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Tackling Lumbar Degenerative Disorders with the Right Treatment

By
Dr. Alex Jimenez
-

How can spinal decompression reduce pain while restoring spinal flexibility in many individuals with lumbar degenerative disorders?

Introduction

As we naturally age, so do our spines and spinal discs, as the natural fluids and nutrients stop hydrating the discs and cause them to degenerate. When disc degeneration starts to affect the spine, it can cause pain-like symptoms in the lumbar regions, which then develop into lower back pain or other musculoskeletal disorders that affect the lower extremities. When disc degeneration starts to affect the lumbar region, many individuals will notice that they are not as flexible as when they were younger. The physical signs of straining their muscles from improper lifting, falling, or carrying heavy objects can cause muscle strain and pain. When this happens, many individuals will treat the pain with home remedies, which can provide temporary relief but can aggravate it more when people make repetitive motions to their lumbar spine, which can result in injuries. Fortunately, non-surgical treatments that can help slow down the process of disc degeneration while rehydrating the spinal disc. Today’s article looks at why disc degeneration affects lumbar flexibility and how treatments like spinal decompression reduce disc degeneration while restoring lumbar flexibility. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide various treatment plans to reduce the disc degeneration process and provide pain relief. We also inform them that there are non-surgical options to reduce the pain-like symptoms associated with disc degeneration and help restore lumbar flexibility. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer

 

How Does DDD Affect Lumbar Flexibility?

Have you been experiencing stiffness in your back when you wake up in the morning? Do you feel muscle aches and pains when bending down and picking up heavy objects? Or do you feel radiating pain in your legs and back? When many individuals are in excruciating pain, many don’t often realize that their lower back pain could also be associated with their spinal disc degenerating. Since the spinal disc and the body can degenerate naturally, it can lead to the development of musculoskeletal disorders. DDD, or degenerative disc disease, is a common disabling condition that can greatly impact the musculoskeletal system and is the main cause of individuals missing out on their daily activities. (Cao et al., 2022) When normal or traumatic factors begin to cause repetitive motions to the spine, it can cause the spinal disc to be compressed and, over time, degenerate. This, in turn, causes the spine to be less flexible and becomes a socio-economic challenge.

 

 

When disc degeneration starts to cause spinal inflexibility, it can lead to the development of low back pain. Since low back pain is a common health concern, it can affect many individuals worldwide, as disc degeneration is a common factor. (Samanta et al., 2023) Since disc degeneration is a multi-factorial disorder, the musculoskeletal and organ systems are also affected as it can cause referred pain to different body locations. Luckily, many individuals can find the treatment they are looking for, as many seek relief from the many pain issues that disc degeneration has caused.

 

Lumbar Spine Injuries In Athletes- Video

Lumbar Spine Injuries in Athletes | El Paso, Tx (2023)

Since disc degeneration is a multi-factorial cause of disability, it can become a primary source of back pain. When normal factors contribute to back pain, it likely correlates with disc degeneration and can cause cellular, structural, compositional, and mechanical changes throughout the spine. (Ashinsky et al., 2021) However, many individuals seeking treatment can look into non-surgical therapies as they are cost-effective and safe on the spine. Non-surgical treatments are safe and gentle on the spine as they can be customizable to the person’s pain and combined with other treatment forms. One of the non-surgical treatments is spinal decompression, which uses gentle traction on the spine to rehydrate the spinal disc from degeneration and help kick-start the body’s natural healing process. The video above shows how disc degeneration is correlated with disc herniation and how these treatments can reduce its pain-like effects on the spine.

Spinal Decompression Reducing DDD

When many individuals are going in for treatment for disc degeneration, many will often try spinal decompression as it is affordable. Many healthcare professionals will assess the individual by creating a personalized plan before entering the traction machine. Many individuals will get a CT scan to assess the changes caused by DDD. (Dullerud & Nakstad, 1994) This determines how severe the disc space is. The traction machine for spinal decompression determines the optimal treatment duration, frequency, and mode of administrating traction to the spine to reduce DDD. (Pellecchia, 1994) Additionally, the efficiency of traction from spinal decompression can help many people with low back and provide relief. (Beurskens et al., 1995)

References

Ashinsky, B., Smith, H. E., Mauck, R. L., & Gullbrand, S. E. (2021). Intervertebral disc degeneration and regeneration: a motion segment perspective. Eur Cell Mater, 41, 370-380. doi.org/10.22203/eCM.v041a24

Beurskens, A. J., de Vet, H. C., Koke, A. J., Lindeman, E., Regtop, W., van der Heijden, G. J., & Knipschild, P. G. (1995). Efficacy of traction for non-specific low back pain: a randomised clinical trial. Lancet, 346(8990), 1596-1600. doi.org/10.1016/s0140-6736(95)91930-9

Cao, G., Yang, S., Cao, J., Tan, Z., Wu, L., Dong, F., Ding, W., & Zhang, F. (2022). The Role of Oxidative Stress in Intervertebral Disc Degeneration. Oxid Med Cell Longev, 2022, 2166817. doi.org/10.1155/2022/2166817

Dullerud, R., & Nakstad, P. H. (1994). CT changes after conservative treatment for lumbar disk herniation. Acta Radiol, 35(5), 415-419. www.ncbi.nlm.nih.gov/pubmed/8086244

Pellecchia, G. L. (1994). Lumbar traction: a review of the literature. J Orthop Sports Phys Ther, 20(5), 262-267. doi.org/10.2519/jospt.1994.20.5.262

Samanta, A., Lufkin, T., & Kraus, P. (2023). Intervertebral disc degeneration-Current therapeutic options and challenges. Front Public Health, 11, 1156749. doi.org/10.3389/fpubh.2023.1156749

 

Disclaimer

Tomatoes Nutrition Benefits: All You Need to Know

By
Dr. Alex Jimenez
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Tomato juice and fresh tomatoes

“Tomatoes are low-calorie and nutrient-dense, what health benefits can individuals gain from their consumption?”

Tomatoes Nutrition Benefits: All You Need to Know

Tomato Benefits

All varieties of tomatoes offer nutrients, including potassium and vitamin C, making them part of a balanced diet.

  • Raw tomatoes contain vitamin C, which brightens skin and fights inflammation.
  • Cooking tomatoes releases more antioxidants which are vital in small quantities such as lycopene, for maintaining heart health and preventing certain cancers.
  • Other benefits contribute to heart, prostate, and cognitive/brain health.

Various tomato recipes and products can offer a balance of nutrients. Variety is key and this applies to all fruits and vegetables. Try them raw, cooked, and steamed, as the different methods can offer different benefits.

Cooked and Raw Tomatoes

Tomatoes are low in calories and rich in nutrients. A raw, medium-sized tomato contains roughly 22 calories and less than 1 gram of fat. It is low sodium and low glycemic, with just 6 milligrams of sodium and 3 grams of sugar. They are an excellent source of hydration as a raw tomato contains about half a cup of water.

Nutritional Information

A medium tomato includes the following nutrients: (USDA: FoodData Central. 2018)

  • Protein – 1.1 grams
  • Fiber – 1.5 grams
  • Calcium – 12 milligrams
  • Magnesium – 13.5 milligrams
  • Phosphorus – 29.5 milligrams
  • Potassium – 292 milligrams
  • Vitamin C – 17 milligrams
  • Choline – 8.2 milligrams
  • Lycopene – 3.2 milligrams

Certain Antioxidants

  • Tomatoes contain several essential vitamins and minerals that support the immune system and the bones and blood.
  • Antioxidants help combat free radicals and unstable molecules that damage the body’s cells. (Edward J. Collins, et al., 2022)
  • Antioxidants like lycopene, lutein, and zeaxanthin, are better absorbed with cooked tomatoes.
  • Raw tomatoes contain small amounts of vitamins A and K, fluoride, folate, and beta-carotene.

Heart Health

  • Tomatoes provide a healthy serving of potassium.
  • Potassium and sodium are both vital for heart function.
  • Potassium is essential for relaxing the blood vessels.
  • One medium tomato contains around the same amount as a banana.
  • The heart needs these electrolytes to contract and expand.
  • Most individuals with high blood pressure can benefit from high potassium, fiber, and lycopene levels.
  • Studies have linked lycopene to lower heart disease risk and mortality. (Bo Song, et al., 2017)

Exercise Recovery

  • Electrolytes are essential for basic cell function.
  • Potassium, sodium, magnesium, and fluoride can help decrease muscle soreness and exercise fatigue after physical activity or workouts.
  • The anti-inflammatory properties come from the vitamin C.
  • Eating tomatoes before or after physical activity can help replenish magnesium which is essential for muscle contraction. (Edward J. Collins, et al., 2022)

Protection Against Dementia

  • Potassium provides power to the heart and has a role in body nerve function.
  • One recent study found that individuals who consumed more potassium and less sodium had improved cognitive function. (Xiaona Na, et al., 2022)
  • Another study analyzed how carotenoids/antioxidants that affect the color of vegetables affect long-term brain health.
  • Researchers found that individuals with increased blood levels of lutein and zeaxanthin, which are both present in cooked tomatoes had a lower rate of dementia. (May A. Beydoun, et al., 2022)
  • Lutein and zeaxanthin are also known for protecting eye health as the body ages.

Help Prevent Prostate Cancer

  • Cooking tomatoes compromises the vitamin C content, but increases the availability of several antioxidants that can protect against cancer growth.
  • Especially for men, lycopene is beneficial to help reduce prostate-related issues.
  • Studies have found that men who eat tomatoes, including raw, sauce, and on pizza have a lower risk of developing prostate cancer due to the total amount of lycopene absorbed, which is optimized in cooked tomatoes. (Joe L. Rowles 3rd, et al., 2018)
  • Lycopene and other plant pigments/carotenoids are believed to protect against cancer because of their antioxidant properties. (Edward J. Collins, et al., 2022)
  • Lycopene and other antioxidants in tomatoes can also benefit male fertility by improving sperm count and sperm motility. (Yu Yamamoto, et al., 2017)

Balance Blood Sugar

  • Tomatoes can help manage blood sugar in individuals with diabetes.
  • They have fiber that helps regulate blood sugar and bowel movements.
  • Fiber naturally slows digestion to keep the body fuller and longer and does not negatively impact blood sugar levels.
  • This is especially important given that 95% of the U.S. population does not consume the appropriate amount of fiber. (Diane Quagliani, Patricia Felt-Gunderson. 2016)

Healthy Skin, Hair, and Nails

  • Tomatoes contain chlorogenic acid, a compound that can encourage collagen production.
  • Vitamin C and A in raw tomatoes can help the appearance of skin, hair, and nails.

The Healing Diet to Combat Inflammation

References

USDA: FoodData Central. Tomatoes, red, ripe, raw, year-round average.

