BACK/ NECK PAIN RELIEF

How can it be possible that most doctors do not understand the true cause of back and neck pain? Like many people you have been told that the problem with your pain is a specific condition like, Degenerated Disc Disease, Spondylolisthesis, Herniated or Bulging Discs, Sciatica Leg Pain, Stenosis, Arthritis and Scoliosis Spinal Curvature. In 1996 doctors Vert Mooney, MD, Jeffery A Saal MD and Joel S Saal, MD discovered the cause for more than 80% of all back, neck and sciatica pain was the loss of the "Pump Mechanism".  ​I am willing to bet that most readers, doctors included, have never heard of the pump mechanism. ​Well let's dive on...

The spinal disc gets nutrition from a mechanical process called the "Pump Mechanism". This happens naturally in a healthy spine from normal movement. It is similar to applying pressure to a wet sponge, the spinal disc is able to move fluid (nutrition) in and out of the tissues which maintains a healthy structure. Injuries to the spinal disc damage the delicate blood vessels that feed the disc nutrition and stimulate the pump mechanism. When this pump mechanism  fails a disc is unable to transfer nutrition into the cells and it enters a chronic cycle of degeneration, bulging and inflammation  which eventually leads to stenosis (end stage arthritis).  Without this constant supply of blood the discs become ischemic. As the disc continues to degenerate it will leak inflammatory chemicals that produce pain and further injury to surrounding tissues. This is a progressive, degenerative condition. ​

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HERE IS A VIDEO TO EXPLAIN THE PROCESS

Our treatment program resolves 75% of all cases in 4 weeks and 85% in 8 weeks. In a 4 year follow up study those successful cases were still symptom free. (1, 2)​​​

REFERENCES
1. Efficacy of Vertebral Axial Decompression (VAX-D) on Chronic Low Back Pain: A Study of Dosage Regimen Ramos G., MD, Journal of Neurological Research, Volume 26, April 2004
2. VAX-D Reduces Chronic Discogenic Low Back Pain- 4 year Study Odell R., MD. Ph.D, Boudreau D. DO Anesthesiology News, Volume 29, Number 3 , March 2003

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​​ISCHEMIA IS THE FUNDAMENTAL CAUSE

The above diagram is very important in understanding the true mechanism of most pain and dysfunction. The secret, if there is one, exists in the health of the vascular system. When the blood vessels to the spinal discs are injured they fail to provide the nutrition need to promote healing.

Discs that are degenerated show abnormal vascularity.
-Dr. Michael Martin, MD Department of Neurological Surgery, University of Oklahoma.

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​​SPINAL DISCS CAN HEAL NATURALLY

Many people have been told that the spinal discs cannot heal naturally and this is not true. Spinal discs have the ability to regenerate and heal, please take a minute and read this medical article that supports my statement. This article is written and endorsed by the Dr. Michael Martin, MD, Chris Boxell, MD and David Malone, MD Department of Neurological Surgery, University of Oklahoma.

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​​SPINE SURGERY HAS A POOR OUTCOME

Less than 25% of low back surgeries will be successful
-Dr. Eugene Carragee MD, Stanford University

You do not want back surgery unless absolutely necessary. Although there are cases that need surgery, our experience is that this is needed in less than 5% of patients.

• Failed back surgery syndrome is seen in up to 40% of patients who undergo back surgery. It is characterized by intractable pain and varying degrees of functional incapacitation occurring after spine surgery. More risks include infection, nerve damage, deterioration of health and post operative complications. (1)
• Fewer than 5% of people with back pain are good candidates for surgery. (2)
• The spinal disc accounts for 85% of all cases of chronic spinal pain. The facet joints 15% and the sacroiliac joint less than 5%. (3)​​

References
1. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD, Summer 1994.
2. John P. Kostuik, MD, and Simeon Margolis, MD, Ph.D. Low Back Pain and Osteoporosis. The John Hopkins White Paper on Low Back Pain and Osteoporosis, 2002.

