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Spine Inc.com

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    Alternate Leg Raises

    Take a deep breath and exhale slowly through your mouth. Now bringone knee up towards the shoulder, then return the foot to the mat,sliding the leg all the way out. When the leg is all the way out, slide itback to the starting position. Now bring the other knee up towards theshoulder, return the foot to the mat, and slide the leg all the way out.When the leg is all the way out, slide it back to the starting position.o this exercise twice more, alternating each leg.

    This exercise is designed to release tension and relax the muscles inthe middle and lower back. The important thing to keep in mind aboutthis exercise is not to bring the knee too far back. !ou"ll know your"rebringing it too far back if you lift your buttock from the mat.#f you lift your buttock, you will produce tension, and you want torelease tension with the exercise. $ust bring the knee up to where it

    stops naturally without raising the buttock.

    Alternate Leg %lides

    This is almost the same exercise as Leg %lides. %lide one leg forwardon the mat so that the leg is fully extended and resting on the mat.%lide the leg back to the bent knee position. Now do the sameexercise with the other leg. After you ha&e done that, stretch out thefingers of both hands and let them relax.

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    Arm 'xercise

    (end one arm at the elbow and let it drop easily to the mat. o thesame exercise with the other arm. Take a deep breath and exhaleslowly through your mouth.

    (um )lex

    Roll o&er onto your stomach with your forehead resting on your foldedhands. *oint your toes inwards. Take a deep breath and exhaleslowly through your mouth. Now tighten your buttock muscles. +oldthose muscles tight for two seconds and then let go. o this exercisetwo more times.

    The purpose of this exercise is to release tension in the buttocksarea, and pointing your toes inwards helps you to isolate your buttockmuscles from your leg muscles. %ome people may sense or

    experience a slight cramping in the soles of the feet. #f this happensto you, rotate your feet so they are pointed outwards.

    at (ack

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    Assume a kneeling position on all fours so that you are resting onyour hands and knees. Arch your back like a cat and at the sametime drop your head slowly and tuck in your pel&is.

    Now re&erse the exercise by gently forming a -- in your back.

    As you perform this mo&ement, raise your head and stick yourbuttocks out at the same time. As with all exercises, this one inparticular, do it slowly and smoothly. o the exercise twice more. #t"spurpose is to stretch the back muscles to make them more flexible.

    )oetal *osition

    Turn on either side, eyes closed, so that you assume a -foetal-position, with your head resting comfortably on your underarm. !oucan place your other arm in front of you or on your hip. Take a deepbreath and exhale slowly through your mouth.

    Remember, keep your eyes closed. %lide the top leg towards yourshoulder, letting it fall off the leg beneath it. Now slide the leg out in astraight line as indicated in the illustration, and then slide it back tothe starting foetal position. o this mo&ement twice more.

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    Roll o&er onto the other side and assume the foetal position with youreyes closed. Take a deep breath and exhale slowly through yourmouth. o this exercise three times, exactly as you did while lying onthe opposite side.

    The purpose of this exercise is to relax the muscles in your lowerback so as to reduce tension. The important point to bear in mindwhen you perform this exercise is that the upper leg is always -dead

    weight- as it slides up towards and then away from the shoulder. Theupper leg always slides on the under leg. #f you lift the leg or raise ite&en the slightest bit during this exercise, you will produce tension inthe low back muscles and defeat the purpose of the exercise.

    +ead Roll

    Take a deep breath and exhale slowly through your mouth. Now letyour head fall to one side. %lowly roll your head to the opposite side. #repeat, do this slowly. (e sure you do not force your head to more

    than it"s natural weight will permit. This exercise helps to reducetension and stiffness in the neck muscles.o this exercise twice more with your head rolling easily from side toside.

    +ead %hrug

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    Take a deep breath and exhale slowly through your mouth. %hrugyour shoulders and let them go loose. To do this exercise correctly,slide your shoulders up towards your ears along the mat. #f you raiseyour shoulders off the mat you will cause tension in the shoulderswhich defeats the purpose of the exercise. o this exercise twicemore.

    /nee )lex

    Lay flat on your back, pull both knees up to your chest, and thengradually lower your legs as you return to your basic starting positionwith both feet on the floor. (e sure you do not raise your hips off the

    mat. o the exercise twice more.

    This exercise is designed to start the strengthening of your abdominalmuscles.

    Leg %lides

    Lie flat on your back and close your eyes. Remo&e all non0exercisethoughts from your mind. oncentrate on the exercise you are aboutto do. This helps you to achie&e a more relaxed state of mind, whichin turn helps immensely to release tension in your muscles

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    Assume the basic positon with your arms at your sides, bend yourknees as shown. Take a deep breath and exhale slowly through yourmouth. Now slide one leg forward on the mat so that the leg is fullyextended and resting on the mat. %lide the leg back to the bent kneeposition. Now do the same exercise with the other leg. Take anotherdeep breath. 'xhale slowly. After you ha&e done that, clench bothfists and then let them go 1loose2.


    Extracted from The Back Pain Sourcebook by Stephanie Levin-Gervai

    Reflexology is a Western pressure point therapywhich focuses on the feet. Reflexology posturesthat points on the bottom of the feet are linked tospecific organs. (y massaging these areasreflexology promotes health to correspondingorgans. Reflexologists belie&e that the toxicdeposits collect in the feet and that reflexologybreaks them up and facilitates their elimination.

    'xtracted from www.reflexology.org

    What is Reflexology3

    The ancient healing art of reflexology has been known to man formany thousands of years. #t was first practiced by the early #ndian,hinese and 'gyptian peoples.

    #n 4546 r. William )it7gerald, an American ear, nose and throatsurgeon, introduced this therapy to the West. +e noted that pressureon specific parts of the body could ha&e an anaesthetising effect on a

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    related area. e&eloping this theory, he di&ided the body into tene8ual and &ertical 7ones, ending in the fingers and toes. +econcluded that pressure on one part of a 7one could affect e&erythingelse within that 7one. Thus, reflex areas on the feet and hands arelinked to other areas and organs of the body within the same 7one.

    #n the 4569"s, 'unice #ngham, a therapist, further de&eloped andrefined the 7one therapy into what is now known as foot reflexology.%he obser&ed that congestion or tension in any part of the footmirrors congestion or tension in a corresponding part of the body.Thus, when you treat the big toes there is a related effect in the head,and treating the whole foot can ha&e a relaxing and healing effect onthe whole body.

    +ow an Reflexology +elp !ou3

    The body has the ability to heal itself. )ollowing illness, stress, in:uryor disease, it is in a state of -imbalance-, and &ital energy pathwaysare blocked, pre&enting the body from functioning effecti&ely.Reflexology can be used to restore and maintain the body"s naturale8uilibrium and encourage healing.

    A reflexologist uses hands only to apply gentle pressure to the feet.)or each person the application and the effect of the therapy is

    uni8ue. %ensiti&e, trained hands can detect tiny deposits andimbalances in the feet, and by working on these points thereflexologist can release blockages and restore the free flow ofenergy to the whole body. Tensions are eased, and circulation andelimination is impro&ed. This gentle therapy encourages the body toheal itself at its own pace, often counteracting a lifetime of misuse.

    Who an (enefit )rom Reflexology3

    %ince reflexology treats the whole person, not the symptoms of

    disease, most people benefit from treatment. The therapy brings reliefto a wide range of acute and chronic conditions, and is suitable for allages. ;nce your body is in0tune, it is wise to ha&e regular treatmentsin order to help maintain health and well0being. An increasing numberof people are using this safe, natural therapy as a way of relaxing,balancing and harmonising the body.