Collins, E. J., Bowyer, C., Tsouza, A., & Chopra, M. (2022). Tomatoes: An Extensive Review of the Associated Health Impacts of Tomatoes and Factors That Can Affect Their Cultivation. Biology, 11(2), 239. doi.org/10.3390/biology11020239

Song, B., Liu, K., Gao, Y., Zhao, L., Fang, H., Li, Y., Pei, L., & Xu, Y. (2017). Lycopene and risk of cardiovascular diseases: A meta-analysis of observational studies. Molecular nutrition & food research, 61(9), 10.1002/mnfr.201601009. doi.org/10.1002/mnfr.201601009

Na X, Xi M, Zhou Y, et al. Association of dietary sodium, potassium, sodium/potassium, and salt with objective and subjective cognitive function among the elderly in China: a prospective cohort study. (2022). Glob Transit. 4:28-39. doi:10.1016/j.glt.2022.10.002

Beydoun, M. A., Beydoun, H. A., Fanelli-Kuczmarski, M. T., Weiss, J., Hossain, S., Canas, J. A., Evans, M. K., & Zonderman, A. B. (2022). Association of Serum Antioxidant Vitamins and Carotenoids With Incident Alzheimer Disease and All-Cause Dementia Among US Adults. Neurology, 98(21), e2150–e2162. doi.org/10.1212/WNL.0000000000200289

Rowles, J. L., 3rd, Ranard, K. M., Applegate, C. C., Jeon, S., An, R., & Erdman, J. W., Jr (2018). Processed and raw tomato consumption and risk of prostate cancer: a systematic review and dose-response meta-analysis. Prostate cancer and prostatic diseases, 21(3), 319–336. doi.org/10.1038/s41391-017-0005-x

Yamamoto, Y., Aizawa, K., Mieno, M., Karamatsu, M., Hirano, Y., Furui, K., Miyashita, T., Yamazaki, K., Inakuma, T., Sato, I., Suganuma, H., & Iwamoto, T. (2017). The effects of tomato juice on male infertility. Asia Pacific journal of clinical nutrition, 26(1), 65–71. doi.org/10.6133/apjcn.102015.17

Quagliani, D., & Felt-Gunderson, P. (2016). Closing America’s Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. American journal of lifestyle medicine, 11(1), 80–85. doi.org/10.1177/1559827615588079

Take Control Of Pain With Non-Surgical Spinal Decompression Trials

By
Dr. Alex Jimenez
-

Can healthcare professionals help individuals with spinal pain by incorporating non-surgical spinal decompression to restore mobility?

Introduction

Many individuals don’t realize that putting unwanted pressure on their spines can lead to chronic pain within their spinal discs that is affecting their spinal mobility. This usually happens with demanding jobs requiring individuals to carry heavy objects, step wrong, or be physically inactive, which causes the surrounding back muscles to be overstretched and leads to referred pain that affects the upper and lower body portions. This can cause individuals to go to their primary doctors to get treated for back pain. This leads to them missing out on their busy work schedules and paying a high price to get treated. Back pain correlating with spinal issues can be a huge problem and make them feel miserable. Fortunately, numerous clinical options are cost-effective and personalized to many individuals dealing with spinal pain that is causing them to find the relief they deserve. Today’s article focuses on why spinal pain affects many people and how spinal decompression can help reduce spinal pain and restore spinal mobility. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide various treatment plans to reduce spinal pain affecting their backs. We also inform them that there are non-surgical options to reduce the pain-like symptoms associated with spinal issues in the body. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer

 

Why Spinal Pain Is Affecting Many People?

Have you often experienced pain from your back muscles that seem to ache after bending down constantly to pick up objects? Do you or your loved ones feel muscle stiffness in the back and experience numbness in your upper or lower body portions? Or are you experiencing temporary relief after stretching your back muscles, only for the pain to return? Many individuals with back pain never realize that their pain is within their spinal column. Since the spine is an S-curve shape with three different regions in the body, the spinal discs within each spinal segment can become compressed and become misaligned over time. This causes degenerative changes within the spine and can cause the three different spinal regions to develop pain-like issues in the body. When several environmental factors start to be the causes of degeneration of the spinal discs, it can affect the spinal structure. It can become a strong influence affecting their function, predisposing the disc to injuries. (Choi, 2009) At the same time, this can cause a significant impact when getting treated due to its high cost and can start normal age-related changes that cause pathophysiological issues to the vertebral body. (Gallucci et al., 2005)


When many individuals are dealing with spinal pain associated with herniated discs, it can not only cause discomfort but also mimic other musculoskeletal disorders that can cause radiating pain to different locations in the body. (Deyo et al., 1990) This, in turn, causes individuals to suffer constantly and research various treatments to reduce the pain they are experiencing. When spinal pain affects most individuals, many will seek cost-effective therapies to ease the pain they are experiencing and to be mindful of the daily habits they adopt over time and correct them.

Spinal Decompression In-Depth- Video

Spinal Decompression in Depth | El Paso, Tx (2023)

Do you often feel constant muscle aches and pains in your body that are your general areas of complaint? Do you feel your muscles pull uncomfortably after lifting or carrying a heavy object? Or do you feel constant stress in your neck, shoulders, or back? When many individuals are dealing with general pain, they often assume that it is just back pain when it could be a spinal issue that can be the root cause of the pain they are experiencing. When this happens, many individuals opt for non-surgical treatments due to its cost-effectiveness and how it can be personalized depending on the severity of the pain. One of the non-surgical treatments is spinal decompression/traction therapy. The video above gives an in-depth look at how spinal decompression can help reduce spinal pain associated with low back pain. Spinal pain can increase with age and be provoked by extreme lumbar extension, so incorporating spinal decompression can help reduce pain in the upper and lower extremities. (Katz et al., 2022)

How Spinal Decompression Can Reduce Spinal Pain


When individuals develop spinal issues, spinal decompression can help restore the spine to its original position and help the body naturally heal itself. When something is out of place within the spine, it is important to naturally restore it to its proper place to allow the affected muscles to heal. (Cyriax, 1950) Spinal decompression uses gentle traction to pull the spinal joints to let the spinal disc back in its original position and help increase fluid intake back in the spine. When people start incorporating spinal decompression into their health and wellness routine, they can reduce their spinal pain after a few consecutive treatments.

 

Spinal Decompression Restoring Spinal Mobility

Spinal decompression can also be incorporated with other non-surgical treatments to restore spinal mobility. When pain specialists utilize spinal decompression within their practices, they can help treat various musculoskeletal conditions, including spinal disorders, to allow the individual to regain spinal mobility. (Pettman, 2007) At the same time, pain specialists can use mechanical and manual manipulation to reduce the pain the individual feels. When spinal decompression starts to use gentle traction on the spine, it can help minimize radical pain correlated with nerve entrapment, create negative pressure within the spinal sections, and relieve musculoskeletal disorders causing pain. (Daniel, 2007) When people start thinking more about their health and wellness to reduce their pain, spinal decompression can be the answer through a personalized plan and can help many individuals find the relief they deserve.

 

References

Choi, Y. S. (2009). Pathophysiology of degenerative disc disease. Asian Spine Journal, 3(1), 39-44. doi.org/10.4184/asj.2009.3.1.39

 

Cyriax, J. (1950). The treatment of lumbar disk lesions. Br Med J, 2(4694), 1434-1438. doi.org/10.1136/bmj.2.4694.1434

 

Daniel, D. M. (2007). Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media? Chiropr Osteopat, 15, 7. doi.org/10.1186/1746-1340-15-7

 

Deyo, R. A., Loeser, J. D., & Bigos, S. J. (1990). Herniated lumbar intervertebral disk. Ann Intern Med, 112(8), 598-603. doi.org/10.7326/0003-4819-112-8-598

 

Gallucci, M., Puglielli, E., Splendiani, A., Pistoia, F., & Spacca, G. (2005). Degenerative disorders of the spine. Eur Radiol, 15(3), 591-598. doi.org/10.1007/s00330-004-2618-4

 

Katz, J. N., Zimmerman, Z. E., Mass, H., & Makhni, M. C. (2022). Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA, 327(17), 1688-1699. doi.org/10.1001/jama.2022.5921

 

Pettman, E. (2007). A history of manipulative therapy. J Man Manip Ther, 15(3), 165-174. doi.org/10.1179/106698107790819873

Disclaimer

Heal Naturally with Natural Biologics Treatments

By
Dr. Alex Jimenez
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Stem cell researcher working in laboratory

“As the body grows older the ability to live life to the fullest can be difficult. Can using natural biologics help enhance the body’s natural ability to heal?”

Natural Biologics

Though sometimes a necessary treatment option, surgical procedures can be the first line of treatment introduced to patients. Natural biologics is a less invasive alternative that can eliminate hospitalizations and expedite recovery. (Riham Mohamed Aly, 2020)

What Are They?

The body is born with components to initiate healing and recovery. These components include:

  • Cells
  • Cytokines
  • Proteins
  • Collagens
  • Elastin
  • Hyaluronic acid

At the time of birth, these components are in abundance but decrease as the body ages. This is why children recover from injuries quicker than adults.  Recovery for adults can be slower from a decrease in these natural healing components. The objective of natural biologics treatments is to increase the healing components by reintroducing the body’s own components – autologous – or by bringing in new components – allogeneic – from a donor. (National Institutes of Health 2016) Choosing between the two options depends on an individual’s age and health, as those who are older or in poor physical health may experience complications from inferior component amounts.

  • Healing components derived from donor sources can show more promise, as treatments are usually acquired from discarded birth tissues at delivery.
  • Birth tissues are rich in healing components, containing the most abundant collection of natural healing elements.
  • It’s important to note that there is no harm to the mother or the baby from the obtained tissue products.

Heal Naturally with Natural Biologics Treatments

Autologous Treatment

Derived from the individual receiving the cell therapy. (Yun Qian, et al., 2017)

Platelet-Rich Plasma – PRP

  • Platelet-rich plasma is cultivated by drawing an individual’s blood and spinning it in a centrifuge to separate the plasma.
  • The resulting liquid is reinjected into the injured area to generate a healing environment.
  • This form of natural biologics is effective for individuals with minor injuries that can be repaired easily.
  • This process is not as effective for older individuals who already have a reduction in natural healing components.
  • Lifestyle factors such as smoking, unhealthy diet, and alcohol/substance abuse can decrease the effectiveness of PRP treatments.

Bone Marrow Aspirate

  • This is an invasive, painful process that begins by putting a patient under anesthesia and drilling into the bone to extract the marrow. (American Cancer Society, 2023)
  • Like PRP, success depends on the individual’s age, health, and lifestyle.
  • Invasive procedures like this have a higher probability of infection and require a long-term recovery period.

