What is Inflammation
Crossfit & Health Fitness
Dr Alex Jimenez and Dr. Mario Ruja
3 Points of Weight Loss
Metabolic Syndrome: Getting Deep Into It
Sciatica: The Nasty Back Scourge | El Paso, Texas
Sciatica Explained | El Paso, Texas
Metabolic Syndrome: What It Is & How to Fix It
Metabolic Syndrome | El Paso Texas
The Push Fitness Story | El Paso Texas
El Paso Chiropractor: What We Do- El Paso, Tx
Dr. Alex Jimenez Presents (Personalized Medicine & Wellness)
Gentle Chiropractic Therapy After Spine Surgery Or Spinal Fusion
Individuals that have undergone spine surgery or spinal fusion for extreme low back pain caused by degeneration, herniated disks, sciatica, and other injuries could benefit from gentle chiropractic therapy post-surgery. Spinal fusion surgery is one of the last options after non-invasive treatment/s aren’t providing relief like:
- Massage
- Physical therapy
- Chiropractic
- Medications
However, many patients still experience pain/discomfort after the surgery and wonder which rehabilitation treatment options are available to them. Is chiropractic care still an option after major spinal surgery? Doctors will warn patients about the risks of receiving chiropractic treatment after surgery. This is true with high-velocity low-amplitude spinal adjustments/manipulation.
But incorporating gentle chiropractic therapy could benefit individuals still experiencing back pain after surgery. However, an individual needs to be adequately healed prior to beginning treatment. At Injury Medical Chiropractic and Functional Wellness Clinic, we regularly consult with patients post-surgery about the effectiveness of spinal rehabilitation therapy.
Table of Contents
After surgery wait time
Spinal fusion surgery removes the discs between two or more vertebrae and fuses the bones together with screws and plates. The objective is to correct conditions like herniated discs and degenerative disc disease by immobilizing the spine in that area. It can take three months for the vertebrae to fuse together and create a complete immobilized graft. Once the graft is complete, physical therapy is brought in to strengthen the muscles around the graft. Patients are told to avoid any twisting and bending motions, or the graft could break.
How gentle chiropractic therapy can help
Spinal fusion surgery is not guaranteed to cure the problem causing an individual’s back pain. Gentle chiropractic therapy can help by therapeutically massaging the area/s keeping the muscles loose and flexible. Gentle manipulations are utilized to adjust or realign bones in the spine and other areas of the body. Because chiropractic treatment can involve intricate spinal manipulations, many individuals that have undergone back surgery can be hesitant to consider chiropractic treatment.
Discuss the possibility of receiving chiropractic therapy with a physician to determine whether the surgical graft is strong enough to withstand gentle spinal manipulations. A patient post-surgery is at greater risk of injury if they are not healed correctly before receiving chiropractic treatment. If the graft is adequately healed and a physician feels that the body is strong enough to endure mild spinal manipulations, reach out to a chiropractor to discuss treatment options.
Body Composition Clinic
Benefits of a cheat day
Cheat days can be a highly useful tool to help motivate sticking to a diet plan. Cheat days can help build a positive relationship with food. The goal is to see one’s favorite dessert/comfort food as a reward and not a coping mechanism. However, cheat days not a license to binge eat.
Binge eating can lead to eating-related issues and hurt an individual’s ability to self-regulate. Binge eating does not boost the body’s metabolism, but it can have the opposite effect. After a binge, the body’s system is overloaded with a rush of calories, sugar, and fat. In addition to causing hormone and energy levels to fluctuate, the excess of calories promotes:
- Fat storage
- Inflammation
- Digestive discomfort
- Bloating
- Constipation
Cheat day frequency
Ultimately, cheat days depend on how well an individual self-regulates and what their short and long-term goals are. However, it can become very easy for a cheat day to become a cheat weekend, to a cheat week, and so on. Next thing an individual is back to old unhealthy eating habits. The objective is to understand what helps maintain motivation and develop a sustainable, long-term plan.
Dr. Alex Jimenez’s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Perrucci, Rachel M, and Christopher M Coulis. “Chiropractic management of post spinal cord stimulator spine pain: a case report.” Chiropractic & manual therapies vol. 25 5. 6 Feb. 2017, doi:10.1186/s12998-017-0136-0
Fernandez, Matthew et al. “Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.” European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 25,11 (2016): 3495-3512. doi:10.1007/s00586-015-4148-y
O’Shaughnessy, Julie et al. “Chiropractic management of patients post-disc arthroplasty: eight case reports.” Chiropractic & osteopathy vol. 18 7. 21 Apr. 2010, doi:10.1186/1746-1340-18-7
Weight Loss Strategies That Are Evidence-Based
The human body is a complex system, that requires consistent development in all areas. When it comes to weight loss being too strict can cause the body to rebel. Examples are individuals that have lost weight, then put it right back on, or get stuck in a plateau. The objective is to step off the weight loss rollercoaster and embrace weight-loss strategies that work. Here, we explore a few evidence-based weight loss strategies that focus on long-lasting success.
