Back Pain

The incidence of lumbar disc herniation has gradually increased in recent years, and most patients I see in the Las Vegas area have symptoms of low back pain and nerve compression, which brings a heavy burden to patients and society alike. Although the causes of disc herniation are complex, intervertebral disc degeneration (IDD) is considered to be the most common factor. The intervertebral disc (IVD) is composed of the upper and lower cartilage endplates, nucleus pulposus, and annulus fibrosus. Aging, abnormal mechanical stress load, and metabolic disorders can exacerbate the progression of IDD. Among them, high glucose and insulin resistance (IR) can lead to fat accumulation, abnormal glucose metabolism, and inflammation, which are considered important factors affecting the homeostasis of IDD. Diabetes and advanced glycation end products (AGEs) accumulation – can lead to various adverse effects on the IVD, including cell senescence, apoptosis, pyroptosis, proliferation, and Extracellular Matrix (ECM) degradation. While current research provides a fundamental basis for the treatment of high glucose-induced IDD patients further exploration into the mechanisms of abnormal glucose metabolism affecting IDD and in the development of targeted drugs will provide the foundation for the effective treatment of these patients. We aimed to systematically review studies regarding the effects of hyperglycemia on the progress of IDD. 80% of people with low back pain are overweight and 60% are obese. 95% of these people have “insulin resistance”.

Low back pain (LBP) is a common public health concern both in Nevada and worldwide. Approximately 60-80% of patients experience chronic low back pain throughout their lifetime. Furthermore, LBP is the main cause of disability and productivity loss seriously affects the quality of life of patients. Although the cause of most cases of LBP is unclear, intervertebral disc degeneration (IDD) is considered to be the most common factor. The intervertebral disc (IVD) consists of the annulus fibrosus (AF) nucleus pulposus (NP) and cartilage endplate (CEP). The NP is rich in proteoglycans and type II collagen and is highly hydrated. Therefore, physiological osmotic pressure can easily dissipate any mechanical force transmitted through the spine. The AF is a layered structure mainly composed of type I collagen, whereas the CEP is composed of transparent cartilage located between the IVD soft tissue and the vertebral bone structures. The CEP is crucial in the maintenance of mechanical integrity and nutrient exchange of the IVD. Furthermore, the IVD can increase the range of spinal movement, withstand pressure, cushion vibration and protect the spinal cord.

Degeneration of the IVD occurs naturally with age, weakening its elasticity and toughness. Imbalance between anabolism and catabolism in the IVD can lead to changes in the composition of the extracellular matrix (ECM), cell loss, excessive oxidative stress and inflammation. Additionally abnormal spinal mechanical changes can easily cause a series of symptoms of intervertebral disc herniation. Age, repeated mechanical stress, occupational factors, metabolic disorders (such as obesity and diabetes), trauma, heredity, and even smoking may lead to the development of IDD. The first step in healing your back is to see how insulin resistant you are!

Common Causes of Low Back Pain

1. Sciatica

Sciatica is pain radiating from the lumbar-sacral and buttock through the back of the thigh and lower leg to the foot. The pain occurs in the area innervated by the sciatic nerve and may sometimes be accompanied by neurological symptoms, such as sensory disturbances or muscle weakness. Symptoms result from compression or irritation of the sciatic nerve or the nerve roots that connect to form the nerve. The pain may affect one or both legs and is usually preceded by lower back pain. If you are suffering from Sciatica, contact our Las Vegas sciatica medical experts.

The signs of sciatica include:

Low back and lower back pain
Muscle weakness
Radicular pain
Sharp pain in the lumbar spine
Pain radiating to the buttock
Pain radiating to the back of the thigh
Numbness, tingling in the back

Sensory paresthesia
Paresis of the muscles that straighten the foot
Muscle contractures
Sensory changes to the legs
Night pain
Foot drop
Abnormal ankle reflex
Urinary incontinence

The most common sign of sciatica is discopathy or conditions of the intervertebral discs (most often intervertebral disc herniation) at the level of the sections of the spin through which the spinal nerves run.

There are four stages of a herniated disc depending on the extent of displacement of the nucleus towards the outside annulus.

Other causes of sciatica include:

A. Spinal Stenosis

In the spine, there are small spaces that allow the nerves to travel in and out the spinal column. Spinal stenosis occurs when these spaces become narrow and increases the pressure on the nerves that travel through the vertebral column. It is most commonly caused by changes in the spine due to wear and tear and is associated with osteoarthritis.

