Disc Problems: Part 1 – Disc Herniation – A NYC Chiropractor/ Applied Kinesiologist / NeuroKinetic Therapist Explains

Before we begin to talk about herniations; we need to talk about the structure and function of an intervertebral disc.

An intervertebral disc lies between adjacent vertebrae in the vertebral column. There are 23 discs in the human spine: 6 in the neck (cervical) region, 12 in the middle back (thoracic) region, and 5 in the lower back (lumbar) region. Each disc forms a fibrocartilaginous joint ( symphysis), it allows slight movement of the vertebrae, acts as a ligament to hold the vertebrae together, and functions as a shock absorber for the spine. 

Intervertebral discs consist of an outer fibrous ring, the annulus fibrosus  which surrounds an inner gel-like center, the nucleus pulposus. The annulus fibrosus consists of several layers  of tough fibrocartilage that can withstand compressive forces.  The nucleus of the disc acts as a shock absorber…think of it as a gliding ball moving in reaction to the movement of the vertebrae. For example as the spine flexes (bends forward) , the nucleus pulposus moves to the back or posterior of the disc absorbing the impact of the body’s activities and keeping the two vertebrae separated.

 

And as the spine extends , the gliding nucleus moves forward; bend sideways, the gel moves to the opposite side. You get the idea.

However what happens if the spine is “struck in a relatively immobile or restricted  position? That means that the nucleus pulposus is constantly in one location pushing up against the annulus fibers; and between the pressure from the nucleus and the increase of compressive forces from the abnormal spinal movement, the annulus fibers start to weaken. This allow part of the nucleus to protrude (and the fibers ) into either the spinal canal or up against a spinal nerve. This is called herniation or a bulging disc.

 

A spinal disc herniation  can happen during a trauma or a result of chronic abnormal spinal mechanics combined w/ poor posture.  Both the deformed annulus and the gel-like material of the nucleus pulposus can be forced laterally, or posterior, distorting local muscle function, and putting pressure on the nearby nerve. This can give the symptoms typical of nerve root entrapment. These symptoms can vary between parasthaesia (tingling), numbness, chronic or acute pain, either locally or along the area of the body served by the entrapped nerve (dermatome) and loss of muscle tone. 

The two most common areas of herniation are the cervical (neck) vertebrae and the lumbar (low back) vertebrae.  Please see below blogs for more information about problems with these regions.

Cervical Radiculitis – A NYC Chiropractor/Applied Kinesiologist/NeuroKinetic Therapist Explains What It Is & How She Treats It

How a NYC Chiropractor /Applied Kinesiologist /NeuroKinetic Therapist Treats Sciatica

 There are varying degrees of herniation; sometimes there is rupture of the annulus fibers and some of the nucleus pulposus escapes into the spinal canal and the area of the spinal cord. This is called a noncontained extrusion, which sometimes requires a surgical correction.

The degree of herniation requires visualization via MRI. However abnormal findings on MRI do not necessary relate to degree of symptoms; in fact, a number of MRI’s done on asymptomatic volunteers showed various herniations.

A proper examination with orthopedic and neurological testing will show at what spinal nerve level does the pain originates from. Muscle testing will show if an imbalance of muscle pull is affecting the spine and the patient’s posture.

The Importance of a Proper Chiropractic Examination – A NYC Chiropractor’s/Applied Kinesiologist’s Take

The Use of Applied Kinesiology in a Chiropractic Examination

How a Combination of Applied Kinesiology, NeuroKinetic Therapy and Chiropractic Works

I use a table that provides flexion distraction and spinal decompression; biomechanically it can open the disc space  by 28%; allowing for a gentle reversal of the herniation. This table and SOT non-force adjustments produce rapid improvement.

Low Back Pain & Non Force Adjustments/SOT Blocking: A NYC Chiropractor/Applied Kinesiologist/NeuroKinetic Therapist Explains

As the patient improves, symptoms such as pain or numbness will decrease, orthopedic and neurological tests will go from positive to negative and the muscles will test strong and balanced.

Think you may have a herniation problem? Please give me a call at 212-431-3724 or email me at drvittoriarepett@aol.com. 

And lets talk and see if I can help you.

 

 

© 2019-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic./ NeuroKinetic Therapy practice at 230 W 13thSt., NYC 10011; please go to www.drvittoriarepetto.com.

And please check out the Patient Testimonials page at my web site.

Want to be in the know on holistic information and postings? Follow me at https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/
Or join me at Twitter: www.twitter.com/DrVRepetto

 

 

 

 

Low Back Pain & Non Force Adjustments/SOT Blocking: A NYC Chiropractor/Applied Kinesiologist/NeuroKinetic Therapist Explains

One of the major complaints that causes patients to seek out a doctor of chiropractic is low back pain; it can be caused by either a problem with the lumbar spine or the sacrum.

As a doctor of chiropractic who is also an applied kinesiologist, I use a technique developed by Dr. DeJarnette called Sacro Occipital Technique (SOT); so named because of the relationship between the sacrum (base of the spine) and the occiput (base of the skull).

