:
Ligaments, Tendons, Muscles
Head, shoulders, chest
Connects upper and lower body
Balance and weight distribution
Flexibility and Mobility:
Flexion (forward bending)
Extension (backward bending)
Side bending (left and right)
Rotation (left and right)
Combination of the above
Bones produce red blood cells
As evident, it is highly improbable to have a healthy active life without a healthy well functioning spinal disc. Thus, so the need to have regular check-ups, evaluations and if need target specific treatments for long-term health and stability.
Unlike other living species, the human vertebra is a weight bearing structure designed for a biped; its characteristics, composition, and function are unlike that of any other. It is this fact that the human spine has been one of the most difficult structures to study. It was not until the advent of new technological breakthroughs such as the MRI where a thorough understanding of the spine took place. A vertebra is a technical name given to a spinal bone. The very first vertebra is directly beneath the skull and the last one above the tailbone. In total, there are 24 spinal bones in the human spine, of course not counting the tailbone.
The vertebral body is the largest part of the vertebrae. They are somewhat cylindrical in shape. The vertebral bodies are smallest in the neck and largest in the lower back. The Atlas (the first vertebrae in the neck) is the only vertebra that does not have a body.
In the human spine, there are 23 vertebral bodies (the first vertebra does not have a vertebral body). At the top and bottom of each vertebral body, there is a cartilaginous plate called the vertebral end-plate (AKA epiphyseal plate). The vertebral end-plates are part of, and securely attached to, the vertebral body. These vertebral end-plates are also a point of attachment to the spinal disc.
The vertebral body is responsible for the bulk of the vertebra and hence provides much of the weight bearing. The body is in the anterior (front) portion of the vertebrae. It is the point in which the vertebral arch and the neural arch originates. The neural arch is at the back portion of the vertebral body and forms the boundary around the neural canal (AKA spinal canal). The arch is the term for the paired laminae and pedicles.
Each typical vertebra has two vertebral end-plates. These vertebral end-plates are on the top and bottom of each vertebral body. It serves as a point of attachment for the intervertebral disc, but more importantly the end-plates supply vital nutrients to the entire disc. Due to its close relationship to the disc, the vertebral end-plates are considered to be a part of the vertebral discs. In the human spine, there are 46 vertebral end-plates, sandwiching the disc from top and bottom.
The vertebral discs are as soft but sturdy pads that separate the bones of the spine (vertebrae) from one another. These highly specialized structures act as a ligament by holding the vertebrae of the spine together, a shock absorber, and as a pivotal point allowing motion.
There are 23 discs in the human spine: 6 in the neck (cervical spine), 12 in the mid back (thoracic spine) and 5 in the lower back (lumbar spine). A disc has three basic structures: The Nucleus Pulposus (AKA nucleus pulposa), the Annulus Fibrosus (AKA annular fibers), and the vertebral end-plate. Although their composition differs: three building blocks are standard in all: proteoglycan (protein), collagen (cartilage) and water.
Our spinal column (vertebral column) extends from the skull to the pelvis and is made up of 24 moveable bones, the Sacrum and the Coccyx. The vertebrae are stacked on top of each other to form the spine. In the spine, there are three regions: cervical (neck), thoracic (mid-back) and lumbar (lower back). The sacrum and coccyx are the two regions that are not part of the spine, but collectively with the three areas of the spine form the spinal column (vertebral column). Let‘s take a closer look at each of these regions:
- Cervical Spine
- Thoracic Spine
- Lumbar Spine
The twp parts of the cervical spine are the upper cervical region (C1 & C2), and the lower cervical region (C3 to -7). The occiput (C-O), also known as the occipital bone, is a flat bone that forms the back of the head. C1 is the term most often used for Atlas and C2 for the Axis.
The first cervical vertebra is given its name because it supports the weight of the head. Its appearance is different from the other spinal segments. The Atlas is a ring-like structure that consists of two lateral (side) masses joined at the front and back by anterior (front) and posterior (back) arches.
The second cervical vertebra is given the name Axis for its principal point of rotation of the head and the neck. Axis sits directly below the Atlas (first spinal segment). The head and the Atlas pivot around the axis. Axis is the strongest and the thickest of all the cervical vertebrae.
The thoracic vertebrae increase in size from T-1 through T-12. Thoracic spine has small pedicles, long spinous process, and relatively large intervertebral foramen (neural passageways), which result in less incidence of nerve compression.
The rib cage is joined to the thoracic spine posteriorly and the sternum anteriorly. At T-11 and T-12, the ribs do not attach and so are called “floating ribs.” The range of motion in the thoracic spine is limited due to the many rib-vertebrae connections as well as the long spinous processes.
