ArizonaBackInstitute

By Randall C Pruitt, DC, DACNB, DAAPM, FACFN, MUAC, CES-NASM

Here at the Arizona Back Institute we see a lot of unfortunate souls who have really been put through the ringer when it comes to their back and neck pain treatments. If you don’t know already, my practice really deals mostly with this type of patient and very rarely do we see someone who just hurt their back yesterday. We see really chronic cases that have been going on for months to years. These patients not only have a lot of pain, but they also have very weak and atrophied spinal muscles which in and of itself promotes further damage.

Therefore, a big portion of my program centers on the use of very specific and progressive exercise to restore spinal function and stability. This is an integral part of the process and one that really cannot be skipped. Most people in our society unfortunately are not big on prevention and are de-conditioned to begin with. And we go about our daily lives not really thinking of preventing things like back pain because it doesn’t seem as important as things like cholesterol and heart disease and the other conditions that can potentially kill us. But trust me many of my patients would have done things a lot differently if they only knew.

With prevention in mind let’s take a look at a review on the primary prevention of back pain by Stanley Bigos MD professor of orthopedic surgery at the University of Washington. He and his colleagues conducted a systematic review to see whether any primary prevention method found support in high quality clinic trials. And they concluded that medicine and industry may have overlooked an effective prevention strategy: exercise in both the workplace and community settings. In this review the researchers found strong and consistent evidence that exercise had a significant impact , both in terms of preventing symptoms, and reducing back pain-related work loss. They also noted that with the exception of exercise no other prevention method had strong scientific evidence to support it. Things like belts, shoe inserts even ergonomic training.

I always find it interesting that common sense things like using exercise to reduce back pain, need to be studied over and over again and proven with more and more studies. I am sure that you probably already knew you needed to exercise more and that you feel better overall when you do, not to mention your back doesn’t hurt as much or as often. But nonetheless as doctors we need to make sense of things and prove it once and for all before we can sit back and say with conviction that exercise reduces the prevalence of back pain.

Even treatments like spinal decompression make sense to people. When I go into detail with a patient about how the discs are injured or how they heal and explain the role of spinal decompression most people “get it”. It makes sense and in over 12 years of offering it and with over 10,000 people coming through my door, I am convinced it is THE best treatment for disc related back and neck pain, bar none. The problem is that by itself it can’t prevent a re-occurrence of back pain, that is where prevention comes into play and our type of prevention is utilizing MedX technology to strengthen the back and neck to a point where you are normal for your age and weight. Then it is up to you to exercise on your own to maintain good spinal health. Don’t worry we’ll give you the tools, but you have to use them.

I applaud the authors of the above study, because sometimes things need to be spelled out for us before we’ll really take them seriously.

By Randall Pruitt, DC, DACNB, DAAPM, FACFN, MUAC, CES-NASM

Over the past 12 years I have offered a program centered around spinal decompression. In those 12 years I have steadily improved on my program and have added techniques and technologies that I have found to be valid and results producing.Therefore, I can honestly say that my program works for the majority of chronic back and neck pain sufferers. So when a study comes out that inadvertently proves what I have seen in my practice for many years I get a bit excited.

To explain this,let me start with a common question I get from patients and that is “would it help if I lost weight”? Referring to their current and ongoing back pain. In the past my knee jerk reaction was always…it certainly couldn’t hurt, but I always knew intuitively that their weight really wasn’t the issue. The other question I answer routinely is, “can my disc really heal, because my doctor said it can’t” and my answer to this questions is always “of course it can, they just have yet to see what I have seen in my practice.”

Now you may not see the relationship between these two questions, but the correlation is profound, which brings me to the study I mentioned above. You see recently at the meeting of the North American Spine Society a paper was presented that came to some rather alarming conclusions. These particular researchers looked at identical twins to determine certain factors on disc degeneration and what they found was unexpected to say the least. The twins involved in this study had one very important difference, one of the twins was at least 30 pounds heavier then the other. What they were looking for was how this impact of extra weight would effect the discs in the lumbar spine. Would there be accelerated degeneration? Would there be more disc breakdown? Would the situation in general for the spines of these overweight twins be worse in comparison to their lighter sibling?

On completion of the study several finding were relayed. The overall message was that being heavier actually slowed down the process of degeneration. What??? That is precisely the opposite of what most would expect, right? Well, here is what they found…Higher body weight was associated with a 6.2% higher bone density in the lumbar spine, Disc signal results were 5.4% higher (better) in the heavier twin. The heavier twin also had a greater disc height (2.6% higher) and a higher adjusted disc signal (2.9%).

So am I advocating that you gain an extra 30 pounds to fix your back? Of course not, the take away from this study is simply that the disc is a viable structure! It can adapt and it can respond to stresses. That is why I was excited to see this study, because it clearly indicates the discs ability to heal. Something that I have seen in my practice now for over 12 years!

