How Outcome Measurement Tests Benefit Physical Therapy

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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A physiotherapist helps an elderly woman in a rehabilitation center

Can individuals experiencing difficulty with functional mobility benefit from physical therapy to help them return to normal activities?

Table of Contents

Outcome Measurement Tests

Outcome measurement tests assess the effects of a treatment plan on a patient. They can be used to determine a patient’s baseline function, monitor their progress, and evaluate the effectiveness of treatment. They also give the therapy team an effective way to measure mobility, flexibility, and range of motion.

Function and Purpose

Outcome measurement tests serve various purposes. These include: (American Physical Therapy Association, N.D.)

To assist in goal-setting
Provide motivation
To guide treatment
To give a prognosis for the specific condition
To justify the treatment

The physical therapist may use other functional outcome measurements to help assess physical therapy progress.

They may measure your strength and range of motion.
Balance and posture may be evaluated.

Effective functional outcome measurement tests must meet certain criteria to be useful in a physical therapy clinic. First, they must be reliable, meaning the results must be consistent with each patient and within groups of patients. They must also be valid to measure exactly what they are intended to measure. An effective measurement test must also be easy to administer, so it must be practical and simple. Outcome measurement tests must also be purposeful. For example, a balance test must reflect a patient’s current function and be related to their balance ability.

Common Outcome Measurement Tests Used

Common functional outcome measurement tools that a physical therapist may use include:

The timed up-and-go or TUG test is a simple assessment used to evaluate a person’s mobility and balance by measuring how long it takes them to stand up from a chair, walk a short distance, turn around, walk back, and sit down again; it’s often used to identify potential fall risks in older adults, particularly those with mobility concerns, as a longer time to complete the task may indicate increased fall risk. (Centers for Disease Control and Prevention, 2017)
The Tinetti balance and gait evaluation, also known as the Performance-Oriented Mobility Assessment (POMA), is a clinical test used to assess balance and gait abilities, particularly in older adults. It evaluates stability during various standing and walking tests and provides a score that indicates a person’s fall risk potential.
The Berg Balance Scale (BBS) is a standardized test for adults that measures balance and the risk of falling. It’s widely used and can be performed in various settings.
The six-minute walk test (6MWT) is a medical assessment in which a person walks as far as they can in a designated area for exactly six minutes. This allows healthcare providers to evaluate their functional exercise capacity. It is particularly useful for assessing patients with lung or heart conditions where walking ability might be compromised. The distance covered during the six minutes is the key measurement used to interpret the test results. (Ferreira M. B. et al., 2022)
The functional reach test (FRT) is a clinical assessment that measures an individual’s dynamic balance by determining the maximum distance they can reach forward while standing in a fixed position. It assesses their risk of falling by evaluating how far they can extend their arm before losing stability. The FRT is often used to assess older adults or individuals with potential balance issues.
The Oswestry low back pain disability questionnaire is a self-administered questionnaire used to measure the level of disability a person experiences due to low back pain. It assesses how the pain impacts their daily activities in various aspects of life, such as personal care, work, and social life; a higher score indicates greater disability.
The functional independence measure (FIM) assesses a patient’s ability to perform daily activities independently. It also measures the patient’s disability level and how much assistance is needed.

Functional outcome measurement tests provide a starting point for developing physical therapy goals. For example, if the TUG test takes 19 seconds, individuals may aim for 10 seconds. A TUG score that falls at or over 10 seconds indicates reduced physical capacity (Kear B. M., Guck T. P., & McGaha A. L. 2017). This can be the motivation needed to reach physical therapy goals.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Understanding The Effects of Personal Injury

References

American Physical Therapy Association. (N.D.). Outcome Measures in Patient Care. https://www.apta.org/your-practice/outcomes-measurement

Centers for Disease Control and Prevention. (2017). Timed Up & Go Assessment. Retrieved from https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf

Ferreira, M. B., Saraiva, F. A., Fonseca, T., Costa, R., Marinho, A., Oliveira, J. C., Carvalho, H. C., Rodrigues, P., & Ferreira, J. P. (2022). Clinical associations and prognostic implications of 6-minute walk test in rheumatoid arthritis. Scientific reports, 12(1), 18672. https://doi.org/10.1038/s41598-022-21547-z

Kear, B. M., Guck, T. P., & McGaha, A. L. (2017). Timed Up and Go (TUG) Test: Normative Reference Values for Ages 20 to 59 Years and Relationships With Physical and Mental Health Risk Factors. Journal of primary care & community health, 8(1), 9–13. https://doi.org/10.1177/2150131916659282

Facet Arthropathy: Managing Arthritis in the Spine

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Providing Physical Therapy for Shoulder Pain Relief — Physical therapist helping patient with shoulder pain in clinic, assisting with movement and providing therapy techniques, in calm and supportive environment

Can individuals managing facet arthropathy treat the condition with over-the-counter pain relievers, prescription muscle relaxers, exercise, and chiropractic spinal manipulation?

Table of Contents

Facet Arthropathy

Facet arthropathy, or facet osteoarthritis, is arthritis that affects the facet joints in the spine. It causes pain and stiffness due to cartilage degeneration within these joints, often resulting from wear and tear associated with aging. Essentially, it occurs when the small joints in the back of the spine become arthritic and rub against each other painfully.

It affects the bony protrusions, called facet joints, that connect the spine’s bones.
Symptoms include neck and back pain that can worsen with standing, bending, or twisting.
Facet arthropathy is diagnosed using X-rays and other imaging studies.
Severe cases may require surgery.

Facet Joints

Twenty-four vertebrae form the spine, with two facet joints between each. Facet joints are small joints located at the back of each vertebra in the spine. They allow movement and stability, help maintain the alignment of the spinal bones/vertebrae, and limit excessive motion. The joints and the cushioning intervertebral disc form a three-joint complex between each vertebra.

The three-joint complex allows the spine to move, including bending, rotating, and extending.
Synovial fluid lubricates the joints so they can move.
The intervertebral disc provides flexibility and dissipates compressive loads.
The facet joints stabilize the spine by constraining rotation and bending.

Symptoms

Arthropathy refers to any disease affecting a joint, including arthritis. Osteoarthritis, also known as arthrosis, is a specific type of arthropathy. It is a non-inflammatory, degenerative arthritis. Pain is the main symptom that is typically worse in the morning when awakening, and in the evening, the pain can also get worse when twisting or bending backward. The symptoms can vary based on the part of the affected spine. Low back pain is the most common, a condition referred to as lumbar facet arthropathy because it affects the lumbar spine of the lower back. (Perolat R. et al., 2018) Common Symptoms include:

Muscle spasms or cramps.
Pain that may come in periodic flare-ups
Pain that worsens with standing or inactivity.
Dull pain on both sides of the spine.
Aching pain on both sides of the spine.
Pain in the lower back, buttocks, shoulders, or back of the skull
Radiating pain to the buttocks and legs.
Pain that improves with sitting, leaning forward, or changing positions.
Pins-and-needles sensations in the hands or feet.
Clicking sounds when moving the spine.
Catching sensations when moving the spine.
Muscle weakness.

Causes

Facet arthropathy causes progressive damage to the spine. Spinal osteoarthritis, aka spondylosis, is the most common cause, but it can also occur with a severe form of spinal arthritis known as ankylosing spondylitis. It is primarily due to age-related wear and tear, but injuries or repetitive stress on the spine can also cause it. Arthritis in the facet joints can develop due to:

Aging-related wear and tear
Disc problems
A previous back injury
Torn ligaments
Spinal fractures

Deterioration of facet joints can also cause bony overgrowths called osteophytes or bone spurs, which can cause radiating pain and restrict the spine’s range of motion.

Degeneration

The facet joints and intervertebral discs degenerate due to age-related wear and tear.
The cartilage in the facet joints can dry out, crack, and wear down.
The joint capsule and synovial membrane can inflame or tear, affecting synovial fluid production.
The loss of cartilage can lead to hypermobility, and the joint can stiffen over time.

Diagnosis

Imaging studies are important to the diagnosis. Several types confirm the diagnosis and also characterize the nature and severity of the condition:

X-rays provide a plain, black-and-white image of the spinal column.
CT scan composites multiple X-rays to create a three-dimensional image of the spinal column.
MRI uses magnetic and radio waves to generate images of soft tissues like ligaments and cartilage.

To confirm the diagnosis, a diagnostic block, which is a small amount of local anesthetic, is injected into a facet joint. The needle placement is directed either with an ultrasound or a CT scan. Facet arthroplasty is confirmed if the injection provides immediate relief (American Academy of Orthopaedic Surgeons, 2022). The healthcare provider will want to exclude other possible causes as part of the differential diagnosis. Conditions that mimic facet arthropathy include:

Herniated disc
Psoriatic arthritis
Reactive arthritis
Spinal gout
Spinal compression fracture

Treatment

The treatment varies depending on the location and severity of the condition. Generally, conservative treatments are used before more invasive procedures are considered.

Lifestyle Changes

Initially, a healthcare provider may recommend rest and avoiding aggravating movements, including any activity that involves bending or twisting.
Activities that take the weight off the facet joint, such as sitting, leaning forward, or changing positions, may help ease the pain.
Patients may also be advised to adjust their sleep positions to take the pressure off facet joints.
Options included curling up on your side or lying on your back with the knees supported with pillows.

Medications

If a diagnostic block is used, a patient may not need medications immediately. However, as the anesthetic starts to wear off, the patient may be prescribed over-the-counter or prescription pain relievers based on the severity of the pain. These can include:

Analgesics like Tylenol
Nonsteroidal anti-inflammatory drugs like Advil or Aleve
Muscle relaxants like Lloresal for acute back pain
Antidepressants like Cymbalta for chronic back pain

Physical Therapy

Physical therapy is a major part of the treatment of lower back pain. The treatment plan will include personalized exercises to strengthen the core muscles and avoid stress on the spine. Examples include:

Mechanical traction and non-surgical spinal decompression.
Knee-to-chest stretches, hugging your knees for 30 to 60 seconds.
Walking 10 to 20 minutes per day.
Aquatic therapy to alleviate pressure on the spine.

