Disc Chiropractic
Disc Chiropractic
What is chiropractic “Flexion-Distraction Decompression” Technique?
Flexion-Distraction Decompression Technique has become the most widely used approach to treating symptomatic disc injuries involving back pain and the often accompanying leg pain or sciatica in USA. Unfortunately, only a few doctors of chiropractic utilize this technique in Australia. Dr Perkoulidis has over 25 years clinical experience in Flexion Distraction and while he was a University lecturer, he developed, taught and was the author of the program at RMIT University. He also successfully adapted the principles and practice of this method in the treatment of cervical and thoracic spine intervertebral disc protrusions and prolapses.
Flexion Distraction Therapy involves the use of a specialised and skillful technique which is applied with the use of a specific treatment table that gently distracts or stretches the spine and which, in turn, allows Dr Perkoulidis to manually isolate and suspend the exact area of disc involvement at a determined angle.The spine is then flexed in a gentle pumping rhythm. There is no forceful manipulation and usually there is no pain involved during treatment. There are two types of treatment, one with a manual table and one with a motorized table.
Clinically, the decompression and distraction of the disc combined with isolation of the involved area allows the inner area of the disc{the nucleus pulposus} to assume its central position in the disc.
The Flexion Distraction Decompression technique increases the interval between the vertebrae, thus enlarging the space into which the disc bulge or prolapse can recede. Dr Perkoulidis skillfully applies gentle pressure to the involved disc thereby isolating and reducing the disc prolapse and any associated nerve compromise or damage. These actions move the disc away from the spinal canal and its contents including spinal nerves. This relieves the central spinal canal pressure and reduces the inflammation in the canal around the disc and the nerve root. Thus the associated pain, discomfort and disability in the back, neck, arms and legs is resolved.
Treatment is applied specifically to the individual based on an accurate clinical examination and diagnosis. The reults of all xrays, CT scans and/or MRI findings are studied and are used to guide the treatment.
Flexion Distraction is applied in a series of treatments combined with adjunctive therapy, supplementation, and home instructions. The rehabilitation process includes a muscle strengthening exercise program which is individually taught to enhance and stabilize the benefits of spinal decompression. Patients are evaluated and monitored throughout the treatment program.
Dr Perkoulidis studies all xrays & scans and takes the time to explain these findings to all his patients. He often says: "To see is to know & not to see is to guess. I refuse to guess with your health!"
The Agony of Back Pain can be fixed!
A Scientific Method
Dr Paul Perkoulidis
Diagnostic conditions treated by “FLEXION DISTRACTION DECOMPRESSION” Technique:
1.Low back, mid back and neck spinal disc bulges, protrusions, prolapses and disc herniations.
2.Nerve injuries like back related sciatica and neck related brachial neuritis or neuralgia.
3.Abnormal curvature of the spine and Functional Scoliosis.
4.Failed Spine Surgery Syndromes.
5.Degenerative Joint conditions like osteoarthritis of the spine.
6.Compression fractures of the spine.
7.Functional spinal stenosis.
8.Spondylolisthesis
9.Spinal facet syndrome, Vertebral joint dysfunction and Subluxation.
10.Musculoligamentous conditions.
Normal spine anatomy
CT scan of disc prolapse which encroaches on the intervertebral foramen causing sciatic symptoms.
Large L5/S1 disc prolapse
Spine disc injury anatomy
Benefits of “FLEXION DISTRACTION DECOMPRESSION” Technique:
1.Reduction and resolution of disc prolapse, disc protrusion and herniation.
2.Reduction of spinal stiffness by improving spinal joint mobility and flexibility.
3.Reduction of inflammation and swelling.
4.Reduction of vertebral joint dysfunction, subluxation and misalignment.
5.Improvement of blood supply and circulation to congested spinal joints and tissues.
6.Restoration of normal nerve function.
7.Reduction of functional central spinal canal and foraminal compromise and stenosis.
8.Importantly, relief and resolution of pain, discomfort and disability thereby improving one’s quality of life, capacity to work and ability to perform normal activities of daily living.
Reversal of cervical spine curve{lordosis}with loss of disc space at C5/C6 & C6/C7 with disc protrusions confirmed later by MRI scans
MRI cervical spine disc protrusion
CT Scan of large disc prolapse at C5/C6 causing spinal cord and nerve root compression. Treatment with Dr Perkoulidis completely resolved the disc prolapse.
Plain Xray of same patient with C5/C6 large disc prolase
Causes of Disc Protrusion or Herniation:
The Intervertebral Disc is a fibrocartilagenous structure which consists of rings of fibres which surround and contain a gel-fluid called nucleus pulposus. It proper function is essential in that it seperates the vertebrae, acts as a shock absorber and distibutor, as well as allowing for normal spinal and body motion to occur.
There are many causes which may lead to disc damage and some include: injuries, bad posture, lack of exercise, inadequate nutrition, repetative lifting, bending and twisting activities, excessive sitting or driving etc.These when combined with the effects of daily wear and tear, makes it is easy to see why discs herniate or protrude.
In general, there are four stages of disc herniation:
1.Disc degeneration-where chemical changes associated with aging results in the weakening of the disc.
2. Prolapse-the position and internal structure of the disc changes with a degree of movement into the spinal canal. Clinically, 'prolapse' is the generic term for disc bulges and protrusions and they are so defined by estimation of size the deviation from normality.
3. Extrusion-where the gel-like nucleus pulposus breaks through the outer layers or annulus fibrosus of the disc but the disc is still in tact.
4. Sequestration-where the disc fibres become broken and the nucleus breaks through and parts of the disc proper lie outside the disc confines into the spinal canal as fragment or pieces..
Acute phase of disc protrusion
1st Phase of Degeneration after disc injury
Advanced phase of deterioration following disc injury
Final phase of degeneration after disc injury
The purpose of Flexion Distraction Decompression Therapy is to increase the interval between the spinal segments,ie the vertebrae, thus enlarging the space into which the prolapse must recede to allow the nucleus pulposus to assume its central position within the annular fibrosus.As well, flexion distration tightens the spinal joint capsules allowing the spinal ligaments to exert a centripetal force all around, thus tending to squeeze the pulposus back into place. It is estimated that this opens the vertebral canal by 3.5mm to 6mm more than extension as it increases posterior disc height.
Other physiological effects of Flexion Disctration Therapy include: relief of muscular spasm and fatigue; improvement of local vascular supply; relief of spinal nerve root congestion; "micro-massage" effect by increasing molecular movement and membrane permeability; dispersion of inflammatory fluids; increase rate of metabolic transport into the disc; reduction of intradiscal pressure which drops to below 100mg/Hg.
By reducing the disc prolapse the normal, physiological vertebral joint motion is re-established resulting in improved motion and posture.Overall, clinical management and treatment protocals are aimed at keeping the intradiscal pressure low enough for long enough to allow adequate healing of the disc's annulus fibrosus. If this does not progressively heal subsequent tearing may recur with further disc prolapse and complications. The possibility of exacerbations are reduced by adhering to Dr Perkoulidis' after-care instructions and home advice.
Votes:0
Comments: 0