What is a slipped disc and how can IDD Therapy help?

Mark Roughley is the Clinical Director of Leominster Osteopaths in Herefordshire. Mark has been using IDD Therapy to treat his chronic disc patients for the past three years.  Here Mark talks about herniated or 'slipped' discs and why IDD Therapy is a significant step forward in the way clinicians can treat them non-invasively. 

The spine is made up of 24 individual bones (vertebrae).  The discs are the padding or ‘shock absorbers’ in between the bones which protect us when we run or jump.  A ‘slipped’ disc is a disc which has bulged outwards from its original or intended position; is also termed a prolapsed or herniated disc.  It can happen for a number of reasons but generally it occurs due to excessive pressure being absorbed by the disc and the jelly substance being squashed outwards.

Unless due to trauma, the underlying cause is always the individual’s posture. Whether the spine is too stiff, too flat or too curvy, the disc always ruptures at the point of most pressure.  In some cases it is only a minor bulge but in others it can be a serious herniation of internal disc fluid through a rupture in the disc wall and into the spinal space.

The degree to which a disc is slipped is not indicative of the level of pain a patient is in; however, the tissue which the bulge or prolapse comes into contact with is significant.  Comparison MRI scans have revealed that some patients with only a slight disc bulge can be in the most debilitating pain whilst others showing severe degenerative changes and multiple disc prolapses have no symptoms at all.

If the slipped disc disturbs or irritates other tissues then this will setup an inflammatory response whereby you get swelling, redness, heat and pain. Muscles and other tissues respond and contract, causing stiffness and aching, and if a nerve root is involved then you can get pain referred down the leg, termed radicular pain or commonly sciatica.  Leg pain can be referred from other tissues not only the nerves so just having leg pain does not automatically mean sciatica.

IDD Therapy is an invaluable tool for decompressing the slipped discs and thereby reducing the pressure on other structures.  It passively stretches the muscles, reducing their level of heightened tension and ‘guarding’ and creates more space between the bones to permit the bulge to be drawn back in towards the centre of the disc.

It also improves the blood flow to the area and stimulates the healing process and stretches the deep postural ligaments which hold the spine together (simple physics: increased volume leads to reduced pressure).  In an acute case, relief can happen at an early stage as the injury is fresh and not a lot of physiological changes have occurred in and around the slipped disc. However most cases treated with IDD Therapy are chronic ones.

By the time patients have exhausted the usual medical avenues (a period of months usually) their condition and local tissues will have undergone significant changes.  Muscles will have either gone into a long-term contracted state and started to become more fibrous in nature or they will have switched off and weakened.  Ligaments will have tightened in an attempt to give better stability and the patient will tend to weight-bear in a manner which avoids loading the damaged disc. 

 IDD Therapy gives the body a chance to rehabilitate under passive decompression and give relief to the troubled area. During a programme of IDD Therapy, exercises are given to the patients at the progressive stages of treatment to enhance the IDD Therapy and improve their flexibility and strength. 

Osteopathy is used during the course of treatment to address the crux of the problem which is the posture.  Addressing the posture is crucially important to the long term benefits of IDD Therapy - and for the general health and well being of the patient.

The three key components of the IDD TherapyProgramme: mechanical distraction and mobilisation, osteopathy and exercise can provide the complete rehabilitation a chronic disc patient requires to gain long-lasting pain relief and mobility.

For more information about IDD Therapy at Leominster Osteopaths, call the clinic on 01568 610610 or go to www.leominsterosteopaths.co.uk

Leading Coventry chiropractic clinic introduces IDD Therapy disc treatment

IDD Therapy at Central Chiropractic Clinic

Central Chiropractic Clinic has recently introduced IDD Therapy at its modern premises in Coventry.  Located in the heart of the city - a two minute walk from Coventry station - this leading multidisciplinary clinic is one of an upsurge of UK clinics now using the targeted spinal disc treatment.

Specialising in back pain, neck pain and associated symptoms such as nerve pain, Central Chiropractic is an established family-friendly clinic which has been helping the Coventry community for over 15 years.   

Principal chiropractor, Dr Maria Kibkalo says:  

“Since qualifying as a chiropractor in 1999, I’ve treated many patients with complex back conditions and although most have responded well to manual chiropractic treatment, there has always been a category of patients with ‘difficult’ disc problems - some of which have needed to be referred on for invasive treatments.  Now we have the luxury of IDD Therapy which treats specific spinal segments non-invasively.”

