Blog

• Degenerative Joint Disease (DJD)
• Facet Arthropathy
• Disc-Osteophyte Complex

Many patients we see in our clinic have concerns about terms they noted on the X-ray and MRI reports they have received. These terms above, “degenerative” joint disease, facet arthropathy, and disc-osteophyte complex, sound scary and authoritative and seemingly are serious issues that may require surgical intervention. When seen through a functional lens, these issues are not necessarily a problem, they may actually represent a normal adaptive process by the body that serves to improve a person’s overall health, their spine stability and to reduce their pain. To see through that lens, one must first ask the question, “Why did this process happen?”.

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OK, sorry if that reference to the old movie, When a Stranger Calls, triggered anyone (30 second trailer/meme here), but the title is probably correct. In the past decade, research has shown us that if we compare the X-rays and MRIs of people without back pain to people with back pain, they look frightfully similar (1). How can this be? It’s because the things that seem to be best associated with a painful disc are not apparent on an MRI or X-ray. Those things are inflammatory cytokines (2). For most of our readers here, the amount of circulating inflammatory cytokines in your body are due to your behavior in 2 rooms in your home…the bedroom and the kitchen. Let me explain…

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Saphenous nerve knee pain-How your back pain can cause your knee pain (and how your knee pain can cause your back pain)

In our clinical practice in Portland, OR, we work with disc herniation patients daily. If you came to this link mainly because your back hurts, you might find this site helpful. Commonly, a secondary complaint in these patients is knee pain with squatting or lifting. Often, these patients don’t even mention it because the pain in the back or the sciatica in the leg is much more noticeable. In the course of the exam, we ask them to squat and return to standing. Many of them demonstrate a tendency for the involved knee to drift inward. Some research suggests that this inward drift of the knee with squatting (valgus displacement) is associated with knee pain and knee injury. Put differently, that research shows that a large percentage of people with knee pain demonstrate this valgus tendency with squatting. Other research seemingly contradicts that by noting that many people without knee pain demonstrate this valgus tendency. Which research should you believe? The answer is…both.

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The cluneal nerves are sensory nerves that supply the skin over the top of the buttocks, over the sacrum and in the lumbar flank area. They originate from the upper part of the lumbar spine (L2-L3) but are often a source of back pain when a person has a lumbar disc herniation in the lower lumbar region. “How?” you may ask. It’s a systems based problem, but here’s the basics and how you can get relief.

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Many of us in the United States have fond memories of the 4th of July…fireworks, hot dogs and hamburgers in a backyard BBQ, time with family and friends. Others, however, have a different kind of memory around the 4th of July. Veterans who have seen combat, felt the concussion of bombs, heard the fire of weapons around them and have seen brothers and sisters in arms die in those conditions, are sometimes drawn back to those traumatic times when the fireworks start on July 4th. Most of us are aware of post traumatic stress disorder (PTSD) and the way a past traumatic experience can result in the survivor’s vulnerability in certain future situations. The paralyzing fear, racing heart, muscle tension, rigidity can return in innocuous situations when enough of the elements the person’s brain has flagged as associated with the original threat are present. Here, we’d like to introduce the thought that chronic severe back pain may actually result in a type of PTSD.

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A systems analysis of this condition opens doors to understanding why back pain persists, how it changes over time and how we can more effectively treat it.

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