Surgery

If conservative measures don’t work or provide sufficient relief, a healthcare provider may recommend specialist procedures or surgeries that include:

Lumbar intra-articular injections deliver an anesthetic or corticosteroid into the spine for longer-lasting pain relief.
Sinuvertebral nerve ablation destroys spinal nerves with a strong electrical current.
Extracorporeal shockwave therapy ESWT delivers low- or high-energy electrical pulses to help ease pain.
Spinal fusion surgery involves fusing two or more vertebrae to eliminate movement and pain in the facet joints.
Facet rhizotomy is a surgical procedure used to sever one of the nerves supplying the facet joint.
Stem cell regeneration is an experimental procedure in which stem cells are harvested and injected into damaged joints to restore function.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Facet Syndrome Pain Treatment

References

Perolat, R., Kastler, A., Nicot, B., Pellat, J. M., Tahon, F., Attye, A., Heck, O., Boubagra, K., Grand, S., & Krainik, A. (2018). Facet joint syndrome: from diagnosis to interventional management. Insights into imaging, 9(5), 773–789. https://doi.org/10.1007/s13244-018-0638-x

American Academy of Orthopaedic Surgeons. (2022). Spinal injections. https://orthoinfo.aaos.org/en/treatment/spinal-injections/

The Ultimate Guide to Warming Up Before a Run

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Horizontal shot of motivated sporty woman stretches legs and arms does warming up exercises before workout looks forward dressed in sportsclothes poses outside on big stadium. Exercising concept

Should individuals wanting to engage in the exercise start with a warm-up and end with a cooldown to prepare the muscles for optimal performance and post-workout recovery?

Table of Contents

Warming Up, Cooling Down

Warming up 5 to 10 minutes before exercise is beneficial for pumping blood to the muscles and preparing them for a run. Dynamic or active stretching and light aerobic activity are a few ways to warm up. This could be active stretching, such as walking lunges, brisk walking, or riding a stationary bike for a few minutes before running. However, individuals should avoid static stretches before running, as they can increase the risk of injury. The minimum length of time for an effective cooldown session is five minutes. Depending on the intensity of the workout, individuals may choose to extend that to 10 minutes.

Steps for a Running Warmup

Do five to 10 minutes of light aerobic exercise to loosen up muscles.
Walk briskly, march, jog slowly, or cycle on a stationary bike.
Don’t rush.
Perform dynamic stretches and movements during the warmup, including walking lunges, jumping jacks, or toe touches.
Begin the run with a slow jog and gradually increase speed.
Slow down if you run out of breath.
This is part of knowing how fast you should run; starting too fast is a common mistake.
Pay attention to posture and form.
Ensure you are using the best technique before speeding up.

Warm Up Benefits

When warming up, the blood vessels dilate. The increased blood flow primes the muscles with oxygen and prepares them to perform at their best. Blood flow also increases the temperature in the muscles for enhanced flexibility. Allowing the heart rate to increase gradually is beneficial, instead of going full max heart output by jumping full speed into the running. (The American Heart Association, 2024)

Properly Cooling Down

At the end of the run:

Cool down by walking or slowly jogging for five to 10 minutes.
Breathing and heart rate should gradually return to normal.
Drink water or an electrolyte-infused drink to rehydrate the body.

Benefits of a Cooldown

The cool-down keeps blood flowing throughout the body at a consistent level. Stopping immediately can cause light-headedness because heart rate and blood pressure can drop rapidly. Winding down slowly allows heart rate and blood pressure to fall gradually. The cooldown is also a good mental transition from the intensity and accomplishing the workout.

Before or After Stretching

Stretching evidence shows it doesn’t have the benefits once thought. Static stretching before, during, or after exercise has not been shown to prevent injury or delayed onset muscle soreness. (Herbert R. D., de Noronha M., & Kamper S. J. 2011) Stretching cold muscles is not recommended. However, there is some evidence that dynamic or active stretching after a warmup can benefit performance. Active stretching is done with exercises that take the muscles through their full range of motion and mimic the actions that will be done during the workout. (Van Hooren B., & Peake J. M. 2018)

Stretching After Running

Standard stretching includes the hamstring stretch, quad stretch, calf stretch, low lunge stretch, IT band stretch, butterfly stretch, hip and backstretch, arms and abs stretch, and triceps stretch. Tips for proper stretching:

Don’t Bounce

Avoid bouncing, as this mimics pulling a rubber band back and forth. You want the muscle to stay stretched.
Hold the stretch for 15 to 30 seconds.

Don’t Stretch Through Pain

Don’t stretch beyond the point where tightness is felt in the muscle.
Do not push through muscle resistance.
Never stretch to the point of pain.

Stretch Whole Body

Don’t just stretch the areas with tightness and/or soreness.
Stretch the whole body equally to prevent injury.

Don’t Hold Your Breath

Take deep breaths during the stretch.
Stay relaxed and breathe in and out slowly.

If starting a new fitness routine, consult your healthcare provider to determine the optimal running warmups and stretching exercises.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

The Science of Motion

References

The American Heart Association. (2024). Warm up, cool down. https://www.heart.org/en/healthy-living/fitness/fitness-basics/warm-up-cool-down

Herbert, R. D., de Noronha, M., & Kamper, S. J. (2011). Stretching to prevent or reduce muscle soreness after exercise. The Cochrane database of systematic reviews, (7), CD004577. https://doi.org/10.1002/14651858.CD004577.pub3

Van Hooren, B., & Peake, J. M. (2018). Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports medicine (Auckland, N.Z.), 48(7), 1575–1595. https://doi.org/10.1007/s40279-018-0916-2

Unlocking the Power of Probiotic and Prebiotic for Optimal Body Function

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Can individuals dealing with gut issues incorporate the beneficial properties of probiotics and prebiotics to improve body function?

Table of Contents

How The Gut Works Together With The Body

When many individuals are dealing with chronic issues that are causing referred pain in their bodies, it could be an issue that is affecting their gut system. Have you experienced unpredictable food reactions that make you unable to enjoy your favorite meal or food item anymore? Do you notice any abdominal swelling after a heavy meal? Or have you been more constipated and found it difficult to go to the bathroom? This is because the gut system is the second brain of the human body. The gastrointestinal (GI) system provides many beneficial properties to the host and the human body. It helps strengthen the gut’s integrity, harvest and give energy, protect the body from foreign pathogens, and regulate the immune system. (Thursby & Juge, 2017) Inside the gut system is home to trillions of bacteria that help transport the nutrients and vitamins of food to different areas of the body. This, in turn, gives the individual the energy to be mobile and complete their daily activities. However, environmental factors like illnesses, stress, bad dietary habits, and lifestyles can cause the gut ecosystem to undergo abnormal changes, causing gut dysbiosis. (Zhang et al., 2015)

When environmental factors impact the body, especially the gut system, the immune system produces inflammatory cytokines caused by certain bacteria. Once certain structural component bacteria strains trigger inflammation, it can cause a cascade of inflammatory pathways to affect the entire body, causing the individual to experience pain and discomfort. (Al Bander et al., 2020) Additionally, gut dysbiosis can also be associated with the occurrence of several chronic metabolic diseases that are developed. (Xiong et al., 2023) Fortunately, there are numerous ways people can reduce the impact of gut dysbiosis and help restore normal body function by including probiotics and prebiotics. We associate with certified medical providers who inform our patients of how the gut system can affect the body when environmental factors impact it. While asking important questions to our associated medical providers, we advise patients to integrate various probiotic and prebiotic foods to help regulate healthy bacteria back to the gut and reduce pain and discomfort in the body. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Nutrition Fundamentals- Video

Nutrition Fundamentals | El Paso, Tx (2023)

Probiotic & Prebiotic Foods For The Gut

Now, when it comes to the gut system, it is important to know that trillions of bacteria help with gut regulation. When environmental factors cause various issues, it can cause pain and discomfort to the rest of the body. Hence, incorporating probiotics and prebiotics can help regulate the gut and reduce the impact of harmful bacteria from affecting the body. As part of a healthy diet, probiotics have the potential to regulate gut microbiota by affecting the intestinal microbial dynamics and homeostasis, thus influencing the intestines and distill organs physiology. (Kim et al., 2021) Additionally, when a person is incorporating probiotics and prebiotics to regulate their gut, it can be used to help manipulate the host’s microbiota while being used for potential therapeutic strategies. (Radford-Smith & Anthony, 2023) Some of the foods that have probiotics and prebiotics include:

Jicama
Bananas
Garlic
Miso
Kimchi
Yogurt

How Probiotics & Prebiotics Improve Body Function

When people start to incorporate prebiotics and probiotics, they will notice an increased abundance of health-promoting bacteria that can increase microbiome diversity and metabolic pathways that can affect the qualitative and quantitative changes of the gut composition. (Jager et al., 2019) Different bacterial strains can have various properties that can help with the gastrointestinal microbiome diversity and improve the body through metabolic support.

Conclusion

So, when people think about their health and wellness, the best place to start is with the gut by adding prebiotics and probiotics as part of a healthy diet. This, in turn, can help the loss of beneficial bacteria that have been affected by environmental factors and can help reduce the inflammatory effects of chronic illnesses. Making these small changes can be helpful to one’s health and well-being and allow many people to come up with tasty food combinations to improve gut health and metabolic pathways.