Maria and her team work with patients to find the cause of their pain and help to provide long-term solutions so that they can move forward with their lives without pain or disability.  The team is always keen to incorporate innovative treatments and new technology within their services to provide the best care for each individual. 

“Chiropractic treatment focuses on re-positioning the spine to establish mobility and relieve pain.  IDD Therapy makes perfect sense in chronic back and neck pain cases where what we do with our hands is not always enough.  IDD Therapy gives us that extra assistance in distracting and mobilising the spine - relieving irritation and pressure from discs and surrounding nerves - helping to create the right environment for the body to heal itself. 

The treatment programme is an invaluable means for us to improve the way we treat patients with unresolved disc problems.”

  

To contact the clinic, call Central Chiropractic Clinic now on 02476 222 002 or visit www.CentralChiropracticClinic.co.uk

For more information about IDD Therapy go to www.IDDTherapy.co.uk

Spinex Disc Clinic opens second IDD Therapy location in Twickenham

Spinex Disc Clinic - the UK’s first dedicated spinal disc treatment clinic - has opened its second location in Twickenham, the homeland of English rugby.

Located within the Evolved Clinic and just two minutes from Twickenham station, this second location heralds the continuing success of IDD Therapy and why it is the fastest growing targeted disc treatment for back pain, neck pain and related symptoms such as sciatica.

The clinical director of Spinex Disc Clinics, Sally Lansdale says:

“As an experienced osteopath, I have been treating back pain for over 25 years.  I always treated patients with disc problems but I found that it sometimes took months to get them better just using osteopathic manual techniques.  When my own lumbar disc problem got me down I decided to look for alternative treatments.”

After hearing about IDD Therapy, Sally visited the UK’s first IDD Therapy treatment provider, the Buckingham Clinic in Glasgow for a programme of treatment.  She could immediately feel how IDD Therapy offered something more for herniated or 'slipped' discs which osteopathic treatment alone couldn’t do.  Suffice to say, her back pain was relieved.

Sally spent most of her career working in Herefordshire at Leominster Osteopaths - where she first introduced IDD Therapy to her patients.  She subsequently moved to London, setting up Spinex Disc Clinic at Edgware Road.

“It is hugely exciting to see the outcomes we are able to achieve with IDD Therapy.  Most of our patients have tried different manual therapy treatments but, like me, they need something more for their pain.  We are delighted to be able to bring IDD Therapy to Twickenham.”

Jonathan Grice, Clinical Director of the Evolved Clinic is equally excited:

“Working closely with Sally and the team, we now have a complete package of care for our patients.  We do see a lot of patients suffering with chronic pain at the clinic.  With IDD Therapy, we have an invaluable addition to our services which is particularly aimed at patients with disc problems and related conditions such as sciatica. ”

There are 21 IDD Therapy Disc Clinics in the UK and over one thousand internationally.  Over 36,000 treatments have been carried out in the UK alone.

For more information about Spinex Disc Clinic visit www.spinexdiscclinic.com or to book an appointment at the Twickenham clinic, please call 020 3151 9161

What causes sciatica and how can IDD Therapy treatment help?

What is sciatica?

The term sciatica is used to describe the inflammation and/or compression of the sciatic nerve - the longest nerve in the body which runs from the back of the pelvis through the buttocks and down both legs to the feet.

Nowadays clinicians tend to refer to sciatica as radicular pain - a shooting or grinding pain which radiates from the lower back down the length of the sciatic nerve.  Sometimes the pain can be accompanied by numbness and/or weakness in the legs and feet which is known as radiculopathy.

Sciatica can be an extremely painful and debilitating condition with sufferers finding it difficult to walk, sleep and go about their normal daily activities.

The good news is that most acute (short-term) episodes of sciatica can generally be resolved within a few weeks with over the counter anti-inflammatory drugs - alongside the continuation of normal daily activities.  However, if sciatica becomes a long-term problem (for more than six weeks) sufferers need to seek medical advice from a specialist, making sure they receive the correct diagnosis and treatment.

Sciatica is commonly associated with a bulging or herniated disc.  A bulging disc is when the whole or part of the disc bulges outside of its normal space between the vertebrae.  A herniated disc is when the inner nucleus of the disc actually ruptures out of its casing.  Both conditions - which are sometimes commonly referred to as a ‘slipped’ disc - can cause compression or irritation of the sciatic nerve.  Other causes of sciatica include spinal stenosis (narrowing of the nerve passages in the spine), a spinal injury or infection, or a growth or tumour within the spine.

