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Treating Finger Sprains and Dislocations: An Analysis

By
Dr. Alex Jimenez
-
Closeup of x-ray filmof a fractured finger

“Finger sprains and dislocations are common hand injuries that can happen during work, physical/sports activities, or in automobile collisions and accidents. Can recognizing the symptoms help in developing an effective treatment strategy?”

Treating Finger Sprains and Dislocations: An Analysis

Finger Sprains and Dislocations

Finger sprains and dislocations are common injuries of the hand that cause pain and swelling.

  • A sprain happens when the finger tissue that supports a joint gets stretched beyond its limits in a way that stresses the ligaments and tendons.
  • The ligament tissue can be partially or completely torn. If the damage is bad enough, the joint comes apart.
  • This is a dislocation – A dislocation happens when the joint in the finger gets shifted out of its normal position.
  • Both injuries can cause pain and stiffness in the finger and hand.

Sprains

Finger sprains can happen any time the finger bends in an awkward or unusual way. This can happen from falling on the hand or getting hurt when engaged in physical activities like sports or household chores. Sprains can occur in any of the knuckle joints in the finger. However, most commonly, the joint in the middle of the finger gets sprained. It’s known as the proximal interphalangeal or PIP joint. (John Elfar, Tobias Mann. 2013) Symptoms of a finger sprain can include:

  • Pain when you move your finger
  • Swelling around the knuckle
  • Tenderness in the finger and around the joint
  • For a sprain, individuals may need to have imaging done to see if any of the bones in the hand are broken or fractured. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)

Treatment

Individuals are encouraged not to move the injured finger while in recovery and healing. It can be hard to do, but wearing a splint can help.

  • Splints are supports that are usually made from foam and pliable metal.
  • A sprained finger can also be taped to one of the fingers next to it while in recovery, known as buddy-taping.
  • Splinting a sprained finger while engaged in activities can protect the hand from worsening or further injury.
  • However, splinting the finger when it is not needed can cause the joint to become stiff. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)
  1. An injury known as “gamekeeper’s thumb” is a more serious type of sprain.
  2. Injury to the ligaments at the thumb joint can cause difficulty in pinching and gripping.
  3. This injury must often be taped up or splinted for a significant amount of time for full recovery and could require surgery. (Chen-Yu Hung, Matthew Varacallo, Ke-Vin Chang. 2023)

Other treatments to help a sprained finger include:

  • Elevate the hand if swelling and inflamed.
  • Gentle finger exercises/movements to prevent stiffness.
  • Icing the injured finger.
  • Take an anti-inflammatory medication.

Individuals who have not broken bones or dislocated the joint will probably be able to move their finger in about a week. A doctor will set a timeline for when to start using the finger normally.

  1. Individuals who sprain their finger that feels swollen and stiff for longer than a few weeks are recommended to consult a doctor or specialist.
  2. They will need to check the hand to make ensure there aren’t any breaks or fractures. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)
  3. Thumb sprains and finger sprains in children may need to be splinted or taped for longer periods, as the ligament is not fully developed or as strong, which could lead to a tear.

Dislocations

A finger dislocation is a more severe injury involving the ligament, joint capsule, cartilage, and other tissues that causes misalignment of the finger. The ligaments and the joint capsule get torn when a joint is dislocated. The joint needs to be reset, which can be a simple process, or in severe cases, patients may need to be placed under anesthesia or undergo surgery to reset the joint properly.

  • In these cases, tendons or other tissues might be preventing the joint from getting into position.
  • Putting the finger back into the right position is known as”reduction.” Once reduced, the finger needs to be splinted.
  • Individuals also need an X-ray to ensure the joint is lined up correctly and that any bones were not broken or fractured when they sustained the injury. (James R. Borchers, Thomas M. Best. 2012)
  • Once reset, caring for a dislocated finger is basically the same as a sprained finger. Using ice on the finger, keeping the hand elevated to reduce swelling.
  • Individuals need to check with their doctor to find out when to start moving the finger. (James R. Borchers, Thomas M. Best. 2012)

The Chiropractic Approach To Improving Health

References

Elfar, J., & Mann, T. (2013). Fracture-dislocations of the proximal interphalangeal joint. The Journal of the American Academy of Orthopaedic Surgeons, 21(2), 88–98. doi.org/10.5435/JAAOS-21-02-88

OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Hand fractures.

Hung, C. Y., Varacallo, M., & Chang, K. V. (2023). Gamekeeper’s Thumb. In StatPearls. StatPearls Publishing.

OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Finger fractures.

Borchers, J. R., & Best, T. M. (2012). Common finger fractures and dislocations. American family physician, 85(8), 805–810.

Tips to Relieve Burning Feet and Heal the Underlying Condition

By
Dr. Alex Jimenez
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Close up on women feet and hand massage on injury spot

“Individuals’ feet will heat up when walking or running; however, burning feet could be a symptom of medical conditions like athlete’s foot or a nerve injury or damage. Can awareness of these symptoms help identify solutions to relieve and heal the underlying condition?”

Tips to Relieve Burning Feet and Heal the Underlying Condition

Burning Feet

Walkers and runners often experience heat in their feet. This is natural from the increased circulation, heart rate, warm or hot sidewalks, and pavement. But the feet could experience an abnormal hot or burning sensation. Usually, the overheating is caused by socks and shoes and fatigue after a long workout. The first self-care steps include trying new or specialized footwear and workout adjustments. If burning feet persist or there are signs of infection, tingling, numbness, or pain, individuals should see their healthcare provider. (Mayo Clinic. 2018)

Footwear

The shoes and how they are worn may be the cause.