References

Al Bander, Z., Nitert, M. D., Mousa, A., & Naderpoor, N. (2020). The Gut Microbiota and Inflammation: An Overview. Int J Environ Res Public Health, 17(20). https://doi.org/10.3390/ijerph17207618

Jager, R., Mohr, A. E., Carpenter, K. C., Kerksick, C. M., Purpura, M., Moussa, A., Townsend, J. R., Lamprecht, M., West, N. P., Black, K., Gleeson, M., Pyne, D. B., Wells, S. D., Arent, S. M., Smith-Ryan, A. E., Kreider, R. B., Campbell, B. I., Bannock, L., Scheiman, J.,…Antonio, J. (2019). International Society of Sports Nutrition Position Stand: Probiotics. J Int Soc Sports Nutr, 16(1), 62. https://doi.org/10.1186/s12970-019-0329-0

Kim, C. S., Cha, L., Sim, M., Jung, S., Chun, W. Y., Baik, H. W., & Shin, D. M. (2021). Probiotic Supplementation Improves Cognitive Function and Mood with Changes in Gut Microbiota in Community-Dwelling Older Adults: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. J Gerontol A Biol Sci Med Sci, 76(1), 32-40. https://doi.org/10.1093/gerona/glaa090

Radford-Smith, D. E., & Anthony, D. C. (2023). Prebiotic and Probiotic Modulation of the Microbiota-Gut-Brain Axis in Depression. Nutrients, 15(8). https://doi.org/10.3390/nu15081880

Thursby, E., & Juge, N. (2017). Introduction to the human gut microbiota. Biochem J, 474(11), 1823-1836. https://doi.org/10.1042/BCJ20160510

Xiong, R. G., Li, J., Cheng, J., Zhou, D. D., Wu, S. X., Huang, S. Y., Saimaiti, A., Yang, Z. J., Gan, R. Y., & Li, H. B. (2023). The Role of Gut Microbiota in Anxiety, Depression, and Other Mental Disorders as Well as the Protective Effects of Dietary Components. Nutrients, 15(14). https://doi.org/10.3390/nu15143258

Zhang, Y. J., Li, S., Gan, R. Y., Zhou, T., Xu, D. P., & Li, H. B. (2015). Impacts of gut bacteria on human health and diseases. Int J Mol Sci, 16(4), 7493-7519. https://doi.org/10.3390/ijms16047493

Disclaimer

How Knee Braces Provide Support and Stability for Healing

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Orthopedist woman putting a knee brace on a young client — Interior of an orthopedics store with a female orthopedist putting a knee brace on a young woman

Can a knee brace relieve discomfort, provide support, and expedite recovery for individuals recovering from an injury or surgery?

Table of Contents

Knee Brace

A knee brace is a medical device that supports and stabilizes the knee joint to help with pain and recovery after an injury or surgery. Many knee braces are made of various materials and offer a range of support levels. A healthcare provider or physical therapist can recommend the appropriate one for your condition and suggest the best one. Ask a healthcare provider if you’re unsure, as wearing a knee brace correctly and for the recommended time is important for healing. They are generally safe. However, individuals with health conditions such as poor circulation should be cautious when using them and consult their healthcare provider.

What They Do

The knee joint comprises bones, cartilage, ligaments, tendons, and muscles. A knee brace stabilizes these structures, preventing them from moving too much or too fast. Some braces redistribute the knee joint’s weight, decreasing the force the knee absorbs. (American Academy of Family Physicians, 2020)

Conditions

A knee brace is used after surgery to aid in healing and following an injury. This can be:

Sprain
Ligament injury
Patellar/kneecap dislocation

They are also used to support the knee and relieve pain from some chronic conditions including: (Sprouse R. A., McLaughlin A. M., & Harris G. D. 2018)

Tendonitis
Patellar tendinopathy
Chondromalacia patellae
Patellofemoral stress syndrome
Medial knee osteoarthritis

Types

Knee braces differ in function and support level. Some stabilize the knee, while others completely immobilize the joint. A healthcare provider and/or physical therapist will explain what support is needed and how to use it. They can also check the brace’s fit and determine if adjustments or a different size are required.

Most Commonly Used

Prophylactic Brace

This is a protective knee pad that shields the kneecap from direct impact.
It’s used by athletes who play contact sports, like football. (American Academy of Pediatrics, 2019)

Unloader

This brace helps rebalance the weight and shift the pressure on the knee joint to other parts of the leg, reducing pain. (American Academy of Family Physicians, 2020)
A knee unloader is typically used to control discomfort due to inflammatory conditions like tendonitis and osteoarthritis.

Functional

This brace limits motion in the joint after an injury or prevents dislocation.

Bledsoe Brace

This brace has straps to wrap around the thigh and shin and support brackets on the inside and outside of the knee joint.
A small mechanism locks the knee into full extension or allows the knee to bend a specific amount.

Knee Immobilizer

A knee immobilizer keeps the knee in one position.
It is a long cloth brace that runs the length of the shin and thigh.

Knee Brace vs Knee Support

A knee support or sleeve is usually a tight-fitting fabric garment. It provides compression to help reduce swelling and discomfort. A knee brace offers more support and can also be set to limit mobility.

Wearing The Brace

Individuals may need to wear a knee brace all day or only when performing specific tasks and operations. It depends on the individual and the condition the brace is being used for. Some may only need to wear a knee brace during certain activities or a flare-up of pain. (Mayo Clinic, 2022) Wearing a brace for unnecessarily long periods can cause skin abrasion, joint stiffness, and muscle atrophy. (American Academy of Family Physicians, 2020) Conversely, neglecting to wear it can cause more susceptibility to injury or extend and or impair healing time. Ask a healthcare provider when you should and should not wear the brace. This could be when:

Sitting
Walking
Driving
Sleeping
Stretching

Contraindications

Some medical conditions can make an individual susceptible to injury and adverse effects from wearing a knee brace. These include: (Holden, M. A. et al., 2021)

Poor circulation
Superficial wounds on the knee
Psoriasis
Eczema
Arterial insufficiency
Severe varicose veins
A history of thrombophlebitis

Injury Medical Chiropractic and Functional Medicine Clinic

If you have one of these conditions, a healthcare provider will decide if a knee brace is safe. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Best Knee Injury Chiropractor

References

American Academy of Family Physicians. (2020). Knee Bracing: What Works? https://familydoctor.org/knee-bracing-what-works/

Sprouse, R. A., McLaughlin, A. M., & Harris, G. D. (2018). Braces and Splints for Common Musculoskeletal Conditions. American family physician, 98(10), 570–576.

American Academy of Pediatrics. (2019). Knee pain: how to choose the right knee brace for your child. https://www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Knee-Pain-and-braces.aspx

Mayo Clinic. (2022). To brace or not to brace: What’s the best answer? https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/to-brace-or-not-to-brace#:~:text=If%20you%20have%20early%20onset%2C%20mild%20arthritis,below%20the%20knee%20for%20compression%20and%20comfort.

Holden, M. A., Callaghan, M., Felson, D., Birrell, F., Nicholls, E., Jowett, S., Kigozi, J., McBeth, J., Borrelli, B., Jinks, C., Foster, N. E., Dziedzic, K., Mallen, C., Ingram, C., Sutton, A., Lawton, S., Halliday, N., Hartshorne, L., Williams, H., Browell, R., … Peat, G. (2021). Clinical and cost-effectiveness of bracing in symptomatic knee osteoarthritis management: protocol for a multicentre, primary care, randomised, parallel-group, superiority trial. BMJ open, 11(3), e048196. https://doi.org/10.1136/bmjopen-2020-048196

Enhance Spine and Back Health with these Simple and Effective Exercises

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Can individuals incorporate these simple but effective exercise routines to reduce pain and discomfort in their spine and back?

Table of Contents

Why It’s Important To Keep The Back Mobile

When many individuals are dealing with back pain from their upper, middle, and lower portions, it can put a halt to a person’s routine. When back pain becomes present, it causes the person to find a comfortable place like a couch or a bed and lie down. However, this can cause more issues than the original one, affecting the individual. Back pain is a common worldwide problem and is the leading issue of disability associated with a high socio-economic cost. (Chou, 2021) Additionally, when a person is dealing with back pain, they are also dealing with degenerative issues that are also affecting their spines, thus causing problems to their joints, discs, and bones. (Hauser et al., 2022) This is because back pain is a multifactorial musculoskeletal disorder that can cause referred pain to different body locations. So when a person dealing with back pain rests, it can become an issue as inflammation builds up and swelling in the affected areas. Hence, many doctors, chiropractors, physical therapists, and spine specialists recommend keeping mobile to allow blood flow and the body’s natural healing response to reduce pain and speed up recovery. Since back pain relief is challenging through visceral-somatic disturbances, it is important to find various treatment options to aid the person’s specific condition. As a person goes to get treatment for their back pain, it is important to note that the causes of their back pain can help determine which exercises can be most effective within their treatment plan. We associate with certified medical providers who inform our patients of the benefits of incorporating simple but effective exercises for their back pain. While asking important questions to our associated medical providers, we advise patients to integrate an exercise routine to reduce the chances of environmental factors causing back pain to return. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Understanding Academic Low Back Pain- Video

Understanding Academic Low Back Pain: Impact and Chiropractic Solutions | El Paso, Tx (2024)

Effective But Simple Exercises For The Back

Many people often wonder, “If I am dealing with back pain, why should I exercise to reduce this pain?” The answer is simple: since the affected back muscles are tight and weakened, simple but effective exercises can help recover. Exercise therapy can help increase muscle-joint strength in the body while improving muscle function and increasing range of motion. This boosts a speedy recovery and allows the individual to return to their usual activities. (Hayden et al., 2021) At the same time, with a customized treatment plan, exercise therapy can incorporate other non-surgical treatments with one goal: to restore normal musculoskeletal function and reduce the pain caused by environmental factors, diseases, or injuries. (Karlsson et al., 2020) Now, depending on the severity of the back pain, there are simple but effective exercises below to help reduce the pain and restore mobility to the back.

Physical Therapy & At-Home Workouts

Physical therapy and at-home exercises can help many individuals with back pain. They can help figure out which position can help centralize the pain and correct any restricted motions. Many physical therapists incorporate the McKenzie method to strengthen and support the spine while decreasing pain and inflammation. At-home exercises can be combined with a series designed to be practical, assessable, and feasible for therapeutic gain or even to improve physical capacity to maximum effort. (Quentin et al., 2021)

Water Exercises

Water exercises are amazing exercises that can help lessen the body’s weight to take pressure and stress off the spine. This is because water is supposed to help cleanse and rejuvenate the body. When individuals are experiencing chronic back pain, aquatic physical therapy can help relieve pain intensity, relax the aching muscles, and even promote a positive workout experience for the individual. (Ma et al., 2022) After a few consecutive sessions, many individuals can see improvement in pain intensity and restored mobility function in their routines.

