After twenty years of service to my fellow humans in the care of their spines and neuromusculoskeletal systems, a theory once old has become new. By that I mean that in Chiropractic we have always had the concept of the subluxation. A subluxation, in chiropractic terminology, is the misalignment of two adjacent vertebrae blocking the flow of innate energy down the nerve. The theory had the duality of the physical (bone, muscle, nerve) interacting with the energetic, i.e. flow of innate energy in the nervous system. In an attempt to become more “medical” as a result of much heavy criticism from the medical/pharmaceutical industry, chiropractic has turned away from the energetic approach of the subluxation, to a more empirical one, or one that can be understood by the medical community. Furthering the attempt to appease the medical community, terminology has changed as adjustment has become manipulation and subluxation has become misalignment. Many chiropractors have thus turned to a more conservative orthopedic model of spinal care. While this model is effective it can be limiting. The essential question of why the results seem to be more than expected is not answered. In fact, the lesion called the subluxation has never been found on a x-ray. Measuring systems can be used to find bone misalignment, pathological conditions can be illustrated, but the flow or lack of flow of innate energy cannot be demonstrated with the current level of technology. It requires the human touch.

In opposition to the more orthopedic type of care that is highly dependent on the use of x-ray to find the problem, there is a re-emergence of the traditional skills of palpation (the use of the hands) in feeling neuromusculosketal problems and energetic anomalies. Newer methods of muscle challenge and kinesiology have given the doctor additional methods to detect the subluxation. As we enter the new millenium a re-emergence in the skills of the healer has begun to take its place along side of the skills of the doctor. As a society we are spending millions of dollars a year on “alternative” health care. We are starting to realize that putting more emphasis on staying healthy is better than getting sick, then trying to get well. The old saying, “an ounce of prevention is worth a pound of cure,” comes to mind.  

What does it mean when my doctor says I have degeneration in my spine?

The term degeneration refers to an arthritic condition, where either the disc has lost its normal height or bone spurs have appeared on the vertebra or a combination of these has occurred.

First lets discuss the disc. For degeneration to occur, the disc has had to loose vital fluid thus undergoing a drying and weakening. This can occur from injury or aging. It is readily seen in a MR scan. To understand what happens from here, a little knowledge of the anatomy of the disc is necessary. Picture the disc as a donut but instead of a hole in the middle there is a substance like jelly. The donut part is composed of such tough fibrous dough that you would not want to eat. The jelly needs to be in the middle all the time. Using the donut model, you would not want to eat this part of the donut, as it would cause intense pain, as the jelly is neuro-toxic.

When a disc is injured, some of the outer fibers of the donut start to tear. As this worsens, it allows the jelly to move usually posterior (backward). This will cause a response in the body where inflammation and muscle spasms occur. As this process progresses, motion between the vertebrae is lost. In time the normal biomechanics of the spine is compromised thus placing additional stress and pressure on the injured disc. As the fibrous part of the disc is compromised the jelly part moves posterior pushing toward the nerve root. First a protrusion of the fibrous part occurs and in addition to pain you may feel some tingling or numbness or pain from the disc and vertebral area downward into your leg. As the protrusion gets worse so does the pain. If the jelly extrudes through, as can happen suddenly due to hard work or heavy lifting or intense sports, severe pain will likely result with the pain radiating down the leg. This condition can become so bad that almost any activity is met with severe pain and must be curtailed or stopped.

When a disc is injured, some of the outer fibers of the donut start to tear. As this worsens, it allows the jelly to move usually posterior (backward). This will cause a response in the body where inflammation and muscle spasms occur. As this process progresses, motion between the vertebrae is lost. In time the normal biomechanics of the spine is compromised thus placing additional stress and pressure on the injured disc. As the fibrous part of the disc is compromised the jelly part moves posterior pushing toward the nerve root. First a protrusion of the fibrous part occurs and in addition to pain you may feel some tingling or numbness or pain from the disc and vertebral area downward into your leg. As the protrusion gets worse so does the pain. If the jelly extrudes through, as can happen suddenly due to hard work or heavy lifting or intense sports, severe pain will likely result with the pain radiating down the leg. This condition can become so bad that almost any activity is met with severe pain and must be curtailed or stopped.

After the acute phase is over it is very important to rehabilitate the injured area and associated areas that have become week due to the disc problem. The rehabilitative phase is particularly important is avoiding further problems. At this point there is no cure, only management of the condition. Those with the most successful management strategy have the fewest problems going forth.

In my experience the highly successful strategy involves both specific skilled chiropractic adjustment of the dysfunctional vertebrae, and a program of exercises targeted to increase spinal strength and flexibility. The chiropractic adjustments will decrease pressure on the damaged disc and nerve root allowing for a return to normal intervertebral motion. The normal intervertebral motion will allow for increased exercise and strengthening thus reversing the degenerative spiral.