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Nonsurgical Therapeutic Options for Chronic Low Back Pain: Exploring Your Options

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

Can nonsurgical therapeutic options help individuals with chronic low back pain find the relief they are looking for to restore body function?

Introduction

Between the upper, middle, and lower back portions of the musculoskeletal system, many individuals have succumbed to traumatic injuries, repetitive motions, and overlapping environmental risk profiles that cause pain and disability, thus affecting their everyday routine. As one of the most common work conditions, back pain can cause individuals to deal with socio-economic burdens and can range from acute to chronic, depending on the injuries and factors that correlate with this issue. As part of the musculoskeletal system, the back has various muscles in the three quadrants that support the upper and lower extremities and have an outstanding relationship with the spine as each muscle group surrounds the spine and protects the spinal cord. When environmental factors and traumatic injuries start to cause pain-like symptoms in the back, it can put a person in excruciating pain, hence why many seek non-surgical treatments to reduce the pain-like effects of back pain and find the relief they are seeking. Today’s article looks at the impact of chronic low back pain and how non-surgical treatments can positively affect individuals dealing with chronic low back pain. We talk with certified medical providers who consolidate our patients’ information to provide numerous non-surgical treatment options to minimize chronic lower back pain affecting their extremities. We also inform and guide patients on how various non-surgical treatments can benefit their health and wellness as they can help reduce musculoskeletal conditions like chronic back pain. We encourage our patients to ask their associated medical providers intricated and important questions about their chronic low back pain and what small changes they can incorporate to reduce its pain-like symptoms. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

The Impact Of Chronic Low Back Pain

Do you constantly feel severe muscle aches or pains in your back after an excruciating long workday? Do you experience muscle tiredness from your back to your legs after carrying a heavy object? Or have you noticed that twisting or turning motions temporarily relieve your lower back, only to worsen after a while? Often, many of these pain-like scenarios are correlated with chronic low back pain, and it can be due to the various factors that correlate with this common musculoskeletal condition. When it comes to musculoskeletal conditions associated with chronic low back pain, they are prevalent while their impact is pervasive. To that point, they affect many individuals as they are the number one most common cause of severe long-term pain and physical disability. (Woolf & Pfleger, 2003) Since back pain can be either acute or chronic, it can become multifactorial as many other pain symptoms tend to cause overlapping risk profiles in the body. The impact of chronic low back pain has underlying pathological causes that are not well-defined but can be related to psychosocial dysfunction. (Andersson, 1999)

 

 

Additionally, degenerative changes within the spine can also cause an impact on the development of chronic lower back pain. The risk factors that cause overlapping risk profiles can range from smoking and obesity to various occupations that require excessive motions. (Atkinson, 2004) When that happens, it causes people to have unnecessary stress that impacts their lives and causes them to be miserable. This is where many individuals start seeking treatment to reduce the effects of chronic lower back pain and reduce the chances of seeking surgical intervention. 

 

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Non-Surgical Treatments For Chronic Back Pain

When people deal with chronic lower back pain, many often don’t realize that various motions, ages, and pathologies can modify the spine, causing the spinal discs to go through degenerative changes that correspond to the development of chronic lower back pain. (Benoist, 2003) When degenerative changes start to cause pain-like symptoms in the back, many will begin looking for affordable and effective treatments. Hence, this is why non-surgical treatments can help reduce the pain-like symptoms of chronic lower back pain and help restore body mobility. Non-surgical treatments are personalized to the person’s pain and range from acupuncture to massage therapy and spinal decompression. Non-surgical treatments are also affordable and help reduce the overlapping risk profiles of chronic low back pain while reducing its associated conditions.

 

Spinal Decompression Effects On Chronic Low Back Pain

 

Spinal decompression, as stated before, is a form of non-surgical treatment that incorporates mechanical gentle traction on the spine to alleviate chronic low back pain and can reduce the pain-like symptoms associated with it. Spinal decompression helps reduce the friction of the lumbar muscles, affecting the lumbar spine but also provides pain relief and body function. (Choi et al., 2022) Spinal decompression is safe while being gentle on the spine, combined with stabilization exercises to enhance intra-abdominal pressure and spinal ability to the lumbar. (Hlaing et al., 2021) When a person incorporates spinal decompression as part of their health and wellness journey, their pain and disability will lower over time while strengthening weakened muscles that were affected by chronic lower back pain. Incorporating these non-surgical treatments can help a person be more mindful of the environmental impact they are inflicting on their backs and live a better and healthier life.

 

References

Andersson, G. B. (1999). Epidemiological features of chronic low-back pain. Lancet, 354(9178), 581-585. https://doi.org/10.1016/S0140-6736(99)01312-4

Atkinson, J. H. (2004). Chronic back pain: searching for causes and cures. J Rheumatol, 31(12), 2323-2325. https://www.ncbi.nlm.nih.gov/pubmed/15570628

https://www.jrheum.org/content/jrheum/31/12/2323.full.pdf

Benoist, M. (2003). Natural history of the aging spine. Eur Spine J, 12 Suppl 2(Suppl 2), S86-89. https://doi.org/10.1007/s00586-003-0593-0

Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P. B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 6343837. https://doi.org/10.1155/2022/6343837

Hlaing, S. S., Puntumetakul, R., Khine, E. E., & Boucaut, R. (2021). Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord, 22(1), 998. https://doi.org/10.1186/s12891-021-04858-6

Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bull World Health Organ, 81(9), 646-656. https://www.ncbi.nlm.nih.gov/pubmed/14710506

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572542/pdf/14710506.pdf

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A Nutrition Breakdown of Tomatillos: Benefits and Nutrient Content

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
tomatillos in a pile in rustic scene

“For individuals looking to add other fruits and vegetables to their diet, can adding tomatillos provide variety and nutrition?”

A Nutrition Breakdown of Tomatillos: Benefits and Nutrient Content

Tomatillo

Tomatillos are a fruit that can bring a bright citrus flavor to various dishes.

Nutrition

The U.S. Department of Agriculture provides the following information for one medium/34g tomatillo. (FoodData Central. U.S. Department of Agriculture. 2018)

  • Calories – 11
  • Carbohydrates – 2 grams
  • Fat – 0.3 grams
  • Protein – 0.3 grams
  • Fiber – 0.7 grams
  • Sodium – 0.3 milligrams
  • Sugars – 1.3 grams

Carbohydrates

Fats

  • Tomatillos contain less than half a gram in one medium-sized tomatillo.

Protein

  • There is less than half a gram of protein per tomatillo.

Vitamins and Minerals

Tomatillos provide:

  • Vitamin A
  • Vitamin C
  • Potassium
  • And provide several other micronutrients in smaller doses.

Benefits

Tomatillo’s health benefits include the following.

Cardiovascular Health

Tomatillos provide a heart-healthy dietary addition. They are naturally low in sodium and rich in potassium, which could help regulate blood pressure. They provide vitamins A and C and antioxidants against free radicals.

The American Heart Association recommends the consumption of a variety of fruits and vegetables daily for various benefits. One of them is their fiber content. Fiber is the indigestible part of carbohydrates that can help decrease cholesterol by binding and removing cholesterol from the body. Tomatillos contain about one gram of fiber, a recommended addition to a heart-healthy diet. (American Heart Association. 2023)

Potentially Help Reduce Cancer Risk

Tomatillos have several antioxidants with cancer-preventing properties. They are a source of phytochemicals known as withanolides. These natural plant compounds have been shown to induce apoptosis/cell death in colon cancer cells. (Peter T. White et al., 2016) Diets high in fruits and vegetables have been associated with lower risks of cancer, making tomatillos a welcome addition to a high-antioxidant nutrition plan focused on cancer prevention.

Arthritis Symptoms Improvement

The withanolide antioxidants are also anti-inflammatory. Research on withanolides demonstrates clinical benefits in the alleviation of symptoms of osteoarthritis and rheumatoid arthritis. (Peter T. White et al., 2016) Tomatillos may help reduce inflammation, which can make arthritis more manageable.

Vision Loss Prevention

Tomatillos provide a healthy source of key nutrients for eye health. Lutein and zeaxanthin are antioxidants that concentrate in the retina and help protect against environmental deterioration. Tomatillos provide:

Weight Loss

Tomatillos are a low-calorie whole food ingredient. Because of their high water content, it’s possible to fill up without adding excess calories. Fresh salsa made with tomatoes or tomatillos is a healthy, flavorful choice that is virtually free of added sugars. (The National Kidney Foundation. 2014)

Adverse Effects

Tomatillos are part of the nightshade family. While there is no conclusive evidence confirming any harmful effects, some individuals report experiencing sensitivity to them. (Cleveland Clinic. 2019) Individuals who believe they may be sensitive to tomatillos should consult a registered dietitian to determine the root cause and ways to improve tolerance.

Allergies

  • Although rare, serious reactions, including anaphylaxis, are possible even if the individual shows no signs of a tomato allergy.
  • Individuals unsure about an allergy to tomatillos should see an allergist for testing.

Varieties

  • Different varieties include yellow, green, and purple. (MacKenzie J. 2018)
  • Rendidora is a green variety that grows upright with a high yield.
  • Gulliver Hybrid, Tamayo, Gigante, and Toma Verde are also green but grow in a sprawling pattern.
  • Some purple varieties include Purple Hybrid, De Milpa, and Coban. (Drost D, Pedersen K. 2020)

Choosing

  • Choose tomatillos that are firm and green but large enough that they fill up the husks.
  • When they ripen too long, their flavor becomes bland. (MacKenzie J. 2018)

Storage and Safety

  • Tomatillos can last months in their husks, spread out in a well-ventilated area. (MacKenzie J. 2018)
  • Keep them in a paper bag in the refrigerator for no longer than 2 weeks if using sooner.
  • Do not store in plastic, as this can cause spoilage.
  • For extended storage, tomatillos may be frozen or canned.
  • Remove the husks, wash them, and dry them before eating or preparing them for long-term storage.