  • First, look at the material of the shoes. They could be shoes and/or insoles that don’t circulate air. They can get hot and sweaty without proper air circulation around the feet.
  • When choosing running shoes, consider a mesh material that allows airflow to keep the feet cool.
  • Consider getting fitted for shoes that are the right size, as the feet swell when running or walking.
  • If the shoes are too small, air can’t circulate, creating more friction between the foot and the shoe.
  • Shoes that are too large can also contribute to friction as the feet move around too much.
  • Insoles could also contribute.
  • Some insoles can make the feet hot, even if the shoes are breathable.
  • Swap the insoles from another pair of shoes to see if they are contributing, and if so, look into new insoles.

Tips to help prevent hot feet:

Topical Ointments

  • Use an anti-blister/chafing topical cream to lubricate and protect the feet.
  • This will reduce friction and prevent blisters.

Lace Properly

  • Individuals may be lacing the shoes too tight, constricting circulation, or irritating the nerves at the top of the foot.
  • Individuals should be able to slide one finger under the knot.
  • Remember that the feet will swell as walking or running commences
  • Individuals may need to loosen their laces after warming up.
  • Individuals are recommended to learn lacing techniques that will ensure they are not too tight over the sensitive areas.

Cushioning

  • Fatigue from long workouts or long days standing/moving can result in burning feet.
  • Individuals may need added cushioning in the shoes.
  • Look for work and athletic shoes that have added cushioning.

Shoe Allergies

Individuals may have an allergic reaction or a sensitivity to the fabric, adhesives, dyes, or other chemicals. (Cleveland Clinic. 2023) The chemicals used in production vary for leather compared to fabric and are different by brand and manufacturer.

  • A shoe material allergy may also result in burning, itching, and swelling.
  • It’s recommended to note whether symptoms only happen when wearing a specific pair of shoes.
  • Recommendations are to try different kinds and brands of shoes.

Socks

The sock fabric could be contributing to hot or burning feet. Steps to take can include:

Avoid cotton

  • Cotton is a natural fiber but is not recommended for walking and running as it holds sweat that can keep the feet wet.
  • It is recommended to use socks made of Cool-Max and other artificial fibers that wick sweat away and cool them down.

Wool

  • Wool socks can also cause itching and burning sensations.
  • Consider athletic socks made from itch-free wool.

Mindfulness

  • Individuals could be sensitive to other fabrics or dyes in socks.
  • Take note of which socks cause hot or burning feet symptoms.
  • Individuals could also be sensitive to laundry products and are recommended to try a different brand or type.

Medical Conditions

In addition to shoes and socks, medical conditions could cause and contribute to symptoms.

Athlete’s Foot

  • Athlete’s foot is a fungal infection.
  • Individuals may feel a burning sensation in the affected area.
  • Typically, it is itchy, red, scaling, or cracking.
  1. Rotate shoes.
  2. The fungus grows in damp places, therefore, it is recommended to rotate shoes to allow them to dry out between workouts.
  3. Wash and dry the feet after walking or running.
  4. Try home and over-the-counter solutions, powders, and remedies to treat athlete’s foot.

Peripheral Neuropathy

Individuals frequently experiencing burning feet apart from when they have been exercising could be due to nerve damage known as peripheral neuropathy. (National Institute of Neurological Disorders and Stroke. 2023) Peripheral neuropathy symptoms include pins and needles, numbness, tickling, tingling, and/or burning sensations.

Examination

  • Diabetes is one of the most common causes of peripheral neuropathy.
  • Diabetes can come on at any age.
  • Individuals need to learn how to protect their feet, as exercise is recommended for diabetes.

Other conditions that can produce peripheral neuropathy include:

  • Vitamin B-12 deficiency
  • Alcohol abuse
  • Circulatory disorders
  • AIDS
  • Heavy metal poisoning

Massage and Movement

  • Massaging the feet also increases circulation.
  • Exercise such as walking is recommended for peripheral neuropathy as it improves circulation to the feet.

Other Causes

Symptoms could also be caused by other conditions including: (Cleveland Clinic. 2023)

Nerve Entrapment

  • Degenerative changes in the spine or back trauma can cause injury/damage to the nerves that can cause pain, tingling, and numbness in the feet.

Tarsal Tunnel Syndrome

  • Compression of the posterior tibial nerve in your lower leg can cause tingling and burning in your feet.

Morton’s Neuroma

  • Morton’s neuroma, which is caused by thickened nerve tissue, can cause pain and burning at the base of the toes.

Autoimmune Diseases

  • Diseases such as multiple sclerosis or Lupus can also cause burning feet.

Self-Care

Adjustments or additions to routines and habits can help.

  1. Don’t walk or run in worn-out shoes.
  2. Protect the feet by using the right socks, foot powder, and ointments, and cover any areas where rubbing and friction occur.
  3. Immediately change out of shoes and socks after exercise, allowing thorough air drying.
  4. This will help reduce the risk of the athlete’s foot fungus growth.
  5. Soak the feet in cool water. Do not use ice, as it could damage the skin.
  6. Soak the feet in Epsom salts to relieve pain and inflammation and dry up blisters.
  7. Elevate the feet after exercising.
  8. Rotate the shoes and socks between workout sessions and during the day.
  9. Try different shoes, socks, and insoles.
  10. Overtraining can worsen symptoms.
  11. Try gradually building on distance while monitoring symptoms.

See a doctor or specialist healthcare provider if symptoms continue and are not associated with walking or running exercise.

Exploring Integrative Medicine

References

Mayo Clinic. (2018). Burning Feet.

National Institute of Neurological Disorders and Stroke. (2023). Peripheral Neuropathy.

Cleveland Clinic. (2023) Burning Feet Syndrome.

Iliopsoas Syndrome: Causes Behind Leg & Hip Pain

By
Dr. Alex Jimenez
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Dissatisfied fit black lady holding aching hip, has kidney inflammation, touching location of paim, wearing sport clothes, having sporty shaped body

“Individuals suffering from hip, thigh, and/or groin pain could be experiencing iliopsoas syndrome. Could knowing the symptoms and causes help in diagnosis and treatment?”

