Chiropractors use spinal manipulation or adjustment to treat neck and back pain. The foundation of chiropractic is to return the body's joints to normality so that they can move properly. Good vertebral joint movement is crucial to good disc health since it encourages blood flow and fluid exchange in the disc area, and also is important for relieving pain and muscle imbalance to avoid abnormally rapid disc degeneration. In addition, vertebral movement reduces scar tissue formation which can lead to degeneration and stiffness.
Degenerative Disc Pathology
Scientists are unsure why degenerative disc disease occurs. Research has shown that there may be an autoimmune or genetic factor linked to the disease, and environmental circumstance also may contribute to the disease's development. Smoking and repetitive activities also can contribute, according to Centra Care Health Library. Degenerative disc pathology can eventually weaken the disc, leading to disc bulging and ultimately, disc herniation. According to the Mayfield Clinic, the protruding disc can push out and impinge upon the adjacent spinal nerves or the spinal cord causing pain and a myriad of other symptoms.
Purpose of Manipulation
According to the website Spine-Health, chiropractic manipulation involves several techniques. Primarily, high velocity short thrusts are applied to the vertebrae resulting in an audible release of gas between the joints, called joint cavitation. The patient usually feels an immediate sense of relief. If any muscle begins to spasm the chiropractor might apply ice, massage or electrical stimulation. The end result is that there is a range of motion increase, reduced muscle tension and simultaneous and lasting pain relief. In addition, blood flow increases and blood pressure drops, and a host of beneficial chemical changes occur in the blood stream.
Manipulation Under Anesthesia
Under certain conditions such as extreme pain, manipulation under anesthesia can be offered, according to Spine-Health. In a hospital or surgery center, the patient can be put under general anesthesia, mild sedation or local anesthesia of the involved tissues. The spine is then manipulated, and along with passive stretching and other maneuvers, fibrous adhesions and scar tissue are broken from around the spinal column.
Candidates for MUA
Spine-Health suggests that scar tissue and adhesions form after injury to the neck and back. This then produces pain and other symptoms. The issue of adhesion and scarring is not addressed, however, when a patients undergoes disc surgery, which is why some patients ultimately feel pain as time goes on after surgery. Usually patients who are selected for manipulation under anesthesia have tried conservative therapy for six to eight weeks. If improvement is not satisfactory, then manipulation under anesthesia can be tried. First, diagnostic testing such as MRI and CT scan should be used to support the need for this treatment.
Risks and Contraindications
Any patient who may react adversely to anesthesia may not use manipulation under anesthesia. Also, certain pathologies of the spine such as bone weakening may not lend itself to safe manipulation techniques, according to Spine-Health. Other contraindications include malignancy of the vertebrae, vertebral tuberculosis, vertebral fracture, acute arthritis, acute gout, diabetic neuropathy, bacterial infection of the vertebrae, spinal tumor and advanced osteoporosis.
