Spinal Imaging Back Pain Clinic Expectations

By

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

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selective focus of smiling radiologist writing on clipboard while assistant operating ct scanner

Chiropractors and spine specialists utilize spinal imaging through X-rays, MRIs, or CT scans to figure out what is causing back problems and pain. Imaging is common. Whether chiropractic or spinal surgery, they help immensely discover back issues and allow the individual to see what is happening. Types of cases include back pain that:

Comes from trauma
Has lingered for four to six weeks
It is accompanied by a history of:
Cancer
Fever
Night sweats

Doctors use these images when diagnosing a spinal condition. Here is some insight into spinal imaging.

Table of Contents

X-rays

X-rays for back pain can be quite helpful. An X-ray is radiation-based and is used to examine the conditions of the bone structures. X-rays are optimal for bone tissue or tissues that are ossified or calcified. They work the best with hard tissues, specifically bones. Soft tissues like muscles, ligaments, or intravertebral discs do not present as well.

Individuals undergoing a back X-ray will be scanned by a machine that generates a beam. A receiver picks registers the beam after it passes through the body and generates an image. It takes around five minutes to complete but could be longer depending on the doctor’s number of images. X-rays are helpful for insurance purposes and rule out bone conditions like compression fractures and/or bone spurs. X-rays are ordered for specific reasons and are often part of a whole-body diagnostic study. This includes MRI and/or CT scan.

CT Scan

CT stands for computed tomography. It is a series of X-rays that are digitized into images using a computer. The advantage of a CT scan to standard X-rays is that it offers different views/angles of the body and can be in 3D. CT scans are most often used in trauma cases or individuals who have had surgery. They take around five minutes. For X-rays, individuals stand up or lay under the X-ray machine as it scans the body. A CT scan has the individual lie down in a circular donut-looking machine that scans while rotating during the imaging. Individuals are recommended to wear casual loose, comfortable clothing. Sometimes a dye, or intravenous contrast, is used to get the vascular tissues to stand out, generating clearer images.

MRI

MRI is short for magnetic resonance imaging. MRIs use magnets to generate images. MRI imaging is often used in individuals that have undergone surgery. They take longer, usually around 30 to 45 minutes. No metallic objects are allowed in the MRI. Patients are asked to remove items like belts, jewelry, etc. Contrast dye can be a part of an MRI. The machine is like a tunnel. This can become challenging for individuals that have claustrophobia. Consult with a doctor and find out how to get comfortable during the process.

Other Forms of Spinal Imaging

Other forms of imaging include:

CT navigation

CT navigation shows real-time CT scans during the procedure.

Fluoroscopy

Fluoroscopy involves an X-ray beam that passes directly through the body that shows live, moving images.

Both of these types of spinal imaging are utilized during surgeries. For some cases, intraoperative imaging is used. This type of imaging uses high-tech robotics to help surgeons navigate through tight spaces during the procedure. This increases the surgeon’s accuracy and reduces the size of the incision.

Ultrasound

Ultrasound can be used for spinal conditions. This is an imaging test that uses sound waves to generate images. However, the imaging tests which are used in spinal imaging are primarily X-rays and MRIs.

Imaging Appointment

Talk with your doctor or chiropractor ahead of time to understand what to expect during the imaging process. They will let you know how to prepare and any special instructions before the appointment. Along with medical history and a physical examination, spinal imaging is an important part of the diagnostic process to find what is causing the pain and to develop the best treatment plan.

Body Composition

Short-term Effects of Coffee and Blood Pressure

The caffeine in coffee is a stimulant or substance that excites the body’s systems. When caffeine is ingested, individuals experience an increase in excitement, specifically in the cardiovascular system. This excitement causes the heart rate and blood pressure to rise and then lower back to a baseline level for healthy individuals. Coffee slightly increases short-term blood pressure. Moderate coffee consumption is safe for individuals that do not have pre-existing cardiovascular conditions.

References

United States Nuclear Regulatory Commission. (May 2021) “Doses in Our Daily Lives” https://www.nrc.gov/about-nrc/radiation/around-us/doses-daily-lives.html

X-Ray for Back Pain: Current Reviews in Musculoskeletal Medicine. (April 2009) “What is the role of imaging in acute low back pain?” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697333/

Weight Training To Strengthen The Back Muscles

By

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

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beautiful determined sportswoman in weight lifting gloves training with barbell at sports center

When back pain presents for a prolonged period, the back muscles reduce in mass but increase fat content, resulting in more stiffness. This leads to chronic muscle fatigue and results in chronic pain symptoms. Adding resistance to a workout routine in weight machines, free weights, and/or resistance bands helps reduce back pain. Studies have shown that specific therapeutic back muscle weight training is safe and can help relieve pain. A sports chiropractic specialist can recommend appropriate exercises for individuals and their specific condition/s to safely participate in strength training.

Table of Contents

Back muscles development

With time, back pain and increased fatigue can lead to a fear of moving the body and engaging in physical activity. This results in spinal deconditioning and instability. Weight training works on incrementally/progressively increasing the load that the back muscles can tolerate. This technique gradually improves the body’s ability and strength to perform regular daily activities without strain and in optimal fashion. Weight training improves whole-body health because:

Back muscles and core muscles increase in function and performance.
Muscles are strengthened.
Lean muscle mass increases.
The range of motion of the spine increases.
Body fat decreases.

Guidelines while using weights

When weight training, it is important to understand safety guidelines to help relieve back pain and not worsen or cause further injury. Weighted treatment exercises are for individuals that have been cleared by their physician or chiropractor and are specific to their injury and /or condition. Depending on the underlying pain source, weight training may not be suitable for individuals that have:

Severe pain.
Back pain that originates from:
Previous spinal surgery
Tumor
Nerve root compression
Neurological symptoms
Sciatica
Spinal fracture/s
Spinal infection/s

Medical professionals and chiropractors can accurately diagnose and determine if weight training is safe and which specific exercises to perform. Guidance from a trained therapist or therapeutic trainer is recommended for optimal results.

Weight training techniques to alleviate back pain are different from regular weight or resistance exercises.
Trained physical/occupational therapists and sports chiropractors can educate an individual on:
Correct techniques
Frequency
Type of training that will help an individual’s condition.
Therapeutic training can significantly reduce the risk of further injury and damage to the spine.
After initial training, individuals are encouraged to exercise to maintain back muscles and total body health.

Smaller weights build strength progressively

Effective ways to strengthen the spine.

Begin with small/light weights and exercise slowly.
Fast rapid movements or incorrect lifting and pulling techniques can cause additional damage to the tissues.
It is recommended to start with:
Low-load motor control exercises without weights activate and stretch the muscles and improve balance.
Simple stretches

Exercise machines can be recommended instead of free weights.

Exercise machines can provide safe, effective, and progressive resistance to the exercises.
The machines can help reduce/prevent injury compared to free weights.
The machines can maintain proper support on the back and spine.

It is recommended to combine regular walking activity with a weight training program.

Low impact aerobic exercises increase blood circulation along with essential nutrients to the muscles and soft tissues.
This promotes healing and reduces stiffness.

Training program and benefits

Gaining the most benefits from strength training, tips to keep in mind:

Warm up for a few minutes using heat therapy and simple stretches.
Try for 2 or 3 times a week for 30 minutes.
Focus on building strength in the core muscles – back, abdominals, obliques, buttocks, and pelvic leg muscles.
There is no need to join a gym or buy expensive equipment.
Work out at home with small hand weights, resistance bands, and body weight.
The therapist or chiropractor will inform the individual on which exercises to avoid, which require extreme or quick moves.
Slow, steady resistance training takes advantage of muscle lengthening exercises and muscle shortening exercises for strengthening.
If back pain presents with a sustained increase, take time off or modify the strength training exercises.
Some soreness is to be expected, but sharp pain is not. If any sharp, sudden pain presents while exercising, stop immediately.
Ice therapy can be beneficial after exercising to decrease inflammation and alleviate pain.

Record the amount of weight when beginning the training and note when progressing to a heavier weight. Consistent improvements in pain, flexibility, strength, and function will help maintain motivation. Consult with a professional sports injury chiropractor today to see if weight training is a suitable and safe treatment.

Body Composition

Carbohydrates and Muscle Growth

Simple carbs are a quick, periodic source of energy. Complex carbs are a recommended source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are but are more efficient and healthier. Complex carbs offer sustainable energy, meaning the energy is constant with no crash like simple carbs. Because complex carbs have slow-release properties, they should be the largest component of daily energy consumption.

Carbs prevent muscle weakness.

