The Analyst™

Comprehensive diagnosis of your symptoms

Healthy

  Low Back Pain / Problems  
 
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Conditions that suggest it | Contributing risk factors | Other conditions that may be present | Recommendations

 

Acute Low Back Pain
Usually due to muscle strain, approximately 90% of patients with acute low back pain recover within 4 weeks without therapy. Further diagnostic work is not necessary unless there are red flags such as:
1) Possible fracture (major trauma, minor trauma in older patients or patients who may have osteoporosis).
2) Possible tumor or infection of a patient aged over 50 or under 20, a history of cancer, constitutional symptoms such as fevers, chills and weight loss, risk factors for spinal infection, recent bacterial infection, intravenous drug use or immunosuppression, pain that is worse when lying on back or severe night time pain.
3) Possible cauda equina syndrome: saddle anesthesia, bladder dysfunction, severe or progressive neurologic dysfunction in the legs, lax anal sphincter, major motor weakness in quadriceps (knee extensors), ankle plantar flexors, evertors, and dorsiflexors (foot drop).

Chronic Low Back Pain
A lifetime of poor posture and poor lifting and bending habits may stress ligaments posterior to the intervertebral disk to the point that even a minor stress precipitates a herniation and low back pain. Always bend with your knees, not your back.

Most medical physicians rely too heavily on diagnostic tests, especially for low back problems. As a consequence, many patients that suffer from low back pain do not find relief: the tests may show that little is wrong, or show abnormalities that are not the cause of the problem. In one magnetic resonance imaging study of 98 people, none of whom had back pain, bulging disks were detected in 52% at one or more intervertebral disks and 27% had protrusions. These findings emphasize the importance of matching test results with the patient's description of symptoms before contemplating surgery. Some specialists recommend being very conservative in managing patients with back pain. Before ordering an MRI there really should be a reason.

Sciatica, pain along the large sciatic nerve that runs from the lower back down through the buttocks and along the back of each leg, is a relatively common form of back pain.

Sciatica is usually caused by pressure on the sciatic nerve from a herniated disc (also referred to as a bulging disc, ruptured disc or pinched nerve). Other common causes include lumbar spinal stenosis, degenerative disc disease, priformis syndrome or isthmic spondylolisthesis. A little more detail about this is provided below. The problem is often diagnosed as a radiculopathy, meaning that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve root.

For some people, the pain from sciatica can be severe and debilitating. For others, the pain might be infrequent and irritating, but has the potential to get worse. Usually, sciatica only affects one side, and the pain often radiates through the buttock and/or leg.

One or more of the following sensations may occur:

  • Pain in the buttocks and/or leg that is worse when sitting
  • Burning or tingling down the leg
  • Weakness, numbness or difficulty moving the leg or foot
  • A constant pain on one side of the buttocks
  • A shooting pain that makes it difficult to stand up
While sciatica can be very painful, it is rare that permanent nerve damage will result. Many pain syndromes result from inflammation and will get better within two weeks to a few months. Nerve pain is caused by a combination of pressure and inflammation on the nerve root, and treatment is centered on relieving both of these conditions.

Sciatica is a descriptive term and not an actual diagnosis for the underlying condition that is causing the pain. Lower back conditions that can cause sciatica include:
  • Disc herniation - the soft inner core of the disc presses through the fibrous outer core of the disc and the bulge places pressure on the nerve root.
  • Spinal stenosis - the facet joints become enlarged and place pressure on the nerve roots as they exit the spine.
  • Degenerative disc disease - as discs degenerate, the inflammatory proteins from inside the disc can become exposed and irritate the nerve root.
  • Isthmic spondylolisthesis - the nerve root can get pinched through a combination of the disc space collapse, fracture, and the vertebral body slippage associated with this condition.
  • Piriformis syndrome -The sciatic nerve can get irritated as it runs under the piriformis muscle in the buttocks. Further information and exercises to help can be found here.
  • Sacroiliac joint dysfunction - the sacroiliac joint can also irritate the L5 nerve, which lies on top of it, and cause sciatica.
Symptoms that may constitute a medical emergency include progressive weakness in the legs or bladder/bowel incontinence. Patients with these symptoms should seek immediate medical attention.
 

