Leg Pain

Leg pain is very common and a very broad topic with numerous potential causes. In this section we will only touch on a few things to consider regarding leg pain; as always, consult with your doctor for proper evaluation.

The causes of leg pain can range from muscle strain to degenerative joint disease. The legs can be prone to pain as they, in combination with the hips, knees, ankles and feet, move the entire body's weight and provide support.

Exercise and repetitive stress and strain, improperly performed activity, or heavy lifting may cause strain in the legs. In addition, many conditions in the trunk of the body may produce symptoms that radiate into the lower extremity.

Leg cramps, one of the more common leg pain complaints, can result after exercise or can be due to an
imbalance in the body's chemicals. Circulatory problems, such as blocked arteries and blood clots, are another cause of leg pain.

If you have been diagnosed with herniated or bulging discs, degenerative disc disease, or spinal stenosis, then your leg pain may be due to nerve compression or inflammation, resulting in radiculopathy that begins in the low back and frequently causes leg pain. If this is your case, many people have found relief with spinal decompression therapy . Although this treatment may not be right for everyone, patients who are considered
candidates have very high success rates in healing their disc injuries and diminishing their leg pain.

Spinal stenosis , which may cause compression of spinal nerves, can also manifest itself as pain in the legs. Leg pain may also result from neuropathies, such as from diabetes or chronic alcoholism.

A physical examination by your doctor is the first step in identifying the cause of leg pain. An individual's physician may perform several tests to determine the potential source of the pain. These tests may include orthopedic or chiropractic tests, x-rays, other imaging studies of the low back, nerve conduction studies, laboratory blood work, doppler ultrasound to test blood flow, or a special blood pressure measurement in the legs.

Relief of leg pain involves treating the cause. If the cause of your leg pain is from your lumbar spine and you have herniated discs, bulging discs, sciatica, or degenerative disc disease, then you may benefit greatly form non-surgical spinal decompression therapy.

Additional management may involve lifestyle modification to improve circulatory or nerve health, medications, and/or physical therapy .

Lifestyle changes, such as maintaining a healthy spine and weight, getting regular exercise as well as quitting smoking, may prevent the onset of certain painful leg problems.

 

Herniated Disc

Anatomy of the spine

The intervertebral discs are located between each vertebrae in the spinal column. Of the vertebrae, there are 7 cervical (neck), 12 thoracic (mid-back) and 5 lumbar (low back) discs. The discs make up approximately 1/3 of the spinal column. They have three main functions: (1) "Absorb shock" from everyday wear and tear. (2) Allow movement of our spinal column. (3) Separate the vertebrae.

The intervertebral disc is actually a type of fibrocartilaginous material. Discs consist of an outer layer, annulus fibrosis, and an inner nucleus pulposus, which is a soft, jelly-like, substance. The disc is made up of proteins called collagen and proteoglycans that attract water. Normally, discs compress when pressure is put on them and decompress when the pressure is relieved. These discs do not have a blood supply; therefore, they exchange nutrients by a process called "imbibition". Imagine a sponge filled with water; when that sponge is compressed, the water is forced out of the sponge. When the compressive force is removed, the water is "sucked" back into the sponge. This is precisely how discs stay healthy and functional. Diseased discs can lead to degenerative disc disease that can then lead to: arthritis, herniated discs, bulging discs, facet syndromes, sciatica and spinal stenosis.

A herniation describes an abnormal condition of an intervertebral disc. A disc herniation is also commonly referred to as a "slipped", "ruptured", or "blown" disc. Most often what caused the disc to herniated is unknown, but it is thought to occur from repetitive stress due to occupation, poor spinal posture, and/or natural processes of aging and/or trauma.

A herniation begins when the inner material called the nucleus pulposus bulges through the outer material called the annulus fibrosis, causing a bulging or protruding disc. This bulge may cause compression on a spinal nerve. This not only decreases the impulse of the nerve, but also interferes with the natural blood supply to the nerve roots and sets up a condition known as intraneural edema. Basically, the nerve root microcirculation is compromised and can progress to the point where the nucleus begins to leak out of the disc. This causes an autoimmune response to the disc material (nucleus pulposus). The reaction of this defense mechanism causes severe inflammation and progressive deterioration of the nerve root. If the herniation is located in the cervical spine (neck), the symptoms can range from neck pain, with or without arm pain, to numbness and tingling. Muscle weakness can be common as well. If the herniated disc is located in the lumbar spine (low back), the
symptoms can range from low back pain, with or without leg pain, to numbness and tingling. Muscle weakness is also common. This type of pain and/or numbness in the legs or arms is referred to as a "radiculopathy". This happens because the nerves that exit your spinal cord carry nerve signals to and from the skin in your arms and legs. They are responsible for sensation and for movement of the muscles in your arms and legs. They are also responsible for the reflexive movements as well. This is the reason some individuals with these conditions experience extremity (leg/arm) pain / numbness / tingling and/or weakness when they have a herniated or bulging disc. A common misconception is that back or neck pain will also be present. However, some individuals with herniated discs may report arm or leg pain only, with minimal neck or low back pain.

LEG PAIN/SCIATICA PARASTHESIAS

This pain is most commonly experienced at the outside of the thigh, the lower leg and/or the foot. Shooting pain that radiates down the leg is a common experience with herniated discs. Patients commonly report an electric shock type of symptom. The sciatic nerve is made up of branches of nerves from the lumbar spine

This is the medical word for abnormal sensations such as tingling, numbness, weakness or “pins and needles”. These symptoms may be the result of a herniated disc and may be experienced in the same regions as painful sensations.