Iliopsoas Syndrome: Causes Behind Leg & Hip Pain

Iliopsoas Syndrome

Iliopsoas syndrome encompasses several conditions that affect the inner hip muscle and can cause hip and thigh pain. The muscle helps to bend the leg toward the body.

  • The condition is usually caused by overuse injuries and commonly affects individuals who perform repeated hip flexion movements, like cyclists, gymnasts, dancers, runners, and soccer players. (Liran Lifshitz, et al., 2020)
  • The term is often used interchangeably with psoas syndrome, iliopsoas tendonitis, snapping hip syndrome, and iliopsoas bursitis. However, there are clinical differences.

Symptoms

Symptoms include: (American Association of Hip and Knee Surgeons. 2020)

  • Tenderness in the hip and groin area.
  • Hip or groin clicking or snapping that can be heard and/or felt during movement.
  • Pain and/or stiffness in the hip and thigh area.
  • Pain that worsens when bending the hip – walking, climbing stairs, squatting, sitting.
  • Movements that involve bringing the knee toward the chest can worsen the pain.

Causes

The iliopsoas muscles are hip muscles on the front of the hip. They are made up of the psoas major, the psoas minor, and the iliacus. Small, fluid-filled sacs/bursae are within the hip joint between bones and soft tissues. The bursae reduce friction and provide cushioning to help the tendons, muscles, and other structures move smoothly over the bony prominences.

  1. Iliopsoas bursitis happens when the bursa, which is located between the iliopsoas tendon and the inside of the hip joint, becomes inflamed and irritated.
  2. Iliopsoas tendonitis/hip tendonitis happens when the tendon that attaches the thigh bone to the iliopsoas muscle becomes inflamed and irritated.
  3. Iliopsoas bursitis and tendonitis are commonly caused by overuse injuries and intense activities like cycling, running, rowing, or strength training.

Diagnosis

  • Healthcare providers can diagnose iliopsoas syndrome based on symptom history and a hip examination.
  • Imaging tests – MRI and X-rays may be used to rule out other injuries or conditions like muscle tears. (Paul Walker, et al., 2021)

Treatment

Most mild cases of hip bursitis and hip tendonitis can be managed using the RICE method (American Association of Orthopedic Surgeons. 2020)

Rest

  • Avoid putting weight on the hip for a few days after the injury.

Ice

  • Apply ice immediately after the injury to bring the swelling down.
  • Use a cold pack for 20 minutes at a time, several times a day.
  • Do not apply ice directly on the skin.

Compression

  • Wrap the area in a soft bandage or use compression shorts to prevent further swelling.

Elevation

  • Rest as often as possible with the leg raised higher than the heart.

Medical Treatment

  • Non-steroidal anti-inflammatory drugs like ibuprofen and naproxen sodium can alleviate pain and reduce inflammation. (Paul Walker, et al., 2021)
  • Steroid injections can be used if symptoms continue or come back with additional injections administered as necessary. (Paul Walker, et al., 2021)
  • After pain and swelling subside, physical therapy may be recommended, as well as mild exercises to gradually improve hip strength and flexibility. (Paul Walker, et al., 2021)
  • A healthcare provider may recommend surgery in severe cases where pain persists, and conservative treatments don’t provide enough relief.
  • However, this is rare due to muscle weakness and nerve damage risks. (Paul Walker, et al., 2021)

Hip Labral Tear – Chiropractic Treatment

References

Lifshitz, L., Bar Sela, S., Gal, N., Martin, R., & Fleitman Klar, M. (2020). Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment. Current sports medicine reports, 19(6), 235–243. doi.org/10.1249/JSR.0000000000000723

American Association of Hip and Knee Surgeons. Iliopsoas tendonitis/bursitis.

Walker, P., Ellis, E., Scofield, J., Kongchum, T., Sherman, W. F., & Kaye, A. D. (2021). Snapping Hip Syndrome: A Comprehensive Update. Orthopedic reviews, 13(2), 25088. doi.org/10.52965/001c.25088

American Association of Orthopedic Surgeons. OrthoInfo. Hip strains.

Reducing Osteoarthritis Pain with Massage Therapy

By
Dr. Alex Jimenez
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Caucasian senior woman 60s doing physiotherapist with support from nurse. Senior elderly female sitting on sofa in living room workout exercise for patient with caregiver in nursing care..

“For individuals managing osteoarthritis, could massage therapy provide added treatment benefits?”

Reducing Osteoarthritis Pain with Massage Therapy

Osteoarthritis Massage Therapy

Osteoarthritis happens when the cartilage between the joints wears away, causing stiffness and pain. Massage therapy is a treatment used to relieve various types of pain symptoms.

  • There are many types of massage therapy, that healthcare providers utilize to manipulate the muscles and other soft tissues to relieve symptoms, relax muscles, increase circulation, reduce inflammation, release trigger points, and restore mobility, flexibility, and function. (Ergonomic Trends. 2023)
  • Professional therapists can help relieve osteoarthritis joint pain by relaxing the surrounding muscles and other soft tissues to release stiffness. (Adam Perlman, et al., 2019)

Massage Objectives and Types

Massage therapists use their hands and fingers, forearms, elbows, and/or instruments to manipulate the body’s soft tissues. Soft tissues support and surround body structures and include muscle, fat, tendons, and ligaments.

  • The goal of osteoarthritis massage therapy is to relax muscles and soft tissues, increase blood and oxygen circulation, warm the affected area/s, relieve pain, and restore mobility and function.
  • Depending on the location of the muscles being massaged, individuals may be seated or lie down on a specialized table.
  • The amount of pressure and direction of movement depend on the body area.
  • Therapeutic oils and/or massage creams may be used to increase the therapy.