The lumbar vertebrae vary in size from L-1 through L5 and bear much of the body’s weight. Hence, they are affected most by the biomechanical stresses. In the lumbar spine: pedicels are longer and wider than those in the thoracic spine. However, the spinous processes are horizontal and square in shape. The intervertebral foramen are relatively large, but because of their increased role in mobility, the lumbar spine has the highest rate of nerve root compression.
Joints, Muscles and Ligaments of the Spine and their impact on Spinal Discs
Posterior Common Ligament
This ligament attaches from the axis where it is continuous with the membrane tectoria (ligament-like continuation of PLL that connects to the cranial dura mater) and runs downward to the posterior surface of the first sacral segment. Unlike the anterior longitudinal ligament, the posterior longitudinal ligament is widest at the top (C2) and most narrow at the bottom. It also differs from the anterior longitudinal ligament in that it attaches to both the disc and a tiny portion of the vertebral bodies.
“Posterior longitudinal ligament (PLL) as a strong ligamentous tissue which courses down the anterior aspect of the neural canal and is attached to the outer fibers of the spinal disc. Inside the spinal canal, the PLL is in close contact with the spinal dura mater. The loose areolar tissue separates the PLL from the Dura Mater. The Areolar tissue is the housing for internal vertebral plexus of veins; highlighting yet another critical role or the PLL. Therefore, it becomes incumbent on you to fully assess any injury to the neck before shrugging it off as a simple sprain or strain. We have had many patients that wished they had this information years ago. So, please share this critical page with friends and loved one, especially if they are injured.
Posterior Longitudinal Ligament is of great importance as injury can result in thickened and even classifications; leading to agonizing pain and even disability.
Thickening of the PLL ligament is common in untreated sports injuries or auto accidents. Thus, so the importance of a proper evaluation by an expert clinical team familiar with the spine. As such, we encourage all that have had previous episodes of sports injuries or car accidents to check their neck and spine at one of our centers; especially if you have neck pain or neck discomfort. If you or loved one is diagnosed with a “Cervical Spondylosis,” chances of having a calcified PLL is significant. We can HELP.
The function of the posterior longitudinal ligament is to:
- Provide a vertebra-to-vertebra connection.
- Provide vertebrae to disc connection (above and below).
- Stabilize and strengthen the already resilient spinal disc.
- Protect the spinal cord from other spinal structures.
The posterior longitudinal ligament has a rich nerve supply. The most interesting of the nerve fibers is the pain-sensing nerve. This pain-sensing nerve fiber is a form of defense. It protects the spinal cord from compressive structures such as spinal discs or bone spurs. It does so by activating its delicate nerve fibers and alarming the individual of a harmful event. These pain carrying nerve fibers often is the last-line-of-defense the spinal cord has against an irritated, inflamed, bulged or herniated spinal disc.
Joints and Ligaments of the Spine and their association with the Spinal Disc:
In this section of our spinal disc page, we will try to shed light on all connective tissues your spine needs for proper function. Keep in mind that your body is as strong as its weakest link. Thus, so a weakness in any of the support structures in your spine will lead to spinal disc damage and even slipped disc (AKA slip disc or slip disk). You can learn more about the harmful effects of spinal disc damage (degenerative disc disease) and disc herniation by visiting the associated pages of our website.
Before we start discussing the connective tissue (muscles and ligaments), let’s go over some basic information.
Ligaments are the fibrous band of tissue that interconnects bones of the body. When these bones join through a fibrous band of tissue, that connection is known as a joint (or articulation).
We have compiled the joints and ligaments of the spine together because they must be studied concurrently. A joint is not merely classified by its anatomical makeup, but also its function, which is dependent upon the ligaments of that joint. In this section, we will briefly cover the joint type and ligaments of the spine.
Vertebral Body Articulation
- The Anterior Longitudinal Ligament (ALL).
- The Posterior Longitudinal Ligaments (PLL).
- The Intervertebral Discs (IVD).
Anterior Common Ligament
This ligament attaches to the vertebral bodies at the front. It begins at the axis (C2) and runs down to the first sacral segment. As it passes each intervertebral disc (spinal disc), it firmly attaches to it, hence providing a protective barrier for the disc as well. This ligament is most narrow at the top (C2) and widest at the bottom (S1). A commonly encountered disorder in our centers is calcification of the ALL (Anterior Longitudinal Ligament AKA Anterior Common Ligament). Often, it the result of familial predispositions, neglected injuries or wear and tears. Non-the-less, the condition can be quite painful, and the hallmark of diagnosis is a limited range of motion. In reality, it is similar to the PLL calcification, which we shall discuss in the box below.