MUSCLE WEAKNESS BOWEL OR BLADDER PROBLEMS

Signals from the brain may be interrupted due to nerve irritation. This can cause muscle weakness, usually of the ankle. Nerve irritation can be tested by examining the reflexes of the knee and ankle.

These symptoms are important because they may be a sign of Cauda Equina syndrome. This condition is possibly caused by a herniated disc. This is a medical emergency! You must see a medical doctor immediately if you have problems urinating, having bowel movements, or if you have numbness around your genitals. All of these symptoms are likely caused by irritation to one of the nerves as a result from a herniated disc.

   

DIAGNOSIS

Diagnosis of a herniated disc (either neck or low back) can be made from a thorough physical examination including a detailed history, orthopedic and/or neurological evaluation. Some disc patients will present with an antalgic gait (lean away from the side of the disc lesion), extremity pain/numbness/tingling (abnormal sensation) in addition to neck or low back pain. Muscle weakness may be present in the more chronic cases as well as complete loss of normal reflexes. X-rays can help identify degenerative changes of the vertebra, but MRI’s are very useful in identifying the exact nature of the lesion. When the disc is herniated in the lumbar spine (low back), and it is compressing the spinal nerve roots causing pain and numbness down the buttocks, thigh and leg, it is often referred to as sciatica.

TRADITIONAL TREATMENTS

Traditional treatments for herniated disc includes Chiropractic care, physical therapy, epidural injections,
surgery and pain killers such as non-steroid anti-inflammatory medication (NSAID's).

Please keep in mind that NSAID's have an inherent risk of digestive disorders such as: perforation, ulceration and hemorrhages. The New England Journal of Medicine reported that it has been conservatively estimated that 16,500 NSAID-related deaths occur every year in the United States, and conservative calculations estimate that approximately 107,000 Americans are hospitalized every year due to NSAID related digestive complications. The number of deaths reported in the same study due to AIDS was 16,685. In addition to digestive or gastrointestinal disorders, drugs such as VIOXX have been known to cause serious cardiovascular (CV) events such as: heart attacks, strokes and heart failure. There have been similar complaints from other NSAID's such as: Bextra and Celebrex.

NON-SURGICAL SPINAL DECOMPRESSION

Non-Surgical Spinal Decompression offers to treat the root cause of the diseased or pathological disc based on the anatomical and physiological principles of Non-Surgical Spinal Decompression.  Non-Surgical Spinal Decompression relieves pressure from the disc, which, in turn, relieves pressure from the  nerve thus relieving related symptoms.

Research has shown that Non-Surgical Spinal Decompression can create a negative pressure within the disc causing a "vacuum effect". This vacuum effect can effectively draw the disc material back inside, thus relieving the pressure from the nerve.

According to the FDA 510k papers, the definition of decompression is “unloading due to distraction and
positioning”, and additionally, “unweighting due to distraction and positioning”. This is important because the “unloading” of the injured area creates positive changes in the microcirculation of the disc and nerve roots.

Therefore, Non-Surgical Spinal Decompression for herniated discs is based on the following principles.

  • A vacuum effect which reduces ("sucks in") the size of the herniation, and which then takes pressure off  the involved nerve root
  • Decompression of the involved disc creates a negative pressure inside the disc which, in turn, creates
  • Reduction or elimination of extremity (leg/arm) pain and/or numbness, while at the same time
  • The pumping motions, due to Non-Surgical Spinal Decompression, called, "imbibition", allows nutrients  to be exchanged at the level of the disc and inflammation around the nerve root to be dispersed resulting  in reduction or elimination of low back pain.

EPIDURAL INJECTION

Epidural injections (injection within the epidural space of the spinal cord) with corticosteroids, lidocaine
or opioids have no proven benefit in treating neck or upper back symptoms. In the instances that people
find improvement, the effects are often temporary and require repeat injections, and several per year are not uncommon. There is also risk in contracting a spinal infection that can lead to meningitis. In fact, the results of a double-blind, randomized trial published in the June 2003 issue of the Annals of Rheumatic Diseases indicated that an epidural steroid injection was no better than an epidural saline (salt water) injection (i.e. placebo) for sciatica. These findings are consistent with those of another definitive trial presented at the last American College of Rheumatology meeting.

Given that there have been advances in spinal surgery, the outcomes can still be very unpredictable. In failed back surgery, post-operative pain syndrome is a very disabling and troubling reality of surgical intervention. According to the 2002 Johns Hopkins White Paper on “Low Back Pain and Osteoporosis “* by John P. Kostulk, M.D. and Simeon Margolis, M.D., PhD., surgery "is not the treatment of choice for most people with back pain." The report goes on to say “fewer than 5% of people with back pain are good candidates for surgery”. "Surgery ought to be used when all other measures have been explored, and only if it appears that there is a strong probability that it will improve the condition." An article in Spine reviewed the outcomes and complication rates for surgical intervention in degenerative disc disease. Complication rates were as high as 55% and included: hematoma, neurologic adjacent segment degeneration, infection and hardware/instrument-related issues. Another study determined the effects of single-level (2 vertebrae) and 2-level (3-4 vertebrae) spinal fusion success rates reported 53% with "good" and "fair" results with single- level fusion and no "good" results with 2-level fusions.

Having read about the possible side effects relating to these “traditional” treatments, you might want to consider the drugless, non-surgical approach that Non-Surgical Spinal Decompression has to offer.

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