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    What +appens When !ou or you may feellethargic, nauseous or tearful, but this is transitory. #t is, howe&er, &italinformation for reflexologists, as it shows how your body isresponding to treatment.

    )urther information can be found at=

    Reflexology Research

    Reflexology World ?aga7ine(ritish Reflexology AssociationReflexology Association of America


    'xtracted from *age Wise

    What is hydrotherapy3

    The benefits of @water healing, or hydrotherapy ha&e beenrecogni7ed for thousands of years. #n 'urope, where hydrotherapy is

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    especially popular, there are numerous health spas and healthfacilities for all types of @water cures.

    Water healing is one of the oldest, cheapest and safest methods fortreating many common ailments. We know from personal experiencethat water is not :ust for cleansing, but for making us feel better.When you plop into that tub of hot water, after a strenuous day, youknow youBll feel much better when youBre done, for hot water relie&esfatigue and pre&ents stiffness.

    Ancient ci&ili7ations recogni7ed the healing power of natural hot andcold springs. (ack in the Cth century (., the

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    )or tired feet, a cold footbath is recommended. While an alternatinghot and cold footbath is said to promote circulation in the legs, help&aricose &eins, insomnia, headache and high blood pressure.

    Alternating hot and cold baths are good for treating hands and feet,with water as hot as you can stand it, in one bowl, ice water in theother. *ut hands or feet in the hot water for one minute, then plungeinto the cold for E9 seconds. Then back into hot and cold again until atotal of 49 minutes ha&e been spent doing this, ending with theplunge into the ice water. (eneficial for arthritic :oints and tired,aching feet, and the alternating hot and cold stimulates circulation.

    Remember that the application of heat is soothing, easing muscletension and relie&ing pain. +eat also impro&es circulation by causing

    blood &essels to dilate. old can either be stimulating or soothing.

    Water healing is helpful in maintaining metabolic function, and inmaking us feel much better, and is easily accomplished right in ourown homes.


    'xtracted fromAromatherapy

    What is Aromatherapy 3

    Aromatherapy is the therapeutic use of aromatic substances.Therapeutic use co&ers both mind and body, whereas aromaticsubstances tend to be the eential oil. As a treatment, it is usuallycombined with body0contact therapy in the form of massage.

    Aromatherapy massage is one of the most relaxing types of massage

    and is best done with subdued lighting and gentle background music.The nature of aromatherapy is as a holistic treatment, restoringbalance to mind and body as well as its specific use in treating a widerange of symptoms.

    What are 'ssential ;ils 3

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    'ssential oils are pure, concentrated plant extracts obtainedspecifically for their fragrance and therapeutic &alue. The chemicalcomposition of these oils is exceedingly complex 0 often tens orhundreds of constituent parts. #t is now thought that all of these partsplay a &ital role in the effecti&eness of essential oils and thus thechemical synthesis of these oils has pro&ed remarkably tricky.

    'xamples of common essential oils include la&ender oil, rose oil andpeppermint oil.

    +istory of Aromatherapy

    Aromatherapy, while relati&ely new to the Western World, goes backa long way. Although the term eential oilis a recent one,

    ci&ilisations ha&e been using incense, perfumes and cosmetics forthousands of years. +erbs and spices ha&e been used in cooking fora long time, but their use has often been linked to both religious andmedicinal purposes. #ndian literature, dating from around E999(mentions the use of cinnamon, ginger, myrrh, coriander andsandalwood. The hinese ha&e a long tradition of alternati&emedicine. Aromatherapy is :ust one of a number of treatments whichinclude acupuncture, reflexology and herbal remedies. The 'gyptianswere renowned for their herbal potions and ointments. Temples werefilled with incense. orpses were embalmed in oils of cedar and

    myrrh. 'gyptian women wore perfume.

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    the modern drug industry. uring the twentieth century, essential oilswere mo&ed away from therapeutic use into perfumes, cosmetics andfoodstuffs.

    ?odern ay Aromatherapy

    #n 45EF, RenG0?aurice

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    The following additional methods are used for the extraction ofaromatics...

    %ol&ent 'xtraction

    +ydrocarbon sol&ents 1 such as petroleum or hexane 2 are used todissol&e the aromatic material. The remaining residue is known as aconcrete and is usually solid in form. A further process of sol&entextraction using ethanol yields an absolute. A small proportion of non0&olatile matter 1 wax 2 usually remains which can be remo&ed bymolecular distillation. Absolutes are usually highly concentrated&iscous li8uids but they may contain up to EJ of ethanol. lary sageabsolute is a semi0solid.

    When the base material is organic but dead, the extraction yields aresinoid. This base material includes balsams 1 eg. ben7oin 2, resins 1eg. amber 2, oleoresins 1 eg. turpentine 2 and oleo gun resins 1 eg.frankincense and myrrh 2. Resinoids range from li8uids to solids.When the resinoid is sufficiently &olatile, it may be steam distilled intoan essential oil. (en7oin is so &iscous that this is not possible and theoil is simply a resinoid that has been dissol&ed in a suitable li8uid.


    ;nce a principal method of extraction from flowers, this method is&irtually obsolete today. The aromatic material is placed on sheets ofglass coated with an odourless fat 1 chassis 2. The fat becomessaturated with the aromatic oils which can then be dissol&ed out withalcohol. The fragrance0saturated fat is known as a pomade. Thealcohol extractions are known as absolutes.

    *hysical haracteristics

    'ssential oils can be li8uid, semi0solid 1 rose 2 or solid 1 orris 2. Li8uid

    is the most common form at room temperature. 'ssential oils dissol&ein alcohol, fats and other oils but not in water. ontrary to popularbelief, they are not oilyto touch. (eing of a &olatile nature, theye&aporate on exposure to air and do not lea&e an oily residue.

    #nteraction with the +uman (ody

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    'ssential oils can be absorbed by the human body in a &ariety ofways. The &apour, once inhaled, can trigger neurochemical release inthe brain &ia receptors in the nose and mouth. ?any people arefamiliar with the phenomenon of a sudden awareness of pastmemories after detecting a particular smell or taste. Although thesememories can be buried deep in the subconscious, they suddenlyflood into &iew. ;f all the fi&e senses, smell has the strongest link intothe subconscious. Hapour can also be absorbed by the blood once itgets into the lungs. ;nce in the bloodstream, it can circulate 8uicklyto all the organs of the body, not :ust the brain. As a li8uid, essentialoils can be taken orally 1 not recommended 2 with direct action on thestomach and the small K large intestines. ?ore usually, oils form partof an aromatherapy massage, in which case there is an immediatelocal action on the skin 1 epidermis and dermis 2 and from there into

    muscle tissue, :oints and the bloodstream.

    TE$% &achine

    A Transcutaneous 'lectrical Ner&e %timulation machine is aremarkable de&ice which can help remo&e backache extremelyeffecti&ely at &ery low cost and with few side effects. To understandhow it works it would be best to explain how

    your body recognises pain.The gate control theory of pain put forwardby two scientists called ?el7ack and Wallsuggested that when body tissues aredamaged, messages carrying informationabout the in:ury tra&el towards the brainalong two 8uite separate sets of ner&e fibres. The larger fibres carrymessages about sensations other than pain, and the smaller fibrescarry the pain messages. The messages which tra&el along the larger

    fibres tend to arri&e at the spinal cord before the messages tra&ellingalong the smaller fibres and, if there are enough non painfulsensations tra&elling, the pain messages won"t be able to get throughto the brain.

    ;nce this theory had been accepted it was possible to explain allsorts of natural phenomena which had, up until then, been a mystery.