Best to contact us right away before your spinal disc condition progresses. We can help even if others fail. If you suffer from a spinal disc disorder, try our advanced methods of Spinal Decompression methods today. You have nothing to lose except the pain! The Slipped disc treatment you get from our Chiropractors is second to none. You can count on it.
Articular Process Articulation
The capsular ligaments are thin and loose to allow gliding motions while limiting the degree of movement. This ligament is longer and looser in the cervical spine, allowing for greater mobility.
As stated previously, the capsular ligament completely encloses the articular surfaces of the articular process (facets, zygapophyseal joints), surrounding its bony structures with synovial membrane. The synovial membrane is the internal lining of the capsular membrane. This lining is a membrane that produces synovial fluid necessary for joint lubrication, local Phagocytosis, and nutrients.
Spinous Process Articulation
For some, it’s hard to consider, or perhaps imagine, the spinous, processes of the vertebral column as joints. So, before we get any further, let’s refresh our memories. As mentioned before, joints form when bony structures of the body connect to one another through fibrous bands of tissue known as the ligament. The spinous processes are all attached to each other through a series of ligaments, which therefore appropriately categorizes them as articulations.
The alignment of spinous processes is of critical importance for the wellbeing of the spine and spinal disc. A misaligned spinous process is common in those that have scoliosis. We have encountered rotational misalignments in almost all our scoliotic patients. A misaligned spinous process or spinal bone is a subluxation and can be corrected if caught and treated early. When the spinous process of a vertebra (spinal bone) misaligns, it places enormous stresses on muscles, ligaments and of course spinal discs.
Our clinical teams of Chiropractors and physiotherapists are experts yu need for proper assessment and evaluation to ensure the proper alignment of all spinal disc.
Visit one of our centers today for a healthier more active life.
The joint classification of the spinous process is cartilaginous syndesmosis. A cartilaginous syndesmosis is a slightly movable joint where the contiguous bony surfaces are united by an interosseous ligament, as in the tibiofibular articulation, radial-ulna articulation and that of the spinous process to spinous process articulations. There are three ligaments to consider:
- Supraspinous Ligament
- Interspinous Ligament
- Ligament Nuchae
- It attaches to the entire length of each spinous process (from the root to the apex).
- Posteriorly it is attached to the supraspinous ligament.
- Anteriorly joins with Ligamentum Flavum.
Ligamentum Flavum is of vital clinical importance. It is often implicated in most spinal disc disorders, especially if there is disc herniation (slip disc). Our clinical team pays close attention to ligamentum Flavum often the ligamentum Flavum Hypertrophy worsened symptoms of spinal disc disorders, leading to sciatica-like symptoms down the legs and even feet.
Disorder, malfunctions or damage to the Ligamentum Nuchae has been shown to effect severity and frequency of headaches, migraines, neck pain, and upper back pain and may even cause lack of energy or dizziness. Our collaborated team of chiropractors and physiotherapists will assess your spine in it’s’ entirety to maximize the impact of each session. Rest assured as our centers treat pain with Advanced Technology not found elsewhere.
The lamina to lamina articulations is perhaps one of the most overlooked, but yet important spinal articulation. While this is true for back or neck pain, it is imperative for those that suffer from a spinal disc disorder such as a herniated disc, protruded disc, prolapsed disc (often referred to as “Slipped Disc” by the lay-person). Our chiropractors and physiotherapists pay particular attention to this as it is a major source of pain for those that have Spinal Stenosis, or hypertrophy of the ligamentum flavum. If you suffer from these conditions, we are the experts that you need NOW.
- Ligaments serve as a connecting point between two adjacent bony structures
- Prevents excessive motion
- Protects the joint from injury
Ligamentum flavum is the only elastic ligament in the human body. Unlike the other ligaments, it has contractile abilities. This ligament also serves as a protective barrier for the neural canal. The elastic and contractile abilities of ligamentum flavum are evident during spinal flexion.
The elastic and contractile abilities allow for the separation of the laminas and returning it back to a normal state without folding on itself. If ligamentum flavum ever folded on itself, it would compress the spinal dura mater or get caught. However, our lives are full of stresses and even pragmatic events, all of which has consequences in the long-term. These stresses can lead to changes in the Ligementum Flavum that affect our quality of life. The most significant change that occurs in Ligamentum Flaum is thickening or Hypertrophy. Once this ligament thickens (hypertrophies), there will be consequences of severe nature.
