Conditions We Assess
Back, neck and nerve symptoms are not always straightforward.
Two people can have almost identical MRI reports and very different symptoms. A relatively small disc change can cause severe nerve pain if it affects the wrong structure, while another person may have significant degenerative changes and remain surprisingly functional.
At Auckland Disc Clinic, our focus is on understanding how your symptoms, neurological findings, spinal mechanics and imaging fit together.
We commonly assess people who have been dealing with persistent or recurring spinal problems, particularly where pain is travelling into an arm or leg, where imaging has identified disc or degenerative changes, or where previous treatment has not provided the improvement they expected.
The aim is not simply to attach a diagnosis to your scan.
It is to work out what is most likely driving your symptoms, whether conservative treatment is appropriate, and what the most sensible next step should be.
Disc Bulge & Herniation
Disc changes are extremely common on MRI, but they are not all clinically significant.
A disc bulge is different from a protrusion, extrusion or sequestration, and the terminology matters when we are trying to understand what may be affecting a nearby nerve.
Symptoms can include:
local back or neck pain
pain into an arm or leg
burning or aching nerve pain
pins and needles
numbness
weakness
pain aggravated by sitting, bending or particular positions
We compare the location of the disc finding with the patient's symptoms and neurological examination rather than assuming that every abnormality on a scan needs treatment.
Contained disc bulges and herniations may sometimes be suitable for conservative management. More significant neurological compromise or some sequestrated disc presentations may require medical or surgical assessment instead.
Learn more about Disc Bulge & Herniation
Sciatica & Leg Pain
Sciatica describes symptoms affecting the sciatic nerve pathway, usually travelling from the lower back or buttock into the leg.
It is a symptom rather than a diagnosis.
Disc herniation is one common cause, but narrowing around a nerve, degenerative change, spondylolisthesis and other spinal conditions can produce a similar pattern.
Sciatic symptoms may include:
buttock or leg pain
burning or electric pain
tingling
numbness
altered sensation in the foot
weakness
difficulty sitting, standing or walking comfortably
Some people have severe leg symptoms with surprisingly little back pain.
Our first job is to determine why the nerve appears to be irritated, because that determines whether decompression or another form of conservative treatment makes sense.
Learn more about Sciatica & Leg Pain
Cervical Disc & Arm Pain
Problems in the cervical spine can cause symptoms far beyond the neck.
An irritated cervical nerve may produce aching, burning, tingling, numbness or weakness into the shoulder, arm, forearm, hand or fingers.
Some patients barely notice their neck at all.
One interesting clinical clue is when raising the affected arm and resting the hand over or behind the head temporarily relieves the arm symptoms. This can occur with cervical nerve-root irritation, although it is only one part of the overall assessment.
Cervical disc and nerve presentations have been among the more encouraging cases we have treated with spinal decompression.
As always, however, we first need to establish whether the symptoms are actually coming from the cervical spine rather than the shoulder, elbow, wrist or another source.
Learn more about Cervical Disc & Arm Pain
Spondylolisthesis
Spondylolisthesis occurs when one vertebra has shifted relative to the vertebra beneath it.
There are several types and causes, including longstanding pars defects, degenerative changes and previous injury.
Some people have a spondylolisthesis for years without significant symptoms. In others it may contribute to:
persistent lower-back pain
stiffness
pain into the buttocks or legs
nerve irritation
difficulty standing or walking
recurring episodes of mechanical back pain
These cases require more care than simply seeing the word “spondylolisthesis” on an X-ray and applying a standard treatment.
Stability, degree of slip, neurological findings, symptoms and imaging all matter.
In selected longstanding cases, we have seen positive responses using carefully controlled decompression, sometimes combined with specific chiropractic management. Some can initially become mildly more symptomatic before settling, which is why progression and response need to be monitored rather than treatment simply being pushed ahead.
Learn more about Spondylolisthesis
Degenerative Disc & Joint Changes
Spinal discs and joints change throughout life.
Loss of disc height, reduced hydration, osteoarthritis, osteophytes and narrowing around the nerve openings become increasingly common with age.
An MRI or X-ray describing “degeneration” does not automatically mean that those changes are responsible for the patient's symptoms.
The important question is what those changes are doing mechanically.
In some people they may contribute to:
persistent back or neck pain
stiffness
restricted movement
narrowing around spinal nerves
arm or leg symptoms
reduced tolerance for sitting, standing or walking
The objective of conservative care is not to reverse normal ageing or make an older spine look young again.
It is to determine whether the mechanical consequences of those changes can be managed well enough to reduce symptoms and improve function.
Learn more about Degenerative Disc Disease
Spinal Stenosis
Spinal stenosis describes narrowing around the spinal canal or the openings where nerves leave the spine. It commonly develops alongside degenerative disc and joint changes and can contribute to back or neck pain, sciatica, arm or leg symptoms, numbness, weakness, or reduced walking tolerance.
The important question is not simply whether stenosis appears on imaging, but where the narrowing is, what structure it is affecting, and whether it matches the patient's symptoms and neurological findings.
Some forms of foraminal or disc-related narrowing may be suitable for conservative management, while severe central stenosis or significant neurological compromise may require specialist assessment.
Learn more about Spinal Stenosis
When Several Things Are Going On at Once
Real patients do not always fit neatly into one diagnostic box.
Someone may have a disc protrusion, degenerative narrowing, an old spondylolisthesis and joint changes all visible on the same scan.
That does not mean every finding is equally important.
Part of our assessment is determining which findings matter now and which may simply represent background changes that have accumulated over time.
This is particularly important when someone has already received multiple opinions, tried several forms of treatment or has been told that their scan looks terrible without having the findings properly related to their symptoms.
Imaging Is Important — But It Is Not the Whole Diagnosis
Where appropriate, we review existing MRI, CT and X-ray imaging alongside the clinical examination.
We are looking for agreement between:
where you feel your symptoms
how those symptoms behave
muscle strength
sensation
reflexes
neurological tension
spinal movement and mechanics
what the imaging actually shows
When those pieces line up, it gives us considerably more confidence about where the symptoms are coming from.
When they do not, we need to question whether the scan finding being blamed is actually the problem.
Knowing When Not to Treat Matters Too
Not every spinal problem belongs in a conservative care clinic.
Progressive neurological loss, significant weakness, cauda equina symptoms, unstable pathology and some severe disc presentations may require urgent medical or surgical assessment.
We have referred patients back for specialist care when we believe decompression or chiropractic treatment is unlikely to be the right approach.
That is an important part of the assessment process.
Our objective is not to find a reason to treat everybody.
It is to help you understand what appears to be happening and determine the most appropriate path forward.
Not Sure Which Condition Fits?
You do not need to work that out before you come in.
Many patients arrive knowing only that they have pain, nerve symptoms or an MRI report full of terminology they do not completely understand.
Your Initial Disc Assessment is designed to bring those pieces together.
The 30-minute assessment with Dr David Kay includes your history, neurological and orthopaedic examination, review of relevant imaging where available and a discussion of the most appropriate next step.
That may involve spinal decompression, specific chiropractic or manual care, further imaging, medical referral or simply explaining why treatment may not be necessary.
Initial Disc Assessment — $130
Treatment is not included in the initial assessment.