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    %o, for example, it became clear that when we rub a sore spot whatwe are doing is increasing the number of non0pain messagestra&elling towards the spinal cord 1and thence the brain2. #f you knockyour elbow you will automatically reach to rub the spot because sub0consciously you know that by rubbing the area you will be able to cutdown the amount of pain that you feel.

    +a&ing reali7ed :ust how rubbing a sore or painful place can relie&epain, the next step for scientists was to come up with the idea ofusing electrical pulses to produce the necessary stimulus.

    When the theory was first put into practice in the late 45I9s doctorssuggested that electricity should be introduced into the body throughelectrodes surgically implanted in the spine. Although that did work,

    the fact that it in&ol&ed an operation limited the usefulness anda&ailability of the procedure.

    Next, it was disco&ered that all ner&es within an inch or so of thesurface of the skin can be stimulated by electrodes which are simplystuck onto the skin. That encouraged medical researchers to startgi&ing patients pocket0si7ed battery0operated stimulators which sentout a continous series of electrical pulses which could transmit thosepulses into the large ner&es of the body &ia silicon electrodes stuck tothe skin with a special conducting paste. #t worked

    ?ore exciting still, it was disco&ered that Transcutaneous 'lectricalNer&e %timulation 1T'N%2 did not :ust stimulate the passage ofsensory impulses designed to inhibit the passage of pain impulses> italso stimulated the body to start producing its own pain0relie&inghormones known as endorphins.

    uring the last ten years an enormous number of research pro:ectsha&e shown that T'N% machines are con&enient, safe and effecti&e.They are also cheap to buy and extremely cheap to run.

    T'N% machines ha&e been shown to be effecti&e in the treatment ofall kinds of pain. )or example, a %wedish study has shown that T'N%machines are the only painkillers re8uired by M9 per cent of women inlabour> and backache is one of the types of pain best treated withT'N% machines.

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    With this sort of success a&ailable from a small, cheap, portable,long0lasting machine that can be used at home without anytraining and that does not seem to produce any side effects at all,you might imagine that doctors would be recommending T'N%machines to millions of patients and that shops would ha&edifferent models stocked high on their shel&es. (ut if you try tobuy a T'N% machine you"ll ha&e difficulty. This problem layss8uarely at the door of the drug companies who don"t want

    patients in pain to be able to deal with their symptoms so easily,8uickly and cheaply. rug companies make huge amounts of moneyout of selling painkillers to pain sufferers and if people used T'N%machines instead it would cost them a fortune in lost sales.

    #f you want to try a T'N% machine ask your doctor to refer you to the

    nearest pain clinic. !ou should be able to get one on loan and if youfind that the machine works for you then you should be able to obtainone for permanent use.


    Acupuncture is one of the oldest established medical techni8ues inthe world. #t first started when ancient warriors began to notice that

    although they were being wounded by enemy arrows the pain of longstanding aches and pains no longer ga&e them so much trouble.They gradually learned how and where to prick themsel&es witharrows to get rid of their chronic pains. '&entually thin bron7e needleswere in&ented to replace the arrows and today acupuncture needlesare made of &ery thin stainless steel or copper.

    %adly, there are still many sceptics in the medical establishment whorefuse to accept acupuncture because it is not a part of orthodox

    medicine. +owe&er, acupuncture treatment is widely a&ailable andthe World +ealth ;rganisation announced se&eral years ago that itshould be taken seriously. Acupuncture is a&ailable for free in thenited /ingdom through the National +ealth %er&ice.

    There is a considerable amount of e&idence a&ailable now to showthat acupuncture can, and often does, work. And backache 1together

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    with other bone and :oint disorders2 is one of the problems which ismost likely to be treated effecti&ely.

    Although a massi&e amount of research has been done to try to findout how acupuncture works there is still a considerable mystery aboutthis. The hinese traditionally belie&e that the body had as internalenergy force called -chi- which flows around the body &ia a system ofchannels or meridians. #llness can be caused by one of the channelsbecoming blocked. They claim that acupuncture works by remo&ingblockages through the insertion of needles into one or se&eral of the4999 acupuncture points around the body. This allows energy totra&el more freely around the body. ;ther theories include those whobelie&e that acupuncture may work by stimulating the patient"s ownbody to produce endorphins 0 or natural, pain relie&ing hormones. A

    third group of scientists ha&e suggested that acupuncture may workby blocking the pathways along which pain impulses are transmitted.

    +owe&er acupuncture works there is no longer any doubt that it can,and fre8uently does, work.

    #t is howe&er, important to make sure that you &isit a properly trainedacupuncture specialist for in the wrong hands acupuncture needlescan undoubtedly be dangerous. (efore commencing treatment askilled acupuncturist should ask you about your symptoms and make

    a diagnosis in much the same way as an orthodox doctor would.Sex and the Back

    'xtracted from www.spine0dr.com

    #f you or your significant other is suffering from back or neck pain, youknow that sex is one of the first acti&ities to be put at the bottom ofthe list of things to do. This is a &ery common problem and one that isinfre8uently discussed or written about for people with back or neckpain. The reasons for this closed mouth attitude are multiple. *eoplewho are suffering with it feel that they may be the only ones ha&ingthe problem and therefore embarrassed to talk about it, e&en with thedoctor. %ome doctors do not feel comfortable with the sub:ect, or may

    not e&en recogni7e it as a problem.

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    %exuality is an integral part of normal and healthy relationships. #tneed not be the first thing abandoned when you are bothered by aflare0up of your neck or back pain. #f you ha&e chronic pain, it shouldnot pre&ent you from en:oying this part of your relationship.

    To o&er simplify the problem, there are basically 6 components ofsexual functioning. All 6 must be in working order for things tofunction normally. )irst and foremost are the emotional andpsychological aspects of sexuality. #f you are depressed, angry,frustrated, preoccupied or uninterested, you are unlikely to en:oy asexual experience. #f you are preoccupied with your performance youmay not be able to function as you would wish. This article is notmeant to be an in0depth examination of the psychological aspects ofsexuality. #f you are experiencing any of the abo&e and are not able to

    resol&e them with your partner, discuss it with your primary carephysician or seek help from a licensed psychiatrist, psychologist ormental health clinic. ?ost problems are successfully and rapidlyresol&ed.

    The second key components of sexuality are the physiological andanatomical ones. These refer to your e8uipment and wiring. #f theyare not working normally, you will not be unable to function normally.This is not to say that you will not be able to en:oy sex, but that it willbe different. )or example, men with pinal cord in'urieare not able

    to obtain to maintain erections without assistance, yet they are able toha&e intercourse and achie&e orgasm. The ner&e connections, orwiring, must be intact from the brain to the sexual organs and theymust get an ade8uate blood supply in order for things to proceed-normally-. There are a &ery large number of medical conditions thatcan affect sexuality in this fashion. These include but are not limitedto diabetes, heart disease, prostatism, &ascular disease, and the painfrom compression of a ner&e. #f you ha&e the desire and are free ofpain yet are not able to function, then you should be thoroughly

    examined by a physician to look for a medical source.

    Thirdly, many people ha&e the desire, and the e8uipment and wiringare fine, but are unable to en:oy sex because they are not able to getinto a comfortable position due to neck or back pain. ?any conditionsof the spine can make certain positions uncomfortable. These areusually easily o&ercome with some thought and experimentation. The

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    general rule is -#f it hurts do not do it-. *ositions that are notcomfortable in your day0to0day acti&ities will not be comfortableduring sex either. o not be afraid to experiment, there is no right orwrong, normal or abnormal.

    The following is a general outline of some of the more common backdiagnoses and their symptoms. Along with the position diagrams, tryto use these examples as a ":umpimg off point" to guide you throughan e&aluation of what works and what does not.