Table of Contents
Improve insulin sensitivity
When consuming carbohydrates, it is broken down into sugar.
The body needs a certain amount of sugar to function. However, it is a narrow safety range. If the level gets too high for too long, cellular damage happens. The role of insulin is to guide the excess sugar/glucose into the cells. However, more individuals are experiencing high blood insulin levels, called hyperinsulinemia. Possible symptoms can include:
- Sugar cravings
- Unusual weight gain
- Frequent hunger
- Excessive hunger
- Unable to concentrate
- Anxiety or feelings of panic
- Lack of focus
- Extreme fatigue
Insulin rises because the blood sugar does. It’s dangerous to let glucose levels stay elevated, which is why more insulin gets produced to bring the blood sugar down. Given enough time constant hyperinsulinemia can result in a condition called insulin resistance, where the cells become resistant to the effects of insulin and are less effective.
Insulin sensitivity and weight loss
A high level of insulin in the blood can trigger weight gain and make losing it difficult. Results of high insulin:
- Disrupts the breakdown of fat known as lipolysis
- Raises the potential for fat storage
- Increases the risk of regaining weight despite following a low-calorie diet
Improving insulin sensitivity can be done by:
- Consuming whole, low glycemic foods
- Eating healthy fats
- Incorporating high-intensity interval training
- Going for optimal gut health
- Managing stress effectively
Manage stress levels
Stress and stress eating could be contributing to an expanding waistline. Examples could be eating a favorite meal while barely being conscious of the process or the inability to resist a chocolate bar after a long, distressing day. Research published in the Journal of Health Psychology found that stress-related eating has a preference for calorie-dense and highly tasty foods. And when stress levels rise, food cravings rise, triggering fat gain.
Reducing stress
There are a variety of techniques that can help the mind and body relax turning off the stress response. Here are some science-based favorites:
- Meditation
- Exercise
- Progressive Muscle Relaxation
- Yoga
- Emotional Freedom Technique
- Foods that have B vitamins, zinc, and Omega-three fatty acids. These include:
- Free-range eggs
- Nuts
- Seeds
- Fatty fish
- Dark chocolate
Proper sleep cycle
Proper sleep means sound sleep eight hours each night. Many individuals have convinced themselves that five or six hours is enough. Unfortunately, research shows otherwise. In a study published in PLOS Medicine, researchers studied the effects of short sleep duration on hormones that lessen or increase hunger, and on body mass index or BMI. They found the participants with short sleep had reduced leptin and elevated ghrelin which increases appetite and can contribute to weight gain.
Improving sleep quality
- Developing a healthy sleep routine
- Have the same sleep and waking time
- Time to wind down
- Meditate a little before sleep
- Take a warm bath 90 minutes before bed
- Avoid blue light at least 90 minutes before going to sleep
- Limit caffeine intake as it can negatively affect sleep even when taken six hours before sleep
- Avoid/limit alcohol in the evenings
- Regular physical activity can help release stress and tension, tiring the body out so sleep comes naturally
- 30 to 40-minute endurance sessions a week are plenty. However, for some individuals, exercising too close to bedtime can have the opposite effect. Therefore, take note of whether this would be a problem.
High-Intensity Interval Training
There are a variety of approaches to exercising. But there is one evidence-based approach that has been proven to:
- Burn abdominal fat
- Reduce waist circumference
- Address insulin resistance
It is known as HIIT.
High-Intensity Interval Exercise involves:
- Repeated brief sprints with all-out intensity immediately followed by low-intensity exercise or rest.
- This type of exercise is a perfect match for:
- Treadmill workout
- Elliptical trainer workout
- Skipping/jumping rope
- Rowing workout
- Walking workout
Increasing Muscle Mass
An increased amount of muscle increases the basal metabolic rate or BMR. This increases the body’s ability to burn fat and lose weight. A loss of lean body mass lowers resting energy expenditure and increases fatigue and injury risk. For individuals trying to lose weight the metabolic decline triggered by a loss of lean body mass can cause regaining the fat previously lost. What this means is that when muscle mass drops so does metabolism along with the ability to keep the weight off.