Many centers have difficulty identifying this disorder, let alone treating it.
But, yet they claim to be experts. Well, that will not happen in one of our centers. Chiropractic Specialty Center training and education programs are quite intensive, and we see to it that all our clinical teams are thoroughly educated and skilled. Hypertrophy of Ligamentum Flaum requires exact knowledge, skills, and even advanced technology. It is a hard condition to treat, but not impossible. It becomes impossible if you get your care from centers that don’t know how to handle it.
Our advice to you is to visit one of our centers and receive your care from an experienced clinical team of Chiropractors and Physiotherapists. Having the correct treatment is the way forward. The Spinal disc therapy or treatments must be holistic. Spinal Disc therapy or treatments will impact your health in a positive manner when the care you get is target specific and based on an accurate diagnosis. We are the best Chiropractic and Physiotherapy Center in Malaysia: let us Help you Today!
Transverse Process Articulation
- Spinal discs (Intervertebral discs)
- Anterior Longitudinal Ligament
- Posterior Longitudinal Ligament
- Capsular Ligament
- Supraspinous Ligament
- Interspinous Ligament
- Ligamentum Flava
The intertransverse-like ligament of the lumbosacral articulations is a well-developed dual ligament and separately named as the iliolumbar ligament. The Lumbosacral Articulation is the joint where the vast majority of those with back pain have issues. Often, ignoring of back pain leads to scarring, adhesion and even hypertrophy of the lumbosacral joint and its associated ligaments. The need for proper evaluation and care is paramount.
Chiropractic Specialty Center has the technology and clinical collaborative teams of Research-Based Chiropractors, Clinical Physiotherapists and Advanced Technology. Our systems and methods of spine care for the slipped disc, sciatica, facet pain and soft tissue disorder is second to none in Malaysia. Don’t settle for less, visit us for the best non-operative means of treatments.
- Intervertebral fibrocartilage; a disc-like structure
- Anterior Sacrococcygeal ligament
- Superficial posterior sacrococcygeal ligament
- Deep posterior sacrococcygeal ligament
- Lateral Sacrococcygeal ligament (AKA Intercornual ligament)
We always encourage everyone to get care from centers that have the knowledge, experience, and technology needed to get you better fast. Why fast? Time is critical when dealing with damage, injury or malfunction. The longer a condition is left untreated, the harder it becomes to correct. Therefore, you should only get care from centers that avoid wasting time, resources or clinical efforts. Centers that offer holistic; meaning comprehensive spine and joint are best. In other words, visit us to discover excellence in Chiropractic.
The Costovertebral joint treatment or rehabilitative care at our clinical team renders for any joint is diagnosis dependent. Our methods of the spine and joint care are diagnosis specific and target to get you better fast. The rib attachment point to the spine is through articulations that require specialized means of care. These joints linked to neck and upper back disorders of the spine or spinal discs. Of course, if you have scoliosis, you already are explaining the impact of the ribs has on you. But, for those not informed, please continue reading this section to understand how critical the ribs are.
To make learning easy for you, we have divided joints into two separate parts:
Rib head articulation
The Rib joint forms when the rib heads attach to either the costal facets or the costal demi-facets. Three ligaments are holding this joint together: the articular capsule, radiate ligament, and the intra-articular ligament.
This type of articulation is in all but the last two articulations of the thoracic spine. Five ligaments hold this joint together: articular capsule, superior costotransverse ligament, posterior costotransverse ligament, ligament of the neck of the rib and ligament of the tubercle of the ribs. The rib-spine articulation is critical in many spine disorders including but not limited to scoliosis, slipped disc, arthritis, degeneration. In fact, rib articulation problems are always present in patients with spinal disc disorders of the cervical spine (Neck). Unlike other chiropractic or physiotherapy centers, we pay close attention to rib articulation in every patient; even more so in those with spinal disc disorder.
The costovertebral joint articulation is yet another example of the need to get care from a center that has the expertise, knowledge, and technology when it comes to spine. Do not limit your healing by getting subpar treatments from individuals, centers, clinics and hospitals with limited abilities. Visit one of our centers to discover excellence in Chiropractic as well as excellence in physiotherapy. Our centers have the experts, knowledge, and technology unparalleled by the rest.
The clinical significance of the costovertebral joints
But, yet many orthopedic surgeons, chiropractors, and physiotherapists ignore it, or do little beneficial. The ignorance or the inability of giving patients the comprehensive care they deserve is the most common reason for re-flare-ups of their conditions. Unfortunately, many centers are all too comfortable with the little that they do. The so-called “mom and pop” centers with limited staff, technology are for the most part a wasted effort.