Preparation

Tomatillos have a distinct flavor and firm texture. They can be eaten whole with no need to seed or core them. (Drost D, Pedersen K. 2020) Use tomatillos for:

  • Raw
  • Salsa verde
  • As a topping
  • Sandwiches
  • Salads
  • Soups
  • Stews
  • Fried
  • Broiled
  • Roasted for a side dish
  • Added to smoothies

The Healing Diet: Combat Inflammation, Embrace Wellness

References

FoodData Central. U.S. Department of Agriculture. (2018). Tomatillos, raw. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/168566/nutrients

American Heart Association. (2023). How to Eat More Fruit and Vegetables (Healthy Living, Issue. https://www.heart.org/en/healthy-living/healthy-eating/add-color/how-to-eat-more-fruits-and-vegetables

White, P. T., Subramanian, C., Motiwala, H. F., & Cohen, M. S. (2016). Natural Withanolides in the Treatment of Chronic Diseases. Advances in experimental medicine and biology, 928, 329–373. https://doi.org/10.1007/978-3-319-41334-1_14

National Institutes of Health, Office of Dietary Supplements. (2023). Vitamin A: Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/

The National Kidney Foundation. (2014). 6 of the Best and Worst Condiments for Health (Kidney Basics, Issue. https://www.kidney.org/news/ekidney/july14/7_Best_and_Worst_Condiments_for_Health

Cleveland Clinic. (2019). What’s the Deal With Nightshade Vegetables? (healthessentials, Issue. https://health.clevelandclinic.org/whats-the-deal-with-nightshade-vegetables/

Jill, M. (2018). Growing Tomatillos and Ground Cherries in Home Gardens. https://extension.umn.edu/vegetables/growing-tomatillos-and-ground-cherries#harvest-and-storage-570315

Drost D, P. K. (2020). Tomatillos in the Garden (Horticulture, Issue. https://digitalcommons.usu.edu/cgi/viewcontent.cgi?article=2658&context=extension_curall

Comprehending the Difference Between Dry Needling and Acupuncture

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

For individuals dealing with musculoskeletal pain, can incorporating acupuncture and dry needling therapy improve functionality?

Introduction

All around the world, many individuals have experienced musculoskeletal pain at one point in their lives. Musculoskeletal pain can range from acute to chronic, depending on how severe the affected muscles are in pain. Sometimes, when a person is dealing with pain in one location and feels it in a different body location, that is known as referred pain, and it can lead to overlapping risk profiles. Additionally, many individuals dealing with musculoskeletal pain are often associated with various environmental factors that contribute to its development or have traumatic injuries that causes the spine to be out of alignment with the body. When it comes to treating musculoskeletal pain, many individuals will do home remedies that can provide temporary relief until the pain flares up again. When that happens, many will seek treatment to reduce the pain-like effects and find the relief they are looking for. Today’s article examines two treatments, their benefits, and how they can reduce musculoskeletal pain. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to minimize musculoskeletal pain affecting their bodies. We also inform and guide patients on how various treatments can be beneficial to their health and wellness as they can help reduce musculoskeletal pain. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from musculoskeletal pain that is causing them pain and discomfort. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

What Is Acupuncture?

Do you wake up in the morning feeling general aches and pains in various muscle locations? Do you feel muscle stiffness in your neck, shoulders, or back after a long, hard workday? Or have you experienced pain-like symptoms like numbness or radiating burning sensations in your upper or lower body extremities? In these pain-like scenarios, many individuals are experiencing musculoskeletal pain once in their lives. This usually happens when environmental factors or traumatic injuries occur in the musculoskeletal system, causing the surrounding muscles, ligaments, and tissue to be overstretched, tight, or weakened, depending on the severity. When a person is dealing with musculoskeletal pain, they will seek treatments to reduce the musculoskeletal pain and be affordable and customizable to the individual’s pain, hence why non-surgical therapies can benefit the person dealing with musculoskeletal pain.

 

 

One of the oldest forms of non-surgical treatment is acupuncture, which can help reduce musculoskeletal pain. Acupuncture has been practiced in China for over two thousand years by modulating the body’s physiology by stimulating specific body regions or acupoints. (Wang et al., 2023) Acupuncture incorporates thin, solid needles used by highly trained medical professionals to restore the balance of qi or energy flowing through the body while positively affecting the central and peripheral nervous system. To that point, by changing pain perception, acupuncture can help reduce the inflammatory cytokines associated with musculoskeletal pain. (Kelly & Willis, 2019)

Acupuncture Benefits

Some of the benefits that acupuncture can help a person dealing with musculoskeletal pain include:

  • Release tight muscles.
  • Inflammation reduction
  • Regulate gut activity associated with musculoskeletal pain.
  • Improve pain and disability.

Since pain is a common indication for acupuncture, acupuncture for individuals experiencing musculoskeletal pain can help enhance the descending inhibitory effects while modulating the feelings of pain, which, to this point, modify central sensitization. (Zhu et al., 2021) This, in turn, helps many individuals experience positive effects from musculoskeletal pain reduction in their bodies.

 

What Is Dry Needling?

 

Dry needling is a different form of acupuncture that combines TCM (traditional Chinese medicine) and structural manipulation of the affected muscles experiencing pain. Dry needling is safe and, like acupuncture, cost-effective. It reduces pain and improves fascial and scar tissue mobility back to the muscle. (Munoz et al., 2022) At the same time, dry needling is used by highly trained professionals to treat soft tissues and neurovascular bundles correlated with numerous neuromusculoskeletal pain syndromes by inserting fine monofilament needles and stimulating specific reactions in the targeted tissue. (Lara-Palomo et al., 2022)

 

Dry Needling Benefits

Dry needling can help reduce musculoskeletal pain symptoms associated with myofascial pain syndrome by mechanically disrupting the trigger points to elicit a local twitch response. (Lew et al., 2021) Some of the benefits that dry needling provides include:

  • Decrease muscle tightness.
  • Pain reduction
  • Joint and muscle mobility
  • Increase blood flow. 

 

How Acupuncture & Dry Needling Help With Pain?

Depending on how severe the individual’s pain is affecting their daily life, they can choose either acupuncture or dry needling and combine them with other non-surgical therapies to reduce the chances of musculoskeletal pain from causing overlapping risk profiles that can make a person’s life miserable. Both non-surgical techniques can be effective with patients dealing with musculoskeletal pain, improve stiffness and fatigue, and enhance quality of life. (Valera-Calero et al., 2022) Incorporating these non-surgical treatments to reduce musculoskeletal pain with healthy habits can give helpful results to the individual by making small changes in their everyday lives and being mindful of their bodies. This allows them to reduce the chances of musculoskeletal pain and its associated factors from recurring again in the future.

 

Revolutionizing Healthcare- Video

Revolutionizing Healthcare | El Paso, Tx (2023)

References

Kelly, R. B., & Willis, J. (2019). Acupuncture for Pain. American Family Physician, 100(2), 89-96. https://www.ncbi.nlm.nih.gov/pubmed/31305037

https://www.aafp.org/pubs/afp/issues/2019/0715/p89.pdf

Lara-Palomo, I. C., Gil-Martinez, E., Antequera-Soler, E., Castro-Sanchez, A. M., Fernandez-Sanchez, M., & Garcia-Lopez, H. (2022). Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Trials, 23(1), 238. https://doi.org/10.1186/s13063-022-06179-y

Lew, J., Kim, J., & Nair, P. (2021). Comparison of dry needling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis. J Man Manip Ther, 29(3), 136-146. https://doi.org/10.1080/10669817.2020.1822618

Munoz, M., Dommerholt, J., Perez-Palomares, S., Herrero, P., & Calvo, S. (2022). Dry Needling and Antithrombotic Drugs. Pain Res Manag, 2022, 1363477. https://doi.org/10.1155/2022/1363477

Valera-Calero, J. A., Fernandez-de-Las-Penas, C., Navarro-Santana, M. J., & Plaza-Manzano, G. (2022). Efficacy of Dry Needling and Acupuncture in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health, 19(16). https://doi.org/10.3390/ijerph19169904

Wang, M., Liu, W., Ge, J., & Liu, S. (2023). The immunomodulatory mechanisms for acupuncture practice. Front Immunol, 14, 1147718. https://doi.org/10.3389/fimmu.2023.1147718

Zhu, J., Li, J., Yang, L., & Liu, S. (2021). Acupuncture, from the ancient to the current. Anat Rec (Hoboken), 304(11), 2365-2371. https://doi.org/10.1002/ar.24625

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Acupuncture for Weight Loss: An Overview

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
An Auriculotherapy by using needles and pressure points

“For individuals wanting to improve and/or maintain health, research shows evidence that acupuncture may help promote weight loss. Can incorporating acupuncture into an overall health plan help achieve this goal?”

Acupuncture for Weight Loss: An Overview

Acupuncture Weight Loss

Acupuncture is a traditional medical therapy that inserts thin, flexible needles into the body at specific points. It has been around for more than 2,500 years. The practice is believed to stimulate the body’s energy/circulation, and research suggests that it could improve various factors known to contribute to weight gain and obesity. (Kepei Zhang et al., 2018)

  • Acupuncture regulates energy flow and helps restore the body’s balance, which is believed to promote homeostasis and self-healing. (Ning-Cen Li et al., 2019)
  • Acupuncture stimulates connective tissue, which affects blood circulation, nerves, and the immune system.
  • It has been used to help manage conditions like migraines, infertility, pain management, and weight loss.
  • At the first appointment, the acupuncturist will take a general medical history and identify weight loss goals.
  • They will help identify the root causes contributing to weight gain, e.g., slow metabolism, thyroid issues, and overeating, to develop an effective personalized treatment plan.
  • A trained and licensed practitioner may also be able to provide nutritional and health coaching in addition to acupuncture treatments.

Procedure

  • The needles are thin and designed to work effectively without causing pain or bleeding.
  • The needles are left in for 15 to 30 minutes per session, depending on the treatment stage.
  • The practitioner may lift or rotate the needles as part of the technique during a session.
  • Many individuals report that acupuncture treatments are relaxing and pain-free.
  • For weight loss, the ear points will be the focus.
  • Research suggests that stimulating certain outer ear points may help balance hormones that help decrease cravings and suppress appetite. (Li-Hua Wang et al.,2019)
  • Two hormones that help in weight loss and acupuncture may help rebalance include: (Li-Hua Wang et al.,2019)

Ghrelin

  • Controls appetite and meal stimulation.

Leptin

  • Regulates fat storage and metabolism.

Acupuncture Weight Loss can help:

  • Decrease food cravings
  • Suppress appetite
  • Improve digestion
  • Increase metabolism

Research

Acupuncture weight loss recent research:

  • One study compared the effectiveness of auricular/ear acupuncture to body acupuncture in obese women and found that those who received ear acupuncture lost more weight than the individuals who received acupuncture in other body areas. (Cayir Yasemin et al., 2017)
  • Another study found that overweight females between 20 and 30 years of age who received six weekly treatments of ear acupuncture experienced a reduction in waist circumference. (Felicity Lillingston et al., 2019)
  • Many individuals gain weight as a result of stress.
  • Research suggests that acupuncture therapy helps stimulate the release of endorphins or the body’s natural pain-relieving hormones.
  • This helps create calming, relaxing effects that counteract stress eating caused by tension, frustration, and anxiety. (Laila Ahmed Abou Ismail et al., 2015)
  • When incorporated with lifestyle adjustments, like regular exercise, improved sleep, stress management, and a balanced diet, a review of studies concluded that acupuncture is effective for weight loss. (S-Y Kim et al, 2018)

Safety

The risks of acupuncture are low when performed by a licensed and certified practitioner. The most common side effects include:

  • Soreness
  • Bruising
  • Minor bleeding where the needles were inserted
  • Fatigue

Before seeking acupuncture treatment, consult your healthcare provider about consideration. They may recommend a reputable practitioner if the treatment is right for you.

