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Axial Decompression New Wave of Treatment
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Techniques
Written by Dr. Richard E. Busch, III, D.C.   
Thursday, 01 February 2007 15:42

What is the deal with this new wave of treatment called axial decompression, spinal decompression and or IDD Therapy? Is it truly the greatest thing next to sliced bread (for the treatment of back or neck pain) or is it just a passing trend?

Axial decompression therapy has reached the highest level of interest ever, even though it is not a new treatment. It is a successful alternative treatment to surgery for patients with appropriate disc conditions for the cervical and lumbar spine. The way it works is by reducing pressure or creating a negative pressure inside the disc by a directed force to the desired disc level (L1-L5) and the force can be redirected by changing the vector of force. This is implemented by immobilizing both the pelvis and the thoracic spine. Axial decompression causes a negative intra-discal pressure to develop, causing oxygen, water and nutrients to be pulled into the disc. As this happens, the healing process inside the disc is facilitated by giving the chondroblasts, as well as the fibroblasts, what they need to heal.

Most readers, by now, understand that axial decompression is not traction and that traction has many limitations; one of which is related to the weight of the patient. The amount of force used in traction is limited to 50lbs and this does little more than separate the facet joints.

Lumbar axial decompression was developed by Dr. Alan Dyer, a former Canadian Deputy Minister of Health, and he was the designer of the Vax-D. The Vax-D is the predecessor to more recent axial decompression tables, such as the DRS System, the Spine-Med, Spina, DRX 9000, ABS and many others.

One thing is certain, axial decompression is a hot item and an important business, but the technology really does work. Axial decompression is the biggest innovation for the non-surgical treatment of appropriate lumbar and cervical disc conditions.

Axial decompression should not be just another trend that will go the way of any trend, craze or phase, if we know what we are doing. We must know what conditions can successfully be treated with axial decompression, how to educate the patient and how to be paid for the services rendered.

I have successfully treated thousands of patients for conditions of herniated and degenerative disc, sciatic pain, numbness and tingling in the legs, arms and hands and failed back and neck surgery pain with this technology for over ten years. These patients have generally seen multiple doctors, have had epidural injections, taken steroids, anti-inflammatory medications, pain medications, physical therapy, and failed surgeries. I can attest, based on ten years proven success, axial decompression does work! Outcomes are excellent. Results are predictable and reproducible. Patients respond exceptionally well to care, avoid surgery and achieve sustained improvement after treatment is completed!

Why are the successful results of my patients and practice so predictable and reproducible? The answer is there are procedures and protocols that must be implemented in order for axial decompression to be successful. The procedures, which are a series of steps followed in a regular order, which begin with the first new patient telephone call and continue throughout care. The procedures apply not only to staff but also to the doctor. The procedures are detailed and exact, not just visit to visit, but word to word, and by patient category. Procedures are exact, absolute and learned by consistent and continual training by both doctor and staff. These procedures are ultimately responsible for influencing the patient to begin care.

The protocol, which is a specific treatment regimen, is equally as important as procedure and must be customized and individualized for each patient. The doctor—not the manufacturer—determines each patient’s treatment plan. This is much more involved than just placing a patient on the axial decompression table.

Successful results are also determined by accepting the correct patient and condition. This decision is based on specific criteria: a review of films and examination findings, establishment of diagnosis, and evaluation of the patient type. After assessing all information, including patient type, the doctor determines if the patient is a candidate for successful axial decompression.

Now everything falls on the doctor’s ability to communicate so that the patient fully understands, believes, responds and achieves. Therefore, again, it is back to procedure. The doctor’s training on procedure of presentation will determine whether the patient begins care. If the doctor communicates successfully, purposely and makes sense about the necessity of their care, the patient has confidence, begins care and responds well.

Several times each week, I have doctors who have axial decompression tables of various makes and models call and ask the same questions: “How do you make this work?” “How do you make any money with this thing?” “Are you getting reimbursed?” “What codes are you using?” “How do you get patients to pay for it?”

My response remains the same. “Well, Doc, these are questions that you wish you had asked before investing in a table, right? You probably wish you had discussed all this with someone who was successfully treating with axial decompression. I know it was all supposed to be so easy.”

The real answer is that it takes intensity, drive and the desire to seek outside reliable resources to get to the next level. It is an investment and similar to opening another practice. It is not like the movie, Field of Dreams; if you build it, they will come. It is not just financing a table, or parking a table in your office and expecting patients to show up and hop on. You have to understand how to operate, market, and train, not only yourself but also your staff, on how to successfully run a cash and an axial decompression practice.