 
 

Conditions that suggest Low Back Pain / Problems:
 
 
Nutrients  Copper Deficiency
 A copper deficiency has been associated with weakening of connective tissue that can be a contributing factor for the development of slipped or herniated discs.

Tumors, Malignant

Counter-indicators:
  Prostate Cancer
 Back pain from bony metastases, particularly in the pelvis and lumbar spine, is a major symptom of metastatic prostate cancer. Consequently, if progressive and persistent low back pain occurs as a new symptom, prostate cancer may be responsible.
 
 

Risk factors for Low Back Pain / Problems:
 
 
Allergy  Allergy / Intolerance to Foods (Hidden)

Autoimmune

  Ankylosing Spondylitis
 The inflammation occurring in cases of ankylosing spondylitis usually starts around the sacroiliac joints i.e. the areas where the lower spine is joined to the pelvis. The pain is worse during periods of rest or inactivity, often awakening patients in the middle of the night. Symptoms typically lessen with movement and exercise. Over a period of time, pain and stiffness may progress into the upper spine and even into the chest and neck.

Diet

  Dehydration
 Once dehydration starts in the body, the back is one of the first places to be affected, with the fifth lumbar disk being involved in 95 percent of the cases of LBP. The heavier a person is, the more water they need.

Environment / Toxicity

  Mercury Toxicity / Amalgam Illness
 Mercury toxicity can cause low back pain when it is stored in the sensory ganglia near the low back.

Habits

  Aerobic Exercise Need
 Exercise that strengthens the abdominal musculature sometimes helps reduce low back pain. Further, strenuous exercise involving significant movement of the lower back has resulted in pain reduction/elimination for many with low back pain.

Hormones

  Hyperparathyroidism
  Hypothyroidism
  Low Estrogen Levels

Infections

  Dysbiosis, Bacterial
 Autointoxication or intestinal toxemia (self-poisoning) from poor digestion and by and overgrowth of harmful gut bacteria can cause low back pain.

  Chronic / Hidden Infection
 Some dentists report treating low back pain patients by removing infected bone in the third molar area. Chronic fatigue and arthritic pain disappear in many patients with these conditions after removing dental infections.

Medications

  Birth Control Pill / Contraceptive Issues

Musculo-Skeletal

  Short Leg
  Osteoarthritis

Nutrients

  Vitamin D Requirement
 In a study conducted in Saudi Arabia, researchers found vitamin D deficiency in a group of 360 chronic back patients. All the patients were given physiological doses of cholecalciferol for three months, which improved the chronic pain. Even though the doses they were given (5,000 to 10,000 IU) are said to be toxic (the American institute of Medicine says 3,800 IU is toxic) all the patients normalized their calcidiol levels. [Mayo Clinic Proceedings December, 2003]

Taking vitamin D with vitamin A has been reported to be helpful in treating some cases of sciatica pain.

  Magnesium Requirement

Organ Health

  Prostatitis

Symptoms - Skeletal

  One leg shorter than the other
 A 'functionally' short leg is one that can be corrected by pelvic adjustment. A 'structurally' short leg exists when one leg is physically shorter than the other. Walking and standing when one leg is shorter than the other can result in spinal problems as the hips rotate and to low back tries to compensate for this tilt.

Tumors, Benign

  Fibroids
 See link between Constipation and Fibroids.

Tumors, Malignant

  Ovarian Cancer

Uro-Genital

  Endometriosis
 
 

Low Back Pain / Problems suggests the following may be present:
 
 
Autoimmune  Ankylosing Spondylitis
 The inflammation occurring in cases of ankylosing spondylitis usually starts around the sacroiliac joints i.e. the areas where the lower spine is joined to the pelvis. The pain is worse during periods of rest or inactivity, often awakening patients in the middle of the night. Symptoms typically lessen with movement and exercise. Over a period of time, pain and stiffness may progress into the upper spine and even into the chest and neck.

