The human spinal column is the center of postural control.
It is built to provide stability and at the same time allow flexibility.
These two seemingly incompatible functions of support (inflexibility) and movement (flexibility) are at opposite ends of a spectrum of movement, and this fact is one reason the spine is so vulnerable to injury.
Proper Treatment of Neck & Back Pain Must Begin With The Diagnosis
Of fundamental importance
Difficult without appropriate tools and strategies
70% of problems DO have a diagnosable physical cause
“ It is clear from clinical experience and formal studies that when a patient presents with spinal pain there are no clinical features that permit the source of pain to be diagnosed. Even imaging studies do not provide a diagnosis. The appropriate investigations are the ones that answer the questions ( where does the pain come from )” Bogduk et al
CONTRAST DISTRIBUTION  : (AS EVALUATED BY FLUOROSCOPY ) Disk has a complete radio fissure that allows injected fluid to escape. Can be in any stage of degeneration. “ Ruptured” (R) Degenerated disk with radio fissure leading to the outer edge of the annulus. “ Fissured” (F) Degenerated disk with fissures and clefts in the nucleus and inner annulus. “ Irregular” (I) Mature disk with nucleus starting to degenerate into fibrous lumps. “ Lobular” (L) No signs of degeneration, Soft white amorphous nucleus “ Cotton Ball” (CB) Stage of Disk Degeneration (C-arm View) Discogram Type “ Ruptured” “ Fissured” “ Irregular” “ Lobular” “ Cotton Ball”