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  • 500 SW 7th St. Suite 205,Des Moines, Iowa, 50309
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515.971.6143

Category Archives: Low Back

Des Moines Disc Herniation Doctor

Des Moines Disc Herniation Doctor

How does a disc herniation start?

Des Moines Disc Herniation Doctor

Onset:

    1. High risk activities and individuals to incur a disc herniation / budge:
      1. Older perople
      2. Sedentary lifestyle
      3. Nutritional defects
      4. Repetitive lifting with pelvic rotation
      5. Smokers / alcoholics / drug users
      6. People who have received many steroids both orally or injected.
    2. Mechanisms of Injury
      1. Most often improper lifting involving bending at the waist, picking something up (sometimes things as small as a pencil) and rotating the back while lifting.
      2. Compression injury. Most common include heavy squat, heavy deadlift, poor suspension on a vehicle, or a trampoline injury.
      3. Idiopathic: often times there is no cause of injury. Often people who develop these conditions without a cause of injury have office jobs involving sitting for 8+ hours per day. Or people who are on their feet without rest for 8+ hours per day. It seams that a good mix of standing, walking, and sitting avoids most spinal conditions. Any job involving a static posture for long periods of time increases the risk of disc injury

How does a disc herniation present?

  1. Patients present with low back pain that radiates down the leg. Most often in only involves one leg as the disc usually budges or herniates in a posterior, lateral direction as the PLL (posterior longitudinal ligament) prevents it from bulging straight posterior. Many times, initial presentation involves only pain symptoms following a specific dermatome and does not include any sensory motor dysfunction. If left alone, tingling, numbness, muscle weakness and even bowl and bladder dysfunction can occur.
  2. SLR is almost ALWAYS positive
  3. Severe pain on palpation lateral to spinous process of involved level
  4. Pain is WORSE while sitting. This is because there are more compressive forces on the lumbar spine in a seated position
  5. Often, patients will have a hard time describing the pain in their back and leg. Many times, patients will say it’s like nothing they have ever felt before.
  6. Severity will fluctuate day to day from a 1/10 to a 10/10 in pain intensity. Also, how far the symptoms travel will fluctuate as well.

What is the typical treatment in the medical field for a disc herniation?

First, they take an X-ray. This is to rule out any rare causes to the symptoms such as a bone spur, past traumas, growths, fluid buildup, masses, or congenital defects.

If the X-ray is clean, the patient is given the following options. 1: Do nothing as 90% will spontaneously resolve. Although most will take a long period of time. Patient should expect it to take up to 6 months and must avoid any exacerbating activities. 2: Physical therapy where patients receive stretches and exercises involving increasing lumbar spine ROM, increasing core strength and stability, and working on the piriformis muscle. Traction may also be involved in physical therapy. 3: Medications. What medications the doctor recommends will depend on the doctor. The most common meds involved are continued use of over the counter pain medications, a prescription NSAID, an oral steroid, or a steroid shot. If the patient has not yet attempted conservative treatment than the doctor will most likely not recommend a surgical treatment so long as there are no serious sensory motor problems or bowel and bladder dysfunction.

Physical Therapy Treatment

Conservative treatment (physical therapy) will be tried for 3-4 weeks. Most often, the patient reports feeling better for a small period of time after the treatments but the symptoms return. The time frame for symptoms to return after PT ranges from 30 min to 1 day after treatment depending on the patient’s condition. At PT, patients are given exercises and stretches to perform in the office. Sometimes, the exercises are performed under supervision. Often though, and depending on how busy the office is, the patient recieves instructions and performs the activities on their own.

If PT is ineffective, patient will be instructed to return to their primary care physician and will most likely get referred for an MRI. The MRI will be able to see a disc herniation unlike an X-ray. X-rays only see high density structures or the lack of high-density structures. It can’t soft tissue as the disc is basically a fluid filled pillow. MRI will confirm the herniation / disc budge diagnosis. It will also see if there is any other fluids / soft tissues pushing or irritating the spinal nerve roots.

Surgical Treatment

There are many options for surgery: Laser spinal treatment, a surgical discectomy, laminectomy, artificial disc surgery. These are often the final option for people once they have exhausted all conservative treatments. When considering these options for which one is best for you, it is best to discuss with your prescribing surgeon as each surgeon has different preferences and skills. DO NOT TRUST GOOGLE.

Des Moines disc herniation doctor

CHIROPRACTIC AND AT HOME TREATMENT

In Office Chiropractic Treatment:

  • Flexion Distraction or McKenzie treatment
      1. Each herniation is different. Some respond well to flexion others respond well to extension. The first appointment we must differentiate where the protrusion / herniation is to prescribe the proper treatment
      2. First appointment is a trial treatment involving Flexion Distraction as most are posterolateral
      3. Second appointment: Try to have it be the next day, evaluate the results. So long as there is no increase in symptoms, Flexion Distraction is the proper treatment. We then develop a specialized plan for the individual
  • NO SIDE POSTURE ADJUSTMENTS.
  • Electrical stimulation for 10 min in office: Acute setting while crossing the streams to keep the involved segment at the center of the current.
  • Frequency of adjustments should be at a minimum of 3X per week until symptomatic improvement. Once symptoms start to improve, a progressive decline in appointments per week can start.