Axial decompression will continue to explode in this market as well as the medical market. Axial decompression is a very successful, conservative treatment for the patient, as an alternative to invasive surgery and other medical treatment options. Axial decompression can create another tier for your existing practice, allowing you to successfully treat patients that may not have responded to standard chiropractic care. The technology is safe, effective and successful. In most communities, axial decompression is well recognized by the medical profession as a viable alternative to surgery, and inter-professional referrals are standard.

Doctors, you should consider investing in axial decompression; however, learn lessons from someone else’s experience. Get counsel and investigate; do your research, because there is more to it than writing a check. Become an educated consumer and not an impulsive buyer. There are specific and correct methods, from beginning to end, for running a successful, axial decompression/cash practice.

Dr. Richard E. Busch III, President and Founder of Busch Chiropractic Center, Fort Wayne, Indiana, established what could be considered the largest single-practitioner, axial decompression cash practice in the world. Dr. Busch is co-founder of Freedom Awaits™, a program teaching exact, step-by-step procedures to establish a highly organized first-class practice, and how to implement a case fee cash program for an axial decompression practice.

To contact Dr. Busch, call 888 - DRS - BACK, or e-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 
Don’t Limit the Subluxation
Techniques
Written by Tedd Koren, D.C.   
Friday, 01 December 2006 11:11

Using different terminology, D.D. Palmer
(chiropractic), A.T. Still (osteopathy) and Samuel Hahnemann (homeopathy) all recognized life as a triune of matter (physical), energy (emotion) and consciousness (intelligence) and viewed dis-ease as the result of disharmony amongst them.

There is no purely physical or purely mental illness—all physical illness includes emotional symptoms and all emotional illness includes physical symptoms.

Physical balance can relieve emotional disorders; emotional happiness promotes physical health; and spiritual connections can cure physical and mental illness.

Physical, mental, spiritual subluxations?

A subluxation is the physical expression of a mind/body/spirit disharmony; the three are interrelated.

Koren Specific Technique (KST) works with the body’s wisdom to locate subluxations. KST asks the body/mind, “What is the priority?” “What is the first subluxation needing correction?

The occipital drop
The body responds to properly asked questions with physiological biofeedback. Leg length shortening (Van Rumpt’s DNFT™ and Truscott), muscle weakness (Applied Kinesiology™) and autonomic tone (Toftness™) are examples of biofeedback systems.

KST uses the occipital drop (OD), wherein the occipital bone appears to drop on one side when challenged.

Discovered by Lowell Ward, DC (Spinal Column Stressology), the OD has certain advantages:

1. The patient can be checked standing, sitting or in position of subluxation, injury, etc. No table is usually needed.
2. No muscle fatigue.
3. It correlates to AK, to Van Rumpt/Truscott and to Activator™.
4. One can test oneself.
5. It responds to both physical and mental challenges.

Adjusting instrumen
t
Some subluxations are best revealed when standing, sitting or holding a certain posture; an adjusting instrument permits us to adjust in the posture of subluxation. Less force is needed—it is much easier on doctor and patient alike.

Using biofeedback
We are limited only by the questions we ask. When we start asking about subluxations, we should be open to the answers we get.

“Where is the subluxation?” I asked one patient’s body when I first discovered this system.

I was directed to the cranium.

The cranium? Cranial subluxations?

I was also directed to the spine, discs, ribs, femur heads and other places. I noticed something very interesting.

1. The body had a priority or order in which it wanted subluxations corrected.
2. Sometimes a segment was adjusted a second time after other subluxations were released.
3. The body knew what it wanted and I shouldn’t question it because…
4. I was pretty stupid compared to the body’s wisdom.

But most importantly
Most importantly, patients were responding faster and holding their adjustments longer. People who had not responded to other techniques were responding now. Also, it was psychologically easier: Since I was learning from the body, I didn’t have the pressure of having to know all the answers; I only needed to ask and listen.

Where will this lead us?

Sometimes the body says to check for dehydration (usually a cause or contributor to disc problems, depression, etc.), scars interfering with the flow of body energy, footwear, emotional factors (we use a KST-modified version of NET) or something else. Most of the time it’s pretty simple; sometimes it’s not.
 