Some glycogen is stored in the muscles. When those muscles are used during exercise, the body taps into the glycogen stores in that specific muscle. Lifting weights with the arms, for example, access the glycogen in the biceps. Athletes take advantage of glycogen by loading up on carbs by consuming a day or more before a workout. This maximizes the muscle glycogen stores. This delays muscle fatigue, making for a better workout and stronger muscles, and can improve athletic performance.

Carbs help muscles recover after exercise.

Recovery goes back to the glycogen stores. Right after exercising, the body needs to replenish its glycogen stores to prevent glycogen depletion. Glycogen depletion, when the stores run out, causes gluconeogenesis. What happens is the body forms glucose from new sources. This is to compensate for the lack of glucose from carbohydrates. This is when the body turns to sources like fat and protein to fill the need. Protein is the last line of defense when energy is required, meaning that energy is running low. When the body breaks down protein for glucose production, it takes what it needs from the muscle/s, causing them to shrink and break down.

References

Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.

Lee JS, Kang SJ. Strength exercise and walking effects on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325

Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.

Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics, and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050

Testosterone deficiency in Men | EL PASO, TX (2021)

By

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

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***Testosterone deficiency in Men*** | EL PASO, TX (2021)

Welcome to our newest functional Medicine presentation, in this episode we will talk Testosterone Deficiency in Men.
An expert will help us describe testosterone deficiency, its prevalence in the male population, and relationship to aging. He will also list etiologies of diminished testosterone levels, and physiological impact of low testosterone levels. We will Identify signs, symptoms, and conditions associated with low testosterone and choose the most useful laboratory tools to assess men with low testosterone. And finally we will be able to develop a plan for prescribing nutraceuticals, diet and lifestyle interventions to enhance production, transport, sensitivity and detoxification of testosterone. Stay tuned for the next part of this presentation brought to you by Dr. Alex Jimenez…
If you have any questions you can call us at 915-850-0900
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please feel free to subscribe and share with us.

Thank You & God Bless.
Dr. Alex Jimenez DC, MSACP, ATN, IFMCP. CIFM, CCST

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Disclaimer:
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our presentations share knowledge and information from research, experience, and the collaborative functional medicine community. The information and scope are limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. Our discussions include Integrative Doctors, Functional Medicine Experts, Nutritionists, Health Coaches, Chiropractors, Physical Medicine Doctors, Therapists, Exercise Performance Specialists, Physicians, and others. Each specialist practices within their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care plans for the musculoskeletal system’s injuries or disorders. Our discussions, videos, posts, topics, subjects, and insights cover clinical matters and issues that relate to and support, directly or indirectly, our collaborative clinical scope of practice. We make a reasonable attempt to provide supportive citations and identify the relevant research studies supporting our presentations. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover issues that may require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subjects matters presented, please feel free to contact Dr. Alex Jimenez.

The Importance Of Sleeping On The Right Pillow

By

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

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Happy young African American woman posing after wake up — Good Morning. Portrait of beautiful carefree well-slept black lady lying on the white bedsheets at home, looking aside at window, resting in bedroom, feeling good after waking up on weekend

Many individuals do not realize the importance of the type of pillow they use for sleep. Sleeping on the wrong pillow is the perfect set-up for neck, shoulder, and back pain. Here are a few chiropractic tips on what to know about picking the best pillow. Knowing which is the right pillow for you can be the key to proper sleep and waking up pain-free.

Table of Contents

Importance of Pillows

Neck and shoulder pain can be a nightmare, especially when the body cannot get decent rest. The right pillow/s can help with neck and back pain symptoms and recover from injuries quicker. When the head is in an awkward position for sleep duration, this causes neck, shoulder, and headache problems. The importance of finding the right pillow follows a set of guidelines.

Shape

The shape of the pillow has a definitive role in the cervical/neck’s curvature.

Posture

Sleep posture is important in preventing neck, shoulder, and back musculoskeletal pain.

Sleep quality

Craniocervical pressures and cervical spine alignment are height-specific. Any changes can affect an individual’s sleep quality.

Height

Cervical alignment can become significantly impacted by the shape and height of the pillow.

Pillow Comfort Importance

Trying to find the right pillow will require trial and error. The basics to consider include:

One sign that it’s time for a new pillow is waking up with pain.
Age of current pillows. The recommendation is they should be replaced every year or two. This depends on the stuffing/material used as different types wear down quicker.
If problems are getting comfortable and being able to fall asleep.
Constantly readjusting or fluffing the pillow/s.
The pillow has become lumpy or lost its shape.
It is flat with no cervical support or, too high placing the head in a forward tilt.
A new pillow to consider are those that control temperature.
Cooling pillows are made to prevent heat retention. If a warm/hot pillow is keeping you up at night.

Temperature affects sleep quality.

Tossing and turning all night means loss of sleep.
The frustrating, angry, shifting movements can aggravate back and neck pain/issues.
Consider bed linens and pillowcases that cool the body.

Pillow Types

Today’s pillows are made from a variety of materials. Learning about the different kinds of materials can help make an educated choice.

Choose a retailer or brand that offers a guarantee or fair return/exchange program.
If the pillow isn’t right, you can return it and try another type.

Memory Foam

This material is polyurethane that has been combined with certain chemicals to make it viscoelastic.
These pillows return to their shape, can stretch and conform to the curves of the body.
Different kinds of memory foam include Open cell, Egg crate, and Gel.
They will mold to the contour of the spine, helping with misalignments.

Down Pillows and Down Alternative/polyfill

These pillows are generally softer.
They are made from actual down feathers or a non-allergic synthetic alternative that feels like real down.
There is not a great deal of firmness, but they are a good option because they are soft and workable.

Latex

These can be natural or synthetic latex, also known as rubber pillows.
They offer soft cushioning and proper support.
The latex is generally shredded, meaning it can be customized with more or less filling depending on the individual’s needs.

Combo style

There are combination pillows that could have a foam core with down around it for comfort and support.
Gel cores are common, specifically in cooling pillows.

How to Choose

Tips and things to keep in mind include:

Does it conform to the shape of your neck and spine?
How soft is it?
Is the pillow stiff?
Is it too high?

Remember the importance of sleeping positions. Back, side, or stomach. Pillows that match an individual’s sleeping position criteria:

Back sleepers are recommended to use a medium-thick pillow. This keeps the head, neck, and spine properly aligned.
Side sleepers are recommended to use a slightly thicker, firmer pillow for proper alignment.
Stomach sleepers are a challenge because of the strain placed on the pelvis and lower back. An almost flat pillow is recommended.

Shopping

If possible, try out the pillow before buying it.
Most stores will allow this, and some companies take it further.
For example, The Sleep Number company offers a service called PillowFit.
This is an online quiz along with a personalized process in their stores.
The process helps choose a pillow based on individual support preferences and sleep position for the best spinal alignment.
Customizable or adjustable pillows are another option. These pillows allow the individual to change the amount of filling to fit their needs.
Research, personal preference, and advice from a doctor and or chiropractor will help find the pillow that is right for you.
A third of an individual’s life is spent in bed, make it as comfortable as possible.

Body Health

Sleep Body Composition Importance

Not getting enough sleep makes it difficult to gain muscle.

Not getting enough sleep means that the body experiences less short wave sleep, affecting the body’s ability to secrete Growth Hormone and develop muscle.
Testosterone is negatively affected by lack of sleep.
Not enough sleep increases cortisol levels, impairing muscle development.

Not getting enough sleep makes it difficult to lose fat.

Irregular sleep throws off the body’s ghrelin/leptin cycles, causing hunger.
Not getting enough sleep has been linked to eating more.
Not getting enough sleep can cause reductions in the body’s Basal Metabolic Rate, reducing total energy output.
Tiredness reduces spontaneous movements.