Tai Chi & Stabalizing Exercises

Now, another simple and effective exercise routine can help stabilize the surrounding muscles in the back and spine and become effective as part of a health and well-being routine. Tai chi and Qigong practices can help the individual emphasize stillness and controlled movements to promote calmness, resilience, body awareness, and relaxation for proper body alignment. (Yang et al., 2024) Tai chi and Qigong can also help support immune function in the body while regulating inflammation, which can help reduce and prevent diseases. (Oh et al., 2020) At the same time, yoga can help improve flexibility, mobility, and stability within the muscles and joints while also improving spinal alignment, which can help many individuals have proper posture. (Zhu et al., 2020) Depending on which exercise a person prefers for their treatment plan and to reduce their back pain; it is important to make these small changes to achieve optimal results. Making these small changes can help many individuals reduce the chances of their back pain returning and help them along with their health and wellness journey.

References

Chou, R. (2021). Low Back Pain. Ann Intern Med, 174(8), ITC113-ITC128. https://doi.org/10.7326/AITC202108170

Hauser, R. A., Matias, D., Woznica, D., Rawlings, B., & Woldin, B. A. (2022). Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review. J Back Musculoskelet Rehabil, 35(4), 701-712. https://doi.org/10.3233/BMR-210097

Hayden, J. A., Ellis, J., Ogilvie, R., Malmivaara, A., & van Tulder, M. W. (2021). Exercise therapy for chronic low back pain. Cochrane Database Syst Rev, 9(9), CD009790. https://doi.org/10.1002/14651858.CD009790.pub2

Karlsson, M., Bergenheim, A., Larsson, M. E. H., Nordeman, L., van Tulder, M., & Bernhardsson, S. (2020). Effects of exercise therapy in patients with acute low back pain: a systematic review of systematic reviews. Syst Rev, 9(1), 182. https://doi.org/10.1186/s13643-020-01412-8

Ma, J., Zhang, T., He, Y., Li, X., Chen, H., & Zhao, Q. (2022). Effect of aquatic physical therapy on chronic low back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord, 23(1), 1050. https://doi.org/10.1186/s12891-022-05981-8

Oh, B., Bae, K., Lamoury, G., Eade, T., Boyle, F., Corless, B., Clarke, S., Yeung, A., Rosenthal, D., Schapira, L., & Back, M. (2020). The Effects of Tai Chi and Qigong on Immune Responses: A Systematic Review and Meta-Analysis. Medicines (Basel), 7(7). https://doi.org/10.3390/medicines7070039

Quentin, C., Bagheri, R., Ugbolue, U. C., Coudeyre, E., Pelissier, C., Descatha, A., Menini, T., Bouillon-Minois, J. B., & Dutheil, F. (2021). Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health, 18(16). https://doi.org/10.3390/ijerph18168430

Yang, Y., McCluskey, S., Bydon, M., Singh, J. R., Sheeler, R. D., Nathani, K. R., Krieger, A. C., Mehta, N. D., Weaver, J., Jia, L., DeCelle, S., Schlagal, R. C., Ayar, J., Abduljawad, S., Stovitz, S. D., Ganesh, R., Verkuilen, J., Knapp, K. A., Yang, L., & Hartl, R. (2024). A Tai chi and qigong mind-body program for low back pain: A virtually delivered randomized control trial. N Am Spine Soc J, 20, 100557. https://doi.org/10.1016/j.xnsj.2024.100557

Zhu, F., Zhang, M., Wang, D., Hong, Q., Zeng, C., & Chen, W. (2020). Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLOS ONE, 15(9), e0238544. https://doi.org/10.1371/journal.pone.0238544

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Relief for Back Spasms: Understanding Muscle Relaxers

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Chiropractic spinal adjustment on a patient lying on a therapy table, focusing on realigning the spine to relieve back pain and improve mobility

For individuals who injure their neck or back, the muscles may spasm or seize up, making it difficult to get through the day, exercises, physical activities, etc. Can skeletal muscle relaxers help relieve pain and reduce frequency?

Table of Contents

Back Spasms Muscle Relaxers

Back muscle spasms are common back pain that feels like a sudden tightness or contraction in the back muscles. They can range from minor twinges to severe pain.

Causes

Poor posture: Sitting or standing with bad posture can strain the back muscles.
Overuse: Picking something up, bending, or lifting can cause a spasm.
Dehydration: Not drinking enough water can cause electrolyte imbalances, leading to spasms.
Underlying conditions: A herniated disc or degenerative disc disease can cause back spasms.
Muscle imbalances: Weak muscles or muscles that are too tight can cause spasms.

Treatments

Home treatments: You can apply heat or ice, take over-the-counter pain medication, try gentle stretching, or massage the area.
Exercise: Improve your back’s strength and flexibility with exercise or physical therapy.
Hydration and nutrition: Drink enough water and eat foods rich in magnesium and calcium.
Chiropractic Adjustments: These can realign the spine to the correct position and muscles to relax.
Non-surgical Decompression: Decompression of the spine will allow more blood and nutrients to heal any painful areas.

Skeletal Muscle Relaxers

A healthcare provider may prescribe skeletal muscle relaxers. These medications are not available over the counter and must be prescribed by a healthcare provider.

Skeletal muscle relaxers will probably cause drowsiness.
Individuals should not drive, operate heavy machinery, or engage in other physical activities while taking back spasm muscle relaxers.
Skeletal muscle relaxers are not recommended for 65 or older because safer, effective alternatives exist.
Also, women who are pregnant or breastfeeding should not take these medications.
Discuss these issues with your healthcare provider.

Carisoprodol

Carisoprodol is available generically and as Soma and Vanadom brands. It works by suppressing nerve impulses located in the brain and spinal cord. Healthcare providers prescribe this medication in combination with physical therapy for the healing release of any muscle spasm and management of musculoskeletal injuries and/or pain. (Witenko C. et al., 2014) It’s not about having to continue taking the medication to feel better but more as a jump start to help with the physical therapy program.

Back muscle spasms are a perfect example of a condition that may benefit from carisoprodol in the short term.
Carisoprodol can be habit-forming.
Be sure to talk to a healthcare provider before suddenly going off this medication.
Carisoprodol can cause side effects that may impair thinking or reactions.
Avoid drinking alcohol as it may increase drowsiness and dizziness that are often caused by carisoprodol. (Zacny J. P., Paice J. A., & Coalson D. W. 2012)
Inform your healthcare provider of any drug allergies, kidney disease, or liver disease, or if you get seizures.

Cyclobenzaprine

Cyclobenzaprine is available as Amrix and in generic form. Like other muscle relaxers, cyclobenzaprine may cause dizziness or drowsiness. The sedation effects are how it works on painful, tension-filled muscles. Cyclobenzaprine is used together with physical therapy to treat skeletal muscle-related conditions and/or injuries, especially when pain or spasm is involved. When used in conjunction with physical therapy, it can help expedite recovery.

Cyclobenzaprine is chemically related to tricyclic antidepressants.
Although it is considered a derivative of the tricyclic antidepressant class, it does not pose the same risk to liver health.
According to the National Institutes of Health, reasons not to take this medication include having a thyroid disorder, heart block, congestive heart failure, a heart rhythm disorder, or having recently had a heart attack. (Witenko C. et al., 2014)

Metaxalone

Skelaxin is the brand name for metaxalone. As with the other muscle relaxers, metaxalone is used in combination with physical therapy and rest when muscles get too tight. (Witenko C. et al., 2014) It works by suppressing nerve impulses in the brain and spinal cord. In addition to older individuals and pregnant women, metaxalone is usually not prescribed for those with kidney disease, liver disease, seizures, or blood disorders.

Injury Medical Chiropractic and Functional Medicine Clinic

Back spasms: Muscle relaxers could help individuals, along with a personalized physical therapy treatment program. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Thoracic Spine Pain

References

Witenko, C., Moorman-Li, R., Motycka, C., Duane, K., Hincapie-Castillo, J., Leonard, P., & Valaer, C. (2014). Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. P & T: a peer-reviewed journal for formulary management, 39(6), 427–435.

Zacny, J. P., Paice, J. A., & Coalson, D. W. (2012). Subjective and psychomotor effects of carisoprodol in combination with oxycodone in healthy volunteers. Drug and alcohol dependence, 120(1-3), 229–232. https://doi.org/10.1016/j.drugalcdep.2011.07.006

Effective Natural Botanicals for Sleep Issues

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Can many individuals with sleep issues incorporate natural botanicals to get a good night’s sleep and reduce stress?

Table of Contents

Why Sleep Is Important?

Often, many people are constantly on the move and trying to find ways to rest and relax; however, in today’s world, many individuals are still experiencing various sleep issues that are not fulfilling them to achieve the full 8 hours of restful sleep. How often have you experienced fatigue throughout the day due to staying up late working on a project? Do you doom scroll on your phone while lying in bed at night that you accidentally stayed up late? Or do chronic health issues keep you up at night, which makes sleep difficult? When it comes to understanding why sleep is important, many people do not realize that sleep plays a huge role in cognitive functioning, mental health, and creativity. (Charest & Grandner, 2020) When environmental factors start to impact the body over time, it can lead to the development of sleep disorders. Environmental factors like stress can affect the circadian rhythm, causing dysregulation and sleep disorders. (Agorastos & Olff, 2021) However, there is some good news: there are various natural ways to help relax the body, get the full recommended amount of sleep without medications, and even help many people stay asleep longer. We associate with certified medical providers who inform our patients of the benefits of getting the full recommended amounts of sleep to reduce the stress affecting the body. While asking important questions to our associated medical providers, we advise patients to integrate natural ways to reduce stress and sleep disorders to ensure proper sleeping habits. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Balancing Body & Metabolism- Video

Balancing Body and Metabolism | El Paso, Tx (2023)

Natural Botanicals & Remedies To Promote Sleep

When it comes to incorporating healthy sleeping habits, many individuals have found natural remedies to not only stay asleep but also reduce any stressors associated with environmental factors. Many people trying to make small changes in their sleeping habits can do some of the following:

Find the right mattress and pillows
Turning off electronics an hour before bedtime
Have the room be in a comfortable, cool temperature

Additionally, herbal botanicals can help relax the body and ensure proper sleep. Almost all natural botanicals are found in teas and supplements at the local grocery store. Below are some botanicals that can help many individuals get quality sleep.