    !our back or legs hurts when you sit, bend or stoop. !ou feelbetter standing, walking, sitting in a recliner or lying with yourback supported. These symptoms are usually caused by discdisease such as internal disc disruption, annular tears, central

    disc herniations and or sprains and strains . Acute discherniations and "sciatica" will some times act similarly. )lexingthe low back worsens symptoms. This means bending itforward. The symptoms may be relie&ed by straightening or byextending, bending the spine backwards. #n these situationsyou will be more comfortable with your low back in a neutral,which is straight, or extended position. This can beaccomplished in the following ways. Any of the following alsoapply to your neck and arm symptoms. (e &ery careful inpositioning your neck in extension, this can increase pressure

    on your spinal cord. $ust remember one simple rule. -#f it hurts,do not do it.-

    !our back or legs hurt when you stand, walk or reach o&erhead. !ou feel better sitting, reclining and in certain positionslying down. %pinal stenosis, spinal arthritis, facet :oint disease,sprains and strains, deconditioning and soft tissue diseases,may cause these symptoms. Acute disc herniations and"sciatica" will some times act similarly. These conditions tend to

    be worsened by extension of the spine and relie&ed by flexionor the neutral position. This can be accomplished in thefollowing ways. Any of the following also apply to your neck andarm symptoms. $ust remember one simple rule= -#f it hurts, donot do it.-

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    As you and your partner embark on this ad&enture to make sex moreen:oyable, remember that this can be emotionally charged andpotentially frustrating. Take your time and start slowly. #f your partneris the one in pain, offer to start with a hot bath or shower together.?ost conditions respond fa&orably to gentle massage with somewarm oil. The massage works to decrease pain, relax the musclesand mind, and can be stimulating. %hare your feelings and en:oy.

    What follows are some positions which may be more comfortable forcertain conditions=

    The female back patient with back problem liessupine and comfortably on the floor or bed with hipsand knees bent. *illows or towels may be used for

    support. +er partner without back pain is on topbeing more acti&e, but cautious and gentle.

    The woman with back problem lies supine in acomfortable position supported by pillows or towels.

    +er hips and knees are bent and relaxed o&er her partner. +e entersher while facing her, with minimal stress to his or her back.

    The patient with back pain can lie supine on the floor or bed withappropriate supports, pillows or towels for comfort. The patient shouldbe relati&ely passi&e and reduce stress to his back. +is partnerwithout back problem is on top and is taking a more acti&e role.

    The patient with the back problem lies in the supine position on the

    floor or bed with appropriate supports, pillows or towels for comfort.+is back is protected and immobile. +is partner without back problemis on top and is taking a more acti&e role.

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    With certain spine problems 1ususally non0disc related2,sitting may be more comfortable during sex. This sitting

    position may allow more sensuous caressing> howe&er, carefulcoordination by the partners is important.

    A woman with a back problem, especially disc related, may be morecomfortable in the prone position. When she lies in the proneposition, on her stomach, the lumbar spine is in extension, which putsless stress on her discs. The degree of back extension can bead:usted using pillows or cushions under the chest or abdomen.

    *atients with back problems other than disc disease may be morecomfortable when sitting. There may be less pain during sex byad:usting the posture and mo&ements. 'xcessi&e spinemo&ements can be a&oided by careful coordination with yourpartner. This position often allows more intimate caressing and


    A woman may rest on her arms and knees while her partner ispositioned posteriorly. While kneeling, the partners" knees should bepadded for appropriate height and comfort. A woman with back painshould assume a more passi&e but protecti&e posture.

    Pleae do not try thee exual poition (ithout your doctor preent)*ut kidding - but +atch ,our Back

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    Extracted from The Back Pain Sourcebook by Stephanie Levin-Gervai

    Acupressure is an ancient therapy for tension and pain relief.Acupressure uses the same points as acupuncture. The distinctionbetween acupressure and acupuncture is that needles are used inacupuncture and a gentle, but firm pressure of the hands is the basisfor acupressure.

    Acupressure is the older of the two techni8ues. Acupressurist posturethat the power and sensiti&ity of the human hand, is most effecti&e inrelie&ing tension related to ailments in self0treatment and inpre&ention. #n order to relax muscular tension and balance the &italforces of the body, acupressure uses a system of points.

    Acupressure sessions focus not only on relie&ing discomfort, but onresponding to these tensions and toxicity"s in the body before theyde&elop into an illness. The practice of acupressure has de&elopedprimarily through a combination of instinct and hands0on experience.

    A session runs between E9069, and incurs no risk.

    The "lexander Techni#ue

    The Alexander Techni8ue was founded at the turn of the century byan Australian actor called ). ?atthias Alexander who belie&ed thatmany common illnesses are caused by our failure to use our bodiesproperly.

    Alexander started his researches when he repeatedly lost his &oiceon stage. octors were unable to help him and more and more oftenhe found himself losing his &oice in mid0performance.

    '&entually, he reali7ed that whene&er he was talking he hadde&eloped a habit of stiffening his neck and pulling his headbackwards and downwards. This meant that his &ocal cords got

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    s8uashed and when he tried to correct the problem by deliberatelyputting his head forwards he again found himself pressing on his&ocal cords. After months off work Alexander decided that the onlysolution was to make an effort to change his posture and to hold hisbody in such a way that his &oice could be sa&ed.

    The techni8ue worked. Alexander found that once he had learnedhow to stand and how to hold his head his &oice no longer kept ondisappearing.

    Alexander was so delighted by this disco&ery that he ne&er returnedto the stage. #nstead he decided that since he had successfullymanaged to con8uer his own problem by changing his posture, thenthere was a good chance that other people would also benefit by

    alerting their posture. +e created an educational programme aimed ateradicating bad posture and increasing self0awareness. The therapywas designed to pre&ent illness de&eloping, and to treat problemswhich had already de&eloped simply by training indi&iduals to usetheir bodies gracefully, sensibly and according to their natural,mechanical strengths and weaknesses. Teachers of the Alexander*rinciple are more interested in pre&ention than cure, and more adeptat eradicating bad habits than in attacking existing symptoms directly.

    )urther information can be found at=



    Extracted from The Back Pain Sourcebook by Stephanie Levin-Gervai

    $udith Aston came to #da Rolf for treatment after se&eral automobileaccident. ;riginally trained as a dancer, she was told she should gi&eup her career. #nstead she went on to study Rolfing, but felt that thesimilar results could be achie&ed with less force. Aston0*attering

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    postulates that no one has a symmetrical body> the body is not linear,but has cur&es. Working in a gym on symmetrical Nautilus e8uipmentworks against the body"s natural symmetry. #nstead of pro:ectingsymmetry as the ultimate goal, Aston0*atterning encourages bodyparts to cooperate with one another through a system of learning andeducation through mo&ement.

    Aston0*atterning focuses on three integrated mo&ement systems. Ane&aluation determines the restrictions limiting mo&ement options>treatment aims at facilitating change throughout the body to create anen&ironment where restricted mo&ement doesn"t ha&e to occur andthe indi&idual performs exercises which loosen patterns of tension.The pace and se8uence of Aston0*atterning sessions depends onthe indi&idual"s need. Aston0*attering practitioners work with a &ariety

    of back and neck problems and indi&iduals, who like $udity, were toldthey couldn"t perform a certain acti&ity again due to in:ury. Thesessions include both massage and mo&ement work so the client hasimmediate feedback about how to release tension in the body.

    *rice between MD0FD. a session.