References

“Effect of sleep posture on neck muscle activity.” Journal of Physical Therapy. June 2017. https://pubmed.ncbi.nlm.nih.gov/28626314/

“Effect of pillow height on the biomechanics of the head-neck complex: investigation of the craniocervical pressure and cervical spine alignment.” PeerJ. August 2016. https://pubmed.ncbi.nlm.nih.gov/27635354/

“How Often Should You Replace Your Pillows?” Sleep Foundation, Seattle, WA. https://www.sleepfoundation.org/bedding-information/how-often-should-you-replace-your-pillows

“Improving the quality of sleep with an optimal pillow: a randomized, comparative study.” Tohoku Journal of Experimental Medicine. July 2014. https://pubmed.ncbi.nlm.nih.gov/25008402/

“The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis.” Clinical Biomechanics. May 2021. https://pubmed.ncbi.nlm.nih.gov/33895703/

Okamoto-Mizuno, Kazue, and Koh Mizuno. “Effects of thermal environment on sleep and circadian rhythm.” Journal of physiological anthropology vol. 31,1 14. 31 May. 2012, doi:10.1186/1880-6805-31-14

Chronic Pain and Nutritional Habits

By

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

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Low-back, neck, shoulder, hip, leg, and foot pain are all causes of everyday discomfort and a bad mood. Chronic pain exacerbates the discomfort and bad mood times 10. Chiropractic treatment can help realign the spine and alleviate the pain. However, to maintain pain relief, individuals need to make healthy lifestyle adjustments. One of the most important adjustments is eating habits. Those dealing with chronic pain may not realize their diet is contributing to the pain.

At Injury Medical Chiropractic and Functional Medicine Clinic, we have a combined team of chiropractors, physical therapists, a health coach, and a nutritionist to help educate, develop, and support a personalized treatment plan on spinal health, posture, physical activity/exercise, balance, and eating habits.

Table of Contents

Salt, Sugar, and Fat Affects the Body

A sedentary lifestyle is a significant contributor to chronic pain, but unhealthy eating habits also play a role. Poor diet adds weight to the body. This stresses the body’s biomechanical structure. It also aggravates inflammation. Too much salt, sugar, and fats ingested through processed foods, fast food, and unhealthy habits affect the body’s regulating systems. They can affect everything from the nervous system, nerves, proper circulation, even the limbic system. The inflammation and stress generate and exacerbate chronic pain symptoms.

Changing unhealthy eating habits is up to the individual.

Individuals can be advised to cut back or cut out unhealthy diet choices; however, it is easier said than done. A doctor, health coach, and nutritionist have no control over what individuals do when they leave the clinic. Individuals themselves can have little control over their own eating habits. Many have an addiction to unhealthy food, which is a disease in itself. To help change poor eating habits, individuals need to be educated on how their eating habits affect the total body and mental health.

Nutrition Discussion

Chronic pain associated with inflammation linked to a poor diet is the first step in the diagnosis and developing an optimal treatment plan. It could be as simple as informing an individual that eating cheeseburgers are causing the inflammation that is hurting their back. However, there is more to it, but individuals are more inclined to avoid the foods causing the inflammation upon hearing a full explanation. Targeting specific foods is the first step in alleviating pain.

The temptation is always there, especially when stress comes into the picture. This is why it is important to have ready-to-go adjustments/alternatives that keep the individual eating healthy, despite the chaos going on around them. A treatment plan will include quick alternatives that can happen in stages. An example could be:

Having one cheeseburger and not two.
Having a burger without cheese.
Eating a burger without the buns.
Switching to a plant-based burger.
There are many options to be explored to improve eating habits in small steps.

Willpower also has to be addressed in a controlled and supportive setting. This is where the whole team comes in. Many individuals’ eating habits are part of who they and adjusting them can be an uphill challenge. To educate on:

Methods of accountability
Keeping a journal
Having the family or friends eat healthy with them
These are techniques and methods to increase willpower to make healthy changes.

Body Composition

Foods Can Support Body Detoxing

The proper foods can support the body in detoxifying toxins and counter the negative effects like brain fog, neurodegenerative disorders, and chronic pain. The foods help to:

Neutralize oxidative stress
Lower inflammation
Increase immunity
Strengthen the musculoskeletal system
Foods and nutrients that detoxify can be a part of a healthy lifestyle.

References

Bjørklund, Geir et al. “Insights on Nutrients as Analgesics in Chronic Pain.” Current medicinal chemistry vol. 27,37 (2020): 6407-6423. doi:10.2174/0929867326666190712172015

Elma, Ömer et al. “Chronic Musculoskeletal Pain, and Nutrition: Where Are We and Where Are We Heading?.” PM & R: the journal of injury, function, and rehabilitation vol. 12,12 (2020): 1268-1278. doi:10.1002/pmrj.12346

Gómez-Pinilla, Fernando. “Brain foods: the effects of nutrients on brain function.” Nature reviews. Neuroscience vol. 9,7 (2008): 568-78. doi:10.1038/nrn2421

Stress Management and The Body’s Health

By

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

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Young male osteopath doing a craniosacral massage on a female patient gently massaging and palpating the cranium and spinal fluid with his hands

More individuals are reporting extreme levels of stress. Studies indicate that an increasing number of individuals are feeling worried, anxious, or depressed regularly from various stressors. Maintaining the body’s health includes:

Following a balanced diet
Getting enough exercise
Taking vitamins or supplements to ensure the body gets what it needs for optimal function.

However, research has found that a sudden increase in stress, specifically stress associated with anger, can trigger:

Arrhythmias
Heart attacks
Sudden death

This type of stress can affect individuals that did not know they had heart disease. Intense short-term stress can have dangerous effects on the body’s health, leading to chronic stress. Chronic stress continues at a low level for weeks, months, or years. It can significantly change the way the body functions. Stress management is very important for overall well-being. Learning how to handle stress properly is the goal.

Table of Contents

Poor Stress Management

When stress hits it triggers the brain to release various hormones. These hormones increase heart rate and raise blood pressure. This comes from evolution that helped early humans escape from predators and stay safe from different types of physical danger. This same stress reaction is what we go through, however, it is not to escape danger but to deal with work, family, school, commuting, and social issues, etc. And when the stress response happens on a regular basis it can have serious and long-term effects on the body’s ability to function properly. Stress includes mental, behavioral, and physical symptoms. The effects of stress that are most familiar are related to mood. Mood changes that can result from chronic low-level stress include:

Feelings overwhelmed
Increased anxiety
Generalized anxiety that is not connected with anything specific
Unmotivated or unfocused
Sadness
Depression
Irritability
Impatience
Unusually quick to anger
Restlessness

These mood changes can be tied to changes in behavior. The following behaviors are associated with increased stress levels:

Alcohol and/or drug abuse
Starting or increasing tobacco use
Eating changes – undereating or overeating
Withdrawing from friends and family
Avoiding social interaction
Little to no physical activity

Physical effects that are associated with long-term stress.

Chronic stress that lasts for a long period can affect the whole body. The immune system, digestive system, sleep cycles, etc. Physical symptoms include:

Tension in the neck and back
Persistent headaches
Stomach aches
Constant fatigue, even after waking up
Sleeping pattern changes
Insomnia
Muscle pain
Changes in libido
Being more prone to infections because of a weakened immune system
Chest pain

Learning Healthy Stress Management

Mental health is now an important part of living a healthy life. Stress comes from all kinds of different places. We can’t always change these moments, but we can change our reactions to reduce the negative effects and results. To manage stress, it is important to know what is causing it.

It could be an argument with a boss, co-worker, family member, or significant other.
Work deadlines
School grades, teachers, kids, etc
Bills
Repairs

Clearly identifying the main stressors will help individuals anticipate them and form a plan. There are different ways of dealing with it. The different strategies need to be researched and tried by individuals to see what works for them. Think about what helps the mind and body relax and unwind. A few recommended ways include:

Watching favorite shows or movies
Listening to music
Breathing techniques
Spend time with friends or family
Make time for yourself to do something you love – alone time
Unplug from devices like phones, tablets, or computer
Play a sport
Practice yoga
Physical activity
Take a nature hike
Write, paint, sculpt, knit, sew, crafts, make music, play instrument/s – real media or digital
Meditate and practice mindfulness techniques

These are strategies that can be incorporated into regular daily life. Be sure to set time aside to focus on mental wellbeing. Learn to recognize the signs when getting overwhelmed. Don’t hesitate to ask for help when needed. This can be a support system or mental health professional. This is to empower individuals to take better care of themselves in both body and mind.

Body Composition

Setting Attainable Goals

Individuals that have trouble achieving health goals might want to look at the goals themselves. Individuals typically have a general idea of their fitness journey. However, it is hard to reach those goals without a map. Losing weight or getting healthy is the goal but these goals are not measurable. This is too broad that can be different things to different people. Trying to accomplish a vague goal makes it hard to plan, making it happen, or seeing progress. A recommended strategy for goal setting is to use the SMART system. The acronym stands for:

Specific
Measurable
Attainable
Realistic
Timed

When goals fall into these parameters, it provides a clear picture of what is trying to get accomplished and the ability to plan accordingly. An example could be: An individual will work out at home or the gym for one hour, five days a week for one month. This is a specific and measurable goal when compared to I’m going to work out more. This provides clear guidelines of what needs to happen to achieve success.