Valerian

As a native to Europe and Asia, valerian is a perennial flowering plant with a unique and long history in traditional medicine, as it is used as a sedative and an anxiolytic. However, it has many sleep-promoting effects. (Yeom & Cho, 2024) The unique characteristic of valerian is that it interacts with the neurotransmitter GABA, as it is used to reduce sleep onset latency and increase sleep quality. (Bruni et al., 2021) The valerian plant can be utilized in a tea or a supplement as it is given to individuals for about 2 weeks at a time for its beneficial effects to start to work.

Ashwagandha

Known as winter cherry and located in India, ashwagandha has numerous health properties that can help many people with multiple ailments. The entire plant has been marketed in many forms and is common in pills and capsules as it possesses anti-inflammatory and antioxidant properties. (Cheah et al., 2021) Additionally, ashwagandha in small dosages can help improve cognitive function and immunity and reduce cortisol levels to help relax the body. (Park et al., 2023) Sleep can come easily to the individual when the body is relaxed after taking ashwagandha.

Chamomile

A common herb that can be used in teas, oils, or extracts, chamomile has been used as a sedative, mild analgesic, and sleep medication as it induces relaxation. (“Chamomile,” 2012) In tea form, this herb can become the most relaxing drink to sip at night and make a person sleepy. At the same time, when people drink chamomile, its soothing, beneficial properties can relieve and target the receptors in their central nervous system, causing them to be stressed and anxious, thus calming them down.

Lavender

As one of the most popular herbs everyone uses, from teas to aromatherapy, lavender is a multipurpose plant with many beneficial properties that can help anyone. Lavender has two main components, linalool, and linalyl, with sedative, antinociceptive, and anti-spasmolytic effects to stimulate the parasympathetic system. (Hamzeh et al., 2020) This, in turn, can help relax the body with its calming aroma and provide beneficial results for individuals dealing with insomnia. In its essential oil form, lavender can help increase the total amount of NREM (non-rapid eye movement) and reinforce a person’s sleep ability. (Ren et al., 2025) By making small changes and incorporating these natural botanicals to provide better sleep quality, many people will notice their bodies becoming more relaxed, their minds less anxious, and finally get that full 8 hours of sleep they deserve because sleep is for everyone, not the weak.

References

Agorastos, A., & Olff, M. (2021). Sleep, circadian system and traumatic stress. Eur J Psychotraumatol, 12(1), 1956746. https://doi.org/10.1080/20008198.2021.1956746

Bruni, O., Ferini-Strambi, L., Giacomoni, E., & Pellegrino, P. (2021). Herbal Remedies and Their Possible Effect on the GABAergic System and Sleep. Nutrients, 13(2). https://doi.org/10.3390/nu13020530

Chamomile. (2012). In LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. https://www.ncbi.nlm.nih.gov/pubmed/31643492

Charest, J., & Grandner, M. A. (2020). Sleep and Athletic Performance: Impacts on Physical Performance, Mental Performance, Injury Risk and Recovery, and Mental Health. Sleep Med Clin, 15(1), 41-57. https://doi.org/10.1016/j.jsmc.2019.11.005

Cheah, K. L., Norhayati, M. N., Husniati Yaacob, L., & Abdul Rahman, R. (2021). Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. PLOS ONE, 16(9), e0257843. https://doi.org/10.1371/journal.pone.0257843

Hamzeh, S., Safari-Faramani, R., & Khatony, A. (2020). Effects of Aromatherapy with Lavender and Peppermint Essential Oils on the Sleep Quality of Cancer Patients: A Randomized Controlled Trial. Evid Based Complement Alternat Med, 2020, 7480204. https://doi.org/10.1155/2020/7480204

Park, C. W., Hong, K. B., Suh, H. J., & Ahn, Y. (2023). Sleep-promoting activity of amylase-treated Ashwagandha (Withania somnifera L. Dunal) root extract via GABA receptors. J Food Drug Anal, 31(2), 278-288. https://doi.org/10.38212/2224-6614.3456

Ren, Y. L., Chu, W. W., Yang, X. W., Xin, L., Gao, J. X., Yan, G. Z., Wang, C., Chen, Y. N., Xie, J. F., Spruyt, K., Lin, J. S., Hou, Y. P., & Shao, Y. F. (2025). Lavender improves sleep through olfactory perception and GABAergic neurons of the central amygdala. J Ethnopharmacol, 337(Pt 3), 118942. https://doi.org/10.1016/j.jep.2024.118942

Yeom, J. W., & Cho, C. H. (2024). Herbal and Natural Supplements for Improving Sleep: A Literature Review. Psychiatry Investig, 21(8), 810-821. https://doi.org/10.30773/pi.2024.0121

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Exploring the Use of Acupuncture for Anxiety and Panic Disorders

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Acupunturist treating patient chronic back pain

Can acupuncture be an effective treatment for anxiety and panic disorders in addition to other treatments, like therapy and/or medication?

Table of Contents

Acupuncture For Anxiety and Panic Disorders

Considered one of the most popular types of alternative medicine, acupuncture has grown in popularity as a way to treat a variety of mental health conditions, including depression, post-traumatic stress disorder (PTSD), and other anxiety disorders. With the growth in popularity, more research has been focused on treatment for panic and anxiety symptoms. (Pilkington K. 2010)

Acupuncture can enhance personal wellness.
Acupuncture is generally safe and has few side effects.
It can help reduce physical and mental symptoms like tension, pain, and rapid heart rate.

Other alternative medicine practices include yoga, therapeutic massage, herbal medicines, and aromatherapy.

Traditional Chinese Medicine

Acupuncture is a healing technique originating from traditional Chinese medicine (TCM). The practice is based on the concept that medical conditions and mental health disorders are caused by an imbalance in the energy and circulation of the body’s vital life energy, known as chi or qi (National Institute for Complementary and Integrative Health, 2022). When the body and mind function properly, energy flows optimally through the channels/meridians at certain points throughout the body. Like tight or spasming muscles, energy or circulation becomes congested in different meridian pathways, leading to disease or disorders. The goal of acupuncture is to restore the health and balance of these channels.

How It Works

During acupuncture treatment sessions, small needles are placed along specific body areas, known as acupuncture points. These areas are thought to be where energy blockage occurs. The needles, which come in various thicknesses and lengths, stimulate and open blocked energy channels. Experts have conceptualized acupuncture from a neuroscience perspective, where nerves, muscles, and connective tissues are stimulated, and neurochemicals are released.

Acupuncture can help regulate the nervous system.
It can stimulate the body’s feel-good hormones and reduce stress hormones.
It can help deactivate the analytical brain, which is responsible for anxiety and worries.

Acupuncture is recognized by the National Institutes of Health (NIH) for treating pain management and other medical conditions. (National Institute for Complementary and Integrative Health, 2022)

Effectiveness

Clinical trials examining acupuncture for anxiety and panic disorders have shown some positive results. (Pilkington K. 2010) Acupuncturists and medical professionals are still not clear exactly why it may help with anxiety, but some research has noted that acupuncture appears to have a calming effect. More research studies are needed to prove the effectiveness of acupuncture for anxiety disorders. (Kim Y. K. 2019)

Getting Treated

What it can help with:

Agoraphobia
Generalized anxiety disorder (GAD)
Panic disorder
Phobias
Selective mutism
Separation anxiety disorder
Social anxiety disorder

If you are interested in treating your anxiety and panic symptoms through acupuncture, the first step is to consult your main healthcare provider. Professional acupuncture practitioners are on websites, including the National Certification Commission for Acupuncture and Oriental Medicine and the American Academy of Medical Acupuncture. The use of acupuncture continues to rise, making it more readily available. Since it has been evaluated for effectiveness and is available through many hospitals, some insurance policies may cover some acupuncture treatments.

Injury Medical Chiropractic and Functional Medicine Clinic

Acupuncture can help relieve symptoms of anxiety, stress, pain, discomfort, tightness, and poor circulation. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Discovering The Benefits of Chiropractic Care

References

Pilkington K. (2010). Anxiety, depression, and acupuncture: A review of the clinical research. Autonomic neuroscience : basic & clinical, 157(1-2), 91–95. https://doi.org/10.1016/j.autneu.2010.04.002

National Institute for Complementary and Integrative Health. (2022). Acupuncture: Effectiveness and Safety. Retrieved from https://www.nccih.nih.gov/health/acupuncture-effectiveness-and-safety

Kim Y. K. (2019). Panic Disorder: Current Research and Management Approaches. Psychiatry investigation, 16(1), 1–3. https://doi.org/10.30773/pi.2019.01.08

The Power of Chiropractic Care and Health Coaching in Reducing Sick Days

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Can individuals reduce being sick by incorporating chiropractic care and health coaching as a treatment plan to relieve pain?

Table of Contents

What Happens To The Body When It’s Sick?