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​REPAIRING THE SPINAL DISC

As a controlled stress is applied to the small blood vessels that feed the injured disc they temporarily dilate increasing blood flow and helping remove inflammation. Over time as this stress is continued to the delicate blood vessels the body responds by promoting vascularization to the area in need. This increases the blood supply and allows for scar tissue to form in the small cracks and tears (annular tears)  of  the injured disc. We begin to see this process start in the first 2-4 weeks of treatment however a spinal disc requires unto 500 days to completely recover. ​

The repair mechanism for the spinal disc, called glycosaminoglycan turnover, takes around 500 days to complete.  
-Nachemson, A.L, The Lumbar Spine- An Orthopedic Challenge, Spine, Vol 1, No.1 (March 1976)​​

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​WHEN A NEGATIVE IS A POSITIVE

EFFECTS OF VERTEBRAL AXIAL DECOMPRESSION (VAX-D) ON INTRADISCAL PRESSURE
Gustavo Ramos, M.D., William Marin, M.D.Journal of Neursurgery 81:350-353 1994 Departments of Neurosurgery and Radiology, Rio Grande Regional Hospital, McAllen, and Division of Neurosurgery, Health Sciences Center, University of Texas, San Antonio, Texas

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​PUBLISHED RESEARCH

With over 20 years of clinical research VAX-D is the number one non surgical treatment for back and neck pain in the world. Here you can download all the main research. ​

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​​WHEN TO RESUME ACTIVITIES

Even when you feel better the disc will need just over a year to fully stabilize. Any movement that involves torque, such as golf, tennis or bowling will place stress on the disc and hamper this healing process. We give patients a very specific set of instructions to follow during the healing phase so they can enjoy an active life without re-injuring the spinal disc before it is completely stable.​​ Patients ask, "How long before I can do these movements? When can I golf?" The realistic answer is, IT DEPENDS! Certain movements will always place the spinal disc under stress and likely cause injury and degeneration 100% of the time so these are always to be avoided, but with proper post treatment conditioning most patients return to normal in about 3 months. We encourage all patients to start walking immediately as the number one way to assist the healing. Once you are feeling better, you may add in an activity you once enjoyed doing, but only at a 20% level. Using a common sense approach, if you feel okay at a 20% level, stay at that level for a brief period of time and slowly add more in, judging it by how you feel. If you notice an increased level of pain the next day, back off from it and listen to your body.

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​THE DR. ALLAN DYER LECTURE

This is a lecture I attended where my mentor, Dr. Allan Dyer, MD explains his Vax-D treatment and the research conducted that proves it's usefulness in cases of chronic back pain and disability. For those interested in the "nuts and bolts" of the procedure I recommend you watch the entire lecture first and then if you still have questions feel free to contact me at the clinic or via email. ​

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​WHAT CAN YOU DO YOURSELF?

Not everyone can travel to the clinic, but fortunately there is an affordable alternative that can activate the pump mechanism and begin the healing process of disc repair. I would recommend creating a self treatment program that consists of 3 elements:
1. Daily decompression with a DDS Belt that consists of between 2-8 hours of treatment. This can be done in a single session or separated into several 2 hour sessions. If you are a person who is working at a job that is stressing the spinal discs then wear the belt all day, only taking short breaks up to 20 minutes to maintain skin integrity. 

• Order these devices directly from the manufacturer www.ddsbelt.com and by using code DRSTOKES 
• Get FREE SHIPPING
• A 60 day money back guarantee
• Unlimited Support from Dr. Stokes (239) 645-2405, drstephenstokes@yahoo.com

2. Heavy supplementation to promote regeneration of cartilage, reduction of pain and relaxation of the sympathetic nervous system. 

To buy these products directly from the manufacturer you can use register for a patient direct account (for free). Here is the Link: http://www.realplantmedicine.com/blog/purchase-supplements

