In our office, caring for patients with spinal pain begins with a detailed physical exam that includes a comprehensive history review, postural evaluation and other procedures to objectively assess the structural condition of the spine and the spinal curves.  Once we understand the mechanism of injury, the exact abnormal postures that contributed to disc damage and the condition of the spinal curves (alignment), appropriate and effective treatment can be provided.

Spinal pain - such as back and neck pain is one of the largest and fastest growing healthcare challenges in the industrialized world...

The costs of this epidemic are enormous: for example, in the United States alone, about $50 billion annually is incurred as a result of low back pain.  

What can be done to gain control of this problem?

In order to provide appropriate and effective treatment for any suffering patient, it is imperative to identify the exact source of their complaint and the mechanism of their injury or condition.  We explore where your pain is coming from and why.

What irritates or damages the disc to cause pain?

New research into the nerve supply of spinal discs together with the clinical studies on pain has dispelled many long-held beliefs about the source of back and neck pain.  Strong evidence now points directly to the intervertebral disc (the cushion between each vertebrae) as one of the primary sources of pain.  Following the disc, the next most common originator of pain is the joint capsule (the touch ligamentous covering that encapsulates spinal joints).

Two primary factors have been shown to irritate or damage spinal discs: (1) acute hyperflexion loading of the disc, such as sudden lifting of a heavy object in a bent-over position, and (2) sustained loading of the disc, such as prolonged sitting.

In both cases, positions of flexion where the normal spinal curves are reduced or reversed is the mechanism by which compressive loads are applied to the spinal discs to create injury.  This has been demonstrated in several studies that show many back and neck pain sufferers tend to have less lordosis (lumbar and cervical curves) than normal.  Adverse loading of the disc may also be the result of abnormal posture and repetitive unilateral activities, all of which load the disc asymmetrically.  Thus, many factors can cause damage to the disc, resulting in impaired disc nutrition and eventual deterioration which produces pain.

Most spinal pain, therefore, is a direct result of a loss of normal spinal alignment and curvature, and abnormal posture, causing asymmetrical disc pressure.