Chiropractic Care and Metabolism

References

Zhang, K., Zhou, S., Wang, C., Xu, H., & Zhang, L. (2018). Acupuncture on Obesity: Clinical Evidence and Possible Neuroendocrine Mechanisms. Evidence-based complementary and alternative medicine : eCAM, 2018, 6409389. https://doi.org/10.1155/2018/6409389

Li, N. C., Li, M. Y., Chen, B., & Guo, Y. (2019). A New Perspective of Acupuncture: The Interaction among Three Networks Leads to Neutralization. Evidence-based complementary and alternative medicine : eCAM, 2019, 2326867. https://doi.org/10.1155/2019/2326867

Wang, L. H., Huang, W., Wei, D., Ding, D. G., Liu, Y. R., Wang, J. J., & Zhou, Z. Y. (2019). Mechanisms of Acupuncture Therapy for Simple Obesity: An Evidence-Based Review of Clinical and Animal Studies on Simple Obesity. Evidence-based complementary and alternative medicine : eCAM, 2019, 5796381. https://doi.org/10.1155/2019/5796381

Yasemin, C., Turan, S., & Kosan, Z. (2017). The Effects of Auricular and Body Acupuncture in Turkish Obese Female Patients: A Randomized Controlled Trial Indicated Both Methods Lost Body Weight But Auricular Acupuncture Was Better Than Body Acupuncture. Acupuncture & electro-therapeutics research, 42(1), 1–10. https://doi.org/10.3727/036012917×14908026364990

Lillingston, F., Fields, P., & Waechter, R. (2019). Auricular Acupuncture Associated with Reduced Waist Circumference in Overweight Women-A Randomized Controlled Trial. Evidence-based complementary and alternative medicine : eCAM, 2019, 6471560. https://doi.org/10.1155/2019/6471560

Ismail, L. A., Ibrahim, A. A., Abdel-Latif, G. A., El-Haleem, D. A., Helmy, G., Labib, L. M., & El-Masry, M. K. (2015). Effect of Acupuncture on Body Weight Reduction and Inflammatory Mediators in Egyptian Obese Patients. Open access Macedonian journal of medical sciences, 3(1), 85–90. https://doi.org/10.3889/oamjms.2015.010

Kim, S. Y., Shin, I. S., & Park, Y. J. (2018). Effect of acupuncture and intervention types on weight loss: a systematic review and meta-analysis. Obesity reviews : an official journal of the International Association for the Study of Obesity, 19(11), 1585–1596. https://doi.org/10.1111/obr.12747

How Decompression Can Help with Leg Back Pain

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

Can individuals with leg and back pain find the relief by incorporating decompression to reduce pain-like associated symptoms?

Introduction

The lower extremities help stabilize the upper body’s weight and provide movement to the individual. The lower body portions include the lower back, pelvis, hips, thighs, legs, and feet, as they all have specific jobs to do and have an outstanding relationship with each other. However, their lower back and legs are susceptible to injuries. When environmental factors or injuries start to cause issues in the musculoskeletal system, it can lead to referred pain and overlapping risk profiles that can cause a person to have mobility and stability issues. The affected muscles, tissues, ligaments, and nerve roots can become irritated, weak, and tight when environmental factors start to compress the spine and lead to pain over time. Today’s article looks at how the back and legs work together in the body, how they are impacted by pain from environmental factors, and how spinal decompression can reduce leg and back pain. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to minimize back and leg pain affecting their mobility. We also inform and guide patients on how treatments like decompression can help reduce pain-like symptoms within the legs and back. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from their legs and since that is disrupting their daily routine. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

How The Back & Legs Work Together?

Do you feel radiating pain in your back that is affecting your ability to walk? Do you experience muscle aches or tiredness in your legs after a long workday? Or do you feel stiffness in your back and legs after waking up? Many of these scenarios are correlated with leg and back pain that can impact a person’s gait and lead to associated pain-like symptoms. The back and leg muscles work together through the sciatic nerve, a long nerve from the lumbar spinal region, past the gluteal muscles, traveling down the back of the legs and stopping at the knees. The back consists of the core muscles and the lumbar spinal region, allowing the person to bend, twist, and extend.

Meanwhile, the leg muscles help a person become mobile while stabilizing the person’s weight. These two muscle groups have an outstanding relationship in the lower extremities, as people need to be mobile when doing activities. However, they can also become vulnerable to injuries and pain that can cause disability issues.

 

How Pain Is Associated With The Back & Legs?

When it comes to the lower back and the legs, environmental factors and traumatic injuries can affect the surrounding muscles, tendons, ligaments, and nerve roots. For example, when working individuals routinely lift heavy objects, it can increase the risk of developing lower back pain while causing whole-body vibrations in the legs. (Becker & Childress, 2019) This is because what the heavy loading object does to the lower back is that it causes the spine to be compressed and contract the surrounding muscle. When it is repeated constantly, it can cause the spinal disc to herniate and aggravate the nerve roots. When these nerve roots become aggravated, it can lead to nerve entrapment and inflammation, thus causing individuals to experience chronic leg pain, foot drop, or ankle stability that affects their mobility. (Fortier et al., 2021) 

 

Additionally, back and leg pain can even happen when the spine starts to experience degeneration, a natural process when the spinal disc shrinks over time. When the spinal disc in the lumbar spinal region degenerates over time, the nutrient supplies and changes in the extracellular composition cause the discs to be less capable of maintaining their load distribution function in the lower extremities. (Kim et al., 2020) However, many people who are experiencing leg and back pain can seek treatment to reduce the pain-like symptoms. 

 

Chiropractic Care For Leg Instability- Video

Chiropractic Care for Leg Instability | El Paso, Tx (2023)

Spinal Decompression Reducing Pain On The Legs & Back

When it comes to treating leg and back pain, many individuals will start to seek affordable treatment that can reduce pain-like symptoms. Many non-surgical treatments like spinal decompression are excellent for reducing pain that is affecting the back and legs. Spinal decompression uses a traction machine that can help stretch out the tight muscles from the lower back and provide negative pressure to the affected disc by increasing the blood nutrient flow back to the disc while reducing pressure off the aggravated nerve root. (Choi et al., 2022) Spinal decompression can be combined with core stabilizing exercises that can help reduce pain and disability and improve stability in the legs and lower extremities. (Hlaing et al., 2021) With spinal decompression to reduce back and leg pain, many individuals can notice positive results after consecutive treatment, and their mobility is improved. (Vanti et al., 2021) When individuals who are experiencing leg and back pain and are looking for treatment can find the benefits of spinal decompression to be incorporated into their daily routine since it can be customizable and help them be more mindful of what movements and environmental factors are causing them pain. Making these small changes over time can improve their health and help them live healthier lives.

 

References

Becker, B. A., & Childress, M. A. (2019). Nonspecific Low Back Pain and Return To Work. American Family Physician, 100(11), 697-703. https://www.ncbi.nlm.nih.gov/pubmed/31790184

https://www.aafp.org/pubs/afp/issues/2019/1201/p697.pdf

Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P. B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 6343837. https://doi.org/10.1155/2022/6343837

Fortier, L. M., Markel, M., Thomas, B. G., Sherman, W. F., Thomas, B. H., & Kaye, A. D. (2021). An Update on Peroneal Nerve Entrapment and Neuropathy. Orthop Rev (Pavia), 13(2), 24937. https://doi.org/10.52965/001c.24937

Hlaing, S. S., Puntumetakul, R., Khine, E. E., & Boucaut, R. (2021). Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord, 22(1), 998. https://doi.org/10.1186/s12891-021-04858-6

Kim, H. S., Wu, P. H., & Jang, I. T. (2020). Lumbar Degenerative Disease Part 1: Anatomy and Pathophysiology of Intervertebral Discogenic Pain and Radiofrequency Ablation of Basivertebral and Sinuvertebral Nerve Treatment for Chronic Discogenic Back Pain: A Prospective Case Series and Review of Literature. Int J Mol Sci, 21(4). https://doi.org/10.3390/ijms21041483

Vanti, C., Turone, L., Panizzolo, A., Guccione, A. A., Bertozzi, L., & Pillastrini, P. (2021). Vertical traction for lumbar radiculopathy: a systematic review. Arch Physiother, 11(1), 7. https://doi.org/10.1186/s40945-021-00102-5

Disclaimer

Walk Better and Faster with an Exercise Schedule

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
idea of healthy lifestyle and sports in a modern city. Female jogger. Fit young Caucasian woman running in park and enjoying healthy outdoor. Fitness girl in public park.

“For individuals who have decided to start exercising for fitness and health, walking is a great place to start. Can planning a walking exercise schedule help individuals maintain a fitness routine and improve endurance and speed quicker?”

Walk Better and Faster with an Exercise Schedule

Walking Exercise Planning Schedule

While any amount of walking benefits health, individuals can increase the benefits by walking more per week or by increasing the pace. Brisk walking for 30 minutes per day, totaling 150 minutes per week, is recommended by health experts to decrease risks for heart disease, stroke, diabetes, and other conditions. (Centers for Disease Control and Prevention. 2022)

  • Individuals with ongoing health conditions should talk to their doctor before starting any new exercise program.
  • Beginners are encouraged to focus on using proper walking posture and technique to steadily improve strength and endurance.
  • The increased duration or intensity can help if weight loss is a goal.
  • Improving diet is also necessary for the best results.
  • Individuals can build healthy walking habits by tracking walks.

Schedule

Checklist

  • Individuals can walk outdoors, indoors, or on a treadmill.
  • Wear proper athletic shoes and clothing.
  • Check walking posture.
  • Walk at an easy pace for a couple of minutes before picking up speed.

First Week

An example of what a walking exercise schedule can look like, but it’s advised to consult a professional trainer to develop a personalized fitness plan.

  • Start with a 15-minute walk at an easy pace.
  • Walk five days the first week.
  • Building a healthy habit is the goal, so consistency is important.
  • Spread out rest days, like making days 3 and 6 rest days.
  • Weekly goal – 60 to 75 minutes

Second Week

  • Add five minutes, so the walk time increases gradually.
    Or, individuals can extend more on some days, followed by a rest day.
  • Weekly goal – 80 to 100 minutes

Third Week

  • Add five more minutes with each session, so the walk increases to 25 minutes.
  • Weekly goal – 100 to 125 minutes

Fourth Week

  • Add another five minutes to increase the walk to 30 minutes.
  • Weekly goal – 120 to 150 minutes

Individuals who find any week to be difficult are suggested to repeat that week instead of adding time until they are able to progress naturally. Once able to walk for 30 minutes at a time comfortably, individuals are ready for a variety of different walking exercise workouts to add intensity and endurance. A weekly walking plan can include:

  • Longer walks
  • Higher-intensity walks
  • Speed-building walks

Beginner Walking Speed

An individual’s objective should be brisk walking to achieve a moderate-intensity workout. This is the intensity that is associated with the most health benefits.