Adipose-Derived Stem Cells

  • Adipose tissue/fat treatments are collected through a procedure that resembles the process of liposuction.
  • The procedure is done under general anesthesia and is an invasive process.
  • Once the tissue is collected, the cells are separated and reinjected. (Loubna Mazini, et al. 2020)
  • The treatment’s success depends on the individual’s health, age, and lifestyle.
  • There is more risk of infection when choosing this procedure and a long-term recovery period.

Allogeneic Treatment

Donor-based regenerative cells.

Amniotic Fluid Therapy

Amniotic fluid contains various growth factors, cytokines, and anti-inflammatory proteins that may promote tissue repair, reduce inflammation, and stimulate cellular regeneration. (Petra Klemmt. 2012)

  • Collected at the time of birth, this therapy is an ideal treatment for individuals who have sustained injuries that affect day-to-day functionality.
  • Physicians and clinicians are utilizing amniotic fluid therapy to treat many conditions, from orthopedic to wound care.
  • Amniotic fluid is collected at the time of birth and is abundant with increased healing components compared to autologous sources.
  • Amniotic fluid is immune-privileged (limits or suppresses immune response) and the risk of rejection is rare.
  • These therapies are usually done in a physician’s office with minimal downtime after treatment.

Wharton’s Jelly

  • Wharton’s jelly is derived from the umbilical cord at the time of birth and is primarily composed of a gel substance made up of hyaluronic acid and a network of collagen fibers.
  • Its unique properties make it ideal for protecting and supporting the umbilical cord. (Vikram Sabapathy, et al., 2014)
  • Believed to contain a population of mesenchymal stem cells that have the capacity to differentiate into various cell types, and other secreted growth factors and cytokines. (F. Gao, et al., 2016)
  • It is considered the most valuable source to enhance the healing of various tissues, including bone, cartilage, skin, and nerve tissue.
  • It is immune-privileged with little risk of rejection and minimal if any, recovery time after an in-office treatment.

Exosomes

  • Exosomes are small, membrane-bound vesicles that play a role in intercellular communication within the body. (Carl Randall Harrell, et al., 2019)
  • They contain a variety of bioactive molecules, including proteins, lipids, nucleic acids (like RNA), and signaling molecules.
  • They serve as vehicles for transferring the signaling molecules from one cell to another, allowing cells to influence the behavior and function of neighboring or distant cells.
  • They can be collected or isolated from various biological fluids and cell cultures through specialized techniques but are most robust when collected at birth.
  • The exosomes within the umbilical cord are utilized for tissue repair and regeneration, signaling the cells to promote:
  • Proliferation – increase in the number of cells through cell division.
  • Differentiation – the transformation of unspecialized cells into specialized cells.
  • Tissue healing in damaged or injured areas.
  • Exosomes from the umbilical cord are immune-privileged with minimal risk of rejection.
  • Treatments are ideal for increasing cell communication and initiating repair when paired with another source of allogeneic therapy like amniotic fluid or Wharton’s Jelly.

Choosing which natural biologics therapy is the best is different for everyone. When selecting a treatment, it is essential for individuals to consult their primary healthcare provider to determine which application will have optimal results.

Is Motion Key To Healing?

References

Aly R. M. (2020). Current state of stem cell-based therapies: an overview. Stem cell investigation, 7, 8. doi.org/10.21037/sci-2020-001

National Institutes of Health. (2016). Stem Cell Basics.

Qian, Y., Han, Q., Chen, W., Song, J., Zhao, X., Ouyang, Y., Yuan, W., & Fan, C. (2017). Platelet-Rich Plasma Derived Growth Factors Contribute to Stem Cell Differentiation in Musculoskeletal Regeneration. Frontiers in chemistry, 5, 89. doi.org/10.3389/fchem.2017.00089

American Cancer Society. (2023). Types of Stem Cell and Bone Marrow Transplants.

Mazini, L., Rochette, L., Admou, B., Amal, S., & Malka, G. (2020). Hopes and Limits of Adipose-Derived Stem Cells (ADSCs) and Mesenchymal Stem Cells (MSCs) in Wound Healing. International journal of molecular sciences, 21(4), 1306. doi.org/10.3390/ijms21041306

Klemmt P. (2012). Application of amniotic fluid stem cells in basic science and tissue regeneration. Organogenesis, 8(3), 76. doi.org/10.4161/org.23023

Sabapathy, V., Sundaram, B., V M, S., Mankuzhy, P., & Kumar, S. (2014). Human Wharton’s Jelly Mesenchymal Stem Cells plasticity augments scar-free skin wound healing with hair growth. PloS one, 9(4), e93726. doi.org/10.1371/journal.pone.0093726

Gao, F., Chiu, S. M., Motan, D. A., Zhang, Z., Chen, L., Ji, H. L., Tse, H. F., Fu, Q. L., & Lian, Q. (2016). Mesenchymal stem cells and immunomodulation: current status and future prospects. Cell death & disease, 7(1), e2062. doi.org/10.1038/cddis.2015.327

Harrell, C. R., Jovicic, N., Djonov, V., Arsenijevic, N., & Volarevic, V. (2019). Mesenchymal Stem Cell-Derived Exosomes and Other Extracellular Vesicles as New Remedies in the Therapy of Inflammatory Diseases. Cells, 8(12), 1605. doi.org/10.3390/cells8121605

Healing Muscle Strains & Injuries: Pulled Muscle Treatment

By
Dr. Alex Jimenez
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Construction, work and back of a man with pain from building, home renovation or handyman work. Mas.

“When individuals experience a neuromusculoskeletal injury strain, can following basic pulled muscle treatment protocols help in healing and a full recovery?”

Pulled Muscle Treatment

Pulled Muscle Treatment

A pulled muscle or muscle strain occurs when a muscle is stretched beyond its ability resulting in discomfort symptoms and mobility issues. Microscopic tears can occur within the muscle fibers potentially worsening the injury. This type of injury usually causes mild to severe pain, bruising, and immobility, and nerve injuries can develop as well. Common muscle strains include:

  • Pulled hamstrings
  • Groin strains
  • Pulled abdominal muscles
  • Calf strains

Pulled muscle treatment requires patience to promote proper healing and restoration of optimal function.

  • Individuals need to focus on the different stages of healing.
  • Gradually increase activity levels as the body allows to prevent stiffness and atrophy which can cause complications.

Symptoms

The usual symptoms of this type of injury include:

  • Pain
  • Limited mobility
  • Muscle spasms
  • Swelling
  • Bruising
  • Often individuals will feel a sudden grabbing or tearing sensation and are then unable to continue the activity.

Grading

Muscle strain injuries are graded by severity: (Hospital for Special Surgery. 2019)

Grade I

  • Mild discomfort.
  • Often there is no disability.
  • Usually does not limit activity.

Grade II

  • Moderate discomfort
  • Can limit the ability to perform certain activities.
  • May have moderate swelling and bruising.

Grade III

  • Severe injury that can cause significant pain.
  • Muscle spasms.
  • Swelling.
  • Significant bruising.

Basic Treatment Protocols

Most pulled muscle strain injuries heal with simple treatment. Following the right steps can ensure an expedited recovery. In the early stages after the injury, there is a balance between doing too much or not enough. The amount of activity an individual will be able to do, and the time required for recovery depends on the severity of the injury. Here are some guidelines in the right direction.

Rest

  • Rest is recommended for the early recovery stage.
  • Depending on the severity of the injury this could last from one to five days.
  • Immobilization is usually not necessary, and not moving at all can lead to muscle and joint stiffness.
  • This can be harmful and interfere with mobility. (Joel M. Kary. 2010)
  • If immobilization is necessary, like using a splint or cast, careful supervision should be monitored by a healthcare provider.

Cold Therapy

  • Cold therapy should begin as soon as possible after sustaining a pulled muscle.
  • The therapy/ice helps reduce swelling, bleeding, and pain. (Gerard A Malanga, Ning Yan, Jill Stark. 2015)
  • Cold therapy applications can be done frequently, but should not exceed 15 minutes at a time.

Stretching

  • Stretching is important to relax the muscles and for pre-mobilization.
  • Muscles that maintain flexibility help prevent further injury.

Strengthening

  • The injury and the rest period can decrease the strength of the muscle.
  • It is important to rebuild strength before returning to physical activities.
  • Strengthened muscles help prevent re-injury.

Increased Activity to Prevent Muscle Fatigue

Properly Warming Up

  • Warming up before taking on physical activities will help loosen the muscles and prevent injuries.
  • Beginning work or exercise with stiff muscles can lead to an increased chance of strain.
  • Studies have shown that temperature can influence the stiffness of a muscle. (K. W. Ranatunga. 2018)
  • Maintaining body and muscle warmth helps prevent injury and re-injury.

Injuries and Chiropractic: The Road To Recovery

References

Hospital for Special Surgery, Muscle Strain: What You Need to Know About Pulled Muscles.

Kary J. M. (2010). Diagnosis and management of quadriceps strains and contusions. Current reviews in musculoskeletal medicine, 3(1-4), 26–31. doi.org/10.1007/s12178-010-9064-5

Malanga, G. A., Yan, N., & Stark, J. (2015). Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate medicine, 127(1), 57–65. doi.org/10.1080/00325481.2015.992719

Mair, S. D., Seaber, A. V., Glisson, R. R., & Garrett, W. E., Jr (1996). The role of fatigue in susceptibility to acute muscle strain injury. The American journal of sports medicine, 24(2), 137–143. doi.org/10.1177/036354659602400203

Ranatunga K. W. (2018). Temperature Effects on Force and Actin⁻Myosin Interaction in Muscle: A Look Back on Some Experimental Findings. International journal of molecular sciences, 19(5), 1538. doi.org/10.3390/ijms19051538

The Best Nonsurgical Therapeutic Options for Low Back Pain

By
Dr. Alex Jimenez
-

Can healthcare professionals provide the best non-surgical therapeutic options for individuals with chronic low back pain?