Subluxations are ubiquitous
People are healed by many different kinds of healers and systems because the real healer is within. The various healing modalities are merely different ways of activating that inner healer. ~ George Goodheart, from Innate intelligence is the healer, in Healers on Healing, Carlson R and Shield B (Eds.)

There are so many ways we can disconnect from our wholeness. Using KST we do not make assumptions about what a person needs—we ask, and learn to respect their inner wisdom.

In conclusion

Chiropractic links the spiritual with the material. ~ D.D. Palmer

From the earliest days of chiropractic, D.D. Palmer saw the subluxation as a disconnection between body, mind and spirit. The subluxation has an intangible component (intelligence or consciousness) that can and should be addressed.

Physically, mentally and spiritually we are far healthier than we think we are. Each person’s innate wisdom is constantly trying its best to communicate to us. We have to learn to ask the right questions and to respectfully listen to the answers.

Koren Specific Technique, developed by Tedd Koren, D.C., is a quick and easy way to locate and correct subluxations anywhere in the body. It is a gentle, low-force technique. Patients hold their adjustments longer. It’s easy on the doctor, too. With KST, practitioners can specifically analyze and adjust themselves. For seminar information, go to www.teddkorenseminars.com or call 800-537-3001. Write to Dr. Koren at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

 
MVA’s affect form and function of the C-Spine
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Techniques
Written by Dennis Woggon, B.Sc., D.C.   
Tuesday, 14 November 2006 16:30

Trauma, especially motor vehicle crashes (MVC), can change an individual’s posture. This will, in turn, affect the victim’s stance and gait, due to soft and hard tissue injuries which cause abnormal function.

Humans adapt in time and need to their environment. The human body must adapt when external forces damage the internal environment. This induced aberrant posture causes the body to function in a minimum, although abnormal, energy state.

The lordotic curves of the spine give the spine strength and stability. Ligament damage to the posterior ligaments found after whiplash causes a loss of the cervical lordosis and forward head posture. This ligament damage is diagnosed as a loss of motion segment integrity.

In a study of motor vehicle patients, Burl Pettibon, DC, and Ray Wiegand, DC, found an abnormal extension malposition of the occiput (C0) on the Atlas (C1).1 This abnormal spinal displacement subluxation results in a loss of cervical lordosis and Forward Head Posture (FHP).

Forward Head Posture is better acknowledged as “Forward Head Syndrome,” and can cause many symptoms, including back pain, headaches, depression, emphysema, intestinal problems, hemorrhoids, varicose veins, osteoporosis, hip and leg deformities, poor health, decreased quality of life, shortened life span, breathing difficulties, hormonal imbalances, spinal pain, headaches, mood swings, high blood pressure, lung and pulse problems, decreased lung capacity and bone changes.2

George Ehni, MD, states, “Ligaments are made of collagen. Collagen fibers can only elongate four percent before they rupture.”3

Ruth Jackson, MD, states, “Ligaments heal with fibrous tissue in an irregular pattern, which is less elastic and less functional. It is different from the origin tissue.”4

When a fractured bone heals, it heals through osteoblastic activity with new bone cells, in four to six weeks. When ligaments are torn, they heal though fibroblastic activity with fibrous or scar tissue. John Kellet said, “The organization of normal ligament tissue has not been approached by the remodeled scar tissue even after forty weeks of healing.”5

In MVC, the cervical spine does not simply go through extension and flexion. The initial phase is compression of the cervical spine followed by traction, with flexion of the upper cervical spine and extension of the lower cervical spine. This produces a kyphotic S-Curve. This is a non-physiological motion of the vertebral segments.6,7

The average car accident occurs in 200 milliseconds. The nervous system reacts in 350 milliseconds. The nervous system does not have enough time to adapt a neuro-muscular protection, and injuries result.

The head experiences initial flexion BEFORE it touches the headrest. The entire spine experiences straightening and compression. At 9.5 km/h or 6 mph, the cervical spine experiences a compressive load of fifty pounds. At the same time, the spine’s shear strain is twenty-two pounds. When the cervical spine is compressed, it loses its ability to withstand shear forces. A forty-pound load reduces facet stiffness by 73%.”7

Calliet explains that, for every inch of forward head posture, the apparent weight of the head increases by ten pounds.8 There also may be serious ligament damage to the posterior longitudinal ligament. This is clearly explained in the AMA’s Guides to the Evaluation of Permanent Impairment, 5th edition, November 2000.9

It is not disputed that many healthy-appearing individuals may have herniated or bulging discs and degenerative changes. The Guides state, “Several reports indicate approximately 30% of persons who have never had back pain will have an imaging study that can be interpreted as positive for herniated disks, and 50% or more will have bulging disks. Further, the prevalence of degenerative changes, bulges and herniations increases with advancing age.” (Page 378)

“While disc problems and degenerative changes are common in the general population, loss of motion segment integrity is rare, unless accompanied by trauma.” Chronic areas will show associated degenerative changes while acute areas will not.

