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Understanding Fitness vs. Wellness for Better Health

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
During Christmas holidays, a chiropractic patient performs prescribed stretches and exercises post-injury treatment and recovery plan.

Understanding Fitness vs. Wellness: How Physical Activity and Chiropractic Care Boost Your Health

Understanding Fitness vs. Wellness for Better Health
Patient is prescribed chiropractic exercises after her injury

Many people mix up fitness and wellness, but they are not the same. Fitness is about your body’s ability to do physical tasks. This includes factors such as strength and endurance. For example, being fit means you can run a mile without getting too tired or lift heavy boxes easily. Wellness is a bigger idea. It covers your overall health in many areas, like mental, emotional, social, and physical well-being. When you have optimal wellness, you feel balanced and happy in life, not just strong in your muscles.

Physical activity ties fitness and wellness together. It acts like glue, improving both. Regular exercise builds your fitness by enhancing strength and stamina. At the same time, it boosts wellness by reducing stress, lifting your mood, and helping you sleep better. Fitness focuses on physical skills for top performance, while wellness aims for harmony between your mind and body. Integrative chiropractic care helps with this. It aligns your body, eases pain, improves nerve function, and suggests exercises like core workouts and stretches. These steps support spinal health, better movement, and make physical activity more effective for long-term mobility and health.

In this article, we will explore these ideas step by step. We will look at what makes fitness and wellness different, how exercise connects them, and the role of chiropractic care. Along the way, we will use simple examples and lists to make it clear.

What Is Fitness?

Fitness means how well your body can handle physical work. It includes strength, which is how much force your muscles can make, and endurance, which is how long you can keep going without stopping. Think of fitness as your body’s engine. A strong engine helps you do daily tasks, play sports, or even climb stairs without huffing and puffing.

Experts say fitness has key parts:

  • Cardiovascular endurance: This is about your heart and lungs. Activities like running or swimming build it by helping your body use oxygen more efficiently.
  • Muscular strength and endurance: Lifting weights or doing push-ups strengthens muscles so they can work harder and longer.
  • Flexibility: Stretching or yoga helps your joints move more freely, reducing your risk of injury.
  • Body composition: This is the mix of fat and muscle in your body. Good fitness often means less fat and more muscle, which benefits health.

Fitness is not just for athletes. It helps everyone avoid diseases like heart problems or diabetes. For instance, regular strength training can strengthen bones and improve balance, helping prevent falls as you age. When you focus on fitness, you gain energy for everyday life, like playing with kids or walking the dog.

But fitness alone is not enough for full health. It is mostly about the physical side. If you ignore your mind or emotions, you might still feel off balance. That is where wellness comes in.

What Is Wellness?

Wellness is a wider term than fitness. It means being at your best in all parts of life. This includes physical health, as well as mental, emotional, social, and even spiritual areas. Wellness is about thriving, not just getting by. It is like a puzzle where every piece fits to make you feel good overall.

Here are some main areas of wellness:

  • Physical wellness: This overlaps with fitness. It involves eating well, sleeping enough, and moving your body to stay healthy and recover from illness.
  • Mental and emotional wellness: Managing stress, feeling happy, and handling feelings like anxiety or sadness.
  • Social wellness: Building strong relationships with family, friends, and your community.
  • Other areas: Work satisfaction, personal growth, and a sense of purpose.

Unlike fitness, which you can measure by how fast you run or how much you lift, wellness is more about balance. For example, you might be super fit but stressed at work, which can hurt your wellness. Wellness encourages habits such as good nutrition, rest, and self-care to foster harmony. It helps prevent problems before they start, leading to a longer, happier life.

Wellness sees health as a whole. If one part is weak, like poor sleep, it can affect everything else. That is why wellness often includes practices beyond exercise, such as meditation or talking to friends.

The Key Differences Between Fitness and Wellness

Fitness and wellness are linked, but they have clear differences. Fitness is specific to your body’s physical power. It aims to optimize performance in tasks that require strength, speed, or stamina. Wellness is broader, focusing on well-being through mind-body balance. Fitness might make you run a marathon, but wellness helps you enjoy the run without worry or burnout.

To break it down:

  • Focus: Fitness targets physical abilities like endurance and strength. Wellness covers all aspects of life for total health.
  • Measurement: Fitness uses tests such as body fat percentage and heart rate. Wellness looks at life satisfaction and stress levels.
  • Approach: Fitness often involves workouts and training. Wellness includes habits like diet, relationships, and relaxation.

Both are important. Neglecting fitness can lead to weak muscles or low energy levels. Skipping wellness can lead to emotional issues, even if you are strong. The good news is that physical activity can improve both at once.

How Physical Activity Connects Fitness and Wellness

Physical activity is the bridge between fitness and wellness. It means any movement that uses energy, like walking, dancing, or gardening. Regular exercise builds fitness by strengthening and improving your body’s efficiency. But it also boosts wellness by enhancing your mood, reducing stress, and helping you connect with others.

Exercise releases endorphins in your brain. These make you feel happy and calm. For example, a brisk walk can lower anxiety and help you sleep better, both of which support emotional wellness. On the fitness side, activities like cycling or weightlifting increase heart health and muscle power.

Benefits of physical activity include:

  • Health protection: It reduces the risk of diseases such as cancer, diabetes, and heart disease. Aim for 150 minutes of moderate activity a week.
  • Weight control: Burning calories helps keep a healthy body composition.
  • Mood boost: It helps fight depression and build confidence.
  • Energy increase: Better oxygen use means more stamina for daily chores.
  • Better sleep and sex life: It deepens rest and improves arousal.

Types of physical activity to try:

  • Aerobic: Running, swimming, or biking for heart endurance.
  • Strength: Push-ups or weights for muscle building.
  • Flexibility: Yoga or stretching for joint health.
  • Balance: Tai chi or stability exercises to prevent falls.

Start small if you are new. Even 10-minute sessions add up. Consistency is key for long-term gains in both fitness and wellness.

The Role of Integrative Chiropractic Care

Integrative chiropractic care takes fitness and wellness to the next level. Chiropractors focus on aligning your spine and body. This improves nerve function, relieves pain, and supports better movement. They often recommend targeted exercises, such as core workouts or stretches, to promote spinal health and enhance the effectiveness of physical activity.

Chiropractic care is holistic. It looks at your whole body, not just symptoms. For example, a misaligned spine can cause pain that stops you from exercising. Adjustments fix this, allowing you to build fitness without hurt. It also boosts wellness by reducing stress and improving sleep through better nerve signals.

How chiropractic supports fitness and wellness:

  • Pain relief: Eases back, neck, or joint pain so you can stay active.
  • Better posture: Aligns your body for efficient movement and less injury.
  • Nerve function: Removes blockages for optimal body performance.
  • Exercise integration: Suggests core strengthening, yoga, or Pilates to enhance flexibility and strength.

Chiropractors often work with other practices, such as nutrition or massage, for comprehensive wellness. This integrative approach addresses root causes, not just fixes.

Insights from Dr. Alexander Jimenez

Dr. Alexander Jimenez, a chiropractor and nurse practitioner, shares valuable observations on these topics. He stresses non-invasive care for conditions such as back pain and sports injuries. Through spinal adjustments and functional medicine, he helps people improve mobility and wellness.

Dr. Jimenez recommends exercises like yoga for flexibility and jumping rope for balance. He notes that strength training builds muscles and aids brain health. For wellness, he focuses on nutrition, such as balanced diets to control inflammation, and on gut health for overall energy. He uses tools like body scans to create personalized plans that blend physical activity with chiropractic care for long-term health.

His approach shows how aligning the body supports both fitness tasks and emotional balance.

More Ways Chiropractic Enhances Health

Chiropractic care fits into family wellness, too. It helps all ages, from kids to elders, by preventing issues early. For example, regular adjustments improve posture and reduce the risk of sciatica.

Combined with exercise:

  • Yoga and Pilates: Boost flexibility and pair well with adjustments.
  • Strength training: Builds core for spinal support.
  • Aerobic activities: Such as walking, help maintain heart health.

This synergy leads to better recovery, less pain, and a higher quality of life.

Practical Tips to Get Started

To improve fitness and wellness with exercise and chiropractic:

  • See a chiropractor for a check-up.
  • Start with 30 minutes of activity most days.
  • Eat balanced meals and get 7–9 hours of sleep.
  • Track progress with a journal.

Remember, small changes add up.

Conclusion

Fitness and wellness work together for better health. Fitness builds physical power, wellness creates balance, and physical activity connects them. Integrative chiropractic care supports this by aligning your body and suggesting exercises for lasting benefits. As Dr. Jimenez observes, this holistic path leads to pain-free, energetic living. Start today for a healthier tomorrow.

Is Motion Key to Healing? | El Paso, Tx (2023)

References

Unveiling the Connection: Understanding the Difference Between Fitness vs Wellness — Kellie Chambers (Chambers, n.d.)

Wellness as a Whole—Fitness, Nutrition, Lifestyle (Foothills Rehab, n.d.)

Fitness and Wellness (Fyzical, n.d.)

Are Wellness and Fitness the Same? — Juliette’s House (Juliette’s House, n.d.)

Exercise & Fitness – HelpGuide.org (HelpGuide.org, n.d.)

Fitness vs. Wellness – What’s the Difference? – VIDA Fitness (VIDA Fitness, n.d.)

Physical wellness | Research Starters | EBSCO Research (EBSCO, n.d.)

NIH MedlinePlus Magazine (MedlinePlus, n.d.)

Unlocking Wellness: How Chiropractic Care Enhances Overall Health | Half Moon Bay, El Granada, Moss Beach, and Montara, CA Chiropractor | Newbold Chiropractic (Newbold Chiropractic, n.d.)

Integrating Exercise with Chiropractic: A Synergistic Approach to Sports Medicine (Tigard Chiropractic, n.d.)

A Beginner’s Guide to Combining Exercise with Chiropractic Care for Maximum Benefits (AdventHealth, n.d.)

Wellness vs. Fitness (ACE Fitness, n.d.)

Promoting Family Wellness Through Chiropractic Care (Tigard Chiropractic, n.d.)

Unlocking Wellness: The Power of Integrating Chiropractic Care with Holistic Health Practices | St Paul, MN Chiropractors (ML Chiro, n.d.)

Top Three Methods for Holistic Wellness Maintenance – Tri-States Chiropractic (Dubuque Chiropractic, n.d.)

Integrative Approaches for Complete Wellness Journey – ShoreLife Chiropractic & Wellness (ShoreLife Chiro, n.d.)

Functional Medicine | Discover Root Solutions — Integrative Medical of DFW (Integrative Medical, n.d.)

Why Does Chiropractic Care Focus on Wellness and Prevention? – Evolve Chiropractic (Evolve Chiropractor, n.d.)

7 great reasons why exercise matters (Mayo Clinic, n.d.)

Injury Specialists (Jimenez, n.d.)

Treatment Guide for Opioid Use Disorder in a Clinical Approach

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

Understand the clinical approach to opioid use disorder, highlighting essential techniques for effective treatment and support.

Overcoming Barriers in Managing Opioid Use Disorder: Strategies for Effective Care

A lot of individuals nowadays have a major health problem called opioid use disorder (OUD). It is a kind of substance use disorder (SUD). It might be hard to treat OUD since each individual has their unique concerns, such as underlying health issues or discomfort. Doctors and other health care professionals need to develop plans tailored to each patient. They also need to keep up with the latest legislation, ethics, and best practices for protecting patient information. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 covers all patients, but there are specific regulations for those who are obtaining assistance with drug or alcohol issues.

This article discusses how to address problems that arise while managing OUD. We discuss patient-centered treatment, how to talk to patients, stigma, team-based approaches, and the law. Health care practitioners may help patients get healthier faster by employing these methods. Keywords like “managing opioid use disorder,” “overcoming stigma in OUD,” and “patient-centered care for SUD” help people find your content and comprehend it better.

Learning Objectives

  • Explain treatment planning methods that use patient-focused choices and proven ways to talk.
  • Name the three kinds of stigma and how they affect people with mental health issues, SUD, and especially OUD.
  • Talk about legal, ethical, and privacy concerns in caring for people with OUD.

Effective Treatment Planning with Patient-Centered Decisions

People with complex issues, like mental health problems, SUD, and pain, need special care. Each person shows up differently, so health systems are now focusing on care that puts the patient first.

Patient-centered care means building teams with doctors, patients, and families. They work together to plan, give, and check health care. This way ensures the patient’s needs are met, and their wishes, likes, and family situations are respected. It focuses on shared choices about treatments while seeing the patient as a whole person in their daily life (Dwamena et al., 2012; Bokhour et al., 2018).

Studies show key steps for a good patient-centered plan:

  • Take a full patient history and a check-up, reviewing old and new treatments.
  • Find all available drug and non-drug options.
  • Check the patient’s current health, recent changes, and patterns.
  • Look at risks for misusing or abusing opioids.

If starting opioids or if the patient is already on them, think about opioid stewardship. This means checking harms, benefits, risks, side effects, pain control, daily function, drug tests, stop plans, and ways to spot OUD. These programs, sometimes called analgesia stewardship, help manage opioids safely (Harle et al., 2019; Coffin et al., 2022). Guides exist to set them up (American Hospital Association, n.d.; Shrestha et al., 2023).

Integrative chiropractic care can play a big role here. It uses spinal adjustments and targeted exercises to get proper spinal alignment. This helps reduce pain without relying only on drugs, making it a good fit for OUD patients with pain. For example, adjustments fix spine issues that cause pain, and exercises strengthen muscles to keep alignment right.

A Nurse Practitioner (NP) adds full management and ergonomic advice. They look at work setups to prevent pain, such as how to sit or lift. NPs coordinate care by reviewing options such as therapy, meds, and lifestyle changes, ensuring everything works together.

Dr. Alexander Jimenez, DC, APRN, FNP-BC, with over 30 years in chiropractic and as a family nurse practitioner, observes that blending these methods cuts opioid use. At his El Paso clinic, he uses functional medicine to address root causes through nutrition and non-invasive treatments. He notes that poor posture from modern life worsens pain, leading to OUD risks. His teams help patients with self-massage and VR for recovery, reducing drug needs (Jimenez, n.d.a; Jimenez, n.d.b).

Evidence-Based Ways to Communicate

Good talking skills are key to building a patient-centered plan (Schaefer & Block, 2009). There are proven methods for starting conversations and getting patients involved.

One method is BATHE:

  • Background: Ask, “How have things been since your last visit?”
  • Affect: Ask, “How does this make you feel?”
  • Trouble: Ask, “What bothers you most?”
  • Handling: Ask, “How are you coping?”
  • Empathy: Say, “That sounds hard.”

This uses open questions to let patients lead and feel supported (Stuart & Lieberman, 2018; Thomas et al., 2019).

Another is GREAT:

  • Greetings/Goals: Start with hello and set aims.
  • Rapport: Build trust.
  • Evaluation/Expectation/Examination/Explanation: Check and explain.
  • Ask/Answer/Acknowledge: Listen and respond.
  • Tacit agreement/Thanks: Agree and thank.

This guide talks well (Brindley et al., 2014).

Motivational interviewing is also useful. It’s a team-style talk to boost a patient’s desire to change. Build a bond, focus on the issue, spark a desire for change, and plan steps (Frost et al., 2018).

These methods emphasize listening, clear communication, and a structured approach to planning. For OUD patients with pain or mental issues, mix techniques for the best results.

Dr. Jimenez shares that in his practice, these talks help patients see non-drug options, such as chiropractic adjustments. He finds that empathy reduces stigma and fear, encouraging openness about OUD (Jimenez, n.d.a).

The Power of Chiropractic Care in Injury Rehabilitation-Video

The Power of Chiropractic Care in Injury Rehabilitation | El Paso, Tx (2024)

Understanding Stigma in Mental Health and Substance Use Disorders

Stigma blocks good talk for many with mental health or SUD. It’s attitudes, beliefs, actions, and systems that lead to unfair views and bad treatment (Cheetham et al., 2022).

Studies show stigmas like linking mental illness to violence (Perry, 2011). Media on shootings with mentally ill people strengthens this (McGinty et al., 2014; McGinty et al., 2016; Schomerus et al., 2022). For SUD, people think they’re more dangerous than those with schizophrenia or depression (Schomerus et al., 2011). Society blames people with SUDs more and avoids them (McGinty et al., 2015; Corrigan et al., 2012).

Views come from knowledge, contact with affected people, and the media. Public ideas are tied to norms on causes, blame, and danger. Race, ethnicity, and culture shape attitudes too (Giacco et al., 2014).

Health workers have biases. A survey of VA mental health providers showed awareness of race issues but avoidance of talks, using codes like “urban,” and thinking training stops racism (McMaster et al., 2021).

There are three stigma types:

  • Structural Stigma: The ways Society and institutions keep prejudice. In health, it’s worse care, less access to behavioral health. Less funding for mental vs. physical issues (National Academies of Sciences, Engineering, and Medicine, 2016).
  • Public Stigma: General or group attitudes, like police or church norms. Laws reinforce it, like broad mental illness rules implying all are unfit (Corrigan & Shapiro, 2010).
  • Self-Stigma: When people internalize stigmas, it leads to low self-worth and shame. “Why try” affects independent living (Corrigan et al., 2009; Clement et al., 2015).

Dr. Jimenez observes that stigma makes OUD patients hide symptoms, delaying care. In his integrative work, he addresses this through education on holistic options, showing that recovery is possible without judgment (Jimenez, n.d.b).

Overcoming Stigma and Addressing Social Factors

To fight stigma, use education, behavior changes, and better care. Laws like the ADA and MHPAEA help ensure equal coverage and prevent discrimination (U.S. Congress, 2009; U.S. Congress, 2008; U.S. Department of Health and Human Services, n.d.; Busch & Barry, 2008; Haffajee et al., 2019).

These address social determinants of health (SDOH), such as coverage, access, quality, education, and stability (Centers for Disease Control and Prevention, n.d.).

Community programs help too:

  • West Virginia’s Jobs and Hope: Training, jobs, education, transport, skills, record clearing for SUD people (Jobs and Hope, n.d.).
  • Belden’s Pathway: Rehab for failed drug tests, leading to jobs (Belden, n.d.).

Education boosts provider confidence in OUD meds, reducing barriers (Adzrago et al., 2022; Hooker et al., 2023; Campbell et al., 2021).

Overcoming stigma is key to success in mental health and SUD.

Interprofessional Team Work

Teams improve outcomes for patients with chronic pain and mental health or SUD (Joypaul et al., 2019; Gauthier et al., 2019).

Teams include doctors, nurses, NPs, pharmacists, PAs, social workers, PTs, therapists, SUD experts, and case managers.

Each helps uniquely:

  • Pharmacists watch meds, spot interactions.
  • Case managers link specialists, find resources, and support families (Sortedahl et al., 2018).
  • Teams set goals, max non-opioid treatments (Liossi et al., 2019).

Integrative chiropractic care includes adjustments and exercises for alignment, easing pain naturally.

NPs give full care, ergonomic tips to avoid pain triggers, and coordinate options.

Dr. Jimenez’s clinic shows this. As a DC and FNP-BC, he leads teams with therapists, nutritionists, and coaches. He observes interprofessional work cuts opioid use by addressing the roots with functional medicine, VR, and nutrition. For OUD, he blends chiropractic care for pain, NP coordination for plans, and stigma-fighting through team support (Jimenez, n.d.a; Jimenez, n.d.b).

Legal and Ethical Issues in SUD Care

Providers must know laws and ethics for mental/SUD patients, like discrimination, aid, and privacy (Center for Substance Abuse Treatment, 2000).

Key Federal laws:

  • Americans with Disabilities Act (ADA) of 1990.
  • Rehabilitation Act of 1973.
  • Workforce Investment Act of 1998.
  • Drug-Free Workplace Act of 1988.

ADA and Rehabilitation ban discrimination in government and in business services like hotels, shops, and hospitals. Protect those with impairments limiting life activities (U.S. Department of Health and Human Services, n.d.).

Provisions:

  • Protect “qualified” people who meet the requirements.
  • Reasonable accommodations for jobs.
  • No hire/retain if there is a direct threat.
  • No denial of benefits, access, or jobs in funded places.

For SUD: Alcohol users are protected if qualified, no threat. Ex-drug users in rehab are the same. Current illegal drug users are protected for health/rehab, not others. Programs can deny if used during.

Workforce Act centralizes job programs; no refusal to SUD people (U.S. Congress, 1998).

Drug-Free Act requires drug-free policies for federal funds/contracts: statements, awareness, actions on violations (U.S. Code, n.d.).

States have their own laws; check the local laws.

Public Aid laws:

  • Contract with America Act (1996): No SSI/DI if SUD key factor (U.S. Congress, 1996).
  • Adoption Act (1997): 15-month foster reunification limit (U.S. Congress, 1997).
  • Personal Responsibility Act (1996): Work after 2 years of aid, drug screens (U.S. Department of Health and Human Services, 1996).

These push work, sobriety.

Dr. Jimenez notes that legal awareness helps his practice by ensuring holistic plans comply and by reducing OUD risks through a non-drug focus (Jimenez, n.d.a).

Keeping Patient Info Private

Privacy is vital. Laws include:

  • HIPAA (1996): Protects PHI, sets use/disclosure rules (U.S. Department of Health and Human Services, n.d.).
  • 42 CFR Part 2: Extra for SUD records. No disclosure of name or status without consent. Fines for breaks. Applies to federal-aided programs (Substance Abuse and Mental Health Services Administration, n.d.).

Consent needs: program name, receiver, patient name, purpose, info type, revoke note, expire date, signature, and date.

This fights discrimination fears, encouraging treatment (Center for Substance Abuse Treatment, 2000).

Wrapping Up

It’s evident that managing opioid use disorder (OUD) effectively necessitates a multimodal strategy that puts patient welfare ahead of band-aid solutions. Healthcare professionals are essential in changing lives, from adopting patient-centered decision-making and evidence-based communication to eliminating the three forms of stigma—structural, public, and self—that impede healing. Individuals seeking assistance may do so without fear of prejudice because of legal and ethical frameworks like HIPAA and 42 CFR Part 2 privacy regulations, while interprofessional teams promote complete treatment.

With its emphasis on spine adjustments and focused exercises for correct alignment, integrating chiropractic therapy provides a non-invasive method of reducing pain and opioid dependency. This is improved by nurse practitioners (NPs), who provide comprehensive care, ergonomic advice to avoid injuries, and coordination of various treatment choices, including therapy and lifestyle modifications. In his clinical practice, Dr. Alexander Jimenez, DC, APRN, FNP-BC, highlights that these integrative approaches not only treat physical symptoms but also empower patients with individualized plans and education, resulting in long-lasting recovery and reduced opioid usage (Jimenez, n.d.a; Jimenez, n.d.b).

Advances in OUD therapy as of 2025 highlight a trend toward more accessible and individualized alternatives. For example,

  • OUD drugs: FDA-approved medications such as buprenorphine, naltrexone, and methadone remain essential for reducing cravings and withdrawal symptoms while promoting long-term stability.
  • Precision medicine: By tailoring treatments to social, psychological, and genetic factors, one can go beyond one-size-fits-all approaches and achieve better outcomes.
  • The World Health Organization’s 2025 revisions to the guideline include more emphasis on community-based overdose prevention and wider access to care, while also emphasizing psychological assistance in addition to pharmaceutical treatments.
  • Declining Trends: It is encouraging to see that opioid-related mortality has had its first yearly decline in 2023 since 2018, indicating that continued efforts in treatment, education, and legislation are having an effect.

Together with collaborative treatment and stigma reduction, these technologies may help us create a future in which OUD is a treatable illness rather than a life sentence. To ensure that every person receives the kind, evidence-based assistance they are entitled to, healthcare professionals, communities, and legislators must keep pushing for equal access. In the end, overcoming obstacles in OUD management is about more than simply therapy; it’s about regaining dignity, hope, and quality of life.

References

Clinical Approach Guidelines for Pain Management in Opioid Therapy

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

Understand the clinical approach to pain management, including critical insights on opioid therapy and its effectiveness.

Key Points on Safe Pain Management with Opioids

  • Pain Affects Many People: Research suggests that about 100 million adults in the U.S. deal with pain, and this number might grow due to aging, more health issues like diabetes, and better survival from injuries. It’s important to address pain early to prevent it from becoming long-term (Institute of Medicine, 2011).
  • Non-Opioid Options First: Evidence leans toward starting with treatments like exercise, therapy, or over-the-counter meds before opioids, as they can be just as effective for common pains like backaches or headaches, with fewer risks (National Academies of Sciences, Engineering, and Medicine, 2019).
  • Team-Based Care Works Best: Studies show teams of doctors, nurses, and therapists can improve pain relief and daily life, though results vary. This approach seems likely to help more than solo care, especially for ongoing pain (Gauthier et al., 2019).
  • Opioids When Needed, But Carefully: Guidelines recommend low doses, short times, and regular check-ins to balance relief with risks like addiction. It’s complex, so talk openly with your doctor (Centers for Disease Control and Prevention, 2022).
  • Alternatives Like Chiropractic and NP Support: Integrative methods, such as chiropractic adjustments for spine alignment and ergonomic tips from nurse practitioners, can reduce reliance on meds. Clinical observations from experts like Dr. Alexander Jimenez highlight non-invasive approaches to managing pain effectively.

Understanding Pain Types

Pain can be short-term (acute), medium-term (subacute), or long-lasting (chronic). Acute pain often lasts less than three months and comes from injuries. If not treated well, it might turn chronic, affecting daily activities. Always respect someone’s pain experience—it’s personal and influenced by life factors (Raja et al., 2020).

Assessing Pain Simply

Doctors use tools like questions about when pain started, what makes it worse, and how it feels. Scales help rate it, from numbers (0-10) to faces showing discomfort. For kids or elders, special tools watch for signs like faster heartbeats (Wong-Baker FACES Foundation, 2022).