References

Bailey, Ryan R. “Goal Setting and Action Planning for Health Behavior Change.” American journal of lifestyle medicine vol. 13,6 615-618. 13 Sep. 2017, doi:10.1177/1559827617729634

Carlson, Linda E et al. “Integrative Approaches to Stress Management.” Cancer journal (Sudbury, Mass.) vol. 25,5 (2019): 329-336. doi:10.1097/PPO.0000000000000395

Jamison, J R. “Stress management: an exploratory study of chiropractic patients.” Journal of manipulative and physiological therapeutics vol. 23,1 (2000): 32-6. doi:10.1016/s0161-4754(00)90111-8

Jamison, J. “Stress: the chiropractic patients’ self-perceptions.” Journal of manipulative and physiological therapeutics vol. 22,6 (1999): 395-8. doi:10.1016/s0161-4754(99)70085-0

Quadriceps Thigh Strain: Chiropractic

By

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

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Female relay racing team on racetrack — Young woman running a relay race and giving relay baton to her teammate. Female runner passing the relay baton during race.

The quadriceps muscle consists of four muscles in front of the thigh that connects to the knee right below the knee cap. These muscles straighten the knee for walking, running, and jumping. They also help bend the knee for squatting. They move the leg forward when running and fire/transmit electrical impulses when the foot hits the ground to absorb shock. When jumping, the muscles provide stability coming down as well as when standing on one leg.

Table of Contents

Quadriceps Strain

Thigh strains are common in sports. Most players are sidelined because of this injury when compared to strains in the hamstrings or groin. Factors that can increase the risk of injury include:

Exhaustion
Muscle weakness
The strength of the quadriceps to the hamstrings is uneven, causing one set to get overused.
Consistent sprinting and/or kicking
Previous strain and/or injury

The quadriceps is made up of four muscles. One is the rectus femoris, which gets injured the most. It’s the only muscle that crosses two joints – the hip joint and the knee joint.

Symptoms and Injury Grades

Individuals commonly report a pulling/stretching sensation in the front of the thigh. Common symptoms include:

Pain
Swelling
Bruising
Muscle tenderness
For minor quadriceps strains or tears, moderate to dull pain presents along with stiff movement.

Grades categorize the severity of the strain:

Grade 1 presents with mild discomfort in the thigh with no loss of strength.
Grade 2 presents with moderate pain, swelling, and some loss of strength.
Grade 3 is a complete rupture of the fibers. Individuals are in severe pain and unable to walk.
Grade 3 is where surgery is required.

Symptoms can vary depending on the type of injury that has been sustained and the severity. There is pain and localized swelling for both strains and contusions. If a muscle rupture has happened, there could be a bump/lump within the muscle or a gap in the muscle. If rupture of the Quadriceps Tendon has occurred, individuals often report hearing a pop when the injury happens. The swelling often makes straightening the leg difficult or impossible.

Injury causes

Thigh strains usually happen when slowing down/decelerating after a sprint. This can be because the individual takes too small or too large steps causing the muscles to overstretch, much like a rubber band that, if overstretched, tears, and if under stretched, it bunches up, which can cause spasms and tears.

Treatment

In the initial stages after a quadriceps strain, it is recommended to follow the RICE Procedure for 24 hours: This includes:

Rest
Ice
Compression
Elevate
The leg needs to be rested every 2-3 hours in 20-minute sessions.
A bandage can provide added support.
For slight tears and strains, it is recommended to stretch the quadriceps gently.
This helps prevent the muscles from experiencing shortening. This happens by the formation of scar tissue that pulls the muscle/s, making them shorter.
Gentle stretches allow the muscles to heal with minimal shortening. This helps prevent further and/or re-injury.

Chiropractic Physical Therapy Rehabilitation

After the acute stage of the injury, receiving regular chiropractic sports adjustments, physical therapy massage, coupled with strength training exercises will speed up recovery.

Physical therapy massage will remove scar tissue and keep the muscle/s loose and flexible.
Exercises for strengthening the muscles after injury will be recommended according to the individual’s condition/case.
Following correct post-injury-care, exercises, and physical therapy.
Healing time can be 4- 6 weeks.

Body Composition

Strength Training: The Inverted Row

This workout targets the back muscles, spine and scapular stabilizers, deep abdominals, and arms. Everyday activities that require various types of pulling motion, lifting, etc., become easier. To perform:

Lie flat on your back.
Grab a stable barbell or set of straps that are above you.
Pull your upper body up as high as possible while keeping the back straight.
Squeeze the shoulder blades together at the top.
Complete as many reps as possible.
Once enough strength and endurance have been built, try a pullup.

References

Kary, Joel M. “Diagnosis and management of quadriceps strains and contusions.” Current reviews in musculoskeletal medicine vol. 3,1-4 26-31. 30 Jul. 2010, doi:10.1007/s12178-010-9064-5

Hillermann, Bernd, et al. “A pilot study comparing the effects of spinal manipulative therapy with those of extra-spinal manipulative therapy on quadriceps muscle strength.” Journal of manipulative and physiological therapeutics vol. 29,2 (2006): 145-9. doi:10.1016/j.jmpt.2005.12.003

Wenban, Adrian B. “Influence of active release technique on quadriceps inhibition and strength: a pilot study.” Journal of manipulative and physiological therapeutics vol. 28,1 (2005): 73. doi:10.1016/j.jmpt.2004.12.015

A Teenagers Spine During Development

By

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

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Schoolgirl using mobile phone on the corridor

Poor spinal health in adolescence can lead to chronic pain in adulthood. Teenagers, just like adults, can experience back pain from accidents, sports injuries, a sedentary lifestyle, part-time jobs, chores, etc. However, sitting too long in school along with heavy backpacks can also contribute to compromised spinal health. Chiropractic professionals can help these young individuals address and prevent spinal issues/injuries to maintain a healthy spine.

Table of Contents

Teenagers Spine Issues

If discomfort or pain is present, much push through, as they and their spines are young. There are common spinal dysfunctions that teens and parents should be aware of. These include:

Disc injuries

Teenagers can put a serious strain on the spine from various forms of physical activity, jumping, dancing, and playing. This pressure gets transmitted through the spine. During a teenager’s development, this can result in permanent disc damage.

Scoliosis

A spinal deformity or exaggerated curvature of the spine is common and affects young children and teens. It usually happens during the growth spurt just before puberty. This is why it is important to have a teenager’s spine checked regularly and analyzed for signs/symptoms of scoliosis.

Spondylolysis

This condition is often associated with sports injuries. It happens when teenagers overextend/overreach their backs. It’s most common in gymnastics, weight lifting, tennis, football, diving, and other similar sports.

Protection and Prevention

There are several ways that parents and healthcare providers can help teenagers make healthy decisions to achieve and maintain optimal spinal health.

Sitting less, moving more.

Children are taught to sit from a very young age. In school, watching t.v., or doing homework, teenagers spend more time sitting than their bodies should. Teenagers need to stand, walk and move around just like adults to protect their spines from degeneration and injury.

Maintaining healthy posture

Teens who learn how to maintain proper posture at a young age can maintain it for the rest of their life. Learning proper posture at a young age.

Sports safety

Playing sports is healthy. However, there is a risk associated with teen sports. Although they are taught to play safely, encourage them to continue to educate themselves about sports injuries and know how to address them.

Chiropractic Support

At Injury Medical Chiropractic and Functional Medicine Clinic, we’re committed to helping young adults and adolescents overcome and prevent spinal injuries that could turn into chronic pain conditions. We are continually developing our chiropractic, and physical therapy treatment approaches to achieve optimal results.

Body Composition

Sleep and Growth Hormone In Children

Growth hormones primarily control growth. The hypothalamus and the pituitary gland regulate this hormone. Sleep plays an important role in the proper function of these glands. A review showed that:

Growth hormone levels rise and peak at the onset of deep sleep
Multiple but smaller peaks were seen during other sleep stages
Individuals that have a delay in the onset of deep sleep have delayed peaks in growth hormone levels

For children to grow properly, they need to have adequate levels of growth hormone. This means they need to have a sufficient amount of sleep. The proper amount of sleep is vital for healthy body composition. A study measured the body composition of preschool-aged children. The study found that children who had proper sleep levels had less overall fat mass and reduced body fat. Children and teenagers need to get the proper amounts of sleep for their bodies to grow healthily.

