Pancakes: Nutrition Facts & Health Benefits

“For individuals wanting to eat pancakes regularly, are there ways to increase pancake nutrition and lower the calorie and carb counts so they can be included in a balanced diet?”

Table of Contents

Pancake Nutrition

This high-carbohydrate meal can provide enough energy to fuel a day’s physical activity.

Nutrition

The following nutrition information is provided for:

Two regular pancakes made with white flour – 154g. (USDA Food Data Central. 2019)
Butter – 1 teaspoon, unsalted. (USDA Food Data Central. 2019)
Syrup – 1 tablespoon. (USDA Food Data Central. 2019)

Calories – 430.8
Fat – 18.77g
Sodium – 693.9mg
Carbohydrates – 55.9g
Fiber – .75g
Sugars – 8.6g
Protein – 8.64g

Pancakes made with whole-wheat flour offer more fiber and protein. The following is nutrition info for two or three whole-wheat pancakes (150g) made from a mix. (Child Nutrition Recipe Box. 2023)

Calories – 348
Fat – 15g
Sodium – 594mg
Carbohydrates – 45g
Fiber – 6g
Sugars – 6g
Protein – 12g

Carbohydrates

Pancakes will increase carbohydrate intake. The body uses carbohydrates as a primary fuel source, making them an important nutrient. However, most nutritionists suggest that individuals get their daily carbohydrates from nutrient-dense sources. Pancakes typically don’t fall into this category. White flour pancakes do not provide much fiber, and around 60 grams of carbohydrates are consumed in this meal. Substituting whole-wheat flour changes the amount to around 6g of fiber or 20% of the daily recommended value.

Fat

Pancakes can include dairy and eggs and are topped with butter that contributes a significant amount of fat. Pancake mix may contain trans fat. Some brands include partially hydrogenated oils. Health experts recommend that individuals limit or completely avoid foods containing trans fat. If the label ingredient list contains partially hydrogenated ingredients, it is recommended to avoid it. (MedlinePlus. 2022)

Protein

Pancakes may provide some protein, which varies based on the type of flour used. Some brands add protein powder to increase intake.

Vitamins and Minerals

Pancakes and ready mixes are generally made from enriched flour. Enriched foods are those that have had nutrients added during the manufacturing process. In most cases, the nutrients, vitamins, and minerals are stripped away, and then some are added back in during processing. Constantly eating enriched bread products limits diet-friendly fiber and nutrients. The enriched flour in pancakes and added sugar and syrup raise blood sugar levels rapidly and then generate hunger shortly afterward.

Calories

Total nutrition numbers also depend on serving size. The numbers on the label only apply to a single serving which is just two medium pancakes. Many individuals consume 3-4 medium pancakes and double the amount of butter and syrup as well. This can add up to more than 1,000 calories.

Benefits

Whole-wheat pancakes made with whole-grain flour are more nutritious than pancakes made with white flour and can be a delicious way to eat more whole grains. They can be topped with berries or other fruits for added fiber and nutrients.

Digestion

Whole-wheat pancakes made with whole-grain flour provide significant fiber for healthy digestion. Fiber helps with waste evacuation and has prebiotic compounds that fuel beneficial gut bacteria. (Joanne Slavin. 2013)

Improves Hunger Satisfaction

Whole-grain pancakes taste heartier and include fiber that keeps the body fuller longer than pancakes made with faster-digesting refined flour.

Decreases Risk of Heart Disease

A review of studies examining whole grain consumption and heart disease found that eating whole grains was associated with a reduced risk of heart disease. (Dagfinn Aune, et al., 2016)

Reduces Risk of Obesity

Research suggests that whole grain intake reduces the risk of obesity and could help individuals maintain a stable weight. (Katrina R. Kissock et al., 2021) The fiber will also help keep the fuller longer after the meal.

Helps Prevent Birth Defects

Whole-wheat flour is fortified with folic acid, an important B vitamin during pregnancy. Folic acid decreases the risk of neural tube defects, which can affect the development of the brain or spine. (Centers for Disease Control and Prevention. 2022)

Variations

Nutrients for regular pancakes will vary based on the size.

One made-from-scratch small pancake – 3″ across provides:

30 calories
1 gram of protein
5 grams of carbohydrate
0 grams of fiber
1 gram of sugar

One made-from-scratch medium pancake – 5″ across provides:

93 calories
2 grams of protein
15 grams of carbohydrate
0 grams of fiber
2 grams of sugar

One made-from-scratch large pancake – 7″ across provides:

186 calories
4 grams of protein
30 grams of carbohydrate
1 gram of fiber
5 grams of sugar

Making Pancakes

If pancakes are part of a weekly meal plan, try to keep them lower in sugar, fat, and calories.

Make pancakes from scratch without the mix to avoid any trans fats.
Use whole wheat flour to get fiber to increase hunger satisfaction.
Instead of frying the pancakes in oil or butter, use a quality non-stick pan to reduce fat intake.
Use syrup with no sugar.
Top with blueberries, raspberries, or strawberries.

Eating Right to Feel Better

References

USDA Food Data Central. (2019). Pancakes, plain, prepared from recipe.

USDA FoodData Central. (2019). Butter, without salt.

USDA FoodData Central. (2019). Syrups, table blends, pancake.

Child Nutrition Recipe Box. (2023). Pancakes – USDA recipe for schools.

MedlinePlus. (2022). Facts about trans fat.

Slavin J. (2013). Fiber and prebiotics: mechanisms and health benefits. Nutrients, 5(4), 1417–1435. doi.org/10.3390/nu5041417

Aune, D., Keum, N., Giovannucci, E., Fadnes, L. T., Boffetta, P., Greenwood, D. C., Tonstad, S., Vatten, L. J., Riboli, E., & Norat, T. (2016). Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ (Clinical research ed.), 353, i2716. doi.org/10.1136/bmj.i2716

Kissock, K. R., Neale, E. P., & Beck, E. J. (2021). Whole Grain Food Definition Effects on Determining Associations of Whole Grain Intake and Body Weight Changes: A Systematic Review. Advances in nutrition (Bethesda, Md.), 12(3), 693–707. doi.org/10.1093/advances/nmaa122

Centers for Disease Control and Prevention. (2022). Folic acid.

Try Non-surgical Decompression for Sensor Nerve Dysfunction

Dr. Alex Jimenez

Can individuals with sensory nerve dysfunction incorporate nonsurgical decompression to restore sensory-mobility function to their bodies?

Table of Contents

Introduction

The spinal column in the musculoskeletal system comprises bones, joints, and nerves that work together with various muscles and tissues to ensure that the spinal cord is protected. The spinal cord is part of the central nervous system where the nerve roots are spread out to the upper and lower body parts that supply sensory-motor functions. This allows the body to move and function without pain or discomfort. However, when the body and spine ages or when a person is dealing with injuries, the nerve roots can become irritated and cause weird sensations like numbness or tingling, often correlating with body pain. This can cause a socio-economic burden on many individuals and, if not treated right away, can lead to chronic pain. To that point, it can lead to many individuals dealing with body extremity pain associated with sensory nerve dysfunction. This causes many individuals dealing with musculoskeletal disorders to start looking for treatment. Today’s article examines how nerve dysfunction affects the extremities and how nonsurgical decompression can help reduce nerve dysfunction to allow mobility back to the upper and lower limbs. We speak with certified medical providers who incorporate our patients’ information to provide nonsurgical solutions like decompression to help individuals with nerve dysfunction. We also inform patients how nonsurgical decompression can restore mobility-sensory to the upper and lower extremities. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the sensory nerve dysfunction. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

How Nerve Dysfunction Affects The Extremities

Do you experience tingling or numb sensations in your hands or feet that don’t want to go away? Do you feel pain in different back portions that can only be relieved through stretching or resting? Or does it hurt to walk for long distances that you feel like you need to rest constantly? Many pain-like scenarios are associated with sensory nerve dysfunction that can affect the upper and lower extremities. When many individuals experience sensory nerve dysfunction and deal with weird sensations in their extremities, many think it is due to musculoskeletal pain in their neck, shoulders, or back. This is only part of the issue, as many environmental factors can be associated with sensory nerve pain, as the nerve roots are being compressed and agitated, causing sensory nerve dysfunction in the extremities. Since the nerve roots are spread out from the spinal cord, the brain sends the neuron information to the nerve roots to allow sensory-mobility function in the upper and lower extremities. This allows the body to be mobile without discomfort or pain and functional through daily activities. However, when many individuals start to do repetitive motions that cause the spinal disc to be compressed constantly, it can lead to potential disc herniation and musculoskeletal disorders. Since numerous nerve roots are spread to the different extremities, when the main nerve roots are aggravated, it can send pain signals to each extremity. Hence, many people are dealing with nerve entrapment that leads to lower back, buttock, and leg pain that can affect their daily routine. (Karl et al., 2022) At the same time, many people with sciatica are dealing with sensory nerve dysfunction that affects their walking ability. With sciatica, it can be associated with spinal disc pathology and causes many individuals to seek treatment. (Bush et al., 1992)

Sciatica Secrets Revealed-Video

Sciatica Secrets Revealed! | El Paso, Tx (2023)

When it comes to looking for treatment to reduce sensory nerve dysfunction, many individuals will opt for nonsurgical solutions to minimize the pain-like symptoms and reduce the pain signals that are causing the upper and lower extremities to suffer. Nonsurgical treatment solutions like decompression can help restore sensory nerve function through gentle traction by causing the spinal disc to lay off the aggravated nerve root and start the body’s natural healing process. At the same time, it helps reduce musculoskeletal disorders from returning. The video above shows how sciatica associated with sensory nerve dysfunction can be decreased through nonsurgical treatments to allow the body’s extremities to feel better.

Nonsurgical Decompression Reducing Nerve Dysfunction

Nonsurgical treatments can help reduce low back pain associated with sensory nerve dysfunction to restore sensory-motor function to the upper and lower extremities. Many individuals who incorporate nonsurgical treatments like decompression as part of their health and wellness routine can see improvement after consecutive treatment. (Chou et al., 2007) Since many healthcare practitioners incorporate nonsurgical treatments like decompression into their practices, there has been quite an improvement in pain management. (Bronfort et al., 2008)

When many individuals start to use nonsurgical decompression for sensory nerve dysfunction, many will see improvement in their pain, mobility, and activities of their daily living. (Gose et al., 1998). What spinal decompression does for the nerve roots is that it helps the affected disc that is aggravating the nerve root, pulls the disc back to its original position, and rehydrates it. (Ramos & Martin, 1994) When many individuals start thinking about their health and wellness, nonsurgical treatments can be effective for them due to their affordable cost and how they can be combined with other therapies to manage better the pain associated with nerve dysfunction affecting their body extremities.

