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Phase 2 – Instability

Bone spurs form and the body starts to “splint” the abnoramlly functioning spinal joints. It is like a car with a wheel alignment problem and the tyres are being scrubbed out.

Phase Two involves Structural Changes to the Spine

Side view of Cervical Spine: The Neck This is the 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 to the nerve)
D: The Fifth cervical vertebra (C5)
E: The Spinous Process
F: The Intervertebral Disc (the disc)

Note:

  • There is no forward curve
  • The loss of curve indicates a decreased ability to move
  • The windows for the nerves have decreased in size
  • Bone spurs are fusing the joints (osteophytes) Instability –

Dysfunction – Phase 2: 20 years of uncorrected spinal injury

Symptoms:

Those of Dysfunction of Phase 1 with additonal symptoms:

  • Sharp and acute painful episodes, back “gives away” and “catches” on simple movements.
  • Dull constant pain but with intermittent sharp pain that radiates out into either the arms or hands or into the groin, thigh and legs.
  • Sharp ‘knife like’ pain whilst attempting to change posture as in bending forward to a standing position or whilst attempting to sit up from a lying position.
  • Numbness and tingling constant in hands, fingers or feet and toes.
  • Continuing coldness to an extremity region with occasional blueness of the area. Most commonly either hands and fingers or the feet and toes.

Signs:

1. Clinical examination reveals abnormal motion with regions of restrictive and excessive motion often accompanied by a “giving way” or collapsing reaction.
2. Observations of a typical “catch”, sway, or shift when coming erect after flexion.
3. Weakness of specific muscle groups depending on the spinal level involved.
4. Organ related problems including stomach, bowel, bladder, and sexual dysfunction.
5. Radiographs: Your x-rays are usually read as “normal” or you have slight “arthritis” by a GP.
6. Significant lateral rotatory displacement of vertebral bodies.
7. Widening or narrowing of the facet joints.
8. Narrowing of the intervertebral foramen (the window for the exiting nerve).
9. Calcification or “splinting” ligaments around the spine.
10. Usually a decrease in disc height, the beginning of the fusion process.

Treatment Frequency:

Initially programs vary between 2 to 4 sessions per week for 8 to 12 weeks before significant recovery is obtained.

Functional loading X-ray comparison performed approximately 9 to 12 months after the commencement of treatment, following completion of rehabilitative care.

If this is left untreated, or treatment is suspended for any reason – sometimes the patient starts to feel “well” and doesn’t see the need to continue care – the condition will progress to Phase 3