3. Correct, gentle exercises to promote angiogenesis.

The best exercise to help rehabilitate your spine (back or neck) and prevent future problems is walking (1).  Your goal is to walk a 20 minute mile twice a day, which means a pace of about 2.5 miles per hour. Ideally you walk morning and night, wearing good walking shoes and socks. Do not walk in sandals and do not walk with your phone. As you walk look around and pay attention to how you move and feel. Do not be surprised if your body hurts during the first week. If recommended wear a brace to support your spine and possibly put an ice pack against your lower back as you walk. Do not try and extend the times past 20 minutes and go twice a day, not once for 40 minutes. Seriously, walking daily can change people’s lives, physically and mentally (2). Walking activates the pump mechanism and stimulates all your peripheral nerves. Concentrate on how you are moving. Make sure to swing your arms in a cross crawl pattern with your leg movements and do not look down at the ground. If recommended, wear a neck or back brace to maintain your posture. Finally remember to breath as you walk. Try and breath through your nose pushing the belly out as you inhale and in as you exhale.
Another great activity is swimming. The pressure of the water against the skin nerve receptors (called mechanoreceptors) aids in reducing pain and the ability to float reduces pressure on the spinal discs. At this point we are not wanting to swim laps and extend our back and neck instead get a pool noodle floatation device and place it under your arms. Float around the pool, wading. Do not arch your lower back by kicking your feet because this will hurt your healing discs. A better exercise is the peddler. Suspended by the pool noodle allow your knees to come up in front of your body and start peddling as if you were riding a bike. Relax your shoulders and neck as you recline and move around the pool. Every 10 minutes stop and just suspend your spine straight down like you are hanging on a hook. Feel it open and stretch. You can also take the pool noodle and wrap it around your neck under your skull as you suspend your entire body. Do not twist or turn as you do these suspensions and stop immediately if anything hurts, it shouldn’t. If you are suffering from a neck injury and you want to swim a bit it is ok to do a few laps and kick your legs, again only if your lower back is not injured, but you must wear a mask and snorkel so you do not have to constantly look up as you swim, which would increase neck pain. So just wade around the pool with your neck relaxed and you will have no problems. I understand that not everyone has access to a pool or they are uncomfortable getting into the water. For many of my older patients a rocking chair is a perfect exercise device. Rocking back and forth, gently activates the pump mechanism moving fluids in and out of the injured tissues. Rocking activates the cerebellum of your brain and helps improve balance and spinal muscle control. There are many, expensive alternatives to rocking, like balance ball chairs but I find the old fashioned wooden rockers work best. Buy some nice cushions to go with it so your backside does not hurt and make sure the chair is large and sturdy enough for your size. If you are stable enough and do not want to invest in a rocking chair you can buy a Swiss Ball. These inflated exercise balls are good alternatives and you can sit on them and gently rock your lower back while building stabilization muscles.
Once you are at least 50% improved I will suggest that you begin doing some more aggressive exercises. As you may already have guessed we want to stabilize the spine and strengthen our core. My feelings towards exercise have changed in recent years, based on my personal experience. After I hurt my back, any rehab just irritated my spine and made me hurt more. I went through years or cyclical flare-ups where I would be doing good and then start to exercise and re-injure myself. I began telling patients to be more cautious and not attempt core training, thus avoiding flair ups. As the years went by, my spine and supporting muscles atrophied and weakened to the point where I was unable to do everyday tasks without hurting. Although I was not in constant pain, if I lifted a suitcase or carried too many grocery bags, I was in pain the next day. After years of studying under Dr. Stuart McGill, professor at the University of Waterloo and the author of Low Back Disorders: Evidence-Based Prevention and Rehabilitation, I realized my approach was incorrect. I decided to follow Dr. McGill’s advice and begin exercising my core. To my dismay as I started the program I also started to hurt all the time. It required a lot of trust in Dr. McGill’s methods to not quit, but I pushed onward. I began to truly understand that hurt did not equal pain, for my particular case and that the only way I was going to leave the world of chronic pain was by changing my body and mind’s perception of what was going on. Exercise is essential and the pain and discomfort that will come with it are also necessary. Make sure you work directly with a trainer or physician that is educated in McGill’s system and stay positive. It will be a log but rewarding journey.

1. Park SM, Kim GU, Kim HJ, Kim H, Chang BS, Lee CK, Yeom JS Walking more than 90minutes/week was associated with a lower risk of self-reported low back pain in persons over 50 years of age: a cross-sectional study using the Korean National Health and Nutrition Examination Surveys. Spine J. 2019 May;19(5):846-852. doi: 10.1016/j.spinee.2018.11.007. Epub 2018 Nov 15
2. Hurley, D. A, Tully, M. A, Lonsdale, C., Boreham, C. A, van Mechelen, W., Daly, L., Tynan, A. & McDonough, SM. (2015). Supervised walking in comparison with fitness training for chronic back pain in physiotherapy : Results of the SWIFT single-blinded randomized controlled trial. Pain,156(1), 131-147. United States of America: Lippincott Williams & Wilkins.

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GOOD LUCK!

Get professional help and work with your provider to create a plan that works for you. After 20 years treating thousands of low back and neck pain patients this is the approach that I have seen work best, but remember every case is unique and you are ultimately responsible for your own health. Good luck and please contact me if you have any questions, drstephenstokes@yahoo.com.

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