Types include:

Swedish

  • The therapist uses long strokes, kneading, and friction on the muscles.
  • Joints are moved to increase flexibility.

Deep Tissue

  • The therapist uses deep finger or instrument pressure, focusing on muscles that are tight or knotted.

Trigger Point

  • Trigger points represent a source of radiating pain symptoms.
  • The therapist focuses pressure on these myofascial tissue points using various strokes to release them.

Shiatsu

  • The therapist applies rhythmic pressure with their thumbs, fingers, and palms to redirect and increase energy or chi/qi.

A massage session lasts around 30–60 minutes depending on the severity of the condition and the number of sessions the patient has undergone. Chronic pain patients usually go through a series of specialized sessions that focus on specific areas and gradually build.

Risk Factors

Certain precautions must be taken before getting osteoarthritis massage therapy. Although there are a few serious risks, certain individuals are not suitable candidates and should not receive massage therapy. The conditions include: (Medical Massage Therapy Resource & Reference. 2023)

  • Damaged nerves.
  • Damaged blood vessels.
  • Infection and inflammation in the area to be massaged.
  • Open wounds.
  • Fever.
  • Taking a blood thinner.
  • Deep vein thrombosis – blood clots.
  • Bleeding disorders.
  • Osteoporosis – weak and brittle bones.
  • Recent fractures – broken bones.
  • Tumors.
  • Cancer.
  • Individuals who have recently undergone surgery.
  • Individuals with a skin condition that is contagious, like warts or herpes, or noncontagious, like psoriasis, could be aggravated by touch or pressure.
  • Individuals who have cancer, fragile skin, heart problems, or dermatomyositis are recommended to discuss osteoarthritis massage therapy with their healthcare provider.

Research on the effects of massage therapy on various health conditions is ongoing. Massage therapy promotes relaxation while reducing stress, which can help with chronic joint issues like osteoarthritis.

Arthritis Explained

References

Ergonomic Trends. 20 most common types of massages and their benefits explained.

Perlman, A., Fogerite, S. G., Glass, O., Bechard, E., Ali, A., Njike, V. Y., Pieper, C., Dmitrieva, N. O., Luciano, A., Rosenberger, L., Keever, T., Milak, C., Finkelstein, E. A., Mahon, G., Campanile, G., Cotter, A., & Katz, D. L. (2019). Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial. Journal of general internal medicine, 34(3), 379–386. doi.org/10.1007/s11606-018-4763-5

Medical Massage Therapy Resource & Reference. When not to get a massage: 26 reasons you cannot get a massage.

The Health Benefits of Resistant Starch Explained

By
Dr. Alex Jimenez
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Food bowl with baked potatoes, lentils and spicy chickpeas, avocado, arugula, vegan, vegetarian healthy dinner

“For individuals with digestive and other health issues, could resistant starch provide health benefits?”

The Health Benefits of Resistant Starch Explained

Resistant Starch

Typical starchy foods are simple starches that are rapidly digested. This sends their sugars into the bloodstream, contributing to weight gain and increasing the risk of diabetes and heart disease. (Erik E. J. G. Aller, et al., 2011) Resistant starch is a food component that is a type resistant to digestion. This means that it passes into the large intestine and interacts with the gut flora. Foods that contain resistant starch pass through the stomach and small intestine without being absorbed. In the large intestine, they are fermented by the gut bacteria which releases substances that are beneficial to health.​

Health Benefits

Studies on the health benefits are ongoing. Scientists are researching how it can help with weight management and colon health:

Weight Management

Research is beginning to show indications that foods with resistant starch can help with weight loss and the ability to help offset the diseases associated with weight gain that include: (Janine A. Higgins. 2014)

  • High cholesterol
  • Diabetes
  • Metabolic syndrome
  • Cardiovascular disease

Colon Health

In addition, researchers are finding preliminary evidence indicating that it might possibly help with: (Diane F. Birt, et al., 2013)

  • A prebiotic that encourages a healthy balance of gut flora.
  • Inflammatory bowel disease symptom improvement.
  • Prevention of colon cancer.
  • Protection against diverticulitis.

However, more research is needed.

Consumption Amount

Estimates on how much should be consumed range from a minimum of 6 grams to a maximum of 30 grams. It is estimated that most individuals consume less than 5 grams per day, (Mary M. Murphy, et al., 2008). As individuals increase their intake, it is recommended to do so slowly, to minimize unwanted gas and bloating.

Bananas

  • Bananas are a healthy source of resistant starch.
  • They have the maximum amount when they are unripe.
  • The resistant starch content reduces as the banana ripens.
  • If green/unripe bananas are not appealing, making a smoothie can help with the taste.

Potatoes

  • Potatoes have their highest level of resistant starch when raw.
  • However, individuals can maximize their intake by allowing the potatoes to cool before eating.

Rice

  • Levels of resistant starch depend on whether the rice is white or brown.
  • Similar to potatoes, intake can be maximized from rice by allowing the rice to cool.

Oats

  • Cooking oats in water, as most are accustomed to making oatmeal, diminishes the resistant starch content.
  • Rolled or steel-cut oats are recommended as dependable sources of resistant starch.

Chickpeas

  • Chickpeas, also known as garbanzo beans, are nutritional powerhouses.
  • They are a healthy source of dietary fiber, along with many vitamins and minerals, and resistant starch.
  • Cooked and/or canned chickpeas contain high levels of resistant starch.
  • They go with salads or as a side dish or snack.
  • For individuals with IBS, well-rinsed canned chickpeas are considered to be low in FODMAPs or carbohydrates that can contribute to symptoms. (Anamaria Cozma-Petruţ, et al., 2017)
  • It is recommended to keep the serving size to a 1/4 cup.

