RELATED PAIN AND

SYMPTOMS
WITH SPINAL
INFORMATION FOR ALL
Autors

DR. WILFREDO RAMON STOKES

Scientific Medical Researcher
BEST AWARD IN RHEUMATOLOGY

LICDA NORA HERNANDEZ

General Psychologist

Guatemala 20 june 2,010

e-mail: drwstokes@gmail.com
licdanorahdz@gmail.com
 RELATED PAIN AND SYMPTOMS
WITH SPINAL
INFORMATION FOR ALL
THE PAIN IS ONE OF THE WHIPS OF HUMANITY
OUR LIFE LIMITED MAKING US FEEL UNHAPPY
PREVENTS THE DEVELOPMENT OF A NORMAL LIFE WITH MAJOR PHYSICAL,
PSYCHOLOGICAL, ECONOMIC AND MORAL

This text is dedicated to pain related to the spine is the authors intention that the people benefit from
the information cited here. Contains information based on scientific medical knowledge, some
concepts are based on personal and medical experience, has tried to pick terms of everyday language
to facilitate understanding of people who have no medical knowledge but can benefit from these
concepts, patients, families and staff studing or working in the field of medicine.

As the main idea is to inform you and what are the events leading to the pain associated with vertebral
column, there will be emphasized in treatment. Patients who appear in the photos are cases seen in
STOKES INTEGRAL MEDICAL CLINIC and its statistics are part of a study that will demonstrate a new
therapeutic approach for patients with disorders of the spine and its treatment without surgery.

It is the intention to make a contribution to medicine in terms of therapeutic approach and spine pain
that despite today's billion invested worldwide in addressing these problems are of uncertain results
very ill as evidenced the fact of failure of surgery in more than 75% of patients undergoing surgery for
this condition (radiculopathy, bulging discs, facet syndrome, tightness, nerve root compression, and
the preferred and famous herniated disk), of course this does not include congenital
anomalies, fractures or other clear and unambiguous indications for surgery.

Dr Wilfredo Ramon Stokes Licda. Ps. Nora Lissette Hernandez

Scientific Medical Mesearcher Somatization Research Psychologist

BEST AWARD IN RHEUMATOLOGY 29 Word Congress of Medicine Buenos Aires Argentina 2,008

IS USELESS FAILURE TO SHARE INFORMATION

COLUMN AND COMPLAINTS

11110 THE PEOPLE ARE BETTER INFORMED PATIENTS 1

Our column is the mainstay of your upper body. It allows us to remain upright, bend or twist our
trunk. It also covers and protects the spinal cord. The spinal nerves of our branch to the rest of our
body.

MAY SAY THAT THE SPINE IS IN CHARGE OF THE BRAIN CONNECTION WITH THE REST OF THE
BODY AND IF WE THINK SO SPREAD ABROAD THAT THE MANIFESTATIONS OF ITS SYMPTOMS
CAN BE JUST AS WIDE AND NOT ONLY AS USUALLY THINK LOCAL.

The spine is composed of vertebrae. At the top are the cervical vertebrae. There
are 7 and are numbered C1 to C7 starting up at the base of the skull. The
seventh vertebra joins the first
thoracic vertebra. Following are 12
thoracic, in sequence on the back
and provide a place for ribs
join. These lists are vertebrae from
T1 to T12 or D1-D12. from top to
bottom. The bottom of our spine is
made up of five lumbar vertebrae
which are obviously those without
ribs. These are listed in the L1 to
L5. Below them, follows a group
of five fused vertebrae CALL THE
SACRO which are located between
the bones located in the bottom of
the column. Lastly comes the
coccyx or tailbone, another group of
fused vertebrae.

The vertebrae are connected by the facet joints. Between each vertebrae are discs, which provide
mobility and act as shock absorbers. The spinal cord is moved to the center of the column, and
each of the vertebrae and branch nerves exit the spine through foramina openings to the body

LUMBAR
VERTEBRAE
L-1 to L-5

BETWEEN THE SPACES ARE OCCUPIED BY THE VERTEBRAE INTERVERTEBRAL DISCS

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 HOW DOES THE SPINE

When we think of the spine in vertebrae (bones) that are one above the other and
that most of them are separated by a few packages that are the intervertebral
discs and when it comes to back pain related to the column is precisely in These
parts that focuses all the attention.
The column and the discs
could not perform any
movement if not fixed,
secured and protected by
muscles, ligaments and
tendons, which hold the
vertebrae in their normal
position and movements using
levers provided between the
multiple and complex
insertions between
Lumbar Vértebrae
muscles ligaments and almost
all the vertebrae.
One very important thing to
mention is that not only the muscles that are in the back have to do with the
stability of the spine, the muscles of the neck and back of the head and the
abdomen and buttocks are related to the column vertebral including the legs and
feet, the same happens with the shoulders and arms.