Treatment Basics

Start with non-drug options like rest, ice, or physical therapy. For chronic pain, meds like acetaminophen or therapies like yoga help. Opioids are for severe cases but come with risks—use them wisely (Agency for Healthcare Research and Quality, n.d.).

Role of Experts

According to clinical observations by Dr. Alexander Jimenez, DC, APRN, FNP-BC, who runs a multidisciplinary practice in El Paso, Texas (https://dralexjimenez.com/), combining chiropractic care with exercises targets root causes, such as misaligned spines, reducing opioid needs. As a nurse practitioner, he coordinates care and offers ergonomic advice to prevent pain from daily habits (LinkedIn Profile).

Comprehensive Guide to Safe and Effective Pain Management Using Opioid Therapy

Pain is a widespread problem that affects millions of people, affecting everything from hobbies to employment. Finding healthy methods to handle discomfort is crucial, whether it’s a recent injury or persistent pain. This comprehensive manual covers pain management, available treatments, and responsible opioid use recommendations. Non-opioid substitutes, team-based treatment, and perspectives from professionals like Dr. Alexander Jimenez, who prioritizes holistic methods, will all be discussed. To assist you in finding trustworthy information online, keywords such as “pain management strategies,” “opioid therapy guidelines,” and “non-opioid pain relief” are sprinkled throughout.

Introduction to Pain in America

The Institute of Medicine estimates that around 100 million American adults face acute or chronic pain daily. This number is expected to climb due to an aging population, rising rates of conditions like diabetes, heart disease, arthritis, and cancer, plus better survival from serious injuries and more surgeries that can lead to post-op pain (Institute of Medicine, 2011).

As people learn more about pain relief options and gain better access through laws like the Affordable Care Act (ACA), more folks—especially older ones—seek help. Passed in 2010, the ACA requires insurers to cover essential pain management benefits, including prescription drugs, chronic disease care, mental health support, and emergency services (111th Congress, 2009-2010). To use these effectively, healthcare providers need a solid grasp of pain assessment, classification, and treatment.

What Is Pain?

The International Association for the Study of Pain defines it as an unpleasant feeling associated with real or potential tissue damage. It’s subjective, shaped by biology, emotions, and social life. People learn about pain through experiences—some seek help right away, others try home remedies first. Respect their stories (Raja et al., 2020).

Pain falls into three main types, though definitions overlap:

  • Acute Pain: Lasts less than 3 months, or 1 day to 12 weeks; often limits daily activities for a month or less.
  • Subacute Pain: Sometimes seen as part of acute, or separate; lasts 1-3 months, or 6-12 weeks.
  • Chronic Pain: Persists over 3 months, or limits activities for more than 12 weeks (Banerjee & Argáez, 2019).

Poorly managed short-term pain can become chronic, so early action is important (Marin et al., 2017).

Assessing Pain Thoroughly

Pain is complex, influenced by body, mind, and environment. A full check includes history, physical exam, pain details, other health issues, and mental states like anxiety.

Basic pain evaluation covers:

  • When it started (date/time).
  • What caused it (injury?).
  • How does it feel (sharp, dull?)?
  • How bad it is.
  • Where is it?
  • How long does it last?
  • What worsens it (moving?).
  • What helps it?
  • Related signs (swelling?).
  • Impact on daily life.

Mnemonics help remember these. Here’s a table comparing common ones:

Mnemonic Breakdown
COLDERRA Characteristics, Onset, Location, Duration, Exacerbation, Radiation, Relief, Associated signs
OLDCART Onset, Location, Duration, Characterization, Aggravating factors, Radiation, Treatment
PQRST Provoked, Quality, Region/Radiation, Severity, Timing

 

Pain scales provide information but aren’t diagnoses because they’re subjective. Single-dimensional ones focus on intensity:

  • Verbal: Mild, moderate, severe.
  • Numeric: 0 (none) to 10 (worst).
  • Visual: Like Wong-Baker FACES®, using faces for kids, adults, or those with barriers (Wong-Baker FACES Foundation, 2022). An emoji version works for surgery patients (Li et al., 2023).

Multi-dimensional scales check intensity plus life impact. The McGill Pain Questionnaire uses words like “dull” to rate sensory, emotional, and overall effects; shorter versions exist (Melzack, 1975; Main, 2016). For nerve pain, PainDETECT helps (König et al., 2021). Brief Pain Inventory scores severity and interference with mood/life (Poquet & Lin, 2016).

For babies, watch heart rate, oxygen, and breathing. Tools like CRIES rate crying, oxygen need, vitals, expression, sleep (Castagno et al., 2022). FLACC for ages 2 months-7 years checks face, legs, activity, cry, consolability (Crellin et al., 2015). Older kids use Varni-Thompson or draw pain maps (Sawyer et al., 2004; Jacob et al., 2014).

Elders face barriers like hearing loss or dementia. PAINAD assesses breathing, sounds, face, body, and consolability on a 0-10 scale (Malara et al., 2016).

The Joint Commission sets standards across various settings, which affect tool choice (The Joint Commission, n.d.).

Building Treatment Plans

Plans depend on pain type, cause, severity, and patient traits. For acute: meds, distraction, psych therapies, rest, heat/ice, massage, activity, meditation, stimulation, blocks, injections (National Academies of Sciences, Engineering, and Medicine, 2019).

Re-check ongoing acute pain to avoid chronic shift. Goals: control pain, prevent long-term opioids. Barriers: access to docs/pharmacies, costs, follow-ups.

For chronic: meds, anesthesia, surgery, psych, rehab, CAM. Non-opioids include:

  • Oral Meds:
    • Acetaminophen.
    • NSAIDs (celecoxib, etc.).
    • Antidepressants (SNRIs like duloxetine; TCAs like amitriptyline).
    • Anticonvulsants (gabapentin, etc.).
    • Muscle relaxers (cyclobenzaprine).
    • Memantine.
  • Topical: Diclofenac, capsaicin, lidocaine.
  • Cannabis: Medical (inhaled/oral/topical); phytocannabinoids (THC/CBD); synthetics (dronabinol) (Agency for Healthcare Research and Quality, n.d.).

Opioid use has risen, raising concerns (National Academies of Sciences, Engineering, and Medicine, 2019).

Key plan elements:

  • Quick recognition/treatment.
  • Address barriers.
  • Involve patients/families.
  • Reassess/adjust.
  • Coordinate transitions.
  • Monitor processes/outcomes.
  • Assess outpatient failure risk.
  • Check opioid misuse (Wells et al., 2008; Society of Hospital Medicine, n.d.).

Beyond Adjustments: Chiropractic and Integrative Healthcare- Video

Beyond Adjustments: Chiropractic and Integrative Healthcare | El Paso, Tx (2024)

Team Approach to Pain

Studies support the use of interprofessional teams for better results (Gauthier et al., 2019). Teams include docs, nurses, NPs, pharmacists, PAs, social workers, PTs, behavioral therapists, and abuse experts.

A 2017 report showed that teams improved pain/function from baseline, though not always compared with controls (Banerjee & Argáez, 2017). A meta-analysis found that teams were better at reducing pain after 1 month and sustained benefits at 12 months (Liossi et al., 2019).

Integrative chiropractic care fits here. It involves spinal adjustments—gentle manipulations to correct misalignments—and targeted exercises, such as core strengthening, to maintain alignment and reduce pressure on nerves/muscles. Dr. Alexander Jimenez observes that this helps sciatica/back pain without opioids, using tools like decompression (dralexjimenez.com).

Nurse Practitioners (NPs) provide comprehensive management, including ergonomic advice (e.g., better sitting postures) to prevent strain. They coordinate by reviewing options, referring to specialists, and overseeing plans, as seen in Dr. Jimenez’s practice, where his FNP-BC role includes telemedicine for holistic care (LinkedIn, n.d.).

Managing Opioids Safely

CDC’s 2022 guidelines cover starting opioids, dosing, duration, and risks (Centers for Disease Control and Prevention, 2022).

1. Starting Opioids:

Maximize non-opioids first—they match opioids for many acute pains (back, neck, etc.). Discuss benefits/risks (Recommendation 1, Category B, Type 3).

Evaluate/confirm diagnosis. Non-drug examples:

  • Back: Exercise, PT.
  • Low back: Psych, manipulation, laser, massage, yoga, acupuncture.
  • Knee OA: Exercise, weight loss.
  • Hip OA: Exercise, manuals.
  • Neck: Yoga, massage, acupuncture.
  • Fibromyalgia: Exercise, CBT, massage, tai chi.
  • Tension headache: Manipulation.

Review labels, use the lowest dose/shortest time. Set goals, exit strategy. For ongoing, optimize non-opioids (Recommendation 2, A, 2).

2. Choosing/Dosing Opioids:

Immediate-release (hydromorphone, etc.) over ER/LA (methadone, etc.). Studies show no edge for ER/LA; avoid for acute/intermittent (Recommendation 3, A, 4).

No rigid thresholds—guideposts. Risks rise with dose; avoid high if benefits dim (Recommendation 4, A, 3).

Taper slowly to avoid withdrawal (anxiety, etc.). Collaborate on plans; use Teams. If there is disagreement, empathize and avoid abandonment (Recommendation 5, B, 4).

3. Duration/Follow-Up:

For acute, prescribe just enough—often 3 days or less. Evaluate every 2 weeks. Taper if used for days. Avoid unintended long-term (Recommendation 6, A, 4).

Follow-up 1-4 weeks after start/escalation; closer for high-risk (Recommendation 7, A, 4).

4. Risks/Harms:

Screen for SUD/OUD. Offer naloxone for overdose risk (Recommendation 8, A, 4).

Check PDMPs for scripts/combos (Recommendation 9, B, 4).

Toxicology tests are performed annually to assess interactions (Recommendation 10, B, 4).

Caution with benzodiazepines (Recommendation 11, B, 3).

For OUD, use DSM-5 (2+ criteria/year); offer meds like buprenorphine (Recommendation 12, A, 1) (Hasin et al., 2013; American Psychiatric Association, 2013).

OUD signs: Larger amounts, failed cuts, time spent, cravings, role failures, social issues, activity loss, hazardous use, continued despite problems, tolerance, withdrawal.

Treatment: Meds, counseling, groups. Coordinate with specialists.

Conclusion

To sum up, successful pain management does not require relying only on opioids. We can improve the lives of millions of people by giving priority to non-opioid alternatives like acetaminophen, physical therapy, or mindfulness, and by taking opioids only when necessary under strict supervision. Teams of professionals, such as physicians, nurses, pharmacists, and specialists like chiropractors, collaborate to develop individualized strategies that lower dangers like addiction. By emphasizing spinal adjustments and targeted exercises, integrative chiropractic therapy may help restore normal alignment and reduce pain naturally, often eliminating the need for medication. Complete management, ergonomic guidance to prevent problems, and treatment coordination for optimal outcomes are all ways nurse practitioners provide value.

According to experts like Dr. Alexander Jimenez, these approaches target underlying issues using non-invasive treatments and functional medicine, promoting long-term well-being. Future developments in pain management seem promising, including FDA-approved non-opioid medications and distraction technologies such as virtual reality. In the end, everyone is empowered to address pain head-on, enhancing everyday activities and general health, when patients are included in decision-making and kept informed. Early evaluation and balanced treatment are crucial; discuss your options with your healthcare professional to determine what is best for you.

References

Navigating Holiday Gut Health for a Happy Season

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
At Christmas time overindulgence can cause stomach and gut issues.

Navigating Holiday Gut Health: Simple Strategies for Digestive Comfort and Resilience

Navigating Holiday Gut Health for a Happy Season
A woman cooks for the Christmas holidays

The holiday season sparkles with joy, family gatherings, and mouthwatering feasts. Yet, for many, it also brings unwelcome guests: bloating after that extra helping of pie, gas from festive drinks, or heartburn that lingers long after the party ends. These digestive hiccups are more common than you might think, affecting a large chunk of people during the winter months. According to a 2022 survey, about 67% of adults experience gastrointestinal issues such as acid reflux, diarrhea, and indigestion around the holidays (King Edward VII’s Hospital, 2022). Understanding why these problems pop up and how to ease them can help you savor the season without the stomach regrets.

At its core, the digestive system is like a busy highway, moving food through your body while pulling out nutrients. When holidays disrupt this flow—through big meals, skipped routines, or holiday cheer overload—it can lead to slowdowns or pile-ups. The good news is that there are solutions available. Simple tweaks in eating, moving, and relaxing can keep things running smoothly. This guide breaks down the main culprits behind holiday gut troubles, from bloating to constipation, and shares practical ways to fight back. We’ll also explore how experts like chiropractors and nurse practitioners use whole-body approaches to build lasting gut strength.

Why Holidays Hit Your Gut Hard: Common Culprits and Symptoms

Holidays mean treats like creamy casseroles, sugary cookies, and fizzy toasts—delicious, but tough on your tummy. Large, rich meals high in fats, spices, and sugars slow digestion, leading to a buildup of gas and discomfort (Mayo Clinic Healthcare, 2023). Adding alcohol, which irritates the gut lining, can exacerbate the situation. One study notes that over half of people blame a mix of new foods for their flare-ups (King Edward VII’s Hospital, 2022).

Stress plays a sneaky role, too. The rush of shopping, travel, and family dynamics ramps up cortisol, a hormone that shifts your body’s focus from “rest and digest” to “fight or flight.” This slows gut motility, letting bacteria build up and cause inflammation (GI Associates & Endoscopy Center, 2023). Winter’s chill doesn’t help; cold weather reduces blood flow to the digestive tract, making everything feel sluggish (United Digestive, n.d.).

Changes in routine, like late nights or less sleep, throw off your internal clock, messing with the gut microbiome—the trillions of bacteria that keep digestion balanced. A disrupted microbiome can lead to irregular bowel movements and weakened immunity (News-Medical, 2025). Even dehydration sneaks in as holiday busyness makes us forget to sip water, hardens stools, and sparks reflux.

Here’s a quick rundown of the top holiday gut gremlins:

  • Bloating: That full, puffy feeling often comes from swallowed air (from gulping food or fizzy drinks) or fermenting foods like Brussels sprouts (Guts UK, 2024a).
  • Gas: Excess air or undigested carbs in rich dishes create embarrassing bubbles (Guts UK, 2021).
  • Indigestion: Upper belly discomfort after heavy meals, thanks to extra acid production (Rush University Medical Center, n.d.).
  • Heartburn: A burning chest sensation from acid splashing up, worsened by lying down post-feast (Mayo Clinic Healthcare, 2023).
  • Diarrhea: Quick runs from food poisoning risks at potlucks or alcohol’s laxative effect (Guts UK, 2024a).
  • Constipation: Slowed bowels from low fiber and inactivity, affecting about 1 in 4 people (Guts UK, 2021).

These issues aren’t just annoying—they can spark cycles of discomfort that drag into the new year. But spotting them early lets you act fast.

The Science Behind the Season: How Stress and Food Team Up on Your Tummy

Your gut isn’t just a food processor; it’s a smart network tied to your brain via the gut-brain axis. Nerves and chemicals chat between your head and belly, influencing everything from mood to motility (Harvard Health Publishing, 2019). During holidays, stress hormones like cortisol dial down this chat, reducing blood flow to the gut and letting bad bacteria thrive. This dysbiosis—imbalance in gut bugs—fuels inflammation, which can mimic or worsen conditions like IBS (irritable bowel syndrome) (Physicians Weekly, n.d.).

Take alcohol: A sparkling wine toast disrupts beneficial bacteria, paving the way for leaky gut and more inflammation (King Edward VII’s Hospital, n.d.). Sugary treats feed the wrong microbes, leading to gas and cramps (Blue Cross Blue Shield of Michigan, n.d.). Even winter blues, like seasonal affective disorder, crank up cravings for carbs, which ferment and bloat (Star Imaging, n.d.).

  • Microbiome Mayhem: Holiday sweets and fats shift bacterial balance, causing irregular poops and low energy (News-Medical, 2025).
  • Inflammation Ignition: Stress plus rich eats spark gut-wide fire, linked to joint aches and fatigue (Bare Chiropractic, n.d.).
  • Routine Wreckers: Travel and parties mess with sleep, slowing digestion by up to 20% (University of Minnesota, n.d.).

Dr. Alexander Jimenez, a chiropractor and nurse practitioner, observes this in his practice: “Patients often report post-holiday sluggishness from gut inflammation, but addressing the gut-brain link through nutrition and adjustments restores balance quickly” (Jimenez, n.d.a). His work highlights how everyday stressors amplify these effects, turning a merry meal into a moody middle.

Everyday Fixes: Diet and Hydration Hacks for Holiday Harmony

You don’t need a total overhaul to tame your tummy—just smart swaps. Start with fiber: Aim for 25-30 grams daily from veggies, fruits, and whole grains to keep things moving (Healthline, 2023). Swap creamy dips for yogurt-based ones packed with probiotics, those friendly bacteria that crowd out the bad guys (Healthcert, n.d.).

Hydration is your secret weapon—chug 8-10 glasses of water to soften stools and dilute acids (Guts UK, 2024a). Alternate booze with H₂O to curb dehydration’s constipation kick (Covenant Health, n.d.). Portion control helps too: Use smaller plates to trick your brain into feeling full sooner (Gastroenterology Specialists, n.d.).

Pro tips for feast-proof eating:

  • Breakfast Buffer: Kick off with oats or fruit to curb overeating later (Rush University Medical Center, n.d.).
  • Chew It Over: Slow bites reduce air swallowing and aid breakdown (Guts UK, 2021).
  • Trigger Dodge: Skip fizzy drinks or Brussels if they gas you up; try herbal tea instead (King Edward VII’s Hospital, 2022).
  • Ferment Friends: Add sauerkraut or kefir for natural gut boosters (Healthline, 2023).
  • Sweet Swap: Fruit salad over pudding cuts sugar spikes (King Edward VII’s Hospital, n.d.).

In cold months, warm soups with ginger or turmeric soothe inflammation—Dr. Jimenez recommends these for their anti-inflammatory punch in functional medicine plans (Jimenez, n.d.b). These tweaks not only ease symptoms but also rebuild microbiome diversity for year-round resilience.

Move It to Lose It: Activity and Sleep for Gut Glow

Sitting through endless family stories? Your gut pays the price. Light movement, such as a post-dinner stroll, jump-starts motility and reduces bloating by 15-20% (Digestive Disease Consultants, n.d.). Yoga or deep breaths calm the nervous system, flipping the switch back to “digest mode” (Northwestern Medicine, n.d.).

Sleep’s non-negotiable too—7-9 hours nightly regulates hunger hormones and gut repair (GI Associates & Endoscopy Center, 2023). Skimp, and you’re prone to emotional eating that worsens reflux (News-Medical, 2025).

Quick wins for motion and rest:

  • Daily Dose: Walking for 20 minutes helps reduce stress and improve bowel function (Star Imaging, n.d.).
  • Breath Break: Diaphragmatic inhales ease cramps via the gut-brain link (Harvard Health Publishing, 2019).
  • Wind-Down Ritual: Herbal tea and dim lights signal sleep, stabilizing your microbiome (University of Minnesota, n.d.).
  • Active Fun: Engaging in activities like dancing to carols or playing games is more enjoyable than forced workouts (Guts UK, 2024a).

Integrative pros like Dr. Jimenez integrate gentle chiropractic adjustments to balance the nervous system, noting quicker relief from holiday cramps in patients who pair it with walks (Jimenez, n.d.c). It’s about steady habits, not extremes.

Supplements and Therapies: Boosts from Pros for Lasting Relief

When food fixes fall short, supplements step in. Probiotics restore bacterial balance, easing IBS-like flares (Healthline, 2023). Vitamin D, often low in winter, supports gut lining health—aim for 1,000-2,000 IU daily (United Digestive, n.d.). Digestive enzymes break down fats in heavy meals, curbing indigestion (Gastroenterology Specialists, n.d.).

For root relief, turn to integrative care. Chiropractors use spinal tweaks to calm the vagus nerve, enhancing “rest and digest” signals (Harvard Health Publishing, 2019). Nurse practitioners like Dr. Jimenez blend this with nutrition coaching: “In my clinic, we see gut inflammation drop with targeted probiotics and stress protocols, preventing carryover into January” (Jimenez, n.d.a).

  • Probiotic Picks: Strains like Lactobacillus for diarrhea control (News-Medical, 2025).
  • Enzyme Edge: Help with fatty roasts without the bloat (Healthline, 2023).
  • D for Defense: Fights winter microbiome dips (United Digestive, n.d.).
  • Therapy Team-Up: Manual work plus mindfulness slashes symptoms 30% faster (Bare Chiropractic, n.d.).

Always chat with a doc before starting—personalized plans beat guesswork.

Warning Signs: When to Wave the White Flag and See a Pro

Most holiday gripes fade in days, but don’t ignore red flags. Persistent diarrhea over two weeks, blood in stool, or unexplained weight loss scream for a check-up (Guts UK, 2024a). Severe pain, fever, or vomiting could signal infection or worse (Covenant Health, n.d.).

For chronic folks with GERD or IBD, holidays amplify risks—plan with your provider (Physicians Weekly, n.d.). Early intervention prevents big issues.

Building Gut Armor: Long-Term Wins Beyond the Holidays

Holidays end, but gut smarts stick. Focus on diverse plants—30 types weekly—for a thriving microbiome (King Edward VII’s Hospital, n.d.). Mindful eating fosters intuition and cuts stress-eating (Healthcert, n.d.). Dr. Jimenez stresses functional medicine: “Track triggers with journals; pair with chiropractic for holistic reset” (Jimenez, n.d.d).

Sustain with these pillars:

  • Diversity Diet: Veggies, nuts, ferments weekly (Healthline, 2023).
  • Stress Shield: Weekly yoga or meditation (Northwestern Medicine, n.d.).
  • Routine Anchor: Consistent meals and sleep (University of Minnesota, n.d.).
  • Pro Check-Ins: Annual gut scans for peace (Mayo Clinic Healthcare, 2023).

Embrace these, and your gut becomes a holiday hero, not a headache.

Chiropractic and Brain Health: The Impact of Obesity on Your Brain | El Paso, Tx (2023)

References

Bare Chiropractic. (n.d.). Post-holiday gut health: How inflammation can carry into the new year. https://barechiropractic.com/post-holiday-gut-health-how-inflammation-can-carry-into-the-new-year/

Blue Cross Blue Shield of Michigan. (n.d.). How harmful are the holidays to my gut health? https://www.bcbsm.mibluedaily.com/stories/health-and-wellness/how-harmful-are-the-holidays-to-my-gut-health

Covenant Health. (n.d.). How to manage gut health during the holidays. https://www.covenanthealth.com/blog/how-to-manage-gut-health-during-the-holidays/

Digestive Disease Consultants. (n.d.). Keeping your digestive system happy during the holidays: Tips to prevent unhealthy habits. https://ddcorlando.com/keeping-your-digestive-system-happy-during-the-holidays-tips-to-prevent-unhealthy-habits/

Gastroenterology Specialists. (n.d.). Tips for managing digestive distress during the holidays. https://www.gastrohonesdale.com/blog/tips-for-managing-digestive-distress-during-the-holidays

GI Associates & Endoscopy Center. (2023). The effect of holiday stress on the gastrointestinal system. https://gi.md/the-effect-of-holiday-stress-on-the-gastrointestinal-system/

Guts UK. (2021). Understanding your guts at Christmas. https://gutscharity.org.uk/2021/12/understanding-your-guts-at-christmas/

Guts UK. (2024a). Understand your guts at Christmas. https://gutscharity.org.uk/2024/12/understand-your-guts-at-christmas/

Harvard Health Publishing. (2019). Brain-gut connection explains why integrative treatments can help relieve digestive ailments. https://www.health.harvard.edu/blog/brain-gut-connection-explains-why-integrative-treatments-can-help-relieve-digestive-ailments-2019041116411

Healthcert. (n.d.). Supporting holiday gut health. https://www.healthcert.com/blog/supporting-holiday-gut-health

Healthline. (2023). Essentials to keep your gut happy and healthy through holidays. https://www.healthline.com/health/essentials-to-keep-your-gut-happy-and-healthy-through-holidays

Jimenez, A. (n.d.a). The relationship between the gut-brain axis in health and disease. https://dralexjimenez.com/the-relationship-between-the-gut-brain-axis-in-health-and-disease/

Jimenez, A. (n.d.b). Beneficial properties of turmeric: Joint health. https://dralexjimenez.com/beneficial-properties-turmeric-joints/

Jimenez, A. (n.d.c). Photobiomics and gut health. https://dralexjimenez.com/photobiomics-and-gut-health-el-paso-tx-2021/

Jimenez, A. (n.d.d). Functional medicine. https://dralexjimenez.com/category/nutrition-wellness/functional-medicine/

King Edward VII’s Hospital. (n.d.). How to have a gut-friendly Christmas. https://www.kingedwardvii.co.uk/health-hub/how-to-have-a-gut-friendly-christmas

King Edward VII’s Hospital. (2022). Christmas cramps: A third of Brits with digestive problems say symptoms get worse over Christmas. https://www.kingedwardvii.co.uk/health-hub/christmas-cramps-a-third-of-brits-with-digestive-problems-say-symptoms-get-worse-over-christmas

Mayo Clinic Healthcare. (2023). Guide to digestive health during festive season. https://www.mayoclinichealthcare.co.uk/news/guide-to-digestive-health-during-festive-season

News-Medical. (2025). How the holidays can impact digestion and gut health. https://www.news-medical.net/whitepaper/20251201/How-the-holidays-can-impact-digestion-and-gut-health.aspx

Northwestern Medicine. (n.d.). Holiday stress and gut health. https://www.nm.org/healthbeat/healthy-tips/Holiday-Stress-and-Gut-Health

Physicians Weekly. (n.d.). How the holidays hinder digestive health. https://www.physiciansweekly.com/post/how-the-holidays-hinder-digestive-health

Rush University Medical Center. (n.d.). Keep your stomach happy holiday season. https://www.rush.edu/news/keep-your-stomach-happy-holiday-season

Star Imaging. (n.d.). Winters impact on digestive health: Tips & seasonal remedies. https://www.starimaging.in/blog/winters-impact-on-digestive-health-tips–seasonal-remedies.html

United Digestive. (n.d.). Why your digestive system needs extra care during the winter months. https://www.uniteddigestive.com/why-your-digestive-system-needs-extra-care-during-the-winter-months/

University of Minnesota. (n.d.). Gut health during holidays. https://twin-cities.umn.edu/news-events/gut-health-during-holidays

A Clinical Approach for Professionals to Manage Substance Use Disorder Patients

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

Understand the essentials of a clinical approach to substance use disorder to enhance interventions and support sustainable recovery.