By Randall C Pruitt, DC, DACNB, DAAPM, FACFN, MUAC, CES-NASM

I recently came across a study in the medical journal Spine that looked at the evidence surrounding invasive treatments for back pain. Guess what they found? Not a lot, and when I come across research like this it makes me mad…why? Because these treatments cost a lot of money and I see in my practice everyday people that have gone through them all and are no better and often worse. Some of the treatments and diagnostic protocols they review included discography, facet injections, epidural steroid injections, spinal cord stimulators and of course surgery of various kinds including disc replacement.

What is interesting is that none of these treatments really cut the mustard in efficacy. There is an interesting phenomenon in health care that when you challenge someones belief system or way of doing things they get a little angry about it so in the conclusions of this study phrases like “clinicians should employ a shared decision-making approach to x or y treatment” was included. I guess this phraseology takes a little of the sting out, but at least to their credit they would go on to say what the discussion should include. For example in the case of spinal cord stimulators they recommended that the discussion include the fact that the panel in this study could not find any sufficient evidence to recommend spinal cord stimulation for failed back surgery syndrome. And in the use of facet injections, prolotherapy and intradiscal steroid injections the panel again couldn’t find any compelling evidence that these treatments work, and they included IDET, medial branch blocks and radio-frequency ablation.

My point to all of this, is that in the world of back pain treatments you really should be informed about what options are available. I have seen thousands of what I would call “failed traditional” cases in the many years I have been practicing. In my opinion spinal decompression really is the most effective treatment I have ever seen in the treatment of chronic neck and back pain. Not to mention it’s safe and actually leaves your spine healthier, unlike most of the invasive treatments mentioned in the study. I see too often the results of long term mismanagement of these cases and it only makes it more difficult to treat. Many patients are left without a lot of options. So before you undergo an invasive procedure look into alternatives like spinal decompression. You’ll be glad you did.

By Randall Pruitt, DC, DACNB, DAAPM, MUAC
Chiropractic Neurologist

If you suffer from chronic back or neck pain and have been told you may require surgery there is a treatment we offer here at the Arizona Back Institute called manipulation under anesthesia. This treatment has been one of our most effective tools for helping patients with chronic back or neck pain.

The treatment is performed in a surgery center with the patient under light sedation. This allows us to go in and gently restore range of motion and break up scar tissue and adhesion’s that have formed in and around spinal joints. The process is repeated over 3 days and then a comprehensive rehabilitation process is started to help restore function and ensure that as scar tissue is reformed it will do so in a way that is appropriate for full motion.

We have treated patients from all over the country with this process and have been able to help the majority of them The selection process is very specific and for properly screened patients the success rate is very high. In fact here are a few studies that have been published on the subject.

-Robert Mensor MD an orthopedic surgeon, compared the outcomes of MUA and laminectomy in patients with lumbar intervertebral disc lesions and found 83% of MUA patients had good to excellent results while only 51% of the surgical patients reported the same outcome.

- Siehl reported on 723 MUA patients, the largest clinical trial conducted on MUA procedures. They found that 71% had good results, 25% had fair results, and 4% ultimately required surgery.

As you can see the results for MUA patients are very good and the fact that it is a non-invasive process makes it a very good choice for chronic back pain and neck pain patients.

by Dr. Randall Pruitt, DC, DACNB, DAAPM, MUAC, CES-NASM

Spinal Decompression has grown in popularity over the past several years, many orthopedists, chiropractors and even spinal surgeons are beginning to take a good hard look for themselves at this technology. Spinal decompression offers doctors an opportunity to make lasting changes to the discs to provide patients with long term results and not just temporary relief, unlike the vast majority of traditional treatments for back and neck pain that focus on symptom relief only.

The concept of Spinal Decompression is one that most people with lower back or neck pain can relate to. Most of my patients have always said they feel like they just need to be stretched or pulled apart. Spinal Decompression is a non-surgical therapy which demonstrates very good long term results for conditions like herniated, bulging and degenerative discs.

There are many decompression systems available vying for market share. The most popular form of modern decompression and the one I personally use is the DRX9000 unit, manufactured by Axiom Worldwide. Many system manufacturers are tout that there system does the same thing, but in my 10 years of experience the DRX9000 is consistently superior. Many of the other devices in the market are nothing more then traction tables, a very different and inferior form of treatment.

I always instruct patients to first try other more conservative forms of treatment first and if those fail, Spinal Decompression can then be prescribed. Spinal decompression should definitely be a first alternative to those facing invasive procedures like laminectomy and fusion surgeries. Spinal surgery is a risky proposition and does not enjoy a very good reputation, based on usually poor curative results. Remember, surgery is always still an option if decompression does not relieve your pain…Spinal Decompression on the other hand is not if a spinal fusion is performed.

Spinal decompression is spreading in popularity and is truly a revolutionary approach to chronic unrelenting back and neck pain. The risks are low and the relief is lasting. Best of all, there is no painful recovery time, as there is after surgery. To learn more about Spinal Decompression you can go to our web site at www.ArizonaBackInstitute.com.

Randall Pruitt, DC,DACNB, DAAPM is a board certified chiropractic neurologist and an authority on spinal decompression for back pain. Click here to learn more about Spinal Decompression In Phoenix Arizona. You can also Order a copy of his Herniated Disc Guide.