Mike Lee:
Welcome to “Innovator Spine Care with Dr. Troy on 93.9 KPDQ. I’m Mike Lee.
Our very special guest expert is Dr. Troy M. Dreiling, Doctor of Chiropractic who serves as vice president of the International Disc Education Association here in the masterclass certificate on non-surgical spinal decompression and is triple certified in it.

Disc Centers of America, Vancouver is located at 3021 NE 72nd Drive, #15 in Vancouver, Washington. That’s just south of Fourth Plain Boulevard, and you can give them a call at 360-727-0787 and even chat live with an expert from Vancouver Disc Center on the website at VancouverDiscCenter.com.

Call 360-727-0455 to schedule if you are suffering from herniated discs, sciatica, low back pain, spinal stenosis, neck pain, numbness, or tingling in your hands. Or if you know someone who is call 360-727-0455 or you can even chat live with them on the website, vancouverdisccenter.com. And that’s spelled as Vancouverdisccenter.com.
How are you today, Dr. Troy?

Dr. Troy:
Hey Mike, I’m super great and I’m excited to share today’s topic with our listeners.

Mike Lee:
Well, we’re excited to hear about the “Five Causes of Low Back Pain”, so maybe you can tell our listeners how prevalent this condition is and then we can go into detail on the causes in treatment options.

Dr. Troy:
Back pain is a huge problem in America and around the world, and we’re seeing more and more cases. And you know, it’s interesting – I’ve been to a lot of conferences, multidisciplinary conferences on back pain, and based on the treatment methods that we are using, we’re starting to see just tremendous results with people to help reduce back pain, manage their back pain, and get their quality of life back.

They estimate that 80% of Americans are suffering back pain at any given time and anywhere from $550 to $600 billion is spent annularly to manage and treat and do therapies for back pain. So it’s a big drain on our system and as the population gets older, the mechanics of the body start to break down just like the mechanics of your car. So it’s a real big problem and you know, I’m excited to get on the radio and tell people some of the solutions offered that naturally and conservatively can help them feel better, function better, and get their quality of life back.

Mike Lee:
Troy, I know today it’s just so easy to go on Google and search out symptoms and then go to your office and say, “Oh, I must have this”. What do they call that? Confirmation bias? Yes, that’s right. But can you discuss the causes and effects of herniated discs from an expert’s perspective?

Dr. Troy:
Yes, I can. There are five main causes of back pain and one of them is herniated discs. And it’s quite fascinating that I actually experienced this in my own life. In fact, I had three herniated discs. One of the other causes is annular tears. But typically if somebody presents (shows symptoms of) a herniated disc, they’re going to have some sort of history of a specific trauma or event.

We always love the patients that come in and go, “I don’t know what I did”. Well, if you dig deeper, you’ll find out that they’ve been doing some repetitive stresses and it could create a big trauma. That’s what everybody thinks. Oh, I didn’t have a big trauma. But it’s these micro-trauma people that have repetitive jobs. You know, their cashier, their hairdresser, I just had one yesterday, she was a hairdresser for 20 years. And just the mechanics of that, the body’s going break down unless you’re taking care of yourself.

So people with disc issues, like a herniated disc, they’ll tend to present (show symptoms of). You know, it’s interesting because they all present a little differently, Some of them have similarities, but classic herniated disc patients don’t wanna sit. If they sit, it increases their back pain. And usually, we’re going see leg pain greater in a herniated disc patient than in their back pain, but not always. It can also hurt them to flex and bend forward.

And a couple of the orthopedic tests that we do, are to see if they do a straight leg raise, and whether they are going have pain on the same side of the leg where the herniation is. So there are some tests that we can do, as well as imaging which can help us rule this in, and out. Also, if they cough, or sneeze, or they strain during the stool. These can also produce back pain and leg pain if it’s a classic herniated disc.

Mike Lee:
So Troy, how can the annular fibers in the spine tear and how does this present clinically?

Dr. Troy:
So the annular fibers, if you look mechanically at a disc, have the outer fibers of the disc, that are called the annular fibers. That’s what holds the nucleus in. And I kind of look at it as like a jelly donut or an egg white with an egg yolk. So the yolk is the center of the disc, and then the white of an egg is a representation of the annular fibers and they are kind of built like the steel radial tires that you see on cars.

So if those fibers tear or they weaken, then they can present with a whole other set of symptoms. And clinically, sometimes you’ll have herniated discs AND an annular tear and so they’ll present with similar symptoms. I actually had two annular tears and usually, they’re going to present with some sort of significant trauma. Usually – not always – but usually. For me, it showed up after I was lifting my daughter, and putting her on the toilet, and that’s what the annular fibers showed in my two lower discs when I had an MRI (imaging).