Introduction

Chronic low back pain can happen to numerous individuals, affecting their daily routine and making them miss out on important life events. With the ever-changing world, many individuals, especially working individuals, will experience chronic low back pain at some point due to unbearable stress that seems to affect the surrounding muscles that protect the lumbar spine. This causes many individuals to overstretch or shorten the muscles that are contributing to lower back pain, which can be the causing factor in the development of lower back pain. At the same time, when individuals suffer from low back pain, it can be imposed as a grave economic cost to society. (Pai & Sundaram, 2004) This, in turn, causes many individuals to miss out on work and be financially burdened as the cost of chronic low back pain treatment is high. However, numerous therapeutic options are cost-effective, safe, and effective in reducing chronic low back pain. Today’s post looks at the effects of chronic low back pain and how many individuals can look at various non-surgical options that many individuals can utilize to reduce chronic low back pain. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide various treatment plans to reduce chronic low back pain. We also inform them that there are non-surgical options to reduce the pain-like symptoms associated with the factors that cause chronic lower back pain. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer

 

The Effects Of Chronic Low Back Pain

Have you been dealing with chronic pain that flares up in your lower back after a hard workday? Do you feel muscle aches or pains that don’t relieve itself after a day of rest? Or do you and your loved ones take any medication to temporarily relieve your back pain, only to have it come back after a few hours? Many people with chronic low back pain will feel symptoms of stiffness, muscle aches, and radiating pain traveling to their lower extremities. When chronic low back pain is associated with musculoskeletal conditions, it can impact their daily routine. To that point, musculoskeletal disorders correlating with chronic low back pain can encompass a spectrum of conditions and increase naturally over time. (Woolf & Pfleger, 2003) When many individuals are dealing with chronic low back pain, it can become a socio-economic burden that leads to disability. (Andersson, 1999) However, there are numerous options for individuals with chronic lower back pain who can find the relief they need to reduce its effects and will be able to get back to their daily routine.

 

 

Understanding Long-Lasting Injuries- Video

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

Chronic low back pain is when back pain that lasts longer than a few weeks and is one of the most common problems many people experience. When finding relief for chronic low back pain, many individuals will try home remedies to alleviate the pain. However, it can temporarily relieve the issue and mask the symptoms. When individuals see their primary doctor for chronic low back pain, many will seek a personalized plan to reduce chronic low back pain and its associated symptoms. When relieving chronic low back pain, comprehensive pain management treatments often rely on physical therapy, multidisciplinary approaches, and non-surgical options to reduce chronic low back pain. (Grabois, 2005) When understanding how the individual has chronic low back pain, it is important to identify the causes and how it can cause lifelong injuries that can develop into disability. When primary doctors start to utilize non-surgical treatments in their practices, many individuals can find the benefits of non-surgical treatments as they are cost-effective, safe, and gentle on the spine and lumbar region and can be personalized with associated medical providers to reduce pain-like symptoms correlating with chronic low back pain. Check out the video above to learn more about how non-surgical treatments can help reduce chronic low back pain and help revitalize a person’s body through a personalized treatment plan.

Non-Surgical Options For Chronic Low Back Pain

When treating chronic low back pain, non-surgical treatments effectively relieve pain and restore mobility to the back. Non-surgical treatments can be customized to the individual’s pain severity while being cost-effective. When individuals are evaluated for chronic low back pain, they are provided with many healthcare providers to reduce the pain-like symptoms caused by chronic low back pain. (Atlas & Deyo, 2001) Many individuals will incorporate various treatment options like:

  • Exercises
  • Spinal Decompression
  • Chiropractic care
  • Massage Therapy
  • Acupuncture

Many of these treatments are non-surgical and incorporate various mechanical and manual manipulation techniques to stretch and strengthen the weak back muscles, elongate the spine through realignment, and help restore movement while reducing symptoms in the lower extremities. When individuals incorporate non-surgical treatments consecutively, they will have a positive experience and feel better in the long run. (Koes et al., 1996)

 

References

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

Atlas, S. J., & Deyo, R. A. (2001). Evaluating and managing acute low back pain in the primary care setting. J Gen Intern Med, 16(2), 120-131. doi.org/10.1111/j.1525-1497.2001.91141.x

Grabois, M. (2005). Management of chronic low back pain. Am J Phys Med Rehabil, 84(3 Suppl), S29-41. www.ncbi.nlm.nih.gov/pubmed/15722781

Koes, B. W., Assendelft, W. J., van der Heijden, G. J., & Bouter, L. M. (1996). Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials. Spine (Phila Pa 1976), 21(24), 2860-2871; discussion 2872-2863. doi.org/10.1097/00007632-199612150-00013

Pai, S., & Sundaram, L. J. (2004). Low back pain: an economic assessment in the United States. Orthop Clin North Am, 35(1), 1-5. doi.org/10.1016/S0030-5898(03)00101-9

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

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

 

Disclaimer

A Beginner’s Guide to Central Nervous System Activation

By
Dr. Alex Jimenez
-
African American woman cardio for weight loss aerobics workout on bike, active lifestyle, share health, regular workout

“For individuals about to engage in physical activity or exercise, how does central nervous system activation and warming up help the body prepare for the work ahead?”

Optimize Your Performance with Central Nervous System Activation

Central Nervous System Activation

A proper warm-up before physical activity or working out prepares the mind and body to reduce risks of injury, mentally and physically transition to physical activity work, and enhance performance. A well-designed warm-up also primes the central nervous system/CNS for activity. The central nervous system transmits messages to the muscles to prepare them for action. Central nervous system activation increases motor neuron recruitment and engages the sympathetic nervous system so the body can better handle the physical stressors. The process may seem complex, but priming the nervous system is as simple as warming up with light aerobic activity before getting into more explosive movements.

CNS

The CNS consists of the brain and spinal cord. This central communication system uses another part of the nervous system known as the peripheral nervous system or PNS to transmit and receive messages throughout the body. The PNS is connected to the entire body and the brain and spinal cord (CNS).

  • Nerves run throughout the body, receiving signals from the CNS to the muscles, fibers, and organs, transmitting various information back to the brain. (Berkeley University. N.D.)
  • There are two types of systems within the peripheral nervous system – somatic and autonomic.
  1. Somatic nervous system actions are those controlled by the person through voluntary actions like choosing to pick something up.
  2. The autonomic system is involuntary and generates actions like breathing or heartbeat. (Cleveland Clinic. 2020)

Properly preparing the body for an intense strength training session or other physical activity needs the correct messages to be sent through the autonomic nervous system.

Parasympathetic and Sympathetic States

The autonomic nervous system consists of two subcategories, which are parasympathetic and sympathetic.

  • The sympathetic nervous system helps the body get ready to face stress which includes physical stress. (R. Bankenahally, H. Krovvidi. 2016)
  • The fight, flight, or freeze response describes the sympathetic nervous system’s aspect.
  • The parasympathetic nervous system is responsible for relaxation and de-stressing.

Individuals are recommended to perform a few calming movements and actions after a workout to return the body to a parasympathetic state. This can be:

  • Stretching
  • Lying with the legs elevated
  • Relaxing yoga poses
  • Box breathing
  • Taking a warm shower or bath
  • Foam rolling
  • Massage

Returning the mind and body to a calm state helps with recovery and reduces stress hormone production. (National Academy of Sports Medicine. 2022)

Why Activate the CNS

Activating the CNS can increase performance and prevent injuries. The process wakes up and alerts the body for the activity. Individuals are recommended before beginning a training session, to communicate to the body about the physical stress it is about to endure and to prepare for the work ahead. This is a concept known as post-activation potentiation/PAP. (Anthony J Blazevich, Nicolas Babault. 2019) PAP helps increase force and power production, which enhances physical performance.

  • Whenever an individual trains, the brain adapts and learns what the body is doing and the purpose of the training.
  • Muscle memory describes this interaction.
  • Individuals who have started up a new strength training routine or after an extended break report feeling awkward for the first few sessions, or even weeks, depending on their experience. (David C Hughes, Stian Ellefsen, Keith Baar, 2018)
  • However, after a few sessions, the body is more adept at performing the movements and ready to increase resistance, repetitions, or both.
  • This has to do with the neural drive and muscle memory than it has to do with true potential physical abilities. (Simon Walker. 2021)
  • Training the CNS to be alert and pay attention can increase the development of a healthy mind-muscle connection combined with muscle memory. (David C Hughes, Stian Ellefsen, Keith Baar, 2018)

General Warm-Up

The first step is a general warm-up that should use large muscle groups and be of low intensity so as not to exhaust the body before beginning the actual training. General warm-up benefits central nervous system activation and the entire body include: (Pedro P. Neves, et al., 2021) (D C. Andrade, et al., 2015)

  • Increases blood circulation.
  • Assists the release of oxygen from hemoglobin and myoglobin.
  • Warms the muscles, so they contract more effectively.
  • Increases nerve impulse speed.
  • Increases nutrient delivery.
  • Lowers joints’ resistance through increased synovial fluid/joint lubrication.
  • Increases joint range of motion.
  • Improves joint resiliency.
  • Removes metabolic waste quicker.
  • Reduces risk of injury.

A general warm-up can be simple as any aerobic activity will work. This can include:

  • Performing bodyweight movements – light jumping jacks or jogging in place.
  • Treadmill
  • Rowing machine
  • Stair climber
  • Elliptical trainer

It is recommended to use the rating perceived exertion scale/RPE to determine the general warm-up effort. An exertion rating of between 5 to 6 is equivalent to moderate walking or a slow jog. Individuals should be able to speak clearly without taking a pause.

Try this strategy before the next workout to see increased performance and reduced injury risks.

Ankle Sprains Recovery

References

The nervous system. Berkeley University.

Cleveland Clinic. Nervous system: What it is, types, symptoms.

Bankenahally R, Krovvidi H. (2016) Autonomic nervous system: anatomy, physiology, and relevance in anesthesia and critical care medicine. BJA Education. 16(11):381-387. doi:10.1093/bjaed/mkw011

National Academy of Sports Medicine. Sympathetic vs. parasympathetic overtraining.

Blazevich, A. J., & Babault, N. (2019). Post-activation Potentiation Versus Post-activation Performance Enhancement in Humans: Historical Perspective, Underlying Mechanisms, and Current Issues. Frontiers in physiology, 10, 1359. doi.org/10.3389/fphys.2019.01359

Hughes, D. C., Ellefsen, S., & Baar, K. (2018). Adaptations to Endurance and Strength Training. Cold Spring Harbor perspectives in medicine, 8(6), a029769. doi.org/10.1101/cshperspect.a029769

Walker S. (2021). Evidence of resistance training-induced neural adaptation in older adults. Experimental gerontology, 151, 111408. doi.org/10.1016/j.exger.2021.111408

P. Neves, P., R. Alves, A., A. Marinho, D., & P. Neiva, H. (2021). Warming-Up for Resistance Training and Muscular Performance: A Narrative Review. IntechOpen. doi: 10.5772/intechopen.96075

Andrade, D. C., Henriquez-Olguín, C., Beltrán, A. R., Ramírez, M. A., Labarca, C., Cornejo, M., Álvarez, C., & Ramírez-Campillo, R. (2015). Effects of general, specific, and combined warm-up on explosive muscular performance. Biology of sport, 32(2), 123–128. doi.org/10.5604/20831862.1140426

Non-Binary & Inclusive Gender Affirming Healthcare

By
Dr. Alex Jimenez
-

Can healthcare professionals implement an inclusive and positive approach for gender affirming healthcare for non-binary individuals?