For this column requires a healthy balance of forces as they usually look like a
healthy spine is based on the symmetry that is not only anatomical but
functional. It seems unbelievable but even when standing without moving the
spine muscles are in action pulling and contracting the muscles so that we can
maintain a comfortable upright position, the same happens even when we are
asleep.

Then we need to talk about the spine are more structures that comprise such as:
muscle, vertebrae, tendons, ligaments, intervertebral discs and deep and
superficial nerves exiting the spinal cord that is inside the vertebrae which protect
and prevent any contact with another structure.

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Note the INTERIOR OF THE SPINAL CORD SECTION COLUMN T-10 to S-5
nerve roots may be out of the spinal

Under each vertebra nerve branching out to each side and carry
messages to muscles and various organs collected and the brain.

WE HAVE MANY OVERLAPPING MUSCLES TENDONS IN DIFFERENT LAYERS SET

TO SERVE THESE COLUMN AND PROTECT AND ALLOW TIME RUN MOVEMENTS

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 MANIFESTATIONS COMMON DISORDERS

In normal individuals there is a certain symmetry and is manifested by a harmony

of all components of the trunk and limbs, can draw an imaginary line vertical and
horizontal and vertical across the body and divided into two fairly equal parts into
components, angles, size and thickness of the structures (muscles) and all this
looks better with the patient standing with arms extended down and hands
outstretched and legs attached to

Pain is the most common symptoms often associated with low back pain I low
back pain, back or middle back and neck pain.

Difficult or restricted movement and pain that it does not allow us to move freely,
this type of pain are usually defensive positions and are accompanied by shrinkage
or extension of certain parts of the body and are called for Pain POSITIONS (anti-
pain ) and its main objective is not to do the same movement that the damage
allegedly caused us and if we try to force the movement we will have a further
contraction of the defense and thus initiate a vicious circle:

A greater stretch - more pain - but limited - greater contraction (defense) to finish
disabling the patient - as more and more muscle groups are involved - often the
person being reduced to a single position
- and with marked and restricted movement - of course much pain.

DO NOT TAKE ALL THE PAIN IS "MACABRE EVOLUTION" but it is easy to see how
people adopt abnormal positions if asked no big concern but if back pain and even
suffer its consequences are treated by other things not often associated with the
column as: headache, dizziness, poor circulation to have sleeping hands, feet or
legs asleep, insecurity in walking, weakness and atrophy (decrease in size) of
some muscles.

The people and many doctors believe that any back pain related to disc problems
or spinal abnormalities is common and therefore without much consideration to
start by doing tests such as MRI, CT, electromyograms and other strange and
sophisticated tests obviating the history and physical examination is most
important.

Speaking of back pain should be assessed first thing is the appearance of the
patient, to see if there are bent or loss of symmetry only to see him standing in his
underwear and you can see if the shoulders, hips, hands are at the same height. If
the neck is stiff or shrunk, you must draw a straight as a plumb line from the
center of the head down and see if the vertebrae is aligned or not, these are all
indicative of scoliosis is a lateral deviation of the column where more or less takes
the form of an "S" see image.

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 BEFORE TREATMENT

PATIENTS WITH
SEVERE PAIN OF
LUMBAR REGION 28
AND 30 YEARS OLD
Pain was very severe
Fallen Man

VERTICAL CENTER
LINE OF THE HEAD IS
NOT PASS OUT OF
CENTRE BETWEEN
BOTH RIGHT BUT
Buttocks look at the
previous operation
scar which caused
increased pain

FALL RIGHT HAND

SEEMS THAT THIS IS
THE LONGEST ARM
SCOLIOSIS

Other important information is obtained with the patient lying face down on
a special table where the face is in one where you can see the following
anomalies: shrunken neck, stiff neck, crooked, uneven shoulders, lifting of parts of
the back, hips raised, buttocks misaligned, crooked or uneven one foot longer than
another.