In severe cases, surgery may be required to free the entrapped nerves for pain relief and return to mobility. If you think you are suffering from spinal stenosis, contact our Las Vegas spinal stenosis medical professionals today for a free consultation.

The two main types of spinal stenosis are classified based on the location: cervical stenosis (in the neck) and lumbar stenosis (in the lower back). While many patients have stenosis seen on imaging not all patients experience symptoms. Symptoms come on slowly and increase over time:

B. Spondylolisthesis

Spondylolisthesis is a spinal condition that causes lower back pain. It occurs when one of your vertebrae, the bones of your spine, slips out of place onto the vertebrae below it. Most of the time, nonsurgical treatment can relieve your symptoms. If you have severe spondylolisthesis, surgery is successful in most cases.

Grade I spondylolisthesis is 1-25% slippage, grade II is up to 50% slippage, grade III is up to 75% slippage, and grade IV is 76-100% slippage. If there is more than 100% slippage, it is known as spondyloptosis or grade V spondylolisthesis.

Note:

Disc disease, spinal stenosis and spondylolisthesis are all found more frequently in these with insulin resistance (diabesity)

A few other causes of sciatica include:

Tightness of the spinal canal (e.g., caused by massive degenerative changes in the spine)
Piriformis syndrome (strain of the muscle adjacent to the sciatic nerve in the buttock)
Trauma (resulting in nerve damage, intramuscular injection at the location of the nerve, or fracture of the femur)
Local inflammations / infections

Cancerous changes within the spinal canal

2. Sprains, Strains, Spurs of the bone and Scoliosis can all cause low back pain

Note: Most symptoms of sciatica will improve with time. Yes, herniated discs can heal without surgery. In fact 90% of people with a herniated disc find that it resolves with conservative care. This includes rest, over-the-counter pain relief medications, heat therapy, cold therapy and physical therapy.

Additional Diagnostics:

As with any medical problem, history taking is the first step, including the review of previous diagnostic studies or surgical interventions. Always document what makes the condition worse and what helps? What interventions helped and for how long? What were the factors surrounding the onset? Is the pain localized or does it radiate? Describe radiation by anatomical landmarks or have the patient draw the pattern with a finger. Is there associated weakness, numbness, or other findings to report?

As with any evaluation, a medical exam should be accomplished to exclude other causes of back pain, such as cancers and renal/ abdominal/ genitourinary pathology. Osteoporosis, fractures, spinal instabilities and rheumatoid spondylitis should also be excluded. A quality lumbar X-ray and blood profile will rule out most conditions.

With your exam, pay attention to posture and movements. With the patient in an exam gown, palpate the spine for curvature and soft tissue pathology. Beware of flexion occurring only at the hips and not at the spine. A stiff lumbar spine can appear to move through 90 degrees during a bending motion, when it actually is the bending of the hips and not of the back that is occurring. Always document the amount of flexion/extension/rotation/ bending of the lumbar spine.

When the patient is fully flexed forward, run your fingers up the spinous processes to palpate the curvature of the spine. Have the patient stand on tiptoes or jump on alternating feet. If a person can do tandem gait with eyes closed, they have excellent coordination. Perform a straight leg raise on each extremity to note the degree of elevation that produces pain in the back and leg.

With the patient lying supine, bend the thigh at the knee up towards the chest. Abduct the thigh outward to see how far it will rotate the hip. This indicates hip, sacroiliac, and piriformis muscle dysfunction. With hands on the pelvis rock, gently to see if there is movement. Turn the patient prone and push with your thumbs on both sides of the sacrum evaluating asymmetry or pain, then palpate each spinal level with your fingers pressing on either side. In cases where you suspect pelvic bone or spiny bone dysfunction as a cause of pain, evaluation by a physical therapist, chiropractor or D.O. would be helpful.

Palpate the musculature of the back as well as the sciatic notch. With the patient sitting, evaluate muscle strength, reflexes, and sensory changes in the lower extremities. If necessary, measure calf and thigh muscle girth on each leg. Check for leg length discrepancy on the patient. The patient should lie supine. Ask the patient to lift the buttocks up and drop them again while keeping the feet planted on the examining table. Grasp both feet with your thumbs on the medial malleolus and stretch out the legs. Note any discrepancy. Sensation in the lower extremity should be tested using a sharp instrument and soft cotton wisp. Check vibration at the knees-note any deficiency. Check vibration at the ankle and report how strong it is in relation to the knee. If both are decreased, check at the hip and pelvis.