Sure enough, we saw it there. Usually what we’re going see then is back pain. And for me at the time, the back pain was greater than the leg pain. I really didn’t have any leg pain with my annular tears or my disc damage. It was just constant chronic low back pain. And again, the pain can increase when they sit, when leaning forward, when they cough, when sneezing, coughing, or strain. That all increase increases the disc pressure.

And so we can do a straight leg brace test or other neurological tests that we can do. But these are classic annular tears. And really, Mike, the biggest thing is that the pain generator is the chemical irritation that’s caused by the disc material leaking out, hitting the spinal cord, or the nerve roots.

And so one of the things we would like to focus on is reducing the inflammatory process. And you might attest to this, where if you hurt your shoulder, now your knee starts to hurt because when you have inflammation, the chemicals that create irritation and pain, show up everywhere – they’re systemic. They don’t just stay in one spot, but they spread throughout the body.

So you might see other areas light up (in pain) that you may have injured in the past when you have an annular or tear. So it’s quite interesting to observe. But one of our biggest tasks, is that we want to reduce the inflammation and get mobility back into these joints gently, very conservatively, so that people can heal and get their quality of life back.

Mike Lee:
Dr. Troy, what is myogenic pain and what are the classic signs you see when people visit you at Vancouver Disc Center?

Dr. Troy:
Yeah, so myogenic pain – I see people come in all the time that present with either herniated disc type symptoms or disc tear type of symptoms and they’ll come in and they go, “Oh it’s just a muscle”. And you know what, they may be right, but myogenic pain or muscle-related issues are usually related to some sort of history of an injury to the muscle.

They have recurrent pain symptoms related to use. So if they’re going to bend and lift and twist, it’s interesting to see because usually, it’s not midline in their spine, it’s usually off to the side and they’ll present with things that increase their pain. Like if they have prolonged muscle use, the longer they bend and lift and do things throughout the day, the more those muscles get fatigued and that can cause pain.

So there’s definitely a component when we see disc issues and annular tears that there could be a muscular component. And usually, it’s not just muscle because muscles are controlled by nerves, and if there’s something irritating the nerve that controls the muscles, it may present and they are just perceiving it as muscle pain. So we have to dive deeper into the exam, using imaging to see if it in truth is just a muscle or if it’s a myogenic issue.

Mike Lee:
Troy, you know, it’s a big word being used a lot in the spine world; “stenosis”. Can you explain what stenosis is and what signs tell you when people are suffering from it?

Dr. Troy:
I’ll tell you this, Mike, of the average 60-year-olds, 59% of them have spinal stenosis. You’ve heard of a stent, right Mike? You’ve heard of a stent?

Mike Lee:
Sure. Like when you get a stent in your heart.

Dr. Troy:
Yeah, exactly. Or an artery. So a “stent stenosis”, actually, if you look at that word because a lot of people bring me their report and they’re like, what are all these words? I have fibrosis and myositis and stenosis. Well, stenosis means the narrowing of the canal that the nerve sits in. And classic stenosis, the classic definition is a herniated or bulged disc. So stenosis could be obviously a disc bulge, or herniation stenosis can also come from degeneration.

So now you’ve got joints where they start to degenerate also some people call it degenerative osteoarthritis. That’s a cause of stenosis. You also can have ligament thickening. So ligaments thicken due to the stress. When the segments of the spine start to fail, now you’re hanging on the ligaments instead of the joint. And so those ligaments start to thicken, which actually creates stenosis narrowing of the canal.

And the beautiful thing about spinal decompression and flex distraction therapy, you can gently open those canals that the nerves sit in. Research shows that you can open up the frame, and that the nerve that sits in it goes into the legs or the organs. You can open that canal up to 28% by doing flex distraction decompression therapy. And that’s usually enough to give people relief and get the blood flowing in there and get those chemicals outta there that cause pain.

So stenosis is on the rise and as we get older, our spine mechanically breaks down. One of the leading causes of stenosis, a classic sign for stenosis patients, is they have increased pain when they stand and they have increased pain when they walk. So I always ask patients, “When you go to the shopping center, do you have to lean over the cart to make you feel better so you can walk around?”, and if they’ve got stenosis, they’ll always say yes.

The other thing that makes them feel better is they’ll flex forward – and usually when you do a straight leg in the ranges where you’re stretching the sciatic nerve in the nerve roots, they usually don’t present with any pain. So there are some classic ways that we can test people to see if they’ve got stenosis. And a lot of people will come in with all four of the things we talked about, disc issues, annular tears, muscle issues, and spinal stenosis.