So, if you suffer from neck pain, back pain, sciatica, scoliosis or any other spine or spinal disc condition consider Chiropractic Specialty Center. Save your healthy, time and your hard earned money and visit one of our centers before you waste them on the inexperienced, uneducated, poorly trained or those that simply couldn’t be bothered if you got better or not.
At Chiropractic Specialty Center we are committed to excellence in Chiropractic. In fact, we are not aware of a better center when it comes to excellence in chiropractic. Don’t settle for less; aim for centers that exceed excellence in chiropractic. Actions are louder than words, judge us by our ability in excellence in chiropractic.
The Intervertebral disc (Spinal Disc AKA Spinal Disk)
The Spinal Disc is a soft yet sturdy pad that separates the bones of the spine (vertebrae) from one another. These highly specialized structures act as shock absorbers, a ligament by holding the vertebrae of the spine together, and as a pivotal point allowing motion. Spinal Discs are at each segment except for the first and the second bone of the cervical spine.
There are 23 intervertebral discs, the first being between the axis (C2) and the third cervical vertebra (C3), and the last being between the fifth lumbar (L5) and the sacral base (S1). They are collectively responsible for approximately 25% of the length of the adult spine (18 cm) and are progressively larger from above down.
The discs are strong ligaments that give shape to the spinal column by forming the secondary curves. In the lordotic curves (cervical and lumbar), the discs are slightly thicker at the anterior, whereas in the thoracic spine they are of uniform thickness. The strength of a spinal disc is further increased by the attachment of the anterior and posterior longitudinal ligaments. They also act as powerful shock absorbers to help protect the human body.
The healthy, adult intervertebral disc is considered the largest avascular structure in the human body, consisting of three main components:
- The Vertebral End-Plates
- The Annulus Fibrosus
- The Nucleus Pulposus
Although their composition percentage differs, the following three structures are the building blocks a spinal disc needs:
- Proteoglycan (protein)
- Collagen (cartilage)
The annulus is made up of collagen, which is a tough fibrous tissue similar to the cartilage found in the knee. The nucleus is made mostly of proteoglycan; produced by the cells within the spinal disc. The proteoglycan is designed to hold and trap water. In fact, due to their ability to soak and hold water, you could say that the disc is mostly of water. Studies have shown that a healthy nucleus has 80% water and the annulus 65% water.
It is in the peripheral portion of the disc. The annular fibers are the sturdy fibrous outer layer of the disc. This fibrous layer is a type 1 collagen and attaches to the vertebral end-plates. To further increase the already strong Annulus Fibrosus, individual sheets of collagen sheets placed between the annular ligaments. These sheets are called lamellae: a cartilage-like substance.
The very outer lamellae (or sharpie’s fibers) attaches to the edges of spinal bones (ring apophysis) of each vertebral body. Incidentally, this is the region that osteophytes (bone spurs) like to form. The inner lamellae are firmly attached to the vertebral end-plates.
There are approximately 15 to 25 concentric sheets of lamellae present within each disc. These sheets (lamellae) are positioned in successive rings and arranged in a unique configuration (running at 45-degree angles: giving it an ‘X’-like appearance). It is this unique arrangement that has made the annulus robust enough to contain the highly pressurized Nucleus Pulposus.
The annulus is the only innervated portion of the disc. This innervation is through the Sinuvertebral Nerve and is present in the outer layers of the annular ligament. The Sinuvertebral Nerve is a mixed nerve that carries both the autonomic fibers (sympathetic) and the sensory (afferent) fibers.
The sensory portion of this nerve is the part that is capable of carrying noxious (painful) stimuli. In other words, when the disc is under stress–either from an acute inflammatory reaction, irritation, or tears of the annulus fibrosus–this nerve gets activated, and that is why you feel the sudden sharp painful events. This type of pain is known as a discogenic pain. In other words, it is a pain that originates from the spinal disc.
The very outer layer of the Annulus Fibrosus has its blood supply, the middle layer and inner layers of the annulus along with the nucleus are completely void of blood vessels, and hence, considered avascular. Tiny capillary beds embedded in the subchondral bone (end-pate) provides the nutrients for the middle annulus, inner annulus, and the nucleus. This subchondral vascular network feeds the spinal disc almost in its entirety through diffusion. In other words, the food your spinal disc needs are sucked in. But, before they can get sucked in, the cartilage above the spinal disc must be soaked in nutrients. Thus, so the nutrients diffuse or “soak” their way through the vertebral end-plates and then sucked into the spinal disc. This diffusion method is how the cells of the spinal disc obtain nutrients such as water, oxygen, glucose and amino acids as required by the disc cells.