Pfirrmann Grading System

Grade I:

disc is homogeneous with bright hyperintense white signal intensity and normal disc height

Grade II:

disc is inhomogeneous but keeping the hyperintense white signal
nucleus and annulus are clearly differentiated, and a gray horizontal band could be present
disc height is normal

Grade Ill:

disc is inhomogeneous with an intermittent gray signal intensity
distinction between nucleus and annulus is unclear
disk height is normal or slightly decreased

Grade IV:

disc is inhomogeneous with a hypointense dark gray signal intensity
there is no more distinction between the nucleus and annulus
disc height is slightly or moderately decreased

Grade V:

disc is inhomogeneous with a hypointense black signal intensity
there is no more difference between the nucleus and annulus
the disc space is collapsed

Spinal Films

Evaluation of spinal films (MRI or X-Ray) less than 3 months old should be performed prior to initiating a program of computer monitored spinal mobilization. Evaluation of oblique films may also be helpful.

Rule Out:

Spondylolysis
Spondylolisthesis (Grade II or higher)
Compression fracture
Metastatic lesions
Scoliosis
Other pathology which may be contraindicated

An MRI should be accomplished in all patients with neurologic deficits or refractory pain.

Patients with diagnosis consistent with disc herniation, degenerated disc disease, facet syndrome, sciatica and mild to moderate spinal stenosis are candidates for this rehabilitative regimen. Post-surgical patients who do not possess surgical hardware or severe spinal instability may also qualify for treatment.

Note: All additional conditions and deficits need to be documented, such as muscle spasm and neuritis.

Disc Degeneration can be graded on MRI T2 weighted images.

Usage:

The Pfirrmann grading system is the most widely known classification for intervertebral disc degeneration and is used in both clinical and research capabilities. The intra-and inter-observer agreement of the Pfirrmann grading system is excellent.

View the Below Video to see How the Accu-Spina IDD Therapy Spinal Decompression System Available at our Las Vegas Medical Clinic can Help you Today.

The Goal of IDD Trinity Therapy

Restore “Insulin Sensitivity”

Create a greater diffusion of cell to cell signaling throughout the cell matrix by promoting and restoring the natural balance of O2, H2O and glucose; vital nutrients, which affects cell production. We restore “insulin sensitivity” and reduce body fat. As a result, we are reversing the regeneration cascade and restoring the regenerative potential of the disc in order to return the disc back to a more balanced biomechanical and biochemical environment.

Non-Surgical Spinal Decompression

We use the Accu-SPINA®, an FDA approved device, the best in class to further increase the nutrition and mobility of the spine.

Electrical Cell Signaling Therapy (ECST)

We use another FDA approved device to reduce pain, modulate inflammation and enhance tissue repair.

The Healing Back Pain Trinity By Eternity Medicine

1. Non-Surgical Spinal Decompression

Spinal decompression is a surgical procedure performed on vertebral structures to relieve pressure in the spine that may be causing severe pain. It may involve shaving or removing bone or cutting into the disk to remove a piece of the herniation that is pressing on a nerve root. Non-surgical spinal decompression aims at the same result, utilizing movement and positioning to effect change rather than surgical intervention.

Spinal decompression was born of an understanding “just pulling” at the human spine does not necessarily result in a therapeutic outcome. That in fact, the body has certain thresholds which must be understood in order to affect the desired outcome, particularly one that can create a retraction of bulging disc material if the inverse relationship between intradiscal pressures and distraction of the involved structures is understood.

The key paper published in 1994 was the first to demonstrate that negative pressure could be created inside the human disc by applying variable pressures of increasing force to the spine.

This 1994 paper known as the Ramos Study established the basis for utilizing decompression treatment to relieve spinal pain. The Ramos Study also went to birth an entire category of nonsurgical spinal treatment devices indicated to relieve back pain applying the principles demonstrated by Ramos and Martin.

The first device to make the claim of performing non-surgical spinal decompression was developed, and FDA cleared in 1996 by Dr. Allan Dyer, an MD from Canada.