Lentils

  • Lentils serve as a healthy source of plant-based protein.
  • Cooked they can provide resistant starch.
  • They can be prepared in soups or side dishes.
  • From a can, they can be IBS-friendly by being well-rinsed and limited to a 1/2 cup serving.

Bread

  • Various breads offer varying levels of resistant starch.
  • Pumpernickel bread contains high levels.
  • Breadsticks and pizza crusts have high levels.
  • Individuals with IBS may be reactive to the FODMAP fructan or the gluten protein.
  • Other recommended high-resistant starch options are corn tortillas or artisanal sourdough bread that is traditionally prepared.

Green Peas

  • Green peas, even when cooked, are a healthy source of resistant starch.
  • They can be prepared in soups or as a side dish.
  • However, green peas have been found to be high in the FODMAP GOS and could be problematic for individuals with IBS. (Anamaria Cozma-Petruţ, et al., 2017)

Beans

  • Most types of cooked and/or canned beans are recommended sources of resistant starch.
  • The highest levels are found in white and kidney beans.
  • They can be served in soups, as a side dish, or mixed with rice.
  • Beans are a high-FODMAP food and could contribute to digestive symptoms in individuals with IBS.

Body In Balance: Chiropractic Fitness and Nutrition

References

Aller, E. E., Abete, I., Astrup, A., Martinez, J. A., & van Baak, M. A. (2011). Starches, sugars and obesity. Nutrients, 3(3), 341–369. doi.org/10.3390/nu3030341

Higgins J. A. (2014). Resistant starch and energy balance: impact on weight loss and maintenance. Critical reviews in food science and nutrition, 54(9), 1158–1166. doi.org/10.1080/10408398.2011.629352

Birt, D. F., Boylston, T., Hendrich, S., Jane, J. L., Hollis, J., Li, L., McClelland, J., Moore, S., Phillips, G. J., Rowling, M., Schalinske, K., Scott, M. P., & Whitley, E. M. (2013). Resistant starch: promise for improving human health. Advances in nutrition (Bethesda, Md.), 4(6), 587–601. doi.org/10.3945/an.113.004325

Murphy, M. M., Douglass, J. S., & Birkett, A. (2008). Resistant starch intakes in the United States. Journal of the American Dietetic Association, 108(1), 67–78. doi.org/10.1016/j.jada.2007.10.012

Cozma-Petruţ, A., Loghin, F., Miere, D., & Dumitraşcu, D. L. (2017). Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!. World journal of gastroenterology, 23(21), 3771–3783. doi.org/10.3748/wjg.v23.i21.3771

What Triggers Plantar Fasciitis Flare-Ups and How to Treat Them

By
Dr. Alex Jimenez
-
Young woman getting examination of her injured leg by orthopedist at clinic.

“Individuals with plantar fasciitis may experience consistent flare-ups. Can knowing the causes help to find pain relief?”

What Triggers Plantar Fasciitis Flare-Ups and How to Treat Them

 

Plantar Fasciitis Flare-Up

Plantar fasciitis is a common cause of heel and foot pain. The plantar fascia is a band of tissue that runs along the bottom of the foot and becomes inflamed. Certain factors can cause plantar fasciitis flare-ups, including:

  • Increased levels of physical activity.
  • Not stretching regularly.
  • Wearing shoes without proper support.
  • Weight gain.

Causes

A plantar fasciitis flare-up is often triggered by physical activity. (MedlinePlus. U.S. National Library of Medicine. 2022) It can also be brought on by underlying conditions, like increased body weight, arthritis, or the shape of the foot. (Johns Hopkins Medicine. 2023) Despite the root cause, there are activities and experiences that can contribute to and/or worsen the condition.

New Exercise Routine

Weight Gain

  • Individuals who have an increased or increasing body weight add more pressure to their feet, placing them at higher risk for plantar fasciitis. (MedlinePlus. U.S. National Library of Medicine. 2022)
  • If experiencing consistent flare-ups, a healthcare provider may suggest an appropriate weight loss program combined with a treatment plan.

Pregnancy

Shoes Without Support

  • Wearing shoes without arch support can cause general foot pain and plantar flare-ups.
  • Individuals should wear shoes with plenty of cushioning and arch support, like sneakers. (Ortho Info. Academy of Orthopaedic Surgeons. 2022)
  • Shoes that are not recommended include:
  • Flip-flops
  • Shoes that are flat.
  • High heels, boots, or shoes that raise the heel above the toes.
  • Worn-out shoes like exercise workout shoes.

Not Stretching Properly or At All

  • Tight calves can increase pressure on the plantar fascia.
  • Stretching the calves, Achilles tendon/heel, and the bottom of the feet is highly recommended to help treat and prevent the condition. (Johns Hopkins Medicine. 2023)
  • Not stretching thoroughly or skipping stretches can worsen symptoms.
  • Individuals with plantar fasciitis are recommended to stretch before and after physical activities, exercise, before going to bed, and after waking up.

Working Through the Pain

  • Individuals may try to continue physical activities during a flare-up.
  • This is not recommended as doing so can cause more pain and worsen the condition.
  • When pain presents, it’s recommended to:
  • Stop all activities that strain the feet
  • Stay off the feet for at least a week.

Tearing the Plantar Fascia

  • The plantar fascia rarely tear completely from repeated stress known as a plantar fascia rupture.
  • If this happens, sudden severe pain will present and individuals are advised to call their healthcare provider. (Stephanie C. Pascoe, Timothy J. Mazzola. 2016)
  • However, individuals can recover relatively fast, and pain alleviates quickly.
  • Individuals with tears will be recommended to wear a foot orthotic as the foot may have flattened more.

Risk Factors

Plantar fasciitis can happen to anyone, but individuals who have the following characteristics are at an increased risk: (Ortho Info. Academy of Orthopaedic Surgeons. 2022)

  • A high-foot arch.
  • Jobs or hobbies that place added strain on the feet.
  • Tight calf muscles.
  • A sudden increase in physical activity.
  • A new exercise regimen.
  • Increased body weight.
  • Sudden weight gain like during pregnancy.

