Dynamic Neuromuscular Rehabilitation

Dynamic Neuromuscular Rehabilitation

Dynamic Neuromuscular Rehabilitation

Bulged or Herniated disc



ExtenTrac Elite

Read more about the ExtenTrac Elite.

In following section a detailed explanation on our unique approach to treatment of herniated disc is explored. In our experience a combination of DNS therapy with spinal decompression brings most affective and stable results.

Spinal decompression is a non-surgical treatment of painful syndrome caused specifically by protrusion or herniation of an intervertebral disc resulting in the pressure on the root of the nerve that happened to originate from the affected segment of the spine. Depending on the location of the damage, the resulting pain may irradiate along the compressed nerve and embed itself in the low back, neck or limbs causing what is known as sciatica, radiculopathy.

Spinal decompression relieves the pressure on the displaced disc by increasing intervertebral space thus creating negative pressure within the disc itself. Presently it is mostly achieved by targeted segmental distraction applied by a variety of available mechanical means including specialized apparatuses, harnesses, belts and other systems. The negative pressure within the disc allows better diffusion of nutrients into a disc.

Good blood supply is essential for the healing process for it brings collagen precursors required for rebuilding of the damaged tissues of the disc. Spinal discs are avascular (lacking blood vessels) and therefore rely on the supply by diffusion from the surrounding tissues. This process, called imbibition, occurs mainly at night when the body is in the horizontal position and axial pressure on the spine is removed. In case of a protruded or herniated disc the nutrient supply is severely impeded due to compromised integrity of disrupted spinal anatomy that makes the influx of the nutrients difficult even during the time of rest, especially so to the out-pouched portion of the disc. What decompression is intending to do is to relieve the excessive load on the herniated portion of the disc enabling it to receive the inflow of vital supplies.

Targeted spinal decompression has been developed to replace an old mechanical traction, which proved to be ineffective due to the overly generalized pull that is spread out through the entire length of the spine providing diminished effect to the segment in need. Numerous clinical studies have shown the effectiveness of the targeted spinal decompression resulting in the increase in the recovery time and decrease in symptoms caused by herniated discs.

The healing capabilities of targeted spinal decompression should not be overestimated however. Its effectiveness is vastly increased when it is combined with other therapeutic approaches. This is due to the fact that decompression alone does not address all the pathological factors that constitute the clinical picture of the herniated disc disease. Its effect is incomplete without proper rehabilitation, addressing insufficient stabilization of the spine, and anti-inflammatory intervention intended to reduce the swelling and alleviate the pain-inducing pressure on the nerve root.

Traditional theories and methods of spinal decompression are based on research conducted on cadavers in the artificial laboratory environment which provide static and suboptimal settings for studying something as dynamic as the forces acting on the human spine. Most important, static cadaver studies entirely lack consideration of the internal forces acting on the spine in the living body. These forces are generated by active muscles and measured not by amount of force, but by the quantity of repetitions. In fact it is the pathological increase in the internal forces, which do the damage to the spinal structure in the first place. Therefore, in treatment of disc injuries, finding the balance between internal and external forces that are continuously acting on the spine is as important as relieving the pressure on the disc, which has been the main focus in the traditional conservative low back care.

It would be a difficult task to attempt to pinpoint the absolute prescription for the conservative treatment of disc-related spinal injuries, since every case is different. The main objective of conservative care for the disc herniation should be not much different from the goals of other types of back pain. It is restoration of the function that is the primary goal of any therapy.

However progressive and effective, spinal decompression by mechanical means has its limitations due to the short lived duration of its effect and frequent visits to the doctors. The effect on the disc only lasts a few hours after the treatments if so... This requires very frequent and costly visits to doctors...

In our view, the best results are achieved by combining stabilization exercises, manual therapy and axial spinal decompression procedures. The DNS method according to Kolar includes specific exercises, designed to achieve the same effect as mechanically induced spinal decompression. The widening of the disc space generated by DNS exercises and neuromotor stimulation is not as large as one produced by the mechanical means, however its effect has much longer duration because of targeted activation of deep spinal musculature, especially so that once the patient learns these exercises he/she can activate this decompression repeatedly in the course of the day by himself., Therefore the cumulative effect is stronger and more stable making the patient less dependant on the doctor. Moreover, since the patient actively performs these exercises, the motor learning effect is induced and this memory is transferred into the daily activity becoming habitual, therefore making the decompression to last longer.

Kolar DNS method acts by establishing ideal points of support of the patient's body placed in the primal developmental positions. When proper body positioning is achieved with the patient relaxed and comfortable, the Global Motor Reaction (GMR) is initiated. The GMR results in profound coordinated muscular contractions that expand throughout the entire body creating a variety of secondary reactions, including a sharp increase of deep intra-abdominal pressure, and reaches the deepest spinal inter-segmental muscles, which put spinal segments in the neutral position generating the sagital stability of the whole spine. The opposing pull of muscles in neutral position creates the desired decompression relief to the disc.

In our practice we use the newest and the most advanced 3-D decompression unit "ExtenTrac Elite". ExtenTrac Elite unit is a new generation of spinal decompression units with capabilities far beyond spinal decompression. To explore this wonderful inovative technology please click here.

However useful spinal decompression therapy may be, we believe that it is only a tool in good hands. In our practice we maintain that it is the balanced combination of the DNS exercises, pain management and spinal decompression that provides the most effective non-surgical treatment of disc herniation.