The gentle stretching and relaxing of a non-degenerated, healthy spine foster diffusion through a phenomenon called imbibition.
In the simplest terms, this is one method through which a normal healthy disc gets the vital nutrients needed. It is possible to induce Imbibition (will discuss later), but it occurs naturally. One method of natural imbibition is a phenomenon called Diurnal Changes.
Our bodies have the ability to expand and compress over the course of a day. During the recumbency of sleep, the loading on the spinal disc reduces: so, they are relatively unopposed to swelling pressure. Which results in the disc absorbing fluids and increasing in voIn fact; non-degenerated healthy spinal disc will expand some 20%, which in turn increases our stature by 19mm. A 19mm change in size corresponds to change of about 1.5mm in the height of each lumbar disc. And as such provides the much-needed explanation of why we are measurably taller in the morning.
As mentioned earlier, the nucleus is main a protein called proteoglycan that attracts water. Typically, discs compress when pressure is put on them and decompress when pressure is relieved. When a disc is compressed, their moisture content decreases; lifting away of the compressive force normalized fluid levels (nutrient levels). This process happens in healthy discs. The change in the water levels of the spinal disc is the sole responsibility of the nucleus through a process called imbibition.
As mentioned earlier discs are avascular. Imbibition is the method in which the nucleus acquires the life-sustaining nutrients from the vertebral end-plate. Without such transfer, the discs in their entirety will degenerate and eventually will cease to function.
Imagine a sponge filled with water. When the sponge is compressed, the water is forced out. By removing of the compressive force, the water is sucked back into the sponge. This is imbibition, and it is precisely how the Nucleus Pulposus stays health and functional.
It is the water rich (80% water), gelatinous, soft, pulpy, highly elastic, and highly pressurized central structure of the disc. The nucleus is proportionally larger in the cervical and lumbar spinal segments due to their greater degree of mobility. It has three main functions:
- To bear or carry the weight of the body
- To act as a pivot point; from which all movements occur
- To act as a ligament and bind the vertebrae together
The vertebral end-plate is a cartilaginous structure and found at every spinal segment from C2 to L5. Both the top and the bottom of each vertebra is capped with a thin (approx. ¾ millimeter) cartilaginous pad called the vertebral end-plate. Despite their name, these vertebral end-plates are not part of the subchondral bone but are actively Interwoven into the annulus of the disc. It is for this reason, as well as strong morphological similarities that the vertebral end-plate is considered part of the disc and not part of the vertebral body.
The adult vertebral discs are avascular structures (have no blood supply). The nutrients needed by the spinal disc is through the vertebral end-plate. The vertebral end-plates provide nutrients to the inner 2/3 of the annulus and the entire Nucleus Pulposus. These nutrients are diffused (soaked) into the disc from the endplates.
The end-plate’s concentration of water, proteoglycans, collagen and cartilage cells mirrors that of a disc. The center of the vertebral end-plate is mostly water and proteoglycan. As we move towards the periphery, more collagen and fewer proteoglycans are seen. This similarity in biochemical makeup helps the diffusion of nutrients between the subchondral bone of the vertebra and the vertebral endplate of the disc.
How a Spinal Disc Gets Damaged
As the day progresses, our discs will start to compress, like squeezing out a sponge, when axial loading of the spine increases, the spinal disc expels water and nutrients. The continued axial loading of the spine has been shown to increase the outward rate of diffusion and decrease the inward diffusion of fluids and nutrients to the discal cells. This change in the rate of diffusion can vary depending on intensity, length, and type of axial load bearing activity. In fact, mild axial loading translates into a 1.5mm disc height reduction, which correlates with a 12% fluid loss from the annulus and a 5% fluid (water and nutrients) loss from the nucleus.
Loss of fluids, as a result of prolonged axial loading, is due to increase intradiscal pressure (the pressure inside the disc). The average intradiscal pressure in a non-load bearing condition is 70mm Hg. Any time the intradiscal pressure exceeds diastolic blood pressure, infusion of nutrients and oxygen into the disc stops.
Prolonged axial loading (creep loading) has a detrimental impact on the discal tissue. The most significant impact of creep loading known is the increase in intradiscal pressure. An increase in the intradiscal pressure can lead to:
- Annulus and nucleus dehydration as a result of fluid loss.
- The Loss of nutrients.
- Loss of proteoglycans leading to degradation of the aggrecan molecules, with smaller fragments readily leaching from the discal tissue. The most significant biochemical change to occur in disc degeneration is the loss of proteoglycans.