How often do you feel constant aches and pains in various locations of your body? Do you feel that your head feels like there is cotton inside or that you have a pounding sensation that makes you stay in bed? Or how often have allergies made you constantly sneeze, making your back and chest hurt continuously? When it comes to the human body, these scenarios can cause a person to develop various ailments that can cause the body to become tired and sick. Environmental factors like stress, an excessive workload, improper dieting, and physical inactivity all play a role in causing overlapping risk profiles to the body while causing the immune system to work overtime. When it comes to the immune system and environmental factors, there is a bidirectional relationship as the immune system releases inflammatory cytokines to foreign pathogens and eliminates the issue. However, environmental factors affecting the immune system can even impact its functioning at the physical level. (Venter et al., 2020) When the body starts to feel sick, many people experience aches and pain in their muscles in the upper and lower quadrants. This can, over time, develop into overlapping pain-like symptoms that can cause doctors to prescribe medication to control these symptoms. Many symptoms that can be combined with being sick include:

Headaches/migraines
Nausea/vomiting
Fatigue
Muscle aches & pains
Allergies

When this happens, a person could be dealing with a tired, nervous system and experiencing body pains that can lead to various issues, thus needing treatment. We associate with certified medical providers who inform our patients of the benefits of incorporating chiropractic care and health coaching to improve their health and reduce sickness. While asking important questions to our associated medical providers, we advise patients to integrate ways to reduce the chances of being sick through a customized treatment plan. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

A Tired Nervous System & Body Pains

When it comes to the body starting to feel sick, it can be due to a tired, nervous system that is causing problems to arise in the body. The nervous system is the main control for the body as it controls pain, movement, organ function, and reactions, and the body needs to be consistently maintained to achieve optimal operations. When environmental factors affect the nervous system, it can lead to symptoms of nerve interference and body pain that can cause various issues. When various biomechanical, biochemical, and neuropsychological factors contribute to the body and cause pain, it can negatively affect a person’s quality of life. (Sarkovich et al., 2024) It can also negatively impact the spine and cause spinal misalignment, thus affecting the individual. When a person is dealing with spinal misalignment, they begin dealing with poor postural habits, limited range of motion, and pain within the upper, middle, and lower back. (Chu & Trager, 2022) This, in turn, causes a longer duration of the symptoms while increasing the presence and severity of degenerative changes. (Davis et al., 2022) So when degenerative changes and dangerous pressure are affecting the nerves correlated with spinal misalignment, many people can begin to seek treatment to realign the spine and reduce the chances of becoming sick.

The Role of Chiropractic Care On Improving Your Health-Video

Chiropractic Care For Improving The Body

When restoring spinal alignment and reducing the chances of the body becoming sick again, many people seek holistic, non-invasive, customized, cost-effective, holistic treatment. Chiropractic care can help realign the spine through manual and mechanical manipulation to determine the root cause of the issue and reduce nerve interference. Chiropractors can assess and detect nerve interference to identify any problems affecting the body. At the same time, chiropractic care can be used as a therapeutic intervention to regulate the body’s blood pressure and provide spinal rehabilitation. (Sullivan et al., 2020) At the same time, chiropractic care has a unique relationship with other treatments to ensure the body is healthy and energetic.

Health Coaching To Reduce Being Sick

While chiropractors can help restore the body through spinal realignment and rehabilitation, they also work with a health coach to make small changes and incorporate healthy habits to enhance chiropractic care. Exercise, proper dieting, and incorporating supplements combined with chiropractic care benefit complete wellness by reducing days of suffering from illnesses. (Khodakarami, 2020) When people start to think more about their help, incorporating chiropractic care with health coaching can be the key to maintaining healthy habits, listening, and being mindful of their bodies to reduce the effects of pain and discomfort. A healthy body can be energetic and free from diseases, dysfunction, pain, and discomfort, allowing individuals to continue their routine more healthily.

References

Chu, E. C., & Trager, R. J. (2022). Neck Pain and Headache After Pinealectomy: Improvement with Multimodal Chiropractic Therapies. Am J Case Rep, 23, e937906. https://doi.org/10.12659/AJCR.937906

Davis, B. A., Dunn, A. S., Golley, D. J., & Chicoine, D. R. (2022). Chiropractic Clinical Outcomes Among Older Adult Male Veterans With Chronic Lower Back Pain: A Retrospective Review of Quality-Assurance Data. J Chiropr Med, 21(2), 77-82. https://doi.org/10.1016/j.jcm.2022.02.004

Khodakarami, N. (2020). Treatment of Patients with Low Back Pain: A Comparison of Physical Therapy and Chiropractic Manipulation. Healthcare (Basel), 8(1). https://doi.org/10.3390/healthcare8010044

Sarkovich, S., Leonardi, C., Darlow, M., Martin, D., Issa, P., Soria, T., Bronstone, A., & Clement, C. (2024). Back pain in adolescent idiopathic scoliosis: frequency and risk factors. Spine Deform, 12(5), 1319-1327. https://doi.org/10.1007/s43390-024-00904-0

Sullivan, S. G., Paolacci, S., Kiani, A. K., & Bertelli, M. (2020). Chiropractic care for hypertension: Review of the literature and study of biological and genetic bases. Acta Biomed, 91(13-S), e2020017. https://doi.org/10.23750/abm.v91i13-S.10524

Venter, C., Eyerich, S., Sarin, T., & Klatt, K. C. (2020). Nutrition and the Immune System: A Complicated Tango. Nutrients, 12(3). https://doi.org/10.3390/nu12030818

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Unveiling Nociceptors: How the Body Responds to Pain

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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feeling sudden awful back pain, a young african american suffering from injury — feeling sudden awful back pain, young african american suffering from injury

Can understanding how nociceptors function and their role in processing pain signals help individuals who are managing injuries and/or living with chronic pain conditions?

Table of Contents

Nociceptors

Nociceptors are nerve endings that detect harmful stimuli, such as extreme temperatures, pressure, and chemicals, and signal pain. They are the body’s first defense against potentially damaging environmental inputs.

Nociceptors are in the skin, muscles, joints, bones, internal organs, deep tissues, and cornea.
They detect harmful stimuli and convert them into electrical signals.
These signals are sent to the brain’s higher centers.
The brain interprets the signals as pain, which prompts the body to avoid the harmful stimulus.

Nociceptors, often called pain receptors, are free nerve endings all over the body. They play a pivotal role in how the body feels and reacts to pain. The main purpose of a nociceptor is to respond to damage to the body by transmitting signals to the spinal cord and brain. (Purves D, Augustine GJ, Fitzpatrick D, et al., editors. 2001) If you bang your foot, the nociceptors on the skin are activated, sending a signal to the brain via the peripheral nerves to the spinal cord. Pain resulting from any cause is transmitted this way. Pain signals are complex, carrying information about the stimuli’s location and intensity. This causes the brain to fully process the pain and send communication back to block further pain signals.

Classification

There are different classes of nociceptors, which are based on which type of stimuli they respond to (University of Texas McGovern Medical School, 2020)

Thermal

Thermal nociceptors respond to extreme hot or cold temperatures.
For instance, when touching a hot stove, the nociceptors, which signal pain, are activated immediately, sometimes before you know what you’ve done.

Mechanical

Mechanical nociceptors respond to intense stretching or strain, such as pulling a hamstring or straining a tendon.
The muscles or tendons are stretched beyond their ability, stimulating nociceptors and sending pain signals to the brain.

Chemical

Chemical nociceptors respond to chemicals released from tissue damage.
For example, prostaglandins and substance P or external chemicals like topical capsaicin pain creams.

Silent

Silent nociceptors must be first activated by tissue inflammation before responding to a mechanical, thermal, or chemical stimulus.
Most visceral nociceptors are located on organs in the body.

Polymodal

Polymodal nociceptors respond to mechanical, thermal, and chemical stimuli.

Mechano-thermal

Mechano-thermal nociceptors respond to mechanical and thermal stimuli.

Pain Transmission

Nociceptors are also classified by how fast they transmit pain signals. Transmission speed is determined by the type of nerve fiber known as an axon a nociceptor has. There are two main types.

The first type is A fiber axon, fibers surrounded by a fatty, protective sheath called myelin.
Myelin allows nerve signals/action potentials to travel rapidly.
The second type is C fiber axons, which are not surrounded by myelin and transmit slower. (University of Texas McGovern Medical School, 2020)

Because of the difference in transmission speed, the pain signals from the A fibers reach the spinal cord first. As a result, after an acute injury, an individual experiences pain in two phases, one from the A fibers and one from the C fibers. (Ngassapa D. N. 1996)

Pain Perception Phases

When an injury occurs, the stimulated nociceptors activate the A fibers, causing a person to experience sharp, prickling pain.

This is the first phase of pain, known as fast pain, because it is not especially intense but comes right after the stimulus.
During the second phase of pain, the C fibers are activated, causing an intense, burning pain that persists even after the stimulus has stopped.
The fact that the C fibers carry burning pain explains why there is a short delay before feeling the sensation.
The C fibers also carry aching, sore pain caused by organs within the body, such as a sore muscle or stomachache. (Ngassapa D. N. 1996)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

From Injury To Recovery With Chiropractic Care

References

Purves D, A. G., Fitzpatrick D, et al., editors. (2001). Nociceptors. In Neuroscience. 2nd edition. (2nd ed.). Sunderland (MA): Sinauer Associates. https://www.ncbi.nlm.nih.gov/books/NBK10965/

University of Texas McGovern Medical School. (2020). Chapter 6: Pain Principles. https://nba.uth.tmc.edu/neuroscience/m/s2/chapter06.html

Ngassapa D. N. (1996). Comparison of functional characteristics of intradental A- and C-nerve fibres in dental pain. East African medical journal, 73(3), 207–209.

How to Heal a Wrist Sprain: Tips and Techniques

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Physical therapy, exam and physiotherapy with woman muscle in healthcare, fitness wellness or sport.

Can knowing about wrist sprains—their types, symptoms, causes, and diagnoses—help develop an effective treatment program?

Wrist Sprain

Wrist sprains are injuries that affect ligaments that attach bone to bone. They occur after a fall from work overuse, house tasks, during sports activities, or with other direct trauma. Symptoms of a wrist sprain include:

Pain
Swelling
Bruising
Decreased range of motion
Weakness
Tingling

The injury affects the ligaments and soft tissue structures connecting bone to bone. Mild wrist sprains typically heal within a few weeks; most heal without complications in six to 12 weeks. (National Health Service, 2020) However, severe injuries can require surgery, physical therapy, and months to recover fully.

Grades and Types

The three grades of sprains are graded by the severity of the injury (American Academy of Orthopaedic Surgeons, 2024)

Grade 1

Ligaments are stretched; this is considered a mild sprain.
The injury may heal in one to three weeks with standard care. (Mass General Brigham, 2025)

Grade 2

Ligaments are partially torn; this is considered a moderate sprain.
It may need a brace; healing can take three to six weeks. (Mass General Brigham, 2025)

Grade 3

Ligaments are torn completely or have pulled away from the bone.
Sometimes, a piece of bone comes off with it, a condition called an avulsion fracture.
This is considered a severe sprain. It can take months to heal completely. (Mass General Brigham, 2025)

The wrist is made up of three joints (American Society for Surgery of the Hand, 2017)

Distal radioulnar

This joint is between the two forearm bones.
The radius on the thumb side.
The ulna on the pinky side.