Cell Salts

  Cell Salt, Mag Phos Need

Tumors, Malignant

  Ovarian Cancer
 
 

Recommendations for Low Back Pain / Problems:
 
 
Amino Acid / Protein  Phenylalanine
 The brain responds to pain signals by producing and activating morphine-like hormones called endorphins. This pain relief effect lasts for about 30 hours (longer than known analgesics), and without side effects when given frequently. It was discovered that d- and dl-Phenylalanine (DLPA), but not l-Phenylalanine, inhibit several of the enzymes responsible for endorphin destruction. DLPA appears to restore endorphin levels to a normal range, while simultaneously producing a reduction in pain. It often equals or exceeds morphine or other opiate derivatives in its effect and is non-addictive. Start with 500mg qd and work up to 3 or 4gm qd. This is a precursor for epinephrine and phenylethylamine (PEA). PEA has amphetamine-like stimulant properties. Chocolate contains high levels of PEA.

Animal-based

  Cetyl-myristoleate

Botanical

  Chlorella / Algae Products
 Chlorella or other algae may reduce circulating toxins and bowel autointoxication, easing low back pain associated with toxicity.

  Boswellia (Boswellia serrata)
 Boswellin is a standardized extract from the Boswellia Serrata tree in India. It is the first herbal remedy to have documented clinical evidence that it is useful in rheumatoid arthritis, osteoarthritis, low back pain, soft tissue rheumatism and myositis symptoms.

Diet

  Increased Water Consumption
 Drink lots of water to maintain optimal hydration for disc integrity, and help reduce any acid buildup in muscles. Often two large glasses of water helps within minutes in acute low back pain. Consistent rehydration may eliminate and prevent future low back pain.

  Therapeutic Fasting

Drug

  NSAIDs
 Use pain medication, if necessary, such as Tylenol, Aleve or another NSAID such as aspirin as needed during the acute phase of the injury.

  Conventional Drugs / Information
 Colchicine has been regarded by some as the most powerful anti-inflammatory agent known to man. The beneficial effects of colchicine in the treatment of gout are apparently secondary to its ability to inhibit both the metabolic and phagocytic activity and migration of granulocytes. Colchicine's inhibition of the release of histamine containing granules from mast cells is also believed secondary to its interference with granule transportation by the microtubular system. While beneficial in the treatment of the crystal-induced inflammation observed in gout and pseudogout, colchicine is only occasionally effective in the treatment of other types of arthritides (arthritis).

Over the past 30 years, Rask has treated thousands of patients with resistant disc disorders with oral and intravenous colchicine and has noted a 90-95% improvement rate. Since 1979, he has published the results of his uncontrolled studies, some involving up to 500 patients, who have suggested significant therapeutic benefits from colchicine therapy with fewer adverse effects than typically associated with the use of aspirin.

In a 1985 double blind study of 39 patients with low back pain of at least two months duration, Meek compared combined intravenous and oral colchicine treatment with placebo. Patients in the treatment group received colchicine .6-mg orally b.i.d. (twice a day) for 14 days and one-mg IV (intravenous) on days one, four and eight of the 14 day study period.

Adverse Effects
While no real effect from placebo administration was observed, the treatment group demonstrated significant improvements in pain, weakness, leg raising limitations, and muscle spasm. Adverse effects from colchicine administration were documented in only one patient in the form of a burn at the IV site. In a double blind study of oral colchicine in the treatment of low back pain, Schnebel and Simmons compared oral colchicine with placebo in 34 patients with low back symptoms of less than three months duration. Over the 12-week study period, both groups of patients continued in a comprehensive physical therapy program and were administered NSAIDs and muscle relaxants. No significant differences in therapeutic response were noted between the treatment and placebo groups, but an increased number of adverse effects, mainly diarrhea and vomiting, were observed in the colchicine group. This study has several limitations, including a small sample size, multiple etiologies of low back pain, poor patient compliance, and the use of concomitant treatments.