Table of Contents

Integrative Management of Substance Use Disorder (SUD) and Musculoskeletal Health: A Collaborative Model for Chiropractors and Nurse Practitioners

Substance use disorder (SUD) is a long-term medical condition that can be treated. It affects the brain, behavior, and the whole body, including the musculoskeletal system. SUD frequently coexists with chronic pain, injury, emotional distress, and functional impairments in numerous patients. According to the American Medical Association (AMA), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH), an integrative care model that combines evidence-based SUD screening and treatment with chiropractic care and nurse practitioner (NP)–led primary care can lower risk, improve function, and support long-term recovery.

This article discusses SUD, how to identify and classify it, how doctors can treat it through practical workflows, and how chiropractic and NP care can support patients with overlapping risk profiles and musculoskeletal problems.

What Is Substance Use Disorder (SUD)?

SUD is a medical condition in which the use of alcohol, medications, or other substances leads to significant impairment or distress in daily life. It is not a moral failing or a lack of willpower; it is a chronic, brain‑ and body‑based disease that is treatable (NIDA, n.d.; NIMH, 2025).

SUD exists on a spectrum from mild to severe. People with SUD may:

  • Use more of the substance than they planned

  • Try and fail to cut down or stop

  • Spend a lot of time obtaining, using, or recovering from the substance

  • Continue to use even though it harms health, work, relationships, or safety (American Psychiatric Association, 2022; NIMH, 2025)

Person‑first, non‑stigmatizing language

Stigma can keep people from seeking care. Using respectful, person‑first language reduces shame and supports engagement. NIDA and the AMA recommend (NIDA, n.d.; AMA, n.d.):

  • Say “person with a substance use disorder,” not “addict” or “drug abuser.”

  • Say “substance use” or “misuse,” not “abuse.”

  • Focus on SUD as a chronic, treatable condition.

Categories and Diagnostic Features of SUD

DSM‑5‑TR framework: Mild, moderate, severe

Diagnostic criteria for SUD come from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM‑5‑TR) (American Psychiatric Association, 2022; NIAAA, 2025). A diagnosis is based on the number of symptoms present over 12 months.

Typical criteria include (paraphrased):

  • Using more or for longer than intended

  • Unsuccessful efforts to cut down

  • Spending a lot of time obtaining, using, or recovering

  • Cravings or strong urges

  • Role failures at work, school, or home

  • Social or interpersonal problems caused or worsened by use

  • Giving up important activities

  • Using in physically hazardous situations

  • Continued use despite physical or psychological problems

  • Tolerance

  • Withdrawal

Severity is determined by symptom count (American Psychiatric Association, 2022; NIAAA, 2025):

  • Mild: 2–3 symptoms

  • Moderate: 4–5 symptoms

  • Severe: 6 or more symptoms

Substance‑specific categories

Clinically, SUD is further categorized by substance type (NIDA, n.d.; NIMH, 2025):

  • Alcohol use disorder (AUD)

  • Opioid use disorder (e.g., heroin, oxycodone, hydrocodone)

  • Stimulant use disorder (e.g., cocaine, methamphetamine)

  • Sedative, hypnotic, or anxiolytic use disorder (e.g., benzodiazepines)

  • Cannabis, tobacco, hallucinogen, or inhalant use disorders

Each category has similar behavioral criteria but unique medical risks, withdrawal profiles, and treatment options (NIDA, n.d.; NIAAA, 2025).

Risk and severity categories for clinical workflows

For practical care, validated screening tools classify risk that guide next steps (AMA, n.d.; NIDA, n.d.; NIAAA, 2025):

  • Low/no risk: Negative screen or very low scores

  • Moderate risk: At‑risk use with potential consequences (e.g., falls, crashes, future disease)

  • Substantial/severe risk: High scores suggest likely SUD and active harm

For example, adult risk zones using tools like AUDIT and DAST (AMA, n.d.):

  • Low risk/abstain: AUDIT 0–7; DAST 0–2

  • Moderate risk: AUDIT 8–15; DAST 3–5

  • Substantial/severe risk: AUDIT ≥16; DAST ≥6

These categories help teams decide when to give brief interventions, when to intensify care, and when to refer to specialty treatment.

Epidemiology and Public Health Impact

National surveys show that millions of people in the United States live with SUD, yet only a fraction receive treatment (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023). The 2022 National Survey on Drug Use and Health reported high rates of both substance use and serious mental illness, often co‑occurring (SAMHSA, 2023).

Key points from recent federal data (SAMHSA, 2023; NIMH, 2025):

  • SUD commonly co‑occurs with depression, anxiety, and other mental disorders.

  • Co‑occurring conditions worsen medical outcomes and increase healthcare use.

  • Early identification and integrated treatment can improve function, reduce complications, and lower long‑term costs.

Identifying Patients With SUD: Screening and Assessment

Early, routine identification is critical. Primary care teams, NPs, and chiropractic clinics that integrate behavioral health can all play a role (AMA, n.d.; NIDA, n.d.; NIAAA, 2025).

Building a safe, trauma‑informed environment

Before asking about substance use, the team should (AMA, n.d.; NIDA, n.d.):

  • Explain that “we screen everyone” as part of whole‑person care.

  • Emphasize confidentiality within legal limits.

  • Use a calm, nonjudgmental tone and body language.

  • Offer patients the option not to answer any question.

  • Acknowledge that stress, trauma, pain, and life pressures often contribute to substance use.

This aligns with trauma‑informed care principles promoted by SAMHSA and helps patients feel safe enough to share (AMA, n.d.).

Validated screening tools

Evidence‑based tools are preferred over informal questioning. Common options include (AMA, n.d.; NIDA, n.d.; NIAAA, 2025):

For adults:

  • AUDIT or AUDIT‑C (Alcohol Use Disorders Identification Test) – screens for unhealthy alcohol use and risk of AUD.

  • DAST‑10 (Drug Abuse Screening Test) – screens for non‑alcohol drug use problems.

  • TAPS Tool (Tobacco, Alcohol, Prescription medication, and other Substances) – combined screen and brief assessment.

For adolescents:

  • CRAFFT 2.1+N – widely used for youth; captures risk behaviors and problems.

  • S2BI (Screening to Brief Intervention) and BSTAD – brief tools validated for ages 12–17 (NIDA, n.d.; AMA, n.d.).

For alcohol‑specific quick screens:

  • AUDIT‑C (3 questions) or full AUDIT

  • NIAAA Single Alcohol Screening Question (SASQ):
    “How many times in the past year have you had 4 (for women) or 5 (for men) or more drinks in a day?” (NIAAA, 2025)

Results guide risk categorization and next steps.

Role of the care team

In integrated practices, roles can be divided (AMA, n.d.):

  • Medical assistants or nurses

    • Administer pre‑screens and full questionnaires.

    • Flag positive or concerning responses.

  • Nurse practitioners / primary care clinicians

    • Review screening results.

    • Deliver brief interventions using motivational interviewing.

    • Conduct or oversee further assessment.

    • Prescribe and manage pharmacotherapy for SUD when indicated.

    • Coordinate referrals and follow‑up.

  • Behavioral health clinicians (on‑site or virtual)

    • Perform biopsychosocial in-depth evaluations.

    • Provide psychotherapy and relapse‑prevention skills.

    • Support motivational enhancement and family engagement.

  • Chiropractors and physical‑medicine providers

    • Screen for substance misuse related to pain, function, and injury patterns.

    • Observe red flags (frequent lost prescriptions, inconsistent pain reports, sedation, falls).

    • Communicate concerns to the NP or primary medical provider.

Dr. Alexander Jimenez, DC, APRN, FNP‑BC, exemplifies this dual role. As both a chiropractor and a family practice NP, he combines neuromusculoskeletal assessment with medical screening and functional medicine evaluation to identify root causes of chronic pain and unhealthy substance use patterns (Jimenez, n.d.).

Clinical clues that may suggest SUD

Beyond formal tools, clinicians should stay alert for patterns such as (AMA, n.d.; NIMH, 2025):

  • Frequent injuries, falls, or motor vehicle accidents

  • Repeated missed appointments or poor adherence to treatment

  • Drowsiness, agitation, slurred speech, or odor of alcohol

  • Unexplained weight loss, infections, or liver abnormalities

  • Social and financial instability, job loss, or legal problems

In chiropractic and musculoskeletal settings, repeated injuries, delayed healing, inconsistent exam findings, or “pain behaviors” that do not match imaging or biomechanics may prompt gentle, supportive screening and medical referral.

Comprehensive Assessment and Risk Stratification

Once a screen is positive, the next level is a more detailed assessment. This should examine substance type, frequency, amount, impact, withdrawal, mental health, physical comorbidities, and function (AMA, n.d.; NIMH, 2025).

Structured assessment tools

Clinicians may use (AMA, n.d.; NIDA, n.d.; NIAAA, 2025):

  • Full AUDIT for alcohol

  • DAST‑10 for general drugs

  • CRAFFT or GAIN for adolescents

  • Checklists based directly on DSM‑5‑TR criteria to rate symptom count and severity (NIAAA, 2025).

These tools allow classification into mild, moderate, or severe SUD and support shared decision‑making regarding level of care.

Co‑occurring mental health conditions

SUD frequently co‑occurs with (NIMH, 2025):

  • Major depressive disorder

  • Anxiety disorders

  • Posttraumatic stress disorder (PTSD)

  • Bipolar disorder

  • Attention‑deficit/hyperactivity disorder

Co‑occurring disorders can:

  • Increased risk for self‑medication with substances

  • Worsen treatment outcomes if not recognized

  • Require integrated treatment plans (NIMH, 2025)

NPs, behavioral health clinicians, and chiropractors with integrative training should maintain a low threshold for mental health screening and referral.

Managing Patients With SUD: A Practical Clinical Process

Effective SUD care is chronic‑disease care: ongoing, team‑based, and tailored to readiness to change (AMA, n.d.; SAMHSA, 2023).

Core elements of management

Key components include (AMA, n.d.; NIDA, n.d.; NIMH, 2025):

  • Routine screening and re‑screening

  • Brief interventions and motivational interviewing

  • Harm‑reduction strategies

  • Medications for certain SUDs (when appropriate)

  • Evidence‑based behavioral therapies

  • Peer and family support

  • Long‑term follow‑up and relapse‑prevention planning

Brief intervention and motivational interviewing

For patients with low to moderate risk, brief intervention can be delivered in 5–15 minutes and often by NPs or primary care clinicians (AMA, n.d.; NIAAA, 2025). Using motivational interviewing, clinicians:

  • Ask open‑ended questions (“What do you enjoy about drinking? What concerns you about it?”)

  • Reflect and summarize the patient’s own statements

  • Ask permission before giving advice

  • Help patients set realistic, patient‑chosen goals (cutting down, abstaining, or seeking treatment)

This approach respects autonomy and builds internal motivation for change.

Determining level of care

The American Society of Addiction Medicine (ASAM) describes a continuum of care (AMA, n.d.; SAMHSA, 2023):

  • Prevention/early intervention

    • Brief interventions in primary care

    • Self‑management support and education

  • Outpatient services

    • Office‑based counseling and medications for AUD or opioid use disorder (OUD)

    • Integrated behavioral health visits

  • Intensive outpatient / partial hospitalization

    • Several therapy sessions per week, day or evening programs

  • Residential/inpatient services

    • 24‑hour structured care for severe or complex cases

  • Medically managed intensive inpatient services

    • Medically supervised detoxification and stabilization

NPs and primary care teams decide the appropriate level based on risk severity, co‑occurring medical and psychiatric conditions, social supports, and patient preference (AMA, n.d.; NIMH, 2025).

Medications for SUD

For some patients, medications support recovery by reducing cravings, blocking rewarding effects, or stabilizing brain function (SAMHSA, 2020; AMA, n.d.; NIAAA, 2025). Examples include:

  • Alcohol use disorder

    • Acamprosate – supports abstinence after detox

    • Disulfiram – creates an unpleasant reaction to alcohol, discouraging use

    • Naltrexone blocks the rewarding effects of alcohol

  • Opioid use disorder

    • Buprenorphine – a partial opioid agonist that reduces cravings and overdose risk; often prescribed in primary care with appropriate DEA registration

    • Methadone – full agonist, dispensed in specialized opioid treatment programs

    • Naltrexone (extended‑release) – opioid antagonist that prevents relapse after detox

  • Overdose prevention

    • Naloxone – rapid opioid‑overdose reversal, recommended for anyone at risk (AMA, n.d.).

NPs managing patients with SUD work within state scope‑of‑practice rules and in collaboration with addiction specialists where needed.

Behavioral therapies and peer support

Evidence‑based therapies include (AMA, n.d.; NIDA, n.d.):

  • Cognitive behavioral therapy (CBT)

  • Dialectical behavior therapy (DBT)

  • Motivational enhancement therapy

  • The Matrix Model (especially for stimulants)

  • Family‑based therapy for adolescents

Peer support groups (Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery) can reinforce coping skills, hope, and accountability.

Long‑term follow‑up

SUD is chronic; relapse risk can persist for years. Best practice includes (AMA, n.d.; NIMH, 2025):

  • Follow‑up within 2 weeks after treatment initiation

  • Monthly to quarterly visits as patients stabilize

  • Peer support and care management between visits

  • Rapid re‑engagement after any relapse or lapse

NASW, NIDA, and NIMH stress that relapse should be treated as a signal to adjust care—not as failure (NIDA, n.d.; NIMH, 2025).

How SUD Affects the Body and the Musculoskeletal System

SUD impacts nearly every organ system. Many effects directly or indirectly worsen neuromusculoskeletal health and pain.

General systemic effects

Common systemic consequences include (NIDA, n.d.; NIMH, 2025; SAMHSA, 2023):

  • Cardiovascular disease and hypertension

  • Liver disease and pancreatitis (especially with alcohol)

  • Respiratory disease (especially with tobacco and some drugs)

  • Endocrine and hormonal disruption

  • Immune dysfunction and higher infection risk

  • Sleep disturbances and fatigue

  • Worsening of mood, anxiety, and cognitive function

These changes affect healing capacity, resilience, and the way patients perceive pain.

Musculoskeletal and pain‑related effects

Substance use and SUD can influence the musculoskeletal system through several pathways:

  • Increased injury risk

    • Impaired judgment, coordination, and reaction time increase the risk of falls, motor vehicle accidents, and sports injuries.

    • Heavy alcohol use is associated with fractures, soft tissue injuries, and delayed healing (AMA, n.d.; SAMHSA, 2023).

  • Bone, joint, and muscle changes

    • Alcohol and some drugs can impair bone density and quality, increasing osteoporosis and fracture risk.

    • Nutritional deficiencies associated with SUDs weaken connective tissue and muscle function.

    • Sedentary behavior and deconditioning are common in people with long‑standing SUD.

  • Chronic pain and central sensitization

    • Chronic alcohol or opioid use can alter pain pathways in the central nervous system, raising pain sensitivity.

    • Opioid‑induced hyperalgesia can make pain seem worse even at stable or increasing doses.

  • Functional and ergonomic stress

    • Disrupted sleep, poor posture, and prolonged sitting or immobility (for example, in recovery environments or during unemployment) can lead to spinal stress, neck and low back pain, and muscle imbalance.

Clinically, Dr. Jimenez and similar integrative providers often see patients with combined profiles: chronic low back or neck pain, sedentary work, ergonomic strain, poor sleep, high stress, and escalating reliance on medications, including opioids or sedatives. Addressing both the mechanical and behavioral contributors can change the trajectory of pain and SUD risk (Jimenez, n.d.).

Integrative Chiropractic Care in the Context of SUD

Philosophy of integrative chiropractic care

Integrative chiropractic care focuses on restoring alignment, mobility, and neuromuscular control while considering lifestyle, nutrition, sleep, and emotional stress. In the model used by Dr. Jimenez, chiropractic adjustments are combined with functional medicine strategies, targeted exercise, and collaborative medical care (Jimenez, n.d.).

For patients with or at risk of SUD, this approach offers:

  • Non‑pharmacologic pain management

  • Improved movement, posture, and ergonomics

  • Education that empowers patients to self‑manage pain

  • Reduced reliance on habit‑forming medications

Spinal adjustments and targeted exercises

Spinal and extremity adjustments aim to:

  • Restore joint mobility

  • Reduce mechanical irritation of nerves and soft tissues

  • Improve segmental alignment and overall posture

Targeted exercises are prescribed to:

  • Strengthen deep stabilizing muscles (core, gluteal, cervical stabilizers)

  • Correct muscle imbalances and faulty patterns

  • Increase flexibility and joint range of motion

  • Enhance proprioception, balance, and movement control

Examples of targeted exercise strategies often used in integrative chiropractic and rehab clinics include (Jimenez, n.d.):

  • Lumbar stabilization and core‑strengthening sequences

  • Hip mobility and glute activation drills for low back and sciatica‑like pain

  • Cervical and scapular stabilization for neck and shoulder pain

  • Postural retraining, including ergonomic break routines for prolonged sitting

By reducing biomechanical stress and enhancing functional capacity, these interventions may decrease pain intensity, frequency, and flare‑ups, which in turn can lower the drive to self‑medicate with substances.

Reducing overlapping risk profiles

Many risk factors for SUD and for chronic musculoskeletal pain overlap, including (NIMH, 2025; NIDA, n.d.; Jimenez, n.d.):

  • Chronic stress and trauma

  • Poor sleep and circadian disruption

  • Sedentary lifestyle and obesity

  • Repetitive strain and poor ergonomics

  • Social isolation and low self‑efficacy

Integrative chiropractic care can help shift these shared risk profiles by:

  • Encouraging regular physical activity and graded movement

  • Coaching ergonomic and postural strategies at work and home

  • Teaching breathing, stretching, and relaxation routines that reduce muscle tension and sympathetic overdrive

  • Collaborating with NPs and behavioral health clinicians to align interventions with mental health and SUD treatment plans

In Dr. Jimenez’s practice, this often includes structured flexibility, mobility, and agility programs that are adapted to age and functional status, with close monitoring to avoid over‑reliance on medications, including opioids and sedatives (Jimenez, n.d.).

The Nurse Practitioner’s Role in Comprehensive SUD and Musculoskeletal Care

NPs are well-positioned to coordinate SUD care and integrate it with musculoskeletal and chiropractic treatment.

Comprehensive medical management

NP responsibilities typically include (AMA, n.d.; NIMH, 2025; NIAAA, 2025):

  • Conducting and interpreting SUD screening and risk stratification

  • Performing physical exams and ordering labs or imaging

  • Diagnosing SUD and co‑occurring conditions

  • Prescribing non‑addictive pain strategies and medications where indicated

  • Managing or co‑managing medications for AUD or OUD (per training and regulations)

  • Monitoring for drug–drug and drug–disease interactions

  • Coordinating with behavioral health and community resources

In integrative settings like Dr. Jimenez’s clinic, the NP role is blended with functional medicine principles, looking at nutrition, metabolic health, hormonal balance, and inflammation that influence both pain and SUD risk (Jimenez, n.d.).

Ergonomic and lifestyle counseling

NPs also provide individualized counseling on:

  • Workplace ergonomics (desk height, chair support, screen position)

  • Safe lifting strategies and body mechanics

  • Activity pacing and graded return to work or sport

  • Sleep hygiene and circadian rhythm support

  • Nutrition strategies that support musculoskeletal healing and brain health

These interventions lower the mechanical load on the spine and joints, reduce fatigue, and increase a patient’s sense of control—all of which help reduce triggers for substance use and relapse.

Care coordination and team communication

NPs often serve as the central coordinator who (AMA, n.d.; NIMH, 2025):

  • Ensures all team members (chiropractor, physical therapist, behavioral health, addiction medicine, primary care, or specialty providers) share a coherent plan

  • Tracks progress on pain, function, substance use, mood, and quality of life

  • Adjusts the plan as conditions change

  • Supports families and caregivers in understanding both SUD and musculoskeletal needs

In a model like Dr. Jimenez’s, this may involve regular case conferences, shared EHR notes, and integrated treatment plans that align spinal rehabilitation with SUD recovery goals (Jimenez, n.d.).

Understanding Long Lasting Injuries- Video

Understanding Long-Lasting Injuries - El Paso, Tx (2023)

Practical Clinical Pathway: From First Contact to Long‑Term Recovery

For clinics that combine chiropractic and NP services, a practical, stepwise pathway for patients with possible SUD and musculoskeletal complaints can look like this (AMA, n.d.; NIDA, n.d.; NIAAA, 2025; NIMH, 2025; Jimenez, n.d.):

Step 1: Initial visit and global screening

  • Intake includes questions on pain, function, injuries, sleep, mood, and substance use.

  • Staff administer brief tools (for example, AUDIT‑C and DAST‑10 for adults, CRAFFT for adolescents).

  • The chiropractor documents neuromusculoskeletal findings; the NP reviews medical and behavioral health risks.

Step 2: Identification of SUD risk

  • Negative or low‑risk screens → brief positive health message and reinforcement of low‑risk behavior.

  • Moderate risk → NP provides brief intervention, motivational interviewing, and a follow‑up plan.

  • Substantial or severe risk → NP initiates comprehensive assessment, safety planning, and possible referral to specialized services.

Step 3: Integrated treatment planning

The team crafts a unified plan that may include:

  • Spinal adjustments and targeted exercises to correct alignment and biomechanics

  • Gradual increase in physical activity with pain‑sensitive pacing

  • Non‑pharmacologic pain strategies (manual therapy, exercise therapy, education)

  • Behavioral health referral for CBT, trauma‑informed treatment, or other modalities

  • Consideration of medications for AUD or OUD, if indicated

  • Harm‑reduction measures (for example, naloxone prescription for those at overdose risk)

Step 4: Ergonomics and lifestyle

  • NP and chiropractor jointly review workplace and home ergonomics, posture, and activity patterns.

  • Patients learn micro‑break routines, stretching, and strengthening sequences for high‑risk tasks (for example, lifting or prolonged sitting).

  • Nutrition, stress‑management, and sleep interventions are introduced or refined.

Step 5: Monitoring and long‑term follow‑up

  • Regular follow‑up visits evaluate:

    • Pain levels and functional capacity

    • Substance use patterns and cravings

    • Mood, sleep, and quality of life

    • Adherence to exercise and ergonomic plans

  • The team updates the treatment plan to respond to progress, setbacks, or new diagnoses.

  • Patients are coached to view flare-ups or lapses as opportunities to learn and adjust, not as failures.

This kind of coordinated, integrative approach can reduce repeated injuries, unnecessary imaging or surgeries, and long‑term dependence on medications, including opioids.

Clinical Insights from an Integrative Practice Model

Although each practice is unique, Dr. Alexander Jimenez’s clinic illustrates several principles that can guide others (Jimenez, n.d.):

  • Whole‑person assessment: History taking includes injuries, lifestyle, trauma, nutrition, environment, and psychosocial stressors.

  • Functional movement focus: Care plans emphasize flexibility, mobility, agility, and strength to restore capacity rather than just relieve symptoms.

  • Non‑invasive first: Chiropractic adjustments, functional exercise, and lifestyle interventions are prioritized before invasive procedures or long‑term controlled substances.

  • Integrated roles: As both DC and FNP‑BC, Dr. Jimenez unifies neuromusculoskeletal, primary care, and functional medicine perspectives in a single, coordinated plan.

  • Patient empowerment: Education, coaching, and accessible care options help patients take a proactive role in maintaining spinal health and reducing SUD risk.

This model aligns with national guidance on behavioral health integration and SUD management in medical settings while adding the musculoskeletal and ergonomic expertise of chiropractic care (AMA, n.d.; NIDA, n.d.; NIMH, 2025).

Key Takeaways

  • SUD is a chronic, treatable medical condition that often co‑occurs with mental disorders and chronic pain.

  • Validated screening tools and non‑stigmatizing, trauma‑informed communication are core to early identification.

  • Risk and severity categories (mild, moderate, severe) guide brief intervention, level of care, and referral decisions.

  • SUD significantly affects the body, including bone health, soft tissue integrity, injury risk, and chronic pain pathways.

  • Integrative chiropractic care—with spinal adjustments, targeted exercises, and ergonomic guidance—can reduce pain, improve function, and lower overlapping risk factors for SUD.

  • Nurse practitioners provide comprehensive SUD management, coordinate care, and deliver ergonomic and lifestyle counseling that complements chiropractic treatment.

  • A collaborative, long‑term, patient‑centered model—such as the one exemplified by Dr. Alexander Jimenez—offers a promising pathway to healthier spines, healthier brains, and healthier lives.

Conclusion

Substance use disorder is a complicated medical problem that needs compassion, screening based on evidence, and care that is coordinated across many fields. Healthcare professionals, including chiropractors, nurse practitioners, primary care physicians, and behavioral health specialists, can help people with SUD by first learning what it is, how to spot it, and how to respond with respect and proven methods.

Patients who have both chronic pain and substance use problems can benefit from the combination of chiropractic care and primary care led by nurse practitioners. A patient with a work injury, car accident, or years of bad ergonomics may not say that they are also struggling with alcohol dependence, prescription opioid misuse, or stimulant use. But these problems often happen at the same time. The musculoskeletal system is under greater stress due to a higher risk of fractures, muscle wasting, slower healing, and increased pain sensitivity. The mind and nervous system are also affected, with sleep problems, mood swings, and a lower ability to handle stress, all making the cycle of pain and drug use worse.