Sometimes other conditions can mimic the symptoms of sciatica but they are not related to direct compression or inflammation of the sciatic nerve.  Somatic pain in the lumbar spine can produce referred pain in the nerve endings within the discs, facet joints or sacroiliac joints.   As somatic pain is not caused by compression of nerve roots, there is usually no accompanying numbness or weakness.  It tends to centre over the buttock area and upper thigh but can extend to the foot.

Sciatic symptoms are also associated with Piriformis Syndrome.  When the piriformis muscle (located deep in the hip/buttock) becomes tight or inflamed, it can cause irritation of the sciatic nerve.  Sufferers may feel numbness in the buttocks and pain when climbing up or down stairs and while sitting.  Piriformis Syndrome can be treated with strengthening and muscle balancing exercises, deep massage and/or dry needling into the muscles.

Sciatica caused by a herniated or bulging disc

The spine has 24 individual bones (vertebrae) stacked on top of each other.  Discs are the protective pads of connective tissue dividing them - the ‘shock absorbers’ which protect the spine when we run or jump.

Without realising it, we cause small weaknesses in our spine every day with prolonged sitting or standing in certain positions - at workstations or hunched over the ironing board for example.  If too much pressure is put on a disc, a weakness may develop and it’s possible for the whole or part of the disc to bulge out of its normal position or even rupture and the gel inside to bulge outwards - rather like a jam doughnut being squeezed!

The damaged disc can put pressure on or cause irritation to the spinal nerves or a single nerve root - most commonly the sciatic nerve.  Evidence suggests that the inner gel-like substance of the disc can cause an inflammatory response in sciatic nerve roots or compression of the nerve.  Sometimes it can be a combination of the two which is causing the sciatic pain. 

In rare instances, the nerves at the bottom of the spinal cord can become compressed. Known as Cauda Equina (see below), this can result in urinary and/or bowel incontinence and is a medical emergency which may require immediate surgery.     

What treatments can help with sciatica?

For most people, their sciatic episode will be acute (short-term) and they will recover naturally whilst going about their normal daily activities.

However, chronic (long-term) sciatica usually requires a combination of anti-inflammatory medicine, self-help techniques and physical therapy - which can include the targeted disc treatment IDD Therapy.

If patients have exhausted non-invasive treatments and are still in pain, they may need to consider invasive procedures such as steroid injections or surgery.

Painkillers

Over-the-counter non-steroidal anti-inflammatory drugs such as Ibuprofen are usually prescribed for sciatic pain.  For patients with asthma, high blood pressure, liver disease, heart disease or stomach and digestive disorders, GPs may suggest Paracetamol as an alternative.

If symptoms are severe, your GP may prescribe a mild opiate-based painkiller such as Codeine or a muscle relaxant such as Diazepam.

Exercise and lifestyle changes

Sciatica exercises - consisting of stretching and core-strengthening in order to support the spine - can reduce pain and provide conditioning to prevent future recurrences. 

Some patients may need to make lifestyle changes to avoid activities or situations which might put undue stress on the lower back and offset a bout of sciatica.

Awkward working positions such as those where the 'trunk' is twisted or hand is above the shoulder; heavy lifting; playing golf; excessive driving and walking (for more than 1 hour at a time) are all linked with sciatica.

How does IDD Therapy help sciatica patients?

Bridging the gap between hands-on physical therapy and invasive procedures, the IDD Therapy programme offers a non-invasive targeted disc treatment for patients with sciatica or symptoms indicating a disc herniation or bulge.  

Safe and gentle pulling forces are used to distract (draw apart) and mobilise specific spinal segments where discs are damaged or herniated, removing pressure and irritation from targeted discs and trapped nerves.

Patients receive a structured programme of regular IDD Therapy sessions, allowing the body to adapt to treatment whilst progressively relieving pain and improving mobility.  For long-term sufferers, a series of treatments is needed to achieve long-lasting therapeutic changes.

Distracting and mobilising the disc(s) in this way is particularly relevant given the sometimes indistinct origins of sciatica: opening up the disc space promotes the flow of nutrients and oxygen, assisting the dilution of any inflammatory toxins which may be causing irritation to the sciatic nerve whilst also relieving pressure from it.

IDD Therapy Case Study 1 – Margaret (65), retired nurse from Hereford.

  “I’d suffered with lower back pain on and off for a couple of years but after a knee replacement operation in 2011, it got much worse and I also began to get a grinding sciatic pain in my leg when I’d been sitting for too long or walking for any length of time.