BEFORE TREATMENT

NECK unkempt man

shrinks
(see after treatment)

Disheveled man (see

after treatment)

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Surgery is usually not resolve this type of disease but rather the worse as the case
of 28 year old patient who underwent surgery and received only a worsening of
their symptoms on preoperative diagnosis was DISC HERNIA LEVEL L-5 AND S1.

The second patient had to quit his job in the U.S. due to the severe pain and he
recommended surgery, made him infiltration tube chiropractic treatment and did
not improve.
It is very important from the patient assessment that is comprehensive as it is very
common to find that back pain can be the first symptom of a rheumatic disease
which should be in conjunction with the patient's spinal treatment because
otherwise the results will incomplete or negative.
This study that stress is an important factor in the onset or worsening of pain
related to the spine, the patient ideally should be assessed from the psychological
point of view, especially when there are injuries or organic etiology. Psychological
therapy is essential especially in cases of chronic pain and even more if the patient
has been treated by several physicians and provided that has undergone spinal
surgery with negative results.
Psychological situations that can trigger back pain: job dissatisfaction, marital
problems, depression, extreme anxiety and so on.

In most of the failures to inadequate medical treatment evaluation is responsible

for the misdiagnosis and consequent mistreatment.

The history, clinical evaluation, ensures correct diagnosis in 80-90% of patients

without testing them if they are indicated to confirm some findings. Blood tests,
urine and feces are considered complementary.
Radiographic imaging studies may be necessary but not always necessary and that
they are more plain radiographs of the spine as they give an idea of the state,
consistency, alignment and location of the column in full. MRI and CT should not
be made if the clinical picture or history does not indicate this would be
approximately 10% of cases and almost always need surgery, these tests (MRI
and CT) SHALL NOT BE ROUTINE IN OUTPATIENT BACK PAIN PRESENTING TO
THE RESULTS AND be within normal limits or is confusing, which may culminate in
Contraindicated SURGERIES.

An example of this would be that more than half the people have a herniated disc
that is not problematic, ie a person could have a sore back and cause muscle
contraction may be distant from the hernia so if operated pain probably continue
(this happens more often than expected).
A doctor who has no experience may be lost in the constellation of symptoms and
clinical findings and if you do not have a pre-diagnostic tests can not diagnose with
findings that did not foresee making treatment decisions and whether the failure is
the rule.
Should also be noted the status of the patient's overall alignment should be

11110 7
straight, to just above the patient is asked that fits in the center of the table and
when you feel comfortable to say, this is the
time to take measurements.
treatments.

THE PATIENT HAS LOST THE ABILITY

TO RECOGNIZE IF YOUR BODY IS align
only was asked to lie down and
Trafficking YOUR BODY IN THE BED
stood fast that both feet are diverted to
THE RIGHT OF THE CENTER LINE AND
THAT SHOULD GO TO THE LINE OF THE
CENTER OF THE HEAD TO THE CENTER
OF THE HIP LEAVES BOTH LIMBS OUT
OF CENTRE
This patient of 35 years working in a bank
and has a job sitting tight and spends long
hours at a computer that greatly damaged his
muscles and misaligned his spine causing severe pain in back and neck, received
long-inflammatory treatment, steroids, b-complex, esteroids infiltration etc. No
improvement.

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 Prevention
Although some problems can not be avoided, there are things we can do to delay
or even prevent back injuries. Here are some recommendations.

• Regular exercise and stretching helps to keep muscles strong and flexible.
• Always lift objects correctly to avoid injury (investigate properly)
• Avoid excess weight by removing the tension in the spine. (Read about effects of
obesity)
• Quitting smoking not reduce low back pain and improves circulation
• Maintain proper posture (you can search the Web for information on correct
postures that prevents or ameliorates the symptoms).

Soon another publication the same theme that includes the diagnosis and
therapeutic approach used in STOKES INTEGRAL MEDICAL CLINIC OF GUATEMALA
and show the results that appear are EXCELLENT.

Autor: Dr. Wilfredo Stokes B. E-mail: drwstokes@gmail.com

Colaboradora: Licda. Ps. Nora Lissette Hernandez E-mail: licdanorahdz@gmail.com

This document has been prepared for general people who are suffering from ailments of
the spine or for some reason they are studying the issue.

Soon the second document will be edited to include a more detailed explanation of how
injuries occur vertebral responsible for the damage their different symptoms and
presented photos of actual patients treated at
STOKES INTEGRAL MEDICAL CLINIC
Before and after treatment and an explanation of the treatment.

To subscribe or Any Additional Information Contact

e-mail: drwstokes@gmail.com

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