Introduction

When it comes to many individuals looking for the right healthcare options for their ailments and general well-being, it can be scary and challenging to some, including many individuals within the LGBTQ+ community. Many individuals need to research when finding positive and safe healthcare facilities that listen to what the person is dealing with when getting a routine check-up or their ailments treated. Within the LGBTQ+ community, many individuals do find it difficult to express what is affecting their bodies due to past traumas of not being seen or heard due to their identities, pronouns, and orientation. This can cause numerous barriers between them and their primary doctor, leading to a negative experience. However, when medical professionals provide a positive, safe environment, listen to the person’s ailments, and be non-judgmental to their patients, they can open the doors to improving inclusive healthcare wellness within the LGBTQ+ community. Today’s article focuses on one identity within the LGBTQ+ community, known as non-binary, and how inclusive healthcare can be optimized while benefitting many individuals dealing with general aches, pains, and conditions within their bodies. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide a safe and positive experience in inclusive healthcare. We also inform them that there are non-surgical options to reduce the effects of general aches and pain while restoring their quality of life. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer

 

What Is Non-Binary Gender?

 

The term non-binary is used within the LGBTQ+ community to describe a person who doesn’t identify as a male or female within the gender identity spectrum. Non-binary individuals can even fall under various gender identities that make them who they are. These can include:

  • Genderqueer: An individual who doesn’t follow the traditional gender norm.
  • Agender: An individual who doesn’t identify with any gender. 
  • Genderfluid: An individual whose gender identity is not fixed or can change over time.
  • Intergender: An individual who identifies as a combination of male and female.
  • Androgynous: An individual whose gender expression combines masculine and feminine traits.
  • Gender Non-Conforming: An individual who doesn’t conform to society’s expectation of gender identity. 
  • Transgender: An individual whose gender identity is different from their assigned gender at birth.

When it comes to non-binary binary individuals looking for healthcare treatment for their ailments, it can be a bit of a challenge as many individuals who identify as non-binary within the LGBTQ+ community have to deal with the socio-economic impact when getting treatment, which can lead to unnecessary stress when going in for a routine check-up or getting their ailments treated. (Burgwal et al., 2019) When this happens, it can lead to a negative experience for the individual and make them feel inferior. However, when healthcare professionals take the time to be properly trained, use the correct pronouns, and create an inclusive, positive, and safe space for individuals who identify as non-binary, it can open the doors to creating more of an inclusive awareness and lead to more appropriate care for the LGBTQ+ community. (Tellier, 2019)

 

Optimizing Your Wellness- Video

Optimizing Your Wellness | El Paso, Tx (2023)

Do you or your loved ones are dealing with consistent pain in their bodies that makes it difficult to function? Do you feel stress in different body locations that correlate with musculoskeletal disorders? Or do your ailments seem to be affecting your daily routine? More often than not, in today’s ever-changing world, many individuals are researching safe and inclusive healthcare treatments to reduce their ailments. It is an important aspect to many individuals within the LGBTQ+ community, as finding the appropriate care they need can be stressful. Many healthcare professionals must provide the best possible healthcare and interventions within the LGBTQ+ community to understand the health disparities that they are experiencing. (Rattay, 2019) When healthcare professionals create a negative experience with their patients within the LGBTQ+ community, it can cause them to develop socio-economic stressors that can overlap with their pre-existing condition, creating barriers. When disparities are associated with socio-economic stressors, it can lead to poor mental health. (Baptiste-Roberts et al., 2017) When this happens, it can lead to coping mechanisms and resilience that can correlate with serious implications for the person’s overall health and well-being. However, all is not lost, as many healthcare professionals are integrating into safe, affordable, and positive healthcare spaces for individuals who identify as non-binary. We here at Injury Medical Chiropractic and Functional Medicine Clinic will work on reducing the effects of health disparities while raising awareness to continuously improve positive and inclusive experiences for non-binary individuals seeking inclusive healthcare. Check out the video above to learn more about optimizing wellness to improve your health and well-being.

How To Optimize Non-Binary Inclusive Healthcare?

When it comes to inclusive health care for non-binary individuals within the LGBTQ+ community, many healthcare providers must honor the individual’s gender identity while creating a positive and trusting relationship to reduce the ailments they are experiencing. By making a safe and positive experience for their patients, LGBTQ+ individuals will start to address to their doctors what issues they are experiencing, and it allows the doctor to come up with a personalized health care plan that is catered to them while improving their health outcomes. (Gahagan & Subirana-Malaret, 2018) At the same time, being an advocate and systemically improving, including gender-affirming care, can lead to positive results and benefit LGBTQ+ individuals. (Bhatt et al., 2022)

References

Baptiste-Roberts, K., Oranuba, E., Werts, N., & Edwards, L. V. (2017). Addressing Health Care Disparities Among Sexual Minorities. Obstet Gynecol Clin North Am, 44(1), 71-80. doi.org/10.1016/j.ogc.2016.11.003

 

Bhatt, N., Cannella, J., & Gentile, J. P. (2022). Gender-affirming Care for Transgender Patients. Innov Clin Neurosci, 19(4-6), 23-32. www.ncbi.nlm.nih.gov/pubmed/35958971

www.ncbi.nlm.nih.gov/pmc/articles/PMC9341318/pdf/icns_19_4-6_23.pdf

 

Burgwal, A., Gvianishvili, N., Hard, V., Kata, J., Garcia Nieto, I., Orre, C., Smiley, A., Vidic, J., & Motmans, J. (2019). Health disparities between binary and non binary trans people: A community-driven survey. Int J Transgend, 20(2-3), 218-229. doi.org/10.1080/15532739.2019.1629370

 

Gahagan, J., & Subirana-Malaret, M. (2018). Improving pathways to primary health care among LGBTQ populations and health care providers: key findings from Nova Scotia, Canada. Int J Equity Health, 17(1), 76. doi.org/10.1186/s12939-018-0786-0

 

Rattay, K. T. (2019). Improved Data Collection for Our LGBTQ Population is Needed to Improve Health Care and Reduce Health Disparities. Dela J Public Health, 5(3), 24-26. doi.org/10.32481/djph.2019.06.007

 

Tellier, P.-P. (2019). Improving health access for gender diverse children, youth, and emerging adults? Clinical Child Psychology and Psychiatry, 24(2), 193-198. doi.org/10.1177/1359104518808624

 

Disclaimer

Harnessing the Power of Regenerative Cells In Joint Health

By
Dr. Alex Jimenez
-
Treating knee pain with platelet-rich plasma injection. Treatment of arthritis and osteoarthritis

“As the body ages, individuals want to stay active and maintain a healthy pain-free lifestyle. Can regenerative cells for arthritis and cartilage damage be the future of neuromusculoskeletal medicine and joint healing?”

Harnessing the Power of Regenerative Cells In Joint Health

Regenerative Cells For Arthritis and Cartilage Damage

Individuals want to continue to do the physical activities they love, which require healthy joints. Scientists are learning how to harness the abilities of regenerative cells to repair and regrow damaged and deteriorated cartilage. Current stem cell treatment of cartilage problems has not been shown to reverse the effects of arthritis and while studies show clinical improvement, further research is necessary. (Bryan M. Saltzman, et al., 2016)

Cartilage and How It Gets Damaged

Cartilage is a type of connective tissue. In the joints, there are a few types of cartilage. The most commonly referred to is the smooth lining known as articular or hyaline cartilage. This type forms a smooth layer of cushion on the end of a bone at the joint. (Rocky S. Tuan, et al., 2013)

  • The tissue is very strong and has the ability to compress and absorb energy.
  • It is very smooth allowing a joint to glide effortlessly through a limb’s range of motion.
  • When joint cartilage is damaged, the cushioning can wear down.
  • In traumatic injuries, a sudden force can cause the cartilage to break off and/or suffer damage, that exposes the underlying bone.
  • In osteoarthritis – degenerative or wear-and-tear arthritis,  the smooth layer can wear down thin and unevenly.
  • Eventually, the cushion wears away, the joints become inflamed and swollen and movements become stiff and painful.

There are treatments for arthritis and cartilage damage, but these treatments are usually focused on relieving symptoms by smoothing down the damaged cartilage or replacing the joint surface with an artificial implant, like knee replacement or hip replacement surgeries. (Robert F. LaPrade, et al., 2016)

Regenerative Cells

Regenerative stem cells are special cells that have the ability to multiply and develop into different types of tissue. In an orthopedic surgery setting for joint problems, stem cells are obtained from adult stem cell primary sources which are bone marrow and fatty tissue. These cells have the ability to develop into cartilage cells, called chondrocytes. (Rocky S. Tuan, et al., 2013)

  • They also help by stimulating the body to reduce inflammation, stimulate cell repair, and improve blood circulation.
  • This process is caused by cellular signals and growth factors to stimulate the body to activate the healing processes.
  • Once stem cells have been obtained, they need to be delivered to the area of cartilage damage.

Cartilage is a complex tissue that is described as a scaffold structure that is composed of collagen, proteoglycans, water, and cells. (Rocky S. Tuan, et al., 2013)

  • To regenerate cartilage, the complex tissues must also be reconstructed.
  • There are studies on types of tissue scaffolds engineered to recreate a similar type of cartilage structure.
  • The stem cells can then be injected into the scaffold, in hopes of restoring a normal type of cartilage.

Non-Surgical Arthritis Treatments

Standard treatments such as cortisone shots or physical therapies work as well and provide benefits that could be utilized in combination with regenerative cells for arthritis and cartilage damage in the near future. Data takes time and therefore how this impacts the long-term health of a joint needs continued research in terms of tissue engineering and cell delivery to determine the best approach to help individuals.

Arthritis

References

LaPrade, R. F., Dragoo, J. L., Koh, J. L., Murray, I. R., Geeslin, A. G., & Chu, C. R. (2016). AAOS Research Symposium Updates and Consensus: Biologic Treatment of Orthopaedic Injuries. The Journal of the American Academy of Orthopaedic Surgeons, 24(7), e62–e78. doi.org/10.5435/JAAOS-D-16-00086

Saltzman, B. M., Kuhns, B. D., Weber, A. E., Yanke, A., & Nho, S. J. (2016). Stem Cells in Orthopedics: A Comprehensive Guide for the General Orthopedist. American journal of orthopedics (Belle Mead, N.J.), 45(5), 280–326.

Tuan, R. S., Chen, A. F., & Klatt, B. A. (2013). Cartilage regeneration. The Journal of the American Academy of Orthopaedic Surgeons, 21(5), 303–311. doi.org/10.5435/JAAOS-21-05-303

Healthier Dishes Through Smart Food Substitutions

By
Dr. Alex Jimenez
-
Variety of spices and herbs on table background. Cooking concept and ingredients at table top view

“For individuals looking to improve their quality of life, can substituting healthy meal ingredients be a simple step toward better health?”