When muscle mass increases the body can easily burn fat, making it possible to achieve and maintain a healthy weight. It’s important to remember that as the body’s muscle mass increases the body needs more energy to nourish and support this new tissue. This means that higher calories are allowed, as not having enough calories becomes counterproductive. Muscle mass increase can be achieved by:
- A healthy diet will help build muscle
- Strength and resistance training
- Taking protein supplements
Weight loss strategies takeaway
With the right approaches, permanent weight loss is possible. Instead of deprivation, focus on science-backed approaches that work:
- Improved insulin sensitivity
- Stress management
- Sound sleep
- High-intensity interval training
- Increasing muscle mass
- Choose approaches that are enjoyable and fun
This will make sticking to the weight loss strategies easier and will contribute to a happy, healthy life.
Body Composition
Dr. Alex Jimenez’s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Chao, Ariana et al. “Food cravings mediate the relationship between chronic stress and body mass index.” Journal of health psychology vol. 20,6 (2015): 721-9. doi:10.1177/1359105315573448
Taheri, Shahrad et al. “Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index.” PLoS medicine vol. 1,3 (2004): e62. doi:10.1371/journal.pmed.0010062
Spinal Decompression Surgery: Laminotomy and Laminectomy
Spinal decompression surgery could be a treatment option discussion with a doctor to relieve nerve pain brought on by a spinal condition or disorder. Everything to know about the procedures straight from the experts.
Table of Contents
Spinal Decompression Surgery Types: Laminectomy or Laminotomy
Both procedures involve the vertebrae’s lamina, which is an arch of bone that protects the spinal canal.
- In a laminectomy, the lamina is removed almost entirely.
- In a laminotomy, it is a partial removal.
Despite the removal, the large muscles of the back provide sustained protection for the nerves below. Therefore, the spinal nerves are still safe and secure following the procedures. Which one is right depends on the situation.
- A laminectomy is usually performed to treat an arthritic condition of the spinal canal like spinal stenosis.
- Laminotomy is used almost exclusively to remove a herniated disc.
- A laminectomy removes more bone and sometimes the inner edge of the facet joint.
- Ultimately, a surgeon will determine which of the two procedures is best for the individual’s needs and condition.
Decompression Surgery
Spinal stenosis or the narrowing of the spinal canal is usually caused by arthritis and overgrowth of the discs and joints. Similar compression issues respond well to non-surgical treatment. But sometimes surgery is necessary to treat uncommon but potentially severe cases. These include patients with:
- Bowel or bladder problems caused by the pressure on the spinal nerves
- Leg weakness that gets worse
- Inability to walk or move for long periods and distance
The objective of spinal decompression surgery is to create space around the spinal cord and surrounding nerves by removing the compressing structure/s. When the cord and/or nerve/s are compressed, physical and neurological symptoms are experienced down the nerve’s pathway. This includes:
- Tingling
- Numbness
- Electric shock sensations
- Radiating/spreading pain
- Weakness
Once the compressed nerves have space to relax and move around symptoms subside.
Laminectomy process
- Lumbar laminectomy is the most common procedure to treat spinal stenosis in the low back.
- It also helps treat herniated discs by allowing the surgeon to easily access the discs to repair any damage.
- The surgeon removes the lamina and ligaments that have thickened and are causing problems to create more space in the canal.
- The surgery enlarges the spinal canal so that pressure is relieved.
- By removing the source of the pressure, the pain caused by the compressed nerves is alleviated.
- An open laminectomy creates an incision of a couple of inches and exposes the spine.
- The muscles of the spine and back are cut through to expose the bone.
- Another technique that surgeons utilize is operating through a tube.
- They’ve adapted these techniques to be able to decompress both the right and the left sides although they are only operating on one side.
- Both procedures, minimal and traditional accomplish the same goals.
- The difference is the minimally invasive approach involves one or more tiny incisions also known as skin punctures and small instruments designed to separate muscles and soft tissues instead of cutting through them.
- The traditional approach requires a larger incision and instruments that retract, separate and cut tissues.
Laminectomy surgery
- Laminectomies are performed under general anesthesia using a posterior approach/lying face down during the procedure.
- It can be open or minimally invasive sometimes called a microlaminectomy.
- In an open laminectomy, the surgeon makes an incision near the affected spinal area.
- Once the incision is made, a retractor will move the skin, fat, and muscles to the side so the surgeon can access the spine.
- Next, they remove or trim the lamina and thickened ligaments to enlarge the space surrounding the compressed nerves.
- Once done, the retractor is removed and the incision is closed with sutures.
- Minimally invasive surgery or MIS is performed using special instruments like endoscopes and tubular retractors.
- These instruments allow for smaller incisions and less cutting.
- They will also use special eyewear to have a detailed view of the surgical field.
- Sometimes, the surgeon uses an endoscope or a microscope focused down the tube to perform the surgery.