As mentioned earlier, proteoglycans are the building blocks of the aggrecan molecules.
The chondrocyte-like cells of the nucleus and inner annulus manufacture proteoglycans. A disruption in the flow of nutrients will have a dramatic impact on a disc’s ability to maintain homeostasis, leading to a decrease in production of proteoglycans and an eventual degeneration of the vertebral disc.
https://www.mychiro.com.my/spine/degenerative-disc-disease/The loss of proteoglycans in a degenerated discs has a significant impact on the disc‘s load-bearing behavior. With the loss of proteoglycans, the osmotic pressure of the disc falls, and the disc is less able to maintain hydration under load. Degenerated discs have lower water content than do normal healthy discs; when loaded they lose height and fluids more rapidly and tend to bulge or worse herniate. Degenerated disc is the leading cause of disc herniation.
Loss of proteoglycans and matrix disorganization have other important mechanical effects; because of the subsequent loss of hydration, Degenerated discs no longer behave hydrostatically under load. Loading may then lead to inappropriate stress concentrations along the vertebral end-plate or in the annulus.
Loss of hydrostatic behavior has a strong influence on other spinal structures and may affect their function and predispose them to injury. For instance, loss of disc height may subject the apophyseal joints to abnormal loads, leading to an eventual osteoarthritic change along the joint surface. Loss of disc height can also reduce the tensional forces on the ligamentum flavum, and hence, may cause remodeling and thickening of the ligamentum flavum, which leads to a loss of elasticity. With the loss of elasticity, ligamentum flavum tends to hypertrophy (thickened) into the spinal canal, leading to Spinal Stenosis.
Prolonged “axial load-bearing,” repetitive movements, and traumatic activities can tear the fibers of the annular ligaments.
These tears weaken the annular ligament, allowing the nucleus to migrate. This migration can then lead to a more serious condition such as a disc bulge, or worse, a disc herniation (slipped disc).
Today, the most common disc disorder presenting to spinal surgeons is a herniated or prolapsed Spinal Disc (intervertebral disc). In these cases, the discs bulge or rupture (either partially or totally) posteriorly or posterolaterally, and press on the nerve roots in the spinal canal or the foramina. A healthy disc does not herniate as easily as previously believed. In fact, some degenerative changes are necessary before a disc can herniate. Mechanically induced rupture of a healthy spinal disc is accomplished in vitro (controlled laboratory testing) by mechanical forces larger than those that are ever normally encountered; in most experimental tests, the vertebral body failed rather than the disc.
Spinal Decompression Therapy is better than Traction.
ADVANCED Spinal Decompression Therapy Can Heal and Repair the Spinal Disc.
Beware of Centers the Advertise A Traction Device as Spinal Decompression Therapy!
Disc Decompression Therapy is BEST for the Spinal Disc
Lower back and neck pain can have many causes. Back pain impacts up to 80% of the population. Neck and back pain treatments are often flawed, frequently painful, and can be exceedingly expensive.
The spine consists of individual small bones called vertebrae that are stacked on top of one another to form the spinal column. Spinal discs are cushions found between each vertebra. The problem with a disc is that it can pinch or irritate a nerve from the spinal cord resulting in pain that affects the arms (if the problem is occurring in the neck) or the legs (sciatica-like symptoms associated with lower back related problems). Traditionally, it has been difficult to successfully treat people with disc related problems such as degenerations, bulges, and herniations.
Research has proven that spinal discs and ligaments have a poor blood supply. The blood supply available to these areas is sufficient to maintain a healthy disc or healthy ligament. However, when the injury occurs, the need for additional nutrients (blood flow) rises significantly. This need is directly related to the degree of damage and malfunction. Discs, just like any other area in our body, require nutrients to repair and rejuvenate. These nutrients are available to a spinal disc from blood vessels and the circulation of joint fluids nearby of the disc. The most successful method of treating a disc related problem are by enhancing the availability of nutrients. To date, the only method proved to achieve this is a non-surgical decompression therapy.
Traditionally, it has been difficult to successfully treat people with disc related problems such as degenerations, bulges, and herniations. Many have tried to implement traction protocols, but they have all failed miserably.
While traction, can produce some symptomatic improvement for mild and even moderate spinal disc issues, it can never repair. Often those that have found relive through traction will experience flare-ups of their condition. In other words, traction can produce some limited improvements, but short lived. The pain will almost always resurface. A flare-up or a reoccurrence of symptoms is seen with worsening of a condition. It is this potential worsening with flare-ups that most surgeons avoid traction for those that have spinal disc issues.