Clinics and practices that combine screening, short-term treatment, and coordinated care have a strong way to break this cycle. Adjusting the spine brings back mechanical function. Targeted exercises help you regain strength and proprioception. Ergonomic advice enables you to avoid injury again. Nurse practitioners ensure medications are taken correctly, monitor for drug interactions, and guide lifestyle changes that can support both spine health and recovery from SUD. Behavioral health professionals offer therapy, peer support, and help with relapse prevention. This team works on more than just symptoms; they also address the root causes.

Providers like Dr. Alexander Jimenez show that a single clinician with both chiropractic and family practice nurse practitioner credentials can easily put these pieces together into a patient-centered plan. Patients benefit from continuity, goal alignment, and a provider who comprehends both the biomechanics of a herniated disc and the neurobiology of addiction. Larger practices can achieve the same results by ensuring everyone on the team communicates, makes decisions together, and provides trauma-informed care that doesn’t stigmatize people.

The evidence is clear: finding problems early saves lives and leads to better outcomes. Validated screening tools are fast and correct. Brief interventions and motivational interviewing are effective. When used carefully, medications for alcohol and opioid use disorders are safe and work. Non-pharmacologic methods, such as exercise, manual therapy, stress management, and social support, are effective but not used enough. Patients heal faster, get back to normal life faster, and are much less likely to start using drugs again when musculoskeletal and behavioral health care are combined.

Healthcare teams that are willing to look beyond individual complaints, like “just” back pain or “just” anxiety, will be greatly rewarded: patients will get their health, relationships, and sense of purpose back. This is what integrative, collaborative, evidence-based care for substance use disorder and musculoskeletal health promises.

References

Improve Your Posture and Reduce Muscle Strain

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Improve Your Posture and Reduce Muscle Strain
Patients at chiropractic and functional medicine clinic work on spine mobility and posture stretching on a roller

Improve Your Posture: Effective Exercises, Stretches, and Professional Support

Improve Your Posture and Reduce Muscle Strain
A woman at work with poor posture is taking a toll with intense back pain.

Good posture means standing or sitting in a way that keeps your body aligned and balanced. It helps you look confident and feel better. Poor posture can lead to back pain, neck strain, and even headaches. Many people slouch because they sit at desks all day or stare at phones. But the good news is that you can fix it with simple changes. This article explains exercises and stretches to strengthen your muscles. It also covers activities like yoga and swimming. Plus, you’ll learn how chiropractors and nurse practitioners can help. With regular practice, you can stand taller and feel stronger.

Why Good Posture Matters

Good posture supports your spine and keeps your body in line. It reduces stress on your muscles and joints. When you slouch, your head moves forward, which strains your neck. Over time, this can cause back or shoulder pain. Studies show that better posture can boost your mood and energy. It even helps with breathing and digestion because your organs have more space. Fixing posture is not just about looks—it’s about health. You can start by knowing how you sit and stand every day.

Poor posture often comes from weak core muscles or tight hips. Sitting too much makes some muscles short and others weak. This pulls your body out of balance. But exercises can help. They build strength and flexibility. Activities like dancing make you more aware of your body. Professional help, like from a chiropractor, can fix alignments. A nurse practitioner can give advice on daily habits. Together, these steps lead to lasting changes.

Strengthening Exercises for Better Posture

To improve posture, focus on building strong core, back, and shoulder muscles. These hold your body upright. Start slow and do them a few times a week. Always breathe deeply and stop if it hurts. Here are some key exercises:

  • Planks: Lie face down. Lift your body on your forearms and toes. Keep your body straight like a board. Hold for 20 to 30 seconds. This strengthens your core, which supports your spine. Do two to three sets. It helps prevent slouching by strengthening your middle.
  • Bird-Dog: Get on your hands and knees. Extend one arm forward and the opposite leg back. Hold for five seconds, then switch sides. This builds balance and strengthens your back and core. Repeat 10 times per side. It’s great for stability and reducing lower back pain.
  • Glute Bridges: Lie on your back with knees bent and feet flat. Lift your hips, squeezing your butt muscles. Hold for a few seconds, then lower. Do 10 reps. This targets your glutes and lower back, helping align your pelvis for better posture.
  • Side Planks: Lie on one side. Lift your body on one forearm and your feet. Hold for 15 to 30 seconds, then switch. This works the sides of your core and hips. It’s key to keeping your body straight and avoiding leans.
  • Wall Angels: Stand with your back against a wall. Raise your arms like goalposts, then slide them up and down. Stay in contact with the wall. Do 10 reps. This opens your chest and strengthens your upper back, helping you pull your shoulders back.

These exercises take just 10 to 15 minutes. As you get stronger, hold longer or add reps. They help fix imbalances from daily life.

Stretches to Increase Flexibility

Tight muscles pull you out of alignment. Stretches loosen them up. Do these daily, holding each for 15 to 30 seconds. Breathe slowly to relax.

  • Cat-Cow: On hands and knees, arch your back up like a cat, then dip it down like a cow. Repeat five times. This moves your spine and releases tension in your back and neck.
  • Chin Tucks: Sit or stand straight. Pull your chin back like making a double chin. Hold for five seconds. Do 10 reps. This fixes forward head posture and strengthens neck muscles.
  • Chest Openers: Stand and clasp hands behind your back. Lift your arms slightly and open your chest. Hold and breathe. This stretches tight chest muscles that cause rounding.
  • Forward Fold: Stand and bend forward from your hips. Let your arms hang. Bend knees if needed. This stretches your back and hamstrings for better spinal length.
  • Doorway Pec Stretch: Stand in a doorway with arms on the frame. Lean forward to stretch your chest. Hold for 30 seconds. This opens the shoulders and improves upper-body alignment.

Stretching helps you move more easily. Combine it with strength work for the best results.

Mind-Body Activities for Awareness

Activities that connect your mind and body naturally improve posture. They teach you to feel when you’re out of line.

Yoga focuses on poses that strengthen and stretch. For example, Mountain Pose: Stand tall with feet together. Squeeze your thighs and drop your shoulders. Hold and breathe. This builds awareness of alignment.

Pilates works on core control. It uses slow, controlled movements to build strength without strain. Both yoga and Pilates improve flexibility and balance, key to posture.

Tai Chi involves gentle flows. It boosts balance and reduces stress, which can cause tight muscles. Practice for 20 minutes a day to improve body control.

These activities make posture a habit. They’re fun and relaxing, too.

General Fitness Activities to Support Posture

Every day fitness keeps your body active and aligned. Swimming works all muscles without joint stress. It strengthens your back and opens your chest to prevent slumping.

Dancing, like ballroom, engages your core and legs. It teaches upright stance and improves coordination.

Walking or low-impact cardio keeps you moving. Aim for 30 minutes daily. It builds endurance and helps maintain weight, reducing spine load.

Add these to your routine for overall health.

How Integrative Chiropractic Therapy Helps

Chiropractic care fixes spine alignments. Misalignments cause poor posture and pain. Adjustments use gentle pressure to realign bones. This reduces tension and improves movement.

Integrative chiropractic combines adjustments with exercises. For example, after an adjustment, do planks or stretches to keep the fix. It also includes flexibility work, like hip stretches.

Dr. Alexander Jimenez, a chiropractor and nurse practitioner, observes that posture issues often come from daily habits. He uses X-rays and tests to find root causes. His clinic offers programs with adjustments, acupuncture, and exercises for long-term fixes. He notes that combining care with home routines leads to better results.

Regular visits prevent problems. Chiropractors teach ergonomic tips, like desk setup.

The Role of Nurse Practitioners in Posture Health

Nurse practitioners (NPs) provide holistic care. They look at your whole health, not just symptoms. For posture, they offer ergonomic advice, such as adjusting your chair so your feet are flat.

NPs prescribe exercises tailored to you. They coordinate with chiropractors for full plans. Dr. Jimenez, as an NP, integrates nutrition and wellness. He sees that healthy habits like hydration help muscles stay flexible.

They monitor progress and adjust plans. This team approach ensures long-term postural health.

Combining Everything for Lasting Results

Mix exercises, stretches, and activities. Add professional help for guidance. Start with 10 minutes daily. Track how you feel. Over time, you’ll notice less pain and more energy. Remember, consistency is key. Fix your workspace and take breaks. With these steps, good posture becomes natural.

In summary, improving posture takes effort but pays off. Use the tools here to stand tall and feel great.

Correct Bad Posture with Custom *FOOT ORTHOTICS* | El Paso, TX (2019)

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Medical News Today. (2023, February 13). Exercises and tips to improve your posture. https://www.medicalnewstoday.com/articles/325883

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Thrive Chiropractic Cedar Falls. (n.d.). 7 exercises that complement quality chiropractic care. https://www.thrivecedarfalls.com/lowbackpain/quality-chiropractic-care-exercises

Too Ele Chiropractor. (n.d.). 6 physical activities that complement your chiropractic treatments. https://tooelechiropractor.com/physical-activities-complement-chiropractic/

Total Health Clinics. (n.d.). Chiropractic approaches to improving posture: Effective techniques for better alignment. https://totalhealthclinics.com/chiropractic-approaches-to-improving-posture/

Woodlands Sports Medicine Centre. (n.d.). 10 exercises to improve posture and relieve lower back pain. https://www.woodlandssportsmedicine.com/blog/10-exercises-to-improve-posture-and-relieve-lower-back-pain

Autoimmune Conditions Explained Using Functional Wellness

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

Discover practical tips for autoimmune conditions with functional wellness and transform your approach to managing your health.

Table of Contents

Understanding Autoimmune Conditions: How Functional Wellness Can Transform Your Health

Enhanced Surgical Recovery for Spine Surgery Insights

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Enhanced Surgical Recovery for Spine Surgery Insights
Chiropractic nurse practitioner reviews patient spinal injury recovery/rehabilitation imaging.

Enhanced Surgical Recovery for Spine Surgery: Integrative Care, Less Opioids, Faster Return to Life

Enhanced Surgical Recovery for Spine Surgery Insights
A chiropractic nurse practitioner examines a patient’s spine, posture, and spinal surgery rehabilitation.

Enhanced Surgical Recovery (ESR), also known as Enhanced Recovery After Surgery (ERAS), is changing how people heal after spine surgery. Instead of relying mainly on opioids and long bed rest, ESR uses a full pathway that starts before surgery and continues through rehab at home.

This pathway is built around:

  • Multimodal, opioid-sparing pain management

  • Strong patient education and expectation setting

  • Nutritional optimization and prehabilitation

  • Early feeding and early mobilization

  • Coordinated follow-up with rehab, chiropractic care, and sometimes virtual reality (VR) tools

Research in spine surgery shows that ERAS-style programs can:

  • Reduce opioid use without making pain worse PMC+1

  • Shorten hospital stays by about 1–2 days in many fusion and microdiscectomy procedures Europe PMC+1

  • Lower complications and improve function when combined with nutrition and rehab planning PMC+2MDPI+2

Clinics that focus on spine and nerve health often build ESR principles into everything they do—from pre-surgical counseling to long-term post-op rehab.

Foundation of Enhanced Surgical Recovery in Spine Surgery

At its core, ESR is about helping the body handle the “stress” of surgery more smoothly. Spine-specific ERAS protocols usually include: PMC+2PMC+2

  • Preoperative education and counseling

  • Prehabilitation and conditioning

  • Nutrition screening and optimization

  • Multimodal anesthesia and analgesia

  • Early oral intake and early mobilization

  • Structured rehab after discharge

What this looks like in practice

Before surgery, teams:

  • Explain the timeline for pain, walking, and home recovery

  • Screen for problems like malnutrition, anemia, diabetes, and smoking

  • Start simple exercise and flexibility programs when appropriate

During and after surgery, teams:

  • Use multiple non-opioid medications to control pain

  • Encourage sitting up, breathing exercises, and walking as soon as it is safe

  • Move patients more quickly and safely toward home, rather than “keeping them just in case.”

Preoperative Education and Prehabilitation

Education is one of the strongest “medications” in ESR. When people know what to expect, they are more likely to stay calm, move early, and stick with their plan.

Key topics covered before spine surgery

  • What ESR/ERAS means in simple terms

  • How pain will be treated with several tools, not just opioids

  • Why early sitting and walking reduce complications

  • How nutrition, hydration, and sleep affect healing

  • What activity limits and milestones look like in the first 6–12 weeks

Spine-focused ERAS reviews report that structured preoperative counseling improves satisfaction and helps patients meet early mobility goals. PMC+1

Prehabilitation builds on this education. Before surgery, many patients can safely work on:

  • Gentle core and hip strengthening

  • Balance and gait training

  • Flexibility and breathing exercises

These prehab steps can help you stand and walk sooner after surgery, a major ERAS goal for lumbar procedures. Europe PMC+1

Nutrition and Risk Optimization Before Spine Surgery

Spine surgery stresses the body. If a patient is already malnourished or anemic, the risk of wound problems, infections, longer stays, and readmissions climbs. PMC+2PubMed+2

Studies in lumbar fusion and decompression show:

  • Malnutrition is linked to higher infection and wound-healing problems

  • Malnourished patients often stay longer in the hospital and are readmitted more often PubMed+2MDPI+2

Typical ESR-style nutrition steps

  • Screening:

    • Weight loss history

    • Serum albumin or other nutritional markers

    • Simple screening tools such as GNRI in older adults Cureus+1

  • Intervention:

    • Increasing protein intake

    • Using oral nutrition supplements when needed

    • Correcting anemia before elective surgery

  • Modern fasting rules:

    • Clear fluids up to 2 hours before anesthesia in many cases

    • Carbohydrate drinks before surgery to reduce insulin resistance and muscle breakdown PMC+1

In integrative spine clinics, nurse practitioners (NPs) often lead this work—ordering labs, coordinating with dietitians, and adjusting medications—while chiropractors coach neutral spine posture, breathing, and light movement that support better circulation and strength.

Opioid-Sparing Multimodal Pain Management

One of the primary wins of ESR is better pain control with less opioid exposure. Instead of relying on a single strong opioid, teams combine different strategies that each target a piece of the pain pathway.

Common multimodal tools include: PMC+2e-neurospine.org+2

  • Acetaminophen on a regular schedule

  • NSAIDs or COX-2 inhibitors (when safe)

  • Gabapentinoids for nerve-related pain

  • Local anesthetic infiltration and regional blocks

  • Limited, targeted opioids for breakthrough pain

Randomized and observational trials in lumbar fusion and other spine procedures have shown that ERAS-type multimodal analgesia:

  • Reduces hospital opioid consumption

  • Shortens length of stay

  • Maintains equal or better pain scores than traditional opioid-heavy care PMC+2Europe PMC+2

Nurse practitioners play a critical role here by:

  • Starting non-opioid medications before surgery when appropriate

  • Adjusting dosages based on kidney function, age, and other conditions

  • Planning an opioid taper schedule before the patient leaves the hospital

  • Watching for side effects like constipation, dizziness, or mood changes

Early Mobilization, Shorter Stays, and Lower Readmissions

ESR replaces the old idea of “stay in bed and rest” with “move early and move smart.” Spine ERAS protocols push for: PMC+2Europe PMC+2

  • Sitting at the bedside as early as the day of surgery, when safe

  • Standing and taking the first steps within 24 hours for many patients

  • Step goals that increase each hospital day

Across multiple studies, these pathways have led to:

  • Shorter hospital stays by about 1–2 days in lumbar fusion and microdiscectomy Europe PMC+2PMC+2

  • Faster time to first oral intake, which supports gut function and recovery ResearchGate+1

Complication and readmission rates are often stable or improved when ERAS is implemented thoughtfully, and patients are carefully selected and followed. PMC+1

Physical therapists and nursing teams lead much of the early mobilization. Still, NPs are often the ones coordinating orders, tracking milestones, and addressing barriers such as pain, low blood pressure, or nausea.

How Nurse Practitioners Connect the ESR Pathway

In modern spine programs, nurse practitioners are the “glue” that holds the ESR pathway together. Professional organizations stress that advanced practice clinicians improve consistency and patient engagement in ERAS protocols. PMC+1

NP roles across the spine ESR journey

  • Before surgery

    • Perform detailed medical evaluations

    • Order labs, imaging, and nutrition consults

    • Adjust medications (for blood pressure, blood sugar, blood thinning, etc.)

    • Provide education on the ESR steps and realistic recovery goals

  • In the hospital

    • Fine-tune multimodal pain regimens

    • Watch for complications or delirium, especially in older adults

    • Encourage early walking and breathing exercises

    • Communicate with surgeons, anesthesia, therapy, and chiropractic providers

  • After discharge

    • Use telemedicine for early follow-up on pain, mobility, and wound care

    • Taper opioids and reinforce non-drug pain strategies

    • Coordinate referrals to chiropractic, physical therapy, VR-based rehab, and functional medicine when appropriate

Clinicians like Dr. Alexander Jimenez, DC, APRN, FNP-BC, blend these NP skills with chiropractic and functional medicine training, creating a single point of leadership for complex spine and nerve patients. El Paso, TX Doctor Of Chiropractic+2El Paso, TX Doctor Of Chiropractic+2

Integrative Chiropractic Care in ESR-Style Spine Recovery

Chiropractic care fits naturally into a multimodal spine recovery plan when it is coordinated with the surgeon and medical team and timed properly.

Important: Chiropractors should always follow the surgeon’s restrictions and timeline, especially after fusion or instrumentation surgery.

Pre-surgical phase (prehabilitation)

Before surgery, chiropractors can help patients prepare by:

  • Teaching neutral spine mechanics for sitting, standing, and rolling in bed

  • Addressing muscle tension and stiffness with gentle soft tissue work

  • Working on posture and basic movement patterns

  • Building tolerance for walking and light activity within safe limits

Prehab of this kind can make it easier to hit early ERAS mobility targets and may support better function at discharge. PMC+1

Post-surgical rehabilitation (after medical clearance)

Once the surgeon confirms that healing has progressed far enough, chiropractic care can support rehab by:

  • Gently mobilizing segments above and below the surgical level to reduce compensatory strain

  • Using soft tissue techniques to ease muscle guarding, scar-related stiffness, and postural tension

  • Coaching safe bending, lifting, and twisting patterns appropriate for the stage of healing

  • Working alongside physical therapy to rebuild strength, balance, and endurance

Recent clinical content on post-surgical chiropractic rehab notes benefits such as:

For patients treated in multidisciplinary centers, chiropractic is not a stand-alone solution but an important part of a broader ESR-guided plan that also includes medical management, exercise rehab, and lifestyle changes.

Virtual Reality (VR): A New Tool for Pain and Strength After Surgery

Virtual reality is quickly becoming a powerful non-drug tool in surgical recovery programs. Instead of simply distracting patients, many VR systems provide guided relaxation, graded movement, and even structured exercise “games.”

Umbrella reviews and clinical studies show that VR:

  • Reduces acute and chronic pain in many settings, including postoperative pain PMC+2PubMed+2

  • Decreases pain scores during the immediate post-op period more than some standard distraction tools SAGE Journals+1

  • May lower opioid requirements when added to multimodal pain strategies PubMed+1

For people recovering from spine surgery, VR can be used to:

  • Guide breathing and relaxation to calm the nervous system

  • Offer gentle trunk and limb movements in a safe, controlled environment

  • Improve focus and motivation for rehab exercises

  • Help overcome fear of movement by turning therapy routines into interactive sessions

How VR fits into an ESR-style pathway

  • In the hospital

    • Short VR sessions focused on pain relief, breathing, and very small movements as allowed

  • At home

    • VR-based rehab programs that coach posture, balance, and core control

    • Progress tracked through telemedicine visits with NPs and rehab providers

When VR is blended with chiropractic alignment work, physical therapy, and functional training, patients get a layered support system: drug-sparing pain control plus active, engaging movement practice that builds real-world strength and confidence. games.jmir.org+2Wiley Online Library+2

How an Integrated Spine Clinic Might Deliver ESR-Style Care

A modern integrative spine clinic that follows ESR principles typically:

  • Uses evidence-based ERAS protocols as the backbone for spine surgery preparation and recovery PMC+2PMC+2

  • Pairs chiropractors and nurse practitioners with surgeons, therapists, and nutrition professionals

  • Offers telemedicine follow-ups to check pain, mobility, and red flag symptoms

  • Incorporates chiropractic rehab once the surgeon clears manual care

  • Adds VR-based training or tech-supported exercises for patients who benefit from guided, at-home practice

Clinics like Dr. Jimenez’s Injury Medical & Chiropractic Clinic in El Paso are built around this kind of multidisciplinary model, bringing together chiropractic, nurse practitioner care, functional medicine, and performance training to support spine and nerve patients throughout the full recovery journey. personalinjurydoctorgroup.com+3El Paso, TX Doctor Of Chiropractic+3American Academy of Anti Aging Medicine+3

Practical Tips for Patients Preparing for Spine Surgery

If you are considering or already scheduled for spine surgery, you can ask your team about ESR-style care and also take steps on your own.

Questions to ask your surgeon or NP

  • “Do you use an Enhanced Recovery or ERAS pathway for spine surgery?”

  • “What non-opioid options will be part of my pain plan?”

  • “How soon after surgery will I sit up and walk?”

  • “Can I work with chiropractic or physical therapy as part of my rehab, and when would that start?”

  • “Is VR-based pain control or home rehab available in your program?”

Ways to strengthen your body and mind beforehand

  • Stay as active as your pain and safety allow—short walks, gentle stretching, and breathing drills

  • Focus on protein-rich, nutrient-dense foods and discuss supplements with your providers

  • If you smoke or vape, ask for help quitting as early as possible

  • Practice simple relaxation or mindfulness exercises you can reuse after surgery

What to report quickly after discharge

  • New or worsening leg weakness, bowel or bladder changes, or strong numbness

  • Fever, spreading redness, or drainage at the incision

  • Pain that stays out of control despite following your plan

Take-Home Message

Enhanced Surgical Recovery for spine surgery is about more than getting out of the hospital quickly. It is a coordinated, evidence-based pathway that:

  • Uses multimodal, opioid-sparing pain management

  • Optimizes nutrition and prehabilitation before surgery

  • Encourages early feeding and early walking

  • Relies on nurse practitioners to coordinate complex care

  • Integrates chiropractic rehab to restore alignment, motion, and function

  • Adds modern tools like virtual reality to reduce pain and boost engagement

When these pieces work together, many patients experience less opioid use, shorter hospital stays, and a smoother path back to movement, work, and the activities that matter most.

References

Bansal, T., et al. (2022). Enhanced recovery after surgery (ERAS) protocol in spine surgery. Global Spine Journal. PMC

Band, I. C., et al. (2022). Enhanced Recovery After Surgery Protocol in Minimally Invasive Lumbar Fusion Surgery Reduces Length of Hospital Stay and Inpatient Narcotic Use. World Neurosurgery. Europe PMC+1

Bohl, D. D., et al. (2016). Malnutrition predicts infectious and wound complications after posterior lumbar fusion. Spine. PubMed

Chang, H. K., et al. (2020). Less opioid consumption with enhanced recovery after lumbar fusion. Spine. PMC

El-Samadicy, A. A., et al. (2024). Association of malnutrition with surgical and hospital outcomes in spine surgery. Journal of Clinical Medicine. MDPI

Hu, Y., et al. (2023). Preoperative low protein malnutrition and postoperative complications after spinal surgery: A systematic review and meta-analysis. Clinical Spine Surgery. PubMed

Lu, Y., et al. (2023). Enhanced recovery after microdiscectomy: Reductions in opioid use, length of stay and cost. BMC Surgery. PMC

Mirunalini, G., et al. (2025). Comparison of enhanced recovery after surgery guideline-based multimodal analgesia with morphine analgesia for length of stay after spine instrumentation surgeries. Spine Journal. PMC+1

Naftalovich, R., et al. (2022). Enhanced Recovery After Surgery protocols for major spine surgery. Journal of Clinical Medicine. PMC

Viderman, D., et al. (2023). Virtual reality for pain management: An umbrella review. Journal of Clinical Medicine. PMC

Malik, A., et al. (2024). Virtual reality for postoperative pain management. Current Opinion in Anaesthesiology. PubMed

Specht, B. J., et al. (2023). Virtual Reality after Surgery—A Method to Decrease Pain. The American Surgeon. SAGE Journals

Payne, O., et al. (2022). Virtual reality and its use in post-operative pain following laparoscopic surgery. Scientific Reports. Nature

Zhang, T., et al. (2024). Virtual Reality Therapy for the Management of Chronic Spinal Pain. JMIR Serious Games. games.jmir.org

Zitti, M., et al. (2025). Effectiveness of virtual reality environment for pain management in musculoskeletal conditions: A meta-analysis. Musculoskeletal Care. Wiley Online Library

Active Health Center. (2025). Rehabilitation after surgery: Integrating chiropractic care into recovery. Active Health and Wellness Center

Dallas Accident & Injury Rehab. (2024). Integrating chiropractic care with other treatments. dallasaccidentandinjuryrehab.com

Perry Family Chiropractic. (2024). Comprehensive guide to chiropractic rehabilitation. Joe Perry

Essential Chiropractic. (2024). The role of chiropractic care in post-surgery recovery: A complete guide. Essential Chiropractic

Dr. Alexander Jimenez. (n.d.). About | El Paso, TX Chiropractor | Dr. Alexander Jimenez D.C.. El Paso, TX Doctor Of Chiropractic

Dr. Alexander Jimenez. (n.d.). Board Certified Nurse Practitioner (FNP-BC) Dr. Alex Jimenez DC, APRN, FNP-BC. El Paso, TX Doctor Of Chiropractic

A4M. (n.d.). Dr. Alex Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP. American Academy of Anti Aging Medicine

Clinical Setting Approaches to Consider for Pain Management

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

Uncover the importance of a comprehensive clinical setting in pain management and its impact on patient care.