References

Clement, R Carter et al. “What are normal radiographic spine and shoulder balance parameters among adolescent patients?.” Spine deformity vol. 8,4 (2020): 621-627. doi:10.1007/s43390-020-00074-9

Driehuis, Femke et al. “Spinal manual therapy in infants, children and adolescents: A systematic review and meta-analysis on treatment indication, technique, and outcomes.” PloS one vol. 14,6 e0218940. 25 Jun. 2019, doi:10.1371/journal.pone.0218940

Manansala, Christian et al. “Change in young people’s spine pain following chiropractic care at a publicly funded healthcare facility in Canada.” Complementary therapies in clinical practice vol. 35 (2019): 301-307. doi:10.1016/j.ctcp.2019.03.013

Yoga Has Been Shown To Help Reverse Scoliosis

By

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

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Yoga Ardha Uttanasana pose — Sporty beautiful young woman in white sportswear doing variation of Standing Half Forward Bend, Ardha Uttanasana pose with wooden blocks, studio full length shot on white background, isolated

A non-invasive method of treating scoliosis. Yoga Has Been Shown To Help Reverse Scoliosis. Scoliosis is the lateral curvature of the spine. The spine bends inward toward the front of the body at the neck region and lower back region. This curve is known as lordosis and bows outward in the middle-back region. This is known as kyphosis. If the spine curves to the side, this could indicate curvature that could be scoliosis. It can be painful and often can affect an individual’s appearance once the measurement goes beyond 25 – 30 degrees. One shoulder is usually higher than the other, and clothing cannot fit properly. If the curve goes beyond 60 degrees, it can affect breathing and cardiac function.

Table of Contents

Idiopathic Causes Unknown

This condition can consist of various components, especially with more intense curves. The ribs can shift backward on the side where the curve bulges. Most cases consist of adolescent idiopathic (without a known cause) scoliosis. Because the cause is unknown, there are not a variety of effective treatment besides surgery. Physicians carefully keep an eye for:

Curves under 25 degrees.
Bracing between 25 and 45 degrees.
Consider surgery for intense curvature.

Curves in individuals typically appear between 12 and 20 years old.

Yoga Shown To Reverse Scoliosis

Individuals are recommended to do just one yoga pose daily. However, depending on the type and severity of the curves, it could be more than one. They are asked to perform the pose for 5 minutes or less, depending on the condition. A yoga therapist, chiropractor, and physical therapist can generate significant spinal improvement. This could mean that a curve of 30 degrees could be reduced to around 18 degrees in 10-12 months. Individuals that do the poses at least 4 times a week have shown 80-90% improvement. The pose can be done at work during breaks, etc.

The biggest advantage of this technique is that it is non-invasive; it can help individuals with developing curves, reversing the curvature early. Most curves do not reach the point of surgery. In late adolescence and teen years, the spine is still quite flexible. This can help accelerate the effectiveness of the yoga pose to straighten the spine. The technique reduces the curve from worsening. X-rays will show if the curvature has improved or not. Patients could be asked to do the pose/s twice or more daily depending on the direction the condition is taking.

Body Composition

Gluten Effects

Gluten causes digestive issues for individuals that have celiac disease or autoimmune thyroid disease. Individuals with these conditions could experience a variety of uncomfortable and/or painful effects. These symptoms can vary based on their presentation. They fall into classifications.

Classical Celiac Disease

With classical celiac disease, symptoms include:

Diarrhea
Discolored stools
Constipation
Abdominal bloating and pain
Weight loss

However, these symptoms are more common in children than adults. In adults, symptoms are more similar to non-classical celiac disease.

Non-Classical Celiac Disease

With non-classical celiac disease, severe digestive symptoms may not present as classic celiac disease symptoms but develop other symptoms. These include:

Abdominal distention
Pain
Iron deficiency anemia
Fatigue
Migraines
Weak bones
Depression

Silent Celiac Disease

Silent celiac disease is less visible. Individuals might not see any symptoms. However, damage to the intestines is still happening from gluten consumption.

Autoimmune Thyroid Disease

Autoimmune Thyroid Disease or ATD. Autoimmune thyroid disease includes conditions like Hashimoto’s disease. This affects the thyroid gland and causes:

Extreme fatigue
Sensitivity to cold
Hair loss
Body aches
Joint aches
Negative health effects

Studies have shown that gluten-free helps alleviate symptoms.

References

Loren M. Fishman, M.D., B.Phil. (oxon). Healing Yoga. (New York: W.W. Norton, 2014).

Loren M. Fishman, M.D., B.Phil. (oxon). “Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis—A Nonrandomized Control Trial.” Global Advances in Health and Medicine. February 24, 2021. https://journals.sagepub.com/doi/full/10.1177/2164956120988259

Fishman LM, Groessl EJ, Sherman KJ, “Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis.” Global Advances in Health and Medicine. September 1, 2014. https://journals.sagepub.com/doi/10.7453/gahmj.2013.064

Adult Scoliosis: Diagnosis, Measurements, and Chiropractic

By

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

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Man during the consultation with therapist in the office — Man during the medical consultation with senior therapist looking on the tomography print at the office

Scoliosis in adolescents and teens can be corrected with proper bracing, adjustments and lead a normal life. For adult scoliosis correcting the problem is more difficult. Fortunately, cases of adult scoliosis are rare. Scoliosis cases that follow from childhood into adulthood require a comprehensive diagnosis to determine severity. Thoracolumbar scoliosis adult-onset scoliosis requires an understanding of the catalysts to develop an effective treatment plan. Chiropractors use a full range of diagnostic tools to measure the severity of adult scoliosis.

Table of Contents

Diagnosis

Adult scoliosis is the presentation of abnormal curvature of the spine. It can happen in the thoracic, lumbar spine, or both. This can have varying degrees of severity. Severe adult scoliosis can be apparent through visual assessment and examination. Cases that are not as obvious require utilizing diagnostic tools. These include:

Imaging

X-rays will show any asymmetry that is associated with scoliosis. This asymmetry can be present in the hips or shoulder and is usually qualified by spinal misalignment.

Walking Gait Examination

Inspecting how worn out an individual’s shoe/s are and having them perform various walking tests can reveal problems with gait. In adults, this can present instability. For example, having problems with balance or fast-twitch muscle response.

Neuromotor Exams

These exams are general and first performed to get a baseline diagnosis for the presence of adult scoliosis. Tests look at the left and right coordination along with the sense of touch capabilities. This measures the severity of the improper spinal curvature and how much it has affected the development of an individual’s motor functions. It is also done in the context of how it’s affecting the body’s biomechanics. Following these exams are quantitative tools/techniques for measuring the severity of adult thoracolumbar scoliosis. These include:

Cobb Angle Measurement

This tool determines the maximum degree of spinal curvature variation and provides a context for severity.

King Classification Tool

This examines the vertebral alignment to determine the spinal variance in specific vertebrae from the neutral center position.

Lenke Classification Tool

This spinal exam relies on measurements of three positions and looks for flexibility.

Combined Approaches

When assessing adult scoliosis, this is important to understand and helps determine how to proceed with treatment. The body is no longer in development as an adolescent. This means bracing does not come with a one-size-fits-all approach. Chiropractic can help with the assessment modalities used to investigate adult scoliosis cases. These measurement and analyses tools are often used in combination to develop a complete picture of what is going on.

Body Composition

Fill Up With Prebiotics

Individuals can help their gut bacteria thrive in the digestive tract by consuming prebiotics. Prebiotics are a form of soluble fiber. The body cannot digest these prebiotics, but gut bacteria can. Recommended sources of fiber-rich prebiotics can be found in nutrient-dense foods like:

Leeks
Garlic
Onions
Fruits
Legumes
Raw chicory

A diet with various fiber types has been shown to reduce the risk of obesity and prevent weight gain. Resistant starches like plantains, green bananas, and cooled potatoes have increased beneficial bacteria in the colon. Barley, oats, and wheat bran are insoluble high-fiber grains that are also recommended sources.

References

Aebi, Max. “The adult scoliosis.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 14,10 (2005): 925-48. doi:10.1007/s00586-005-1053-9

Haenen, Daniëlle et al. “A diet high in resistant starch modulates microbiota composition, SCFA concentrations, and gene expression in pig intestine.” The Journal of nutrition vol. 143,3 (2013): 274-83. doi:10.3945/jn.112.169672

Lowe, Thomas et al. “The SRS classification for adult spinal deformity: building on the King/Moe and Lenke classification systems.” Spine vol. 31,19 Suppl (2006): S119-25. doi:10.1097/01.brs.0000232709.48446.be

Bursitis Types

By

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

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chiropractor stretching arm of handsome patient lying on massage table in hospital

Bursitis types: This is a condition that affects the bursae, which are the small, fluid-filled sacs that provide cushion for the:

Muscles
Tendons
Bones near joints

The bursae make it easier for tissues to slide over each other. The body has around one hundred and sixty bursae. However, only a few become clinically affected. These include the:

Wrist
Elbow
Shoulder
Hips
Knees
The base of the big toe and heel

The condition typically presents near joints constantly being used repetitively, like a job, sports, house/yard chores, etc. What happens is one or more of the bursae sacs become inflamed, resulting in pain.