Contraindications
Colchicine use is contraindicated those patients with serious gastrointestinal, renal, hepatic or cardiac disease. Colchicine can also harm the fetus when used during pregnancy. When administered intravenously for the treatment of an acute gouty attack, the total dosage over the first 24-hours should not exceed four milligrams, as greater cumulative dosages have been associated with multiple organ failure and death.

Abdominal pain, nausea, vomiting, and diarrhea, are typically the earliest and most common adverse effects associated with colchicine over dosage.

Extract

  Devil's Claw (Harpagophytum Procumbens)
 A Devil's Clas extract (60mg harpagoside per day) improved pain in a study of 104 patients with non-specific low back pain. [Phytomedicine 2002;9(3): pp.181-194]

Habits

  Aerobic Exercise
 An exercise program is important for improvement of low back pain. Begin with those exercises which provide the greatest range of motion with the least amount of pain. Some find that remaining very active and mobile is their key to remaining pain-free. However, you should avoid exercise during the recovery period from acute low back pain. [The New Eng J of Med. Feb. 9,1995;332(6):35 pp.1-55

Exercises to strengthen the back and abdominal muscles can be helpful. Inactivity is definitely detrimental to patients with chronic low back pain. Normal activity produces better recovery than bed rest, so stay mobile. The success of using exercise as a treatment of low back pain and rehabilitation is overwhelming. The tissues of the vertebral column need the stresses of exercise, even under conditions of back pain.

Although not aerobic, there is a particular exercise that has relieved back pain which occurs during long periods of sitting. The technique is: "Sit up straight. Put your feet on the floor, then raise both feet off the floor at the same time 1 inch. This lightens the abdominal muscles and is the sitting-up equivalent of the old bent knee sit-up exercises". This exercise can be done almost anywhere.

An experienced physical therapist can develop an exercise program to help rehabilitate your back and prevent future recurrences.

Lab Tests/Rule-Outs

  Digestive Enzymes / (Trial)
 Some find help from using digestive or pancreatic enzymes or bromelain/curcumin as anti-inflammatory agents that reduce swelling and help clear away debris from the injured area. Papain also has analgesic and anti-inflammatory action. Delayed release (coated) enzymes are preferred, but uncoated preparations are used by doctors for this purpose when coated preparations are not available.

Mineral

  MSM (Methyl Sulfonyl Methane)
 Many sufferers have reported the use of MSM has relieved low back pain and spasms/cramps.

  Molybdenum
 Margaret Moss, MA found that taking oral molybdenum over a 28-day period produces a "statistically significant improvement" in patients with arthritis and other aches and pains as well as in their general health. Moss monitored
14 middle-aged people with symptoms of arthritis, low back pain, frozen shoulder, rheumatoid and osteoarthritis, as they took 400 to 500mcg daily (in 4 or 5 doses of 100mcg) of molybdenum amino acid chelate.

  Magnesium
 Some doctors consider the use of magnesium (muscle relaxant) in back pain that may be due to muscle spasm and toxicity.

Miscellaneous

  Reading List
 John E. Sarno, MD has successfully educated a high percentage of chronic low back pain sufferers by teaching them how psychological issues can be converted into back pain. The pain is then eliminated or controlled by a new awareness of the real reason behind the pain. When no structural or organic cause is detected, his success rate is 80-90%. All the information you need is in his book, The Mindbody Prescription.

For those whose low back pain is not related to a major injury, overly tight hamstring muscles may be causing the pain. With stretching, your back pain may be gone in less than a week. Healing Back Pain Naturally: The Mind-Body Program Proven to Work by Art Brownstein describes this problem and has lead to a pain-free back for many readers. Some consider it the most helpful book they have read on the subject.


8 Steps to a Pain-Free Back: Natural Posture Solutions for Pain in the Back, Neck, Shoulder, Hip, Knee, and Foot by Esther Gokhale.