Understanding Pain: Causes, Categories, and Effective Management Strategies

Millions of people all over the world are in pain, which can range from mild to severe. Environmental factors can have a big effect on how pain develops, especially in the muscles and joints, where things like stress or changes in the weather can make symptoms worse or even cause them. This in-depth book looks at the different types of pain, the reasons for it, and how doctors treat it in clinical settings using both surgical and non-surgical methods. It also gives examples from everyday life. We look into integrative methods that promote natural healing and stop chronic problems with the help of professionals like Dr. Alexander Jimenez, DC, APRN, FNP-BC.

Studies indicate that pain is not solely a result of physical injury; environmental factors, including pollution or humidity, may heighten the body’s sensitivity. It looks like these problems can be solved with targeted therapy and changes to one’s lifestyle. Research indicates that a comprehensive approach, combining natural remedies with medical therapies, empowers individuals to regain control of their health.

Key Insights on Pain and Its Management

  • Environmental Triggers Are Common: Factors such as cold temperatures or air pollution can trigger inflammation in muscles and joints, increasing the risk of pain.
  • Pain Comes in Many Forms: From acute, sharp stabs to chronic, dull aches, understanding the categories helps choose the right treatment.
  • Clinical Care Varies: Specialists use non-surgical options such as exercise and acupuncture for many cases, reserving surgery for severe cases.
  • Integrative Methods Work Well: Experts like Dr. Jimenez show how chiropractic care and massage can address root causes, fostering natural recovery.

Pain management in clinics follows guidelines that prioritize patient safety and effectiveness, as outlined in resources on defining and managing pain (U.S. Department of Justice, Drug Enforcement Administration, 2023).

—

Pain affects everyone differently, but understanding its roots can empower better handling. This article expands on the biology of pain, environmental influences, categories, and management techniques, incorporating clinical observations from professionals like Dr. Alexander Jimenez. We’ll cover detailed examples, case studies, and tables to make the information accessible and actionable.

The Biology of Pain: How It Develops in the Body

Pain starts as a protective mechanism. When the body detects harm, nerves send signals to the brain, which processes them as pain to prompt action, like pulling away from heat. However, this system can go awry, especially with environmental factors involved.

Nociceptors, the body’s pain sensors, are found in skin, muscles, joints, and organs. They respond to stimuli such as temperature and pressure. When activated, they trigger inflammation, which can swell tissues and press on nerves, amplifying discomfort (International Association for the Study of Pain, 2022). In muscles, this might cause tightness or spasms; in joints, it leads to stiffness or swelling.

Chronic pain, lasting over three months, often persists beyond the initial injury due to sensitized nerves. This sensitization lowers the pain threshold, making everyday activities hurtful (International Association for the Study of Pain, 2022). For instance, a minor joint strain can progress to ongoing arthritis if environmental stressors, such as humidity, exacerbate inflammation.

How Pain Affects Muscles and Joints Specifically

Muscles, made of fibers that contract for movement, can develop pain from overuse or tension. Environmental factors cause micro-tears or inflammation, leading to conditions like myalgia. Joints, cushioned by cartilage and synovial fluid, suffer when pressure changes cause fluid shifts, resulting in arthritis-like pain (Arthritis Foundation, 2024).

Case Study: A 45-year-old office worker experiences shoulder pain from poor ergonomics (static posture) combined with stress, leading to muscle knots and joint misalignment. Over time, this evolves into chronic upper back pain, affecting daily life.

Environmental Factors Contributing to Pain Development

Environmental factors are crucial in the onset and progression of pain, especially in muscles and joints. These factors interact with biology, making some people more susceptible.

Weather and Climate Influences

Weather changes significantly impact pain. Low temperatures constrict blood vessels, reducing flow to muscles and causing stiffness. High humidity increases joint fluid pressure, leading to swelling and ache (Arthritis Foundation, 2024). Barometric pressure drops before storms can trigger migraines or joint pain by altering tissue expansion.

Examples:

  • In osteoarthritis, patients report worse knee pain during cold, damp weather due to increased joint rigidity (PMC, 2025a).
  • Fibromyalgia sufferers experience muscle flares from temperature swings, with cold lowering pain thresholds by 11.3°C compared to healthy individuals (PMC, 2025a).

Studies show modest correlations between pain and humidity, pressure, and wind speed (Arthritis Foundation, 2024). For muscles, cold induces spasms; for joints, humidity exacerbates inflammation.

Stress and Psychosocial Elements

Stress releases cortisol, promoting inflammation that affects muscles and joints. Chronic stress from work or life events heightens pain perception, leading to tension headaches or back pain (MDPI, 2022). Low social support or discrimination correlates with thicker brain structures involved in pain processing, such as the insula, making discomfort more intense (Nature, 2024).

Examples:

  • Job insecurity causes muscle tension in the neck and shoulders, evolving into chronic pain.
  • Discrimination experiences are associated with greater hippocampal volume and greater pain in patients with knee osteoarthritis (Nature, 2024).

Pollution and Toxins

Air pollution, including particulates and toxins such as acrolein, increases inflammation, worsening joint pain in rheumatic diseases (ScienceDirect, 2024a). Smoking aggravates arthritis by activating immune cells, predicting higher pain in spinal injuries (ScienceDirect, 2024a).

Examples:

  • Urban dwellers exposed to pollution have more emergency visits for joint pain.
  • Vitamin D deficiency due to reduced sunlight exposure is associated with muscle hypersensitivity (ScienceDirect, 2024a).

Work and Lifestyle Environments

Poor ergonomics, such as prolonged sitting, strains muscles and joints, leading to musculoskeletal pain (MDPI, 2022). Repetitive tasks lead to back pain by reducing movement variability (IASP, n.d.a).

Examples:

  • Factory workers develop joint pain from repetitive lifting.
  • Sedentary lifestyles in air-conditioned offices can cause dry-air-related stiffness.

Sociocultural Factors

Lower income and education are associated with higher pain levels due to limited access to healthy environments (Nature, 2024). Household size and employment status explain variance in pain-related brain structures.

To mitigate, strategies include weather-appropriate clothing, stress management, and pollution avoidance. Tables below summarize factors.

Environmental Factor Description Impact on Muscles Impact on Joints Examples
Weather (Temperature) Changes in ambient heat/cold Constriction, spasms Stiffness, reduced mobility OA knee pain in cold
Humidity High moisture levels Swelling, tension Fluid pressure increase Arthritis flares in damp weather
Stress Psychosocial pressures Tension, knots Inflammation from cortisol Neck pain from job stress
Pollution Air toxins Inflammation, hypersensitivity Rheumatic exacerbations Joint pain in urban areas
Work Conditions Ergonomic issues Strain, fatigue Misalignment Back pain from sitting

Deeper Dive into Physicochemical Factors

Physicochemical factors, such as pollution and toxins, directly alter pain pathways. Air pollution exacerbates neuropathic pain by sensitizing nerves (ScienceDirect, 2024a). Toxic compounds such as 4-HNE activate receptors, triggering neurogenic inflammation in joints.

Biological factors, such as viral infections, lead to arthritis-like joint pain (ScienceDirect, 2024a). Smoking induces hyperalgesia through serotonergic changes.

Psychosocial factors, such as stress, promote chronicity, while environmental enrichment reduces pain by lowering stress (ScienceDirect, 2024a).

Case Study: A patient with rheumatoid arthritis experiences worse joint pain during pollution spikes, managed by indoor air filters and an anti-inflammatory diet.

Exploring Integrative Medicine- Video

Exploring Integrative Medicine | El Paso, Tx (2024)

Categories of Pain: Descriptions and Examples

Pain is classified by duration, cause, and location to guide treatment (Healthline, 2018).

Acute Pain

Short-term, lasting days to weeks, from injury. Sharp or intense, it alerts the body (Healthline, 2018).

Examples:

  • Muscle strain from lifting heavy objects.
  • Joint pain from a sprained ankle.

Chronic Pain

Lasts months or years, often without a clear cause. Mild to severe, impacting life (Healthline, 2018).

Examples:

  • Low back pain from poor posture.
  •  Arthritis causes ongoing joint pain.

Nociceptive Pain

From tissue damage, activating nociceptors. Acute or chronic (WebMD, 2025).

Subtypes:

  • Somatic: Skin, muscles, bones. Aching or throbbing.
    • Examples: Muscle pull, joint fracture.
  • Visceral: Organs. Dull, cramping.
    • Examples: Appendicitis, but it can also refer to muscle pain.

Neuropathic Pain

From nerve damage. Burning, tingling (WebMD, 2025).

Examples:

  • Diabetic neuropathy in the feet (joint-related).
  • Sciatica from spinal nerve compression (muscle/joint).

Other Categories (IASP Definitions)

  • Allodynia: Pain from non-painful stimuli, e.g., light touch on sunburned muscle (IASP, 2022).
  • Hyperalgesia: Amplified pain from normal stimuli, e.g., pinprick on an inflamed joint.
  • Nociplastic Pain: Altered nociception without damage, e.g., fibromyalgia muscle pain.
Category Duration Cause Sensation Muscle/Joint Example
Acute Short Injury Sharp Strained hamstring
Chronic Long Ongoing Dull Chronic knee arthritis
Nociceptive Somatic Varies Tissue Aching Bone fracture joint pain
Neuropathic Varies Nerve Burning Sciatica leg muscle
Nociplastic Chronic Altered processing Widespread Fibromyalgia joint tenderness

Case Study: An athlete with acute nociceptive pain from a joint sprain transitions to chronic pain if left untreated, demonstrating category evolution.

Pain Management in Clinical Settings

Healthcare specialists follow evidence-based rationale for pain management, emphasizing multimodal approaches to minimize risks like addiction (SAMHSA, 2024). The MATE Act requires training on safe prescribing, focusing on opioid use disorders and pain treatment (DEA, 2023).

Non-Surgical Therapies

These are first-line for many, using meds, therapy, and complementary methods.

  • Medications: NSAIDs for inflammation, acetaminophen for mild pain (NEJM, 2019).
  • Physical Therapy: Exercises strengthen muscles and improve joint mobility.
  • Complementary: Acupuncture and massage reduce tension (PMC, 2024).
  • Behavioral: Mindfulness for stress-related pain.

Clinical rationale: Reduces opioid reliance, promotes natural healing (ScienceDirect, 2024b).

Examples: Massage post-injury eases muscle tension; breathing techniques lower anxiety in the clinic.

Surgical Therapies

For severe cases, such as joint replacement. Post-op management includes multimodal analgesia (JAMA, 2021).

  • Opioids: Short-term for breakthrough pain.
  • Non-Drug: Music therapy reduces opioid needs by 31% (PMC, 2024).

Rationale: Balances relief with safety, per guidelines (DEA, 2023).

Therapy Type Examples Benefits Clinical Rationale
Non-Surgical Meds NSAIDs Reduce inflammation Low risk for chronic pain
Physical Therapy Exercises Strengthen muscles Prevents long-term weakness
Surgical Post-Op Opioids + Music Pain relief Minimizes addiction risk

Case Study: Patient with joint pain undergoes non-surgical acupuncture, avoiding surgery.

Insights from Dr. Alexander Jimenez

Dr. Jimenez, with 30+ years in chiropractic and functional medicine, observes correlations such as perimenopausal estrogen drops causing joint pain or TBI leading to posture issues and muscle aches (LinkedIn, n.d.; DrAlexJimenez.com, n.d.).

His integrative approach addresses causes:

  • Targeted Exercise: Rehab programs build strength and prevent recurrence.
  • Massage Therapy: Relieves soft tissue tension.
  • Acupuncture: Promotes healing in sciatica.

Prevents long-term problems through nutrition and monitoring (DrAlexJimenez.com, n.d.).

Case Study: TBI patient regains mobility via chiropractic adjustments and exercises.

Prevention and  Future Trends

Prevention involves environmental awareness, regular physical activity, and a healthy diet. Future trends include wearables for trigger monitoring.

This guide, drawing from diverse sources, shows pain as manageable with informed care.

Conclusion: Embracing a Future Free from Chronic Pain

Pain is a complex signal influenced by biology, environment, and lifestyle, as we have covered in this lengthy text. It is much more than a fleeting discomfort. Understanding these things empowers us, from the distinctions between nociplastic, neuropathic, and nociceptive pain to how pollution and barometric pressure may cause muscles and joints to expand. According to the American College of Surgeons et al. (2024) recommendations, proactive, multimodal approaches in both surgical and non-surgical settings are highly valued for clinical pain management. These approaches aim to alleviate symptoms and prevent the onset and worsening of chronic illnesses.

Healthcare personnel are crucial in this situation. They use ERAS procedures to aid in healing after surgery and integrative therapies to help individuals feel better every day. In El Paso, Dr. Alexander Jimenez, DC, APRN, FNP-BC, has shown that addressing the root causes with focused workouts, massage therapy, chiropractic adjustments, and acupuncture promotes the body’s natural healing process and averts long-term issues. His case correlations show that while environmental stresses, including metabolic imbalances or repeated work pressures, often cause chronic pain, they may be lessened with evidence-based, individualized therapies.

Restoring equilibrium and enhancing general well-being are the ultimate objectives of effective pain management, not masking the issue. You may end the cycle of suffering by determining the environmental reasons for your pain, accurately categorizing it, and looking for all-encompassing answers. If you make the proper decisions and seek professional help, you may still have a more mobile, healthy, and contented life regardless of how long you’ve experienced joint pain or how recently you were injured. Consult a professional immediately, implement your own strategy, and begin a better, less agonizing future.

References

Self-Massage Tools for Chiropractic Patients Benefits

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Self-Massage Tools for Chiropractic Patients Benefits
Happy modern grandmother using percussive massage gun for muscles, doing self-massage

Home Recovery Made Easier: Self-Massage Tools for Chiropractic Patients

Self-Massage Tools for Chiropractic Patients Benefits
percussive massage gun with attachments

Self-massage tools can be powerful partners to integrative chiropractic care when they’re used safely and with guidance. Chiropractors often suggest simple devices—such as foam rollers, massage balls, massage guns, and trigger-point tools—to help patients keep muscles relaxed, support spinal adjustments, and speed recovery between visits (AnteriorAssist, 2024; High Amplitude Health Chiropractic, 2025). Redison Tech LLC+1

This article explains how these tools work, how they fit into Dr. Alexander Jimenez’s integrative approach, and how to use them wisely. Hence, they enhance your chiropractic care rather than replace it.

Important: This is general education, not personal medical advice. Always check with your chiropractor or healthcare provider before starting any new self-massage routine—especially if you have recent injuries, nerve symptoms, or medical conditions.

1. How Self-Massage Supports Integrative Chiropractic Care

Integrative chiropractic care combines spinal and joint adjustments with soft-tissue work, rehab exercise, functional medicine, and—in Dr. Jimenez’s clinic—nurse practitioner medical insight and telemedicine support (Jimenez, n.d.). El Paso, TX Doctor Of Chiropractic

In this model, self-massage tools are used to:

  • Relax tight muscles that keep pulling joints out of alignment

  • Improve circulation so nutrients and oxygen can reach healing tissues

  • Support myofascial release, easing the connective tissue around muscles

  • Extend the benefits of adjustments between appointments

  • Give patients more control over their recovery at home (Outside Online, 2025; RAD Roller, n.d.). Outside Online+1

In Dr. Jimenez’s practice, patients recovering from personal injuries, sports injuries, or chronic pain are often taught self-massage strategies as part of a larger plan that may also include spinal adjustments, corrective exercise, anti-inflammatory nutrition, and medical oversight when needed (Jimenez, n.d.). El Paso, TX Doctor Of Chiropractic

2. How Self-Massage Works: Myofascial Release and Circulation

Most self-massage tools work by creating pressure and movement over muscles and fascia. This is often called self-myofascial release (SMR).

Research and clinical experience show that SMR can:

  • Increase joint range of motion without harming performance

  • Help reduce delayed-onset muscle soreness (DOMS) after exercise

  • Decrease perceived muscle tightness and tenderness (Douglass, 2025). BarBend

Manual therapy and myofascial techniques, when used correctly, can reduce pain and improve mobility in conditions such as low back pain and other musculoskeletal issues (Topaloğlu et al., 2025; Spine-health, 2022). PMC+1

Why chiropractors like SMR tools:

  • They help warm up muscles before adjustments

  • They make it easier for joints to move correctly

  • They can stabilize progress between visits when combined with exercise and ergonomic changes

A key point: too much pressure or poor technique can irritate tissues instead of helping them. Many clinics, including Dr. Jimenez’s, teach patients proper self-massage positions and limits so they don’t overdo it (Jimenez, n.d.; High Amplitude Health Chiropractic, 2025).El Paso, TX Doctor Of Chiropractic+1

3. Foam Rollers: The Foundation Self-Massager

Foam rollers are long cylinders of dense foam used under the body to create pressure while you roll slowly over tight areas.

Main benefits

Foam rollers can:

  • Help release tight muscles in the hips, thighs, glutes, and upper back

  • Improve blood flow and tissue hydration

  • Support better posture and spinal mechanics when combined with adjustments and exercise

  • Reduce muscle soreness and improve flexibility over time (Douglass, 2025; AnteriorAssist, 2024). BarBend+1

High Amplitude Health Chiropractic notes that a foam roller is often the go-to self-massage tool for low-back–related problems. Still, the work is mostly done on the hips, glutes, hamstrings, quadriceps, IT band, and adductors, rather than directly on the lumbar spine (High Amplitude Health Chiropractic, 2025). High Amplitude Health Chiropractic

How chiropractors commonly suggest foam rolling (general principles)

  • Focus on muscles around the spine instead of pressing hard on the bones

  • Use slow, controlled rolling—not fast bouncing

  • When it feels like “good pressure,” you’re usually in a safe range; sharp or burning pain is a stop signal

Examples of areas often targeted:

  • For low-back–related pain:

    • Glutes

    • Hamstrings

    • Quadriceps

    • IT band

    • Hip flexors

  • For upper back and posture:

    • Thoracic spine (mid-back)

    • Lats

    • Pec stretch (lying lengthwise on the roller)

In Dr. Jimenez’s integrative care plans, foam rollers are often used by:

  • Patients recovering from motor vehicle accidents

  • Athletes working on posture and movement patterns

  • Office workers with sitting-related stiffness

He frequently pairs foam rolling with corrective exercises, breathing training, and ergonomic coaching so that muscles and joints can relearn healthier patterns, not just for temporary relief (Jimenez, n.d.). El Paso, TX Doctor Of Chiropractic

4. Massage Balls and Lacrosse Balls: Small Tools, Big Effects

Massage balls (rubber, inflatable, or textured) and lacrosse balls are excellent for targeted trigger points—tight “knots” you can feel with your fingers.

What the evidence and clinicians say

  • A chiropractor-written guide recommends a massage ball (4–5 inches, firm but slightly flexible) as the best self-massage tool for upper back and neck tension (High Amplitude Health Chiropractic, 2025). High Amplitude Health Chiropractic

  • Outside Online notes that a simple lacrosse ball can work deeply into areas like the glutes, trapezius, chest, hamstrings, and feet, almost like dry needling or deep tissue massage when used consistently (Jhung, 2025). Outside Online

  • RAD Roller’s tools are designed to fit alongside the spine or under specific muscles to encourage safe, precise self-myofascial release (RAD Roller, n.d.). RAD Roller

Good uses for massage balls

  • Between the shoulder blades and upper back (against a wall)

  • Along the side of the hip and glutes

  • Under the foot for plantar fascia tightness

  • Around the shoulder and chest to open posture

Simple ball routine (example):

  • 30–60 seconds on each tender spot

  • Slow breathing while you hold or roll gently

  • Stop if you feel sharp, zapping, or radiating pain

In Dr. Jimenez’s experience, ball work is especially beneficial for:

  • Desk workers with tight chests and upper backs

  • Athletes with glute and hip trigger points that keep pulling the pelvis out of balance

  • Post-injury patients who need gentle, precise work once acute inflammation has calmed

5. Massage Sticks and Canes: Easy Control, Great Reach

Massage sticks

Massage sticks are handheld rollers you press along muscles with your arms.

High Amplitude Health Chiropractic recommends a massage stick as the best self-massage tool for the calves and lower leg because it allows strong compression without requiring lying on the floor (High Amplitude Health Chiropractic, 2025). High Amplitude Health Chiropractic

Great for:

  • Calves (for runners and people who stand all day)

  • Shins

  • Quads

  • Outer thigh / IT band

Cane-style trigger-point tools

Tools like the Body Back Buddy or similar trigger-point canes allow you to hook around your shoulder and press directly into upper back and neck knots (Fields, 2025; Jhung, 2025). The Spruce+1

Typical benefits:

  • Reach tight spots in the mid-back without help

  • Apply pressure with leverage instead of finger strength

  • Work on the base of the skull and upper neck for tension headaches (with gentle pressure)

Dr. Jimenez often sees that these tools work well for:

  • People who can’t easily lie on the floor to foam roll

  • Patients with hand or wrist pain who struggle to use classic massage balls

  • Telemedicine patients who need simple tools that travel easily

6. Percussion Massage Guns: When Vibration Helps

Massage guns deliver rapid, low-pressure pulses into muscle tissue. They’ve become extremely popular with athletes, weekend warriors, and physical therapy patients.

What research and reviewers suggest

  • BarBend’s comparison of massage guns vs. foam rollers notes that both tools can help with tension, range of motion, and soreness, but they work differently:

    • Foam rollers provide sustained pressure using your body weight

    • Massage guns use percussive vibration over a smaller area (Douglass, 2025). BarBend

  • Another BarBend review reports that massage guns may improve blood flow, flexibility, and perceived pain, especially when paired with stretching and strengthening (Asti as cited in BarBend, 2024).BarBend

  • Consumer tests from The Spruce highlight that quality massage guns with multiple intensity settings and attachments allow people to customize treatment to their comfort level (Fields, 2025).The Spruce

How chiropractors often recommend using massage guns

Common general tips you’ll hear in clinics and from rehab pros:

  • Start on a low setting and move slowly

  • Aim for 10–15 minutes total on a region, not continuous all day (Fields, 2025) The Spruce

  • Avoid using them directly over:

    • The spine or bony areas

    • Fresh bruises

    • Open wounds

    • Suspected fractures or acute injuries

Many chiropractors (including Dr. Jimenez) consider massage guns beneficial when:

  • Used after adjustments and stretching to encourage circulation

  • Focused on large muscle groups like the quads, glutes, and hamstrings

  • Paired with core and posture training so the nervous system learns more efficient movement patterns (Jimenez, n.d.; Douglass, 2025). El Paso, TX Doctor Of Chiropractic+1

7. Other Helpful Self-Massage Tools

Beyond the big four (foam rollers, balls, sticks, and guns), there are many other self-care options:

  • Textured or vibrating foam rollers – add stimulation that can feel more like a deep-tissue massage (IDEA Health & Fitness Association, 2022). IDEA Health & Fitness Association

  • Myofascial scraping or IASTM tools – rigid tools used with lotion to glide over fascia; best taught by a professional first (Outside Online, 2025). Outside Online

  • Back massager cushions and handheld percussive devices – useful for people who prefer set-it-and-forget-it devices rather than floor work (Fields, 2025). The Spruce

Professional suppliers, like ScripHessco, carry a wide range of balls, rollers, massage sticks, and handheld tools commonly used in chiropractic and massage settings, underscoring their central role in musculoskeletal care (ScripHessco, n.d.). scriphessco.com

8. How Chiropractors Integrate Self-Massage Tools into Care

Chiropractors don’t just hand a foam roller to patients and walk away. In modern integrative practices, self-massage tools are usually included as part of a structured plan:

Typical clinic flow:

  • Assessment

    • Posture, joint motion, muscle strength, and neurologic tests

    • Imaging or specialist referral if red flags are present

  • In-office treatment

    • Manual or instrument-assisted adjustments (e.g., Activator®, ArthroStim®, Impulse Adjusting Instrument) for precise spinal corrections (ChiroTouch, 2025; Current Chiropractic, n.d.). ChiroTouch+1

    • Soft tissue work and rehab exercises

  • Home program

    • Specific foam roller zones to target

    • Massage ball or lacrosse ball points to work on

    • Stick or gun usage with clear time and intensity limits

AnteriorAssist’s overview of chiropractic tools notes that foam rollers, massage balls, and handheld massagers are commonly recommended to help maintain spinal alignment and muscle balance outside the clinic (AnteriorAssist, 2024). Redison Tech LLC

In Dr. Jimenez’s integrative model, these home tools are often taught:

  • In person so that patients can feel the correct pressure and body positions

  • Via telemedicine video visits, where he or his team can watch a patient foam roll or use a massage gun and correct technique in real time (Jimenez, n.d.). El Paso, TX Doctor Of Chiropractic

9. Safety Tips: When to Stop and Call Your Chiropractor

Self-massage tools are helpful, but they’re not risk-free. Spine and myofascial experts warn that aggressive or poorly guided self-treatment can sometimes worsen pain or irritate nerves (Spine-health, 2022; Hospital for Special Surgery, 2021). Spine-health+1

General safety checklist

Stop and contact your chiropractor or medical provider if you notice:

  • Sharp, electric, or radiating pain

  • Numbness, tingling, or weakness

  • Swelling, bruising, or warmth that quickly worsens

  • New headache, dizziness, or vision changes with neck work

  • New loss of bladder or bowel control (emergency—go to ER)

Common “don’ts”:

  • Don’t roll or gun directly over the spine or joints

  • Don’t use heavy pressure on acute injuries or fresh bruises

  • Don’t keep rolling through intense pain thinking “more is better”

  • Don’t replace professional evaluation with gadgets if pain is new, severe, or unexplained

Dr. Jimenez often reminds patients that self-massage tools are partners, not replacements, for proper diagnosis and care—especially in personal injury, neurological issues, or complex chronic pain cases (Jimenez, n.d.). El Paso, TX Doctor Of Chiropractic

10. Building a Simple Daily Self-Massage Routine

Here’s a sample structure many patients find helpful once cleared by their chiropractor:

Before your day (5–10 minutes)

  • 1–2 minutes: gentle thoracic foam rolling

  • 1–2 minutes: hip or glute rolling

  • 1–2 minutes: calf or foot work with a ball or stick

After work or training (10–15 minutes)

  • 3–5 minutes: foam roll quads, hamstrings, IT band

  • 3–5 minutes: ball work on upper back and glutes

  • 3–5 minutes: massage gun or stick on any stubborn areas (if approved)

Weekly check-ins

  • Note which muscles always feel tight

  • Track how you feel after chiropractic adjustments when you stay consistent with the tools

  • Review technique with your chiropractor or via telehealth if pain patterns change

In an integrative setting like Dr. Jimenez’s clinic, this daily routine is often combined with:

  • Targeted strength and stability training

  • Anti-inflammatory nutrition and hydration strategies

  • Sleep and stress-management plans to help the body recover fully

Conclusion

Self-massagers—foam rollers, massage balls, massage sticks, percussion guns, and trigger-point tools—can strongly complement integrative chiropractic care when used thoughtfully and safely. They help keep muscles relaxed, improve circulation, and maintain the progress you make in the clinic.