One of the functions of the sacrum is to pump cerebro-spinal fluid (CSF) from the base of the spine back up the spinal canal to the brain and throughout the nervous system. The occiput also helps to pump CSF. The minute rhythmical motion is essential to optimal health – CSF effectively acts as the circulatory system of the brain and spinal cord.

The pelvis forms the foundational support of the human skeleton. It supports the upper body right up to the skull, and enables us to transfer our weight to our legs. The sacrum is a large bone located at the terminal part of the vertebral spine, where it forms the posterior aspect of the pelvis. The spine holds our body upright, supports all of our organs and provides anchor points for our muscles. It also protects our delicate nervous system. The nervous system controls our body, and can only function normally when our structures are balanced and our pelvis, sacrum and lumbar is stable.

Dr. DeJarnette’s studied two aspects of the sacroiliac joint; the anterior synovial portion and the posterior hyaline cartilage portion. The anterior sacroiliac joint should have motion and this is where sacral nutation and counternutation takes place. The posterior sacroiliac joint is focused on weight-bearing stability and support, which is why at the posterior joint surface there are interlocking of the ridges, and grooves by structures like muscles, ligaments and fascia.

DeJarnette evaluated the weight-bearing characteristics of the sacroiliac joint and determined that when the joint could not adequately support body weight then load bearing stress will be moved upward to the L5/S1 and L4/5 discs, most commonly.

DeJarnette developed an analysis which classified pelvic problems into three different categories and three different non-force techniques using SOT blocks in positions that correct the involved category.

sot-blocks

One of the major complaints that causes patients to seek out a doctor of chiropractic is low back pain; it can be caused by either a problem with the lumbar spine or the sacrum.

As a doctor of chiropractic who is also an applied kinesiologist, I use a technique developed by Dr. DeJarnette called Sacro Occipital Technique (SOT); so named because of the relationship between the sacrum (base of the spine) and the occiput (base of the skull).

One of the functions of the sacrum is to pump Cerebro-Spinal Fluid (CSF) from the base of the spine back up the spinal canal to the brain and throughout the nervous system. The occiput also helps to pump CSF. The minute rhythmical motion is essential to optimal health – CSF effectively acts as the circulatory system of the brain and spinal cord.

Dr. DeJarnette’s studied two aspects of the sacroiliac joint; the anterior synovial portion and the posterior hyaline cartilage portion. The anterior sacroiliac joint should have motion and this is where sacral nutation and counternutation takes place. 

pelvic-ligaments-ant

si-movement

The posterior sacroiliac joint is focused on weight-bearing stability and support, which is why at the posterior joint surface there are interlocking of the ridges, and grooves by structures like muscles, ligaments and fascia.

postsacrummuscles

DeJarnette evaluated the weight-bearing characteristics of the sacroiliac joint and determined that when the joint could not adequately support body weight then load bearing stress will be moved upward to the L5/S1 and L4/5 discs, most commonly.

DeJarnette developed an analysis which classified pelvic problems into three different categories and three different non-force techniques using SOT blocks in positions that correct the involved category.

Category One is a pelvic torsion with altered sacral nutation(motion)  This lack of nutation affects the spinal and cranial meningeal and CSF systems which function to a degree like a closed kinematic chain. Therefore symptoms can be low back pain, chronic shoulder complaints, thoracic outlet syndrome, CSF stagnation, and altered vasomotor function.

Involved muscles can be the piriformis, quadratus lumborum, sacrospinalis, gluteus medius and gluteus maximus. As an applied kinesiologist, I’d check to see if they are hypotonic or hypertonic; as a neurokinetic therapist, I’d check to see if a muscle is weak (or inhibited) by another muscle compensating.

Therapy localization (TL) is done by putting 2 hands on each sacral-iliac joint and then challenging the pelvis for a structural listing and then blocks are put under the patient’s pelvis based to the findings.

The positive Tl’ed side is not adjusted. Cranials are checked.

Category Two happens when ligaments that hold the sacroiliac joint are stretched or sprained, allowing the joint surfaces to separate. Stress can aggravate this ligament weakness via adrenal hormone overdrive.

Symptoms can be low back pain, bowel complaints, possible dysfunction of the reproductive glands and the adrenals, shoulder problems and decreased cervical range of motion.

Involved muscles in addition to the ones mentioned in Category I are the sartorius, gracilis, rectus abdominals and hamstrings along with the iliolumbar ligament. These structures are tested via applied kinesiology and neurokinetic protocols mentioned above. Cranials again are checked.

Category Three occurs when the low back can no longer tolerate the physical stressors placed on it and involves both disc and nerve root aggravation. This can be a sudden one-off event such as a lift, or it can be a pre-existing weakness that is aggravated. Often Category Three produces pain in the low back and sometimes pain radiates down a leg as sciatica.

Muscles to be checked are the psoas as it attaches into the front of the lumbar vertebrae as well as the muscles involved in Category One as Category Three can be a Category One that was never corrected.