References

Bronfort, G., Haas, M., Evans, R., Kawchuk, G., & Dagenais, S. (2008). Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine J, 8(1), 213-225. doi.org/10.1016/j.spinee.2007.10.023

Bush, K., Cowan, N., Katz, D. E., & Gishen, P. (1992). The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up. Spine (Phila Pa 1976), 17(10), 1205-1212. doi.org/10.1097/00007632-199210000-00013

Chou, R., Huffman, L. H., American Pain, S., & American College of, P. (2007). Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med, 147(7), 492-504. doi.org/10.7326/0003-4819-147-7-200710020-00007

Gose, E. E., Naguszewski, W. K., & Naguszewski, R. K. (1998). Vertebral axial decompression therapy for pain associated with herniated or degenerated discs or facet syndrome: an outcome study. Neurol Res, 20(3), 186-190. doi.org/10.1080/01616412.1998.11740504

Karl, H. W., Helm, S., & Trescot, A. M. (2022). Superior and Middle Cluneal Nerve Entrapment: A Cause of Low Back and Radicular Pain. Pain Physician, 25(4), E503-E521. www.ncbi.nlm.nih.gov/pubmed/35793175

Ramos, G., & Martin, W. (1994). Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg, 81(3), 350-353. doi.org/10.3171/jns.1994.81.3.0350

Disclaimer

Tips for Improving Sleeping Mobility After Injury, Illness or Surgery

Dr. Alex Jimenez

Female doctor and male patient Physical therapy is being done at the hospital.

“Individuals in post-surgery recovery or dealing with illness or an injury can experience weakened muscles and endurance that can cause temporary loss of sleeping mobility and inability to move around normally because of weakness, decreased range of motion, or pain. Can they benefit from physical therapy to help get back to normal functional mobility?”

Table of Contents

Sleeping Mobility

For individuals who are hospitalized or homebound from injury, illness, or surgical recovery, a physical therapist will assess various areas of functional mobility. These include transfers – from sitting to standing positions, walking, and sleeping mobility. Sleeping mobility is the ability to perform specific motions while in bed. A therapist can assess sleeping or bed mobility and recommend strategies and exercises to improve movements. (O’Sullivan, S. B., Schmitz, T. J. 2016) A therapist may have the individual use specific devices, like an over-the-bed trapeze or a sliding board, to help move around.

Bed and Sleeping Mobility

When a physical therapist checks mobility, they will assess various motions that include: (O’Sullivan, S. B., Schmitz, T. J. 2016)

Moving from sitting to lying down.
Moving from lying down to sitting up.
Rolling over.
Scooting or sliding up or down.
Scooting or sliding sideways.
Twisting.
Reaching.
Raising the hips.

All of these movements require strength in different muscle groups. By checking out individual motions in sleeping mobility, a therapist can work out specific muscle groups that may be weak and require targeted exercises and stretches to restore mobility to normal. (O’Sullivan, S. B., Schmitz, T. J. 2016) Individuals visiting a therapist in an outpatient clinic or rehabilitation area may have the individual work on sleeping mobility on a treatment table. The same motions on the treatment table can be done in the bed.

Importance

The body is meant to move.

For individuals who cannot move comfortably on their bed, the body may suffer disuse atrophy or the wasting away of muscular strength, which can lead to increased difficulties. Not being able to move can also lead to pressure ulcers, especially for individuals who are severely deconditioned and/or remain in one position for a long period. Skin health may start to break down, leading to painful wounds that require specialized care. Being able to move around in bed can help prevent pressure ulcers. (Surajit Bhattacharya, R. K. Mishra. 2015)

Improvement

A physical therapist can prescribe specific exercises to strengthen muscle groups and improve sleeping mobility. The muscles include:

Shoulder and rotator cuff muscles.
Triceps and biceps in the arms.
Gluteus muscles of the hips.
Hamstrings
Quadriceps
Calf muscles

The shoulders, arms, hips, and legs work together when moving the body around the bed.

Various Exercises

To improve bed movement, physical therapy exercises can include:

Upper extremity exercises
Lower trunk rotation
Glute exercises
Bridges
Leg raises
Short arc quads
Ankle pumps

Physical therapists are trained to assess these motions and functions and prescribe treatments to improve body movement. (O’Sullivan, S. B., Schmitz, T. J. 2016) Maintaining appropriate physical fitness can help the body stay active and mobile. Performing mobility exercises prescribed by a physical therapist can keep the right muscle groups working properly, and working with a physical therapist can ensure the exercises are correct for the condition and are performed properly.

Optimizing Your Wellness

References

O’Sullivan, S. B., Schmitz, T. J. (2016). Improving Functional Outcomes in Physical Rehabilitation. United States: F.A. Davis Company.

Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India, 48(1), 4–16. doi.org/10.4103/0970-0358.155260

Wearable Weights: Get Fit & Achieve Health Goals Easily

Dr. Alex Jimenez

Young woman wearing leather ankle straps prepares to exercise on fitness — Young smiling woman wearing leather ankle straps prepares to exercise on fitness machine in the gym. Fitness, sport, training, people concept.

“For individuals wanting to improve their fitness routine, can incorporating wearable weights and knowing how to use them effectively help achieve health goals?”

Table of Contents

Wearable Weights

Adding wearable weights allows individuals to use their body weight with added resistance. This can add strength training to a routine but can also be used during walks or runs to increase cardiovascular health and aid in weight loss. Research studies have found that wearing a weighted vest reduces body weight and fat mass. This is because heavier loads increase energy expenditure for the increase in physical workload. (Claes Ohlsson, et al., 2020)

Benefits

Wearable weights are easy to use.

Depending on the type, they are compact and can be taken on the go.
Wearing weights is an option for individuals with injuries or degenerative joint disease like arthritis that makes it difficult to hold or move weights.
Exercise has been proven to be a useful tool for treating osteoarthritis. (Lei Chen, Yan Yu. 2020)
There is no age limit for wearable weights.
Because many are only a few pounds, they are available to anyone from adolescents to the elderly.
Anyone can benefit from the different types of wearable weights.

Types

Three main types of wearable weights include wrist weights, ankle weights, and weighted vests.

Wrist weights can replace dumbbells in some cases.
They are typically between 1 to 10 pounds.
Ankle weights can provide extra resistance to leg motions.
They can be found from 1 pound up to 20 pounds.
Weighted vests provide a full-body challenge.
The weight choices for them vary, as most contain pockets where weight can be increased or decreased.

Using The Weights

Individuals can use wearable weights as a complement to strength and cardiovascular regimens. Beginners will want to start with lighter weights worn for less time. As the body becomes stronger, it’s important to increase the weight to see results.

Ankle Weights

Ankle weights can be used during a strength training workout to add resistance to lower body exercises.
As the body ages, it becomes more important to decrease the risk of falls by increasing lower limb and trunk strength.
Wearing ankle weights is recommended to build strength, especially in older adults. (Hiroyasu Akatsu, et al., 2022)
Individuals can wear them during a walk or run to increase the challenge.
They can be used for a high-level core workout.

Wrist Weights

Wrist weights can be used like dumbbells and worn during a walk or a run.
Research shows that walking with wrist weights can improve walking gait. (Hyung Suk Yang, et al., 2018)
Wearing weights on the wrists generates a higher energy expenditure, which allows one to add intensity to a walk or run without having to increase speed. (Catherine T. Campaña, Pablo B Costa. 2017)

Weighted Vests

Wearing a weighted vest during workouts will create a full-body challenge.
They can be used while walking or running and automatically add more difficulty.
Another way to utilize a weighted vest is to wear it while completing a regular workout.
Whether doing HITT, strength training, etc, individuals can wear a weighted vest.
The weight should be evenly distributed to prevent any injuries or functional disorders to the lower body.
Studies show no change in gait or an increased risk of injury when used correctly. (Christopher J. Gaffney, et al., 2022)

Individuals want to talk to a healthcare provider before beginning a new fitness program, and adding weights is no different, especially if there are any current or past injuries.

Is Motion Key To Healing?

References

Ohlsson, C., Gidestrand, E., Bellman, J., Larsson, C., Palsdottir, V., Hägg, D., Jansson, P. A., & Jansson, J. O. (2020). Increased weight loading reduces body weight and body fat in obese subjects – A proof of concept randomized clinical trial. EClinicalMedicine, 22, 100338. doi.org/10.1016/j.eclinm.2020.100338

Chen, L., & Yu, Y. (2020). Exercise and Osteoarthritis. Advances in experimental medicine and biology, 1228, 219–231. doi.org/10.1007/978-981-15-1792-1_15

Akatsu, H., Manabe, T., Kawade, Y., Masaki, Y., Hoshino, S., Jo, T., Kobayashi, S., Hayakawa, T., & Ohara, H. (2022). Effect of Ankle Weights as a Frailty Prevention Strategy in the Community-Dwelling Elderly: A Preliminary Report. International journal of environmental research and public health, 19(12), 7350. doi.org/10.3390/ijerph19127350

Yang, H. S., James, C. R., Atkins, L. T., Sawyer, S. F., Sizer, P. S., Jr, Kumar, N. A., & Kim, J. (2018). Effects of arm weight on gait performance in healthy subjects. Human movement science, 60, 40–47. doi.org/10.1016/j.humov.2018.05.003

Campaña, C. T., & Costa, P. B. (2017). Effects of walking with hand-held weights on energy expenditure and excess postexercise oxygen consumption. Journal of exercise rehabilitation, 13(6), 641–646. doi.org/10.12965/jer.1735100.550

Gaffney, C. J., Cunnington, J., Rattley, K., Wrench, E., Dyche, C., & Bampouras, T. M. (2022). Weighted vests in CrossFit increase physiological stress during walking and running without changes in spatiotemporal gait parameters. Ergonomics, 65(1), 147–158. doi.org/10.1080/00140139.2021.1961876

Unhealthy Posture: What Causes It and How to Counteract It

Dr. Alex Jimenez

shot-of-a-young-businesswoman-experiencing-back-pa-2023-11-27-05-25-14-utc_02 — Shot of a young businesswoman experiencing back pain while working at her desk in a modern office.