How Long Does a Flare Last?

Treatment

In addition to rest treatments for plantar fasciitis can include: (Ortho Info. Academy of Orthopaedic Surgeons. 2022)

Ice

  • Icing the bottom of the foot for 15 minutes a few times a day decreases inflammation.

Nonsteroidal anti-inflammatory drugs – NSAIDs

  • Over-the-counter NSAIDs like ibuprofen and naproxen, can reduce pain and inflammation.
  • It is recommended to consult a healthcare provider for short-term use and dosage.

Proper Shoes

  • Shoes with arch supports are highly recommended.
  • A healthcare provider can order custom orthotics for more support.

Stretching

  • Stretches are essential for treatment.
  • Stretching the calf and bottom of the foot daily will keep the tissue relaxed.

Massages

  • Massaging the area with a therapeutic massage ball soothes the tissues.
  • Using a percussive massager can increase circulation.

What is Plantar Fasciitis?

References

MedlinePlus. National Library of Medicine.  (2022) U.S. Plantar fasciitis.

Johns Hopkins Medicine. (2023) Plantar fasciitis.

Boston Children’s Hospital. (2023) Plantar fasciitis.

Ortho Info. Academy of Orthopaedic Surgeons. (2022) Plantar fasciitis and bone spurs.

Pascoe, S. C., & Mazzola, T. J. (2016). Acute Medial Plantar Fascia Tear. The Journal of orthopaedic and sports physical therapy, 46(6), 495. doi.org/10.2519/jospt.2016.0409

Mental Toughness: Strategies for Maximum Performance

By
Dr. Alex Jimenez
-
Female athlete taking rest after fitness training looking away

“It can be difficult for individuals and athletes to stay motivated, manage stress, and prevent becoming overwhelmed. Can mental toughness and a positive attitude help increase potential and performance levels?”

Mental Toughness: Strategies for Maximum Performance

 

Mental Toughness

Athletes and fitness enthusiasts work on conditioning, skills training, and perfecting techniques. Physical training can take individuals far but another necessary part of maximizing athletic potential is building mental toughness and having the right attitude. Like anything, mental training takes time, effort, and regular adjustments to find ways to shift a losing or bad attitude into a positive one that can bring out the best.

Attitude Is Important

If negativity begins to set in like dealing with an injury, getting rid of self-limiting beliefs can be difficult, as well as generate optimism to rise up and succeed. For athletes or individuals who enjoy competitive sports, developing a positive mental attitude will help with:

  • Emotions that can affect cognitive functioning strategies.
  • Energy levels.
  • Other aspects of physical performance.

Mental Strategies

Mood Improvement

Individuals frustrated by a pessimistic perspective tend to dwell on problems or issues. To shift into a positive mood do something to lift your spirits, even if you don’t think it will help.

  • Listen to your favorite or uplifting music.
  • Watch an inspirational movie.
  • Read a sports psychology book.
  • Get together or call a teammate or friend that are cheerful and upbeat.
  • Play different games just for fun.
  • Take a break, go to the park, walk around, and meditate.
  • Get into hobbies.
  • Relax with a therapeutic massage.

Positive Self Talk

Continuing sports psychology research shows that practicing positive self-talk can improve athletic performance. (Nadja Walter, et al., 2019) Sports psychologists describe this through the idea that thoughts create beliefs, that drive actions.

Positive self-talk can take different forms.
For some reciting a specific phrase, sentence, or a single word can effectively manage thoughts, push out the negativity, and focus on taking care of business. Anything that inspires can include:

  • Focus
  • Remember the fundamentals!
  • You know what to do!
  • You can do it!
  • You got this!

Research shows that positive self-talk reduces anxiety and increases self-confidence, optimization, efficacy, and performance. (Nadja Walter, et al., 2019) However, self-talk needs to be practiced and part of a regular routine to be effective.

Visualization

Another strategy is using visualization exercises.

  • This means imagining various scenarios in which competition is happening and things are working out. (Mathias Reiser, Dirk Büsch, Jörn Munzert. 2011)
  • This could be using all the senses to imagine the venue where the tournament is taking place, the sound of the crowd, the smells, how the ground or court feels, and/or how the ball or specific sports object feels.
  • The wisdom is if you can think it, you can do it, once that is determined apply strategies to get there.

Sports Injury Rehabilitation

References

Walter, N., Nikoleizig, L., & Alfermann, D. (2019). Effects of Self-Talk Training on Competitive Anxiety, Self-Efficacy, Volitional Skills, and Performance: An Intervention Study with Junior Sub-Elite Athletes. Sports (Basel, Switzerland), 7(6), 148. doi.org/10.3390/sports7060148

Reiser, M., Büsch, D., & Munzert, J. (2011). Strength gains by motor imagery with different ratios of physical to mental practice. Frontiers in psychology, 2, 194. doi.org/10.3389/fpsyg.2011.00194

What Are The Therapeutic Options For Upper Crossed Syndrome?

By
Dr. Alex Jimenez
-

Can various therapeutic options provide relief for individuals with upper crossed syndrome to restore muscle strength?