The key is guidance and balance:

  • Choose tools that match your body and needs

  • Use them in short, focused sessions

  • Pair them with adjustments, exercise, and healthy habits

  • Always ask your chiropractor or medical provider before starting or changing your routine

With the right plan, these tools put more of your recovery back in your own hands—while staying anchored to expert, integrative care from providers like Dr. Alexander Jimenez, DC, APRN, FNP-BC.

Beyond Medicine: The Power of Chiropractic Care | El Paso, Tx (2023)

References

AnteriorAssist. (2024, September 28). 10 essential chiropractor tools for a healthy back: Your guide to spinal wellness. Redison Tech LLC

ChiroTouch. (2025). The 18 most popular chiropractic tools and equipment. ChiroTouch

Current Chiropractic. (n.d.). Why our chiropractors use the Activator. Current Chiropractic

Douglass, I. (2025, March 18). Massage gun vs. foam roller — Which is better for strength athletes?. BarBend.BarBend

Fields, J. (2025, October 17). After testing a dozen back massagers, here are the best we recommend. The Spruce.The Spruce

High Amplitude Health Chiropractic. (2025). All the best tools to use for self-massage. High Amplitude Health Chiropractic

Hospital for Special Surgery. (2021). Myofascial release therapy. Mayo Clinic

IDEA Health & Fitness Association. (2022). Self-care massage tools for recovery. IDEA Health & Fitness Association

Jhung, L. (2025, September 20). My body is high maintenance. I rely on these five self-massage tools to keep it healthy. Outside Online.Outside Online

Jimenez, A. (n.d.). Dr. Alex Jimenez – Chiropractic and functional medicine insights. El Paso, TX Doctor Of Chiropractic

RAD Roller. (n.d.). Self-care massage tools everybody should own. RAD Roller

ScripHessco. (n.d.). Massage tools. scriphessco.com

Spine-health. (2022). Myofascial release (myofascial therapy). Spine-health

Topaloğlu, S., et al. (2025). [Effectiveness of myofascial release in chronic low back pain: Systematic review] (summary referenced in recovery-tool overviews).PMC

Telemedicine Enhances Nutrition Guidance at Home

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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The lady is engaged in a video telemedicine conference with a doctor via computer, discussing a healthy diet.

How Telemedicine Enhances Nutrition Guidance: An Integrative Approach with Chiropractic and Functional Medicine

Telemedicine Enhances Nutrition Guidance at Home
in-person nutritionist and patient nutrition plan development after online telemedicine consultation

Telemedicine is changing how people get health advice, especially when it comes to eating right. Imagine talking to a doctor from your couch about what foods can help your body feel better. This tech makes it easy for patients to get meal tips without leaving home. It helps with things like creating meal plans just for you, sharing easy-to-follow guides, and even setting up special meals tailored to your health needs. All this makes taking care of your health through food less of a hassle.

In this article, we examine how telemedicine works in nutrition. We focus on combining chiropractic care, which addresses spinal and body alignment, with functional medicine, which explores the root causes of health issues. Together, they use online tools such as video calls, apps, and home tests to provide advice on food, supplements, and daily habits. This way, doctors can check lab results, track your progress, and suggest changes to your exercise or routine, all remotely.

Why does this matter? Many people struggle with health problems like diabetes or pain that food can help manage. Telemedicine breaks down barriers such as travel and busy schedules. It lets experts create plans with foods to eat or avoid, plus tips on sleep and movement. Studies show this approach can lead to better health over time. Let’s dive into how it all comes together.

Understanding Telemedicine Basics

Telemedicine means using tech like video calls or apps to see a doctor without being in the same room. It started growing rapidly due to needs like the pandemic, but now it’s common in everyday care. For nutrition, it means diet experts can talk to you about what to eat from anywhere.

This setup uses different ways to connect:

  • Real-time video chats for face-to-face talks.
  • Apps that track what you eat or your steps.
  • Messages or emails for quick questions.
  • Devices that send data like blood sugar levels straight to the doctor.

It’s safe and private, with secure apps to protect your info. Telemedicine makes health care more reachable, especially if you live far from specialists or have trouble getting around. For nutrition, this means getting meal advice without waiting in a clinic.

How Telemedicine Provides Nutrition Guidance

Telemedicine makes it easier to give nutrition advice by connecting patients and experts online. Patients can share their eating habits, health goals, and even photos of meals through apps. Doctors then create plans tailored to needs, such as weight loss or diabetes management.

One big way it helps is with personalized meal plans. During a video call, a nutritionist asks about your likes, allergies, and daily life. They use this to suggest meals that fit. For example, if you have heart issues, they might plan low-salt options. Apps can even use AI to scan food pics and count calories or nutrients.

It also includes sharing instructional materials. For example, some videos explain how to read food labels, and online classes teach portion sizes. These tools teach you how to make better choices on your own. Group video sessions can cover topics such as healthy cooking, making learning fun, and socializing.

Another key part is organizing medically tailored meals. These are ready-made foods designed for your health condition, such as low-sugar options for diabetes. Telemedicine lets doctors work with delivery services to get these to your door. They check your needs, like allergies, and adjust as you go.

All this convenience helps patients stick to healthy eating. No more long drives to appointments—log in and get support. This leads to better control over health issues through diet.

Here are some examples of telemedicine tools for nutrition:

  • Mobile apps for logging meals and getting instant feedback.
  • Wearable devices that track activity and send data to your doctor.
  • Patient portals where you upload lab results or food diaries.
  • AI chatbots that answer quick questions about recipes or nutrients.

Benefits of Telemedicine for Managing Health Through Nutrition

Managing health problems with food gets simpler with telemedicine. It helps with chronic conditions like diabetes or heart disease by remotely monitoring them. For instance, patients can share glucose readings, and doctors can tweak meal plans right away.

This approach makes care more patient-focused. You set goals together, like eating more veggies, and track progress online. It empowers you to take charge, leading to lasting changes.

Family involvement is a plus, too. Include loved ones in calls to share recipes or guidelines. This way, everyone at home follows the same healthy habits, making it easier to stick with.

Telemedicine also connects you to resources such as food banks and delivery apps for healthy options. If money or access is an issue, doctors can help find programs like SNAP.

In hospitals, technology like patient portals lets you order meals with nutrition information displayed. You track intake and see how it meets goals, even from a bed. This boosts awareness and motivation.

Overall, it’s about making nutrition fit your life. Less stress, more support, better health.

Benefits include:

  • Easier access for rural or busy people.
  • Real-time adjustments to plans.
  • Cost savings from fewer in-person visits.
  • Better outcomes for conditions such as cancer or aging.

The Integrative Method: Combining Chiropractic and Functional Medicine

Chiropractic care aligns the body, including the spine, to help nerves function better. Functional medicine digs into why you’re sick, looking at diet, stress, and genes. Together, they provide full nutrition advice remotely.

This mix uses video calls for talks, home tests for labs, and apps for tracking. Doctors review results online and plan treatments with foods, supplements, and habits to address root causes.

For example, if pain is caused by inflammation, they suggest anti-inflammatory foods such as berries or fish. Supplements like collagen support joints, while magnesium helps sleep—key for healing.

At-home testing means blood draws come to you, then are discussed over the phone. Digital support tracks sleep or steps, letting doctors adjust plans fast.

Video calls cover exercise tips, like walks for energy, or habit changes, like better hydration. It’s holistic—body, mind, food, all linked.

This method heals from the inside out. No guessing alone; ongoing check-ins keep you on track.

Key parts of this integrative telemedicine:

  • Root cause checks with history and tests.
  • Personalized diets avoiding triggers, adding healers.
  • Supplements, if needed, like probiotics for the gut.
  • Lifestyle tweaks for stress or sleep.
  • Progress via secure apps and calls.

Chiropractic boosts this by improving digestion through alignment, helping the body better absorb nutrients. The functional side adds nutrition to prevent issues.

Clinical Observations from Dr. Alexander Jimenez

Dr. Alexander Jimenez, a chiropractor and nurse practitioner, shares insights on using telemedicine for nutrition in integrative care. With over 30 years of experience, he focuses on root causes without drugs or surgery.

He notes that nutrition can fix imbalances in chronic pain or injuries. For example, keto diets reduce inflammation, which can help with sciatica. Telemedicine lets him review patient data remotely, like using wearables, to tailor plans.

In his practice, he combines chiropractic with functional medicine for conditions such as diabetes and autoimmunity. Online assessments create diets with macros and supplements, such as vitamin D for bone health or zinc for healing.

He observes that telemedicine makes care accessible, especially for busy or injured people. Video coaching covers gut health, including probiotics and antioxidants for recovery.

Dr. Jimenez stresses patient empowerment. Through apps, folks track progress, leading to lasting changes in habits like hydration or protein intake for muscles.

His work shows this approach works for menopause, TBI, or weight issues, blending food advice with alignments for full wellness.

Observations include:

  • Nutrition speeds injury recovery.
  • Telehealth bridges gaps for remote patients.
  • Integrative plans prevent chronic diseases.
  • Personalized supplements fix deficiencies.

Real-World Examples and Challenges

Take someone with back pain: A Telemedicine session reviews diet, suggests omega-3s, and tracks via app. Adjustments via video-guided home exercises.

For diabetes, plans include low-carb meals and remote monitoring for better control.

Challenges: Tech access or learning curves. Solutions: Simple apps and training.

The future looks bright with more AI for plans.

Conclusion

Telemedicine transforms nutrition guidance, making it easy and effective. Integrating chiropractic and functional medicine adds depth, fixing roots remotely. With tools like apps and calls, patients can better manage their health through food. Dr. Jimenez’s work proves it works. Try it for convenient care.

The uses of ESSENTIAL FATTY ACIDS | El Paso, Tx (2021)

References

Advanced Integrated Health. (n.d.). Virtual functional medicine consultations and care.

Being Functional. (n.d.). Functional medicine and telehealth: The benefits of virtual care.

BMC Health Services Research. (2020). Engaging hospitalised patients in their nutrition care using technology: Development of the NUTRI-TEC intervention.

El Paso Chiropractic. (n.d.). Nutrition category.

Grove Chiropractic. (n.d.). Integrating chiropractic care with nutrition for optimal wellness.

Jimenez, A. (n.d.). Injury specialists.

Jimenez, A. (n.d.). LinkedIn profile.

The Well-House Chiro. (n.d.). Functional nutrition 101: Heal from the inside out for lasting wellness.

The Well-House Chiro. (n.d.). Functional nutrition & health coaching – Holistic nutritionist in Missouri.

U.S. Department of Health and Human Services. (n.d.). Getting started: Understanding telehealth for nutrition care.

U.S. Department of Health and Human Services. (n.d.). Preparing patients to receive nutrition care using telehealth.

Telemedicine for Sciatica Relief: A Modern Solution

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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A patient consults a chiropractor and nurse practitioner online via telemedicine on how to relieve sciatic nerve pain until they can come to the clinic for a full evaluation and treatment.

Telemedicine for Sciatica: Getting Relief From Home With Integrative Chiropractic Care

Telemedicine for Sciatica Relief: A Modern Solution
A woman experiencing back pain and sciatica consults a chiropractor online via telemedicine.

Understanding Sciatica in Simple Terms

Sciatica is not just “low back pain.” It happens when the sciatic nerve—one of the largest nerves in your body—gets irritated or compressed. This nerve starts in your lower back, travels through your hips and buttocks, and runs down the back of each leg.

When the nerve is irritated, you may feel:

  • Sharp, burning, or electric pain running down one leg

  • Numbness, tingling, or “pins and needles” in the leg or foot

  • Weakness when trying to stand, walk, or lift the leg

  • Pain that worsens with sitting, coughing, or bending

Common causes include herniated discs, spinal stenosis, degenerative disc disease, or muscle tightness around the nerve. Chiropractic care and physical therapy are often used to treat sciatica and support recovery. HealthCentral+1

Because sciatica can make every step painful, even getting to a clinic can be challenging. This is why telemedicine—seeing your providers through secure video or phone—has become such an important tool for managing sciatica safely and conveniently. NJ Spine & Orthopedic+1

What Is Telemedicine for Spine and Sciatic Nerve Pain?

Telemedicine (also called telehealth) means you connect with your doctor, nurse practitioner, or chiropractor through video visits, secure messaging, or phone instead of going to the office in person. NJ Spine & Orthopedic

Spine and pain clinics now use telemedicine to:

  • Do first-time consultations for back and leg pain

  • Review imaging results such as MRIs or X-rays

  • Adjust medications and track side effects

  • Guide home exercises and ergonomics

  • Decide when you really need an in-person visit or emergency care

At major spine centers, telemedicine has become a core part of care for back and leg pain, allowing patients to get expert help without always needing to travel, especially when no procedure or imaging is required that day. UT Southwestern Medical Center+1

Key Benefits of Telemedicine for Sciatica

Clinics that specialize in spine care describe several major benefits of telemedicine for people with back pain and sciatica: Southeast Texas Spine+1

  • Better access to care – You can see a specialist even if you live far away or have trouble walking, driving, or sitting in a car.

  • Convenience and time savings – No traffic, parking, or waiting room. You can connect from home, work, or even while traveling.

  • Continuity of care – Easy follow-ups help your provider monitor your progress and adjust your treatment plan.

  • Less exposure to illness – You can stay home if you are at higher risk from infections or recovering from surgery.

  • More comfortable communication – Many patients feel more relaxed speaking from their own environment and can show how they sit, sleep, or work.

For sciatica, this convenience is especially valuable because pain often worsens with prolonged sitting or driving.

How Telemedicine Helps Diagnose Sciatica

You might wonder, “Can a doctor really figure out what’s wrong with my back and leg just by video?” In many cases, yes. For sciatica without emergency warning signs, a careful telemedicine visit can give a strong working diagnosis and guide next steps. Southeast Texas Spine+1

What Happens in a Telemedicine Sciatica Evaluation?

During a telehealth visit for sciatica, your integrative team (nurse practitioner and chiropractor) can:

  • Take a thorough history

    • When the pain started

    • Where it travels (buttock, thigh, calf, foot)

    • What makes it better or worse

    • Past injuries, surgeries, or medical problems

  • Perform a focused virtual exam

    • Ask you to stand, sit, bend, or walk in front of the camera

    • Watch how you move, shift weight, or guard one side

    • Guide you through simple strength and balance tests

    • Observe your posture and how you sit or work

  • Screen for red-flag symptoms that may require urgent in-person care, such as:

    • Sudden, severe weakness in the leg or foot

    • Loss of control of the bladder or bowels

    • Fever with severe back pain

    • History of cancer, major trauma, or infection risk

  • Order tests when needed

    • X-rays or an MRI of the lumbar spine

    • Blood tests if infection or other causes are suspected

Spine and pain clinics report that many decisions about sciatica—such as whether to start conservative treatment, order imaging, or refer to a specialist—can be made safely through telemedicine, as long as emergency signs are carefully checked. Southeast Texas Spine+2Everlywell+2

Telemedicine and Pain Management for Sciatica

Sciatica is both a nerve problem and a pain problem. Telemedicine pain management brings together remote clinical care and structured follow-up to address both. Everlywell+1

Medication Management From a Distance

A nurse practitioner (NP) or other prescribing provider can use telemedicine to: Everlywell

  • Start or adjust medications such as:

    • Nonsteroidal anti-inflammatory drugs (NSAIDs)

    • Muscle relaxers

    • Neuropathic pain medicines (for nerve pain)

  • Monitor side effects and interactions with other drugs

  • Review how often you take over-the-counter pain medicine

  • Discuss safe short-term versus long-term options

The goal is not just to hand out prescriptions but to use medications as part of a larger plan that addresses the underlying causes—such as poor posture, weak core muscles, or disc problems. Everlywell+1

Non-Drug Pain Strategies via Telehealth

Telemedicine visits also allow providers to focus on non-drug strategies, such as:

  • Heat or ice guidance

  • Gentle stretching routines

  • Activity pacing (finding a balance between rest and movement)

  • Ergonomic changes to your workspace

  • Sleep position coaching

Clinics dedicated to spine care and functional medicine often combine these approaches with physical therapy and integrative treatments to minimize reliance on strong pain medications. Integrative Medical of DFW+2Family Integrative Medicine+2

Integrative Telemedicine: Nurse Practitioner + Chiropractor

Dr. Alexander Jimenez, DC, APRN, FNP-BC, is a dual-licensed chiropractor and nurse practitioner who uses an integrative model every day in his El Paso–based practice. His clinic combines functional and physical medicine with advanced diagnostics to treat complex spine conditions, including severe sciatica syndromes, often using a hybrid telemedicine and in-person approach. El Paso, TX Doctor Of Chiropractic+2a4m.com+2

In a similar integrated telemedicine setup, you might receive care like this:

The Nurse Practitioner can:

  • Take a detailed medical history and review medications

  • Order imaging (MRI, CT, X-rays) when indicated

  • Screen for red flags and coordinate referrals to neurology, orthopedics, or pain specialists

  • Prescribe and adjust medications for pain, muscle spasm, sleep, or mood

  • Monitor blood pressure, blood sugar, and other conditions affected by pain and inactivity

The Chiropractor can:

  • Focus on the mechanical cause of your sciatica (disc, joint, muscle imbalance, posture)

  • Analyze posture and movement patterns through video

  • Demonstrate spinal-safe positions and body mechanics

  • Teach you self-care strategies such as specific stretches, core activation, and hip mobility drills

  • Determine the need for hands-on in-person care and schedule in-office visits accordingly.

Dr. Jimenez’s telemedicine content emphasizes that this hybrid model often includes remote triage and education; in-person visits for hands-on chiropractic and physical therapy when needed; and continued telemedicine for follow-ups, rehab progress checks, lifestyle coaching, and even medico-legal documentation when injuries are related to auto or work accidents. El Paso, TX Doctor Of Chiropractic+1

Chiropractic Telemedicine for Sciatica: What Can Be Done Without Hands-On Care?

While telehealth cannot replace hands-on spinal adjustments, chiropractors can still do a lot for sciatica through video visits. tigardchiropracticautoinjury.com+2Evolve Chiropractic+2

Virtual Chiropractic Support May Include

  • Detailed posture and ergonomics review

    • How you sit at your desk or in your car

    • How you lift, bend, or twist at home or work

  • Guided movement tests

    • Which positions ease your pain (for example, lying on your stomach vs. sitting)

    • Which movements trigger symptoms, to identify the involved structures better

  • Instruction in home-based exercises, such as:

    • Gentle nerve “flossing” movements (only if appropriate)

    • Hip and piriformis stretches

    • Core stability exercises like modified planks or bridges

  • Education on spinal health and long-term prevention

    • How to avoid prolonged sitting without breaks

    • Why certain chairs or mattresses worsen symptoms

    • When to stop exercises and call for help

Articles focusing on chiropractic care for sciatica highlight that a holistic approach addresses not only the pain but also lifestyle, movement patterns, and ergonomics. tigardchiropracticautoinjury.com+2Evolve Chiropractic+2

Telemedicine and Physical Therapy for Sciatica

Physical therapy is a core part of conservative sciatica treatment. Many physical therapy and integrative clinics now use virtual sessions to guide patients through home exercises. Integrative Medical of DFW+2Family Integrative Medicine+2

How Virtual Physical Therapy Sessions Work

In tele-PT visits for sciatica, your therapist can:

  • Watch how you stand, walk, and sit

  • Check if you shift weight away from the painful leg

  • Demonstrate exercises on camera and ask you to copy them

  • Correct your form in real time

  • Progress or scale movements based on how you feel

Physical therapy programs rooted in integrative and functional medicine focus on personalized goals—like walking longer, standing at work without pain, or returning to sports—rather than just “generic back strengthening.” Integrative Medical of DFW+2PMC+2

At-Home Sciatica Strategies Taught Through Telemedicine

Telemedicine makes it easy for your care team to “step into your home” and customize your plan using what you actually have—your chairs, bed, desk, and daily routines.

1. Ergonomics and Remote Work

Many people with sciatica also work long hours at a computer. Poor ergonomics can keep the nerve irritated. Chiropractic and spine articles on remote work pain and ergonomic tips stress: tigardchiropracticautoinjury.com+2HealthCentral+2

Telemedicine providers may coach you to:

  • Use a chair that supports your lower back

  • Keep feet flat on the floor and hips and knees near 90 degrees

  • Avoid crossing your legs or sitting on a wallet or phone

  • Place your screen at eye level to avoid hunching

  • Take movement breaks every 30–60 minutes

2. Simple Movements Often Taught Over Video*

(Always get medical clearance before starting new exercises.)

Your integrated team may show you:

  • Gentle stretching

    • Hamstring stretches without rounding the lower back

    • Piriformis and hip external rotation stretches

    • Hip flexor stretches if prolonged sitting is an issue

  • Core activation exercises

    • Pelvic tilts while lying on your back

    • Bridges to engage glutes and protect the spine

    • Modified side planks for lateral trunk support

  • Position changes

    • How to lie prone (on your stomach) or supported on pillows if extension reduces your pain

    • How to log-roll when getting out of bed

These movements are often enough to reduce nerve irritation when combined with posture changes and gradual activity.

Preparing for a Telemedicine Visit for Sciatica

A little preparation makes your virtual visit smoother and more effective. Spine clinics that specialize in telemedicine share practical checklists for patients getting ready for online appointments. Southeast Texas Spine+2Southeast Texas Spine+2

Before Your Appointment

  • Test your technology

    • Make sure your phone, tablet, or computer camera and microphone work

    • Check your internet connection

    • Download and sign into any required patient portal or app

  • Choose the right space

    • Quiet, private room with enough floor space to stand, walk, and do simple movements

    • Good lighting so your provider can see how you move

  • Gather information

    • List of current medications, supplements, and allergies

    • Any recent imaging reports (MRI, X-ray, CT)

    • Notes about what makes the pain worse or better

    • Questions you want to ask

During the Visit

  • Prop your device so your provider can see your whole body when you stand and move.

  • Wear comfortable clothes that allow easy movement.

  • Be honest about pain levels, fears, and goals—this helps shape the treatment plan.

When Telemedicine Is Not Enough

Telemedicine is powerful, but not perfect. There are times when in-person visits or emergency care are necessary. Spine specialists and telehealth guidelines agree that you should seek hands-on care or urgent evaluation if you develop: Southeast Texas Spine+2NJ Spine & Orthopedic+2

  • Sudden or progressive leg weakness

  • Loss of bladder or bowel control

  • Numbness around the groin (“saddle anesthesia”)

  • Fever, chills, or unexplained weight loss with severe back pain

  • Recent major trauma (fall, car crash)

In these cases, telemedicine can still help by quickly triaging your symptoms and directing you to the right emergency department or imaging center. Still, it should not be the only form of care. Most clinics that use telehealth for spine pain recommend a hybrid plan combining: El Paso, TX Doctor Of Chiropractic+1

  • Telemedicine for history, education, and follow-ups

  • In-person visits for physical exams, chiropractic adjustments, and certain physical therapy techniques

  • Ongoing virtual visits for rehab progress, lifestyle coaching, and documentation

How Dr. Jimenez’s Clinical Approach Illustrates Integrated Tele-Sciatica Care

Dr. Alexander Jimenez’s practice is a real-world example of how telemedicine can fit into a sophisticated, integrative sciatica program: El Paso, TX Doctor Of Chiropractic+2El Paso, TX Doctor Of Chiropractic+2

  • Dual perspective: As a chiropractor and nurse practitioner, he can view sciatica from both structural and medical perspectives.

  • Hybrid care model: Telemedicine is used for early triage, detailed history, rehab coaching, imaging review, and functional medicine follow-up, while in-person visits deliver hands-on chiropractic care, advanced diagnostics, and physical therapy.

  • Focus on severe and complex cases: His clinic specializes in severe spinal disabilities, complex lower-back pain, and sciatica syndromes, making telemedicine especially important for patients who struggle to travel due to pain.

  • Functional and integrative focus: Treatment plans often include nutrition, lifestyle changes, and personalized rehab strategies, which can be safely and effectively monitored via telehealth.

This style of care shows how telemedicine can be more than a quick video call—it can be part of a complete, long-term strategy to restore mobility, reduce pain, and support whole-person health.

Why Telemedicine Works So Well for Sciatica

Telemedicine does not “replace” traditional sciatica care—it extends it. When combined with in-person visits, chiropractic treatment, physical therapy, and functional medicine, telehealth offers a strong, patient-friendly way to manage sciatic nerve pain.

Big Advantages for People With Sciatica

  • Less travel when sitting hurts

  • Fast access to spine and pain specialists

  • Better follow-up and accountability for home exercise

  • Safer monitoring of medications and side effects

  • More personalized ergonomic and lifestyle coaching

What You Can Expect From an Integrated Telemedicine Plan

With an integrative team that includes a nurse practitioner and chiropractor, you may experience:

  • A clear diagnosis and explanation of your sciatica

  • A tailored plan that blends medications (when needed), guided movements, and lifestyle changes

  • Regular telehealth check-ins to track your progress and adjust your plan

  • Coordination of in-person visits for hands-on care when necessary

  • A long-term strategy aimed at preventing flare-ups, not just masking pain

Sciatica can be frustrating, but you do not have to face it alone or wait until you can physically get to a clinic. A well-designed telemedicine program—especially one that integrates chiropractic care, physical therapy, and functional medicine—can help you move, sit, and live with less pain, right from the comfort of your home.

