Lower back paincan arise from many sources including facets, sacroillac joints, ligamental instability, muscular dysfunction and the lumbar disc. Discectomy is a common surgical procedure for lower back pain where the disc bulge is surgically trimmed. In the short term this may be beneficial but in the long term it can result in progression of the degenerative process by compromising the integrity and blood supply of the disc.
The disc is composed of two principle components: the annular fibrous and nucleus pulpopus.
The annulus is a ring of strong ligamental fibers that encircle the inner core of the disc. The nucleus pulpopus is the inner core and is compromised of jelly like material. The annulus fibrous functions to prevent the nucleus pulposus from leaking out. It is best thought of as the sidewall of a tire. It is also the only part of the disc that has a significant blood supply.
A discectomycuts through the sidewall of the disc thereby weakening the fibers that contain the nucleus pulpopus and compromising the blood supply to the disc.
Regenexx offers patients an alternative to surgical therapies by using their own stem cells to regenerate the damaged sidewall of the disc. To understand the potential of stem therapy please click video.
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Lumbar disc bulges are a common cause of lower back and leg pain. Common therapies for lumbar disc bulgesinclude physical therapy, lumbar traction, inversion table therapy and lumbar epidural steroid injections. The goal of therapy is to decrease the disc bulge and its compressive effect on the nerve root. If nerve compression is left untreated, it can result in permanent leg pain and weakness.
Lumbar epidurals steroid injections should always be performed under x-ray to ensure accurate placement of the medication. The epidural space is the area immediately outside the spinal cord and is adjacent to the lumbar disc.
If a lumbar epidural steroidis performed without x-ray there is no guarantee that the medication will get into the epidural space let alone on the irritated nerve root and disc. At the Centeno-Schultz Clinic all lumbar epidurals are performed under x-ray. Injection of contrast prior to the injection medication, ensures accurate placement. The x-ray below demonstrates contrast flowing along the right L5 nerve root with extension into the epidural space.
If conservative therapy or lumbar epidural steroid injections fail to provide sustained pain relief, patients now have the option of using their own stem cells to repair their lumbar disc bulges using the Regenexx procedure. Regenexx is a simple needle in-needle out procedure which affords patients the opportunity to avoid the risks of surgery and anesthesia and repair disc bulges.
Review the video below on how stem cells can be used to treat disc bulges.
Chronic lower back pain can arise from many sources. Unfortunately many patients are not provided a thorough examination and evaluation by a physician specializing in pain management. Often times patients are reflexively placed on muscle relaxants and narcotics with no effort to identify the source of back pain. If the pain does not resolve some patients are offered low back surgery. Regrettably both of these options to treat chronic back pain have the potential of making it worse. At the Centeno-Schultz Clinic we are committed to identifying the source of lower back pain so the correct treatment plan is selected.
For example, chronic back pain due to a disc bulge with compression on the nerve can be successfully treated with a stem cell injection into the disc. Patients now have the option of using their own stem cells to repair lumbar disc bulge at Regenexx.
Below is an MRI of the lower back. On the left, note a disc bulge. On the right, following a stem cell injection there is a marked reduction in the disc bulge. The patient had 100% pain relief.
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