- The portion of the lamina is removed, along with any bone overgrowths/osteophytes and ligament tissue.
- The tubular retractors are taken out so the soft tissue moves back into place, and the incision is closed with dissolving sutures.
Other spinal procedures performed alongside
Laminectomies and laminotomies are typically not performed together. However, a surgeon could perform both if the surgery affects multiple levels of the spine. They can also be combined with other spinal surgeries, that include:
Foraminotomy
- A foraminotomy is also a decompression procedure. But instead of removing part or all the lamina, the surgeon accesses the nerves through the spine’s foramen or the passageway that nerves pass through on both sides.
Discectomy
- This decompression surgery involves the removal of all or part of the damaged intervertebral disc and is utilized for herniated discs.
Spinal fusion
- Fusion is often performed after spinal decompression surgery, as the space that was created by removing spinal structure/s can cause instability to the spine.
Candidates for spinal decompression surgery
Both are common procedures performed by neurosurgeons and orthopedic spine surgeons. Laminectomies are considered one of the most effective treatments for spinal stenosis and spinal canal issues like:
- Tumors
- Certain types of infections and abscesses
- Spinal issues involving bowel/bladder dysfunction
- The primary reason for laminectomy is spinal stenosis, most common in individuals over the age of 60.
Other considerations and conditions include:
- Non-invasive treatments that don’t improve the condition that includes medication, massage, and physical therapy
- Fusion surgery failure
- Injection treatment failure
- The presence of tumors in or around the spine
- An infection like an epidural abscess
- Neurologic issues
- Bowel or bladder dysfunction
- Cauda equina syndrome
Ask questions about the procedure to ensure you are comfortable with the operation. Here are some questions:
- What are the risks associated?
- Will the surgery relieve all symptoms?
- Not having the surgery risks?
- What is recovery like?
Recovery
- Open or micro, recovery does take time. Following the doctor’s instructions carefully are essential to make a full, healthy recovery.
- Individuals should be careful for about a month following the surgery. But does not mean laying down or being sedentary. Movement is crucial to recovery.
- The patient should not stay in bed or lie on the sofa.
- Wait a week or two before beginning physical therapy if necessary.
- Most will have a weak core, poor posture, and poor body mechanics, the goal is to help develop and strengthen these areas.
Things to help with recovery include:
- Ice/cold packs will help reduce swelling and pain.
- Try not to sit for too long, as sitting is the least comfortable position after back surgery.
- Body mechanic awareness means avoiding too much bending or lifting and using the right body mechanics when bending or lifting.
- Post-operative body movement after surgery is vital and helps prevent post-surgery issues.
Things to do before surgery:
Quitting smoking
- Especially before surgery. Quitting entirely or at least for at least six weeks before surgery will make recovery easier and healthier.
Losing weight
- Speak with a doctor about weight. Just 5 pounds can make a significant difference during recovery.
Blood sugar
- For individuals with diabetes, having an A1C under eight before surgery is ideal.
Every patient’s recovery is different. Recovery time depends on:
- The complexity of the surgery
- Personal medical history
- Health issues
Recovery typically takes about two to four weeks after the surgery. However, it depends on the reason/s for the surgery.
Questions
Post-laminectomy syndrome
- Post-laminectomy syndrome PLS also known as failed back surgery syndrome is a condition where an individual continues to have pain after surgery. Individuals still having symptoms after should speak with their doctor to determine the next phase of treatment.
How long before exercise?
- Returning to the gym or getting into an exercise routine will take some time. It is important to follow the doctor’s recommendations and complete the full course of physical therapy before regular exercise activity can resume. Discuss workout plans with the doctor to determine the best timeline for the spine.
Full recovery?
- Returning to some activity is possible around four weeks after surgery. Full recovery takes longer as each patient’s recovery is unique. Depending on the complexity of the surgery, most return to all activities within 6 to 9 months.
Body Composition Spotlight
Dr. Alex Jimenez’s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
American Association of Neurological Surgeons. “Minimally Invasive Spine Surgery.” (n.d.) https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Minimally-Invasive-Spine-Surgery
Foraminotomy. MedlinePlus. https://medlineplus.gov/ency/article/007390.htm. Reviewed November 27, 2016. Page last updated December 21, 2017. Accessed January 18, 2018.
Laminectomy. https://medlineplus.gov/ency/article/007389.htm. MedlinePlus. Reviewed November 27, 2016. Page last updated December 21, 2017. Accessed January 18, 2018.
Mayo Clinic. “Laminectomy.” (n.d.) https://www.mayoclinic.org/tests-procedures/laminectomy/about/pac-20394533
Mayo Clinic. “Laminotomy.” (n.d) https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/multimedia/img-20149227