Table of Contents

Causes

Inflamed or irritated bursae typically cause it from overuse or intense/vigorous activity.
It can also be caused by bacterial infection.
Arthritis and gout can also cause bursitis.
Another cause is age.
As tendons age, they can tear easily, lose their elasticity, and can’t take too much stress.

Intense physical activities can lead to bursitis. These include:

Gardening
Typing
Working with a computer mouse
Throwing
Golf
Tennis
Manual tasks
Carpentry

These types of activities can lead to incorrect posture, overuse, and injury/damage.

Symptoms

The main symptom is pain in and around the affected area that worsens with movement. Depending on the severity of the strain and the length of time it has been going on, the pain can be intense with active and passive movements. Other symptoms include:

Tenderness
Stiffness
For some individuals, it can present as acute, with the intensity increasing.
This happens when movement aggravates the condition.

Bursitis Types

Four major types include:

Prepatellar
Trochanteric
Olecranon
Retrocalcaneal

Prepatellar Bursitis

Prepatellar is an inflammation of the sac situated between the skin and the patella/kneecap. The most common causes are trauma from a fall and direct pressure/friction from repetitive kneeling. This is one of the bursitis types that can get infected. Overproduction of liquid places pressure on the other areas of the knee, causing swelling. Most individuals report swelling and knee pain just over the front of the knee.

Trochanteric Bursitis

This bursitis type goes over the lateral area of the hip. There is a distinctive tenderness and aching pain. This type is more common for individuals with arthritis conditions and fibromyalgia. This condition is also seen after surgery, mainly osteotomies. The bursa can become inflamed in case of injury or overuse. It tends to affect middle-aged or older folks. Common causes include:

Muscle tears
Hip injuries
Tight hip or leg muscles
Disc disease of the low back
Leg-length inequality
Improper walking technique from a minor injury or strain
Overuse of the gluteal muscles
Flat feet
Improper footwear

Olecranon Bursitis

Olecranon is a common bursitis type. It is diagnosed by the appearance of swelling over the elbow. The swelling happens just behind the olecranon process of the ulna. The bursa can become infected. This bursitis does cause blood to rupture out, and fluid could be present. Individuals are advised to avoid leaning or resting on the elbows.

Retrocalcaneal Bursitis

This is characterized by pain in the Achilles tendon. Chronic inflammation of the bursa is brought on by friction, supination, and overpronation. The flexibility of the calf muscles can be significantly reduced. Severe pain and swelling of the posterior soft tissue in front of the Achilles tendon are common symptoms. This bursitis type is often accompanied by mid-portion insertional tendinosis.

Risk Of Getting Bursitis

Anybody at any age can develop bursitis, but older individuals, specifically those in their forties and beyond, are more susceptible. This comes from all the wear and tear of the muscles and bones.

Risk Factors

Overpronation of the foot
Leg length deviation
Osteoarthritis
Obesity
Tight hamstring muscles
Incorrect physical training
Not stretching properly

Body Composition

When Inflammation Becomes Permanent

When white blood cells cause inflammation, it’s signaling that the body’s immune system works properly. The process works like this:

Inflammation activates
White blood cells attack the foreign invader
The invader is neutralized
The inflammation deactivates

This is how the body’s defense system naturally works. But, white blood cells are not the only type of cell that emit cytokines. Adipocytes or fat cells are another type of cell that can emit cytokines and cause inflammation. Scientists have learned that fat is an active endocrine organ that secretes various proteins and chemicals, including inflammatory cytokines. The body stores excess calories as fat to be used later for energy. When the body keeps adding more adipose tissue, cytokines are released by the fat cells, triggering inflammation. Obesity is characterized as a state of low-grade, chronic inflammation. Increased fat cells place the body in a constant state of stress activating immune responses. This means the body is in a constant state of inflammation with the immune system switch permanently on.

References

Aaron, Daniel L et al. “Four common types of bursitis: diagnosis and management.” The Journal of the American Academy of Orthopaedic Surgeons vol. 19,6 (2011): 359-67. doi:10.5435/00124635-201106000-00006

Coelho, Marisa et al. “Biochemistry of adipose tissue: an endocrine organ.” Archives of medical science: AMS vol. 9,2 (2013): 191-200. doi:10.5114/aoms.2013.33181

Khodaee, Morteza. “Common Superficial Bursitis.” American family physician vol. 95,4 (2017): 224-231.

Spinal Surgery Options

By

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

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Female doctor showing an x-ray on the tablet — Female doctor showing to female senior patient an x-ray on the tablet

Surgery options when back pain is becoming chronic or so severe that an individual cannot function normally and negatively affects their life. Pretty much everyone experiences back pain at some point. This is often from:

Lifting heavy/non-heavy objects incorrectly
Improper posture
Twisting in an awkward way
Overreaching
Muscle spasms
Physical activity the body is not used to doing

Most cases of backaches and pain go away by themselves or with conservative treatment. But sometimes, surgery is necessary.

Table of Contents

When Surgery Is Necessary

Acute back pain can last for days or weeks and can often resolve with physical therapy, chiropractic, and self-care. Back pain that continues for 12 weeks or longer is considered chronic. Around twenty percent of individuals who experience acute low back pain after a year begin developing chronic back pain. Doctors try to treat most back pain cases with non-surgical approaches.

They usually begin with physical therapy/chiropractic.
If that doesn’t work, then medication is incorporated.
However, many individuals do not want to take long-term medication, which is when surgery may be recommended.
In most cases, surgery is a last resort.

When the pain radiates to the legs or if it is causing problems with bladder and/or bowel function, these are definite signs/symptoms that surgery is needed. If the pain/dysfunction continues after thorough and effective non-surgical treatment, surgery could be recommended to preserve the spine to improve spinal strength and function before the problem worsens, causing further injury and damage. Some of the most common and effective spine surgery options include.

Surgery Options

Microdiscectomy

Microdiscectomy is the most common back surgery in the United States. It is minimally invasive spine surgery. Microdiscectomy patients have low back pain combined with leg pain, tingling, numbness, and weakness. In between the vertebrae are the body’s shock-absorbing discs. The discs can begin to bulge out, a bulging or herniated disc, and press on the surrounding nerve roots, causing pain, tingling, numbness, or weakness. A microdiscectomy removes the portions of the disc pressing on the nerve.

It is called micro because the surgeon wears specialized glasses known as loupes that act as microscopes. This is so the surgeon can see the details when they’re operating. The surgery is performed through a small incision in the middle of the back or on the affected side. Patients can go home a few hours after the surgery and return to normal activities within two weeks. The success rate is 85 – 95%, especially if the surgery is done early before the damage begins to spread out.

Laminectomy

The spinal canal contains a special lining. This is where the nerves and ligaments run through. Age, along with normal wear and tear on the body, causes the ligaments to thicken. This is when bone spurs can develop from osteoarthritis, and the discs can begin to bulge or rupture/herniate. This clogs and impinges the space where the nerves should easily flow through. This narrowing is called spinal stenosis. A laminectomy opens up the space relieving the compression/pressure. The procedure requires removing part of the back of a vertebra called the lamina. This enlarges the spinal canal and relieves the pressure on the nerves. The procedure is done through a small incision in the middle of the back but can also be done through a minimal incision. Leg pain improves after surgery. A traditional incision full recovery takes 6 to 12 weeks. The success rate is around 85 percent.

Spinal Fusion

A spinal fusion joins/fuses two or more bones in the spine. This is done when an individual has severe compression of the nerves, severe instability, or spinal revision surgery. A fusion can help stabilize spinal fractures. Other reasons for a spinal fusion are spine deformity, cancer of the spine, and sometimes used for intractable pain. A fusion stabilizes the spine with screws and rods. The disc causing the compression is replaced with a fusion device and bone graft. The surgery is often performed in combination with a laminectomy. Recovery and returning to activities can take around 3-4 months after the procedure. The success rate is 85-90% with pain improvement.