Food Substitutions

Food Substitutions

Eating well does not mean having to give up favorite foods. Part of the enjoyment of home cooking is putting one’s own style on each dish. Individuals soon discover they prefer healthy food substitutions to the original high-fat, high-sugar, or high-sodium ingredients. Healthy swaps can be introduced gradually to allow the taste buds to adapt. It is possible to reduce:

  • Calories
  • Unhealthy fats
  • Sodium
  • Refined sugars

Simply making smart swaps that replace some ingredients with more beneficial ones.

Ingredients for Healthier Meals

Recipes are the sum of their parts. A dish made with multiple ingredients adds its own nutrition for healthy or unhealthy. Ingredients high in calories, saturated fat, added sugars, and/or sodium can make a dish less nutritious. By making strategic food substitutions, individuals can transform a high-calorie, high-fat, sugary dish into something more nutritious. When done regularly this adjustment leads to long-term healthy behavior changes. Making small adjustments leads to improvements in weight management, heart health, and risk of chronic diseases.

Substituting Unhealthy Fats and Oils

  1. Instead of baking with butter, try using applesauce, mashed avocados, or mashed bananas.
  2. These plant-based alternatives don’t overload the body with saturated fat.
  3. Try using half butter and half an alternative to cut calories and fats.
  4. For cooking, try sautéing, roasting, or pan-frying in olive or avocado oil.
  5. Both contain healthy monounsaturated fats.
  6. These oils can be used for dipping bread with dinner or for a quick snack.
  7. Fresh herbs or a dash of balsamic vinegar can add flavor.

Refined Sugars

Enjoying sweets can be healthy, but the objective is to be mindful of how much refined sugar is consumed. Sweet flavors send signals to the reward centers in the brain, increasing positive associations with sugar. However, eating high amounts of sugar can lead to:

Try to control how much sugar goes in.

  1. Consider incrementally scaling back on sugar in baked goods by adding three-fourths or half of the sugar.
  2. Try using fresh fruit as a natural sweetener.
  3. Mashed dates add caramel-like flavor without spiking blood sugar like white sugar.
  4. Maple syrup is another alternative.
  5. Experiment with options and combinations to keep refined sugars to a minimum.
  6. For soda or other sweetened beverages, consider going half with sparkling water and soda or juice.
  7. Sweeten water with fruit by steeping it in an infusion pitcher or bottle.

Sodium

Salt is another common excess in an individual diet. Sodium contributes to high rates of elevated blood pressure, heart attack, and stroke.

  • The CDC offers tips on how reducing sodium can improve health. (Centers for Disease Control and Prevention. 2018)
  • An array of other herbs and spices can amplify the flavor of meals.
  • Purchase or create various flavor blends.
  • For example, cumin, chili powder, oregano, and red pepper flakes can spice up a dish or a blend of thyme, paprika, garlic powder, and onion powder can add savory notes.
  • A study found that adding lemon juice to recipes could reduce sodium content and add tanginess. (Sunkist Growers. 2014)

Whole Grains

Individuals don’t have to choose brown rice or whole wheat pasta for every meal but try to select whole grains half of the time. Food substitutions that can help achieve the halfway point include:

  • Popcorn or whole wheat crackers instead of refined flour crackers.
  • Whole wheat pizza crust instead of regular crust.
  • Substitute brown rice for white in stir-fries or casseroles.
  • Oatmeal instead of refined grain cereal.
  • Whole wheat pasta for spaghetti and meatballs or other pasta dishes.
  • Quinoa as a side dish instead of white rice or couscous.

More whole grains equals more fiber and B vitamins to help sustain energy, prevent blood sugar spikes, and promote digestive health. Eating more whole grains has been linked with a reduced risk of heart disease (Caleigh M Sawicki, et al. 2021) and a lower risk of colon cancer. (Glenn A. Gaesser. 2020)

Finding the right combination of each of these substitutions takes time. Go slow and taste often to see how each substitution affects a recipe’s taste and texture.

Boost Metabolism

References

Zong, G., Li, Y., Wanders, A. J., Alssema, M., Zock, P. L., Willett, W. C., Hu, F. B., & Sun, Q. (2016). Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies. BMJ (Clinical research ed.), 355, i5796. doi.org/10.1136/bmj.i5796

American Heart Association. Saturated fat.

Harvard T.H. Chan School of Public Health. Different dietary fat, different risk of mortality.

Faruque, S., Tong, J., Lacmanovic, V., Agbonghae, C., Minaya, D. M., & Czaja, K. (2019). The Dose Makes the Poison: Sugar and Obesity in the United States – a Review. Polish journal of food and nutrition sciences, 69(3), 219–233. doi.org/10.31883/pjfns/110735

Harvard Health Publishing. The sweet danger of sugar.

American Heart Association. How much sugar is too much?

Centers for Disease Control and Prevention. How to Reduce Sodium Intake.

Sunkist Growers. Sunkist Growers and Chefs from Johnson & Wales University Release New S’alternative® Research.

Sawicki, C. M., Jacques, P. F., Lichtenstein, A. H., Rogers, G. T., Ma, J., Saltzman, E., & McKeown, N. M. (2021). Whole- and Refined-Grain Consumption and Longitudinal Changes in Cardiometabolic Risk Factors in the Framingham Offspring Cohort. The Journal of nutrition, 151(9), 2790–2799. doi.org/10.1093/jn/nxab177

Gaesser G. A. (2020). Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients, 12(12), 3756. doi.org/10.3390/nu12123756

Discover the Benefits of Hiring A Health Coach: Tips to Get Started

By
Dr. Alex Jimenez
-

“Individuals striving to be healthy may not know where or how to start. Can hiring a health coach help individuals start their wellness journey and reach their goals?”

Discover the Benefits of Hiring A Health Coach: Tips to Get Started

Hiring A Health Coach

It’s easy to get caught up in the desire to make changes, but it is another thing to actually set a consistent plan in motion. Hiring a health coach can help individuals understand the information, develop an effective wellness routine that suits their lifestyle, and achieve health and wellness goals. A primary healthcare provider could be a resource and have referrals to reputable health coaches in the area.

What Do They Do?

Health coaches are experts in helping individuals reach health and wellness goals. This can be:

  • Reducing stress
  • Improving self-care
  • Focusing on nutrition
  • Starting exercise
  • Improving quality of life

A health coach helps create a plan and makes it happen.

  • Health and wellness coaches use motivational interviewing and evidence-based approaches to empower individuals in their wellness journey. (Adam I Perlman, Abd Moain Abu Dabrh. 2020)
  • They help identify areas that need improvement, develop a plan, and encourage the individual all the way like a personal fitness trainer.
  • Health coaches work with physicians and/or other health professionals in a clinical setting or as individual providers.
  • Their role is to provide a holistic approach to health and wellness.

Services Provided

Health coaches can provide and assist with: (Shivaun Conn, Sharon Curtain 2019)

  • Diet and nutrition
  • Exercise, movement
  • Sleep
  • Mental and emotional health
  • Occupational wellness
  • Relationship building
  • Social skills building

A health coach is someone who helps organize and balance various aspects of an individual’s life so they can learn to maintain optimal health.

  • They will help overcome barriers when struggling.
  • A health coach listens and provides support for whatever an individual’s goals may be.
  • A health coach is there until the goal is reached.

Qualifications

It is important to ensure the providers being considered have the necessary qualifications. Because some certification programs offer a focus on specific areas like nutrition, it’s recommended to identify what is needed before choosing a health coach. Health coaches do not need a university degree, however, many certifications are affiliated with colleges and have educational partnerships that qualify coursework and award college credits. Training to become a health coach consists of: (Shivaun Conn, Sharon Curtain 2019)

  • Health
  • Fitness
  • Goal setting
  • Coaching concepts
  • Nutritional concepts
  • Motivational interviewing
  • Stress management
  • Changing behaviors

Health Goal Examples

Health coaching is not a one-size-fits-all approach. A primary healthcare provider or physician provides a diagnosis and medical plan, and a health coach helps guide and support the individual through the plan. However, hiring a health coach does not require a medical condition to employ services. A few examples of health goals that health coaches address include:

  • Improving quality of life
  • Reducing stress and management
  • Lifestyle habits
  • Weight loss
  • Exercise
  • Physical activity
  • Emotional and psychological health
  • Quitting smoking

Finding a Health Coach

A few things to consider.

Health Goals

  • Determine goals and expectations.
  • There are many types of health coaches and some may specialize, therefore try to determine the expertise needed to achieve the goals.

Budget

  • Determine how much money will be invested, as many insurance providers do not cover the cost of a health coach.
  • Health coaches may charge between $50 to $300 per session.
  • Some will offer packages, memberships, and/or discounts.

Certifications

  • Look into their certification.
  • Is it accredited?
  • This will ensure choosing a coach who has received the training and expertise needed to provide quality care.

Compatibility

  • Consult with potential coaches.
  • Ask questions and see if they are compatible with specific health goals.
  • Interview as many as needed.

Availability/Location

  • Virtual sessions, in-person meetings, and/or a combination?
  • How long are the sessions?
  • Frequency of meetings?
  • Finding a coach that is flexible and convenient will help maintain a healthy coach/client relationship.

Multidisciplinary Evaluation and Treatment

References

Perlman, A. I., & Abu Dabrh, A. M. (2020). Health and Wellness Coaching in Serving the Needs of Today’s Patients: A Primer for Healthcare Professionals. Global advances in health and medicine, 9, 2164956120959274. doi.org/10.1177/2164956120959274

Conn, S., & Curtain, S. (2019). Health coaching as a lifestyle medicine process in primary care. Australian journal of general practice, 48(10), 677–680. doi.org/10.31128/AJGP-07-19-4984

An Introductory Guide To Regenerative Cells

By
Dr. Alex Jimenez
-
Nuclear transfer, Stem cells made from the cell nucleus

“Individuals dealing with various conditions and diseases and ongoing research to find treatments, where do human regenerative cells come from?”

An Introductory Guide To Regenerative Cells

Regenerative Cells

Regenerative cells are stem cells that are specialized to potentially develop into many different types of cells. They are unlike any other cell because:

  • Being unspecialized they have no specific function in the body.
  • They can become specialized cells like – brain, muscle, and blood cells.
  • They can divide and renew continually for a long period.
  • Blood stem cells are currently the only type that is regularly used in treatment.
  • For leukemia or lymphoma, only adult cells are used in a procedure known as a bone marrow transplant. (Cleveland Clinic. 2023)
  • For regenerative cell research, the cells can come from different sources, including adult donors, genetically altered human cells, or embryos.