The Guides further state, “When routine X-rays are normal and severe trauma is absent, motion segment alteration is rare; thus flexion and extension X-rays are indicated only when the physician suspects motion alteration from history or findings on routine X-rays.” (Page 379)

“Motion Segment Integrity is defined as two adjacent vertebra, the intervertebral disk, the apophyseal or facet joints, and ligamentous structures between the vertebra. Alteration of motion segment integrity can be either loss of motion segment integrity (increased translation or angular motion) or decreased motion.” (Page 378)

A line is drawn along the posterior bodies of the vertebra below and above the motion segment in question in dynamic (flexion and extension) lateral roentgenograms of the spine. The distance between lines A and B and the distance between lines B and C at the level of the posterio-inferior corner of the upper vertebral body are summed. A value of greater than 3.5 in the cervical spine qualifies as a loss of structural integrity. (See Figure A)

Lines are drawn along the inferior borders of the two vertebral bodies adjacent to the level in question and of the vertebral bodies above and below those two vertebrae. Angles A, B, and C are measured on both flexion and extension X-rays and the measurements subtracted from one another. Note that lordosis (extension) is represented by a negative angle and kyphosis (flexion) is represented by a positive angle. Loss of motion segment integrity is defined as motion at the level in question that is more than eleven degrees greater than at either adjacent level. (See Figure B)

Loss of motion segment integrity (MSI) is defined as “an anteroposterior motion of one vertebra over another that is greater than 3.5 mm in the cervical spine.” (Page 379)

A study published in Spine indicates that angular displacement should be less than seven degrees and that translation (MSI) should be less than .06 mm.10
The Guides further state that this may not show up on a standard examination: “Motion of the individual spine segments cannot be determined by a physical examination but is evaluated with flexion and extension roentgenograms.” (Page 379)

The Guides place a high impairment rating on a loss of motion segment integrity. In the cervical spine, 3.5mm equals 25-28% impairment. This is so important and severe that the Guides equate this damage as equal to a vertebra that has a compression fracture greater than 50%. The reason is that this type of damage to the soft tissue causes abnormal function of the spine and posture!

This ligament instability can lead to a loss of cervical and/or lumbar lordosis. This kyphotic spine is an abnormal form and leads to abnormal function. Abnormal anatomy causes abnormal physiology, which results in pathology. This adverse mechanical tension on the central nervous system can lead to a chronic central mediated pain syndrome.

The lordotic curves of the spine give the spine strength and flexibility. Kapandji states that the # curves + 1 = resistance. With the loss of the lordosis, the body loses strength and flexibility.10 Oktenoglu, et al., state, “It is concluded that a loss of lordosis increases the risk of injury to the cervical spine following axial loading.”11

This loss of lordosis has ramifications with regard to health. Shimizu states that progressive kyphosis of the cervical spine results in demyelination of nerve fibers in the funiculi and neuronal loss in the anterior horn due to chronic compression of the spinal cord.12

Previous studies have suggested that spinal cord compression by the vertebral bodies and intervertebral discs during neck flexion causes cervical flexion myelopathy (CFM). Axial MRI/CTM demonstrated flattening of the spinal cord with the posterior surface of the dura mater shifting anteriorly. The findings of this study suggest that degenerative changes of the dura mater may be a characteristic pathology of CFM.13

Giuliano, et al., compared 100 trauma patients with 100 normal subjects, using flexion and extension MRI.14 The ages varied from 18-53, with an average of 35. The patients were 12-14 weeks post injury. In the normal subjects, hypolordosis was found in 4%.

In the trauma patients, hypolordosis with a loss of normal segmental motion pattern was found in 98%. There were 2% asymptomatic disc herniations in the normal group and 28% disc herniations in the trauma patients. “In no instance was disk herniation and spinal stenosis observed in the absence of hypolordosis and segmental motion restriction.”

