Re: Protruding Disks Part 2

[Guest guest]

Subluxations - causes and treatments.

Per " A Massage Therapist's Guide to Pathology " by Ruth Werner, the

technical definition of subluxation is " An incomplete dislocation;

though a relationship is altered, contact between joint surfaces

remains. "

The vertebrae do not technically " lock " together. The meet, top and

bottom, with a bony protrusion on each side of the upper vertebrae

called a " process " which sit in small depressions called " facets " on

the upper surface of the lower vertebrae. They are actually " joined "

together by ligaments. The whole structure is then held in place by

the surrounding muscles.

For those who get confused or are not sure at all, ligaments join

bone to bone. Tendons join muscle to bone.

Spinal subluxations can be caused in a number of ways. The most

common expression is that someone " threw their back out. " The

reality is that they did something which generated enough force to

shift a vertebrae out of its normal " process-facet " relationship.

This could be from a major trauma such as an auto accident, a fall,

or a sudden twisting, jerking motion.

Or it could be something as simple as bending over to tie their

shoes. And then there are times for those of us with EDS when we

simply haven't got a clue. It just plain " got us again. " It is

actually pretty easy to figure this one out. Ligaments and tendons

are just two forms of connective tissue.

If the " connective " tissue is weak, it can't do the intended job of

holding things in place. In this case, even something as simple as a

tight muscle on one side can be enough to destabilize the

relationship and cause a subluxation.

So much for cause. We all know the effect.

Now, what about treatments? As I said before, there are many. It

all depends on your choice of health care provider and the type of

service they perform. You can, however, break it down into three

broad categories: General Medicine, Manipulative Medicine, and

Bodywork.

For general medicine, you can expect one of four alternatives: drugs

(muscle relaxants and pain killers), bed rest, traction and

surgery. Depending on severity, surgery can include either repair

or removal of a disk combined with spinal fusion. The basic premise

of the first three is that the subluxation is being caused by an

uneven tension of the connective tissue, such as a muscle in spasm

causing a contraction that is pulling things out of position.

Step one is usually to stuff you full of drugs. They give you a

muscle relaxant which causes the involved muscle to relax, allowing

the vertebrae to shift back into place by itself. They give you the

pain killer so you can tolerate the situation until the muscle does

relax. For those who are pill averse, the treatment is usually bed

rest for a few days (or longer). The bed rest takes the strain and

aggravation off the muscle, allowing it to relax over time. Traction

isn't much more than enforced bed rest with the addition of a very

light weight to apply a counter tension. But the results are the

same with any of the three. The only difference is the means used

to achieve the results.

Surgery frankly should only be employed in the most severe

situations. The most obvious one is a ruptered disk, although there

are alternatives even in this case. But for EDS, I suspect that

surgery more often than not is used on the premise that the

connective tissue simply is NOT doing its job. Therefore, we

eliminate future subluxations by fusing the involved vertebrae

together. If they are fused, they can't shift. If they can't

shift, they can't subluxate.

The second broad category is Manipulative Medicine. This is also

broken down into sub-categories: Chiropractic and Osteopathic. Both

modalities use methods which mechanically put the vertebrae back in

position. For chiropractic, it is called a " thrust adjustment. "

Basically, they realign the spine in the proper position and then

literally apply sufficient sudden pressure to force the vertebrae

back where it belongs. I have been told by doctors in the past that

it takes 300 pounds of pressure to do it.

Osteopaths may also use a thrust adjustment technique. The

techniques are similar but not always identical. I have found in my

own experience that the ones used by Osteopaths seem less traumatic

to receive. But many of them also use techniques such as Passive

Positional Release. What this entails is that the practitioner

moves the patients body into a position where the contraction or

spasm is released and then holds that position until the muscle

relaxes and the vertebrae shifts. Osteopaths are also licensed to

be able to prescribe medications where chiropractors are not.

The third category is Bodywork. And once again, I will break this

down into two broad categories. The first covers " massage " intended

to relax the muscle. Again - same goal as above - just a different

way of getting to that goal. There are literally dozens of " styles "

of massage, such as Swedish or Thai, but the focus is on " working

on " the muscle to relax it. The second category is energy work,

especially things like polarity but also including acupressure or

acupucture.

The big difference between " massage " and energy work is that with

massage, spontaneous " adjustments " sometimes happen. The muscle

relaxes, the vertebrae shifts. With energy work, especially

polarity, the focus is on actually getting an " adjustment " to

occur. This happens because energy appears to operate on both soft

tissue and bone. At least that has been my experience with it. At

times I can't tell whether the bone is moving first or the muscle is

relaxing first. I do know that with straight massage, getting the

adjustment is just hit or miss. It may. It may not. But when I am

doing an energy treatment, it is almost automatic that the

adjustment will take place.

I can also tell you that since I started doing it, none of my family

have had to go to either a chiropractor or osteopath (except two

occassions when either Barb or Kerry decided to have an " incident "

when I was on one of my trips and they couldn't wait until I got

home.) And I would guess that I work on one of the three of them at

least once a week for this, and probably more often than that.

Which one depends on who is the klutziest at the time.