Bone Marrow Transplants

  • Bone marrow cells produce all of the body’s blood cells, including red and white blood, and platelets.
  • Hematopoietic stem cells are those found in bone marrow that is the parent for the different types of cells.
  • Hematopoietic cells are transplanted in individuals with cancer to replenish bone marrow.
  • The procedure is often used during high-dose chemotherapy that destroys the existing cells in the bone marrow.
  • Donated stem cells are injected into a vein and settle in the bone marrow where they begin to produce new healthy blood cells. (Cleveland Clinic. 2023)

Peripheral Blood Transplants

  • For some time the only source to extract hematopoietic cells was from bone marrow.
  • Researchers found that many of these cells were freely circulating in the blood.
  • Scientists learned how to extract the cells from the blood and transplant them directly.
  • This type of transplant is a peripheral blood stem cell transplant/PBSCT and has become the more common procedure, however, both methods are still used. (Cleveland Clinic. 2023)
  • PBSCT is less invasive and does not require the removal of marrow from the hip bone.

Somatic Cells

Embryonic Cells

Embryonic stem cells were first grown in a laboratory in 1998 for reproductive research, which created controversy because they were extracted from human embryos that were destroyed or harvested for science. Today their primary use is for research into treatments and potential cures for:

Embryonic cells are pluripotent, which means they can grow into the three types of germ cell layers – ectoderm, mesoderm, and endoderm – that make up the human body and can develop into each of the more than 200 types of cells. (National Institutes of Health. 2016)

Induced Pluripotent Cells

  • Induced pluripotent stem cells/iPSCs are somatic cells that have been genetically reprogrammed to behave like embryonic cells.
  • iPSCs are usually skin or blood cells that undergo genetic programming. (Pavel Simara, Jason A Motl, Dan S Kaufman. 2013)
  • iPSCs were first developed in 2006.
  • A major advantage of iPSCs over somatic and embryonic cells is that iPSCs can be generated to match the patient.
  • This means that a laboratory can tailor-make cells from an individual’s own cells or tissues.

Spine Injuries In Athletes

References

Cleveland Clinic. Stem Cell Transplant (Bone Marrow Transplant).

National Institutes of Health. Stem Cell Basics.

Simara, P., Motl, J. A., & Kaufman, D. S. (2013). Pluripotent stem cells and gene therapy. Translational research : the journal of laboratory and clinical medicine, 161(4), 284–292. doi.org/10.1016/j.trsl.2013.01.001

Finkbeiner, S. R., & Spence, J. R. (2013). A gutsy task: generating intestinal tissue from human pluripotent stem cells. Digestive diseases and sciences, 58(5), 1176–1184. doi.org/10.1007/s10620-013-2620-2

Al-Shamekh, S., & Goldberg, J. L. (2014). Retinal repair with induced pluripotent stem cells. Translational research : the journal of laboratory and clinical medicine, 163(4), 377–386. doi.org/10.1016/j.trsl.2013.11.002

A Guide to Different Types of Back Pain Specialists

By
Dr. Alex Jimenez
-
Osteopath readjusting a patient's lumbar spine while lying on the treatment table

“Back problems and discomfort symptoms are a common ailment that many types of healthcare providers diagnose and treat it. Can knowing a little about what each back pain specialist does and what they have to offer help in choosing a provider?”

Back Pain Specialists

Back Pain Specialists

Nowadays individuals have options for treating back pain. Primary healthcare providers, general practitioners, pediatricians, and emergency room workers are usually the first to examine the injury or problem. If they are unable to properly diagnose or treat the injury, they will refer the individual to a specialist. Specialists include:

  • Osteopaths
  • Chiropractors
  • Orthopedists
  • Rheumatologists
  • Neurologists
  • Neurosurgeons.

They specialize in chronic conditions and diseases like arthritis or problems like herniated discs. Complementary and alternative providers treat individuals solely or with help from a care team. They look at the whole body and focus on improving overall function.

Family and General Practitioners

When neck or back pain begins a regular doctor that’s usually a family or general practitioner/GP or primary care provider PCP is a recommended place to start. They will:

  • Order diagnostic tests.
  • Recommend exercises and stretches.
  • Prescribe medication.
  • Refer the patient to a physical therapist or other back pain specialist.

However, studies suggest general providers can be uninformed and slow to adopt new back treatments. (Paul B. Bishop, Peter C. Wing. 2006) It is recommended to research possible treatment options, ask a lot of questions during an appointment, and ask or request a referral to a specialist.

Pediatricians

Pediatricians diagnose and treat children. They cover a wide range of issues including back problems and injuries. As with a general practitioner or primary care provider, a child’s pediatrician is the place to start. Depending on the child’s needs, they’ll refer them to the proper specialist.

Emergency Healthcare Providers

When there is serious neck or back trauma, individuals need to go to the emergency room. Trauma can include automobile collisions, sports accidents, work accidents, and/or personal home accidents. Someone with a possible spinal injury should not be moved. (W Yisheng, et al., 2007) Go to the ER if there is back pain with loss of bowel or bladder control, or the legs become progressively weaker. These are symptoms of an emergency condition known as cauda equina syndrome. (American Association of Neurological Surgeons. 2023)

Orthopedists

Orthopedists and orthopedic surgeons treat the musculoskeletal system, which includes:

  • Muscles
  • Bones
  • Joints
  • Connective tissues
  • Cartilage

Common orthopedic issues include:

  • Repetitive stress injuries
  • Sports injuries
  • Bursitis
  • Tendonitis
  • Ruptured discs
  • Nerve impingement
  • Scoliosis
  • Osteoporosis
  • Osteoarthritis

Orthopedics can overlap with other specialties. As orthopedists and rheumatologists both treat arthritis and orthopedic surgeons and neurosurgeons do some of the same procedures that include spinal fusions and discectomies.

Rheumatologists

A rheumatologist treats autoimmune, inflammatory, and musculoskeletal conditions that can include different types of arthritis, lupus, and Sjogren’s syndrome. A primary care provider may refer a patient to a rheumatologist if they have symptoms that include:

  • Sacroiliitis – inflammation of the sacroiliac joint at the base of the spine.
  • Axial spondylosis – a form of spinal arthritis.
  • Axial spondylosis – spinal arthritis that causes the bones to fuse together.
  • Rheumatologists can also treat spinal stenosis or advanced osteoarthritis as they overlap with orthopedists.

Neurologists

A neurologist specializes in the function of the nervous system. They treat disorders of the brain, spinal cord, and nerves that include:

  • Parkinson’s disease
  • Multiple sclerosis
  • Alzheimer’s disease
  • Chronic back or neck pain

They are experts in the origins of pain. (David Borsook. 2012) However, a neurologist does not perform spine surgery.

Neurosurgeons

A neurosurgeon specializes in nervous system surgical procedures that include the brain, spine, and spinal cord. However, neurosurgeons do not provide overall treatment for back pain because they are usually the last to be seen after exhausting all other treatment options.

Osteopaths

An osteopath is a licensed physician who practices medicine using conventional treatments and osteopathic manipulative medicine. They have the same education as an MD plus 500 hours of musculoskeletal system studies. (National Library of Medicine. 2022) They take the same exams and are licensed as an MD. Many osteopaths are primary care providers. For back pain, they will focus on:

  • Posture rehabilitation and training.
  • Stretching
  • Therapeutic massage
  • Spinal manipulation

The goal is to relieve pain and muscle tension, increase mobility, and improve musculoskeletal function.

Physiatrists

Physiatrists are holistic providers that focus on physical function. They can be thought of as a primary care provider plus a physical therapist. These back pain specialists provide rehabilitation for various types of conditions and injuries including:

  • Back pain
  • Sports injuries
  • Stroke
  • Often they will coordinate a team of specialists to develop a targeted treatment plan.

Chiropractor

Chiropractic is a hands-on alternative medicine. The goal is to restore neuromusculoskeletal function by realigning the spine to its proper form. They do this with spinal manipulations, non-surgical mechanical decompression, traction, and massage techniques. (Michael Schneider, et al., 2016)

  • The purpose of most chiropractic adjustments is to relax and retrain tight muscles and increase flexibility.
  • Chiropractic helps to relieve stiff muscles and restore range of motion.

Individuals may not be referred to a chiropractor if they:

  • Have loose-joints
  • Have connective tissue problems or conditions.
  • Have osteoporosis/thinning bones

All types of back pain specialists provide various forms of therapy that may be able to help.

Spinal Decompression in Depth

References

Bishop, P. B., & Wing, P. C. (2006). Knowledge transfer in family physicians managing patients with acute low back pain: a prospective randomized control trial. The spine journal : official journal of the North American Spine Society, 6(3), 282–288. doi.org/10.1016/j.spinee.2005.10.008

Yisheng, W., Fuying, Z., Limin, W., Junwei, L., Guofu, P., & Weidong, W. (2007). First aid and treatment for cervical spinal cord injury with fracture and dislocation. Indian journal of orthopaedics, 41(4), 300–304. doi.org/10.4103/0019-5413.36991

American Association of Neurological Surgeons. Caudia Equina Syndrome.

Borsook D. (2012). Neurological diseases and pain. Brain : a journal of neurology, 135(Pt 2), 320–344. doi.org/10.1093/brain/awr271

National Library of Medicine. Doctor of osteopathic medicine.

Schneider, M., Murphy, D., & Hartvigsen, J. (2016). Spine Care as a Framework for the Chiropractic Identity. Journal of chiropractic humanities, 23(1), 14–21. doi.org/10.1016/j.echu.2016.09.004

Identifying Causes of Foot Nerve Pain: What You Need to Know

By
Dr. Alex Jimenez
-
Shock wave therapy, the magnetic field, rehabilitation, physiotherapist doctor performs surgery on a patient's heel.

“Individuals that experience nerve pain in the foot could be caused by a number of different conditions, can recognizing the most common causes help in developing an effective treatment plan?”

Identifying Causes of Foot Nerve Pain: What You Need to Know

Nerve Pain In The Foot

These sensations can feel like a burning, shooting, electrical, or stabbing pain and can happen while in motion or at rest. It can occur on the top of the foot or through the arch. The area closest to the nerve may be sensitive to the touch. A number of different conditions can cause nerve pain in the foot, including:

  • Morton’s neuroma
  • Pinched nerve
  • Tarsal tunnel syndrome
  • Diabetic peripheral neuropathy
  • Herniated disc

Morton’s Neuroma

Morton’s neuroma involves the nerve that runs between the third and fourth toes, but can sometimes occur between the second and third toes becoming thicker. Typical symptoms include a burning or shooting pain in the area, usually while walking. (Nikolaos Gougoulias, et al., 2019) Another common symptom is the sensation of pressure beneath the toes like the sock is bunched up underneath. Treatments can include:

  • Arch supports
  • Cortisone injections to decrease swelling
  • Footwear modifications – can include lifts, orthotics combined with metatarsal pads, and rocker soles, to provide cushion where needed.