Brisk walking should feel like:

  • Breathing is heavier than normal.
  • Able to carry a full conversation while walking.
  • Not out of breath. (Siti Ruzita Mahmod et al., 2018)
  • If the speed is slower and the heart rate is lower during the initial weeks, this is normal.
  1. The first goal is to walk for 30 to 60 minutes a day without injury.
  2. Adding speed and intensity gradually.
  3. Staying consistent in regularly walking before trying to walk faster and longer.
  4. Using proper walking posture and arm motion will help in faster walking.
  5. To reduce the risk of injury, gradually increase the length of the walk or pace, only changing one component at a time.

Individuals may consider joining a walking group or club to have others to walk with and an incentive to maintain regular walking.

Home Exercises for Pain Relief

References

Centers for Disease Control and Prevention. (2022). How Much Physical Activity Do Adults Need? Retrieved from https://www.cdc.gov/physicalactivity/basics/adults/index.htm

Centers for Disease Control and Prevention. (2022). Measuring Physical Activity Intensity. Retrieved from https://www.cdc.gov/physicalactivity/basics/measuring/index.html

Centers for Disease Control and Prevention. (2022). Target Heart Rate and Estimated Maximum Heart Rate. Retrieved from https://www.cdc.gov/physicalactivity/basics/measuring/heartrate.htm

Mahmod, S. R., Narayanan, L. T., & Supriyanto, E. (2018). Effects of incremental cardiorespiratory exercise on the speech rate and the estimated exercise intensity using the counting talk test. Journal of physical therapy science, 30(7), 933–937. https://doi.org/10.1589/jpts.30.933

The Benefits of Acupuncture for Piriformis Syndrome

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

Can individuals with piriformis syndrome incorporate acupuncture with various therapies to reduce sciatic nerve pain and other symptoms?

Introduction

As many individuals move around from one location to another thanks to the lower body extremities, the surrounding muscles, ligaments, nerve roots, and tissues help contribute to the sensory-motor function of the hips, legs, buttocks, and feet. All these muscle groups factor in to ensure they can be mobile without the effects of pain or discomfort. However, many factors and issues can cause the surrounding muscles to develop musculoskeletal problems over time, affecting a person’s mobility. One of the muscles that helps share the responsibility for mobility to hips and buttocks is the piriformis muscle, which is often overlooked when various injuries or repetitive motions start to affect a person’s ability to walk. Today’s article examines how piriformis syndrome affects mobility, how sciatic pain correlates with piriformis syndrome, and how therapies like acupuncture can help reduce piriformis syndrome. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to minimize piriformis syndrome affecting a person’s mobility. We also inform and guide patients on how treatments like acupuncture can help reduce sciatic nerve pain associated with piriformis syndrome. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from piriformis syndrome that is affecting their ability to walk. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

Piriformis Syndrome Affecting Mobility

Have you been experiencing muscle tightness in your hips or buttock region, affecting your walking ability? Do you feel sensations of numbness, tingling, or burning pain traveling down to your knees and feet? Or, after a long day of work, do you feel pain when you are sitting down? Most of these symptoms are often correlated with piriformis syndrome. The six surrounding muscles surrounding the gluteal region of the thighs and hips all work together to provide lower body movement while stabilizing the hips and rotating the thighs. The piriformis muscle is a small, flat, pear-shaped muscle that runs on top of the sciatic nerve. Piriformis syndrome is a clinical musculoskeletal condition that causes sciatic nerve entrapment that causes many individuals to report shooting and burning pain down to their buttock region. (Hicks et al., 2024) This causes many people to think they are dealing with low back pain associated with sciatica. When a person is dealing with piriformis syndrome, they will experience limited mobility in their hips, which, over time, if not treated, will affect the thighs and legs. 

 

How Does Sciatic Nerve Pain correlate with Piriformis Syndrome?

 

Additionally, since piriformis syndrome is correlated with sciatic nerve pain, some clinical findings causing overlapping risk profiles include restricted external hip rotation and muscle tightness of the lumbosacral muscles. Other clinical findings range from palpatory pain over the greater sciatic notch to aggravated pain in a seated position. (Sharma et al., 2023) Since sciatic nerve entrapment is correlated with piriformis syndrome, it is still regarded as the non-discogenic cause of sciatica. (Son & Lee, 2022) When that sciatic nerve gets trapped within the piriformis muscle, many people will experience numbness, tingling sensations, and similar pain patterns in the legs, just like sciatica; however, when individuals are looking for treatments to reduce the sciatic nerve pain and improve the piriformis muscle.

 

Acupuncture Therapy Reduces Piriformis Syndrome

 

When people are looking for treatments to reduce their sciatic nerve pain correlated with piriformis syndrome, they are seeking treatments that are affordable and can reduce the pain through consecutive sessions. Acupuncture therapy can help reduce the effects of piriformis syndrome. Acupuncture is a complementary and alternative therapy from China that uses solid, thin needles to be placed on the acupoints in the body. Additionally, highly trained professionals can incorporate various acupuncture methods to treat and reduce the effects of piriformis syndrome. (He et al., 2023) At the same time, when a person is being treated for piriformis syndrome, an acupuncturist uses ultrasound-guided techniques to allow accurate needle placement within the deep muscles to provide an effective treatment response. (Fusco et al., 2018) This allows the affected surrounding muscles to relax and reduce sciatic nerve pain.

 

Acupuncture Reducing Sciatic Nerve Pain

Since sciatic nerve pain and piriformis syndrome have overlapping risk profiles, they can also be associated with other musculoskeletal pain conditions that can affect a person’s mobility. Acupuncture can help mitigate the pain signals causing motor or sensory disturbances within the pelvic and hip regions. (Kvorning et al., 2004) Acupuncture is one of the oldest forms of non-surgical therapy that can be combined with other various therapies to help remobilize the hips and decompress the pain affecting the sciatic nerve while providing relief. (Vij et al., 2021) By incorporating acupuncture as part of a person’s health and wellness treatment plan, they will begin to gradually manage the associated symptoms and reduce the chances of piriformis syndrome from returning to cause sciatic nerve pain in the lower extremities. This allows people to be more mindful and help restore the body’s natural healing process over time.

Reclaim Your Mobility- Video

Reclaim Your Mobility: Chiropractic Care for Sciatica Recovery | El Paso, Tx (2024)

References

Fusco, P., Di Carlo, S., Scimia, P., Degan, G., Petrucci, E., & Marinangeli, F. (2018). Ultrasound-guided Dry Needling Treatment of Myofascial Trigger Points for Piriformis Syndrome Management: A Case Series. J Chiropr Med, 17(3), 198-200. https://doi.org/10.1016/j.jcm.2018.04.002

He, Y., Miao, F., Fan, Y., Zhang, F., Yang, P., Zhao, X., Wang, M., He, C., & He, J. (2023). Acupuncture Methods for Piriformis Syndrome: A Protocol for Systematic Review and Network Meta-Analysis. J Pain Res, 16, 2357-2364. https://doi.org/10.2147/JPR.S417211

Hicks, B. L., Lam, J. C., & Varacallo, M. (2024). Piriformis Syndrome. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/28846222

Kvorning, N., Holmberg, C., Grennert, L., Aberg, A., & Akeson, J. (2004). Acupuncture relieves pelvic and low-back pain in late pregnancy. Acta Obstet Gynecol Scand, 83(3), 246-250. https://doi.org/10.1111/j.0001-6349.2004.0215.x

Sharma, S., Kaur, H., Verma, N., & Adhya, B. (2023). Looking beyond Piriformis Syndrome: Is It Really the Piriformis? Hip Pelvis, 35(1), 1-5. https://doi.org/10.5371/hp.2023.35.1.1

Son, B. C., & Lee, C. (2022). Piriformis Syndrome (Sciatic Nerve Entrapment) Associated With Type C Sciatic Nerve Variation: A Report of Two Cases and Literature Review. Korean J Neurotrauma, 18(2), 434-443. https://doi.org/10.13004/kjnt.2022.18.e29

Vij, N., Kiernan, H., Bisht, R., Singleton, I., Cornett, E. M., Kaye, A. D., Imani, F., Varrassi, G., Pourbahri, M., Viswanath, O., & Urits, I. (2021). Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review. Anesth Pain Med, 11(1), e112825. https://doi.org/10.5812/aapm.112825

Disclaimer

Acupuncture for Arthritis: Can It Help Manage Symptoms?

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Close up of a needle and hands of physiotherapist doing a dry needling in a physiotherapy center.

“For individuals with arthritis, can incorporating acupuncture with other therapies help manage pain and other symptoms?”

Acupuncture for Arthritis: Can It Help Manage Symptoms?

Acupuncture For Arthritis

Acupuncture has been around for thousands of years and is a form of traditional Chinese medicine that utilizes needles inserted into various parts of the body to relieve pain and inflammation. The practice is based on the concept of life energy that flows throughout the body along pathways called meridians. When the energy flow becomes disrupted, blocked, or injured, pain or illness can present. (Arthritis Foundation. N.D.) Further research is needed to determine how the acupuncture therapeutic mechanisms work and the overall effectiveness. However, there is emerging evidence suggesting that acupuncture can provide symptom relief for individuals with joint pain, especially those with osteoarthritis and rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Benefits

The actual method that reduces the pain and inflammation is still unclear. Theories include that the needles suppress inflammatory responses, improve blood flow, and relax muscles. Although acupuncture cannot cure or reverse arthritis, it may be useful for managing pain and decreasing associated symptoms, especially in combination with other therapies. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Rheumatoid Arthritis

A systematic review of 43 studies, including humans and animals with rheumatoid arthritis, demonstrated varied results. Several studies showed improvement in symptoms and decreased biological markers of rheumatoid arthritis following one to three sessions of acupuncture for four weeks or more. (Sharon L. Kolasinski et al., 2020) Beneficial outcomes following acupuncture treatment for rheumatoid arthritis include:

  • Reduced pain
  • Reduced joint stiffness
  • Improved physical function

The results of the human and animal studies suggested that acupuncture has the potential to down-regulate:

  • Levels of interleukins
  • Levels of tumor necrosis factor
  • Specific cell signaling proteins/cytokines involved in the inflammatory response, which become elevated in autoimmune conditions like rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)
  • Most of the study subjects were also receiving other forms of treatment, especially medication. Therefore, it is difficult to conclude how beneficial acupuncture is alone or as a supplemental addition to other medical treatments. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Osteoarthritis

Acupuncture for osteoarthritis of the hand, hip, and knee is recommended, according to the American College of Rheumatology and Arthritis Foundation, meaning that it may be worth trying, although more research is needed to confirm its effectiveness. However, since the risk is relatively minor, acupuncture is generally considered a safe alternative treatment option for managing the symptoms. (Sharon L. Kolasinski et al., 2020)

Chronic Pain

As clinical trials suggest that acupuncture may be effective in providing pain relief, it may be a recommended option for individuals suffering from chronic pain. A recent systematic review of 20,827 patients and 39 trials concluded that acupuncture is effective for the treatment of chronic musculoskeletal pain, headache, and osteoarthritis pain. (Andrew J. Vickers et al., 2018)

Other possible benefits include the antioxidative effects: (Pei-Chi Chou, Heng-Yi Chu. 2018)

  • Alleviating oxidative stress and inflammation
  • Improving energy metabolism
  • Triggering the release of endorphins/hormones that help reduce pain.