Kyphoplasty

Spinal compression fractures are common in individuals with osteoporosis. When they happen, the pain can be so intense that braces and medication don’t help. Kyphoplasty can bring pain relief. It can be performed by a pain management doctor, interventional radiologist, or surgeon in an outpatient X-ray facility and operating room. The procedure involves conscious sedation, sometimes accompanied by general anesthesia. A small instrument is inserted into the vertebra, and a balloon is inflated to make room for bone cement. After the bone cement is injected, patients can go home within a few hours. The success rate is around 85%, and recovery time could be several days.

Disc Replacement

This is a procedure that can replace spinal fusion for certain cases. A disc replacement can be done in the lumbar/low back or the cervical/neck spine. This procedure is performed to treat a pinched nerve and/or spinal cord compression. The injured/damaged disc is removed and is replaced with an artificial disc. The device allows for motion, whereas fusion procedures fuse the bones to stabilize and immobilize the area. Disc replacement is recommended for younger patients that don’t have serious arthritis. This is because they still have mobility. If significant arthritis is present, the patient could experience more pain and require spinal fusion. Recovery takes around six weeks. Intense physical activity is off-limits for two or three weeks after the initial recovery period. The success rate is more than 90%.

Anterior Cervical Discectomy and Fusion – ACDF

This is a common neck/cervical spine procedure. This surgery is for pain relief, weakness, tingling, and numbness of the arms caused by a pinched nerve or stenosis. The damaged disc is removed through a small incision in the side of the front of the neck. The disc is replaced with a bone graft or specialized spacer and a small plate with screws. This is to stabilize the spine. It is highly effective in relieving pain and in preventing neurological decline from spinal cord compression. Recovery time is around 12 weeks before a full return to normal activities. However, individuals report feeling better after two weeks.

Back Surgery Options

The majority of cases involving back pain get better on their own or with conservative treatment. But if an individual cannot find relief, there are safe and effective surgery options that can help.

Body Composition

When The Immune System Activates

When the body gets sick from a bacterial infection, virus, etc., the body’s defense system activates, causing inflammation. This immune response serves as the first wave of defense against foreign invaders. The infected area becomes red and swollen from increased blood flow. For example, when the nose gets red from a cold, this is inflammation. The reaction is caused by white blood cells known as macrophages, and the proteins they emit called cytokines encourage inflammation. Inflammation that’s triggered by the immune system is normally a good thing. It means the body is releasing a proper amount of hormones and proteins. These activate the white blood cells to start the healing process and work to fight the infection.

References

Low Back Pain Fact Sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

A review of complication rates for Anterior Cervical Diskectomy and Fusion (ACDF). Surg Neurol Int. 2019. https://pubmed.ncbi.nlm.nih.gov/31528438/

Rheumatology Advisor. (2017.) “Back Pain.” https://www.rheumatologyadvisor.com/home/decision-support-in-medicine/rheumatology/back-pain/

Healthy Pregnancy With Chiropractic Treatment

By

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

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pregnant woman enduring pain and leaning on table

Pregnancy is an exciting time in a woman’s life. A healthy pregnancy is the objective, and therefore, essential to maintain a healthy diet and stay physically active. However, it can be easy to forget about the strain that pregnancy places on the body and push through the aches and pain with everything going on. Specifically the spine and pelvis. During pregnancy, the body goes through various changes to accommodate the growing baby. When pregnant, a hormone known as relaxin is released. This relaxes the joints for labor and delivery. Sometimes the ligaments can become too loose that they become structurally unstable. This causes pain. Other factors that can lead to spine misalignment and pain:

25 – 30 lbs of added weight and pressure on the spine, pelvis, legs, feet.
Weakened abdominal muscles.
Lower back curvature becomes more prominent.

Pregnant women going through discomfort/pain can benefit from chiropractic pregnancy adjustments. These maintain spinal alignment while keeping the baby safe. Chiropractors are trained to treat pregnant women; however, there is additional certification to specialize in this area. A prenatal chiropractor also provides information on:

Preparing the body for labor and birth
Maintaining healthy posture
Ensure the body is properly aligned throughout the pregnancy.
Diet
Health coaching
Postpartum care

Table of Contents

Chiropractic Benefits For A Healthy Pregnancy

The obvious benefits include back pain relief, quality of life improvement, and reducing the need for pain medications. Other benefits include:

Alleviates sciatic nerve pain
Helps to control urinary incontinence
Reduces pregnancy-related nausea
Aligns the pelvis for optimal delivery
Reduces labor and delivery time

There is little risk associated with prenatal chiropractic care. However, it is not recommended for pregnant women with health complications like vaginal bleeding or ectopic pregnancy.

Repositioning

If the baby does not have enough room or is going into a breeched position, a chiropractor will work on the ligaments and muscles in the pelvic region to decrease any intrauterine restrictions. Getting the pelvis aligned will allow for an optimal delivery position. This will help move the head down and give the baby more space. If there is a breech position, it is recommended to see a chiropractor once a week during the eighth and ninth months.

When to Start

After receiving approval from the obstetrician, a woman can see a chiropractor at any stage during pregnancy. Many women start chiropractic in the first trimester. This develops a relationship early and benefits the woman as her body changes throughout the pregnancy.

How Often

Most patients visit a chiropractor once a month during the first trimester. Then they increase the sessions as the pregnancy progresses. Every woman’s pregnancy is different, requiring a personalized/customized treatment plan. The chiropractor will best advise on the frequency of treatment.

Pregnancy Technique

A chiropractor’s job is to manipulate the woman’s spine, joints, and muscles into alignment.

The adjustments utilize gentle pressure. The techniques are adjusted accordingly. Depending on how far along the woman is, as well as musculoskeletal health. For example, they could emphasize focus on the pelvis to reduce stress on the uterus and ligaments for a few sessions. Then shift back to the spine. They will not exert excessive pressure on the abdomen and possibly incorporate specialized equipment specifically for pregnant women.

Sciatica

Symptoms of sciatica are common during pregnancy, typically in the later months. This comes from the added pressure on the sciatic nerve. It can be sharp, burning pain from the hip to the foot. This makes walking, sitting, and sleeping uncomfortable to unbearable. Some women are fortunate enough to experience relief if the baby moves off the sciatic nerve. However, most will need some form of treatment to manage and heal the symptoms. This usually includes:

Series of adjustments
Hot and cold therapies
Stretches

Chiropractic can continue to help after giving birth, providing post-natal care helping the body return to its pre-pregnancy state healthily and optimally.

Body Composition

Diet, Nutrition During Pregnancy

From a nutritional perspective, a high GI diet during pregnancy increases the chances of excessive weight gain and overweight babies. Intake of low-glycemic carbs is associated with weight gain in the normal range. If planning to get pregnant or are pregnant, pay attention to the quality of carb intake for a healthy pregnancy. Health care providers recommend avoiding extreme diets for the first four to six weeks after delivery. This gives the body time to recover and helps to establish a consistent milk supply, as rapid weight loss could interfere with breastfeeding. Before going on a diet or starting an exercise program, check with a healthcare provider to rule out any medical conditions.

References

30 of the Most Surprising (And Alarming) Back Pain Statistics. The Good Body. https://www.thegoodbody.com/back-pain-statistics/. Last updated May 30, 2017. Accessed September 22, 2017.

Bernard, Maria, and Peter Tuchin. “Chiropractic Management of Pregnancy-Related Lumbopelvic Pain: A Case Study.” Journal of chiropractic medicine vol. 15,2 (2016): 129-33. doi:10.1016/j.jcm.2016.04.003

Gostine M. Is Lower Back Pain Normal During Pregnancy? BabyQ. https://www.babyq.com/lens/lifestyle/is-lower-back-pain-normal-during-pregnancy/. Published February 4, 2017. Accessed September 22, 2017.

Sabino J, Grauer JN. Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008; 1(2): 137–141. Published online February 26, 2008. doi: 10.1007/s12178-008-9021-8.

Drinking Tea For Inflammation and Back Pain

By

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

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Individuals and doctors have praised the anti-inflammatory, pain-relieving properties of drinking tea. Inflammation is the body’s natural immune response when injury and infection present. This is good. However, it’s meant to be a temporary response that deactivates when there is no longer any danger. When the body is exposed to various irritants like industrial chemicals, inflammatory foods like sugar, refined carbohydrates, and autoimmune disorders can cause the immune system to go into overdrive. Chronic inflammation can develop, circulating powerful hormones and chemicals through the body, causing damage to the cells. One consequence of chronic inflammation is back pain. Besides standard backaches, some chronic conditions are directly tied to inflammation. These include forms of arthritis:

Ankylosing spondylitis
Rheumatoid arthritis
Transverse myelitis
Multiple sclerosis
These conditions involve inflammation of the central nervous system.
Drinking tea can help with back pain and pain in general.