I ended up needing a stick and I found it very difficult to do my normal daily activities and even simple things like dressing myself and standing at the sink to wash the dishes were a problem.

My clinician, Mark Roughley (Leominster Osteopaths) recommended a programme of IDD Therapy to treat the two disc bulges in my spine.  He continually assessed my progress during the programme and suggested gentle exercises to do at home to compliment the treatment. 

At the end of the programme, I was virtually pain-free and able to enjoy my usual daily activities including walking with my friends - something I’d really missed.  I’d definitely recommend IDD Therapy - it’s given me back my life!"

IDD Therapy Case Study 2 – Scott (38), scaffolder from Chingford

“Last year my episodes of sciatica became severe and sometimes my leg would actually go numb when I stood for too long.

 I was in so much pain I could hardly walk and was only sleeping for a couple of hours a night.  I needed to take painkillers every day but even with regular medication, the pain was too much for me to bear - and I’m a big strong bloke! 

My doctor sent me for some osteopathy and acupuncture sessions but they didn’t help and an operation was the last thing I needed - being self-employed, I couldn’t afford the time off work for a start!"

After a review of Scott’s recent MRI scan, Dan Smith (Sports and Spinal Physio) confirmed a large disc bulge and he decided that Scott was an ideal candidate for the IDD Therapy programme.

"I finished my treatment programme in Spring of last year and I’m feeling fantastic; my pain has drastically reduced and I’m able to walk, drive and sleep properly.  I still have to take care of my back and avoid heavy lifting but this is nothing compared to the debilitation I suffered before my treatment.

It’s really not an exaggeration to say that IDD Therapy has changed my life completely.  Without it I’d still be in agony on a four month waiting list for a back operation…”  

A clinician’s view

Sheffield Physiotherapy’s John Wood treats his chronic sciatica patients with IDD Therapy.  He says:

“With the IDD programme we can help to change a patient’s outlook, setting them the realistic goal of becoming pain-free and being able to get back to their normal daily activities.  Specific exercises are tailored to the progressive stages of treatment, developing the patient’s confidence in movement as both safe and constructive to their recovery.”

Research shows that IDD Therapy patients with a herniated disc - most of whom suffered sciatic radiation - showed a good to excellent improvement in 86% of cases.¹  A follow-up study revealed continued pain reduction in IDD Therapy patients one year after treatment.²

When non-invasive treatments aren’t working

In some cases a patient’s sciatica can be so debilitating that they are not able to begin a physical therapy programme.  There will also be patients who have tried non-invasive methods without success.  In these situations their GP may feel that steroid injections or even surgery should be considered.

Epidural steroid injections

Epidural steroid injections dispense medication directly to the inflamed area around the sciatic nerve. Although the effects tend to be temporary (providing pain relief for as little as one week up to a year) an epidural steroid injection can provide relief for a short term sciatic episode or for enough time to allow a patient to progress with a non-invasive treatment plan such as IDD Therapy.

When would surgery be considered?     

With the exception of emergency surgery in cases of Cauda Equina (see below), infection or cancer, surgical procedures are typically considered when the patient has exhausted non-surgical options and remains in pain and is unable to go about their normal daily activities.

Since spinal surgery carries the risk of infection, failure and a low risk that the spinal nerves will be damaged during surgery, surgeons ensure that the patient is aware of all non-surgical options as well as the relative risks and benefits of surgery.

When sciatica becomes an emergency

In exceptional cases, sciatic pain presents itself alongside other more serious symptoms such as urinary or bowel incontinence and/or loss of sensation in the inner thighs, buttocks, back of legs.

These symptoms could be a sign of Cauda Equina Syndrome, a relatively rare but serious condition involving loss of function of the nerve roots in the lumbar vertebral canal at the foot of the spinal cord.

Caused by trauma, tumor, infection or herniated disc/spinal stenosis, it is a medical emergency which may require urgent surgical intervention.

References 

1   Shealy CN and Borgmeyer V. Decompression, Reduction and Stabilization of the Lumbar Spine:  A Cost- Effective Treatment for Lumbosacral Pain.  AJPM 1997. 7(2):63-65

2   C. Norman Shealy, MD, PhD, Nirman Koladia, MD, and Merrill M. Wesemann, Long term effect analysis of IDD Therapy in low back pain. American Journal of Pain Management  Vol. 15 No. 3 July 2005

  

To see more IDD Therapy patient testimonials and to find out the location of your nearest IDD Therapy Disc Clinic go to www.iddtherapy.co.uk