Introduction

Many individuals often suffer neck and shoulder pain from poor posture, improper heavy lifting, musculoskeletal conditions, auto accidents, whiplash, etc. The surrounding muscles that connect the neck and shoulders help protect the cervical and thoracic region of the spine and can succumb to injuries that can cause pain-like symptoms causing discomfort to the individual. Neck, shoulder, and back pain are the three most common issues many individuals have experienced. These musculoskeletal disorders can also correlate with pre-existing conditions; many people will feel pain and discomfort while trying to find the relief they seek. One of the most common issues people often experience is upper crossed syndrome, which can be associated with neck and shoulder pain. Today’s article explains what upper cross syndrome is and how it affects the neck and shoulders while also diving into how different therapeutic options like spinal decompression and chiropractic care can reduce the effects of upper cross syndrome. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to mitigate upper-crossed syndrome in the neck and shoulders. We also inform our patients that there are many therapeutic options, like chiropractic care and spinal decompression, to minimize muscle pain in the neck and shoulders. 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 upper-crossed syndrome. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer

 

What Is Upper Crossed Syndrome?

 

Have you been dealing with muscle pain in your shoulders or neck after being on the computer for a while? Do you feel stiffness in your shoulders that rotating them causes temporary relief? Or does it hurt when you turn your head from side to side? Many of these pain-like scenarios are often associated with upper-cross syndrome. Many people don’t often realize that upper crossed syndrome is a musculoskeletal condition that affects the neck, shoulder, and chest muscles and causes them to be weak and tight due to poor posture. The upper crossed syndrome can cause referred pain to the upper extremities, leading to cervicogenic headaches, limited range of motion, trigger points in the muscles, and muscle imbalance. (Moore, 2004) When many people are dealing with upper crossed syndrome due to poor posture, it can lead to many issues in the neck and shoulders.

 

How Does It Affect The Neck & Shoulders?

Now, why does upper crossed syndrome affect the neck and shoulders? Many people unintentionally hunched over when looking at their phones, being on the computer, or relaxing at home. This causes specific muscles in the neck and shoulder region, like the serratus and lower trapezius muscles, to become weak while the pectoral and neck muscles are tight. (Chu & Butler, 2021) This, in turn, causes the shoulders to be more rounded and hunched, causing the neck and head to crane forward. When people are dealing with upper crossed syndrome, many would often complain about pain-like symptoms like:

  • Headaches
  • Neck Strain
  • Muscle tightness
  • Upper back pain
  • Restricted range of motion
  • Numbness/Tingling sensations in the arms

The upper crossed syndrome can also occur gradually over time and cause nerve compression to the upper extremities. When the upper neck and shoulder muscles start to affect the surrounding nerve roots, which then leads to nerve dysfunction in the sensory and motor skills when a person picks up an object. (Lee & Lim, 2019) However, many individuals dealing with upper-crossed syndrome can seek treatment to relieve muscle pain in their neck and shoulders.

 

An Overview Of Upper Crossed Syndrome- Video

What is Upper Cross Syndrome? | El Paso, Tx (2023)

Since upper cross syndrome is a musculoskeletal condition that affects the neck and shoulders, it can result in muscle imbalance and pain in the individual. Many people, especially in the working field, develop this syndrome by being hunched over for an extended period. (Mujawar & Sagar, 2019) This causes the head to be more forward, the neck posture to be curved and hunched, and the shoulders to be rounded. The video above explains upper-crossing syndrome, its causes, and how it is treated. 

Spinal Decompression Reducing Upper Crossed Syndrome

 

Numerous treatments can help restore muscle strength and reduce muscle pain in the neck and shoulders. Treatments like spinal decompression can help reduce upper crossed syndrome by slowly using gentle traction to the cervical spine region and gently stretching the neck muscles to provide relief. Spinal decompression is one of the non-surgical treatments that many individuals with headaches associated with upper crossed syndrome can find the comfort they seek through pain reduction and improve their quality of life. (Eskilsson et al., 2021) At the same time, spinal decompression can be part of a personalized treatment plan that many individuals can add to their daily routine to prevent the pain from returning. (Saunders, 1983)

 

Chiropractic Care Restoring Muscle Strength

Just like spinal decompression, chiropractic care is a non-surgical treatment that can be combined with various stretching techniques to restore the neck’s range of motion and reduce pain associated with upper-crossed syndrome. (Mahmood et al., 2021) Chiropractic care incorporates manual and mechanical techniques like MET (muscle energy techniques) and spinal manipulation to realign the spine out of subluxation. When chiropractors integrate MET to manage upper crossed syndrome, many individuals find that their pain has decreased, their cervical range of motion is improved, and their neck disability is reduced. (Gillani et al., 2020) When many individuals start thinking about their health and wellness, they can make small changes to improve their posture and be more mindful of their bodies to reduce the chances of upper-cross syndrome returning.

 

References

Chu, E. C., & Butler, K. R. (2021). Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome-A Case Study and Brief Review. Clin Pract, 11(2), 322-326. doi.org/10.3390/clinpract11020045

Eskilsson, A., Ageberg, E., Ericson, H., Marklund, N., & Anderberg, L. (2021). Decompression of the greater occipital nerve improves outcome in patients with chronic headache and neck pain – a retrospective cohort study. Acta Neurochir (Wien), 163(9), 2425-2433. doi.org/10.1007/s00701-021-04913-0

Gillani, S. N., Ain, Q., Rehman, S. U., & Masood, T. (2020). Effects of eccentric muscle energy technique versus static stretching exercises in the management of cervical dysfunction in upper cross syndrome: a randomized control trial. J Pak Med Assoc, 70(3), 394-398. doi.org/10.5455/JPMA.300417

Lee, E. Y., & Lim, A. Y. T. (2019). Nerve Compression in the Upper Limb. Clin Plast Surg, 46(3), 285-293. doi.org/10.1016/j.cps.2019.03.001

Mahmood, T., Afzal, W., Ahmad, U., Arif, M. A., & Ahmad, A. (2021). Comparative effectiveness of routine physical therapy with and without instrument assisted soft tissue mobilization in patients with neck pain due to upper crossed syndrome. J Pak Med Assoc, 71(10), 2304-2308. doi.org/10.47391/JPMA.03-415

Moore, M. K. (2004). Upper crossed syndrome and its relationship to cervicogenic headache. J Manipulative Physiol Ther, 27(6), 414-420. doi.org/10.1016/j.jmpt.2004.05.007

Mujawar, J. C., & Sagar, J. H. (2019). Prevalence of Upper Cross Syndrome in Laundry Workers. Indian J Occup Environ Med, 23(1), 54-56. doi.org/10.4103/ijoem.IJOEM_169_18

Saunders, H. D. (1983). Use of spinal traction in the treatment of neck and back conditions. Clin Orthop Relat Res(179), 31-38. www.ncbi.nlm.nih.gov/pubmed/6617030

 

Disclaimer

Understanding Forward Head Posture: Guide to Posture Correction

By
Dr. Alex Jimenez
-
Shot of a young female doctor writing down a patients information in an office.