Safety

  • Acupuncture is considered a safe procedure by a licensed and certified professional.
  • To practice acupuncture in the United States, an acupuncturist needs a minimum of a master’s degree from a program accredited by the American Academy of Acupuncture and Oriental Medicine and a license in the state where they received their acupuncture treatment.
  • Doctors with an MD or DO degree licensed in the United States to practice medicine can also be licensed by the American Academy of Medical Acupuncture after additional training.

Risks

Risks associated with acupuncture are bleeding and bruising, especially for individuals who have a bleeding disorder like hemophilia or take a blood thinning medication. Individuals are recommended to talk to their healthcare provider to determine if acupuncture is a safe option.

Side Effects

Most individuals do not experience any side effects, although possible reactions can include: (Shifen Xu et al., 2013)

  • Soreness
  • Bruising
  • Scarring
  • Needle shock: a vasovagal response that presents as feeling faint, clammy hands, chills, and slight nausea.

Acupuncture Session

  • During the initial treatment, individuals will discuss their medical history and what joints and areas of their bodies are presenting with symptoms.
  • After a physical exam, the individual will lie on a treatment table.
  • Individuals may be face up or down depending on what areas of the body the acupuncturist needs to access.
  • It is recommended to wear loose clothing that can be rolled up or moved out of the way to access different areas easily.
  • Depending on what areas need to be accessed, individuals may be asked to change into a medical gown.
  • The acupuncturist will use alcohol swabs to disinfect the area before inserting the needles.
  • The needles are made of stainless steel and are extremely thin.
  • Individuals may feel a slight pinch in sensitive areas like the hands and feet, but needle insertion should be comfortable and well-tolerated without significant discomfort.
  • For electroacupuncture, the acupuncturist will pass a mild electric current through the needles, typically 40 to 80 volts.
  • The needles stay in place for 20 to 30 minutes.
  • After the treatment is finished, the acupuncturist will remove the needles and dispose of them.

Frequency

  • The frequency of acupuncture sessions will vary depending on the severity of the symptoms and whether the visits are approved and reimbursed by the health insurance company.

Cost and Insurance

  • Costs for acupuncture can vary from $75 to $200 per session.
  • The first session, which involves an initial assessment and evaluation, usually costs more than follow-up visits.
  • Whether the health insurance will cover some or all of the costs of acupuncture sessions depends on the individual insurance company and the condition being treated.
  • Medicare currently covers acupuncture services up to 12 visits within a 90-day period for chronic low back pain only.
  • Medicare will not cover acupuncture for other conditions. (Medicare.gov. N.D.)

Acupuncture is not a cure for arthritis, but it may be a useful tool to help manage pain and other symptoms. Make sure to consult a healthcare provider if acupuncture is safe to try based on medical history.

Arthritis Explained

References

Arthritis Foundation. (N.D.). Acupuncture for arthritis (Health & Wellness, Issue. https://www.arthritis.org/health-wellness/treatment/complementary-therapies/natural-therapies/acupuncture-for-arthritis

Chou, P. C., & Chu, H. Y. (2018). Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 8596918. https://doi.org/10.1155/2018/8596918

Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W. F., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., Wise, B., … Reston, J. (2020). 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis care & research, 72(2), 149–162. https://doi.org/10.1002/acr.24131

Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists’ Collaboration (2018). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The journal of pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005

Xu, S., Wang, L., Cooper, E., Zhang, M., Manheimer, E., Berman, B., Shen, X., & Lao, L. (2013). Adverse events of acupuncture: a systematic review of case reports. Evidence-based complementary and alternative medicine : eCAM, 2013, 581203. https://doi.org/10.1155/2013/581203

Medicare.gov. (N.D.). Acupuncture. Retrieved from https://www.medicare.gov/coverage/acupuncture

FOOSH Injuries: How to Heal & Get Back on Track

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
attractive doctor looking at handsome man with broken arm

“During a fall, individuals tend to automatically outstretch their hands to help break a fall, which can slam onto the ground, causing a falling onto an outstretched hand or FOOSH injury. Should individuals get checked by a healthcare provider if they believe there is no injury?”

FOOSH Injuries: How to Heal & Get Back on Track

FOOSH Injuries

Falling down usually results in minor injuries. A FOOSH injury occurs when falling down and trying to break the fall by reaching out with the hand/s. This can result in an upper extremity injury like a sprain or a fracture. But sometimes, falling on one’s hands can lead to serious injuries and/or create future musculoskeletal issues. Individuals who have fallen or suffered a FOOSH injury should consult their healthcare provider and then a physical therapist or chiropractor to safely develop a treatment plan to rehabilitate, strengthen, and expedite recovery.

After The Injury

For individuals who have fallen down and landed on their hand, wrist, or arm, here are a few things to ensure the proper care for the injury, including:

  • Follow the R.I.C.E. protocol for acute injuries
  • Visit a healthcare provider or local emergency clinic
  • Contact a physical therapist

A FOOSH injury could be or become serious, so to avoid letting small issues become big problems, get examined by a musculoskeletal specialist. The healthcare provider will obtain an imaging scan of the injured and surrounding areas. They will perform a physical examination to determine the type of injury, like a sprain or muscle strain. Not getting appropriate medical treatment after a fall can result in chronic pain and loss of function. (J. Chiu, S. N. Robinovitch. 1998)

Common Injuries

A FOOSH injury can injure different areas. These usually involve the wrist and hand, but the elbow or shoulder can also be injured. Common injuries include:

Colles’ fracture

  • A wrist fracture where the end of the arm bone is displaced backward.

Smith’s fracture

  • A wrist fracture, similar to a Colles’ fracture, is where the end of the arm bone is displaced towards the front of the wrist.

Boxer’s fracture

  • A fracture of the small bones in the hand.
  • Typically, it occurs after punching something, but it can happen from falling on an outstretched fist.

Elbow dislocation or fracture

  • The elbow can pop out of the joint or can break a bone in the elbow.

Collarbone fracture

  • The force from falling with the hands and arms outstretched can travel up to the collarbone, causing a fracture.

Proximal humeral fracture

  • Falling onto an outstretched hand injury can cause the arm bone to get jammed into the shoulder, causing a proximal humeral fracture.

Shoulder dislocation

  • The shoulder can pop out of the joint.
  • This can cause a rotator cuff tear or labrum injury.

Regardless of the injury, individuals should visit a healthcare provider to evaluate the damage. If the injury is serious, the practitioner can make an accurate or differential diagnosis and develop a treatment plan. (William R. VanWye et al., 2016)

Physical Therapy

Individuals can benefit from physical therapy to help recover and return to their previous level of function. Physical therapy varies depending on the specific injury, but generally, a physical therapist can help individuals return to function after a fall on an outstretched hand. (William R. VanWye et al., 2016) Common treatments can include:

  • Treatments and modalities to decrease pain, inflammation, and swelling.
  • Instruction on how to wear an arm sling properly.
  • Exercises and stretches to improve the range of motion, strength, and functional mobility.
  • Balance exercises.
  • Scar tissue management if surgery was necessary.

The therapy team will ensure the proper treatment is utilized to quickly and safely return to normal activities.

Chiropractic Care For Healing After Trauma

References

Chiu, J., & Robinovitch, S. N. (1998). Prediction of upper extremity impact forces during falls on the outstretched hand. Journal of biomechanics, 31(12), 1169–1176. https://doi.org/10.1016/s0021-9290(98)00137-7

VanWye, W. R., Hoover, D. L., & Willgruber, S. (2016). Physical therapist screening and differential diagnosis for traumatic-onset elbow pain: A case report. Physiotherapy theory and practice, 32(7), 556–565. https://doi.org/10.1080/09593985.2016.1219798

Overcoming Low Back Pain with Acupuncture: Expert Advice

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

Can individuals dealing with low back pain find the relief they are looking for by incorporating acupuncture to reduce muscle spasms?

Introduction

Around the world, many individuals, young and old, have dealt with low back pain, which has an impact on their lives and affects their routines. Since low back pain is a multifactorial musculoskeletal issue, it can range from acute to chronic, depending on the severity and environmental factors that are in play. The lower back or the lumbar spinal region has thicker joints and helps stabilize the upper body portion’s weight. However, it is more susceptible to injury, and it causes the surrounding ligaments, soft tissues, and muscles to be overstretched, tight, and weak. When a person is in excruciating pain from the effects of low back pain, it can impact their day and cause them to be miserable. Today’s article focuses on how lower back pain is associated with pain-like symptoms like muscle spasms and how treatments like acupuncture can help reduce muscle spasms associated with lower back pain. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve low back pain correlated with muscle spasms. We also inform and guide patients on how treatments like acupuncture can help minimize the pain in their lower back. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from low back pain that is affecting their daily routine. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

Low Back Pain Associated With Muscle Spasms

Do you feel radiating or localized pain in your lower back after a long workday? Do you feel stiffness in your lower back region after stretching in the morning? Or have you noticed you are more tense in the different areas of your back and looking for relief? While it is a common problem that many people experience, low back pain can occur to many individuals worldwide and can significantly impact a person. As a major public health concern, low back pain globally transcends through ages, occupations, and socio-economic backgrounds, causing pain-like symptoms to develop over time. (Emorinken et al., 2023) Numerous factors can lead to low back pain and the symptoms that can occur in the lumbar region. Since low back pain can affect many individuals worldwide, this musculoskeletal condition can cause activity limitations in people. It can progressively increase spine degeneration, affecting the joints, bones, and discs. (Hauser et al., 2022) Some of the symptoms that correlate with low back pain include:

  • Stiffness
  • Gait instability
  • Numbing or tingling sensations in the extremities
  • Myofascial referred pain
  • Muscle spasms

 

 

The painful effects of low back pain can cause muscle spasms in the lumbar region as many people continuously make repetitive motions that cause the surrounding muscles to become overworked and develop trigger points to cause muscle spasms. When a person goes to a doctor to treat their lower back pain, they undergo a physical examination to evaluate their lower extremities’ strength, sensation, and reflexes. These examinations help doctors determine the proper protocol for low back pain through inspection, palpation, and range of motion of the lumbosacral musculature to identify point tenderness, restriction, and muscle spasms. (Will et al., 2018) These identity markers allow doctors to devise a personalized plan to reduce the effects of low back pain and help individuals regain their health.