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

References

UT Southwestern Medical Center. (2025, November 19). Virtual visits, real pain relief: Telemedicine brings convenient care for back issues. UT Southwestern Medical Center

The Spine Institute of Southeast Texas. (2025, January 1). How can telemedicine work to help treat my sciatica? Southeast Texas Spine

The Spine Institute of Southeast Texas. (2023, June 1). 6 benefits of telemedicine. Southeast Texas Spine+1

The Spine Institute of Southeast Texas. (2022, October 9). How to prepare for your telemedicine appointment. Southeast Texas Spine+1

Everlywell. (2023, February 24). Telemedicine pain management: How it works. Everlywell

NJ Spine and Orthopedic. (n.d.). What is telemedicine and can it work for back pain? NJ Spine & Orthopedic

Apollo Spine and Pain Center. (2025, May 11). Enhance pain management with telemedicine. apollospineandpain.com

Tigard Chiropractic and Auto Injury. (2023, September 9). Sciatica solutions: How chiropractic care can help office professionals find relief. tigardchiropracticautoinjury.com

Tigard Chiropractic and Auto Injury. (2022, July 19). Dealing with pain from working remotely. tigardchiropracticautoinjury.com

HealthCentral. (n.d.). Chiropractic treatment for sciatica. HealthCentral

HealthCentral. (2022, December 2). Ergonomics and sciatica: How to sit, stand, and work without pain. HealthCentral

Integrative Medical of DFW. (n.d.). Physical therapy – Treatment focused on your goals. Integrative Medical of DFW

Family Integrative Medicine. (2023, October 23). Physical therapy: Restoring strength and mobility. Family Integrative Medicine

Justice, C., et al. (2023). Guiding principles for the practice of integrative physical therapist care. Journal of Integrative and Complementary Physical Therapy. PMC

Jimenez, A. (n.d.). El Paso, TX doctor of chiropractic – Injury rehabilitation & functional medicine. DrAlexJimenez.com. El Paso, TX Doctor Of Chiropractic+1

Jimenez, A. (n.d.). Sciatica pain treatment – El Paso, TX. DrAlexJimenez.com. El Paso, TX Doctor Of Chiropractic+1

Jimenez, A. (2025). How Dr. Alex Jimenez uses telemedicine for injury recovery. DrAlexJimenez.com. El Paso, TX Doctor Of Chiropractic+1

Menopause and Its Importance Through Functional Wellness

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

Discover the importance of functional wellness for navigating symptoms and achieving balance during menopause.

Table of Contents

Flourishing Through Menopause: A Comprehensive Guide to Functional Wellness, Chiropractic Care, and Integrative Therapies for Symptom Relief

Introduction: Understanding Functional Wellness During Menopause

Menopause is one of the biggest changes in a woman’s life. It marks the end of her reproductive years and the start of a new phase of her health and well-being. This normal biological process causes a lot of symptoms that can make life very difficult for millions of women around the world. These symptoms include mood swings, hot flashes, joint pain, and musculoskeletal discomfort. After menopause, the therapeutic reason for functional health becomes more important because this method targets the root causes of symptoms instead of just masking them with drugs. One more nourishhousecalls

Functional wellness focuses on a patient-centered, whole-person approach that considers lifestyle choices, environmental factors, and how different systems of the body work together. Hormonal changes during the menopausal transition can have effects on many parts of the body. This integrative approach gives women all the tools they need to manage their symptoms and improve their overall health. Functional wellness sees menopause as a normal part of life that can be made easier by making lifestyle changes, getting physical therapy, reducing stress, and eating a healthy diet. It does not see menopause as a disease. Cleveland Clinic+2

The musculoskeletal system needs extra care during menopause because lower estrogen levels directly affect joint health, bone density, muscle mass, and connective tissue. Musculoskeletal discomfort is a common symptom of this life change that many people ignore. Studies show that 71% of women going through perimenopause feel it. Joint stiffness, muscle pain, and general body discomfort can make it hard to be active and make life much less enjoyable at the very time when exercise is most important for staying healthy. orthopedicsri+2.

Massage therapy, acupuncture, and chiropractic adjustments are all non-surgical treatments that can help with menopause symptoms. They are based on research and don’t have the same risks as medications. These treatments can be used alongside diet plans, exercise programs, and lifestyle changes to create personalized care plans that meet each woman’s unique needs and health goals. DutchessBraincore +2

​

What is Menopause?

Menopause is a natural biological process that marks the permanent end of menstrual cycles and fertility. It is clinically defined as occurring after 12 consecutive months of amenorrhea (absence of menstruation) not linked to a pathological cause. While menopause itself is a single point in time—the moment when a full year has passed without a menstrual period—the transition encompasses several years of hormonal changes that can produce symptoms affecting virtually every system in the body. pmc.ncbi.nlm.nih+1​

The average age of menopause for women in the United States is 51 years old, though this can vary significantly between individuals. Some women experience menopause in their early 40s, while others may not reach this milestone until their late 50s. The timing is influenced by genetics, lifestyle factors, and overall health status. myobgynvegas​

The Biological Mechanism of Menopause

Menopause results from the natural depletion of ovarian follicles over a woman’s reproductive lifespan. Each woman is born with a finite number of eggs, and as these are gradually used during monthly ovulation or naturally degenerate, the ovaries’ capacity to produce hormones diminishes. The pathophysiology involves a rapid decline in the number of primary ovarian follicles, resulting in an inadequate number to respond to follicle-stimulating hormone (FSH). ncbi.nlm.nih+1​

When the ovaries can no longer respond adequately to FSH signals from the pituitary gland, several hormonal changes occur: pmc.ncbi.nlm.nih+1​

  • Estrogen production declines significantly, though small amounts may still be produced through conversion from testosterone released by the adrenal glands.

  • Progesterone production decreases and eventually stabilizes at very low levels.

  • FSH and luteinizing hormone (LH) levels remain elevated for years after menopause onset due to the lack of negative feedback from ovarian hormones

  • Testosterone levels do not change as dramatically early in menopause, leading to a relative increase in the testosterone-to-estrogen ratio (ncbi.nlm).nih​

This hormonal shift affects virtually every organ system in the body, as estrogen receptors are present throughout tissues, including the brain, heart, bones, joints, skin, and reproductive tract. arthritis+1​

Download

The Phases of Menopause

The menopausal transition unfolds over three distinct phases, each characterized by different hormonal patterns and symptom experiences.columbusobgyn+3​

Perimenopause: The Transitional Phase

Perimenopause represents the years leading up to menopause when the body begins its transition away from reproductive function. This phase typically begins 8 to 10 years before menopause, often starting in a woman’s mid-40s, though it can begin earlier. During perimenopause, hormone levels fluctuate unpredictably, creating a rollercoaster of symptoms that can be challenging to manage. mcpress.mayoclinic+2​

The early perimenopause stage is characterized by: columbusobgyn​

  • Shortened follicular phase leading to more frequent menstrual cycles

  • Occasional hot flashes lasting from seconds to minutes

  • Mild changes in skin elasticity and breast tenderness

  • Subtle mood variations and increased stress sensitivity

As perimenopause progresses into the middle and late transition stages, women typically experience: columbusobgyn​

  • Menstrual cycles that vary by seven or more days from normal patterns

  • More frequent and potentially more severe hot flashes

  • Increased vaginal dryness and sleep disruption

  • Daily hot flashes and night sweats that may feel more intense and last longer

  • Heightened anxiety or mood fluctuations

Menopause: The Defining Moment

Menopause itself is not a phase but rather a single point in time—the day when a woman has gone 12 consecutive months without a menstrual period. At menopause, the body’s production of estrogen, progesterone, and testosterone is significantly reduced, while FSH and LH levels are elevated. samitivejhospitals+2​

Postmenopause: The Years Beyond

Postmenopause begins immediately after menopause is confirmed and continues for the remainder of a woman’s life. Most menopausal symptoms gradually decrease in intensity during postmenopause, with some women experiencing significant relief within the first few years. However, certain changes require ongoing attention: joinmidi+1​

  • Bone density continues to decline due to reduced estrogen’s effects on bone remodeling.

  • Cardiovascular health becomes more vulnerable as estrogen’s protective effects diminish.

  • Genitourinary changes may persist or develop, including vaginal atrophy and urinary symptoms joinmidi​

Common Symptoms of Menopause

Menopause produces a wide spectrum of symptoms that vary dramatically between individuals. myobgynvegas+2​

Vasomotor Symptoms

Hot flashes and night sweats are among the most recognizable menopausal symptoms, affecting approximately 75% to 80% of women with varying severity. Hot flashes typically begin as a sudden sensation of warmth spreading through the upper body and face, often accompanied by flushing, sweating, and heart palpitations. templehealth+2​

Mood and Cognitive Changes

Hormonal fluctuations during menopause significantly impact brain function and emotional regulation: endocrine​

  • Mood swings ranging from irritability to sadness

  • Anxiety and increased stress sensitivity

  • Brain fog is characterized by difficulty concentrating and memory lapses

  • Depression or persistent low mood

These symptoms result from estrogen’s relationship with serotonin and other neurotransmitters that regulate mood. endocrine​

Sleep Disturbances

Sleep problems affect more than 60% of menopausal women: integratedchiropracticofboca+1​

  • Night sweats interrupt sleep cycles

  • Insomnia may develop independently of vasomotor symptoms

  • Sleep apnea risk increases during and after menopause womens-health-concern​

Genitourinary Symptoms

As estrogen declines, significant changes occur in the vulva, vagina, and urinary tract: ncbi.nlm.nih+1​

  • Vaginal dryness and thinning of vaginal tissue

  • Increased urinary tract infections

  • Urinary urgency and incontinence

Musculoskeletal Symptoms

Nearly half of menopausal patients experience musculoskeletal symptoms like joint pain: tandfonline+1​

  • Joint pain and stiffness

  • Muscle aches and loss of grip strength

  • Frozen shoulder

  • Loss of lean muscle mass

How Menopause Affects Hormones in the Body

Understanding the hormonal changes that occur during menopause provides crucial insight into why symptoms develop. samitivejhospitals+1​

Estrogen: The Primary Change

Estrogen is the primary female hormone with receptors distributed throughout the body. During menopause, estrogen levels drop dramatically—often to less than 10 pg/mL—creating widespread effects. aarp+2​

Estrogen’s decline affects multiple systems: pmc.ncbi.nlm.nih​

  • Brain: Impacts mood regulation, memory, and cognitive function

  • Bones: Accelerates bone resorption, increasing osteoporosis risk

  • Heart: Removes protective effects on blood vessels

  • Joints: Reduces cartilage protection and synovial fluid production

Progesterone and Testosterone

Progesterone production decreases during perimenopause as ovulation becomes irregular, then stabilizes at low levels after menopause. Testosterone levels do not decrease as dramatically during early menopause, creating a relative increase in the testosterone-to-estrogen ratio. samitivejhospitals+1​

FSH, LH, and Cortisol

FSH and LH levels increase significantly as the pituitary attempts to stimulate unresponsive ovaries. Cortisol levels may be elevated during menopause, contributing to sleep disturbances, weight gain, and mood changes. ncoa+2​

How Fluctuating Hormones Affect the Musculoskeletal System

The musculoskeletal system is profoundly affected by the hormonal changes of menopause, yet these effects are often overlooked or misattributed to normal aging. Research has established what experts now term the “musculoskeletal syndrome of menopause.” dralisongrimaldi+2​

The Role of Estrogen in Joint and Bone Health

Estrogen plays a vital role in maintaining musculoskeletal health through multiple mechanisms: jointrehab+2​

  • Cartilage Protection: Estrogen helps keep cartilage flexible and supports the production of synovial fluid, which lubricates joints. As estrogen levels decline, cartilage may degrade more rapidly. orthopedicsri​
  • Anti-Inflammatory Effects: Estrogen exhibits anti-inflammatory properties by inhibiting the release of inflammatory cytokines, such as TNF-α and IL-1β. When estrogen declines, inflammation increases throughout the body. pmc.ncbi.nlm.nih+2​
  • Bone Remodeling: Estrogen deficiency leads to accelerated osteoclast activity and increased bone resorption, resulting in bone loss of up to 20% during the menopausal transition. puregym+1​

Prevalence of Musculoskeletal Pain

The overall prevalence of musculoskeletal pain in perimenopausal women is approximately 71%. A study including more than 40,000 women found that osteoarthritis was more common among women who had undergone menopause at least one year prior, compared with those who had a recent menstrual period (31% vs. 24%). rheumatologyadvisor+2​

Specific Musculoskeletal Effects

  • Joint Pain and Osteoarthritis: The decline in estrogen accelerates the progression of osteoarthritis, particularly in weight-bearing joints. pmc.ncbi.nlm.nih+1​
  • Muscle Loss (Sarcopenia): Research indicates that compared to women in early perimenopause, those with menopause have 10% less muscle mass in their arms and legs. puregym​
  • Bone Density Loss: Weakened bones are more prone to fractures, increasing the risk of injury in the spine, hips, and wrists. orthopedicsri+1​
  • Weight Gain Impact: Many women experience weight gain during menopause, which can add extra stress to joints. Visceral fat increases from 5-8% to 10-15% of total body weight. puregym​

Chiropractic Care for Menopausal Symptoms

Chiropractic care offers a safe, effective, and natural approach to managing menopausal symptoms, particularly those affecting the musculoskeletal system. accidentcarechiropractic+2​

How Chiropractic Care Supports Menopausal Women

  • Hormone Regulation Through Nervous System Support: The spine houses the nerves that control the endocrine system. The hypothalamus plays a significant role in hormone production, and misalignments in the spine can interfere with its functioning. By correcting subluxations, chiropractic care can help regulate hormone production and improve menopausal symptoms. raleighchiropractic+3​
  • Reduced Nervous System Stress: Chiropractic adjustments relieve pressure on the spine and restore proper nervous system function, supporting the body’s ability to regulate hormones more efficiently. familychiropracticcolumbus+1​
  • Improved Circulation: Chiropractic adjustments improve circulation by freeing up restrictions in the spine, helping reduce hot flashes and night sweats. dutchessbraincore+1​
  • Stress Management and Better Sleep: Chiropractic care promotes relaxation, stimulates the parasympathetic nervous system, and improves sleep quality in menopausal women. integratedchiropracticofboca+2​

Evidence for Chiropractic Care

Studies published in the Journal of Vertebral Subluxation Research found that chiropractic care was effective in reducing hot flashes, night sweats, and mood swings in menopausal women. The Journal of Manipulative and Physiological Therapeutics reported improved sleep quality in menopausal women receiving chiropractic treatment. dutchessbraincore​

Acupuncture Benefits for Menopause

Acupuncture, rooted in Traditional Chinese Medicine, involves inserting thin needles into specific points to stimulate energy flow and restore balance. pmc.ncbi.nlm.nih+1​

Research on Acupuncture and Menopause

A study of Japanese women in menopause found that menopausal symptoms were significantly reduced with individualized acupuncture treatments, exclusively due to improvement of musculoskeletal symptoms. Participants experienced relief from fatigue, chronic neck pain, and low back pain. pmc.ncbi.nlm.nih​

How Acupuncture Works

Acupuncture provides benefits through several mechanisms: pmc.ncbi.nlm.nih+1​

  • Pain Modulation: Stimulates the release of natural painkillers (endorphins)

  • Inflammation Reduction: Decreases inflammatory markers

  • Hormonal Effects: May help regulate cortisol and melatonin

  • Nervous System Regulation: Activates the parasympathetic nervous system

The number of menopausal women is expected to increase from 467 million in 1990 to 1.2 billion in 2030, suggesting acupuncture’s role as an integrative therapy will continue to grow. pmc.ncbi.nlm.nih​

Massage Therapy for Menopausal Relief

Massage therapy provides valuable benefits for both physical and emotional well-being during menopause. pubmed.ncbi.nlm.nih+2​

Evidence for Massage Therapy

A randomized controlled trial found that both massage and aromatherapy were effective in reducing menopausal symptoms. Research demonstrates that therapeutic massage: pubmed.ncbi.nlm.nih​

  • Decreases the severity of sleep disturbance related to menopause

  • Reduces insomnia and anxiety-depressive symptoms pmc.ncbi.nlm.nih​

  • Improves overall mood through endorphin release and cortisol reduction westernregionhealth​

Benefits of Massage During Menopause

  • Stress Reduction: Massage reduces stress and anxiety by promoting endorphin release and reducing cortisol levels. westernregionhealth​
  • Muscle Pain Relief: Massage targets muscle knots and tension, providing relief from discomforts common during menopause. westernregionhealth​
  • Sleep Enhancement: Massage significantly improves sleep patterns and reduces sleep disturbances. pmc.ncbi.nlm.nih+1​

Physical Therapy and Exercise for Menopausal Health

Physical therapy and exercise represent cornerstones of managing menopausal musculoskeletal symptoms. resilienceorthopedics+2​

The Importance of Exercise

Exercise is one of the best treatments for menopause and joint pain: resilienceorthopedics​

  • Joint Health: Strengthens supporting muscles and promotes synovial fluid circulation.

  • Bone Density: Weight-bearing exercises stimulate bone building uclahealth+1​

  • Muscle Preservation: Resistance training counters sarcopenia puregym​

Types of Exercise for Menopausal Women

  • Resistance Training: The most recommended exercise for menopausal joint pain. Women over 60 with osteoporosis who participated in strength training showed significant improvements in bone density. uchealth+1​
  • Weight-Bearing Exercise: Walking, dancing, and stair climbing promote bone strength. Specialists recommend at least 150 minutes per week of moderate cardiovascular activity. nyulangone​
  • Mind-Body Exercise: Yoga, tai chi, and Pilates significantly improve bone mineral density, sleep quality, anxiety, depression, and fatigue in perimenopausal and postmenopausal women. pmc.ncbi.nlm.nih+1​

Aligned & Empowered: Chiropractic Conversations on Women’s Health-Video

Aligned & Empowered: Chiropractic Conversations on Women’s Health | El Paso, Tx (2020)

Nutrition and Diet for Menopausal Wellness

Nutrition plays a crucial role in managing symptoms and supporting long-term health. pmc.ncbi.nlm.nih+2​

Anti-Inflammatory Dietary Approaches

An anti-inflammatory diet emphasizes: pmc.ncbi.nlm.nih+1​

  • Vegetables: Leafy greens, cruciferous vegetables

  • Fruits: Berries, cherries, citrus

  • Fatty fish: Rich in omega-3 fatty acids

  • Nuts and seeds: Walnuts, flaxseeds

  • Healthy fats: Extra virgin olive oil, avocado

  • Herbs and spices: Turmeric, ginger

The Mediterranean diet has shown particular benefits for menopausal women, associated with better bone mineral density and improved symptoms. rebellehealth+1​

Key Nutrients

  • Calcium: Recommendations of 1200-1300 mg daily for postmenopausal women. pubmed.ncbi.nlm.nih+1​
  • Vitamin D: Intake between 800-900 IU daily, combined with calcium, increases bone mineral density and reduces fracture risk. frontiersin+1​
  • Omega-3 Fatty Acids: Possess anti-inflammatory properties that reduce joint pain. Women who consumed more omega-3 fatty acids had fewer menopausal symptoms. goodrx+1​
  • Protein: Higher intake (approximately 1.2 g/kg body weight) is associated with a 32% lower risk of frailty. pmc.ncbi.nlm.nih​

Sleep Hygiene for Menopausal Women

Sleep disturbances affect more than half of menopausal women.swanstudy+1​

Evidence-Based Sleep Strategies

Research emphasizes addressing sleep issues early during the menopausal transition. Recommended strategies include: swanstudy​

  • Establish a Regular Sleep Schedule: Go to bed and wake up at the same time each day. womens-health-concern+1​
  • Create an Optimal Sleep Environment: Keep the bedroom cool, dark, and quiet; use cooling sheets; consider a fan. healthline+2​
  • Develop a Relaxing Routine: Allow time to unwind; avoid screens for at least one hour before bed. ncoa+1​
  • Mind Dietary Habits: Avoid caffeine after lunchtime; limit alcohol; avoid spicy foods close to bedtime. swanstudy+1​
  • Cognitive Behavioral Therapy for Insomnia (CBT-I): The most effective treatment for chronic insomnia during menopause. womens-health-concern​

Lifestyle Changes for Managing Symptoms

Beyond specific therapies, broader lifestyle changes significantly impact the menopausal experience. whsobgyn+2​

Stress Management

Effective techniques include: nature+1​

  • Mindfulness meditation: Significantly reduces anxiety, depression, and menopausal symptoms

  • Yoga: Improves psychological symptoms, sleep, and musculoskeletal pain

  • Deep breathing exercises: Helps manage hot flashes

Smoking Cessation and Alcohol Moderation

Women who smoke experience more frequent and severe hot flashes. Alcohol can trigger hot flashes and disrupt sleep; limiting intake to no more than one serving per day is recommended. nyulangone​

Weight Management

Maintaining a healthy weight reduces joint stress, helps manage hot flashes, and supports cardiovascular health. medlineplus+1​

Dr. Alexander Jimenez’s Clinical Observations on Integrative Menopause Care

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, based in El Paso, Texas, brings over 25 years of expertise in integrative medicine to menopausal care. His dual licensure as a Family Practice Nurse Practitioner and Chiropractor enables patient-centered care, bridging physical medicine, functional medicine, and advanced diagnostics. a4m+1​

The Functional Medicine Approach

Dr. Jimenez’s practice emphasizes functional medicine principles, viewing the body as one integrated system. Key elements include: dralexjimenez+1​

  • Comprehensive health assessments evaluating genetics, lifestyle, and environmental factors

  • Personalized treatment plans tailored to individual health profiles

  • Integration of conventional and complementary therapies

  • Patient empowerment through education and active participation

Integrative Treatment Protocols

Dr. Jimenez’s protocols integrate multiple modalities: a4m+1​

  • Chiropractic adjustments for spinal alignment and nerve function

  • Acupuncture and electro-acupuncture for pain and hormonal balance

  • Targeted exercise programs focusing on flexibility, mobility, and strength

  • Massage therapy for muscle tension and stress management

  • Nutritional counseling supporting hormonal balance and bone health

As Dr. Jimenez emphasizes in his clinical practice, addressing root causes rather than simply treating symptoms produces lasting improvement. His team at Injury Medical & Chiropractic Clinic in El Paso collaborates to deliver personalized treatment plans, ensuring each patient receives care tailored to their unique needs. dralexjimenez+1​

For more information about Dr. Jimenez’s integrative approach, visit https://dralexjimenez.com/ or connect on LinkedIn.

Conclusion: Embracing Functional Wellness Through the Menopausal Transition

Menopause is a major life change that can be effectively managed with appropriate support. During this period, hormonal shifts have interrelated effects across the body that benefit from integrative, whole-person care, making the clinical case for functional health especially strong. nourishhousecalls plus one 

Up to 71% of perimenopausal women suffer from the musculoskeletal syndrome of menopause, which responds effectively to integrative methods like: tandfonline+1

  • Chiropractic adjustments for nervous system support and spinal alignment
  • Hormonal balance and pain relief with acupuncture
  • Massage treatment for stress relief and tense muscles
  • Exercise and physical therapy can improve bone health, strength, and flexibility
  • An anti-inflammatory diet to lessen inflammation throughout the body
  • Practicing good sleep hygiene can aid in healing and hormone balance
  • Stress reduction using mind-body techniques

Women may manage menopausal symptoms and actually thrive throughout this normal life transition by adopting functional wellness concepts and using evidence-based integrative therapy. The objective is to achieve maximum health, energy, and quality of life for the years to come, not just symptom alleviation.

References

Sports Injury Telemedicine Teamwork: Expert Care at Home

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Athlete goes over massage techniques and exercises for a sports injury via telemedicine with chiropractor and nurse practitioner

Revolutionizing Sports Injury Recovery: Telemedicine Teamwork with a Chiropractor and Nurse Practitioner at Sciatica Pain and Treatment Clinic – El Paso, TX

Sports Injury Telemedicine Teamwork: Expert Care at Home
An athletic individual works out at home and pulls a back muscle, causing intense pain.

Sports injuries strike without warning — a rolled ankle on the soccer field, a shoulder pop during weightlifting, or lower-body tightness that slows a runner down. Getting expert help fast can make the difference between a quick comeback and months on the bench. At Sciatica Pain and Treatment Clinic in El Paso, TX, an integrative chiropractor and a nurse practitioner now work together via telemedicine to treat athletes and active people across Texas and beyond.

This powerful team uses secure video visits to examine injuries, build joint treatment plans, coordinate every step of care, and guide safe at-home recovery. The nurse practitioner handles medical records, orders imaging, and prescribes medications when needed. The chiropractor focuses on spine, joint, and muscle function with targeted adjustments and movement coaching. Together, they deliver complete care that covers both the medical and musculoskeletal sides of any sports injury.

Dr. Alexander Jimenez, DC, APRN, FNP-BC, leads this approach at the clinic. With dual training as a chiropractor and family nurse practitioner, he combines hands-on spinal expertise with full medical authority for faster, safer results (Jimenez, n.d.a).

  • Why Athletes Choose This Telemedicine Team:
    • Same-day or next-day virtual visits — no waiting rooms
    • Care from home, the gym, or even the sideline
    • One coordinated plan instead of multiple doctors
    • Perfect for El Paso, Horizon City, Socorro, and Fort Bliss families

Instant Virtual Examinations from Anywhere

A video call is often all it takes to start healing. Patients simply open an app or browser on their phone or laptop. The nurse practitioner reviews the injury history and medical background, while the chiropractor observes movement patterns in real time.