From this study, it can be stated that individuals with a normal cervical lordosis do not have symptomatic disc herniations. Therefore, the way to correct disc herniations is to restore a normal lordotic curve in the spine.

Ligament damage results in FHP and a loss of the cervical lordosis. Through proper protocols, it is possible to restore the normal lordotic curves of the spine. (See Fig. 1)

A loss of the lordosis causes a stretching of the spinal cord. The diagonal fibers of the dura mater cause a pincer effect when lengthened. Yuan & Marguiles state, “Between a neutral posture and full flexion, the entire cord (C2-C7) elongated linearly with head flexion, increasing 10% and 6% of its initial length along the posterior and anterior surfaces respectively.” Average displacement was 1-3 mm. The upper cord moved caudal and the lower cord cephalad with larger movements on the posterior surface.15

The European Spine Journal, in 2001, indicates a relationship between a loss of lordosis and scoliosis: “A short, unforgiving spinal cord could produce the abnormal rotatory anatomy observed at the apex in scoliosis with, first, lordosis, then lateral deviation and, finally, a rotation of the vertebral column, with the rotation occurring between the canal and the vertebral body, around the axis of the cord.”16 Based upon this, it would also be possible to correct and/or improve scoliosis without bracing and surgery. (See Fig. 2)

These abnormal findings can also be substantiated through the utilization of Myologic computerized muscle testing and range of motion evaluation. This objective outcome assessment is a diagnostic tool that objectively verifies abnormal function as well as determines proper treatment. These changes can be also be verified by CROM, Neck Disability Index, and the Rand 36 activities of daily living / quality of life.

Based on the above, it would appear that rehabilitation and restoration of the cervical lordosis is necessary as a contribution to the health of the individual. The question is then asked, how may this be accomplished?

Standard medical military traction is performed to open the intervertebal foramina (IVF’s), with no regard to the lordosis. This may actually be detrimental in the long run.

In the chiropractic profession, there has been little research as to what is the best way to rehabilitate the cervical lordosis. Current treatment consists of cervical pillows, cervical roll for spinal molding, Posture Pump, fulcrums, head weights, circular traction, Extension Compression Traction, cervical collar brace, limited vision glasses and specific adjusting procedures.

One of the newest procedures is cervical Vibrating Traction (VT)™. The premise behind the Vibrating Traction™ is simple. Research done by top scientists has suggested that occupational drivers tend to suffer from a higher-than-average incidence of low back pain, due to the effect of the engine’s vibration upon the spinal discs.¹ When the vertebrae of the spine are compressed, as in a sitting position, this vibration “grinds down” the discs, reducing their effectiveness in absorbing the force of gravity. But, if the discs and ligaments are vibrated while they are in an uncompressed, relaxed state, it turns out that the exact same frequency has highly beneficial effects in relaxing ligaments and discs, as well as rehabilitating the spine.17,18,19 (See Fig. 3)

The loss of cervical lordosis and resulting forward head posture is detrimental to the health of the individual. Proper treatment should focus on the restoration of the lordosis. There is much to learn with regard to the spinal rehabilitation of the curves of the spine.

The purpose of CLEAR Institute is to empower the DC who wants to specialize with the patients who have scoliosis and the doctors who treats them.
For Seminar information contact Parker College of Chiropractic at www.parkerseminars.com, or call 1- 800-266-4723.
For information on The Vibe or Vibrating Traction (VT), contact Williams Healthcare Systems at www.williamshealthcare.com or call 1-800-441-4967.
For further information, contact Dr. Dennis Woggon at www.clear-institute.com