Things that increase the risk of developing the condition include:

  • Regularly wearing high-heels – the condition occurs more frequently in women.
  • Shoes that are too tight.
  • Participating in high-impact sports like running.
  • Having flat feet, high arches, bunions, or hammertoes.

Pinched Nerve

A pinched nerve can feel like shooting or burning pain. Nerve entrapment can occur in various regions of the foot or the area on top of the foot may feel sensitive. Causes can be caused by: (Basavaraj Chari, Eugene McNally. 2018)

  • Trauma that causes swelling.
  • Blunt impact.
  • Tight shoes.

Treatment can include:

  • Massage
  • Physical therapy
  • Rest
  • Footwear modifications
  • Anti-inflammatories.

Things that increase the risk of developing a pinched nerve in the foot include:

  • Poor-fitting footwear.
  • Repetitive stress injury.
  • Trauma to the foot.
  • Obesity.
  • Rheumatoid arthritis.

Tarsal Tunnel Syndrome

Another type of nerve entrapment is tarsal tunnel syndrome. Tarsal tunnel syndrome is “anything that produces compression on the posterior tibial nerve.” (American College of Foot and Ankle Surgeons. 2019) The tibial nerve is located near the heel. Symptoms include numbness and foot cramps, burning, tingling, or shooting sensations that often radiate from the instep/arch. Both can worsen while the foot is at rest, like when sitting or sleeping. Treatment can consist of:

  • Placing padding in the shoe where the foot is being compressed to relieve the pain.
  • Custom foot orthotics.
  • Cortisone shots or other anti-inflammatory treatments.
  • Surgery may be necessary to release the nerve.

Conditions that compress the tibial nerve and can lead to tarsal tunnel syndrome include:

  • Flat feet
  • Fallen arches
  • Ankle sprain
  • Diabetes
  • Arthritis
  • Varicose veins
  • Bone spurs

Diabetic Peripheral Neuropathy

Long-term high blood sugar/glucose associated with diabetes can lead to a form of nerve damage known as peripheral neuropathy. (Centers for Disease Control and Prevention. 2022) Neuropathy pain feels like burning or shooting pain, or the sensation of walking on bubble wrap that usually shows up overnight. The pain can come and go as well as a gradual loss of feeling in the feet that begins in the toes and moves up the foot. It’s estimated that around half of individuals with diabetes will eventually develop neuropathy. (Eva L. Feldman, et al., 2019) Treatments can include:

  • Physical therapy massage to increase circulation.
  • Topical treatments with capsaicin.
  • Vitamin B.
  • Blood sugar management.
  • Alpha lipoic acid.
  • Medication.

Individuals with diabetes have an increased risk of developing peripheral neuropathy if:

  • Blood sugar is not well-controlled.
  • Diabetes has been present for many years.
  • Kidney disease.
  • Smoke.
  • Overweight or obese.

Herniated Disc

Nerve pain in the foot can be caused by spinal issues. A herniated disc in the lower back can irritate and compress the nerves, causing pain that radiates down the leg and foot. Additional symptoms usually include muscle weakness in the legs and/or numbness and tingling. Most herniated discs don’t require surgery and get better with conservative treatment. (Wai Weng Yoon, Jonathan Koch. 2021) If symptoms don’t improve or worsen, a healthcare provider may recommend surgery. Herniated discs are most common in young and middle-aged adults. Increased chances of developing a herniated disc can come from:

  • Degenerative changes in the spine from normal age wear and tear.
  • Physically demanding job.
  • Lifting incorrectly.
  • Overweight or obese.
  • Genetic predisposition – family history of herniated discs.

Spinal Stenosis

Spinal stenosis occurs when the spaces in the spine begin to narrow, creating pressure on the spinal cord and nerve roots. It is usually caused by wear and tear on the spine as the body ages. Stenosis in the lower back can cause burning pain in the buttocks and leg. As it progresses pain can radiate into the feet along with numbness and tingling. Conservative treatment consists of physical therapy exercises and non-steroidal anti-inflammatory medications/NSAIDs. (Jon Lurie, Christy Tomkins-Lane. 2016) Cortisone injections can be beneficial and if the condition worsens, surgery may be an option. Risk factors include:

  • Age 50 or older.
  • A narrow spinal canal.
  • Previous injury.
  • Previous spinal surgery.
  • Osteoarthritis that is affecting the back.

Other Possible Causes

Other conditions can result in nerve damage and pain symptoms and sensations. Examples include: (Nathan P. Staff, Anthony J. Windebank. 2014)

  • Vitamin deficiencies (Nathan P. Staff, Anthony J. Windebank. 2014)
  • Physical trauma – after surgery or an automobile or sports accident.
  • Certain cancer, antiviral medications, or antibiotics.
  • Complex regional pain syndrome.
  • Tumors that irritate and/or compress a nerve.
  • Liver or kidney disease.
  • Infectious diseases – Lyme disease complications or viral infections.

Nerve pain in the foot is definitely a reason to see a healthcare provider. Early diagnosis can help prevent symptom progression and future problems. Once the cause of the pain has been identified, the healthcare team can work together to develop a personalized treatment plan to release compressed nerves and restore mobility and function. See a healthcare provider right away if the pain and symptoms worsen, or if there are difficulties standing or walking.

Chiropractic After Accidents and Injuries

References

Gougoulias, N., Lampridis, V., & Sakellariou, A. (2019). Morton’s interdigital neuroma: instructional review. EFORT open reviews, 4(1), 14–24. doi.org/10.1302/2058-5241.4.180025

Chari, B., & McNally, E. (2018). Nerve Entrapment in Ankle and Foot: Ultrasound Imaging. Seminars in musculoskeletal radiology, 22(3), 354–363. doi.org/10.1055/s-0038-1648252

American College of Foot and Ankle Surgeons. Tarsal tunnel syndrome.

Centers for Disease Control and Prevention. Diabetes and nerve damage.

Feldman, E. L., Callaghan, B. C., Pop-Busui, R., Zochodne, D. W., Wright, D. E., Bennett, D. L., Bril, V., Russell, J. W., & Viswanathan, V. (2019). Diabetic neuropathy. Nature reviews. Disease primers, 5(1), 42. doi.org/10.1038/s41572-019-0097-9

Yoon, W. W., & Koch, J. (2021). Herniated discs: when is surgery necessary?. EFORT open reviews, 6(6), 526–530. doi.org/10.1302/2058-5241.6.210020

Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. doi.org/10.1136/bmj.h6234

Staff, N. P., & Windebank, A. J. (2014). Peripheral neuropathy due to vitamin deficiency, toxins, and medications. Continuum (Minneapolis, Minn.), 20(5 Peripheral Nervous System Disorders), 1293–1306. doi.org/10.1212/01.CON.0000455880.06675.5a

Regenerative Medicine: Exploring Regenerative Cell Therapy

By
Dr. Alex Jimenez
-

“Nowadays, individuals trying to avoid surgery have more therapy options. Can regenerative medicine help treat neuromusculoskeletal injuries?”

Regenerative Medicine: Exploring Regenerative Cell Therapy

Regenerative Medicine

Regenerative medicine utilizes the body’s raw cells and is used in cancer treatment and to reduce the risk of infections. (American Cancer Society. 2020) Researchers are looking for other ways to use these cells in medical therapies.

What are These Cells

Therapy

Regenerative cell therapy uses these cells as a treatment for a disease or condition.

  • Regenerative cells are given to individuals to replace cells that have been destroyed or have died.
  • In the case of cancer, they may be used to help the body regain the ability to produce regenerative cells after treatment. (American Cancer Society. 2020)
  • For individuals with multiple myeloma and certain types of leukemia, regenerative cell therapy is used to eliminate cancer cells.
  • The therapy is called graft-versus-tumor effect/GvT, where a donor’s white blood cells/WBCs are used to eliminate the cancerous tumor. (American Cancer Society. 2020)

What They Can Treat

This is a new treatment that is still going through research. The Food and Drug Administration has only approved it for certain cancers and conditions that affect the blood and immune system. (Centers for Disease Control and Prevention. 2019) Regenerative cell therapy is FDA-approved to treat: (National Cancer Institute. 2015)

  • Leukemia
  • Lymphoma
  • Multiple myeloma
  • Neuroblastoma
  • It is also used to decrease the risk of infection after regenerative cell transplantation in individuals with blood cancers. (U.S. Food & Drug Administration. 2023)

Researchers are studying how these cells can treat other conditions. Clinical trials are analyzing how to use the therapy for neurodegenerative diseases like:

  • Parkinson’s
  • Alzheimer’s
  • Multiple sclerosis – MS
  • Amyotrophic lateral sclerosis – ALS. (Riham Mohamed Aly. 2020)

Cell Types

During regenerative cell therapy, the cells are given through an intravenous line. The three places where blood-forming cells can be obtained are bone marrow, the umbilical cord, and blood. Transplants can include: (American Cancer Society. 2020)

Autologous

  • The cells are taken from the individual who will be receiving the therapy.

Allogeneic

  • The cells are donated by another individual.

Syngeneic

  • The cells come from an identical twin, if there is one.

Safety

The therapy has shown to provide benefits but there are risks.

  • One risk is known as graft-versus-host disease – GVHD.
  • It occurs in one-third to half of allogeneic recipients.
  • This is where the body does not recognize the donor’s white blood cells and attacks them causing problems and symptoms throughout the body.
  • To treat GVHD medications are given to suppress the immune system to stop attacking the donor cells. (American Cancer Society. 2020)

Other potential risks can include: (American Cancer Society. 2020)

  • Cancer relapse
  • New cancer
  • Hepatic veno-occlusive disease
  • Post-transplant lymphoproliferative disorder – PTLD

Future Possibilities

The future of regenerative cell therapy is promising. Research is ongoing to find out how these cells can treat conditions and find new ways to treat and cure diseases.
Regenerative medicine has been researched for over twenty years for conditions like macular degeneration, glaucoma, stroke, and Alzheimer’s disease. (National Institutes of Health. 2022) This therapy is a new medical treatment that could be used in future therapies as part of a multidisciplinary approach to neuromusculoskeletal injuries and conditions.

Quick Patient Initiation Process

References

American Cancer Society. (2020). How stem cell and bone marrow transplants are used to treat cancer.

National Institutes of Health. (2016). Stem cell basics.

Centers for Disease Control and Prevention. (2019). Stem cell and exosome products.

National Cancer Institute. (2015). Stem cell transplants in cancer treatment.

U.S. Food & Drug Administration. (2023). FDA approves cell therapy for patients with blood cancers to reduce risk of infection following stem cell transplantation.

Aly R. M. (2020). Current state of stem cell-based therapies: an overview. Stem cell investigation, 7, 8. doi.org/10.21037/sci-2020-001

American Cancer Society. (2020). Stem cell or bone marrow transplant side effects.

National Institutes of Health. (2022). Putting stem cell-based therapies in context.

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