    Extracted from The Back Pain Sourcebook by Stephanie Levin-Gervai

    ?oshe )eldenkrais , a mind0body holistic health practioner, was anengineer who worked on the )rench atomic0research program in hisprior life. A :udo master and soccer player, an in:ury led him to applyhis engineering mind to the mechanics of the body and brain thatresulted in the )eldenkrais techni8ue in the 45C9"s. There are literallythousands of exercises in this techni8ue, and the mind andimagination play a key role.

    )eldenkrais drew on the works of other pioneers. +e recogni7ed thata great deal of pain results from patterns of mo&ement that in&ol&eunnecessary muscle tension. #nsightfully, he felt people could -learnto learn- to mo&e in a free and graceful way. )eldenkrais held thatmost people lose the grace, freedom and :oy in mo&ements that they

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    had as infants and small children. +e understood that the relationshipof mo&ement with thinking, feeling and sensing to effect changes inbeha&ior.

    +e coined this -functional integration-. A )eldenkrais sessioncommunicates to the brain precise mo&ements that change habitualpatterns and pro&ide new information to the neuro0muscular systemby gentle touch, mo&ement &ariation and &erbal guidance. Apractitioner gently lifts, halts and supports the head, arms, legs, backand chest as they guide you through slow, easy mo&ements. Touch islight, not deep.

    *rior to his death, )eldenkrais worked with indi&iduals affected bymutlitple sclerosis and cerebral palsy, posturing that if an indi&idual

    had trouble with his mo&ements, he could impro&e their health andwell0being.

    #n some circles he was considered a holistic guru. )or )eldenkrais,touch e&oked cure. There is no risk in&ol&ed with this method.)eldenkrais can be taught in a group setting or indi&idually.

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    structural balance and mo&ement education. #t also incorporatesdeep tissue massage, releasing fascial restrictions, posturalalignment and body awareness. #t"s goal is to realign the body andrelease chronic tension and stress.


    Extracted from The Back Pain Sourcebook by Stephanie Levin-Gervai

    ?ensendieck is a paramedical system of correct body mechanics,correct muscle function, and correct posture based on sound

    fundamental research de&eloped by r. (ess ?ensendieck and haswidespread use in 'urope, specifically enmark, %weden, Norwayand the Netherlands.

    r. ?ensendieck was born into 4FI4 to American parents in New!ork ity. +er father, a ci&il engineer, tra&eled extensi&ely with hisfamily. r. ?ensendieck was gifted both artistically and musically,and made a successful concert debut in *aris before studyingsculpture. #t was the awkward bodies of her models in sculpture thatmade her aware of the human form. With a keen eye she began

    obser&ing children, men and women. %he attended medical lectureson the muscles and finally 8uit sculpting to attend the ni&ersity ofOurich to obtain her medical degree. %he came to see themusculoskeletal system of the body as a remarkable machine with amar&elous capacity for adapting itself to perform perfectly the mostcomplex mo&ements. #n 'urope she lectured around the continentexplaining her mo&ements schemes for correcting the commonabuses of the body. r. ?ensendieck set up schools around 'uropeand in the 69"s opened her first school in the nited %tates.

    The ?ensendieck system works on the premises that if mo&ementsare executed in a beneficial and correct manner, that it contributes toa habitually well0functioning body. #t is a uni8ue and comprehensi&eapproach utili7ing exercise rehabilitation to address the body"s needs.These include= occupational stresses, sports0related in:uries, post0operati&e reco&ery, as well as chronic back and :oint pains produced

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    by bad posture and musculoskeletal diseases. ?ensendieck re8uiresno e8uipment. #t demands moti&ation and perse&erance to unlearnfaulty postural habits that ha&e been a part of one"s life for years.

    &eridian Baed Therapie

    Extracted from The Back Pain Sourcebook by Stephanie Levin-Gervai

    Traditional hinese ?edicine is a unified healing system which hase&ol&ed o&er the past three thousand years. #t consists ofacupuncture, herbal therapy, massage, exercise and diet. #n

    traditional hinese medicine, pre&ention and treatment of disease isstressed by strengthening the body"s own self0regulation, thusrestoring the body"s balance within hinese medicine postulates thatthe life energy ch"i or ki flows along in&isible body pathways calledmeridians. The ch"i or kid is the life force that circulates through thebody and its balance is considered to be the essence of health Whenthe ch"i or ki becomes blocked at specific pressure points, illnessoccurs. The following are a few approaches, based on acupressure0finger pressure, to unclog the energy paths by manipulating thepressure points, thus balancing the body.

    Pilate &ethod

    Extracted from The Back Pain Sourcebook by Stephanie Levin-Gervai

    A herniated disc, with little satisfaction or relief from traditionalmodalities resulted in ?athews exploration of alternati&e possibilities.+e had some success with a healing center who taught him how torelax his upper body, breath and practice &isuali7ation. +e felt better,but not cured. +e contemplated laser surgery, but when the surgeonrecommended a more traditional approach, Larry changed his mind.

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    A pain therapist helped ?athew manage his pain, and recommended*ilates.

    *ilates classic exercise has long been the best kept secret ofdancers. *rominent dancers, singers and mo&ie stars disco&ered*ilates ?ethod decades ago. #ntroduced in 45E6 in New !ork, by$oseph *ilates, the *ilates ?ethod is a form of resistance controlexercise.

    With *ilates and the pain clinic, ?athew felt like he was on the roadto reco&ery. After a few months with his *ilates trainer, religiouslytaking classes three times a week, ?athew"s posture and bodymechanics had altered radically. +e walked differently, and says hisbody is more open.

    ?ore importantly, he feels ali&e and has few days of back pain.?athew also disco&ered that once he hit C9, his body didn"t bounceback like it did in his E9"s and 69"s. ?athew still practices *ilates.

    *ilates works with muscle resistance in the way muscles aredesigned to function, not against natural mechanics. The *ilates?ethod utili7es mental and physical training to teach people how towork from the inside out. (ecause the method looks at the body as awhole unit, it helps to impro&e posture, breathing and releases


    *ilates method is different from other body work in that it usesspecifically designed apparatus, which create &ariable resistancethrough a set of springs. The apparatus has no relationship tomachines in a gym.

    +owe&er, the exercises strengthen supporting muscles in the body.'ach exercise is designed to stretch and strengthen all the musclesand the :oints to release tension.

    The holistic method allows each indi&idual to work at their own pace.While each piece of apparatus permits o&er a do7en different types ofexercise mo&ements, se&eral work to strengthen the spine andabdominal muscles. An indi&idual works independently with aninstructor, and each program is indi&idually designed for eachpersons need and appropriate physical le&el. *ilates has become

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    &ery popular in the last few years. Risk are minimal. Lack ofunderstanding how to use the e8uipment presents the only risk.*ilates can be done in a group, semi0pri&ate or pri&ate classes.

    epending on where classes are taken, prices may &ary. Typically apri&ate session can range from 690DD lasses are sometimesprepared in a group of sessions, and again costs may &ary. A 4Eweek session of lessons can run between 6990D99.


    Extracted from The Back Pain Sourcebook by Stephanie Levin-


    r. #da Rolf, a pioneer in body work, was a former organic chemist.%he perfected the techni8ue structural integration called Rolfing.

    According to r. Rolf, the traditional idea of standing up straight,shoulders back, stomach in and head high, actually misaligns thespine and deforms the skeleton.

    Rolf"s theory postulates that when the body"s structure is corrected,basic chemical changes take place within the body that impro&e o&er

    all health.

    Rolfing straightens the body by correcting the relationship betweenma:or body segments, such as the head, shoulders, thorax, pel&isand legs, toward &ertical alignment. #"&e been rolfed once, and it wasno pleasure trip. #t was, howe&er, &ery effecti&e.

