Low Back Instability
The lumbar spine typically consists of five vertebral bodies and discs and five prepared facet joints along with a very complex array of ligaments, capsules tendons, muscles fascia and nerves their connections from the shoulder region, pelvis, thoracic spine and very complex neuromuscular control mechanisms for optimal function.
Regenerative Masters approach to treatment of the lumbar spine nearly always includes treatment of the pelvic region as well. This consists of the Ilia and sacral bones as well as the Cox a Geo region and all of their neurologic muscular and support structures.
From the standpoint of function and stability, joints – – including between the vertebral bodies/discs – – constitute the most important elements for regenerative treatment protocols. The capsular structures around the joints are highly innervated leading to significant alterations in neuromuscular control as well as pain. Accurately placed and carefully created tissue grafts completed with the precision of ultrasound, fluoroscopy and arthroscopy are critical to tissue regeneration and overall outcome.
Imaging of the lumbar spine is also extremely important. At regenerative Masters, we suggest a motion/stress view based assessment of the lumbar region. At the very least, this should consist of upright MRI views that include both flexion and extension to assess for specific areas of stability loss. Additionally, diagnostic ultrasound of tendon, muscle and ligamentous structures is important. These evaluations aid in a personalized and specific set of injections for each patient.
As is the rule with all regenerative Masters approaches, the contribution of assessments from physical therapy, chiropractic, acupuncture, massage therapy and all other providers aid in the creation of individualized and personalized treatment programs as well as helping to guide Dr. Hanson on where and how to perform regenerative injections. In our experience cumulatively, it is uncommon for a interventional physician to have other providers help guide regenerative injection treatments. Dr. Hansen believes this is critical for the patient’s overall healing and function.
Given the degree of tension, stress and force vectors in the lumbo/pelvic region, a new approach to treatment of the area has been created by regenerative Masters providers.
Dr. Hansen agrees with the concept that the most significant neuromuscular control area in the spine is the upper cervical region. It has the highest concentration of position sensation within the body. Four separate specialty training systems within chiropractic support this thought process. Given this degree of effect on the lumbar region from the cervical region, Dr. Hansen suggests evaluating for upper cervical instability before performing most procedures in the lumbar pelvic region. Completing a set of procedures to stabilize the upper cervical spine and propagate the signal further into regions below organizes and orients the neuromuscular, postural, alignment and recruitment patterns.
Upper cervical stability injections – – see the cervical section for more details – – is completed along with approaches to calm and reset the sympathetic nervous system – – see regenerative energetic day procedures – – to allow for this neurologic resetting of the entire spine prior to lumbar procedures. Often, patients have significant reduction in symptoms of the lumbar spine after cervical procedures. The recovery time in the lumbar spine is also significantly improved if the neurologic patterning has been reset from the cervical region first. This regenerative approach is unique to regenerative Masters and ortho cure clinic to our knowledge.
This is the most successful way to allow for an organized healing process that works with the bodies dominant neurologic processes.
Additionally, as Dr. Hanson has discussed elsewhere, treating neurologic dependent zones and functional movement dependent zones together his unit allows for tissues to heal and neurologically restore function together. Overall, this allows for the most significant amount of healing and restoration of function in his experience. What this means to potential patients is that we inject discs, ligaments, joints, capsules, nerves, muscles and fascia as part of a regional restoration approach.
A very complete injection approach is combined with a collaborative approach between naturopathy, functional medicine, physical therapy, chiropractic and deep emotional healing to address the deepest and root causes of degeneration. The regenerative Masters philosophy is that treating root causes in a synergistic collaborative manner is the most effective way to achieve the greatest results with the most long-lasting improvements in pain and function.
