A subluxation is the loss of movement, swelling or inflammation, nerve root irritation, disc issues, and degenerative changes – like arthritis – at a specific joint level. This joint dysfunction and spinal nerve root irritation can be the cause of your low back pain. It’s important to rid your body of these subluxations because not only can they cause physical pain but, if left untreated, over time they will cause inflammation, edema, and joint immobility that can lead to chronic arthritis and disc issues.
Specific chiropractic adjustments are the only solution to a subluxation. You can do all the massage, stretches, and exercises that you want, but if a vertebra is stuck out of alignment or is not moving properly, until you get that motion back or correct the alignment, you’ll continue to have issues. This is why having your spine assessed by a chiropractor is so important. Today most professional athletes see a chiropractor for optimal performance and most professional sports teams have one on staff.
Bulged Lumbar Discs and Herniated Lumbar Discs
The spinal disc is the shock absorber, or the cushion, in between the bones of the spine, the vertebrae. Discs are like jelly doughnuts. The strong crisscrossing fibers on the outside are like the doughnut and the nucleus, which is a gelatinous material, is like the jelly of the doughnut.
Over time, the discs can wear down and dehydrate. When that happens, those strong, crisscrossing fibers begin to tear. This can be exacerbated by an injury, picking something up incorrectly, or getting into an accident. If those fibers tear enough, the gelatinous nucleus takes the path of least resistance and moves toward the outside of the disc, creating a bulge. Unfortunately, that path of least resistance is directly back towards where the spinal nerve roots and spinal cord are located. That bulge puts pressure on the nerves that travel through the spine and creates pain in your low back that can also radiate down your leg.
Herniated discs, more severe than bulged discs, occur when the outside fibers tear and the nucleus “leaks” out towards the outside of the disc. If the fibers tear enough, the nucleus can break through the exterior of the disc and sit on a nerve. Herniated discs tend to create more leg pain than bulging discs and more intense pain. When the disc ruptures it takes the pressure off the low back area but it also creates a lot of pain down into the leg because the nucleus is out of the disc and sitting on top of the nerve.
A natural way for the herniated disc to resolve itself is a process called phagocytosis – a breaking down and removal of that disc fragment. When this happens, your body sees the nucleus as a foreign object, inflames the area, and then tries to “eat” up that nucleus and reabsorb it. If that doesn’t work, it can create pain that is usually enough to cause people to start to investigate surgery. We treat herniated discs naturally, but if your care is beyond our scope of practice, have no fear, we will refer you to another specialist as surgery may be the only option.
Degenerative Disc Disease
Degenerative disc disease is an age-related condition where the discs begin to break down. Obesity, smoking, past trauma, and work that is hard on the spine can also contribute to degenerative disc disease. Similar to a bulging or herniated disc, as discs become dehydrated and break down they start to lose their natural height. That’s why as we age you may notice that you are an inch shorter than you were 20 years earlier! A fully hydrated disc has enough height to create proper openings for the nerves to emerge from the spine and travel throughout the body. When the disc starts to shrink, the foramen – those openings that the nerves come out of – start to get smaller and thereby irritate the nerves. This is what creates that low back pain and potentially radiating pain.
Unfortunately, with degenerative disc disease, spondylosis, and arthritis, whatever damage has been done cannot be reversed, it can only be treated to reduce pain and improve function. The physiology and cellular makeup of that disc tissue, however, will never be the same. This is why it’s so important to get treatment as soon as possible whenever you’re dealing with low back pain.
Sciatica vs Piriformis Syndrome vs Double Crush Syndrome
Both sciatica and piriformis syndrome can create leg pain, typically beginning in the buttocks and running all the way down the back of the leg to the big toe or stopping anywhere along the way.
While both conditions interfere with sciatic nerve function, sciatica results from spinal dysfunction such as a herniated disc or spinal stenosis. Piriformis syndrome, on the other hand, occurs when the piriformis muscle, located deep in the buttock, compresses the sciatic nerve.
The problem with sciatica is that it could be from both a spinal dysfunction, like a herniated disc or spinal stenosis, and as a complicating factor, like piriformis syndrome. When they happen at the same time it’s known as Double Crush Syndrome. If there is true sciatica caused by a disc or joint in the low back, this initiates inflammation and a tightening/spasm of all muscles in the lower back and down the backside of the leg. As the disc inflames and pinches on the nerves innervating that leg, the piriformis muscle tightens and in turn “crushes” the sciatic nerve. Chiropractors are trained to diagnose sciatica, piriformis syndrome, and double crush syndrome.
Spinal Stenosis can create a lot of significant symptoms because of the pressure it puts on the spinal cord and the adjacent nerves. People will usually find that standing or walking can aggravate their pain and that resting, sitting down, or even bending forward can help relieve some of that pressure. Not only can spinal stenosis cause pain it can also cause weakness, numbness, and Cauda Equina Syndrome, a more medically urgent bladder dysfunction.
Muscle strains are the most common causes of low back pain. They tend to be dull and achy, and the pain is intensified with movement or putting yourself into certain positions. Normally the pain stays localized in the lower back versus radiating into your legs or other areas. Muscle strains can be caused by a sudden activity, or over time with repetitive motion, poor posture, and weak core muscles.
Muscle strains usually resolve in four to six weeks, but we want to address them early if possible because, a lot of times, they are a symptom of a deeper problem. This is why, at Barley Wellness, we always try to attack the root cause of the problem versus just addressing the symptoms.
Sacroiliac Joint Dysfunction (SI Joint Pain)
The sacroiliac joint is where the sacrum – the triangular bone at the base of your spine – meets the pelvis. Many times, patients ask when they feel their own SI joint, “is this a tumor or swelling”, because the two SI joints can be felt on either side of the sacrum and may contain edema-like fluid. This joint isn’t built to move a lot and problems can be created by hypermobility (moving too much) or hypomobility (moving too little).
15-30% of all low back pain cases are caused by SI joint dysfunction. The SI joint works to absorb the shock between the upper body and the pelvis and legs. Causes of SI joint dysfunction are leg length discrepancies, pregnancy, giving birth, or repeated stress on the joints by lifting and twisting.
Twisting is the worst move you could make in the low back, the only thing worse would be twisting in a seated position. An SI joint should move in a specific manner and walking is perhaps one of the best exercises to get those joints moving after an adjustment. You will hear the doctors at Barley Wellness often tell their patients to take a brief walk in the parking lot after a low back adjustment.
Facet Joint Dysfunction
Facet joints are the joints at the back of the spine where the vertebrae meet. These joints have cartilage inside of them that over time can start to break down and become inflamed. People that have facet joint dysfunction normally feel pain when those joints take on a significant load like in extension, meaning they are leaning back, or if they’re standing for long periods of time.