This and other continuing research on the spine began to show that the therapeutic benefit was frequently dependent not on whether the clinician treated a spine by pulling force or not but by HOW the pulling force is administered to the spine.

IDD Therapy is the leading non-surgical spinal decompression treatment. It is a computer directed spinal rehab program which relieves pressure on targeted spinal discs and at the same time gently restores mobility in the vertebral segments.

IDD Therapy consists of intermittent traction sessions in the Accu-SPINA® device (Steadfast Corporation Ltd, Essex, UK), an FDA approved, class II medical device available at our Las Vegas Spinal Treatment Clinic.

With its patented Oscillation feature, “IDD Therapy” is the gold standard (be wary of the other cheaper, less effective forms of decompression/traction). Safe, gentle and non-invasive, IDD Therapy addresses the failings of traditional traction, and the natural limitations of what clinicians can do with their own hands alone.

2. BioEnergetics

Persistent Non-pharmacological Pain Management: The Role of Electric Cell Signaling Treatment (EcST)

In the realm of pain management, the quest for effective non-pharmacological treatments is more relevant than ever. Amid growing concerns over the opioid crisis and the side effects associated with long-term use of pain medication, patients and healthcare providers are increasingly interested in alternative therapies. One such therapy that has garnered attention is Electric Cell Signaling Treatment (EcST), a promising approach for managing persistent pain without relying on pharmaceuticals. Here we list the principles, applications, benefits, and considerations of EcST in the context of non-pharmacological pain management.

Understanding Electric Cell Signaling Treatment (EcST)

Electric Cell Signaling Treatment (EcST) is an advanced form of electrotherapy that uses specific electrical signals to modulate cellular functions, with the aim of alleviating pain and promoting tissue healing. Unlike traditional electrotherapy, which often employs uniform electrical currents, EcST involves the delivery of complex, biologically-relevant electrical signals that mimic the body’s natural nerve impulses. These signals are designed to interact with neural pathways involved in pain transmission, with the goal of reducing pain, modulating inflammation, and enhancing tissue repair.

Mechanism of Action

The mechanism of action of EcST is multifaceted, targeting both the peripheral and central nervous systems. By delivering precise electrical signals, EcST can interfere with the transmission of pain signals at the site of injury, reducing the perception of pain. Additionally, these signals can stimulate the release of endogenous opioids and other neurochemicals that promote pain relief and well-being. Furthermore, EcST is believed to enhance local blood flow, support tissue oxygenation, and facilitate the healing process.

Applications of EcST

EcST has shown promise in the management of various types of chronic and acute pain conditions, including but not limited to:

Neuropathic pain
Musculoskeletal pain
Post-surgical pain
Fibromyalgia
Arthritic pain

Its non-invasive nature and adaptability make it a versatile tool in pain management protocols, particularly for patients who are not candidates for pharmaceutical interventions or those seeking to minimize medication use.

Benefits of EcST in Pain Management

The integration of EcST into pain management strategies offers several benefits:

Non-pharmacological Approach: EcST provides an alternative to medication, reducing the risk of side effects and dependency issues associated with opioids and other painkillers.

Customizability: The electrical signals can be tailored to the specific needs and conditions of the patient, offering personalized pain management solutions. Synergistic Potential: EcST can be used in conjunction with other nonpharmacological therapies, such as physical therapy and cognitive-behavioral therapy, enhancing overall pain management outcomes.

Accessibility and Convenience: As a non-invasive treatment, EcST can be administered in various settings, including clinics and potentially at home.

3. Eternity Weight Loss and Diabetes Reversal Program

A. Weight Loss Program (Program 1)

B. Diabetes Reversal Program (Program 2)

A complete 12 Week Program directed at the root cause of back pain is provided during therapy using decompression and electrical cell signaling to relieve pain rapidly.

Note:

PRP (Exosomes), Nutraceuticals, Select Pharmaceuticals, Hormones and Peptides may be added to the program

The client will be reviewed at least every 3 months after finishing the 12 week program at our Las Vegas facility.

Periodic IDD or EcST Rx’s can be done.

Every 3 months or more frequently labs will be done to ensure IR has been reversed and that INTEGRAL HEALTH MODEL is being adhered to.

In addition, we will repeat the Oswestry Low Back Pain Scale every 3 months.

info@eternitymedicine.com | +1-725-204-8972