1. Burl Pettibon DC. Private Practice Garland Texas, 1994 (anecdotal reference)
2. Dennis Woggon, BSc, DC, CLEAR Institute, Posture, Vol. 1, #1, Dec. 2002
3. George Ehni, MD. Cervical Arthrosis, 1984
4. Ruth Jackson, MD. The Cervical Syndrome
5. John Kellet, Acute Soft Tissue Injuries
6. Grauer, Panjabi et al, Spine, 1997
7. Ono, et al. Society of Automotive Engineers, Strapp Car Crash Conference, 1998
8. Rene Calliet, MD. Neck and Arm Pain.
9. AMA Guides to the Evaluation of Permanent Impairment, 5th edition, November 2000, Chapter 15, pages 378-392
10. Kapandji. Physiology of the Joints, Vol. 3
11. Effects of Cervical Spine Posture on Axial Load Bearing Ability: A Biomechanical Study, Oktenoglu et al, Dept. of Neurosurgery, VKV American Hospital, Instanbul, Turkey, The Cleveland REFERENCES
Clinic Foundation, Cleveland, Ohio, J. Neurosurgey: Spine, Vol. 94, January, 2001
12. A New Model of Kyphotic Deformity Using Juvenile Japanese Small Game Fowls. Spine. 30(21):2388-2392, November 1, 2005. Shimizu, Kentaro MD *; Nakamura, Masaya MD *; Nishikawa, Yuji MD +; Hijikata, Sadahisa MD +; Chiba, Kazuhiro MD *; Toyama, Yoshiaki MD * Abstract:
13. Pathophysiology and treatment for Cervical Flexion Myelopathy. Fujimoto Y, Oka S, Tanaka N, Nishikawa K, Kawagoe H, Baba I. Department of Orthopaedic Surgery, Hiroshima University School of Medicine, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551 Japan. This e-mail address is being protected from spambots. You need JavaScript enabled to view it
14. The Use of Flexion and Extension MRI in the Evaluation of Cervical Spine Trauma: Initial Experience in 100 Trauma Patients Compared with 100 Normal Subjects” Giuliano et al. Emergency Radiology (October 2002) 9: 249-253
15. In Vivo Human Cervical Spinal Cord Deformation and Displacement in Flexion, Yuan & Marguiles, Spine 1998: 23:1677-83
16. Can a short spinal cord produce scoliosis? Eur Spine J 2001 Feb;10(1):2-9
17. The biomechanics of lumbar disc herniation and the effect of overload and instability, Wilder, Pope, Frymoyer. Journal of Spinal Disorders 1988;1(1):p16-32, Univ. of Vermont, Burlington.
18. Energy Medicine: The Scientific Basis, Oschman. Churchill Livingston Publishing, 2001.
19. Neck muscle vibration induces lasting recovery in spatial neglect, Schindler et al. Clinical Neuropsychology Research Group, City Hospital Bogenhausen, Munich, Germany.

 

 
Adjusting Disks
Techniques
Written by Ted Koren, D.C.   
Tuesday, 14 November 2006 16:19

An alternative to spinal surgery

Sometimes the most difficult cases are not due to subluxations of the vertebrae but to subluxations of the disks. As Richard Van Rumpt, DC, developer of directional non-force technique (DNFT) said decades ago, “If the disks are subluxated, the vertebrae won’t hold.”

Is it possible to adjust disks? Yes, it is possible to easily and quickly locate and adjust subluxated disks.

Do herniated disks require surgery? Rarely. In most cases, even a herniated or ruptured disk can heal without surgery. Most heal spontaneously.

As Jerome Groopman, MD, writes: “A recent study of CT scans showed that twenty-seven percent of healthy people over the age of forty had a herniated disk, ten percent had an abnormality of the vertebral facet joints and fifty percent had other anatomical changes that were judged significant. And yet, none of these people had nagging back pain. Another study using MRI scanning, showed that thirty-six percent of people over sixty had a herniated disk, and some eighty to ninety percent of them had significant disk degeneration.  Even patients with acute ruptured disks have a good prognosis, though their recovery is usually slower; some ninety percent will feel significantly better within six weeks, without surgery. Over time, the disk gradually retracts, so that it is no longer pressing on the nerves and the inflammation subsides.”1

Back surgery

Back surgery is perhaps the most dangerous and useless surgery ever developed. “Spinal medicine, unfortunately, is producing patients with failed back surgery syndrome at an alarming rate.”2

According to Norma Shealy, MD: “It was obvious to me that vast majorities of people suffering from chronic pain were actually the result of unnecessary back surgery. In one study, I demonstrated that at least eighty percent of those who had had lumbar surgery for a presumed ruptured disk had not had a ruptured disk before their first surgery. But, by the time they had had between five and seven unsuccessful back operations, they certainly were invalids.”3

No one knows how many of the over 150,000 spinal fusion operations and the 500,000 total spinal surgeries performed each year in the United States are unnecessary. I would guess the number to be over ninety-five percent.  Chronic pain clinics are filled with back surgery failures. Can the disk be addressed without surgery?

How can you adjust the disk?

Years ago, when I studied Van Rumpt’s work with Drs. Pat and Mike McLean, I was instructed as follows: In order to adjust a disk, you must find a tight fiber a few inches lateral to the spine and adjust into it.