Mike Lee:
The last cause of low back pain you mentioned is “Facet Arthropathy”. Can you explain this one to our listeners, Dr. Troy?

Dr. Troy:
Facet arthropathy is basically degeneration. So if you look at a spinal segment, you’ve got a disc in the front, which we’ve been talking about, with annular tears and bulges. And then you have two joints in the back of the vertebra. Those are called facet joints. I was talking to my kid’s eighth-grade class and the teacher called them washer joints.

So they’re like gliding joints that slide over each other. And this help to give us some lateral bending and rotation components to facilitate movement. But facet arthropathy is presented when the joint actually starts to degenerate. We start seeing sclerotic changes and this is where you can get into the ligament thickening that causes stenosis, or facet arthropathy. Usually, we’re going see localized tenderness right over that joint and they’ll have increased pain when they extend and when they lean into the side of the pain.

What you’re doing is you’re compressing those joints. And I gotta tell you, usually every time I see somebody that comes in with a disc issue or annular tear or a muscle issue or a stenosis, they tend to have some sort of facet type of syndrome or condition going on. So we really look at a tripod of joints in the spine, the disc in the front, and the two facet, or washer joints, in the back. So we’re looking at the mechanics of how these joints work and that they really are the pain generators for low back pain people with chronic low back pain.

Mike Lee:
So what are the best methods you found to help treat these cases at Vancouver Disc Center?

Dr. Troy:
I’ve been at the practice for over 29 years, and since we added our spinal decompression with flex distraction techniques, our results have been amazing. I attended the National Spinal Stenosis Conference a few years ago and we had a group of different healthcare practitioners.

We had urologists, we had neurologists, we had orthopedists, we had neuro spine surgeons, and we had a group of flexion distraction doctors, as well as physical therapists. And as I walked away I said to myself, “Wow, if we can mobilize the segments of the spine with flexion, distraction, and decompression, and we can get the patients to do some exercises to help strengthen and support the supporting structures of their spine, these people have the best shot at having a positive outcome so they can avoid the medications long term”.

More importantly. they can avoid invasive procedures that have risks associated with them. We can combine spinal decompression, inflection, and distraction, with some supplementation, and laser therapy. All of these things have really been game-changing for the patients in our clinic.

Mike Lee:
Wrapping up, Troy, do you have any specific cases that you’ve seen that you were able to help out with?

Dr. Troy:
I had just such a patient just the other day. He came in at 89 years old and he’s actually an active track coach who trained some world-class athletes, and he said at 87 he was running faster than a lot of the guys on the track.

So imagine an 87-year-old guy running, doing track, but when the pandemic hit, he stopped training kids because, you know, the track was closed. And so just recently he went back to running track and he flared himself up. So he had an MRI and sure enough, we found all five of the discs in his low back were herniated.

They have bulged, he had spinal stenosis, he’s got facet issues, and he’s got muscle issues. The neurosurgeon recommended surgery. And I said, “You know what, at your age you’re almost 90. I don’t know if it’s worth the risk. If we can help you conservatively get better, I think that’s the way to go”.

And so we put him on the table. The first time we did laser therapy with him, and we did spinal decompression. He got off the table, Mike, and you know, he was amazed! He’s like, “Man, I feel better”. And so that’s really what it’s all about. Basically, he had all five of these top things causing his back pain and we were able to get him some relief after his very first visit. And that is what makes me excited. That’s why I get on the radio and share this because I’m so excited to help people get their quality of life back.

Mike Lee:
That’s wonderful, Dr. Troy. In fact, the next five callers at 360-727-0455 get an opportunity to come on into Vancouver Disc Center for just $29. You can have a spinal decompression screening, which includes a review of your existing MRI or other spine imaging. As well, as a review of your current health state to determine if you are a qualified candidate for their cutting-edge healing technologies.

All for just $29. Call now and pay via check or with a credit card to reserve your spot. 360-727-0455 is the number to schedule if you are suffering from herniated discs, sciatica, low back pain, spinal stenosis, neck pain, numbness, or tingling in your hands. Or if you know someone who is, call 360-727-0455 and you can even chat live online on the website VancouverDiscCenter.com. That’s VancouverDiscCenter.com.

Dr. Troy, thanks so much for making our lives more comfortable and fulfilling.

Dr. Troy:
Hey, thank you Mike. Thanks for having me today.

Mike Lee:
And thank you for joining us on Innovative Spine Care with Dr. Troy on 93.9 KPDQ

Radio Announcer:
Disc Centers of America. A call to us can change your life: 360-727-0455