“Many individuals attribute, to some degree, their neck or back pain to unhealthy posture. Can knowing the causes and underlying factors help guide lifestyle adjustments and seeking medical rehabilitative treatment?”

Table of Contents

Unhealthy Posture Causes

Numerous factors can cause individuals to practice unhealthy postures regularly.

Day-to-day activities and the effects of gravity on the body can cause unhealthy posture. (Dariusz Czaprowski, et al., 2018)
Unhealthy posture can also be brought on by an injury, illness, or genetics.
A combination of these factors is also common.

Practicing healthy posture is a form of exercise where the muscles support the skeleton in stable and efficient alignment that is present in stillness and movement.

Injury and Muscle Guarding

After an injury, muscles can spasm to protect the body and help stabilize injuries and protect against further injury.
However, movements become limited and can lead to pain symptoms.
Prolonged muscle spasms lead to weakened muscles over time.
The imbalance between muscles guarding the injury and those still operating normally can lead to posture problems.
Musculoskeletal treatment with massage, chiropractic, and physical therapy can help restore optimal functioning.

Muscle Tension and Weakness

If certain muscle groups become weak or tense, posture can be affected, and pain symptoms can develop.
Muscle weakness or tension can develop when individuals hold a prolonged position day after day or when performing routine tasks and chores in a way that places tension on the muscles or uses them in an unbalanced way.
A study found how muscle tension, strength, and flexibility affect posture. Dariusz Czaprowski, et al., 2018)
Postural retraining and physical therapy adjustments can help strengthen the muscles and relieve pain symptoms.

Daily Habits

As individuals find ways to accommodate muscle spasms, weakness, tension, and/or imbalances, the mind and body can forget and abandon healthy posture.
The body then begins compensating using alternate, awkward, and counterproductive muscle contractions and stretching that compromise body and spinal alignment.

Use of Technology

Technology – whether sitting at a desk/workstation, using a tablet or cell phone, or working with several devices can gradually shift the body out of alignment. (Parisa Nejati, et al., 2015)
Individuals constantly looking down at their phone may develop a text neck, a condition in which the neck is held in flexion or forward tilting too long, which can lead to pain.

Mental Attitude and Stress

Individuals under stress or are experiencing stressful situations can begin to have posture problems. (Shwetha Nair et al., 2015)
Stress can contribute to over-contracting muscles, which can cause muscle tension, shallow breathing, posture problems, and pain symptoms.
Being aware of body position and correcting and adjusting posture can help to counteract stress. (Shwetha Nair et al., 2015)

Footwear Choice and They Are Worn

Footwear can affect body posture.
High heels shift the body’s weight forward, which can cause misalignment. (Anniele Martins Silva, et al., 2013)
Wearing down the outside or inside of the shoes faster from things like weight-bearing habits will imbalance kinetic forces that translate up the ankle, knee, hip, and lower back leading to pain symptoms in any or all of these joints.

Heredity and Genetics

Sometimes the cause is hereditary.
For example, Scheuermann’s disease is a condition in which adolescent males develop a pronounced kyphosis curve in the thoracic spine. (Nemours. KidsHealth. 2022)

Consult Injury Medical Chiropractic and Functional Medicine Clinic for an evaluation, and let us help you by developing a personalized treatment and rehabilitation program.

The Path To Healing

References

Czaprowski, D., Stoliński, Ł., Tyrakowski, M., Kozinoga, M., & Kotwicki, T. (2018). Non-structural misalignments of body posture in the sagittal plane. Scoliosis and spinal disorders, 13, 6. doi.org/10.1186/s13013-018-0151-5

Nejati, P., Lotfian, S., Moezy, A., & Nejati, M. (2015). The study of correlation between forward head posture and neck pain in Iranian office workers. International journal of occupational medicine and environmental health, 28(2), 295–303. doi.org/10.13075/ijomeh.1896.00352

Nair, S., Sagar, M., Sollers, J., 3rd, Consedine, N., & Broadbent, E. (2015). Do slumped and upright postures affect stress responses? A randomized trial. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 34(6), 632–641. doi.org/10.1037/hea0000146

Silva, A. M., de Siqueira, G. R., & da Silva, G. A. (2013). Implications of high-heeled shoes on body posture of adolescents. Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo, 31(2), 265–271. doi.org/10.1590/s0103-05822013000200020

Nemours. KidsHealth. (2022). Scheuermann’s kyphosis.

Discover How Friction Massage Can Help Improve Scar Tissue

Dr. Alex Jimenez

shoulder-pain-physical-therapy-and-chiropractor-w-2023-11-27-04-49-59-utc_02 — Shoulder pain, physical therapy and chiropractor with patient, injury and healthcare with help and .

“For individuals having difficulty moving or functioning normally due to injury, surgery, or illness, can a chiropractic and physical therapy team help expedite recovery?”

Table of Contents

Friction Massage

Individuals may develop scar tissue or tissue adhesions that limit normal motion after injury or surgery. A pain management team may use various treatments and modalities and may incorporate friction massage as part of a rehabilitation treatment plan. Friction massage, also known as transverse friction or cross friction massage, is a technique used to help improve scar tissue and adhesion mobility to move better and decrease the negative effects. The therapist uses their fingers to massage the scar in a direction that is at right angles to the scar line. It is a specialized technique that breaks up tissue adhesions that are limiting normal movement in the skin and underlying tissues. (Haris Begovic, et al., 2016)

Scar Tissue and Adhesions

For individuals who require surgery due to an injury or an orthopedic condition, their doctor will cut into the skin, tendons, and muscle tissue during the operation. Once sutured and healing has begun, scar tissue forms. Healthy tissue is made up of collagen that is comprised of cells that are arranged in a regular pattern. Healthy collagen is strong and can resist forces when tissues are pulled and stretched. (Paula Chaves, et al., 2017)

During the healing process after an injury, the collagen cells are laid down in a haphazard pattern and form scar tissue. The random accumulation of cells becomes tight and does not react well to tension and stretching forces. (Qing Chun, et al., 2016) The body can form scar tissue after a soft tissue injury, like a muscle or tendon strain. (Qing Chun, et al., 2016)

If a muscle or tendon gets strained the body will generate new collagen during the healing. The new collagen is laid down in a random fashion, and scar tissue or tissue adhesions can form that can limit the normal range of motion. Healthy tissue stretches and glides as the body moves. Scar tissue is rigid. At the site of the scar tissue, there can be some movement, but it is tight, less pliable, and can be painful. If scar tissue or adhesions are limiting motion, cross-friction massage can improve tissue gliding and sliding. This process is referred to as remodeling.

Massage Objectives

The objectives and goals of friction massage to adhesions or scar tissue may include:

Stimulation of nerve fibers to decrease and relieve pain.
Increase blood circulation to the tissues.
Working the affected tissue to break up scarring.
Collagen fibers tissue realignment.
Improve mechanoreceptor activity.

Massage Technique

Friction massage treatment follows a specific technique: (Paula Chaves, et al., 2017)

The entire area of scar tissue or adhesion should be treated.
If the scar tissue is in a muscle, it should be relaxed.
If the scar tissue is in a tendon sheath, that tendon should be slightly stretched during the procedure.
The therapist places two or three fingers over the scar or adhesion and moves their fingers perpendicular to the scar to smooth the collagen fibers down.
The fingers and underlying tissues move together.
The massage should feel deep and uncomfortable but not painful.
There may be some pain, but should remain within the individual’s tolerance.
If the massage is too painful, less pressure may be used.
After several minutes the therapist will assess the tissue mobility.
Specific stretches may be done to elongate the scar tissue or adhesions.
At-home exercises and stretches may be prescribed to maintain flexibility.

Contraindications

There are situations where friction massage should not be used and can include: (Paula Chaves, et al., 2017)

Around an active open wound.
If there is a bacterial infection.
Areas with decreased sensation.
If calcification is present in the muscle or tendon tissue.

The therapist will explain the procedure and inform of the goals and risks associated with it.

Diagnoses Treated

Diagnoses that can be treated with friction massage can include: (Paula Chaves, et al., 2017)

Muscle tears or strains.
For tendonitis or tendinopathy.
After a tendon tear.
Adhesive capsulitis in the shoulder/frozen shoulder.
Joint contracture.
Ligament tears.
Scar tissue buildup after surgery or trauma.

Friction massage is a popular technique used in physical therapy, but some research suggests it is not any more effective than other rehabilitation techniques. One study found that static stretches and exercises were more effective than massage in improving tissue length and strength in uninjured soccer players. Other studies have supported this, but individuals may find that the massage helps improve injured tissues’ movement as well. (Mohammed Ali Fakhro, et al. 2020)

The main goal of any treatment in physical therapy is to help the individual regain movement and flexibility. Friction massage, combined with targeted stretches and exercises, can help individuals expedite recovery and get back to normal.

Chiropractic Care After Accidents and Injuries

References

Begovic, H., Zhou, G. Q., Schuster, S., & Zheng, Y. P. (2016). The neuromotor effects of transverse friction massage. Manual therapy, 26, 70–76. doi.org/10.1016/j.math.2016.07.007

Chaves, P., Simões, D., Paço, M., Pinho, F., Duarte, J. A., & Ribeiro, F. (2017). Cyriax’s deep friction massage application parameters: Evidence from a cross-sectional study with physiotherapists. Musculoskeletal science & practice, 32, 92–97. doi.org/10.1016/j.msksp.2017.09.005

Chun, Q., ZhiYong, W., Fei, S., & XiQiao, W. (2016). Dynamic biological changes in fibroblasts during hypertrophic scar formation and regression. International wound journal, 13(2), 257–262. doi.org/10.1111/iwj.12283

Fakhro, M. A., Chahine, H., Srour, H., & Hijazi, K. (2020). Effect of deep transverse friction massage vs stretching on football players’ performance. World journal of orthopedics, 11(1), 47–56. doi.org/10.5312/wjo.v11.i1.47

Nonsurgical Tips & Tricks To Reduce Low Back Pain

Dr. Alex Jimenez

Can individuals with low back pain find nonsurgical solutions to restore lumbar mobility and stability to the lower limbs?