Radiocarpal

This joint is between the radius and three small bones in the base of the hand.
The scaphoid
The triquetrum
The lunate

Ulnocarpal

This joint is between the ulna and the articular disc and cushions it from the carpal bones, the lunate, and the triquetrum.

Wrist sprains can affect any of these joints but more commonly affect the ligament between the scaphoid and lunate bone or the triangular fibrocartilage complex/TFCC on the pinky side of the wrist.

Symptoms

The primary symptom of a wrist sprain is pain, especially when moving or touching the injured area. Other symptoms can include: (National Library of Medicine, 2021) (American Academy of Orthopaedic Surgeons, 2024)

Decreased range of motion
Swelling
Bruising
Feeling instability in the wrist
Weakness
Numbness/tingling
Popping sensation
Warm skin

Causes

The common cause of wrist sprain is falling on an outstretched hand. (American Academy of Orthopaedic Surgeons, 2024) Other common causes include:

Repetitive overuse work injuries.
Housework and tasks.
Sports include skateboarding, gymnastics, basketball, snowboarding, hockey, and contact sports.

Diagnosis

A healthcare provider will diagnose a wrist sprain based on symptoms and injury causes. X-rays are the first imaging to rule out fractures. Other tests can include:

Magnetic resonance imaging – MRI
Computed tomography – CT scan
Arthrogram -X-rays with contrast dye

Treatment

Nonsteroidal anti-inflammatory drugs, such as Aleve, Advil, Motrin, and aspirin, can treat pain and inflammation. The severity of the wrist sprain determines whether additional treatment is needed. Sprains should initially be treated with the RICE protocol (American Academy of Orthopaedic Surgeons, 2024)

Rest

Minimize using the injured wrist for at least two days.
Wear a splint for support.
Avoid sudden movements.
Avoid placing too much pressure on the wrist.

Ice

Cold packs are recommended several times daily for 20 minutes to decrease pain and swelling.

Compression

Wrap the wrist with an elastic bandage or Kinesio tape to help reduce swelling.

Elevation

To decrease swelling, use pillows to elevate the wrist as much as possible above the level of your heart.

Grade 1 sprains usually heal with basic care within a week or two.
Grade 2 sprains often require wearing a brace for an extended period while the ligament heals, which can take up to six weeks. (American Society for Surgery of the Hand, 2018)
The removable brace or splint should be worn when using the arm.
It can be taken off at rest at night and when bathing. (National Health Service, 2020)
Individuals may need the brace for a week or more.

A healthcare provider may also recommend stretching exercises to overcome stiffness and regain mobility. (American Academy of Orthopaedic Surgeons, 2024) Physical therapy, occupational therapy, or treatment by a certified hand therapist can also reduce pain and improve range of motion and strength.

Treatment for grade 3 sprains often requires surgery. Grade 3 sprains, including avulsion fractures, often require a six-week cast for bones to heal. In some cases, the bones might also need a screw or temporary wires to hold them in the proper position. (Vannabouathong, C. et al., 2018) Severe wrist sprains may also require surgery to repair the injured ligament. If the original ligament cannot be repaired, a piece of the tendon can be used to reconstruct it. (American Society for Surgery of the Hand, 2020)

Healing Time

Mild to moderate sprains usually recover within a few weeks without long-term complications. (American Society for Surgery of the Hand, 2018) The prognosis for severe wrist sprains improves with early diagnosis and treatment. After surgery, ligaments usually heal within eight to 12 weeks but can take six to 12 months for function to return to normal. (American Academy of Orthopaedic Surgeons, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

The Path to Healing Personal Injury

References

National Health Service. (2020). Advice after spraining your wrist. https://www.ruh.nhs.uk/patients/patient_information/ORT_057_Advice_after_a_wrist_sprain.pdf

American Academy of Orthopaedic Surgeons. (2024). Wrist sprains. https://orthoinfo.aaos.org/en/diseases–conditions/wrist-sprains

Mass General Brigham. (2025). Wrist sprains. https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/hand-arm/wrist-sprain

American Society for Surgery of the Hand. (2017). Anatomy 101: Wrist joints. https://www.assh.org/handcare/blog/anatomy-101-wrist-joints

National Library of Medicine. (2021). Wrist injuries and disorders. Retrieved from https://medlineplus.gov/wristinjuriesanddisorders.html

American Society for Surgery of the Hand. (2018). Sprained wrist. https://www.assh.org/handcare/condition/sprained-wrist

Vannabouathong, C., Ayeni, O. R., & Bhandari, M. (2018). A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs. Clinical medicine insights. Arthritis and musculoskeletal disorders, 11, 1179544118809050. https://doi.org/10.1177/1179544118809050

American Society for Surgery of the Hand. (2020). Scapholunate torn ligament. https://www.assh.org/handcare/condition/scapholunate-torn-ligament

Stretch Your Back: Effective Exercises for Pain Relief

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Handsome man doing yoga exercise isolated on a white background

Can knowing how to stretch your back help reduce pain and improve your range of motion?

Table of Contents

Stretch Your Back

Over time, muscle tension can cause significant back pain and increase the risk of a back injury. Getting into a regular back stretching routine can help prevent back and spinal issues. These exercises can be performed when your back hurts to ease a backache or to avoid future problems. However, before beginning an exercise or stretch regimen, talk to your healthcare provider about any questions and what is safe for you. A few things to be mindful of are:

When stretching, don’t try to push past your pain limit.
Listen to your body, which leads to a calmer nervous system.
Take special care when stretching during pregnancy, as the hormones supporting your pregnancy could lead to overstretching or injury.

Warm Up

Stretching cold muscles can lead to injury. Always warm up first.

Do between five and 10 minutes of mild activity, such as walking.
Apply heat for 15 to 20 minutes before stretching.

Knees-to-Chest Back Stretch

To perform:

Lie on your back with your feet flat on the floor.
Bring your legs toward your chest With your knees bent.
Place your hands behind your thighs or on the shins, and pull the legs down toward your chest.
Pull until there is a gentle stretch.
Hold for 15 seconds.
Return to the starting position.
Do a total of 10 reps.

Supine Twist Back Stretch

To perform:

Lie on your back with your knees bent and feet flat on the floor.
Keep your back flat on the floor, rotate your hips to the left, and lower your legs until you feel the stretch.
Hold for 15 seconds.
Return to the starting position.
Next, rotate the hips to the right and lower your legs to the floor until you feel a gentle stretch.
Hold for 15 seconds.
Return to the starting position.
Repeat for nine reps.

Prone Bridging Back Stretch

To perform:

Lie on your stomach.
Prop yourself up on your elbows.
Extend your back.
Start straightening your elbows, further extending the back.
Continue straightening the elbows until the stretch is felt.
Hold for 15 seconds.
Return to the starting position.
Repeat for nine reps.

Supine Butt Lift Back Stretch

To perform:

Lie on your back with your knees bent and feet flat on the floor.
Push down through the feet as you slowly raise yourself off the floor.
Hold for 10 seconds.
Return to starting position.
Repeat for nine reps.

Seated Forward Curl Back Stretch

To perform:

Sit in a chair with your feet flat on the ground.
Bend forward until your chest is on your thighs, and you can touch the ground with your hands.
Hold for 10 seconds.
Return to the starting position.
Repeat for nine reps.

Side Stretch

To perform:

Stand up straight with your arms at your sides and feet shoulder-width apart.
Bend sideways to the left while sliding your left hand down your thigh and reaching your right arm over your head.
Hold for 10 seconds.
Return to the starting position.
Now, bend to the right while sliding your right hand down your thigh and reaching your left arm over your head.
Hold for 10 seconds.
Repeat for nine reps.

Other Treatments to Loosen a Tight Back

Many healthcare providers recommend other treatments for back pain before using medication. Recommended treatments that can help loosen the back include: (Sudhakaran P. 2021)

Acupuncture

Acupuncture needles are inserted in release points to unblock stagnated blood and energy circulation.
They have an analgesic, pain-relieving effect. (Foley C., & Litscher G. 2024)

Massage Therapy

Various massages involve kneading soft tissue in the back with hands, fingers, elbows, or instruments/tools/devices to relieve stress or pain.

Spinal Manipulation

Practiced by chiropractors, this therapy involves using the hands or instruments/tools/devices to manipulate the joints in the spine to relieve pain.

Tai Chi

Based on martial arts, slow movements, and deep breaths help to work muscle groups in flowing motions, supporting back strength and overall health.

Yoga

Yoga combines physical poses, breathwork, and meditation to help build strength, be restorative, and relax the body.

Anti-inflammatory Diet

An anti-inflammatory diet can also benefit tight muscles. (U.S. Department of Defense, 2012)
Incorporating foods like those on the Mediterranean diet, which emphasizes fish, vegetables, and olive oil, can help reduce chronic inflammation and help with back pain.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. We build optimal health and wellness solutions with primary healthcare providers and specialists to integrate a treatment plan to resolve musculoskeletal problems.

Stretching Benefits

References

Sudhakaran P. (2021). Acupuncture for Low-Back Pain. Medical acupuncture, 33(3), 219–225. https://doi.org/10.1089/acu.2020.1499

Foley, C., & Litscher, G. (2024). The Biggest Obstacle to the Integration of Acupuncture: The Meaning of Qi from the Ancients to Einstein. Medical acupuncture, 36(1), 5–11. https://doi.org/10.1089/acu.2023.0054

U.S. Department of Defense. (2012). Complementary Alternative Medicine for Low Back Pain. Retrieved from https://media.defense.gov/2019/Oct/22/2002198454/-1/-1/0/CAM%20FOR%20LOW%20BACK%20PAIN.PDF

Unveiling the Hidden Benefits of Incorporating Miso into Your Cooking

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Can individuals incorporate miso into their diets to improve their gut health and utilize its beneficial properties?

