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Phase 1 – Dysfunction

The spine looks very similar to textbook normal but does not function the same way. It is like a car with a wheel alignment problem, the tyres are not scrubbed out.

Phase One is a Mechanical Problem

Side view of Cervical Spine: The Neck. This is side view of a patient facing to the left

A: The Atlas; the first cervical vertebra (C1)
B: The Axis; the second cervical vertebra (C2)
C: The Intervertebral Foramen (window for the nerve)
D: the fifth cervical vertebra (C5)
E: The Spinous Process
F: The Intervertebral disc (the disc)

Note:

  • That there is no forward curve.
  • The loss of curve indicates a decreased ability to move
  • The windows for the nerves have decreased in size
  • There are not bone spurs (yet)

Dysfunction – Phase 1: 10 years of spinal injury

Symptoms:

  • Stiffness and/or dull intermittent back pains with occasional sharp twinges, which appear to “go away” spontaneously, with rest, ice or heat.
  • Pain often localised in the back or refers down the upper or lower extremity.
  • Painful movement of the back particularly when attempting to lift or whilst changing posture i.e. sitting to standing.
  • Slight numbness and/or coldness either in the arms and hands or the legs and feet.
  • Generally attacks occur with sport or upon repetitive loaded activity.

Signs:

1. Localised and painful with restrictive tenderness upon movement. Muscles surrounding the area are contracted or in spasm.

2.Reduced mobility with increased pain when attempting to hyperextend. Neurological and orthopaedic examinations are usually normal.

3. Radiographs: (*NB: X-rays are often read as “normal” by your GP*) Abnormal increased or decreased functional spinal motion.

4. Spinous processes are misaligned with lateral tilting of the vertebral bodies. Lateral curves are either decreased or increased.

5. Irregular facets including jamming or separation. Early disc and soft tissue change and calcification.

Treatment Frequency:

Initially programs are around 2 sessions per week for a 6 to 8 week time frame before significant sustained recovery is seen. X-ray comparison performed approximately 9 to 12 months after the commencement of treatment when rehabilitative care has completed.

More than 80% of people with phase one subluxation degeneration have no pain. Therefore, if left uncorrected, phase one continues.

This phase is usually described as “normal” by your GP. However, unless the spine is corrected, you will progress to Phase 2.

 

 

 

If you like this article be sure to visit the Spinal Centre website at www.thespinalcentre.com.au and view more content by Dr. Hooper and the Spinal Rehabilitation Team.

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