Table of Contents

Introduction

As one of the top three common problems that many young and older adults experience at some point in their lives, low back pain can have a huge impact on their routine. Back pain can often be due to normal factors like lifting heavy objects, being in a reclined position, or being physically inactive. Other times, it can be due to traumatic injuries, musculoskeletal disorders, or physical injuries. When many people are dealing with low back pain, many will often take over-the-counter medication to reduce the pain-like symptoms that they are experiencing. However, that is only a temporary solution, as the pain does come back through repetitive motions that can lead to a life of disability. To that point, many individuals, especially working adults, will have to call off work to get their lower back pain treated. This causes a socio-economic burden for many, and it can be miserable. Today’s article will examine what causes back pain and how various nonsurgical tips and tricks can reduce low back pain. We speak with certified medical providers who incorporate our patients’ information to provide multiple nonsurgical solutions to ease low back pain in many individuals. We also inform our patients of tips and tricks to reduce common back pain symptoms causing lumbar issues. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the lower back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

What Causes Back Pain?

Do you feel constant aches or pains in your lower back after a long workday? Do you feel stiffness in your lower back muscles that hurts when stretched? Or are you in constant pain that you are unable to function throughout the entire day? Many of these scenarios that people are experiencing are correlated with low back pain. Since the back in the musculoskeletal system is a complicated structure consisting of bones, joints, ligaments, and muscles, it can succumb to various injuries, sprains, and aches, leading to lower back pain. Many individuals dealing with back pain are non-specific and can affect the state of the lumbar spinal discs. When many individuals have various physical activities, they will have disc abnormalities and low back pain. (Jensen et al., 1994) At the same time, many individuals will notice that a series of sequelae develop various pain-like symptoms that are taken into account and cause functional loss associated with acute or chronic lower back pain that can affect the lower limbs. (Hoy et al., 2014) Some of the other causes of low back pain can be musculoskeletal symptoms that can lead to a life of disability. (Malik et al., 2018) More often than not, many individuals dealing with lower back pain do recover; however, after a while, reoccurrence of lower back pain is common when the same repetitive motions are being performed and when people who had lower back pain in previous encounters will deal with chronic pain and disability. (Hartvigsen et al., 2018) Luckily, numerous treatments can help reduce the pain, like the effects of low back pain, help restore mobility to the lumbar spine, and stabilize the lower limbs.

Diabetic Back Pain Explained- Video

Diabetic Back Pain Explained and How Chiropractic Care Can Help! | El Paso, Tx (2023)

Have you been experiencing muscle stiffness and aches in your lower back that are affecting your lower limbs? Did you lift a heavy object that caused you to strain your back muscles and make it difficult to work? Or were you bending over to pick up an object or tie your shoes so your back muscles are aching? When many individuals are dealing with low back pain from these various scenarios, it can lead to a life of disability and misery when not treated right away. Since low back pain is a pervasive musculoskeletal disorder, many individuals have different diagnoses, which can make it difficult to treat. (Deyo et al., 1990) However, there are numerous ways that many people dealing with low back pain can find the relief they deserve. Many people will often seek various treatments that can reduce low back pain and help them regain their spinal mobility so they can get back to their daily routine. The video above explains how back pain can be associated with autoimmune disorders like diabetes and how various treatments can help reduce pain-like symptoms.

Nonsurgical Tips & Tricks To Reduce Low Back Pain

When it comes to reducing and treating low back pain, many individuals will begin to seek treatment to reduce their low back pain. Many will often go to nonsurgical treatments since they are cost-effective and can be combined with other therapies to relieve musculoskeletal pain. Nonsurgical treatments can range from spinal decompression and chiropractic care to spinal manipulation. (Chou et al., 2017) When many people are finding relief for their lower back pain, some tips and tricks that many people can do to prevent it from flaring up include:

Maintaining a healthy weight and diet
Slowly incorporating exercises
Avoid prolonging activity
Stretch
Sleep on a medium-firm mattress
Continue nonsurgical treatments to reduce the chances of low back pain returning
Maintain good posture

With these tips and tricks, many individuals will begin to notice their lower back pain reducing and promote healthy lifestyle choices.

References

Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., Fu, R., Dana, T., Kraegel, P., Griffin, J., Grusing, S., & Brodt, E. D. (2017). Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med, 166(7), 493-505. doi.org/10.7326/M16-2459

Deyo, R. A., Cherkin, D., & Conrad, D. (1990). The Back Pain Outcome Assessment Team. Health Serv Res, 25(5), 733-737. www.ncbi.nlm.nih.gov/pubmed/2147670

www.ncbi.nlm.nih.gov/pmc/articles/PMC1065661/pdf/hsresearch00081-0050.pdf

Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J., Smeets, R. J., Underwood, M., & Lancet Low Back Pain Series Working, G. (2018). What low back pain is and why we need to pay attention. Lancet, 391(10137), 2356-2367. doi.org/10.1016/S0140-6736(18)30480-X

Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., Williams, G., Smith, E., Vos, T., Barendregt, J., Murray, C., Burstein, R., & Buchbinder, R. (2014). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis, 73(6), 968-974. doi.org/10.1136/annrheumdis-2013-204428

Jensen, M. C., Brant-Zawadzki, M. N., Obuchowski, N., Modic, M. T., Malkasian, D., & Ross, J. S. (1994). Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain. New England Journal of Medicine, 331(2), 69-73. doi.org/10.1056/nejm199407143310201

Malik, K. M., Beckerly, R., & Imani, F. (2018). Musculoskeletal Disorders a Universal Source of Pain and Disability Misunderstood and Mismanaged: A Critical Analysis Based on the U.S. Model of Care. Anesth Pain Med, 8(6), e85532. doi.org/10.5812/aapm.85532

Disclaimer

Common Mistakes That Can Hinder Muscle Growth

Dr. Alex Jimenez

J001_C081_09216E Copy — Health smoothie, couple and fitness nutritionist with fruit, healthy food and smile at home. Nutrit.

“For individuals trying to build muscle but are not seeing results, can knowing factors like what foods to eat, how to work out, and genetics help achieve meaningful muscle gains?”

Table of Contents

Muscle Growth Nutritional Mistakes

Muscle growth is an important element of overall fitness and health. Individuals can make nutritional mistakes like not eating enough protein or carbohydrates and not properly hydrating themselves which can prevent them from gaining muscle. Factors that contribute to muscle building, include:

Nutrition
Genetics
Training

Individuals who want to increase muscle mass more efficiently can rework these issues to maintain consistency and commitment to exercise and nutrition. Benefits include:

Building muscle helps strengthen bones
Improves balance
Decreases the risk of cardiovascular disease and diabetes.

Building muscle enhances strength and speed and can also reduce the risk of injuries or falls as you age. (American College of Sports Medicine. 2017)

Factors

Experts point out some common mistakes that can hinder muscle growth, like not eating enough protein, not consuming enough calories, overtraining, or practicing improper form and technique. As everybody is different there is no one-size-fits-all approach to building muscle or hypertrophy. These include:

Genetics

An individual’s genes contribute to how easy or difficult it can be to build muscle.
Some individuals have a higher proportion of fast-twitch muscle fibers, which increases growth potential.
The natural distribution of muscle and body fat also varies and can affect the rate and location of muscle growth.
There are also differences in individual recovery capabilities that can influence the frequency and intensity of training sessions.

Nutrition

Nutrition matters when trying to build muscle. Individuals need to eat enough protein for muscle repair and growth.
Individuals may need to consume more calories than they burn to create energy stores.
At the same time, individuals need to consume enough carbohydrates and healthy fats to fuel workouts and recovery.

Training

Gaining muscle requires regular resistance or strength training exercises.
These exercises cause micro tears in muscle fibers, which then repair and grow back stronger and larger.
Effective resistance training includes – consistency, intensity, recovery, and progressive overload.
Progressive overload means gradually increasing the weight, frequency, or number of repetitions in an exercise routine to challenge the muscles.

Muscle Strength for Healthy Aging

Research shows that performing exercises that build muscle mass can slow age-related cognitive decline and decrease the risk of neurodegenerative diseases like Alzheimer’s disease and dementia. (Joseph Michael Northey, et al., 2018)
Muscle-building exercise can also improve heart health and lower the risk of cardiovascular diseases. (Johns Hopkins Medicine. 2023)

Nutritional Mistakes

When trying to gain muscle, challenges can affect progress. Some of the most common mistakes that can delay or set back muscle growth and recommendations include.

Not Enough Protein

Eating protein like lean meats, dairy products, and seafood, is crucial for muscle repair and growth.
Not consuming enough protein makes the body unable to grow muscles, and you’ll see suboptimal improvements.
Get enough protein from various sources like beef, lamb, chicken, turkey, fish, eggs, dairy, legumes, and plant-based proteins.
However, there is a limit to how much protein the body can use effectively at one time for muscle protein synthesis.
It is recommended to distribute protein intake evenly throughout the day, aiming for about 20 to 30 grams of high-quality protein in each meal.

Not Enough Calories

Muscles need calories to grow.
If the body is in a caloric deficit, the ability to grow muscle is limited.
Insufficient calorie intake can create energy deficits, making the body use muscle for energy instead of growing.
To fix this, individuals need to consume more calories than calories burned.
It can be helpful to track calorie intake with an application to make adjustments as needed.
Individuals having trouble increasing their calorie intake or there are questions about what the body needs, consult with a registered dietitian or nutritionist.

Not Enough Carbs

Carbohydrates are the body’s main energy source during high-intensity workouts.
Not consuming enough can lead to decreased performance and slower recovery.
Recommendations include consuming a variety of whole grains and minimally processed carbohydrates, such as brown rice, potatoes, sweet potatoes, oats, and quinoa.
For individuals doing regular, moderate-to-intense training, carbohydrate recommendations can range from 3 to 7 grams per kilogram of body weight per day.
For individuals doing endurance or intense frequency training routines may need to increase this range.

Not Hydrating Enough

Water is necessary for all bodily functions, including muscle contraction and repair.
Dehydration comes with symptoms like muscle cramps, fatigue, and decreased exercise performance. (Centers for Disease Control and Prevention. 2022)
For individuals who are not sure how much water they need? Recommendations include using half of an individual’s body weight as a starting point to figure out how many ounces to drink per day.
For example, individuals who weigh 140 pounds can set a baseline hydration goal of 70 ounces of water/8 cups per day which can be adjusted according to activities.

Water Intake Recommendations

The recommended total fluid intake from food and drink varies by age and sex. The general recommendations are around:
11.5 cups per day for women
15.5 cups for adult men
For just water, women need around 9 cups of fluid per day, and men need around 13 cups to replace fluids that are lost throughout the day.
However, the exact amount of water needed to stay properly hydrated also depends on an individual’s activity level and overall health. (Academy of Nutrition and Dietetics. 2022)
To prevent dehydration, sip water consistently throughout the day, especially before, during, and after workouts.
Foods with a high water content like certain fruits can help achieve daily hydration goals.