    Rolfers perform deep manipulation of the connecti&e tissue calledcollagen. The collagen changes from hands on energy applied, andbecomes more pliable.

    #n a se8uence of hands0on manipulation, the Rolfers mo&e the tissueback toward symmetry and balance that the body demands. %ufficientforce is used to stretch and mo&e the tissue. *ain may bemomentarily intense.

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    Rolfers speculate that pain fre8uently masks an emotional release.Rolfing is not as subtle as other types of body work with itsmo&ements. %ometimes people being rolfed recalls a traumaticepisode associated with the body.

    ;ften emotion is released after or during a rolfing session. Rolfingtakes place in a series of ten weekly sessions. %essions lastapproximately an hour.


    Extracted from The Back Pain Sourcebook by Stephanie Levin-


    This method of finger pressure has been used widely in $apan foro&er a 4,999 years. uring the Tokugawa period in $apan, theshogunate organi7ed a school of massage for the blind in order togi&e them a profession. )rom that time until the second world war,

    Anma, or $apanese massage was practiced primarily by the blind.These blind professionals were known as Anma0san. They walkedthrough the streets blowing high0pitched bamboo whistles to alerttheir clients that they were ready to come into their homes to gi&e a

    shiatsu treatment.

    Today, the shiatsu practitioner, often a small indi&idual, uses his orher palms, thumbs, feet and sometimes knees to apply a rhythmicpressure to the body. (y using finger pressure on the acupuncturepoints, shiatsu stimulates the /i to flow through the bones, ner&es,arteries and skin. ?oderate pressure applied all o&er the bodystimulates the flow of energy. While there may be moments of intensepressure, shiatsu promotes a feeling of well0being and relaxation. Theen&ironment is relaxing and peaceful.

    %hiatsu can help your back ache by stimulating your life0blood energyof /i to flow. While shiatsu applied correctly has little risk, some folksdon"t care for the intense pressure. There can be moments where thepressure borders on pain, but once released, the pain gi&es way torelief. Ask your practitioner to ad:ust the the finger pressure if it is too

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    hard. While shiatsu is not as relaxing as a %wedish massage whichuses stroking mo&ements, the end result is one of re:u&enation andbalance. An hour shiatsu session costs between D9 to I9. Thesessions end with a cupped pounding on the back to wake up theenergy. Truly, you feel like a new man or woman after a shiatsumassage.


    Extracted from The Back Pain Sourcebook by Stephanie Levin-Gervai

    ?any years ago, # watched an elderly hinese man perform a crossbetween a graceful dance and a martial art. )ascinated with the slow,meditati&e mo&ement, # approached the unassuming gentleman andasked what he was practicing. +e said Tai chi. # learned that he wasan ancient master, and taught a class on %aturday morning in thepark. # :oined the class, and later studied pri&ately with him. Although# admired the beauty of the mo&ements, # couldn"t seem toconcentrate and found my mind soaring abo&e the trees. # 8uit, andthrough the years, as tai chi"s popularity grew, # noticed indi&idualspracticing tai chi on the beach or in parks, and hoped that at another

    time # might be a more subtle student of tai chi.

    Twenty years later, in another time and place, tai chi reappeared.Authoring a book stress is stressful. %itting at a computer screen or inthe library challenges ones backs, eye sight and head. +alf waythrough this book, # reali7ed # badly needed to balance my stress andconfinement at the computer. # returned to the graceful martial art ofmy youth, and began tai chi class one night a week. # mar&eled athow relaxed # felt after the first few sessions.

    The oldest of tall the martial arts, tai chi is -the mother of the martialarts. Tai chi was designed to make manifest the #0hing, or (ook ofhanges. No one knows who wrote the # hing, but the ancient bookdeclares that e&erything in nature houses a yin and yang These twoenergies are found e&erywhere in the uni&erse. ;riginally, the bookwas used as a meditation tool and to predict the future, but the

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    philosophy was later de&eloped into mo&ement, or tai chi. Taichaicharges that e&erything in nature shows the balance of twoenergies. Tai chi uses the names of animals to describe themo&ements and their relationship to the uni&erse. A mo&ement like -the crane- reflects the yin, or retreating, or less substantial energy,while -carry the tiger to the mountain- reflects the yang, or strongforceful forward energy. (oth nature and the self , like a life force,consist of both energies. Tai chi postures that bringing these twoenergies in harmony benefits one"s health both mentally andphysically.

    Tai chi originated centuries ago in hina to impro&e endurance,flexibility and balance. The tai chi practitioner understands thathuman beings are constantly changing and always working through

    inner conflict. hange is a gi&en in life, tai chi helps you find abalance in that change. #t does so by reducing stress, preser&ingyouth and enhancing good health.

    Tai chi is an internal martial art, internal because it is based onworking inside one"s system, the mind and body. With the mind, taichi controls our thoughts0inside the body it works to control ourenergy or chi. Tai chi is a top down method. #t connects the mind atthe top to the body at the bottom. #t works simultaneously on themind, body, thoughts and chi. To practice tai chi, you must become

    aware of your body or how you mo&e. )or someone with a backproblem, tai chi helps you, &ia the postures, to mo&e your bodycorrectly. !ou cannot practice tai chi without first becomingconscientious of your physical presence. (ecause most of us use ourbody incorrectly, tai chi works with warm up exercises to ac8uaint onewith how the body should function in mo&ement. +ip rotation, waistand arm rotations warm the body. Tai chi rotates all the :oints in thebody. hinese medicine belie&es that if the energy is static or blockedin the :oints, aging ensues. When the :oints open, one feels better,

    and the aging process is slowed. The tai chi postures rotate all the:oints in the body. Tai chi is gentle martial art, and you must practicetai chi to learn it. #t is a slow, but a &ery effecti&e process. '&ery taichi mo&e contains elements of yin and yang.

    This graceful discipline is as much reflecti&e as &igorous. The effect isone of relaxation and pleasure. # think of tai chi as the uni&erse in

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    harmony. As we constantly change and shift, we must learn tobalance life0tai chi is the guardian of that balance. #t is also a goodexercise for the back in that it re8uires a therapeutic routine, in whichthe mind and body must mo&e together to maintain that fragilebalancing we all stri&e for. There is little risk in&ol&ed with tai chi. ost&aries, but classes range from F.99 to 49.99, perhaps higher insome cities.

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    massage and stretching mo&ements encourage the body to let go.Through a series of mo&ements, swinging, stretching pressing, androcking the entire torso, the body mo&es into a restful meditati&estate. ;nce the body relaxes, the mo&es appear effortless. *lan onabout an hour to an hour and a half for each session. Trager carriesno risk and is gentle. ost range from D90MD a session, dependingon the practioner.


    Extracted from The Back Pain Sourcebook by Stephanie Levin-Gervai

    !oga has its origin in #ndia and goes back nearly 6,999 years. A%anskrit word meaning :oining together, yoga works to unite the bodyand the mind. !oga in&ol&es the whole person as the mind focusesmeditati&ely on each mo&ement.

    !oga is not an exercise, but a series of postures or poses. The gentleposes are held anywhere from 490I9 seconds. *oses should ne&erbe painful. (ecause yoga combines both mental and physical acti&ity,the two most common types of yoga are hatha and ra:a. There is aninterdependency between the two.

    +atha yoga enhances musculoskeletal strength flexibility, balance,agility and coordination. Ra:a benefits the mind by relaxing and8uieting the mind. (enefits of ra:a yoga are increased mentalstimulation and an ability to handle stress. !oga encourages theindi&idual to sensiti7e himself or herself to their limits while teachingthat physical limits often change.