Table of Contents

Teas With Anti-Inflammatory Properties

Certain teas contain anti-inflammatory compounds. These compounds are called polyphenols and work to decrease the chemicals in the body responsible for pain and inflammation. There are varieties of teas that contain anti-inflammatory properties.

Certain Teas Reduce Inflammation

Drinking specific teas with more polyphenols can better decrease inflammation. For example, green tea is higher in polyphenols than black tea. Recent studies centered on individuals with rheumatoid arthritis over six months found significant improvement in symptoms in those who drank green tea. Green tea works best when part of an anti-inflammatory and nutritional lifestyle adjustment. This supports combating inflammation. Other teas that are believed to reduce inflammation include:

Turmeric
Holy basil
Ginger

Three Cups a Day

The amount of tea depends on the quality of the tea and how it is prepared. Doctors recommend around three cups a day for individuals with rheumatoid arthritis. However, these could contain caffeine. If this is an issue, there are decaffeinated versions with the same anti-inflammatory properties.

Drinking Tea Works Best When Combined with Other Treatments

If experiencing back pain or looking to combat a specific condition, it’s recommended to utilize various treatment approaches combined with drinking tea. This includes:

Chiropractic care
Physical therapy
Acupuncture
Mindfulness meditation
Yoga
Dietary supplements
Anti-inflammatory diet

Tea Is Not For All Types Of Pain

Certain back conditions benefit from drinking tea regularly; however, spine structural issues or fractures will not benefit from tea’s mild anti-inflammatory properties. It is vital for individuals with back pain that a spine specialist or chiropractor perform a proper and thorough examination, especially for Individuals that take medication that could directly interact with anti-inflammatory teas.

Drinking Tea for Back Pain

For most individuals, drinking tea is safe to help treat back pain conditions and added health benefits. For example, studies have found that green tea has mild anti-cancer, anti-diabetic properties and can help in maintaining a healthy weight. If tea helps reduce pain, it’s worth trying. Remember, pain is the body’s way to alert the individual that something is wrong.

Body Composition

Alcohol and Heart Health

According to the Mayo Clinic, consuming more than three alcoholic drinks in one sitting causes a temporary blood pressure elevation. Foods often served with alcohol are usually high in salt, which can also raise blood pressure. A few alcoholic beverages on a night out is fine, but heavy or binge drinking can lead to short-term spikes in blood pressure that could cause cardiac health problems. These are the short-term effects of alcohol on blood pressure. Heavy alcohol consumption can lead to long term health risks like:

Hypertension
Heart disease
Digestive issues
Liver disease
Stroke

It’s recommended that individuals incorporate regular exercise/physical activity and healthy diet changes and watch alcohol intake to improve heart health.

References

The Clinical Journal of Pain. (October 2019) “Nonspecific Low Back Pain:

Inflammatory Profiles of Patients With Acute and Chronic Pain” https://journals.lww.com/clinicalpain/fulltext/2019/10000/nonspecific_low_back_pain__inflammatory_profiles.2.aspx

Certain Teas Bring Down Inflammation More Than Others: Journal of Physical Therapy Science. (October 2016) “Green tea and exercise interventions as nondrug remedies in geriatric patients with rheumatoid arthritis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088134/

The Bottom Line: Proceeding of the Japan Academy, Series B Physical and Biological Sciences. (March 2012) “Health-promoting effects of green tea” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365247/

Losing Weight To Alleviate Back Pain

By

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

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Fitness class training on rowing machine — Group of people exercising in gym using rowing machine together. Side view of sportswoman doing exercise on rowing machine in crossfit center. Muscular girl and sporty men workout on training simulator at cross fit gym.

Losing weight can be one of the hardest things to do. It is also one of the best things anyone can do to get rid of back pain and optimize overall health. Achieving and maintaining a healthy weight impacts the whole body, especially the spine. It is prevalent for individuals who are overweight to experience back pain. This comes from the added weight that the feet, legs, pelvis, and spine have to support. For many, once the weight comes off, the back pain reduces significantly and/or disappears completely. For those embarking on a weight loss journey, our:

Chiropractic team
Physical therapists
Health coach
Nutritionist
Can provide resources to plan, encourage, and assist in reaching health goals.

Table of Contents

Overweight, Obesity and Back Pain

Spine pain is one of the top reasons individuals see a doctor. The need to lose weight is based on body mass index/BMI. BMI can be an indicator that an individual’s weight might not be in a healthy range. BMI ranges:

Normal weight – Body Mass Index of less than 25
Overweight – Body Mass Index of 25 to 30
Obese – Body Mass Index of 31 to 35
Extremely obese – Body Mass Index of 36 or higher

If unsure about how to get an accurate BMI measurement, talk to our team about InBody Testing.

Added Weight Places Pressure On the Spine

Added bodyweight places added strain on the low back. Studies have linked obesity with degenerative disc problems. Combined with the physical impact the added weight has on the spine and overall health, it can also affect spine surgery outcomes. Studies have shown that some overweight/obese individuals have an increased risk for surgery-related complications like:

Infection
Issues recovering from anesthesia
Overall recovery struggles

The good news is that individuals do not have to lose a significant amount of weight to see and feel the benefits. Losing 15% of excess weight will improve chronic back pain.

Exercise

Successful weight loss is the ability to maintain the loss. It needs to be something that can be committed to and brought into an individual’s lifestyle. Trying to go hard with an extreme diet or intense exercise program is not recommended. This is like not having any long-distance running knowledge along with training but entering a 12345K race. An individual will collapse after a few blocks. And sustained weight loss is just that, a long-distance journey that requires:

Getting educated about what is going on with the body
Understanding how foods affect/impact the body
Understanding the body’s unique needs to lose weight
Developing a personal health goal plan
Following through

Lifestyle factors contribute to healthy body weight. Being able to embed healthy habits into one’s life is the objective. Although it can sound easy to do, it can be a challenging process. With professional help, individuals can:

Maintain a nutritious and balanced diet
Have an active lifestyle
Maintain healthy sleep habits
Keep stress under control

Discussing a weight loss plan is very important. A professional health coach, nutritionist, and chiropractor will develop the right program that considers an individual’s specific health status.

Overall Health

Achieving a healthy weight will reduce to relieve back pain completely and significantly improve quality of life. Weight management is challenging, but once the benefits are seen and felt, it becomes second nature.

Body Composition

Healthy Kidneys

The kidneys pump more than 400 gallons of recycled blood through the body every day. These organs work nonstop to filter blood and remove waste. If the kidneys become impaired, the body can become overloaded with waste. Unhealthy lifestyle choices can harm/damage the kidneys. Kidney disease progresses slowly over the years. Individuals can lose 90 percent of kidney function before symptoms become serious. Chronic kidney disease is not reversible. However, with lifestyle adjustments, an individual can lower their risk of developing kidney-related diseases.

Proper Hydration

Drink plenty of water to clear sodium, urea, and toxins from the body and prevents kidney stones. Try to drink eight 8-ounce glasses of water each day. Every individual’s body water levels are different. A body composition test can determine what is normal for the individual.

Maintain healthy diet

Poor diet contributes to visceral fat gain. This has been linked to chronic kidney disease. Reduce visceral fat by eating a healthy diet of vegetables, fruit, and lean protein. Cut down on salty, processed foods. Body composition testing can help form an individualized diet plan to reduce visceral fat.

Supplements, antibiotics, and OTC medications

Overuse of common over-the-counter medications and supplements can cause kidney damage and disease. Consult with a doctor before taking medications and supplements if there is kidney function impairment.

Maintain fitness and physical activity

Cardio and strength training exercises are recommended. High blood sugar levels stress the kidneys. Building adequate muscle mass will help control blood sugar. A body composition test can make sure there are adequate amounts of muscle mass.

References

Liuke M, Solovieva S, Lamminen A, Luoma K, et al. Disc degeneration of the lumbar spine in relation to overweight. Int J Obes (Lond). 2005;29(8):903-908.

Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of Obesity Among Adults and Youth: the United States, 2011–2014. Centers for Disease Control and Prevention: National Center for Health Statistics.https://www.cdc.gov/nchs/products/databriefs/db219.htm. Page last updated: October 28, 2015. Accessed July 10, 2017

Samartzis D, Karppinen J, Chan D, Luk KD, et al. The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: A population-based study. Arthritis & Rheumatology. 2012;64(5):1488-1496.