Correction in all the categories involves using blocks under the pelvis in specific directions related to the category and the subluxation/misalignment of the pelvis/sacrum. The patient’s weight and breathing help to balance the low back, sacrum and CSF flow and takes the pressure or irritation off the nerve. This allows the body to heal.

Patient is told to ice the involved areas, how to do daily activities, given stretches and exercises and advised on nutrition to help the body heal.

For more information on issues mentioned:

Cranial Sacral Therapy in Applied Kinesiology

How a Combination of Applied Kinesiology, NeuroKinetic Therapy and Chiropractic Works

The Use of Applied Kinesiology in a Chiropractic Examination

© 2017-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

How a NYC Chiropractor /Applied Kinesiologist /NeuroKinetic Therapist Treats Sciatica

First what is sciatica; sciatica is an inflammation of the sciatic nerve, the longest nerve in your body. The sciatic nerve is formed from the Lumbar 4 (L4) to Sacral 3 (S3) segments of the spinal nerves as they exit the vertebrae at the same levels.

It provides motor innervation and sensation to part of the muscles along the lower lumbar vertebrae and the muscles of your hip and pelvis, to the muscles in your thigh esp. the hamstrings the back of your knee and lower leg and the sole of your foot.

sciatic_nerve

When you have sciatica, you can have pain, weakness, numbness, or tingling in any of the fore mentioned areas. It can start in the low back and extend down the back of your thigh to your calf, foot, or even your toes. It’s usually on only one side of your body.

Causes of sciatica include a herniation or degeneration of a disc at the levels mentioned above, subluxation of the vertebrae associated w the sciatic nerve. https://drvittoriarepetto.wordpress.com/2010/07/17/the-subluxationspinal-joint-dysfunction/ or a narrowing of the spinal canal that puts pressure on the sciatic nerve root which is called spinal stenosis.

As a doctor of chiropractic, I would do a proper orthopedic and neurological examination to determine the level of spinal dysfunction/subluxation.

But before adjusting the vertebrae to remove the subluxation, I would test via muscle testing and palpation the muscles innervated by the involved spinal segments or attached to the spinal segments.

A case in point would be the testing of the psoas muscle as part of the muscle attaches to the anterior of the lumbar vertebrae; a weakness or a hyper tonicity of the muscle can cause rotation of the vertebrae and place tension on the sciatic nerve root. http://en.wikipedia.org/wiki/Psoas_major_muscle

The piriformis muscle is another important muscle that needs to be checked as the sciatic nerve passes under the piriformis; a spasm of this muscle can put pressure on the sciatic. http://en.wikipedia.org/wiki/Piriformis_muscle

sciatic-nerve

 

Other muscles that may be checked are the hamstrings, the lumbar erector, the quadratus lumborum, the gluteus maximus and the gluteus mediu

I ask,  is there a dysfunction in the coordination of muscles working in patterns. Is the above mentioned psoas or piriformis inhibited by the muscles  like the gluteus maximus or the quadratus lumborum that are compensating (facilitating) for weak or inhibited muscles, for example. or vice versa. Muscle imbalance can cause misalignment of the vertebrea they attach to. 

The muscles that are found to be either weak or hyper tonic are balanced by spindle or golgi tendon work and blood flow and lymphathic drainage to the muscle is increased by working on neuro-vascular and neuro-lymphatic points.

I would also test for problems with the illiolumber ligament and the sacrotuberous ligament which help stabilize the lumbar spine and sacrum respectively.

http://www.healthline.com/human-body-maps/iliolumbar-ligament

http://www.healthline.com/human-body-maps/sacrotuberous-ligament

I also examine the pelvis as the pelvis forms the foundation support of the human skeleton, I look to see if the patient is showing what is known in SOT technique as a Category Three pelvic problem.

Category Three occurs when the low back can no longer tolerate the physical stressors placed on it. This can be a sudden one-off event such as a lift, or it can be a pre-existing weakness that is aggravated. Category Three produces pain in the low back and sciatica. Correction involves using blocks under the pelvis in a specific direction and position. Your weight and breathing helps to gently balance the low back and take the pressure or irritation off the nerve.http://www.soto.net.au/A-patients-guide-to-the-practice-of-SOT

I also check for cranial involvement; there are cranial faults involved in low back and sciatic pain. https://drvittoriarepetto.wordpress.com/2010/05/17/cranial-sacral-therapy-in-applied-kinesiology/

The combination of all these techniques along with nutrition and specific stretches and exercises helps the patient heal faster.

 For information on specific techniques, please read:

https://drvittoriarepetto.wordpress.com/2011/07/29/how-a-nyc-applied-kinesiologist-uses-neurovascular-pts-for-better-physical-and-emotional-wellbeing/

https://drvittoriarepetto.wordpress.com/2011/02/16/how-an-applied-kinesiologist-uses-neuro-lympathics-to-improve-health/

https://drvittoriarepetto.wordpress.com/2010/06/21/muscle-balancing-in-applied-kinesiology/

https://drvittoriarepetto.wordpress.com/2010/05/06/the-art-and-science-of-muscle-testing-in-applied-kinesiology/

© 2015-Dr. Vittoria Repetto/ 2016 revised 

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto