Neuropathy and Spondylosis

Chiropractic Care Can Help Patients with Neuropathy and Spondylosis

We all see patients with chronic pain that may not be related to a
direct inflammatory process, and the examination reveals no hard
neurological signs (diminished reflexes, etc.). Gunn states that there
are functional and/or structural alterations within the central or
peripheral nervous systems, i.e., neuropathy. Neuropathic pain is
associated with abnormal nerve function and/or hyperactivity at some
level in the pain sensory system.

Neuropathic Pain Begins in the Spine and Has a Gradual Origin

The most common cause of neuropathy is spondylosis. He states that
"the spinal origin of neuropathic pain is not always obvious because
spondylotic degeneration follows a gradual, relapsing and remitting
course that is silent. Pain can arise with no history of trauma, and
laboratory, radiological and other tests are unhelpful." Spondylosis,
which refers to the structural disintegration and morphologic
alterations in the intervertebral disc and pathoanotomic changes in
surrounding structures, can eventually cause simultaneous damage to
the nerve roots (radiculopathy) and cord (myelopathy). Gunn speaks of
a prespondylosis which may be symptomless until trauma occurs. A
neuropathy may appear. With an acute injury to a healthy nerve there
is no prolonged discharge of pain signals, whereas, the same injury to
a neuropathic nerve affected by a prespondylosis can cause a sustained
discharge. This may explain why people with spondylosis and no
symptoms can have minor injury and the pain can exist beyond a
reasonable period.

Spondylosis Increases with Age and is More Common among Middle Aged People

Because spondylosis increases with age, spondylotic pain is more
common in middle-aged individuals. They have accumulated an "injury
pool" or an accumulation of repeated major and minor injuries to a
segment leading to unresolved clinical residuals, which may or may not
produce pain. The most important manifestation of neuropathy, besides
sensory and autonomic findings, is the motor sign of muscle shortening
from spasm resulting in ropey bands in muscle, which may eventually
become fibrotic or focal areas of tenderness called trigger points.
Gunn states that in radiculopathy, these tender spastic muscles can be
found throughout the myotome, contralaterally, and in paraspinal
muscles. Gunn feels that shortened muscles can mechanically stress
muscle attachments leading to tendinitis, epicondylitis, and in
muscles crossing a joint which can increase joint pressure, upset
alignment, cause facet joint pressure, and precipitate pain in the
joint, eventually causing degenerative changes. He even believes that
shortening in paraspinal muscles acting across a disc space can
compress a bulged disc irritating the nerve root. Pressure on the
nerve root will cause more spasm and result in further nerve root
compression.

In radiculopathic pain, tender muscle bands will appear in myotomal
muscles supplied by both the anterior and posterior primary rami. For
pain in the knee, Gunn would seek the tender bands not only in the
quadriceps femoris muscles but also in the paraspinal muscles at the
same segmental levels (L2-L4). He states that while back pain is most
common at L5-S1 levels, more often than not, higher segmental levels
are involved, frequently reaching dorsal and cervical levels.

By Warren Hammer, MS, DC, DABCO

As we can see this article soft tissue treatment can help relieve the
pressure from nerve root which could cause ridiculer pain.
The treatment of this condition should be emphasized on not only
chiropractic manipulation for joints also soft tissue treatment for
surrounding structures including soft tissue and fascia.

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Dr. Hyunsuk Oh graduated from Life University in Marietta, Georgia. Dr. Oh currently holds licenses to practice chiropractic in Maryland and Virginia. He is a member of the Maryland Chiropractic Association, American Chiropractic Association and International Chiropractic Association. Dr. Oh has undergone extensive training and has earned the designate of Certified Chiropractic Extremity Practitioner (CCEP) from the Council on Extremity Adjusting. He has also obtained  certification as a Golf Rehabilitation Specialist through Blanchard Institution. Dr. oh has achieved Advanced Certification in the Graston Instrument Assisted Soft-Tissue Mobilization (GISTM) technique (or Graston Technique), a highly advanced and efficient technique developed for treating soft tissue pathology.  He also has achieved Advanced Certification in the SASTM (Sound Assisted Soft-Tissue Mobilization).   Dr. Oh is also a full body licensed provider of Active Release Techniques (ART).  This technique is highly effective for treating a whole host of soft tissue and nerve entrapment issues.   ART is a favorite technique of triathlon participants, volleyball players, marathon runners, and athletes of all sports. Dr. Oh is also a Certified Kinesio® Taping Practitioner (CKTP®). The Kinesio® Taping Method is one of the most sophisticated taping techniques in the world.  It allows for facilitation, inhibition, and functional corrections of the musculoskeletal system.