Table of Contents

What Is Miso?

As the weather starts to get colder, many people start thinking about making soups, stews, and hot foods. However, when it comes to a person’s health and wellness, many people wonder what to add to their soups while adding many nutritional foods and proteins that can make them not only flavorful but also add beneficial properties to their diet. Why not add miso? Miso is fermented soybean paste, a rice-based food product in Japan that is a staple cooking product. (Saeed et al., 2022) Additionally, since miso is a soybean product, many people incorporate it into their soups as it contributes to many health benefits to Japanese-style diets and can even enhance various dishes. (Ito, 2020) At the same time, many people who start to incorporate miso as part of their diet will notice some beneficial results in their gut system. We associate with certified medical providers who inform our patients of the benefits of incorporating miso into a nutritional diet. While asking important questions to our associated medical providers, we advise patients to integrate ways to add miso to their foods and help reduce bad bacterial growth in their gut system. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Types Of Miso

Miso can come in various types depending on how long it has been left to be fermented and its ingredients to see what color and flavor intensity will be put into the cooking. All miso products are in paste form and can be paired well with any protein like chicken, meat, and fish. The types of miso include:

White miso (Shiro miso): Mildest, sweet, less salty
Yellow miso (Shinshu miso): Mild, earthier, more acidic
Red miso (Aka miso): Salty, slightly bitter
Brown rice miso (Genmai miso): Sweet, mild, earthy
Barley miso (Mugi miso): Mild, earthy, not gluten-free

Miso Nutritional Facts

When it comes to the nutritional facts of miso, one tablespoon of miso contains about:

1 tbsp of miso: 17g
Calories: 34
Total Fats: 1g
Cholesterol: 0mg
Sodium: 634mg
Total Carbohydrates: 4.3g
Protein: 2.2g

It is important to note that a bit of miso goes a long way due to its high sodium content and its various vitamins and nutrients.

Eat Right To Feel Better- Video

Eating Right to Feel Better | El Paso, Tx (2023)

Beneficial Properties of Miso

When it comes to the beneficial properties of miso, it has numerous benefits that can help the body provide the nutrients it needs to fuel. Since miso is a fermented seasoning, it is rich in nutrients and has probiotic microorganisms that can help propagate healthy good bacteria to the gut while enhancing the immune system. (Paul et al., 2023) Additionally, when consumed daily, miso can help improve skin moisture, stimulate ceramides, have an anti-hypertensive effect, and many other beneficial effects. (Kotake et al., 2022)

Improves Gut Health

Since miso is a probiotic, it can help many individuals with gut issues since the gut system has trillions of bacteria that activate and mediate the body. (de Vos et al., 2022) Many people don’t realize that the gut is known as the second brain, and when environmental factors start to affect the gut, it can cause many health problems. So, adding miso can help influence good bacteria to reduce harmful bacteria and directly influence the epithelial immune cells of the GI tract. (Wieers et al., 2019)

Incorporating Miso In Your Diet

Since miso has a sweet/salty flavor, it can be used in various recipes. It can be taken in small amounts depending on the individual’s taste and what ingredients many people use for their cooking. At the same time, if a person is on a low-sodium diet, limiting the intake or avoiding it if they have a food allergy to soy is best. Making small changes and adding healthy nutritional substitutes to food can help many people live healthier.

References

de Vos, W. M., Tilg, H., Van Hul, M., & Cani, P. D. (2022). Gut microbiome and health: mechanistic insights. Gut, 71(5), 1020-1032. https://doi.org/10.1136/gutjnl-2021-326789

Ito, K. (2020). Review of the health benefits of habitual consumption of miso soup: focus on the effects on sympathetic nerve activity, blood pressure, and heart rate. Environ Health Prev Med, 25(1), 45. https://doi.org/10.1186/s12199-020-00883-4

Kotake, K., Kumazawa, T., Nakamura, K., Shimizu, Y., Ayabe, T., & Adachi, T. (2022). Ingestion of miso regulates immunological robustness in mice. PLOS ONE, 17(1), e0261680. https://doi.org/10.1371/journal.pone.0261680

Paul, A. K., Lim, C. L., Apu, M. A. I., Dolma, K. G., Gupta, M., de Lourdes Pereira, M., Wilairatana, P., Rahmatullah, M., Wiart, C., & Nissapatorn, V. (2023). Are Fermented Foods Effective against Inflammatory Diseases? Int J Environ Res Public Health, 20(3). https://doi.org/10.3390/ijerph20032481

Saeed, F., Afzaal, M., Shah, Y. A., Khan, M. H., Hussain, M., Ikram, A., Ateeq, H., Noman, M., Saewan, S. A., & Khashroum, A. O. (2022). Miso: A traditional nutritious & health-endorsing fermented product. Food Sci Nutr, 10(12), 4103-4111. https://doi.org/10.1002/fsn3.3029

Wieers, G., Belkhir, L., Enaud, R., Leclercq, S., Philippart de Foy, J. M., Dequenne, I., de Timary, P., & Cani, P. D. (2019). How Probiotics Affect the Microbiota. Front Cell Infect Microbiol, 9, 454. https://doi.org/10.3389/fcimb.2019.00454

Disclaimer

Walking to Lower Blood Pressure: An Accessible Workout

By

Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP

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Close up of athletic feet running on treadmill at home. Side view of women's white shoes having workout on treadmill. Low view sneakers training indoors. Concept of running training, Jogging.

For individuals who are looking to lower blood pressure, can walking help?

Table of Contents

Walking To Lower Blood Pressure

A walking regimen is an accessible workout that can be done almost anywhere at no cost, effectively lowering blood pressure and improving overall health. Studies show that individuals who use walking as a workout for three months have improved systolic blood pressure, which is the top number that measures the pressure in the arteries as the heart beats. (McMullan S., Nguyen C., & Smith D. K. 2022)

How It Works

Walking is an excellent way to get active. It can be done almost anywhere, including on a treadmill, outdoors, or around the house. Exercising lowers blood pressure by strengthening the heart, leading to the heart pumping blood more effectively when it is stronger. This causes less resistance to the blood vessels, which lowers overall blood pressure. (Hegde S. M., & Solomon S. D. 2015) The benefits of walking include: (American Heart Association, 2024)

Weight loss and management
Lowers stress
Improves mental health by reducing anxiety.
Improves sleep quality
Improves cognition
Strengthens the heart
Promotes bone health and reduces the risk of osteoporosis.

Knowing When to Take A Blood Pressure Reading

Various factors can affect blood pressure readings and can include:

Nervousness
Eating a meal
Drinking caffeine
Exercise can affect blood pressure readings.

Knowing how and when to take a blood pressure reading after walking can help prevent false elevated numbers. According to the CDC, individuals should wait at least 30 minutes after exercise before taking a reading (Centers for Disease Control and Prevention, 2024). Exercise and walking have been shown to cause an immediate reduction in systolic blood pressure. This is known as post-exercise hypotension and is normal. The reduction lasts around 24 hours after exercising and is more noticeable in those with high blood pressure. Consistent exercise and walking will cause a longer, more sustained blood pressure reduction. (Hegde S. M., & Solomon S. D. 2015)

Taking Blood Pressure at Home

Correctly taking blood pressure can help improve accuracy and reduce inaccurate readings. To do: (Centers for Disease Control and Prevention, 2024)

It is recommended not to talk while the blood pressure is being taken.
Apply the blood pressure cuff snugly around the arm.
Place your arm on a table, level with your heart.
Sit in a chair, keep your feet flat on the floor, and do not cross your legs or lean back on the chair.
It is recommended not to eat or drink 30 minutes before and to have an empty bladder.

Pace and Intensity

A study found that walking three to five times weekly for 20 to 40 minutes at a moderate pace for three months can lower systolic blood pressure. However, various groups determined BP rates differently by measuring heart rate, VO2 max/the maximum volume of oxygen you can use simultaneously, and walking speed. (McMullan S., Nguyen C., & Smith D. K. 2022)

Increasing Workout Intensity

Individuals with hypertension who walk may want to increase workout intensity to challenge themselves for added fitness. This can include:

Walk faster
Use intervals – walk as fast as you can for a minute or two at a time.
Add inclines
Use ankle or wrist weights or a weighted vest.
Walking with someone to challenge each other to push a little harder.
Try other places to walk.

Always talk to a healthcare provider if you are starting a walking workout for the first time, want to increase walking intensity, and take medications prescribed by a healthcare provider.

Hypertensive Crisis

A hypertensive crisis is when a person’s blood pressure is extremely high, can cause life-threatening conditions like stroke, and is a medical emergency. It is a blood pressure of 180/120 mm Hg or higher. (American Heart Association, 2024) If you get a blood pressure reading of 180/120 mm Hg or higher at home, wait five minutes and take another reading. If the blood pressure is still high, immediately contact a healthcare provider. (American Heart Association, 2024) If the individual is experiencing the below symptoms, call 911 (American Heart Association, 2024)

Chest pain
Shortness of breath
Vision changes
Difficulty speaking
Weakness
Numbness
Back pain

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Hypertension Explained

References

McMullan, S., Nguyen, C., & Smith, D. K. (2022). Can Walking Lower Blood Pressure in Patients With Hypertension?. American family physician, 105(1), 22–23.

Hegde, S. M., & Solomon, S. D. (2015). Influence of Physical Activity on Hypertension and Cardiac Structure and Function. Current hypertension reports, 17(10), 77. https://doi.org/10.1007/s11906-015-0588-3

American Heart Association. (2024). Getting active to control high blood pressure. https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/getting-active-to-control-high-blood-pressure

Centers for Disease Control and Prevention. (2024). Measure your blood pressure. Retrieved from https://www.cdc.gov/high-blood-pressure/measure/

American Heart Association. (2024). Understanding blood pressure readings. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings

American Heart Association. Association, A. H. (2024). When to call 911 about high blood pressure. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/hypertensive-crisis-when-you-should-call-911-for-high-blood-pressure