This book offers a natural, simple solution to chronic back pain. No special machines or contraptions or surgeries are required. Instead it teaches healthy posture. Esther Gohkale studied posture in countries such as India, Burkina Faso, and Portugal, where people have very back-demanding life styles, but suffer very little back injury or pain. Her book offers an anthropological study, with color photographs of beautiful, healthy backs from around the world, in ancient and modern times. She offers clear, simple instructions to help anyone achieve healthy, pain-free posture. Review by Suzanne Churchill.

Nutrient

  TMG (Tri-methyl-glycine) / SAMe

Oriental Medicine

  Emotional Freedom Technique (EFT)
  Acupuncture
 Users of acupuncturist claim that it can be helpful by reducing swelling and inflammation, and by doing so, relieving pain. Even for people who have injuries, degradation of spinal disks, or have arthritic changes in the spine, acupuncture is often useful.

The results of a study provide further proof that acupuncture is a safe and effective procedure for low-back pain, and that it can maintain positive outcomes for periods of six months or longer without producing the negative side-effects that often accompany more traditional pain remedies. [Clinical Journal of Pain 2001;17(4): pp.296-305]

Physical Medicine

  Manipulation
 Osteopathic manual care and standard medical care have similar clinical results in patients with subacute low back pain. However, the use of medication is greater with standard care. [JAMA Volume 341: pp.1426-1431 November 4, 1999[/i>]

Spinal manipulation has been found to be more effective in association with acute low back pain than in chronic low back pain, unless a single adjustment proves helpful.

Most cities in the US will have multiple Chiropractors to choose from. Of all the health professionals, Chiropractors have by far the most training in spinal manipulation.

  Hydrotherapy
 Hydrotherapy is reported to have many beneficial effects in the treatment of people with chronic low back pain. Among the reported benefits are:
  • decreased levels of pain
  • lower intake of medication
  • improved function
  • improved quality of life
  • decreased general practitioner consultation
  • increased range of movement of the lumbar spine

  Physical Supports
 If you sleep on your back, place a pillow under your head and shoulders, a rolled up towel under your neck, and one under your knees to maintain your natural spinal curves. Always use a supportive mattress, and never sleep on your stomach. If you sleep on your side, place a pillow under your head and neck and make sure that your neck is level with the rest of your spine. Put a pillow between your knees, and bend them to relieve strain on your low back. Keep a pillow near your chest so your upper body doesn't roll forward. Before getting out of bed, stretch, raise up slowly, and use your arms to support you as you swing your legs to the floor. Getting out of bed correctly may prevent an injury to your spine.

In 42 male and 116 female subjects with chronic, non-specific low-back pain, those who slept on a medium-firm mattress had less back pain on rising, less disability, and less daytime low-back pain compared with those who used a firm mattress. This benefit took place over a 3 month period. [Lancet. November 15, 2003;362: pp.1599-1604]

Traction was found not be helpful. In evaluating 151 patients over 6 weeks for nonspecific low back pain it was found that traction was not effective for patients with low back pain. [The Lancet, December 16, 1995;346: pp.1596-1600]

In the largest prospective cohort study of back belt use, adjusted for multiple individual risk factors, neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain. [JAMA. 2000;284: pp.2727-2732] However, some people believe that wearing a back belt does remind them to lift properly.

In sciatica, proper support of the lumbar spine helps take pressure off the lumbar disks and can be a valuable adjunct in an overall treatment program for sciatica. Seat wedges can often better disburse pressure equally across the thighs rather than having a seat that applies localized pressure to the sensitive sciatic nerves.

Z-CoiL Pain Relief Footwear was invented by Al Gallegos, a runner and shoe-store owner who was plagued by heel spurs, plantar fasciitis, and other foot troubles. Knee and back problems have been helped by the use of this shoe also. Since the first Z-CoiL running shoes were manufactured in 1997, the product line has expanded to include casual dress shoes, sandals, clogs, hiking books, and work boots.