    (ecause yoga strengthens the musculoskeletal system, your back, asdo your abdominal muscles, benefit. (ecause breathing andrelaxation are a part of yoga, stress is reduced and fresh oxygenflows to the muscles.

    ;nce you"&e had a back attack, yoga works in a slow, methodicalmanner to stretch and strengthen the muscles. !oga takes a holisticapproach that a back problem is not isolated from the rest of yourbody.

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    #f #"&e ne&er taken yoga where do # start3

    Hisit a yoga class and talk to the instructor. #f you are practicing yogato strengthen your back, ask about specific postures. ?any exercisesprescribed by specialists or that are currently part of back schools,deri&e from yoga. #t is &itally important to search out a yoga class oran instructor who understands yoga postures, specifically designedfor back problems. A person with a back problem does not belong ina generic hatha yoga class. Look for a class, and an instructor whospecifically has a background in yoga regarding back problems. $ustas each back problem is uni8ue, so is each instructor. %eek out ayoga teacher who understands your back ailments. #f there is a yogainstitute in your city, call and ask for a referral. ;ften uni&ersities orcommunity colleges offer yoga classes, as do senior citi7en centers.

    The !oga $ournal has a list of yoga instructors, classes and retreatsaround the country. A good instructor teaches you to pay attention toyour own signal of distress. #t is also your responsibility not to pushyour body beyond its limits, :ust because e&eryone else is doing aposture. A bad back will not fare well in a yoga class filled withhealthy backs.

    )urther information can be found at=

    !oga ;nline


    ;ne of the most common surgical procedures is a diskectomy, theremo&al of a herniated disk to relie&e pressure on a ner&e root. Thefirst step is to remo&e a portion of the lamina of the &ertebra. Thelamina is the portion of the &ertebra that forms the roof o&er the spinalner&es. Remo&ing a portion of the lamina creates a window into thespine. The ner&es are then pulled to the side so that the herniateddisk can be seen. %mall instruments are then used to remo&e theherniated disk material. ?ost of the nucleus pulposus is remo&ed topre&ent the disk from herniating again. ;nce the disk material isremo&ed, the ner&es are free of pressure and irritation. The lamina

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    and the area of the disk that is remo&ed fill with scar tissue&ery rapidly.


    The term laminectomy is deri&ed from lumber 1lower spine2,lamina 1part of the spinal canal"s bony structure2 and0ectomy 1remo&al2. The operation is performed to relie&epressure on one or more spinal ner&e roots. This pressure,

    often called ner&e root compression or a -pinched ner&e-, is whatoften causes back and leg pain.

    Ner&e root compression is caused by=

    Ruptured disc 0 Also called a protruded, slipped or herniateddisc.

    %pondylosis 0 eterioration or -wear and tear- of multiple discswith bony spur formation and degenerati&e disc.

    %car tissue ombination of the abo&e factors

    Lumbar laminectomy surgery is performed with the patient lying onthe abdomen or side after being put -to sleep- with general

    anesthesia. The surgeon reaches the lumbar spine through anincision in the lower back. After the muscles of the back are spreadapart using a retractor to expose the lamina, a portion of one or more&ertebra are remo&ed in order to reach the compressed ner&e root1s2.;nce the point where the ner&e is being compressed is located, thesource of the pressure is remo&ed. That may in&ol&e either=

    Remo&ing the ruptured portion of the disc Remo&ing the bony spurs and bony o&ergrowth

    Remo&ing the scar tissue.

    The operation normally takes approximately E hours. The skin layer isclosed with either steri0strips, sutures or skin clips that will beremo&ed at a later date. A large dressing will be placed o&er theincision for protection.

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    What To 'xpect After %urgery

    A plastic drain will be seen through the surgical dressing to remo&eany blood that accumulates in the surgical area. The drain willprobably be remo&ed on the second day after surgery. The dressingwill also be changed and a smaller one applied.

    An #H may remain in your arm for two to three days to administerantibiotics or other medications you may need. This helps pre&entinfection and gi&es you proper nourishment until you are eating anddrinking comfortably. !ou will begin regular fluid and food intakeunder the direction and ad&ice of your surgeon. !ou may be gi&en a-pain pump- or *A0patient controlled anesthesia pump for the first 4to E days after surgery.

    After the acute pain has diminished, usually the day after surgery, aphysical therapist will help you begin standing and walking again.They will also show you the proper way to get in and out of bed, sitand stand, and sleep position.

    *ain#t is normal to ha&e pain after your operation. #t will be most se&ere inthe lower back area where the surgery was done. Residual leg pain isnot unusual, this is caused by swelling of the pre&iously compressed

    ner&e as well as from surgery itself. There may be muscle spasmsacross the back and down the legs. ?edication will be perscribed tohelp relie&e the pain and Kor spasms.

    onstipationonstipation is a significant side effect of the pain medication. !ourdoctor will order a laxati&e to relie&e constipation. We alsorecommend a diet of whole grain cereals, fruit and fruit :uices.


    #nitially, you are permitted to get out of bed following surgery withassistance from a nurse. Thereafter, you should be up walking asmuch as tolerated. The goal is to do more walking each day. %tartwith short trips and set a graduated pace so that each day moreacti&ity is accomplished. The easiest way for you to get out of bed isto raise the head of the bed as far as it will go, balance yourself in asitting position, then stand with weight distributed on the skeletal

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    frame, to a&oid straining of back muscles. A&oid prolonged sitting.#nitially, you should only sit for meals.

    but slowly, one step at atime. !ou should be acti&e, walking as much as possible, but a&oidbeing tired. Lie down to rest as needed. A&oid prolonged sitting. !oumay sit in a hardback wood chair for meals and short periods. 14904Dminutes three times a day2.

    Walking each day is excellent exercise. !ou should begin with shorttrips and increase your distance up to C0D miles daily. This will takeno more than one hour per day. A&oid pulling, pushing or lifting. #n the

    future, always protect your back when lifting or bending. *roper bodymechanics in&ol&e using your knees and not your back during theseacti&ities.

    +a&e a family member check the incision line daily at home. #fincreased redness, swelling or drainage occurs andKor you de&elop afe&er, &isit your doctor. %exual relations are permissible withinreason, but be sure not to strain your back. !ou may take short tripsin the car after two weeks, but should a&oid dri&ing the car yourselffor approximately three weeks.

    Puestions regarding your return to work are best discussed with yoursurgeon at the first postoperati&e checkup. The return date willdepend on a number of factors, including the type of work you do,your particular problem and your postoperati&e condition.

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    !ou will ha&e -good- days and -bad- days :ust as you did at thehospital.Nights may be uncomfortable> use of a heating pad may be of benefit.

    %pecial #nstructions

    )ollow0up to remo&e staples will be scheduled for ten to fourteendays following surgery. Another follow0up to see progress will bescheduled four to six weeks following surgery. ;ther follow0ups whichmay continue for as long as a year after surgery, will be scheduleddepending on progress.

    Spinal .uion

    'xtracted fromAugusta ;rthopedic %urgery

    Another type of spine surgery is spinal fusion. The diseased disc andlamina are first remo&ed. *ieces of bone are remo&ed from your hip1donor2 and are placed along the spine and between the &ertebrae.This is called bone grafting. When the bone heals, this is called abone fusion and the &ertebrae no longer mo&e separately. This fusiontakes three months to heal.

