In the last segment, we discussed Degenerative Joint Disease or DJD, Disc Herniation and Low Back Pain or LBP. We discussed the pathology, anatomy in simple terms as well as symptoms and what to do if you are experiencing them. Lastly, we talked about overuse injuries and natural arthritic changes that occur as we age and the best way to manage and reduce pain. Today in this segment, we will discuss a few more Lumbar Disorders and the symptoms that accompany them. In part 3, I will share medical exercise management, new medical treatment modals and what you can expect from them. The best part is, I will share knowledge with you that will empower you to better care for and manage your medical condition on your own, saving you time, money and a more pain free life! Sound good? Ok then, let's get started.
There is what is called a "Degenerative Cascade" that happens in the lumbar spine. For example, if you find you have disc involvement, a simple cortisone injection to the nerve will do the trick. If it is more serious an Orthopedic physician may recommend a discectomy. This is simply a minimally invasive procedure that cuts away the protruding disc, therefore taking pressure off of the impinged nerve. If the disc is still causing problems, which it often will if the lifestyle of the person continues to cause the disc to protrude, then the next step is a Laminectomy. When the disc protrudes, it is actually pressing against the Lamina, a curved arch aspect of the vertebrae where the disc resides. The nerve root that exits this vertebrae is pressed up against or impinged by the protruding disc against the Lamina. The Orthopedic will again go in using a minimally invasive procedure and remove the Lamina so the disc may have the space it needs to reside without putting pressure on the nerve root. You can see how this degeneration is progressive, thus the "Degenerative Cascade." It's very much like a torn ACL. A torn ACL will eventually become a displaced ACL or complete tear. The last stop is the spinal fusion. Many of you reading this article may have had some of these procedures. The rehabilitation process for these procedures is quite simple. MOVEMENT! Motion is lotion as many in the industry say, and the best way to arrest the degenerative cascade it to incorporate an exercise program that is condition specific that will provide increase in function, strength, flexibility, stability and balance. We will address this more in part 3 of this series, so let's talk some more about the spinal fusion. The spinal fusion is exactly what the name implies. When the disc is worn and degenerated to the point it is practically bone on bone, the pain and activities of daily life can be excruciating! The spinal fusion is designed to put the space back between the vertebral bodies in the lumbar spine using brackets that act as healthy discs. This brings great relief from the radiating pain, numbness and tingling that occur when the disc is gone. Once the brackets are in place, it's as if the discs, at their optimum height and support have been re-entered into the lumbar spine. I have worked with many clients who have had spinal fusions, and with proper medical management, physical therapy and medical exercise, have recovered beautifully and lead for the most part pain free lives. I worked with a client 4 months post spinal fusion and he was experiencing a great deal of pain. After about 3 months of medical exercise following his physical therapy he not only is pain free, but back on the golf course doing what he loves.
These conditions and procedures may sound a little scary. Most ethical orthopedics recommend surgery as a last resort. Basically if the disc or lumbar disorder is so degenerated to the point the patient cannot function and is beyond natural repair, then these procedures are recommended in the order I have listed them. I hope this gives you a better understanding of several lumbar disorders, the medical management of them and the progression and processes that accompany them. I highly suggest to ALWAYS GET A SECOND OPINION as well as explore other options such as physical therapy, medical exercise, chronic pain management and many other wonderful non surgical options. One of the best defenses against lumbar disorders is a good offense. Don't wait for the condition to deal with you, rather deal with the condition! You will be so glad you did! A health lifestyle that includes condition specific exercises such as Pilates (which is fabulous for lumbar disorders!), a diet that includes non-inflammatory foods such as sugar, flour, alcohol and dairy products, pain management and proper rest will reap you benefits you cannot even imagine. In part 3 of this series we will talk specifics: pain management options, non invasive options, exercises for the lumbar spine and more! Stay tuned, thank you for reading and the best of health and success to you!