Not Enough Healthy Fats

Not consuming enough healthy fats can cause the body to not be able to produce enough hormones that support muscle growth.
Relying on supplements instead of getting nutrients from whole foods can also lead to nutritional deficiencies and imbalances.
Eating too many protein bars or shakes can also cause gastrointestinal side effects. (National Capital Poison Center. 2023)
Recommendations are to add more healthy fats, like avocados, nuts, seeds, fatty fish, and olive oil.

Forgetting Post-Workout Nutrition

After working out, the body is ready to absorb nutrients and start the process of muscle repair and growth.
The body needs nutrients to activate the recovery post-exercise
When the body lacks nutrition after a workout it can slow muscle growth and cause fatigue.
Recommendations are to pack a balance of protein and carbohydrates to refuel right after a workout.

Training Mistakes

Undertraining or performing low-intensity workouts can also slow down muscle growth.
Individuals who are not overloading their muscles – for example, using weights that are too light – will not break them down so they can grow bigger and stronger.
A lack of microdamage means muscle growth will be slower.
Muscle overload also requires rest.
Recommendations are to take at least one day of rest per week and avoid strength training in the same muscle group two days in a row.
When creating a lifting plan, be sure to include compound exercises like squats, deadlifts, and bench presses.
These exercises work with multiple muscle groups and are recommended for building strength and muscle.
A training routine should include a variety of compound movements, like lunges, split squats, leg presses, pull-downs, upright rows, and push-ups.
If unsure of which compound exercises to include, consult a personal trainer, physical therapist, or sports chiropractor.

Military Training and Chiropractic Care

References

American College of Sports Medicine. (2017). Resistance training and injury prevention.

Northey, J. M., Cherbuin, N., Pumpa, K. L., Smee, D. J., & Rattray, B. (2018). Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. British journal of sports medicine, 52(3), 154–160. doi.org/10.1136/bjsports-2016-096587

Johns Hopkins Medicine. (2023). Exercise and the heart.

Centers for Disease Control and Prevention. (2022). Water and healthier drinks.

Academy of Nutrition and Dietetics. (2022). How much water do you need?

National Capital Poison Center. (2023). Do protein bars give you gas?

Learn Everything About Lumbar Disc Degeneration Pathology

Dr. Alex Jimenez

Can healthcare providers help many individuals with lumbar disc degeneration find relief through spinal decompression treatments?

Table of Contents

Introduction

Many individuals often do everyday motions that can allow the spine to bend, twist, and turn in various ways without feeling pain and discomfort. However, as the body ages, so does the spine, as the spinal discs begin the natural process of degeneration. Since the spinal discs in the spinal column absorb the vertical pressure weight, it stabilizes the upper and lower extremities and provides motion. To that point, when many individuals suffer from various injuries or environmental factors that cause the spinal disc to be compressed, it can lead to low back issues that cause pain and discomfort when a person is doing an activity. Since low back pain is one of the three most common problems that many people worldwide have dealt with, it can become a socio-economic issue that can lead to a life of disability and misery. Low back pain is often correlated with disc degeneration, and the surrounding ligaments and muscle tissues can affect the upper and lower extremities. This causes referred pain to the different musculoskeletal groups, causing many people to seek treatment that can not only be affordable but also effective in reducing the pain. Today’s article looks at the anatomy of the lumbar disc, how disc degeneration affects the lumbar spine, and how spinal decompression can reduce lumbar disc degeneration from causing more pain to the lower back. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to ease the pain-like symptoms associated with lumbar disc degeneration causing low back pain. We also inform our patients that there are non-surgical options to reduce these pain-like issues correlated with disc degeneration and restore lumbar mobility to the body. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the lower back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

The Anatomy Of The Lumbar Disc

Do you feel tension or stiffness in your lower back after waking up in the morning? Do you feel sudden or gradual pain from bending down to lift a heavy object that is affecting your lower back? Or do you feel the pain in one location or another in your back that is causing you pain and discomfort in your lumbar spinal region? Many of these pain-like issues are often correlated with disc degeneration combined with low back pain. The spinal disc’s anatomy comprises three elements that work together in a specific pattern to resist forces placed in the lumbar spine. (Martin et al., 2002) Since the lumbar spine is the thickest portion of the back, the spinal disc supports the upper body’s weight while stabilizing the lower body. However, the spinal disc will shrink over time when the body ages. Since degeneration is a natural process, many individuals will begin to feel less mobile, which can cause many issues within the lumbar spine.

How Disc Degeneration Affects The Lumbar Spine

When disc degeneration occurs in the lumbar spine, the spinal disc begins to decrease in volume, and the nutrients that hydrate the disc start to deplete and become compressed. When disc degeneration affects the lumbar spine, the nerve roots from the central system are affected. They can be associated with any particular group of pathological conditions that may irritate the surrounding nerves and produce pain-like symptoms. (Bogduk, 1976) To that point, this causes referred pain in the lower limbs and radiating pain in the lower back. At the same time, glycosphingolipid antibodies are activated in the immune system, causing inflammatory effects. (Brisby et al., 2002) When people are dealing with low back pain associated with disc degeneration, many people will feel their lower back lock up, causing limited mobility and stiffness. At the same time, the surrounding muscle and soft tissues are overstretched and tightened. The spinal disc will also affect the nerve fibers surrounding the spine, leading to nociceptive lower back pain. (Coppes et al., 1997) However, many individuals can find available treatments to reduce low back pain associated with disc degeneration.

An Overview Of Spinal Decompression- Video

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

Spinal Decompression Can Reduce Lumbar Disc Degeneration

Many individuals can seek out non-surgical treatments to reduce low back pain associated with disc degeneration as it is cost-effective and, through consecutive treatments, can start feeling better. Some non-surgical treatments like spinal decompression can help rehydrate the spinal disc through gentle traction and promote natural healing. Spinal decompression can be manual or mechanical, using negative pressure to increase disc height. (Vanti et al., 2021) This allows many individuals to feel the relief they deserve and feel better over time. Spinal decompression can reduce disc degeneration, stabilize the lumbar spine, and help regain spinal mobility back to the lower portions. (Daniel, 2007) When many individuals begin to take care of their bodies and reduce the chances of low back pain from returning to cause more issues to the back.

References

Bogduk, N. (1976). The anatomy of the lumbar intervertebral disc syndrome. Med J Aust, 1(23), 878-881. www.ncbi.nlm.nih.gov/pubmed/135200

Brisby, H., Balague, F., Schafer, D., Sheikhzadeh, A., Lekman, A., Nordin, M., Rydevik, B., & Fredman, P. (2002). Glycosphingolipid antibodies in serum in patients with sciatica. Spine (Phila Pa 1976), 27(4), 380-386. doi.org/10.1097/00007632-200202150-00011

Coppes, M. H., Marani, E., Thomeer, R. T., & Groen, G. J. (1997). Innervation of “painful” lumbar discs. Spine (Phila Pa 1976), 22(20), 2342-2349; discussion 2349-2350. doi.org/10.1097/00007632-199710150-00005

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

Martin, M. D., Boxell, C. M., & Malone, D. G. (2002). Pathophysiology of lumbar disc degeneration: a review of the literature. Neurosurg Focus, 13(2), E1. doi.org/10.3171/foc.2002.13.2.2

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

Disclaimer

Managing Chronic Sciatica Symptoms: A Multidisciplinary Plan

Dr. Alex Jimenez

Experienced doctor examines the back of a gray-haired patient, a modern ultrasound machine indoors

“For individuals dealing with chronic sciatica, when pain and other symptoms significantly impact daily activities and the ability to walk, can a musculoskeletal healthcare provider help relieve and manage symptoms through a multidisciplinary treatment plan?”

Table of Contents

Chronic Sciatica

Sciatica is a common condition that results from compression of the sciatic nerve in the lower back or leg. Chronic sciatica occurs when symptoms last for 12 months or longer.

Advanced Sciatica Symptoms

Advanced or chronic sciatica usually produces pain that radiates or travels down the back of the leg. Long-term sciatic nerve compression can result in:

Leg pain
Numbness
Tingling
Electrical or burning sensations
Weakness
Weakness
Instability of the legs, which can impact the ability to walk.

Severe nerve compression can progress to leg paralysis if the nerve is significantly damaged from chronic compression. (Antonio L Aguilar-Shea, et al., 2022)
Sciatica can progress to nerve damage of the smaller nerves and travel into the legs and feet. Nerve damage/neuropathy can result in pain, tingling, and loss of sensation. (Jacob Wycher Bosma, et al., 2014)

Disabling Sciatica Treatment Options

When sciatica becomes disabling, affecting an individual’s ability to walk, more involved treatment is needed to bring relief. Many cases of chronic and disabling sciatica are caused by problems with the lumbar spine. Compression of the nerve roots that form the sciatic nerve can occur from bulging or herniated discs or spinal stenosis. If symptoms of sciatica persist beyond 12 months with little or no relief from physical therapy, non-surgical mechanical decompression, stretches and exercises, or pain management techniques, surgical procedures may be needed. (Lucy Dove, et al., 2023)

Lumbar decompression surgery encompasses several procedures to create more space in the lumbar spine and relieve nerve compression. Lumbar decompression surgery can include: (Mayfield Clinic. 2021)

Discectomy

This procedure removes a portion of a damaged disc between vertebrae to alleviate root compression from a bulging or herniated disc.

Laminectomy

This procedure removes the lamina, a portion of the vertebrae causing nerve compression, especially if there is a bone spur due to arthritic and degenerative changes in the spine.

Foraminotomy

This procedure widens the foramina, the openings in the vertebrae where the nerve roots exit to relieve compression.

Spinal Fusion

This procedure takes two or more vertebrae fusing them together with metal rods and screws for stabilization.
The procedure can be performed if:
An entire disc is removed.
Multiple laminectomies were performed.
One vertebra has slipped forward over another.

Daily Relief Management for Advanced Sciatica

Achieving relief from advanced sciatica symptoms at home can include regularly practicing methods like taking a hot bath or shower massage, and applying a heating pad to the lower back or glutes to relax tight muscles to help release the tightness surrounding the sciatic nerve.