 

Exploring Integrative Medicine- Video

Exploring Integrative Medicine | El Paso, Tx (2024)

Acupuncture Effects On Low Back Pain

When people with back pain are looking for treatment, they are looking for something affordable and can work with their busy schedule. Hence, non-surgical treatments could be the answer to reducing low back pain. Numerous non-surgical treatments can help individuals with specific pain-like symptoms that correlate with various factors. Each treatment, from chiropractic care to traction therapy, is personalized for the individual. Now, one of the oldest forms of non-surgical treatment is acupuncture. Originating from China, acupuncture incorporates solid thin needles at specific body points to balance the energy flow in the body that highly trained professionals perform. The effects of acupuncture can help stimulate the release of adenosine at the sight of needle stimulation while increasing local blood flow to the affected area to promote natural healing. (Mu et al., 2020) So, how does acupuncture help individuals reduce low back pain? 

 

 

Since low back pain can cause a socio-economic burden many people are affected by, acupuncture can help reduce pain and disability in the affected muscle areas while improving the person’s quality of life. (Baroncini et al., 2022) Acupuncture for low back pain benefits individuals by releasing endorphins and other neurohumoral factors that change brain and spinal cord processing. At the same time, acupuncture can also increase microcirculation and reduce the inflammatory effects of low back pain. (Sudhakaran, 2021) Acupuncture can also be part of a person’s personalized treatment plan, as physical and massage therapy can help strengthen the affected muscles caused by low back pain. When people dealing with low back pain are finally getting the relief they need, they can get their quality of life back through small changes to better themselves. This allows them to be more mindful of the various factors that can cause their bodies pain and prevent them from returning over time.

References

Baroncini, A., Maffulli, N., Eschweiler, J., Molsberger, F., Klimuch, A., & Migliorini, F. (2022). Acupuncture in chronic aspecific low back pain: a Bayesian network meta-analysis. J Orthop Surg Res, 17(1), 319. https://doi.org/10.1186/s13018-022-03212-3

Emorinken, A., Erameh, C. O., Akpasubi, B. O., Dic-Ijiewere, M. O., & Ugheoke, A. J. (2023). Epidemiology of low back pain: frequency, risk factors, and patterns in South-South Nigeria. Reumatologia, 61(5), 360-367. https://doi.org/10.5114/reum/173377

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

Mu, J., Furlan, A. D., Lam, W. Y., Hsu, M. Y., Ning, Z., & Lao, L. (2020). Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev, 12(12), CD013814. https://doi.org/10.1002/14651858.CD013814

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

Will, J. S., Bury, D. C., & Miller, J. A. (2018). Mechanical Low Back Pain. American Family Physician, 98(7), 421-428. https://www.ncbi.nlm.nih.gov/pubmed/30252425

https://www.aafp.org/pubs/afp/issues/2018/1001/p421.pdf

Disclaimer

Achilles Tendon Injury: Causes, Symptoms & Treatments

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Football, men and exercise with action, grass and health with workout goal, fitness and motion. Mal.

“Individuals participating in physical and sports activities could suffer an Achilles tendon tear. Can understanding the symptoms and risks help in treatment and return the individual back to their sports activity sooner?”

Achilles Tendon Injury: Causes, Symptoms & Treatments

Achilles Tendon

This is a common injury that occurs when the tendon attaching the calf muscle to the heel gets torn.

About the Tendon

  • The Achilles tendon is the largest tendon in the body.
  • In sports and physical activities, intense explosive movements like running, sprinting, quickly shifting positions, and jumping are exerted on the Achilles.
  • Males are more likely to tear their Achilles and sustain a tendon rupture. (G. Thevendran et al., 2013)
  • The injury often occurs without any contact or collision but rather the running, starting, stopping, and pulling actions placed on the feet.
  • Certain antibiotics and cortisone shots can increase the likelihood of Achilles tear injuries.
  • A specific antibiotic, fluoroquinolones, has been shown to increase the risk of Achilles tendon problems.
  • Cortisone shots are also associated with Achilles tears, which is why many healthcare providers don’t recommend cortisone for Achilles tendonitis. (Anne L. Stephenson et al., 2013)

Symptoms

  • A tendon tear or rupture causes sudden pain behind the ankle.
  • Individuals may hear a pop or a snap and often report the feeling as being kicked in the calf or heel.
  • Individuals have difficulty pointing their toes downward.
  • Individuals may have swelling and bruising around the tendon.
  • A healthcare provider will examine the ankle for continuity of the tendon.
  • Squeezing the calf muscle is supposed to cause the foot to point downwards, but in individuals with a tear, the foot will not move, resulting in positive results on the Thompson test.
  • A defect in the tendon can usually be felt after a tear.
  • X-rays may be used to rule out other conditions, including ankle fracture or ankle arthritis.

Risk Factors

  • Achilles tendon ruptures are most seen in men around 30 or 40. (David Pedowitz, Greg Kirwan. 2013)
  • Many individuals have symptoms of tendonitis prior to sustaining a tear.
  • The majority of individuals have no history of previous Achilles tendon problems.
  • The majority of Achilles tendon tears are associated with ball sports. (Youichi Yasui et al., 2017)

Other risk factors include:

  • Gout
  • Cortisone injections into the Achilles tendon
  • Fluoroquinolone antibiotic use

Fluoroquinolone antibiotics are commonly used for the treatment of respiratory infections, urinary tract infections, and bacterial infections. These antibiotics are associated with Achilles tendon rupture, but further research is needed to determine how they affect the Achilles tendon. Individuals taking these medications are advised to consider an alternative medication if Achilles tendon problems begin to develop. (Anne L. Stephenson et al., 2013)

Treatment

Depending on the severity of the injury, treatment can consist of non-surgical techniques or surgery.

  • The benefit of surgery is there is usually less immobilization.
  • Individuals can often return to sports activities sooner, and there is less chance of re-rupturing the tendon.
  • Non-surgical treatment avoids the potential surgical risks, and the long-term functional results are similar. (David Pedowitz, Greg Kirwan. 2013)

Treating Ankle Sprains

References

Thevendran, G., Sarraf, K. M., Patel, N. K., Sadri, A., & Rosenfeld, P. (2013). The ruptured Achilles tendon: a current overview from biology of rupture to treatment. Musculoskeletal surgery, 97(1), 9–20. https://doi.org/10.1007/s12306-013-0251-6

Stephenson, A. L., Wu, W., Cortes, D., & Rochon, P. A. (2013). Tendon Injury and Fluoroquinolone Use: A Systematic Review. Drug safety, 36(9), 709–721. https://doi.org/10.1007/s40264-013-0089-8

Pedowitz, D., & Kirwan, G. (2013). Achilles tendon ruptures. Current reviews in musculoskeletal medicine, 6(4), 285–293. https://doi.org/10.1007/s12178-013-9185-8

Yasui, Y., Tonogai, I., Rosenbaum, A. J., Shimozono, Y., Kawano, H., & Kennedy, J. G. (2017). The Risk of Achilles Tendon Rupture in the Patients with Achilles Tendinopathy: Healthcare Database Analysis in the United States. BioMed research international, 2017, 7021862. https://doi.org/10.1155/2017/7021862

What You Need to Know About Degenerative Pain Syndrome Relief

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

Can working individuals dealing with degenerative pain syndrome incorporate decompression to provide body relief and mobility?

Introduction

As part of the musculoskeletal system, the spine allows the body to stand vertically and helps protect the spinal cord from injuries. Since the central nervous system provides neuron signals from the brain to the nerve roots, the human body can be mobile without pain or discomfort. This is due to the spinal discs between the facet joints, which can be compressed, absorb the vertical axial pressure, and help distribute the weight to the lower and upper extremity muscles. However, as many people realize, repetitive movements and wear and tear on the spinal structure can lead to overlapping risk profiles that can cause the spinal disc to degenerate and invoke pain in the musculoskeletal system. To that point, it can cause the individual to be in extreme pain and discomfort over time. Today’s article looks at how degenerative pain syndrome affects the spine, the symptoms it’s associated with, and how decompression can reduce degenerative pain syndrome. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve degenerative pain syndrome that is causing mobility issues on the spine. We also inform and guide patients on how decompression can help reduce the pain-like symptoms correlating with degenerative pain syndrome. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from degenerative pain that is affecting their quality of life. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

Degenerative Pain Syndrome On The Spine

 

Do you feel muscle aches or pains in your back after an extended period of lying down, sitting, or standing? Do you feel constant pain after carrying a heavy object from one location to another? Or does twisting or turning your torso provide temporary relief? Many people often don’t realize that many of these pain-like issues are associated with degenerative pain syndrome that affects the spine. Since the body ages naturally, the spine does as well through degeneration. When the spinal discs start to degenerate, it can cause the vertical axial pressure to flatten and squeeze the disc, disrupting its ability to keep hydrated and causing it to protrude out of its original position. At the same time, the height of the spinal disc will gradually fall, and the consequence is a change in dynamics in the affected spine segments. (Kos et al., 2019) Degeneration can cascade down to the surrounding ligaments, muscles, and joints when degeneration starts to affect the spine. 

 

The Symptoms Associated With Degenerative Pain

When the surrounding joints, muscles, and ligaments are affected by degenerative disc pain, it can be due to multiple factors contributing to the pain-like symptoms. Inflammation is one of the symptoms that are associated with degenerative pain syndrome, as disturbances can affect the circadian rhythm and disrupt homeostasis, which then leads to increased stress on the spinal disc, which then contributes to the degenerative process. (Chao-Yang et al., 2021) Inflammation can cause the affected muscles to be inflamed and cause more overlapping risk profiles, as it can affect the upper and lower extremities. Additionally, mechanical loading may affect disc degeneration in various ways at the different vertebral levels. (Salo et al., 2022) This can lead to pain-like symptoms like:

  • Arm and leg tenderness
  • Nerve pain
  • Loss of sensory functions on the upper and lower extremities
  • Tingling sensations
  • Muscle pain

However, numerous treatments can help restore spinal mobility and lessen the painful effects of the degenerative pain syndrome of the spine.