At Home Treatment

  • Core Exercises
      1. Bird Dog
      2. Curl up
      3. Side and front plank
  • NO LEG LIFTS, FLUTTER KICKS, SITUPS, CRUNCHES
  • Avoid long period of sitting. Seated position places more compression forces on the low back then standing.
  • Isolate the activities that increase symptoms and attempt to remove these activities.
  • Heated stretching / hot baths / hot yoga
  • Continued use of over the counter NSAIDS
  • Avoid self-adjusting or self-popping and back rotation

Wellness Care

Wellness Chiropractor: February Events

February Events at Your Des Moines Chiropractor

Des Moines Wellness Chiropractor

Wellness chiropractor. February is one of the worst months in Iowa. Short days, no sun, cold weather and everyone around you getting sick takes its tole one our bodies both physically and mentally. Because of this, we are dedicating each week in February to a specific common condition seen in our office. For each week we will have a related free giveaway to each one of our new patients specific to each dedicated condition. We are also providing free consultations related to the dedicated weekly condition to help ease your worries about your condition.

Wellness Chiropractor

February 3 - 7 and February 10 - 14

Feb 3 – 7

This week will be focused on migraines and headaches. Every new patient this week will receive a free postural strap with their first appointment. This devise is placed on your back, under your shirt and helps keep your mind on sitting in good posture throughout the day. We will also fill the office with information and products dedicated to helping migraines and headaches.

Feb 10 – 14

We will be focusing on Low Back Pain for this week. Every new patient who books their first appointment this week will get a free spinal decompression therapy with their appointment. Dr. Jake is a leader in conservative treatment of spinal disc injuries. This is a great opportunity for people who have been dealing with a disc herniation to finally get answers on how to actually fix the problem. Often, people with low back pain believe it is something they just have to live with. We are here to tell you this is just not true.

FEBRUARY 17 - 21 AND FEBRUARY 24 - 28

Feb 17 – 21

For the next 5 days we will be focusing on hip pain. There are 2 main joints that can cause hip pain. The SI joint, (which is where your spine attaches to your pelvis) and your acetabular joint, (where your pelvis attaches to your femur.) There are also many muscles, ligaments, bursa and tendons that attach at this area. Determining what is giving your the problem will dictate what care you should receive and what exercises you do. Without a diagnosis you may be stretching the wrong muscle or the wrong way. This week we are offering free consultations for people with hip pain to determine the CAUSE of the pain. We are also giving away a free knee pillow to keep the hips aligned as you sleep.

Feb 24 – 28

This week we will be focusing on neck and upper back pain. This type of pain is very common in people with office jobs. 8+ hours hunched over behind a computer causes the head to progressively slouch forward. This increases tension on the upper back and puts a tremendous amount of stress on our traps. We are now seeing the typical “old man/woman hunch” developing at a younger and younger age as we move into the age of cellphones and computers. This week we will again be offering a free back postural strap to help keep you conscious of your posture while at work. This will be the last week of our wellness chiropractic awareness month.

Back Pain Stretch and Exersises Core Excersises

Back Pain Stretches and Exercises

Back Pain Stretches, Sciatica and Radiating Pain Stretch

Back Pain Stretches Quadratus Lumborum Stretch

Core Excersise for Low Back Pain: minimum of a 30 second plank

We always tell our members if they truly want to correct their problems, they have to take the initiative to do their at home stretches and exercises. It is an unfortunate fact that nothing comes easy when it comes to truly correcting spinal biomechanical dysfunction. Especially if your symptoms have been coming and going for long periods of time. The earlier you get a problem addressed, the easier it is to solve. Patients who get the best results will stick to their care plan, not make any excuses, and put their health as a priority. The good news, its actually easier, cheaper and quicker than most people think.

Back Pain Stretches

Making Spinal Health Your Priority

Back pain stretches: Everyone knows they need to see a chiropractor. People will often not take the time to address their problems. Why is this? We hear all the excuses: not enough time, not enough money, it’s not that bad (yet). If these are the reasons you are putting off your spinal health, lets debunk all of them right now.

“I don’t have the time.” A typical chiropractic adjustment takes no more than 5 minuets. The prescribed, at home stretches take less than 10 minuets to perform.  That’s 15 minuets a maximum of 3 times per week to finally address the issue. I don’t know one person who too busy to make that commitment.

“Its not that bad. I can  live with it.” Your body doesn’t feel pain for no reason. Pain is your body’s way of saying something is wrong. Most people who come into the office are not here for an acute injury. The pain that they were saying is not that bad for years, has now gotten that bad. If you do not address a problem when it is small, it will continue to get worse and become a large issue.

“I don’t have the money.” Everyone knows the bigger the problem, the more it costs to fix. Would you rather put a small investment into your health now and feel great as you continue to age? Or put a large investment into fixing a large problem that has likely progressed to a point that you may never feel right again?

Easy spinal maintenance schedule

Your at home, back pain stretches and exercises

Now I’m not saying that without chiropractic you will for sure incur a serious spinal injury. Though, It is much more likely especially in today’s society. If you absolutely cannot get in to see a chiropractor, there are still things you can do to keep your spine healthy. Do the stretches posted above. Try to keep your head back when you are at your desk. Raise your computer screen up so you are not looking down on it. Keep your cell phone up. Try to get your 10,000 steps each day. These are are simple things to help prevent future spinal problems. Remember, you are only ever given one spine. Once degeneration or arthritis starts, it CAN NOT be reversed. The worst part, you can’t feel it progressing until it is a serious issue. So take care of your spine and your body now to prevent larger problems tomorrow.

Summed up:

Wellness spinal care = small investment, continue to feel great, avoid future serious health issues.

Reaction spinal care = large investment, periodic recurrences of pain getting progressively worse, pain medication likely required, dealing with the associated side affects of the pain medication, literally lose height. The list goes on and on!

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