Coaches and parents love this for possible concussions or sudden pain during games. Within minutes, the team can conduct balance tests, assess the range of motion, and decide whether the athlete needs to stop play (Satouf et al., 2021). Schools across the country already use similar systems to cut evaluation time to under 30 minutes (National Federation of State High School Associations, 2023).

The clinic orders X-rays, MRIs, or ultrasounds electronically and reviews the results together on-screen. This speed keeps small problems from turning into season-ending injuries.

  • What Happens in a Typical Virtual Exam:
    • Share how the injury happened (video clips welcome)
    • Guided movement tests to check joints and balance
    • Immediate feedback and next-step plan
    • Prescriptions sent straight to your pharmacy if needed

Building One Unified Treatment Plan

Separate doctors can give conflicting advice. At Sciatica Pain and Treatment Clinic, the chiropractor and nurse practitioner share the same secure chart and talk live during or right after your visit.

For example, a basketball player with knee pain gets anti-inflammatory medication from the nurse practitioner and gentle joint mobilization exercises from the chiropractor — all in one plan. They add custom rehab videos, nutrition tips, and sleep advice because full recovery needs more than just pain relief.

Research shows multidisciplinary telemedicine teams improve outcomes by 20–30% compared to single-provider care (Garg et al., 2024).

Dr. Jimenez notes that athletes who follow the combined plan return to sport faster and with a lower risk of reinjury (Jimenez, n.d.b).

Ongoing Coordination That Keeps You on Track

Healing does not stop after the first visit. The El Paso team schedules short video check-ins — often 10–15 minutes — to see progress and make adjustments.

Wearable data, phone photos of swelling, or quick movement videos help the team spot issues early. When patients require additional assistance, the team connects them with nearby physical therapists while maintaining comprehensive oversight.

This coordination cuts unnecessary emergency room trips. One study found virtual sports medicine visits reduced ER use by 6.7% and saved thousands per case (OrthoLive, 2023a).

  • Coordination Advantages for Active People:
    • Weekend and evening video appointments
    • Direct messaging with the team between visits
    • Automatic reminders for exercises and meds
    • Family or coach can join calls when helpful

Guided At-Home Recovery That Actually Works

Most healing happens outside the clinic. The team creates step-by-step home programs with demonstration videos recorded just for each patient.

The nurse practitioner monitors medication needs and watches for warning signs. The chiropractor teaches self-mobilization techniques and corrective exercises tailored to the specific injury.

Patients track symptoms in a simple app. Weekly video reviews keep motivation high and let the team upgrade the program as strength returns.

Telemedicine physical therapy and rehab guidance now match in-person results for function and quality of life (SportsMD, 2025).

  • Sample At-Home Tools You Receive:
    • Custom exercise video library
    • Daily symptom and activity log
    • Progress goals with virtual “high-fives.”
    • Nutrition, recovery, and sleep guidance

The Nurse Practitioner Side: Full Medical Authority from Home

As an Advanced Practice Registered Nurse (APRN), the nurse practitioner can:

  • Order blood work, X-rays, MRIs, or ultrasounds
  • Prescribe pain relief, anti-inflammatories, or muscle relaxers
  • Clear athletes for return to play when safe
  • Manage concussions with proven protocols

This medical scope means no delays waiting for another provider.

The Chiropractic Side: Fixing Movement and Alignment Remotely

Dr. Jimenez and the chiropractic team assess spine and joint mechanics through the camera and prescribe precise corrective strategies. Patients learn partner-assisted or self-adjustment techniques for instant relief between in-person visits when needed.

This focus on how the body moves and supports itself speeds natural healing and prevents future injuries.

Real-Life Wins at Sciatica Pain and Treatment Clinic

  • High school running back with an ankle sprain — cleared swelling with meds, restored stability with exercises, and returned in 12 days instead of 4 weeks.
  • Weekend warrior with shoulder pain — virtual exam ruled out a tear, and combined adjustments and home rehab avoided surgery.
  • Youth soccer player with a possible concussion — same-night video evaluation kept her safe and back to school faster.

Why El Paso Athletes and Families Choose This Clinic

Located in El Paso but serving all of West Texas through telemedicine, Sciatica Pain and Treatment Clinic removes travel barriers for military families at Fort Bliss, rural communities, and busy parents. One login gives access to both medical and chiropractic expertise — no juggling multiple offices.

The clinic accepts most major insurance plans for telemedicine and offers affordable self-pay rates when needed.

Start Recovering Today

A sports injury does not have to mean weeks away from the game. The integrative telemedicine team at Sciatica Pain and Treatment Clinic in El Paso, TX, stands ready to examine, treat, and guide you or your athlete back to full speed — often the same day.

Book your virtual visit now and experience coordinated care that gets results.

Unlocking Pain Relief: How We Assess Motion to Alleviate Pain | El Paso, Tx (2023)

References

Garg, R., Cheung, J., Kwon, D., & Migliaccio, G. (2024). Telemedicine in sports rehabilitation: A review of current applications and future directions. Journal of Sports Rehabilitation. https://www.jsportrs.com/article_229687_3a67fe77f3fe89d5a5a0d60f333ca189.pdf

Jimenez, A. (n.d.a). Sciatica Pain and Treatment Clinic – El Paso, TX. https://dralexjimenez.com/

Jimenez, A. (n.d.b). Dr. Alexander Jimenez, DC, APRN, FNP-BC [LinkedIn profile]. https://www.linkedin.com/in/dralexjimenez/

National Federation of State High School Associations. (2023). Telemedicine programs provide latest in risk minimization. https://nfhs.org/stories/telemedicine-programs-provide-latest-in-risk-minimization

OrthoLive. (2023a). Five ways telehealth helps sports doctors improve their practice. https://www.ortholive.com/blog/five-ways-telehealth-helps-sports-doctors-improve-their-practice/

Satouf, R., Rozhkova, E., & Schrank, B. (2021). The role of telehealth in sideline management of sports-related injuries. Current Sports Medicine Reports, 20(5), 246–252. https://doi.org/10.1249/JSR.0000000000000838

SportsMD. (2025, January 2). The benefits of telehealth physical therapy. https://www.sportsmd.com/2025/01/02/the-benefits-of-telehealth-physical-therapy/

Connected Care: Integrating Chiropractic and Telemedicine

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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chiropractor and nurse practitioner shows patient how to perform injury rehabilitation exercises

Connected Care: How Chiropractors and Nurse Practitioners Use Telemedicine to Support Healing

Connected Care: Integrating Chiropractic and Telemedicine
A chiropractic doctor and a nurse practitioner explain to a patient the injuries they sustained in their accident.

Integrative chiropractic care, nurse practitioners, and telemedicine are coming together to create a powerful, convenient way to treat pain and movement problems. Many people now search online for “telemedicine chiropractor,” “virtual spine care,” or “NP and chiropractic team” because they want whole-person care without always having to drive to a clinic. This blended model can help with neck and low-back pain, chronic migraines, sports injuries, osteoarthritis, dizziness, and other long-term issues by mixing hands-on visits with remote video visits, home exercises, and lifestyle coaching (Mayo Clinic, 2024; Burstin et al., 2023; El-Tallawy et al., 2024). Mayo Clinic+2PMC+2

Below is a detailed guide to how this integrated telemedicine approach works, which conditions it helps, and how clinicians like Dr. Alexander Jimenez, DC, APRN, FNP-BC, apply it in real life. dralexjimenez.com+1

What Is Integrative Chiropractic Telemedicine?

Telehealth/telemedicine uses secure video, phone, messaging, and apps so patients can meet with health professionals from home or work, rather than always going in person (Mayo Clinic, 2024). Mayo Clinic+1

Integrative chiropractic care combines spinal and joint adjustments with other therapies, such as exercise rehab, massage, nutrition, and functional medicine, to support overall health rather than just pain relief (El Paso Back Clinic, 2025). El Paso Back Clinic+1

When you add nurse practitioners (NPs) and telemedicine into this picture, you get a hybrid model where:

  • The chiropractor focuses on the spine, joints, muscles, and nervous system.

  • The NP manages medical issues, medications, labs, imaging, and chronic disease risks.

  • Telemedicine tools connect you with both providers for virtual exams, follow-ups, and home-care coaching (HealthCoach Clinic, 2025; Jimenez, n.d.). El Paso, TX Health Coach Clinic+2dralexjimenez.com+2

This “connected care” model means your providers can treat pain, track your progress, and update your plan even when you cannot come into the office.

Why People Search for Integrative Chiropractic Telemedicine

Individuals look up this kind of care online when they:

  • Have neck (cervical) or low-back (lumbar) pain that flares with work, driving, or sitting.

  • Struggle with chronic headaches or migraines and want drug-sparing options.

  • Are dealing with sports or “weekend warrior” injuries but have busy schedules.

  • Live with chronic pain or osteoarthritis and need steady support over time.

  • Experience dizziness, balance problems, or whiplash after a car accident or fall.

  • Have difficulty getting to the clinic due to pain, transportation, or work.

Research shows that telehealth can safely extend care for many chronic and pain-related conditions while improving access, convenience, and patient satisfaction (Mayo Clinic, 2024; Der-Martirosian et al., 2023; Burstin et al., 2023). Mayo Clinic+2PubMed+2

How the NP–Chiropractor–Telemedicine Team Works

In an integrated model like those at HealthCoach Clinic and Injury Medical Clinic PA, the NP and chiropractor work as a team, often within the same digital platform (HealthCoach Clinic, 2025; Jimenez, n.d.). dralexjimenez.com+3El Paso, TX Health Coach Clinic+3El Paso, TX Health Coach Clinic+3

Typical roles:

  • Nurse Practitioner

    • Reviews medical history, medications, and risk factors.

    • Orders labs or imaging when needed.

    • Adjusts medications, including for pain, sleep, or blood pressure.

    • Screens for red flags (fractures, infections, serious neurologic signs).

  • Chiropractor

    • Performs virtual orthopedic and neurologic checks when possible.

    • Designs spine-safe home exercise and stretching programs.

    • Coaches posture, ergonomic setups, and self-care strategies.

    • Provides in-clinic adjustments when hands-on care is required.

  • Telemedicine & Digital Tools

    • Secure video visits to check symptoms and movement.

    • Apps for exercise videos, reminders, and pain tracking.

    • Wearables or remote devices for heart rate, sleep, or activity (Haddad et al., 2021). PMC+1

This “hybrid care” model—mixing virtual and in-person visits—is a core recommendation for long-term pain management today (Burstin et al., 2023; NAM, 2023). PMC+2NAM+2

Conditions That Respond Well to Integrative Chiropractic Telemedicine

Many musculoskeletal and pain conditions respond well to a telemedicine-supported, team-based plan. Evidence from integrative and complementary health programs shows that virtual delivery of chiropractic and related therapies is feasible, acceptable, and often effective (Der-Martirosian et al., 2023; Shah et al., 2023). PubMed+2PMC+2

1. Cervical and Lumbar Pain

Neck and low back pain are among the most common reasons people seek telemedicine chiropractic care. Research and clinical experience suggest that combining:

  • Virtual posture coaching,

  • Guided stretching and strengthening, and

  • Periodic in-person manual therapy

can improve pain, function, and quality of life (Grace Medical & Chiropractic, 2024; ActiveCareRx, n.d.; El Paso Back Clinic, 2025). Grace Medical Chiro+2Active Care Rx+2

During telemedicine visits, the NP and chiropractor can:

  • Watch how you sit, stand, bend, and lift using video.

  • Teach safe spinal movements and “spine-neutral” positions.

  • Adjust your home workspace, car seat, or sleeping setup.

  • Decide whether imaging or an in-person exam is necessary.

For many people, this steady coaching combined with occasional in-office adjustments reduces pain episodes and helps avoid heavier medications or surgery.

2. Chronic Headaches and Migraines

Chronic headaches and migraines often involve more than just the head. Tight neck muscles, poor posture, jaw issues, stress, sleep problems, and medication side effects can all play a part. Clinics that combine chiropractic care, physical therapy, and medical management report better outcomes when these pieces are addressed together (Grace Medical & Chiropractic, 2024; Moore et al., 2018). Grace Medical Chiro+2Grace Medical Chiro+2

In a telemedicine-supported, integrative model, your team can:

  • Review headache patterns, triggers, and medication use.

  • Check neck range of motion, posture, and screen for red flags.

  • Guide neck stretches, breathing drills, and relaxation techniques.

  • Adjust preventive medications or supplements when appropriate.

Chiropractic adjustments, soft-tissue work, and exercise—when safely indicated—may reduce headache frequency and intensity, while the NP monitors for issues like medication overuse or blood pressure changes (Grace Medical & Chiropractic, 2024; El Paso Back Clinic, 2025). Grace Medical Chiro+2El Paso Back Clinic+2

3. Athletic and “Sudden Movement” Injuries

Weekend athletes and workers who make sudden twisting or lifting movements often develop:

  • Sprains and strains,

  • Shoulder or knee pain,

  • Low-back pain, or

  • Overuse injuries.

Chiropractic care, when combined with sports medicine and rehab exercises, can speed recovery and prevent reinjury (Dallas Accident & Injury Rehab, 2024; Dallas Accident & Injury Rehab, 2023; HealthCoach Clinic, 2025). El Paso, TX Health Coach Clinic+3dallasaccidentandinjuryrehab.com+3dallasaccidentandinjuryrehab.com+3

Telemedicine is especially useful for:

  • Early triage – Is it safe to stay home with rest, ice, and gentle movement, or do you need imaging?

  • Exercise progressions – Your chiropractor can watch your form and adjust your plan on video.

  • Return-to-sport plans – The NP and chiropractor can coordinate training volume, bracing, and meds.

Dr. Jimenez’s sports- and performance-based rehab model demonstrates how chiropractic adjustments, strength training, and digital follow-up can keep athletes active while reducing future risk (Jimenez, 2025). dralexjimenez.com+2LinkedIn+2

4. Chronic Pain and Osteoarthritis

For many patients, pain never fully goes away—but it can be managed. National experts now recommend hybrid care models that combine telehealth and in-person visits to manage chronic pain and reduce reliance on opioids (Burstin et al., 2023; NAM, 2023). PMC+2NAM+2

For conditions like osteoarthritis of the spine, hips, or knees, an NP–chiropractor–telemedicine team can help by:

  • Teaching joint-friendly movement and pacing strategies.

  • Guiding weight-bearing and strengthening exercises to protect joints.

  • Coordinating medications, injections, or topical treatments when needed.

  • Adding nutrition and weight-management support to lower joint stress.

Regular chiropractic care has been associated with less need for pain medication in some degenerative conditions, while multimodal care improves function and quality of life (ActiveCareRx, n.d.; Grace Medical & Chiropractic, 2024). Active Care Rx+2Grace Medical Chiro+2

Telemedicine makes it easier to maintain this steady, long-term support without the need for constant travel to the clinic.

5. Dizziness, Balance Issues, and Whiplash

Dizziness, “fog,” and balance problems often appear after:

  • Whiplash from a car accident,

  • Sports concussions,

  • Neck strain, or

  • Chronic neck tension.

Chiropractors and NPs can work together to determine whether symptoms stem from the neck, the inner ear, blood pressure, medication side effects, or something more serious. Telehealth programs in chiropractic and complementary medicine have successfully delivered care for conditions such as neck pain, headaches, and dizziness via video and phone visits (Der-Martirosian et al., 2023; El Paso Back Clinic, 2025). PubMed+2El Paso Back Clinic+2

Through telemedicine, your team can:

  • Perform balance and eye-movement screens over video.

  • Teach gentle posture exercises and neck stretches.

  • Review medications that might worsen dizziness.

  • Decide quickly if emergency or in-person neurologic care is needed.

What a Telemedicine Visit Looks Like in This Model

Most integrative telemedicine visits follow a clear, step-by-step structure (Mayo Clinic, 2024; Haddad et al., 2021; HealthCoach Clinic, 2025). dralexjimenez.com+3Mayo Clinic+3PMC+3

Before the visit

  • You complete secure online forms about symptoms, injuries, and medications.

  • You may upload prior imaging, lab results, or photos of your home setup.

  • The clinic may ask you to test your camera and space so you can move safely on video.

During the visit

  • The NP and/or chiropractor takes a detailed history.

  • You perform simple movements (bending, turning your neck, walking) while on camera.

  • Basic neurologic and orthopedic checks are done as safely as possible through video.

  • The team shares your working diagnosis and explains your options in plain language.

After the visit

  • You receive a written care plan through the portal or app.

  • Home exercises, stretches, or breathing drills include video or picture instructions.

  • Follow-up telemedicine and in-person visits are scheduled as needed.

This model is very similar to the approach described in Dr. Jimenez’s telemedicine injury care articles, in which virtual assessments, imaging orders, medication management, and bracing can be coordinated from a distance when clinically appropriate (Jimenez, 2025). dralexjimenez.com+2dralexjimenez.com+2

Home-Based Exercises and Lifestyle Coaching

For conditions like cervical and lumbar pain, chronic migraines, and athletic injuries, home-based work is just as important as in-clinic treatment. Telemedicine platforms and mobile apps now make it much easier to deliver this kind of support (HealthCoach Clinic, 2025; HealthCoach Clinic, n.d.). El Paso, TX Health Coach Clinic+2El Paso, TX Health Coach Clinic+2

Your care team may provide:

  • Personalized exercise videos for core, hip, and shoulder strength.

  • Posture drills for sitting at a computer, driving, or lifting.

  • Foam roller or massage-ball routines for tight muscles.

  • Breathing and relaxation practices to calm the nervous system.

  • Nutrition tips to support anti-inflammatory eating and weight control.

Dr. Jimenez’s integrative practice often links chiropractic adjustments with functional nutrition, sleep support, and strength training to improve mobility and long-term spinal health (Jimenez, n.d.; Jimenez, 2025). dralexjimenez.com+2dralexjimenez.com+2

When delivered through telemedicine, patients can practice in real time on camera, ask questions, and receive immediate corrections.

Telemedicine for Chronic Pain, Osteoarthritis, and Dizziness

The National Academy of Medicine and other groups now highlight telehealth as a key part of chronic pain and long-term condition management (Burstin et al., 2023; NAM, 2023). PMC+2NAM+2

For chronic spine pain, osteoarthritis, or dizziness, a hybrid plan might include:

  • Regular virtual check-ins to review pain, sleep, mood, and function.

  • Adjustments to medications to reduce side effects or dependency.

  • Chiropractic exercise progressions to keep joints mobile and strong.

  • Lifestyle coaching around stress, nutrition, and pacing.

  • Periodic in-person visits for hands-on care, imaging, or advanced tests.

Studies of complementary and integrative health telehealth programs—especially within the VA system—show that virtual delivery of services such as chiropractic, Tai Chi, and massage can be effective and well-liked by patients (Der-Martirosian et al., 2023; Shah et al., 2023). PubMed+2ResearchGate+2

This is exactly the kind of setting where patients with chronic migraines, neck and low-back pain, or mixed dizziness symptoms can benefit from steady monitoring and small, consistent changes.

When Telemedicine Is Enough—and When You Need In-Person Care

Telemedicine is powerful, but it is not right for every situation. Mayo Clinic and other major centers stress that telehealth works best when it is used alongside in-person care, not instead of it (Mayo Clinic, 2024; Haddad et al., 2021). Mayo Clinic+2PMC+2

Telemedicine is usually appropriate for:

  • Ongoing management of chronic neck or low-back pain without new red flags.

  • Stable chronic migraines where triggers and symptoms are well understood.

  • Sports or workplace injuries that have already been examined once in person.

  • Osteoarthritis flare-ups that require activity, bracing, or medication advice.

  • Dizziness that has been medically evaluated and is being monitored.

In-person or emergency care is needed if you:

  • Experience sudden, severe weakness, numbness, or loss of bladder/bowel control.

  • Have new chest pain, shortness of breath, or signs of stroke.

  • Have serious trauma (e.g., major fall, car crash with suspected fracture).

  • Notice rapidly worsening neurologic symptoms or confusion.

In an integrative setting, the NP and chiropractor work together to quickly identify red flags and direct you to the right level of care.

Dr. Alexander Jimenez’s Clinical Perspective

As a dual-licensed chiropractor and family nurse practitioner, Dr. Alexander Jimenez in El Paso has helped build exactly this kind of integrative, telemedicine-ready system (Jimenez, n.d.; Jimenez, 2025). dralexjimenez.com+3dralexjimenez.com+3dralexjimenez.com+3

From his clinical writings, several consistent themes appear:

  • Hybrid care works best. Patients often start with an in-person visit, then move into a mix of video and office care, especially after accidents, sports injuries, or spine flare-ups.

  • Telemedicine speeds up diagnosis. Instead of waiting weeks for a visit, patients can connect quickly, share images, and get their first plan the same day.

  • NP + chiropractic integration fills gaps. Many local clinics offer only chiropractic tele-visits. Dr. Jimenez’s model adds full medical management, including prescriptions, advanced imaging, and detailed medicolegal documentation when needed. dralexjimenez.com+2dralexjimenez.com+2

  • Lifestyle and rehab matter as much as manual care. His programs tie adjustments to nutrition, strength training, and movement coaching so gains last longer (El Paso Back Clinic, 2025; HealthCoach Clinic, 2025). El Paso Back Clinic+2El Paso, TX Health Coach Clinic+2

These observations align with broader research showing that telehealth-supported, team-based care improves access and can enhance outcomes for chronic pain and complex injuries (Burstin et al., 2023; El-Tallawy et al., 2024). PMC+2PMC+2

How to Get the Most Out of Integrative Chiropractic Telemedicine

If you are thinking about working with a chiropractor, NP, and telemedicine-based team, a few steps can help you get better results:

Before your first visit

  • Write down your main symptoms, how long they have been present, and what makes them better or worse.

  • List all medications and supplements, including doses.

  • Gather past imaging or test reports, if available.

  • Make sure you have space to stand, walk, and lie down near your camera.

Questions to ask your team

  • “How do you and the NP work together on my case?”

  • “Which parts of my care can be done via telemedicine, and which need in-person visits?”

  • “What home exercises or lifestyle changes should I focus on first?”

  • “How will we know if this integrated plan is working?”

During follow-up visits

  • Track your pain, sleep, and function in a simple journal or app.

  • Be honest about what you did and did not do between visits.

  • Report any new or unusual symptoms right away.

This active, honest partnership is a big reason why hybrid telehealth programs have shown high patient satisfaction and better long-term engagement (Andrews et al., 2020; Der-Martirosian et al., 2023). PMC+1

Key Takeaways

  • Integrative chiropractic telemedicine brings together chiropractors, nurse practitioners, and digital tools to treat pain, injuries, and chronic conditions more comprehensively.

  • This approach can effectively address cervical and lumbar pain, chronic migraines, athletic injuries, chronic pain, osteoarthritis, and dizziness, especially when combined with home-based exercises and lifestyle changes.

  • Evidence supports the use of hybrid models that combine telehealth and in-person care for chronic pain, as well as complementary therapies such as chiropractic (Burstin et al., 2023; Der-Martirosian et al., 2023). PMC+2PubMed+2

  • Clinicians like Dr. Alexander Jimenez, DC, APRN, FNP-BC, show how a dual-scope, telemedicine-enabled practice can manage complex injury cases while staying patient-centered, convenient, and evidence-informed. dralexjimenez.com+2dralexjimenez.com+2

If you live with ongoing pain or have been injured in a car accident, at work, or during sports, an integrative chiropractor–NP telemedicine team may help you recover more completely while fitting care into your everyday life.

Tension Headaches? | El Paso, Tx (2024)

References

Andrews, E., Berghofer, K., Long, J., Prescott, A., & Caboral-Stevens, M. (2020). Satisfaction with the use of telehealth during COVID-19. Journal of Patient Experience, 7(5), 947–956. PMC

ActiveCareRx. (n.d.). 7 long-term benefits of regular chiropractic care. Active Care Rx

Burstin, H., et al. (2023). Integrating telehealth and traditional care in chronic pain management and substance use disorder treatment: An action agenda for building the future state of hybrid care. NAM Perspectives. NAM+2PMC+2

Dallas Accident & Injury Rehab. (2024). Integrating chiropractic care with other treatments. dallasaccidentandinjuryrehab.com

Dallas Accident & Injury Rehab. (2023). Integrating chiropractic care with sports medicine. dallasaccidentandinjuryrehab.com

Der-Martirosian, C., et al. (2023). Telehealth complementary and integrative health therapies during COVID-19 at the U.S. Department of Veterans Affairs. The Journal of Alternative and Complementary Medicine, 29(8), 1–10. PubMed+1

El Paso Back Clinic. (2025). Integrative chiropractic care benefits in El Paso. El Paso Back Clinic+1

El-Tallawy, S. N., et al. (2024). Innovative applications of telemedicine and other digital health technologies in pain management. Pain and Therapy, 13(1), 1–20. PMC

Grace Medical & Chiropractic. (2024). Why combining different treatments works better. Grace Medical Chiro

Grace Medical & Chiropractic. (2024). Achieving lasting relief from chronic headaches and migraines with Grace Medical & Chiropractic. Grace Medical Chiro

Haddad, T. C., et al. (2021). A scalable framework for telehealth: The Mayo Clinic Center for Connected Care. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 5(1), 171–178. PMC

HealthCoach Clinic. (2025). Connected care: Telemedicine and patient convenience. El Paso, TX Health Coach Clinic+1

HealthCoach Clinic. (n.d.). Telemedicine mobile app – El Paso, TX Health Coach Clinic. El Paso, TX Health Coach Clinic

Jimenez, A. (n.d.). El Paso, TX doctor of chiropractic. DrAlexJimenez.com. dralexjimenez.com+3dralexjimenez.com+3dralexjimenez.com+3

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Sciatica Specialist
STOP SUFFERING! We specialize in advanced non-surgical approaches in treating sciatica. Our focus is to stop the pain, remove the cause and prevent chronic recurrence of complex sciatica pain syndromes. We treat with advanced protocols and supportive care plans. Blessings - Dr. Alex Jimenez DC, MSACP, IFMCP, CIFM, ATN
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