 

The Non-Surgical Approach To Wellness- Video

The Non-Surgical Approach to Wellness with Chiropractic Care | El Paso, Tx (2024)

When it comes to seeking treatment for degenerative pain syndrome, many individuals will do research on which treatment is affordable for their pain, hence why many people opt for non-surgical treatment to alleviate their pain. Non-surgical treatments are customized to the individual’s pain. They can help kickstart the person’s wellness journey, which can include a combination of exercise, manual therapy, and lifestyle modifications. (Brogger et al., 2018) The video above shows how a non-surgical approach can benefit someone with degenerative pain syndrome affecting their spine. 

Decompression Reducing Degenerative Pain Syndrome

 

With many available treatments to reduce pain-like symptoms affecting the spine, non-surgical treatments can be an option. Ranging from chiropractic care to acupuncture, non-surgical treatments can be combined to minimize the pain-like effects. Decompression, as part of the non-surgical treatment options, is an excellent way to reduce the degenerative pain process in the spine. Decompression allows the spinal column to be gently pulled through a traction machine to relieve the spinal disc. When a traction machine decomposes the spine, the pain intensity is significantly reduced in all body parts. (Ljunggren et al., 1984) This is due to negative pressure being reinstated back to the spine to increase disc height and restore the nutrients back to the affected disc and rehydrate them. (Choi et al., 2022) When people start incorporating decompression through consecutive treatment, their pain intensity is reduced, and their spine is mobile again while slowing down the degenerative process on the spine. This allows them to take better care of their bodies by making small changes in their health and wellness.

 

References

Brogger, H. A., Maribo, T., Christensen, R., & Schiottz-Christensen, B. (2018). Comparative effectiveness and prognostic factors for outcome of surgical and non-surgical management of lumbar spinal stenosis in an elderly population: protocol for an observational study. BMJ Open, 8(12), e024949. https://doi.org/10.1136/bmjopen-2018-024949

Chao-Yang, G., Peng, C., & Hai-Hong, Z. (2021). Roles of NLRP3 inflammasome in intervertebral disc degeneration. Osteoarthritis Cartilage, 29(6), 793-801. https://doi.org/10.1016/j.joca.2021.02.204

Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P.-B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 1-9. https://doi.org/10.1155/2022/6343837

Kos, N., Gradisnik, L., & Velnar, T. (2019). A Brief Review of the Degenerative Intervertebral Disc Disease. Med Arch, 73(6), 421-424. https://doi.org/10.5455/medarh.2019.73.421-424

Ljunggren, A. E., Weber, H., & Larsen, S. (1984). Autotraction versus manual traction in patients with prolapsed lumbar intervertebral discs. Scand J Rehabil Med, 16(3), 117-124. https://www.ncbi.nlm.nih.gov/pubmed/6494835

Salo, S., Hurri, H., Rikkonen, T., Sund, R., Kroger, H., & Sirola, J. (2022). Association between severe lumbar disc degeneration and self-reported occupational physical loading. J Occup Health, 64(1), e12316. https://doi.org/10.1002/1348-9585.12316

Disclaimer

Heat Cramps: Causes, Symptoms and Prevention Tips

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Shot of an unrecognisable woman experiencing stomach ache while working out in nature.

“Individuals that engage in heavy exercise can develop heat cramps from overexertion. Can knowing the causes and symptoms help prevent future episodes from happening?”

Heat Cramps: Causes, Symptoms and Prevention Tips

Heat Cramps

Heat cramps can develop during exercise from overexertion or prolonged exposure to high temperatures. The muscle cramps, spasms, and pain can range from mild to severe.

Muscle Cramps and Dehydration

Heat cramps often develop because of dehydration and electrolyte loss. (Robert Gauer, Bryce K. Meyers 2019) Symptoms include:

Electrolytes like sodium, calcium, and magnesium are important for properly functioning muscles, including the heart. The primary role of sweating is to regulate the body’s temperature. (MedlinePlus. 2015) Sweat is mostly water, electrolytes, and sodium. Excessive sweating from physical activity and exertion or a hot environment can cause electrolyte imbalances that lead to cramps, spasms, and other symptoms.

Causes and Activities

Heat cramps most commonly affect individuals who sweat excessively during strenuous activity or are exposed to hot temperatures for prolonged periods. The body and organs need to cool down, which causes sweat production. However, too much sweating can lead to dehydration and electrolyte depletion. (Centers for Disease Control and Prevention. 2022)

Risk Factors

Factors that can increase the risk of developing heat cramps include: (Robert Gauer, Bryce K. Meyers 2019)

  • Age – Children and adults 65 years and older have the highest risk.
  • Excessive sweating.
  • Low sodium diet.
  • Preexisting Medical Conditions – heart disease, diabetes mellitus, and obesity are conditions that can increase the risk of muscle cramping.
  • Medications – blood pressure, diuretics, and antidepressants can affect electrolyte balance and hydration.
  • Alcohol consumption.

Self-Care

If heat cramps begin, immediately stop the activity and look for a cool environment. Rehydrate the body to replenish the fluid loss. Staying hydrated and drinking fluids regularly during intense activity or in a hot environment can help prevent the body from cramping. examples of beverages that increase electrolytes include:

Gently applying pressure and massaging affected muscles can help reduce pain and spasms. As symptoms resolve, it is recommended to not return to strenuous activity too soon because additional exertion can progressively lead to heatstroke or heat exhaustion. (Centers for Disease Control and Prevention. 2021) Heatstroke and heat exhaustion are two heat-related illnesses. (Centers for Disease Control and Prevention. 2022)

  • Heatstroke is when the body loses the ability to regulate temperature and can cause dangerously high temperatures.
  • Heat exhaustion is the body’s response to excessive fluid and electrolyte loss.

Symptom Timing

The timing and length of heat cramps can determine whether medical attention is necessary. (Centers for Disease Control and Prevention. 2022)

During or After Activities

  • The majority of heat cramps develop during activities because of the exertion and sweating, causing more electrolytes to be lost and the body to become more dehydrated.
  • Symptoms can also develop minutes to hours after activity has ceased.

Duration

  • Most heat-related muscle cramps will resolve with rest and hydration within 30–60 minutes.
  • If muscle cramping or spasms do not subside within one hour, seek professional medical attention.
  • For individuals with heart conditions or on a low-sodium diet who develop heat cramps, regardless of duration, medical help is necessary to ensure there are no complications.

Prevention

Tips for preventing heat cramps include: (Centers for Disease Control and Prevention. 2022)

  • Drink plenty of fluids before and during physical activities.
  • Avoid alcohol and caffeinated beverages.
  • Avoid exercising or exposure to extreme heat during peak sunlight hours.
  • Avoid tight and dark-colored clothing.

Assessing Patients In A Chiropractic Setting

References

Gauer, R., & Meyers, B. K. (2019). Heat-Related Illnesses. American family physician, 99(8), 482–489.

Centers for Disease Control and Prevention. (2022). Heat stress — heat related illness. The National Institute for Occupational Safety and Health (NIOSH) Retrieved from https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html#cramps

MedlinePlus. (2015). Sweat. Retrieved from https://medlineplus.gov/sweat.html#cat_47

FoodData Central. (2019). Nuts, coconut water (liquid from coconuts). Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/170174/nutrients

FoodData Central. (2019). Milk, nonfat, fluid, with added vitamin A and vitamin D (fat free or skim). Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/746776/nutrients

Centers for Disease Control and Prevention. (2012). Frequently asked questions (FAQ) about extreme heat. Retrieved from https://www.cdc.gov/disasters/extremeheat/faq.html

The Benefits of Acupuncture for Sciatica Pain Relief

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

Can individuals dealing with sciatica pain find the relief they need from acupuncture to restore low back mobility?

Introduction

The body’s lower extremities provide stability and movement to the individual as they are moving from one location to another without pain or discomfort. The lower extremities consist of the hips, lower back, legs, thighs, pelvis, knees, and feet; each has various muscles, nerve roots, and ligaments with a specific job to each muscle quadrant. The spinal column in the musculoskeletal system helps provide proper posture while protecting the spinal cord from injuries. However, more often than not, the lower extremities can succumb to injuries as many individuals incorporate repetitive motions that can compress the nerve roots that are spread out to the lower extremities, which can invoke pain. The most common pain that seems to affect the lower back and legs is sciatica, and when not treated, it can cause overlapping risk profiles to the lower extremities. Today’s article examines how sciatica is correlated with the lower back and how non-surgical treatments can help reduce the effects of sciatic pain. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve sciatica pain affecting their lower extremities. We also inform and guide patients on how non-surgical treatments can help reduce sciatica pain from the lower musculoskeletal extremities. We encourage our patients to ask their associated medical providers intricated and important questions about the pain-like symptoms they are experiencing from sciatica that are causing them pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

How Does Sciatica Correlate With The Lower Back?

Do you often experience numb or tingling sensations running down your leg that cause your leg or foot to lose sensation briefly? Do you feel shooting pain in your lower back after excessive sitting at your desk? Or do you find that stretching your legs or back temporarily relieves the pain, only for it to come back? Many individual who are experiencing shooting pain running down their legs are dealing with sciatica. When it comes to the lower extremities in the musculoskeletal system, many individuals make repetitive motions on their spine that can cause the spinal discs to become compressed and herniated under pressure. When the spinal disc is herniated in the lumbar spine, that disc will start to press on the surrounding nerve roots, thus sending radiating pain down the legs. Sciatica is defined as when individuals are experiencing pain coming from the lumbosacral nerve root and causing either a burning, heaviness, or tightness sensation. (Aguilar-Shea et al., 2022) Sciatica can range from mild to severe, forcing many individuals to think their foot is asleep. However, the sciatic nerve root is compressed, trapped, stuck, or pinched, which causes muscle spasms within the lower back, buttock, or legs. Hence, many individuals will explain that they are experiencing low back or leg pain when it is sciatica. 

 

 

Since the sciatic nerve is a long, thick nerve in the human body, it travels from the lumbar region down to the knee and connects to other nerves to reach the foot. Sciatica pain can be two conditions with the same pain-like symptom effects known as true or sciatica-like conditions. True sciatica is where an injury is directly affecting the sciatic nerve. This can relate to a slipped disc caused by environmental factors like lifting a heavy object, aggravating the sciatic nerve root, and causing pain that worsens. (Siddiq et al., 2020) For sciatica-like conditions, this is where other musculoskeletal conditions are causing sciatic pain-like symptoms on the lower extremities. Musculoskeletal conditions like piriformis syndrome can cause sciatica pain-like symptoms where the piriformis muscle is irritated or inflamed, pressing on the sciatic nerve, which causes many people to report pain along the gluteal region that may shoot a burning, aching sensations down the back of the legs. (Hicks et al., 2024) However, there are ways to treat sciatica and reduce the pain-like effects causing mobility issues.