Corrective or therapeutic exercises like sciatic nerve glides can help reduce tension along the nerve while low-back exercises that move the spine into forward or backward bending can reduce compression. (Witold Golonka, et al., 2021)
Medications like nonsteroidal anti-inflammatory drugs/NSAIDs, muscle relaxants, or nerve-pain medications may be recommended. (Antonio L Aguilar-Shea, et al., 2022)
Advanced sciatica may not be as responsive to conservative treatment methods, as the injury has set in and the nerve and surrounding tissues have become significantly restricted.
Sciatica symptoms lasting longer than 12 months require more involved treatment like injections or surgery to address symptoms effectively. (Antonio L Aguilar-Shea, et al., 2022)

Healing Chronic Sciatica

If the underlying cause can be effectively treated then chronic sciatica can be healed. Chronic sciatica often results from spinal conditions like herniated discs or lumbar spinal stenosis. These conditions narrow the space around the nerve roots that exit from the spinal cord and merge to form the sciatica nerve. Surgery is performed to open the space in the spine. (Mayfield Clinic. 2021) Sometimes sciatica is brought on by less common causes like a tumor or a spinal infection. In these cases, symptoms will not resolve until the underlying cause is addressed. Tumors may need to be surgically removed while infections require aggressive antibiotics to prevent spreading to other regions of the body. (Hospital for Special Surgery. 2023)

Pain Specialist Treatment Plan Development

Ongoing pain, numbness, tingling, and weakness are all symptoms that should be addressed with a healthcare provider. A pain specialist can help create a treatment plan that involves: (Hospital for Special Surgery. 2023)

Physical therapy
Therapeutic massage
Chiropractic decompression and spinal adjustments
Targeted stretches and exercises
Referrals to specialized healthcare providers
Injections
Medications

Sciatica Causes and Treatments

References

Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-González, R., & Paredes, I. (2022). Sciatica. Management for family physicians. Journal of family medicine and primary care, 11(8), 4174–4179. doi.org/10.4103/jfmpc.jfmpc_1061_21

Bosma, J. W., Wijntjes, J., Hilgevoord, T. A., & Veenstra, J. (2014). Severe isolated sciatic neuropathy due to a modified lotus position. World journal of clinical cases, 2(2), 39–41. doi.org/10.12998/wjcc.v2.i2.39

Dove, L., Jones, G., Kelsey, L. A., Cairns, M. C., & Schmid, A. B. (2023). How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 32(2), 517–533. doi.org/10.1007/s00586-022-07356-y

Mayfield Clinic. ( 2021). Spinal decompression laminectomy & foraminotomy.

Golonka, W., Raschka, C., Harandi, V. M., Domokos, B., Alfredson, H., Alfen, F. M., & Spang, C. (2021). Isolated Lumbar Extension Resistance Exercise in Limited Range of Motion for Patients with Lumbar Radiculopathy and Disk Herniation-Clinical Outcome and Influencing Factors. Journal of clinical medicine, 10(11), 2430. doi.org/10.3390/jcm10112430

Hospital for Special Surgery. (2023). Sciatica.

Hospital for Special Surgery. (2023). Pain management.

Pain Management Specialists: The Multidisciplinary Approach

Dr. Alex Jimenez

Specialist explaining x-ray results to patient in neck brace — Caucasian woman in neck brace looking at x-ray image on digital device held by bearded therapist in lab coat. Medical specialist explaining test results to patient with walking cane in exam room.

“For individuals dealing with chronic pain conditions can having a better understanding of pain management specialists help in developing effective multidisciplinary treatment plans?”

Table of Contents

Pain Management Specialists

Pain management is a growing medical specialty that takes a multi-disciplinary approach to treating all types of pain. It is a branch of medicine that applies scientifically proven techniques and methods to relieve, reduce, and manage pain symptoms and sensations. Pain management specialists evaluate, rehabilitate, and treat a spectrum of conditions, including neuropathic pain, sciatica, postoperative pain, chronic pain conditions, and more. Many primary healthcare providers refer their patients to pain management specialists if pain symptoms are ongoing or significant in their manifestation.

Specialists

Healthcare providers specializing in pain management recognize the complex nature of pain and approach the problem from all directions. Treatment at a pain clinic is patient-centric but depends on the clinic’s available resources. Currently, there are no set standards for the types of disciplines needed, another reason treatment options vary from clinic to clinic. Experts say that a facility should offer patients:

A coordinating practitioner specializing in pain management and consulting specialists on the patient’s behalf.
A physical rehabilitation specialist.
A psychiatrist to help the individual deal with any accompanying depression or anxiety, especially when dealing with chronic pain. (American Society of Regional Anesthesia and Pain Medicine. 2023)

Other Medical Specialties

Other specialties represented in pain management are anesthesiology, neurosurgery, and internal medicine. A coordinating healthcare provider may refer an individual for services from:

Occupational medicine specialists
Social workers
Alternative medicine practitioners
Complementary medicine practitioners (American Academy of Pain Medicine. 2023)

A healthcare provider should have completed additional training and credentialing in pain medicine and be an MD with board certification in at least one of the following (American Board of Medical Specialties. 2023)

Anesthesiology
Physical rehabilitation
Psychiatry
Neurology

A pain management physician should also have their practice limited to the specialty they hold the certification.

Management Goals

The field of pain management treats all types of pain as a disease. Chronic, such as headaches; acute, from surgery, and more. This allows for applying science and the latest medical advances to pain relief. There are now many modalities, including:

Medication
Interventional pain management techniques – nerve blocks, spinal cord stimulators, and similar treatments.
Physical therapy
Alternative medicine

The objective is to minimize and make symptoms manageable.
Improve function.
Increase the quality of life. (Srinivas Nalamachu. 2013)

A pain management clinic will go through the following:

Evaluation.
Diagnostic tests, if necessary.
Physical therapy – increases the range of motion, strengthens the body, and prepares individuals to return to work and daily activities.
Interventional treatment – injections or spinal cord stimulation.
Referral to a surgeon if indicated by the tests and evaluation.
Psychiatry to deal with depression, anxiety, and/or other issues that accompany chronic pain symptoms.
Alternative medicine to support and enhance the other treatments.

Individuals who do well with a pain management program

Individuals who have:

Back pain
Neck pain
Had multiple back surgeries
Failed surgeries
Neuropathy
Individuals determined that surgery does not benefit their condition.

A better understanding of pain syndromes by communities and insurance companies and increased pain studies will help increase insurance coverage for treatments and technology to improve interventional outcomes.

Chiropractic Care for Leg Instability

References

American Society of Regional Anesthesia and Pain Medicine. (2023). The specialty of chronic pain management.

American Academy of Pain Medicine (2023). About the American Academy of Pain Medicine.

American Board of Medical Specialties. (2023). The Most Trusted Medical Specialty Certification Organization.

Nalamachu S. (2013). An overview of pain management: the clinical efficacy and value of treatment. The American journal of managed care, 19(14 Suppl), s261–s266.

American Society of Interventional Pain Physicians. (2023). Pain Physician.

What You Need to Know about Nutrition in Turkey

Dr. Alex Jimenez

Roasted turkey breast sliced on a board with Thanksgiving sides

“For individuals watching their food intake during the Thanksgiving holiday, can knowing the nutritional value of turkey help maintain diet health?”

Table of Contents

Nutrition and Benefits

Minimally processed turkey can be a beneficial source of protein, vitamins, and minerals. However, processed turkey can be high in sugar, unhealthy fats, and sodium.

Nutrition

Nutrition information for a roasted turkey leg with the skin – 3 ounces – 85g. (U.S. Department of Agriculture. 2018)

Calories – 177
Fat – 8.4
Sodium – 65.4mg
Carbohydrates – 0g
Fiber – 0g
Sugars – 0g
Protein – 23.7g

Carbohydrates

Turkey does not contain any carbohydrates.
Certain deli lunch meats contain carbs as the turkey is breaded, marinated, or coated in a sauce containing sugar or added during processing.
Choosing fresh can make a big difference in sugar content.

Fats

Most of the fat comes from the skin.
Turkey generally has equal parts of saturated, monounsaturated, and polyunsaturated fat.
Removing the skin and cooking without added fat significantly reduces total fat content.

Protein

Turkey is an excellent source of complete protein, with around 24 grams in a 3-ounce serving.
Leaner cuts, like skinless turkey breast, have more protein.

Vitamins and Minerals

Provides vitamin B12, calcium, folate, iron, magnesium, phosphorus, potassium, and selenium.
Dark meat is higher in iron than the white meat.

Health Benefits

Supports Muscle Retention

Sarcopenia, or muscle wasting, commonly leads to frailty in elderly individuals.
Getting enough protein at every meal is essential for older adults to maintain muscle mass and physical mobility.
Turkey can help meet guidelines suggesting lean meat consumption 4-5 times a week to maintain muscle health with aging. (Anna Maria Martone, et al., 2017)

Reduces Diverticulitis Flare-Ups

Diverticulitis is inflammation of the colon. Dietary factors that influence the risk of diverticulitis include:

Fiber intake – lowers risk.
Processed red meat intake – raises risk.
Intake of red meat with higher total fat – raises risk.

Researchers studied 253 men with diverticulitis and determined that replacing one serving of red meat with a serving of poultry or fish reduces the risk of diverticulitis by 20%. (Yin Cao et al., 2018)
The study’s limitations are that the meat intake was recorded in men only, the intake was self-reported, and the amount consumed at each eating episode was not recorded.
It may be a helpful substitution for anyone at risk for diverticulitis.

Prevents Anemia

Turkey offers nutrients required by blood cells.
It provides heme iron, easily absorbed during digestion, to prevent iron deficiency anemia. (National Institutes of Health. 2023)
Turkey also contains folate and vitamin B12, which are needed in the formation and proper function of red blood cells.
Regular turkey consumption can help maintain healthy blood cells.