In Malaysia, the best and most advanced spinal decompression therapy is through the RxDecom. Chiropractic Specialty Centers are the ONLY ones that utilize the RxDecom we treat patients through Decompression. Visit one of our centers to experience excellence in Chiropractic, Physiotherapy, Rehabilitating and Spinal Decompression Therapy.
Non-Surgical Decompression Therapy (NSD Therapy®) is an alternative to spinal surgery. It combines technology and medical science that is specifically created to assist physicians and healthcare providers in the treatment and rehabilitation of spinal related ailments, without having to resort to invasive surgeries. NSD Therapy and RxDecom are our technological breakthrough that has allowed Chiropractors in Malaysia achieve the best non-invasive in Malaysia. Our centers get results that were, in the past, unthinkable.
The most sought after, most successful non-invasive back therapy in the United States today is decompression therapy. Decompression therapy is an effective treatment for:
- Herniated Disc
- Degenerative Disc Disease
- Posterior Facet Syndrome
- Post-surgical patients
The treatment given is through a series of mechanical pulls that target a problematic spinal disc segment.
A separation of 5-7mms in the disc space occurs, creating a negative pressure that leads to re-hydration and rapid healing. This non-surgical back and neck treatment are by far the most advanced and painless treatment to date. In our clinic, we use this treatment in conjunction with chiropractic care and rehabilitation therapy. A person with a herniated, degenerated, or bulging disc, also suffers from joint, ligament, and muscle problems. To achieve maximum medical improvement, it becomes imperative to treat and rehabilitate all damaged areas that may be involved.
Our success rate has been greater than 86%. Most of these patients received treatments through the traditional therapies with little to no benefit. Some have even had failed back surgeries. For this reason, we pride ourselves in being able to offer all those who seek our help a complete and well-balanced treatment for neck and back pain.
Do you have a herniated disc, multiple herniated discs, Degenerative Disc Disease, facet syndrome, or any other type of spinal pain problem? Is your medical doctor suggesting surgery or Pain Management? Have you tried chiropractic or physical therapy alone and just could not get enough relief? Come to Chiropractic Specialty Center and try out the Decompression therapy as an additive to your care. At Chiropractic Specialty Center we combine the knowledge and services of decompression, chiropractic, physical therapy, trigger point therapy, physiotherapy and nutrition under one roof.
At Chiropractic Specialty Center, we wanted the most efficient form of back therapy.
As a result, we are proud to be the first in Malaysia to offer Spinal Decompression Therapy. Our chiropractors‘ and physiotherapists‘ in-depth experience with decompression therapy, along with a firm understanding of disc problems, led to the development of the “five-prong approach”:
- Low force gentle chiropractic adjustments.
- Particular form of neuromuscular massage and trigger point therapy
- Flexion/distraction treatment or Non-surgical Spinal Decompression Therapy.
- Specific exercise and nutrition program.
Difference between traction and NSD Therapy methods of Spinal Decompression Therapy and its Physiological Impact on the Spinal Disc
Spinal Traction VS Spinal Decompression and their Impact on the Spinal Disc
Linear traction is the modern day traction device in which the force applied in a straight line, that is, tractional forces given is through a sudden single or multistage pull. This system of treatment is almost as old as back pain itself, dating back some 2000 years. Linear traction ranges from hanging upside down to various “rack” type devices that stretch the body and back.
The modern day traction pulls ranges of sudden single stage “pull and releases” to sudden multistage “pull and releases.” Whatever the setting may be, linear traction is still force applied in a straight line. In a linear traction device, no sensors are monitoring the patient, therapy, or the tractional forces. As a result, the treatment evokes the body’s protective response and triggers muscular tightening and causing nerve irritation to the point where the therapy is painful and perhaps even harmful to the patient.
Non-linear traction, or spinal decompression as given by the RxDecom®, is applied in a smooth arc that gradually builds to the pre-programmed tension over a predetermined period of time as dictated by patient condition.
The forces applied are directed, monitored and controlled through an array of high-tech sensors that monitors not only the therapy but also patient response to the therapy. RxDecom is the latest form of spinal rehabilitation. It has great therapeutic value and is made possible only through the recent technological advancements in medicine, IT and robotic engineering.
Intradiscal pressure increases with load bearing activities. Any time this value exceeds diastolic blood pressure, infusion of nutrients and oxygen into the disc stops. According to medical research, Decompression therapy significantly decreases the intradiscal pressure to negative levels in the range of -100 to -160mm Hg. Such negative pressure would encourage fluid entry; a needed component for restoring discal hydration and retraction.