Although the shock-absorbing coil springs are the most obvious difference between Z-CoiLs and conventional shoes, the product has other unique features: The front of the sole has 20 mm (3/4") of neoprene rubber cushioning to protect the forefoot, and the shoe's footbed incorporates a rigid plastic orthotic for arch support and stability. Such design features have helped Z-CoiL shoes to gain a cult following among nurses, chefs, and other people who work on their feet all day.

  Calming / Stretching Exercises
 Yoga has consistently been used to cure and prevent back pain by enhancing strength and flexibility. Both acute and long-term stress can lead to muscle tension and exacerbate back problems. A number of components of yoga help to ease back pain. Postures provide gentle stretching and movements that increase flexibility and help correct bad posture. Breathing exercises can affect the spine in various ways, such as movement of the ribs and changes in pressure within the chest and abdomen. Exhaling can help relax muscles. Relaxation provides a physiologic antidote to stress.

Healing Back Pain Naturally: The Mind-Body Program Proven to Work by Art Brownstein shows you just how to stretch overly tight hamstring muscles, which has resolved many cases of low back pain.

  Hot Applications
 A warm bath with Epsom salts and/or heating pad two to three times per day for 20 to 30 minutes or longer, can help. In sciatica, for moderate pain along the sciatic nerve, heat and/or ice packs may be helpful. It is usually recommended to use ice in the acute phase of pain, and later heat and ice may be alternated as symptoms begin to subside.

  Craniosacral Therapy (CST)

Psychological

  Counseling
 In a four-year investigation that followed patients who initially had no lower back pain, Stanford researchers studied their subjects' spines using both disc injection and magnetic resonance imaging, or MRI. And they also got to know their research subjects through psychological evaluations. It turned out that psychological factors more accurately predicted who would develop lower back pain than the two diagnostic techniques.

In people both with and without back pain, MRI can detect cracks or tears in the spongy cartilage disc that cushions each unit of the spine. Some doctors also have suggested that if a patient feels pain when fluid is injected into one of the spine's discs in a procedure called discography, the patient will soon develop back pain even if he or she doesn't already feel discomfort. The researchers found that patients with poor coping skills, as measured by psychological testing, or with chronic pain were nearly three times more likely to develop back pain compared to those with neither. A history of disputed workers' compensation claims also predicted future back pain. Meanwhile, a crack in the disc or a "high-intensity zone" seen on MRI was weakly associated with back pain, but the result was not statistically significant. The structural problems were overwhelmed by the psychosocial factors. [Spine May 15,2004;29(10): pp.1112-7]

This study confirms the findings of Dr. John Sarno.

  Visualization / Relaxation Techniques
 (2009) A study by UCLA psychologists suggests that just the thought of a loved one reduces pain, underscoring the importance of social relationships and staying socially connected.

The study, which asked whether simply looking at a photograph of your significant other can reduce pain, involved 25 women, mostly UCLA students, who had boyfriends with whom they had been in a good relationship for more than six months.

The women received moderately painful heat stimuli to their forearms while they went through a number of different conditions. In one set of conditions, they viewed photographs of their boyfriend, a stranger and a chair.

"When the women were just looking at pictures of their partner, they actually reported less pain to the heat stimuli than when they were looking at pictures of an object or pictures of a stranger," said study co-author Naomi Eisenberger, assistant professor of psychology and director of UCLA's Social and Affective Neuroscience Laboratory. "Thus, the mere reminder of one's partner through a simple photograph was capable of reducing pain."

"This changes our notion of how social support influences people," she added. "Typically, we think that in order for social support to make us feel good, it has to be the kind of support that is very responsive to our emotional needs. Here, however, we are seeing that just a photo of one's significant other can have the same effect."

In another set of conditions, each woman held the hand of her boyfriend, the hand of a male stranger and a squeeze ball. The study found that when women were holding their boyfriends' hands, they reported less physical pain than when they were holding a stranger's hand or a ball while receiving the same amount of heat stimulation.