Supports Heart Health

Turkey is a lean alternative to other low-sodium meats, especially if the skin is removed and cooked fresh.
Turkey is also high in the amino acid arginine.
Arginine can help keep arteries open and relaxed as a precursor to nitric oxide. (Patrick J. Skerrett, 2012)

Allergies

Meat allergies can happen at any age. A turkey allergy is possible and may be associated with allergies to other types of poultry and red meat. Symptoms can include: (American College of Allergy, Asthma & Immunology. 2019)

Vomiting
Diarrhea
Wheezing
Shortness of breath
Repetitive cough
Swelling
Anaphylaxis

Storage and Safety

Preparation

The USDA recommends 1 pound for each person.
That means a family of five needs a 5-pound turkey, a group of 12 a 12-pound. (U.S. Department of Agriculture. 2015)
Keep fresh meat in the refrigerator until ready to cook.
Frozen pre-stuffed turkeys labeled with the USDA or state mark of inspection have been prepared under safe, controlled conditions.
Cook frozen pre-stuffed turkeys directly from the frozen state rather than thawing first. (U.S. Department of Agriculture. 2015)

Safe ways to thaw a frozen turkey: in the refrigerator, in cold water, or microwave oven.
They should be thawed for a specified amount of time using guidelines based on weight.
It needs to be cooked to an internal temperature of 165 degrees Fahrenheit.
Cooked turkey needs to be refrigerated within 1–2 hours after cooking and used within 3–4 days.
Turkey leftovers stored in the freezer should be eaten within 2–6 months.

Eating Right to Feel Better

References

U.S. Department of Agriculture. FoodData central. (2018). Turkey, all classes, leg, meat and skin, cooked, roasted.

Martone, A. M., Marzetti, E., Calvani, R., Picca, A., Tosato, M., Santoro, L., Di Giorgio, A., Nesci, A., Sisto, A., Santoliquido, A., & Landi, F. (2017). Exercise and Protein Intake: A Synergistic Approach against Sarcopenia. BioMed research international, 2017, 2672435. doi.org/10.1155/2017/2672435

Cao, Y., Strate, L. L., Keeley, B. R., Tam, I., Wu, K., Giovannucci, E. L., & Chan, A. T. (2018). Meat intake and risk of diverticulitis among men. Gut, 67(3), 466–472. doi.org/10.1136/gutjnl-2016-313082

National Institutes of Health, Office of Dietary Supplements. (2023). Iron: Fact Sheet for Health Professionals.

Skerrett PJ. Harvard Health Publishing, Harvard Medical School. (2012). Turkey: A Healthy Base of Holiday Meals.

American College of Allergy, Asthma & Immunology. (2019). Meat Allergy.

U.S. Department of Agriculture. (2015). Let’s Talk Turkey — A Consumer Guide to Safely Roasting a Turkey.

Non-Surgical Solutions for Back Pain: The Ultimate Guide

Dr. Alex Jimenez

For individuals with back pain, how can health practitioners incorporate non-surgical solutions to reduce spinal pain?

Table of Contents

Introduction

The spine is one of the most important structures in the human body, providing host mobility and stability when vertical pressure is pressing on the spinal structure. The spine is surrounded by various muscles, ligaments, and tissues that help support the upper and lower body portions and extremities. When normal factors like heaving lifting, improper stances, obesity, or pre-existing conditions start to affect the body, it can cause the spinal structure to potentially cause unwanted issues that lead to back, neck, and shoulder pain. When experiencing these three common body pains often correlate with other associated symptoms that can affect the other extremities. When this happens, many individuals begin to miss out on work or daily activities that can cause them to be miserable, and they even try to look for various solutions to reduce the pain they are experiencing. Today’s article looks at one of the common body pains like back pain and how it can cause numerous issues that affect a person’s ability to function, and how non-surgical solutions can not only reduce the pain-like effects but also provide the necessary relief that many people deserve in their health and wellness journey. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to ease the pain-like symptoms associated with spinal issues causing back pain. We also inform our patients that there are non-surgical options to reduce these pain-like issues and restore spinal mobility to the body. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the lower back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

Back Pain Affecting The Spine

Do you often experience radiating pain in your lower back that causes symptoms of numbness or tingling sensations down to your legs and feet? Do you feel muscle stiffness in the morning while getting up, only to slowly disappear throughout the day? Or do you feel symptoms of muscle aches and pain when carrying a heavy object from one location to another? Many individuals, more often than not, have dealt with back pain associated with various factors. With back pain being in the top three common problems in the workforce, many individuals have dealt with the common problem in multiple ways. From improper heavy lifting to excessive sitting at a desk, back pain can cause musculoskeletal issues that many are trying to find relief. Low back pain can either be acute or chronic, depending on the severity. It can lead to mobility impairment within the thoracic, lumbar, and sacroiliac spinal regions, causing referred pain to the lower extremities. It can lead to a life of impairment without any symptoms or signs of serious medical or psychological conditions associated with environmental factors. (Delitto et al., 2012) Back pain is also associated with spinal conditions like inflammation, asymmetric loading, and muscle strain, which can cause the spinal structures to be compressed, thus causing disc herniations. (Zemková & Zapletalová, 2021)

Additionally, back pain is a multifactorial musculoskeletal condition that causes many individuals to be in a socio-economic situation that can decrease their quality of life. Many examples of back pain are correlated with altered motor control within the spinal erector muscles that causes impaired proprioception in the spine. (Fagundes Loss et al., 2020) When this happens to many individuals, they often experience a hindrance of lumbar stability, body balance, posture, and postural control. At the same time, when many working individuals are having severe back pain associated with everyday factors, the amount of pain they are in can change the threshold of the mechanoreceptors that are transmitting the pain signals through the spinal cord. To this point, back pain can affect the neuromuscular response and affect normal musculoskeletal functionality. Fortunately, numerous treatments can help reduce back pain and provide relief to spinal pain that is affecting many individuals.

The Role Of Chiropractic Care- Video

The Role of Chiropractic Care on improving your Health | El Paso, Tx (2023)

How many times a day do you experience back pain associated with stiffness, general aches, or pains that are affecting your ability to work? Do you notice you hunching more when moving from one location to another? Or do you feel aches and pain in your back after stretching in the morning? Many individuals dealing with these common environmental factors are closely associated with back pain. Back pain is in the top three most common problems many individuals have experienced at some point in their lives. More often than not, many people have dealt with back pain by using home remedies to reduce the pain-like effects. However, research studies reveal that when many individuals start to ignore the pain, it can lead them to a life of disability and cause numerous amounts of distress if not treated right away. (Parker et al., 2015) Hence, non-surgical treatments can not only reduce the pain associated with back pain but also help restore spinal mobility. Non-surgical treatments like chiropractic care incorporate spinal manipulation, which can positively affect the spine. (Koes et al., 1996) What chiropractic care does is that it includes mechanical and manual manipulation techniques to stretch out tight muscles and reduce trigger points from reforming. The video above shows how chiropractic care can positively affect the individual while being part of a health and wellness journey to reducing back pain.

Non-Surgical Spinal Decompression For Back Pain

Just like chiropractic care, spinal decompression is another non-surgical treatment that uses traction to gently pull and stretch the spine to alleviate compressed spinal discs associated with back pain and help stretch out tight muscles. When many people start to incorporate spinal decompression as part of their routine, they will notice that spinal decompression can reduce intradiscal pressure within the negative range. (Ramos, 2004) What this does is that when the spinal discs are being pulled by gentle traction, all the fluids and nutrients that were not hydrating the disc flow back and help kickstart the body’s natural healing process. When many people begin to utilize spinal decompression for their back pain, they will notice a huge reduction in their pain after a few consecutive sessions. (Crisp et al., 1955) When many people start to combine other various non-surgical therapies with spinal decompression, they will be able to regain their spinal mobility while being more mindful of what environmental factors are affecting their spine and not repeat the issue to allow back pain to return.

References

Crisp, E. J., Cyriax, J. H., & Christie, B. G. (1955). Discussion on the treatment of backache by traction. Proc R Soc Med, 48(10), 805-814. www.ncbi.nlm.nih.gov/pubmed/13266831

www.ncbi.nlm.nih.gov/pmc/articles/PMC1919242/pdf/procrsmed00390-0081.pdf

Delitto, A., George, S. Z., Van Dillen, L., Whitman, J. M., Sowa, G., Shekelle, P., Denninger, T. R., & Godges, J. J. (2012). Low Back Pain. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1-A57. doi.org/10.2519/jospt.2012.42.4.a1

Fagundes Loss, J., de Souza da Silva, L., Ferreira Miranda, I., Groisman, S., Santiago Wagner Neto, E., Souza, C., & Tarrago Candotti, C. (2020). Immediate effects of a lumbar spine manipulation on pain sensitivity and postural control in individuals with nonspecific low back pain: a randomized controlled trial. Chiropr Man Therap, 28(1), 25. doi.org/10.1186/s12998-020-00316-7

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

Parker, S. L., Mendenhall, S. K., Godil, S. S., Sivasubramanian, P., Cahill, K., Ziewacz, J., & McGirt, M. J. (2015). Incidence of Low Back Pain After Lumbar Discectomy for Herniated Disc and Its Effect on Patient-reported Outcomes. Clin Orthop Relat Res, 473(6), 1988-1999. doi.org/10.1007/s11999-015-4193-1

Ramos, G. (2004). Efficacy of vertebral axial decompression on chronic low back pain: study of dosage regimen. Neurol Res, 26(3), 320-324. doi.org/10.1179/016164104225014030

Zemková, E., & Zapletalová, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. International Journal of Environmental Research and Public Health, 18(10), 5400. doi.org/10.3390/ijerph18105400

Disclaimer

Rib Cage and Pelvis: Connecting the Core for Healthy Posture

Dr. Alex Jimenez

Exercises for posture, smooth straight back, spine. Slim woman training with yoga coach. Private lessons with personal trainer, fitness instructor. Workout, exercises in fitness gym.

“For older individuals experiencing posture problems, slumping, slouching, and upper back pain, could adding rib cage exercises help bring relief and prevent the condition from worsening?”

Table of Contents

Improved Posture

It’s common to associate a collapsed upper back posture with age, but other factors can also contribute to the problems. (Justyna Drzał-Grabiec, et al., 2013) The rib cage and the pelvis are important to body structure and comprise much of the core. If these bone structures become misaligned due to unhealthy posture, the muscles that attach to them become tight, weak, or both, and the surrounding muscles have to compensate, causing a worsening of the condition and further injury.

Unhealthy postures can be caused by a rib cage that compresses down onto the pelvic bone.
As the upper back slumps or compresses, height can begin to decrease.
Posture awareness exercises can help lift the rib cage off the pelvic bone.

Rib Cage Exercises

This exercise can be done sitting or standing. A daily routine can help improve posture and relieve back problems and pain.

The sitting version helps keep the focus on doing the exercise right.
The standing version challenges body awareness, allowing the individual to feel how the rib cage and upper back movements affect pelvic and lower back posture.
To begin, it is recommended to start in a sitting position.
Once the basics are learned, then certainly progress to standing.