“How can that be?” I asked.

“We don’t know the mechanism, but it works,” they said.

The answer may be found in a fascinating phenomenon known as myofascial gelosis, discovered by Janet Travell, MD (discoverer of trigger points).4  Myofascial means relating to the fascia connective tissue, and gelosis means an extremely firm mass in a tissue.

Adjusting the bands

It appears that, when a disk is subluxated, the normally soft, pliable connective tissues surrounding it transform into relatively taut bands. These bands help anchor and stabilize the disk, as guy wires, to protect it from further injury. They are easily palpated as thin bands emanating laterally from the disk—often reaching many inches away.

These bands can be exquisitely sensitive along their length. Dr. Van Rumpt used wooden dowels and a deep thumb toggle—the adjustments could sting.

The results? Three case histories

The technique I developed for adjusting disks is one that applies concepts from Van Rumpt, Lowell Ward and others, using an adjusting instrument. Using the negative (index) finger, the doctor locates a “hot” disk and taut fibers. A body biofeedback device (such as the occipital drop) is used as a “yes-no” indicator. We can then introduce a relatively light force anywhere along the length of the fiber using an adjusting instrument. The results are often amazing.

Case #1. Forty-nine year old male, bedridden with severe back and leg pain. Not able to stand. Had an MRI. By third adjustment, he was able to walk with crutches. By the sixth adjustment, he could stand without pain for about thirty seconds—first time in five days he was pain free.

After ten days he was completely pain free with eighty percent strength in leg. Neurosurgeon was at a loss to explain his recovery. He told patient, “Your MRI is the second worse disk herniation I’ve seen in my career. I would recommend immediate surgery. I cannot believe you are pain free.”5

Case #2. Patient hurt his low back in an accident and was making very slow progress after six weeks of three-times-a-week of diversified adjusting. I had guessed his problem was a disk, and my history with disks was it takes a while to mend. After one adjustment (to the disk) he stated he was fifty percent better; after the second, no more pain, and is bringing in the wife.6

Case #3. I had seen a patient years prior for low back pain with radiating leg pain and numbness/tingling down the leg. Poor response. She discontinued care and, eventually, had surgery to “repair” her disc. She still had numbness/tingling in her foot, even months after the surgery.

She returned to the office. I started adjusting her with KST. After a few adjustments, the numbness/tingling was gone and whatever remaining LPB she had went as well. She was amazed and very pleased. On a follow up with her surgeon, she told him her symptoms were gone because she was back under chiropractic care.7

One final note: dehydration

I have never seen a disk patient who was not dehydrated. Most disk sufferers are moderately to severely dried-out and that may be a major reason why their disks start weakening and compressing in the first place.

The earliest sign of disk herniation is decreased signal on a T-2 weighted image due to desiccation and dehydration of the disk. This is usually associated with a loss of height and a bulging of the annulus fibrosis circumferentially.8

Putting patients on an aggressive hydration plan (a glass of water every hour—not iced or distilled) for one to two weeks can often result in dramatic improvements.

It is gratifying to see that simply drinking water (rehydrating) and adjusting the disk and/or vertebra can help the patient at a fraction of the cost of medical and mechanical traction devices.

Dr. Tedd Koren is the founder of Koren Publications and developer of Koren Specific Technique (KST), an Empirical/Vitalistic method of locating and correcting subluxations anywhere in the body that is easy to learn and is revolutionizing chiropractic practices.. For information on KST seminars, go to www.teddkorenseminars.com or call 1-800-537-3001.  Write to Dr. Koren at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

References
1. Groopman J. A knife in the back (Is surgery the best approach to chronic pain?). The New Yorker. April 8, 2002.
2. The BackLetter. Philadelphia: Lippincott Williams and Wilkins. 2004;12(7):79.
3. Shealy CN. Chronic pain management. The Townsend Letter for Doctors & Patients. January 2005.
4. Simons DG, Travell JG and Simons LS. Myofascial Pain and Dysfunction: The Trigger Point Manual, Vol. 1; The Upper Half of Body (2nd Edition). Philadelphia: Lippincott Williams & Wilkins. 2nd edition (October 1998).
5. Tedd Koren, DC. Conversation with patient. September 12, 2006.
6. Brad Miller, DC. Personal correspondence with author. September 6, 2006.
7. Warren Silver, DC. Personal correspondence with author. September 13, 2006.
8. Bradley WG. MRI of degenerative disease of the lumbar spine.
https://e-edcredits.com/XrayCredits/article.asp?TestID=12