"This study demonstrates how much of an impact our social ties can have on our experience and fits with other work emphasizing the importance of social support for physical and mental health," Eisenberger said.

One practical piece of advice the authors give is that the next time you are going through a stressful or painful experience, if you cannot bring a loved one with you, a photo may do.

Skin

  DMSO Topically

Surgery/Invasive

  Prolotherapy
 Low back pain is one of the easiest conditions to treat with prolotherapy. See Pain, Pain, Go Away, by William J. Faber, DO and Morton Walker, DPM - available in paperback.

Please see the link between Low Back Pain and Surgery. Avoiding surgery appears to be a very reasonable choice.

Vitamins

  Vitamin B Complex
 B-vitamins, such as thiamin (B1), pyridoxine (B6), and cyanocobalamin (B12), have been clinically effective in treating various painful conditions such as lumbago and sciatica.
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Strongly counter-indicative
May do some good
Likely to help
Highly recommended







GLOSSARY

Acute:  An illness or symptom of sudden onset, which generally has a short duration.

Anesthesia:  Loss of sensation caused by neurological dysfunction or a pharmacological depression of nerve function.

Arthritis:  Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis. Osteoarthritis, the most common form, is characterized by a gradual loss of cartilage and often an overgrowth of bone at the joints.

Bacteria:  Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

Cancer:  Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

Chronic Fatigue Syndrome:  CFS (Chronic Fatigue Syndrome) is a disorder of unknown cause that lasts for prolonged periods and causes extreme and debilitating exhaustion as well as a wide range of other symptoms such as fever, headache, muscle ache and joint pain, often resembling flu and other viral infections. Also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), Chronic Epstein-Barr Virus (CEBV), Myalgic Encephalomyelitis (ME), "Yuppy Flu" and other names, it is frequently misdiagnosed as hypochondria, psychosomatic illness, or depression, because routine medical tests do not detect any problems.

Constipation:  Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.

Copper:  An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.

Extensor:  A muscle that opens a joint.

Flexor:  A muscle that closes a joint.

Ganglion:  A group of nerve cell bodies clustered together in a uniform mass outside of but often close to the brain or spinal chord. Nerves run to or from the ganglia in passage to or from the brain to specific sites on the body.

Herniated Disc:  A patient with a herniated or "slipped" disc can have leg and/or back pain. The most common complaint is that of shooting pain down one or, uncommonly, both legs. The pain will typically travel from the back or buttocks to below the knee. The second possible symptom is back pain. Patients often report a history of back pain that occurred before the actual herniation. Many patients recall an episode of their back "going out" or of significant pain that resolved over a period of days with rest and was usually not accompanied by leg pain.

IU:  International Units. One IU is 1/40th (0.025) of a microgram (mcg).

MRI:  Magnetic Resonance Imaging. A technique used in diagnosis that combines radio waves and magnetic forces to produce detailed images of the internal structures of the body.

Osteoporosis:  A disease in which bone tissue becomes porous and brittle. The disease primarily affects postmenopausal women.

Prostate:  The prostate gland in men that surrounds the neck of the bladder and the urethra and produces a secretion that liquefies coagulated semen.

Protein:  Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

Sciatica:  Pain in the lower back and hip radiating down the back of the thigh into the leg, often due to herniated lumbar disk.

Spondylitis:  Inflammation of one or more vertebrae.

Stenosis:  (Esophageal, GI tract): Narrowing.

Vitamin A:  A fat-soluble vitamin essential to one's health. Plays an important part in the growth and repair of body tissue, protects epithelial tissue, helps maintain the skin and is necessary for night vision. It is also necessary for normal growth and formation of bones and teeth. For Vitamin A only, 1mg translates to 833 IU.

Vitamin D:  A fat-soluble vitamin essential to one's health. Regulates the amount of calcium and phosphorus in the blood by improving their absorption and utilization. Necessary for normal growth and formation of bones and teeth. For Vitamin D only, 1mcg translates to 40 IU.