Exercise

Position the pelvis so it is in a slight forward tilt.
This forward tilt will exaggerate the low back curve slightly while tightening the lower back muscles in a good way.
Establishing and maintaining this curve in the sitting position should feel natural.
Inhale and exaggerate the upward lift of the rib cage.
Inhaling causes the spine and ribs to extend slightly.
Exhale and allow the rib cage and upper back to return to their natural position.
Repeat up to 10 times once or twice a day.

For this exercise, use breathing to develop the rib cage’s lift and carriage incrementally.
Don’t max out on the spinal extension.
Instead, focus on how breathing/inhaling supports the movement of the ribs and upper back and develops the muscles from there.
Try to lift the rib cage equally on both sides as the body allows.

With practice, individuals will realize the healthy posture changes and increased distance between the ribs and pelvis.

Guidance and Variation

Perform the exercise with the back against a wall for upper back guidance.
Another variation of the pelvis and rib cage posture training exercise is to raise the arms.
This will create a different posture awareness training perspective.
Focus on rib cage movement when the arms are raised.
Does lifting the arms make the exercise easier, harder, or different?
To enhance posture improvement, stretch the pectoral muscles.

Yoga

Individuals looking for more ways to strengthen healthy posture should consider yoga.

A study published in the International Journal of Yoga suggests that a great way to activate the core may be to include a variety of yoga postures into the routine. (Mrithunjay Rathore et al., 2017) The ab muscles attach to various places on the rib cage and play a role in posture, alignment, and balance. The researchers identified two muscles, the external obliques, and the transverse abdominal, as key to a healthily aligned posture.

Core Strength

References

Drzał-Grabiec, J., Snela, S., Rykała, J., Podgórska, J., & Banaś, A. (2013). Changes in the body posture of women occurring with age. BMC geriatrics, 13, 108. doi.org/10.1186/1471-2318-13-108

Rathore, M., Trivedi, S., Abraham, J., & Sinha, M. B. (2017). Anatomical Correlation of Core Muscle Activation in Different Yogic Postures. International journal of yoga, 10(2), 59–66. doi.org/10.4103/0973-6131.205515

Papegaaij, S., Taube, W., Baudry, S., Otten, E., & Hortobágyi, T. (2014). Aging causes a reorganization of cortical and spinal control of posture. Frontiers in aging neuroscience, 6, 28. doi.org/10.3389/fnagi.2014.00028

What Causes Facet Hypertrophy? Causes & Symptoms

Dr. Alex Jimenez

a young female athlete feeling pain in the body after sport exercise, sport injury — young female athlete feeling pain in the body after sport exercise, sport injury

“Facet hypertrophy is an incurable, chronic disease that affects the facet joints in the spine. Can recognizing symptoms, help in diagnosis, and treatment?”

Table of Contents

Facet Hypertrophy

Facet hypertrophy causes the facet joints in the spine to enlarge. They are found where the vertebrae come into contact on the back of the vertebrae that form the backbone. These joints stabilize the spine when twisting and bending. Hypertrophy results when damage wears down the cartilage that cushions the bones that meet in the joint. This can include:

Aging
Wear and tear
Arthritis
Other joint diseases can damage facet joints.

Swelling, new bone growth, and bone spurs can occur as the joint tries to repair the damaged cartilage. The swelling and new bone growth can narrow the spinal canal and compress surrounding nerves, causing pain and other sensation symptoms. This ailment does not have a cure and worsens over time. The objective of treatment is to manage the pain symptoms and slow down the disease’s progress.

Types

Facet hypertrophy can be described as unilateral or bilateral.

Unilateral – the pain is felt on one side.
Bilateral – the pain is felt on both sides

On the following areas: (Romain Perolat et al., 2018)

Buttocks
Sides of the groin
Thighs

Symptoms

Symptoms can have a wide range of intensity, from a dull ache to chronic, disabling pain. The location of symptoms depends on the affected joint and the nerves involved, Pain manifests when the enlarged joints and new bone growth compresses the nearby nerves. The result leads to nerve damage and the following symptoms: (Weill Cornell Medicine Brain & Spine Center. 2023) (Cedars Sinai. 2022)

Stiffness, especially when standing up or getting out of a chair.
Inability to stand straight when walking.
Inability to look up to the left or right without turning the whole body.
Reduced range of motion and mobility.
Numbness or a tingling sensation of pins and needles.
Muscle spasms
Muscle weakness
Burning pain

The following symptoms are specific to the location of the affected joint (Weill Cornell Medicine Brain & Spine Center. 2023) (Cedars Sinai. 2022)

Radiating pain from the affected joint into the buttocks, hips, and upper thigh when the affected joint/s are in the lower back.
Radiating pain from the affected joint into the shoulder, neck, and back of the head when the affected joint/s are in the upper back.
Headaches when the affected joint is in the neck.

Causes

A common cause is the age-related degeneration of the joints, called spondylosis. Research indicates that more than 80% of individuals who are 40 or older have radiologic evidence of spondylosis, even though they may not have symptoms. (The University of Toledo Medical Center. N.D.) The following conditions can also increase the risk of facet hypertrophy (Weill Cornell Medicine Brain & Spine Center. 2023)

Unhealthy posture
Being overweight or obese
Sedentary lifestyle
Injury or trauma to the spine
Inflammatory conditions like rheumatoid arthritis or ankylosing spondylitis
Osteoarthritis
Genetic predisposition to the condition

Diagnosis

Diagnosis can be challenging when neck or back pain is the main complaint, as symptoms can mimic conditions such as sciatica from a herniated disc or hip arthritis. (Weill Cornell Medicine Brain & Spine Center. 2023)

A healthcare provider will conduct a complete physical examination, medical history, and discussion of symptoms.
As part of the examination, individuals may be asked to move into positions that cause pain and show where the pain is located. (Weill Cornell Medicine Brain & Spine Center. 2023)
Imaging tests can show visible damage and inflammation and/or help rule out other injuries or conditions that may be causing the symptoms. (Romain Perolat et al., 2018) (Weill Cornell Medicine Brain & Spine Center. 2023)

CT scans with or without myelogram – the use of contrast dye in the space around the spinal cord.
MRI
X-rays with or without a myelogram

A diagnosis is confirmed by injecting a diagnostic block that involves administering an anesthetic injection, sometimes with an anti-inflammatory like cortisone, into the joint or nerves near the affected joint. Two injections are given at different times to confirm the effect. (Romain Perolat et al., 2018)

If immediate relief improves after each injection, the facet joint is confirmed as the source of the pain symptoms.
If the block does not decrease the pain, the facet joint is probably not the source of the pain symptoms. (Brigham and Women’s Hospital. 2023)

Treatment

There is no cure for facet hypertrophy.
The goal of treatment is to make the pain more manageable.
Conservative treatment is usually successful in making a difference.

Conservative Treatment

First-line treatment involves utilizing conservative therapies (Romain Perolat et al., 2018)

Massage therapy
Physical therapy to strengthen the core muscles and spine.
Targeted exercises to help maintain flexibility.
Chiropractic adjustments to realign the spine.
Healthy posture retraining.
Non-surgical mechanical decompression.
Bracing to stabilize the spine
Acupuncture
Nonsteroidal anti-inflammatory – aspirin, ibuprofen, and naproxen.
Muscle relaxers – cyclobenzaprine or metaxalone.
Steroid injection into the facet joints.
Injection of platelet-rich plasma/PRP into the joints.

Medial Branch or Facet Block

A medial branch block injects local anesthetic near the medial nerves that connect to an inflamed joint.
Medial nerves are small nerves outside the joint space near the nerve that transmit signals and other impulses to the brain.
A facet block injects the medication outside the joint space near the nerve that supplies the joint called the medial branch.

Neurolysis

Neurolysis, also known as rhizotomy or neurotomy, is a procedure that destroys affected nerve fibers to relieve pain, reduce disability, and reduce the need for analgesics. This treatment can relieve pain for six to 12 months until the nerve regenerates, where further treatments may be necessary. (Matthew Smuck et al., 2012) Neurolysis can be performed using one of the following techniques (Romain Perolat et al., 2018)

Radiofrequency ablation RFA – the application of heat through radiofrequency.
Cryoneurolysis – the application of cold temperatures to the targeted nerve.
Chemical neurolysis – applying chemical agents, like a combination of phenol and alcohol.
Severing the nerves with surgical instrumentation.

Surgery

When one or more facet joints are severely damaged, they can become nonfunctional and painful. Surgery may be recommended when symptoms are not relieved by other therapies. (Ali Fahir Ozer, et al., 2015)

Prognosis

Facet hypertrophy is a chronic condition that progresses with age and does not affect life expectancy. (Weill Cornell Medicine Brain & Spine Center. 2023) The disorder is incurable, but symptoms can be managed with conservative therapies

A healthcare provider can help develop a treatment plan based on the extent and location of the joint affected.
Early diagnosis and treatment can help individuals achieve the best results.

Maintaining an active lifestyle and healthy weight can help prevent further joint stress. Individuals may be recommended to do regular stretching and strengthening exercises to lower inflammation, reduce stress, and improve overall health.

Facet Syndrome Treatment

References

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

Weill Cornell Medicine Brain & Spine Center. (2023). Symptoms of facet syndrome.

Cedars Sinai. (2022). Facet joint syndrome.

The University of Toledo Medical Center. (N.D.). Spondylosis.

Weill Cornell Medicine Brain & Spine Center. (2023). Facet syndrome.

Weill Cornell Medicine Brain & Spine Center. (2023). Diagnosing and treating facet syndrome.

Brigham and Women’s Hospital. (2023). Facet and medial branch blocks.

Smuck, M., Crisostomo, R. A., Trivedi, K., & Agrawal, D. (2012). Success of initial and repeated medial branch neurotomy for zygapophysial joint pain: a systematic review. PM & R : the journal of injury, function, and rehabilitation, 4(9), 686–692. doi.org/10.1016/j.pmrj.2012.06.007

Ozer, A. F., Suzer, T., Sasani, M., Oktenoglu, T., Cezayirli, P., Marandi, H. J., & Erbulut, D. U. (2015). Simple facet joint repair with dynamic pedicular system: Technical note and case series. Journal of craniovertebral junction & spine, 6(2), 65–68. doi.org/10.4103/0974-8237.156049