 
Help for Chronic Subluxations
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Written by Scott Walker, D.C. and Deborah Walker, D.C.   
Tuesday, 14 November 2006 16:12

You try all your regular approaches and the patient reports that “it’s a little better,” but your adjustment doesn’t seem to hold. If you’re like most chiropractors, this has happened in your office, too.  You could keep adjusting the patient every week, but what if you could address the patient’s “emotional physiology of thought” and then your adjustments would hold?  This has actually happened, to the delight of thousands of chiropractors around the world and the many thousands of their patients who have received relief with the correction of their dreaded chronic subluxations and associated conditions.

How does this happen? 

Practitioners trained in helping patients who have an emotional/physiological component to their subluxation generally use a combination of the following dynamics:

1. Muscle Testing.  Applied Kinesiologists have traditionally used muscle testing as an indicator of impaired physiological function (Goodheart, 1964).  Chiropractors who use muscle testing often work with the premise that the muscle will be less able to resist outside force when there is some non-congruency in the function of the nervous system.  This premise has been validated by Monti.1

2. Emotions are physiologically based.  Much of the neurophysiology of emotion is based on various chains of amino acids, called peptides, which travel throughout the entire body via extra-cellular fluids to distant “catcher” amino acid chains called receptors. “This is one reason,” Pert says, “we contend that this ‘whole body’ system—the system of neuropeptides, the system of emotion —can play a critical part in matters of health and disease.”2

3. Pavlovian Responses.  Humans, as well as animals, can be conditioned.  Often, events in our surroundings (like a ringing bell!) can trigger a physiological reaction in our body.  Sometimes we’re aware of it, and sometimes it happens without our conscious awareness.  Of course, much study has been done on this, including the original work by Pavlov.

4. Physiology and the Meridian System.  This is a 1,500- to 4,000-year-old principle.  Acupuncture theory has clinically validated that specific emotional responses are linked with specific meridians.  Classic examples are how “anger” is associated with the liver meridian and “fear” is associated with the kidney. 

5. Repetition Compulsion.  One of Freud’s contributions was the concept of repetition compulsion, which essentially expresses that, once we have been emotionally traumatized, we tend to unconsciously seek to repeat a similar pattern in the future.  The physiology of the body may work in a similar manner. 

6. The Role of Thought and Physiology.  By remembering an emotional event, important somatic and visceral modifications can take place in the body.  Hassan and Ward write, “The recollection of perceptions, which implicates neocortical processes, may evoke (through descending connections via ‘limbic system,’ hypothalamus, brain stem, and spinal cord) the somatic and visceral motor changes which occurred in the original situation.”3

7. Semantic Responses.  A person whose physiology is reactive to the sight of a spider can also be reactive to a picture of a spider, the thought of a spider, or even react to verbal communication.  Monti found this to be true in his Muscle Test Comparison paper, stating, “Overall, significant differences were found in muscle test responses between congruent and incongruent semantic stimuli.”4

8. Homeopathy.  A scientific system of health care that is known to activate the body’s own healing processes and help the body detoxify.  Thousands of research studies support the effectiveness of homeopathy in detoxifying the physiological chemistry of the body.

How can you identify if a chronic subluxation has an emotional/physiological reactivation factor?  Traditionally, using the science and art of muscle testing, the chiropractor can two-point a chronic subluxation to the Emotional Points to discover if there is an emotional/physiological component. The Emotional Points, which were discovered by Bennett (in the 1930’s), are located bilaterally on the forehead, directly above the pupils and halfway between the eyebrows and the natural hairline.

Using the above two steps (See Pg.30) doesn’t correct the situation, but it does help identify a possible component of why your patient’s adjustment is failing to hold.  If the above testing indicates that there may be an emotional/physiological pattern, you can take a different approach in stabilizing the chronic subluxation, rather than continuing to adjust your patient over and over again with the same result of little to no relief. Nowadays, there are many wonderful techniques available to address the emotional/physiological component, and you may even want to refer the patient to a trained professional who deals with this factor if you don’t have such a tool in your present “tool box of techniques.”  The extinguishment of the emotional/physiological conditioned response associated with chronic subluxations offers great relief for our patients who fail to respond to our traditional approaches.

 
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