 

Sciatica, Causes, Symptoms and Tips- Video

Sciatica, Causes, Symptoms and tips| El Paso, Tx (2023)

Non-surgical Treatments For Sciatica

When it comes to reducing sciatica pain, many individuals will seek out treatment that is cost-effective and customized to the person’s pain. Some treatments, like neural mobilization, can apply mechanical forces to the nerve roots to restore healthy movement to the legs and lower extremities. (Peacock et al., 2023) Other treatments, like spinal decompression, use gentle traction on the spinal disc to lay off the pressure on the sciatic nerve to provide relief. Non-surgical treatments are favorable to many people due to how affordable it is and personalized to the person’s pain as they help reduce pain and disability. (Liu et al., 2023) Luckily, a form of non-surgical treatment can help relieve sciatica and its associated pain-like symptoms.

 

Acupuncture Relieving Sciatic Pain

Acupuncture is one of the oldest forms of non-surgical treatments in which trained professionals use thin, solid needles to be inserted and placed on the affected area, causing pain. Acupuncture can help reduce the distortion of the affected nerve roots, and local inflammatory cytokines correlated with sciatica. (Yu et al., 2021) What this does is that it normalizes the neuron signals to a default mode from aggravating the surrounding muscle fibers and descending the pain. Additionally, acupuncture can help restore the body’s qi or energy by reducing the pain by placing the needles on the acupoint of the vital organs that share a relationship with the sciatic nerve. (Yu et al., 2022) This is known as somato-visceral, where the vital organs could be the affected area, causing overlapping muscle and nerve risk profiles. Acupuncture is an excellent form of non-surgical treatment that can be combined with other various therapies to help restore the body’s natural healing factor and allow people to be more mindful of how to take care of their bodies easily to prevent sciatica pain-like symptoms from arising.

 

References

Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-Gonzalez, R., & Paredes, I. (2022). Sciatica. Management for family physicians. J Family Med Prim Care, 11(8), 4174-4179. https://doi.org/10.4103/jfmpc.jfmpc_1061_21

Hicks, B. L., Lam, J. C., & Varacallo, M. (2024). Piriformis Syndrome. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/28846222

Liu, C., Ferreira, G. E., Abdel Shaheed, C., Chen, Q., Harris, I. A., Bailey, C. S., Peul, W. C., Koes, B., & Lin, C. C. (2023). Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials. BMJ, 381, e070730. https://doi.org/10.1136/bmj-2022-070730

Peacock, M., Douglas, S., & Nair, P. (2023). Neural mobilization in low back and radicular pain: a systematic review. J Man Manip Ther, 31(1), 4-12. https://doi.org/10.1080/10669817.2022.2065599

Siddiq, M. A. B., Clegg, D., Hasan, S. A., & Rasker, J. J. (2020). Extra-spinal sciatica and sciatica mimics: a scoping review. Korean J Pain, 33(4), 305-317. https://doi.org/10.3344/kjp.2020.33.4.305

Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., . . . Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ Open, 12(5), e054566. https://doi.org/10.1136/bmjopen-2021-054566

Yu, F. T., Ni, G. X., Cai, G. W., Wan, W. J., Zhou, X. Q., Meng, X. L., Li, J. L., Tu, J. F., Wang, L. Q., Yang, J. W., Fu, H. Y., Zhang, X. C., Li, J., Wang, Y. F., Zhang, B., Zhang, X. H., Zhang, H. L., Shi, G. X., & Liu, C. Z. (2021). Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial. Trials, 22(1), 34. https://doi.org/10.1186/s13063-020-04961-4

Disclaimer

What is a Nerve Block? How it Helps Alleviate Pain Symptoms

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Elderly male complains to the doctor about back pain, the men are located in the ultrasound room

“For individuals dealing with chronic pain, can undergoing a nerve block procedure help alleviate and manage symptoms?”

What is a Nerve Block? How it Helps Alleviate Pain Symptoms

Nerve Blocks

A nerve block is a procedure done to interrupt/block pain signals due to nerve dysfunction or injury. They can be used for diagnostic or treatment purposes, and their effects can be short or long-term, depending on the type being used.

  • A temporary nerve block may involve the application or injection that stops pain signals from transmitting for a short time.
  • For example, in pregnancy, an epidural injection can be used during labor and delivery.
  • Permanent nerve blocks involve cutting/severing or removing certain parts of a nerve to stop pain signals.
  • These are used in cases with severe injuries or other chronic pain conditions that have not improved with other treatment approaches.

Treatment Usage

When healthcare providers diagnose a chronic pain condition caused by nerve injury or dysfunction, they may use a nerve block to locate the area generating pain signals. They may perform electromyography and/or a nerve conduction velocity/NCV test to pinpoint the cause of chronic nerve pain. Nerve blocks can also treat chronic neuropathic pain, such as pain caused by nerve damage or compression. Nerve blocks are regularly used to treat back and neck pain caused by herniated discs or spinal stenosis. (Johns Hopkins Medicine. 2024)

Types

Three types include:

  • Local
  • Neurolytic
  • Surgical

All three can be used for conditions that cause chronic pain. However, neurolytic and surgical blocks are permanent and are only used for severe pain that has worsened with other treatments unable to provide relief.

Temporary Blocks

  • A local block is done by injecting or applying local anesthetics, like lidocaine, to a certain area.
  • An epidural is a local nerve block that injects steroids or analgesics into an area around the spinal cord.
  • These are common during pregnancy, labor, and delivery.
  • Epidurals can also be used to treat chronic neck or back pain due to a compressed spinal nerve.
  • Local blocks are usually temporary, but in a treatment plan, they can be repeated over time to manage chronic pain from conditions like arthritis, sciatica, and migraines. (NYU Langone Health. 2023)

Permanent Blocks

  • A neurolytic block uses alcohol, phenol, or thermal agents to treat chronic nerve pain. (National Institute of Neurological Disorders and Stroke. 2023) These procedures damage certain areas of the nerve pathway on purpose so that pain signals cannot be transmitted. A neurolytic block is mainly used for severe chronic pain cases, like pain from cancer or complex regional pain syndrome/CRPS. They are sometimes used to treat ongoing pain from chronic pancreatitis and pain in the chest wall after surgery. (Johns Hopkins Medicine. 2024) (Alberto M. Cappellari et al., 2018)
  • The neurosurgeon performs a surgical nerve block that involves surgically removing or damaging specific areas of the nerve. (National Institute of Neurological Disorders and Stroke. 2023) A surgical nerve block is only used for severe pain cases, such as cancer pain or trigeminal neuralgia.
  • Although neurolytic and surgical nerve blocks are permanent procedures, pain symptoms, and sensations can come back if the nerves are able to regrow and repair themselves. (Eun Ji Choi et al., 2016) However, symptoms and sensations may not return months or years after the procedure.

Different Body Areas

They can be administered in most body areas, including: (Hospital for Special Surgery. 2023) (Stanford Medicine. 2024)

  • Scalp
  • Face
  • Neck
  • Collarbone
  • Shoulders
  • Arms
  • Back
  • Chest
  • Ribcage
  • Abdomen
  • Pelvis
  • Buttocks
  • Legs
  • Ankle
  • Feet

Side Effects

These procedures can have the potential risk of permanent nerve damage. (Anthem BlueCross. 2023) Nerves are sensitive and regenerate slowly, so a tiny error can cause side effects. (D O’Flaherty et al., 2018) Common side effects include:

  • Muscle paralysis
  • Weakness
  • Frequent numbness
  • In rare cases, the block could irritate the nerve and cause added pain.
  • Skilled and licensed health practitioners like surgeons, pain management physicians, anesthesiologists, and dentists are trained to perform these procedures carefully.
  • There is always a risk of nerve damage or injury, but the majority safely and successfully decrease and help manage chronic pain. (Anthem BlueCross. 2023)

What to Expect

  • Individuals may feel numbness or soreness and/or notice redness or irritation near or around the area that is temporary.
  • There can also be swelling, which compresses the nerve and requires time to improve. (Stanford Medicine. 2024)
  • Individuals may be asked to rest for a certain amount of time after the procedure.
  • Depending on the type of procedure, individuals may have to spend a few days in a hospital.
  • Some pain may still be present, but that does not mean the procedure did not work.

Individuals should consult with a healthcare provider about the risks and benefits to ensure it is the right treatment.

Sciatica, Causes, Symptoms, and Tips

References

Johns Hopkins Medicine. (2024). Nerve blocks. (Health, Issue. https://www.hopkinsmedicine.org/health/conditions-and-diseases/nerve-blocks

NYU Langone Health. (2023). Nerve block for migraine (Education and Research, Issue. https://nyulangone.org/conditions/migraine/treatments/nerve-block-for-migraine

National Institute of Neurological Disorders and Stroke. (2023). Pain. Retrieved from https://www.ninds.nih.gov/health-information/disorders/pain#3084_9

Johns Hopkins Medicine. (2024). Chronic pancreatitis treatment (Health, Issue. https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pancreatitis/chronic-pancreatitis-treatment

Cappellari, A. M., Tiberio, F., Alicandro, G., Spagnoli, D., & Grimoldi, N. (2018). Intercostal Neurolysis for The Treatment of Postsurgical Thoracic Pain: a Case Series. Muscle & nerve, 58(5), 671–675. https://doi.org/10.1002/mus.26298

Choi, E. J., Choi, Y. M., Jang, E. J., Kim, J. Y., Kim, T. K., & Kim, K. H. (2016). Neural Ablation and Regeneration in Pain Practice. The Korean journal of pain, 29(1), 3–11. https://doi.org/10.3344/kjp.2016.29.1.3

Hospital for Special Surgery. (2023). Regional anesthesia. https://www.hss.edu/condition-list_regional-anesthesia.asp

Stanford Medicine. (2024). Types of nerve blocks (For Patients, Issue. https://med.stanford.edu/ra-apm/for-patients/nerve-block-types.html

Anthem BlueCross. (2023). Peripheral nerve blocks for treatment of neuropathic pain. (Medical Policy, Issue. https://www.anthem.com/dam/medpolicies/abc/active/policies/mp_pw_c181196.html

O’Flaherty, D., McCartney, C. J. L., & Ng, S. C. (2018). Nerve injury after peripheral nerve blockade-current understanding and guidelines. BJA education, 18(12), 384–390. https://doi.org/10.1016/j.bjae.2018.09.004

Stanford Medicine. (2024). Common patient questions about nerve blocks. (For Patients, Issue. https://med.stanford.edu/ra-apm/for-patients/nerve-block-questions.html

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