    #ndications for %pinal )usion

    When a disc ruptures, the hydraulic effect of the disc is disrupted.The facet :oints 1the :oints between two &ertebrae2, muscles, andsurrounding ligaments are re8uired to take o&er the :ob of the disc. #fthe disc does not heal, it is said to be degenerati&e. A degenerati&edisc is not able to support the weight of the body and the spacebetween &ertebra narrows. When the space between two &ertebranarrows, so do the holes 1or foramen2 that the ner&es pass through.

    This causes the ner&e to be pinched and results in leg andKor backpain. ;&er time the facet :oints become arthritic, get larger, andde&elop bone spurs.

    This is called spondylolisis and narrows the formen e&en further.)inally, as the facet :oints become arthritic and lose their cartilage,they begin to slide on one another. This allows one &ertebrae to @slip

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    Anterior Approach to %urgical )usions'xceedingly informati&e site on anterior fusions, esp. for the cer&icalarea.

    -ages- #nstead of Rods%maller, more flexible than rods, could these be the answer totraditional fusion methods3

    omplications of Anterior )usionRisks to interior organs when doing anterior surgery.

    )A Appro&es New e&ice;n %eptember E6, 455I, the )A appro&ed a new de&ice for use inspinal fusion of degenerated disks.

    Leg *ain After Lumbar )usionThe Neurology and Neurosurgery )orum offers you a place to getanswers to your fusion 8uestions.

    *edical %crews*ro&ides a timeline of pedicle screw de&elopment and recent legalrulings.

    *osterior Approach to er&ical )usion

    Wheeless" Textbook explains posterior approach to fusions.

    %coliosis and )usion%pinal fusion is one of se&eral treatments for scoliosis.

    %coliosis )usion%outhern alifornia ;rthopedic #nstitute defines scoliosis and fusionwith excellent graphics.

    %pinal )usion

    #nformation from %pine ni&erse.com

    %pinal )usion Q (A/ age %urgery#nformation from Augusta ;rthopedic %urgery

    B"1 /age

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    'xtracted fromAgusta ;rthopedic %urgery

    This surgical procedure is used when there is se&ere enough disc

    degeneration and narrowing that more space is needed between thebones of the spine. A small cylinder is placed between the bones ofthe spine to hold them apart. The cage has holes in it and the bone

    grows in and around it, holding it in place. This relie&es thepressure on the ner&es of the spine and patients are usuallyable to return to a more acti&e lifestyle and control theirback pain.

    The purpose of a spinal fusion is to eliminate painful motion thatoccurs at that spinal segment.

    There are many techni8ues used to fuse spinal segments. The mainad&antage touted in fa&or of the (A/ cage is that it can be donethrough a limited exposure.

    The (A/ cage is typically inserted from the anterior or frontalapproach &ia a laproscopic procedure. Thus it re8uires no largeincision and tissue trauma can be limited. Reco&ery time is therebyminimi7ed.

    The (A/ cage allows the patient to be up and about without a hardplastic brace. +owe&er, the (A/ fusion cage depends on the bone

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    healing from one &ertebra through the cage to the other &ertebra. #t isimperati&e that the patient not smoke. %moking decreases bloodsupply 1because of the nicotine2. %pinal fusions re8uire a good bloodsupply to heal and the process can take up to C months.

    ;nce the pinch on the ner&e is remo&ed, the patients legs feel betterand stronger almost immediately. The patient will experiencemoderate back discomfort, howe&er. A lumbar corset can be worn forsupport. The intense back pain resol&es 8uickly 1E06 days2, but theresidual nagging back ache lasts up until the fusion is healed.

    The procedure must still be considered experimental. #t is not widelya&ailable. #t is also technically demanding and takes alot ofexperience to master the techni8ue. At this time there is promise for

    the procedure, but one must be &ery cautious about pursuing thesurgery, re&iewing the credentials and experience of the surgeons.

    )urther information can be found at=

    (A/0 cage, (A/ cage, fusion spine, back pain 1Asia?edicineNet.com2

    2rthopedic Surgeon

    ;rthopedic surgeons speciali7e in the medical and surgical treatmentof disorders and in:uries to the bones, muscles and :oints. Withinorthopedics, there are also subspecialties. ;rthopedic surgeons canchoose to pro&ide general care, pediatric care, care to cancerpatients, or can focus on specific areas of the body, such as theshoulder or spinal cord.


    -%cience of applied neurophysiologyic diagnosis based on the theorythat health and disease are life processes related to the function of

  • 8/12/2019 Spine Inc.com


    the ner&ous system> irritation of the ner&ous system by mechanical,chemical or psychic factors is the cause of disease> restoration ofhealth and maintenance of health depend on normal function of thener&ous system. iagnosis is the identification of these noxiousirritants and treatment is their remo&al by the most conser&ati&emethod.-

    What is hiropractic3

    hiropractic is a branch of the healing arts which is based upon theunderstanding that good health depends, in part, upon a normallyfunctioning ner&ous system 1especially the spine, and the ner&esextending from the spine to all parts of the body2. -hiropractic-comes from the

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    column, causing irritation to spinal ner&e roots. These irritations areoften what cause malfunctions in the human body. hiropracticteaches that reducing or eliminating this irritation to spinal ner&es cancause your body to operate more efficiently and more comfortably.

    hiropractic also places an emphasis on nutritional and exerciseprograms, wellness and lifestyle modifications for promoting physicaland mental health. While chiropractors make no use of drugs orsurgery, octors of chiropractic do refer patients for medical carewhen those inter&entions are indicated. #n fact, chiropractors, medicaldoctors, physical therapists and other health care professionals nowwork as partners in occupational health, sports medicine, and a wide&ariety of other rehabilitation practices.

    'xtracted from www.chiroweb.com

    What do hiropractors do3

    hiropractors diagnose and treat neuro0muscular skeletal disorderssuch as spinal problems and sporting in:uries.

    hiropractors may perform the following tasks=

    treat patients by ad:usting the spinal column to manipulate:oints and soft tissues

    assess disorders by discussion, obser&ation and examination ofpatients, and by using diagnostic e8uipment such as x0rays,spinal analysis and elecromyography

    reduce physical interference to the ner&ous system, which maycause pain, impairment of normal function or loweredresistance to disease

    prescribes treatment to be followed including pre&entati&e and

    correcti&e exercise and diet refer patients to other health professionals as appropriate

    The $ob

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    )urther information can be found at=

    What is hiropractic are3hiropractic is the health maintenance of the spinal column, discs,related ner&es and bone geometry without drugs or surgery.The or octor of hiropractic spends a minimum of six yearsstudying the ner&ous, muscle, and skeletal system interactions, tooptimi7e these systems for each indi&idual patient"s uni8ue situation.

    Worldwide hiropractic irectory)ind a hiropractor or hiropractic %pecialist near you

    hiropractic )or !our (ack *ainTell ?e About= (ack *ain

    hiropractic )or !our Neck *ain Q WhiplashTell ?e About= )or !our Neck *ainQ Whiplash

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    onsumer %afety

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    hiropractic +istory


    *rosthetistsKorthotists are responsible for the pro&ision of prostheses

    1artificial limbs2 to people with amputations, and orthoses 1supporti&ede&ices2 to people with muscular and skeletal disabilities. They aim tomaximise the function and comfort of the client by pro&iding the mostappropriate prosthetic or orthotic treatment.

    *rosthetistsKorthotists may perform the following tasks=

    assess clients" needs by physical examination assist physicians in pre0surgical planning and in the formulation

    of prescriptions for prostheses design, fabricate, fit and align the prostheses or orthoses e&aluate the effecti&eness and comfort of these aids record and report clinical information pro&ide ad&ice to other health professionals and clients super&ise support personnel.

    *rosthetistsKorthotists may work with prostheticKorthotic techniciansand other health professionals.