“Individuals that sit at a desk/workstation for hours for work or school, or drive for a living, could be fostering a long-term condition known as forward head posture. Can understanding the signs and symptoms help to prevent the condition?”

Understanding Forward Head Posture: Guide to Posture Correction

Forward Head Posture

Neck pain often causes or is caused by misalignment in the area between the shoulders and head. Forward head posture is a common problem that can strain the neck muscles, leading to pain and worsening neck, shoulder, and back posture. (Jung-Ho Kang, et al., 2012) For individuals who are at risk of developing or are already showing signs/symptoms, it’s important to get medical attention to prevent complications, such as chronic neck pain or compressing a nerve. Individuals can continue to do the work that they need to do but may need some postural adjustments and re-training so as not to continue straining the neck while working.

Postural Deviation

  • The head is in a healthy alignment with the neck when the ears line up with the gravity line.
  • The gravity line is an imaginary straight line that represents gravity’s downward pull.
  • It is used in posture assessments as a reference for noting the positions of the body and determining the presence of any postural misalignment or deviation.
  • A forward head posture occurs when the head begins to position forward of the gravity line when looking at the body from the side.
  • Forward head posture is a postural deviation because the head varies from the reference line. (Jung-Ho Kang, et al., 2012)

Muscle Imbalances

  • Forward head posture often results in a strength imbalance between muscles that support and move your neck, shoulders, and head. (Dae-Hyun Kim, et al., 2018)
  • The muscles in the back of the neck become shortened and overactive as they flex forward, while the muscles in the front become lengthened, weaker, and strained when they relax.

Kyphosis

Kyphosis also known as hunchback is when the shoulders round forward, and the head is also brought forward. (Jung-Ho Kang, et al., 2012) After many hours sitting at a desk, computer, or driving, kyphosis can also cause and/or worsen forward head posture.

  • This occurs because the upper back area supports the neck and head.
  • When the upper back moves or changes position, the head and neck follow.
  • The majority of the head’s weight is in the front, and this contributes to the forward movement.
  • An individual with kyphosis has to lift their head to see.

Treatment

A chiropractic injury specialist team can develop a personalized treatment plan to relieve pain symptoms, provide postural retraining, realign the spine, and restore mobility and function.

  • Standing and sitting using a healthy posture, along with exercises to strengthen the neck muscles, can help get the spine in alignment. (Elżbieta Szczygieł, et al., 2019)
  • Targeted stretching can help if the neck muscles are tight.
  • At-home stretches may also relieve pain.

Risk Factors

Pretty much everyone is at risk of developing a forward head posture. Common risk factors include:

  • Constantly looking down at a phone and staying in this position for a long time aka text neck.
  • Desk jobs and computer use can significantly round the shoulders and upper back, leading to a forward head posture. (Jung-Ho Kang, et al., 2012)
  • Driving for a living causes prolonged back, neck, and shoulder positioning.
  • Sleeping or reading with a large pillow under the head can contribute to forward head posture.
  • Doing work that requires dexterity and close-up positions, like a seamstress or technician can cause over-positioning of the neck.
  • Individuals who regularly carry a significant amount of weight in front of their body may begin to develop kyphosis.
  • An example is carrying a child or another load in front of the body.
  • Large breasts can also increase the risk of kyphosis and forward head posture.

Neck Injuries

References

Kang, J. H., Park, R. Y., Lee, S. J., Kim, J. Y., Yoon, S. R., & Jung, K. I. (2012). The effect of the forward head posture on postural balance in long time computer based worker. Annals of rehabilitation medicine, 36(1), 98–104. doi.org/10.5535/arm.2012.36.1.98

Kim, D. H., Kim, C. J., & Son, S. M. (2018). Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion. Osong public health and research perspectives, 9(6), 309–313. doi.org/10.24171/j.phrp.2018.9.6.04

Szczygieł, E., Sieradzki, B., Masłoń, A., Golec, J., Czechowska, D., Węglarz, K., Szczygieł, R., & Golec, E. (2019). Assessing the impact of certain exercises on the spatial head posture. International journal of occupational medicine and environmental health, 32(1), 43–51. doi.org/10.13075/ijomeh.1896.01293

Hansraj K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277–279.

Tingling and Pins and Needles: Paresthesia and its Symptoms

By
Dr. Alex Jimenez
-
Close-up photo of a chiropractor applying pressure to the back of a patient

“Individuals feeling tingling or pins and needles sensations that overtake the arms or legs could be experiencing paresthesia, which occurs when a nerve has been compressed or damaged. Can knowing the symptoms and causes help in diagnosis and treatment?”

Tingling and Pins and Needles: Paresthesia and its Symptoms

Paresthesia Body Sensations

The numbness or tingling feeling when an arm, leg, or foot has fallen asleep is not so much about blood circulation but nerve function.

  • Paresthesia is an abnormal sensation felt in the body due to the compression or irritation of nerves.
  • It can be a mechanical cause like a compressed/pinched nerve.
  • Or it may be due to a medical condition, injury, or illness.

Symptoms

Paresthesia can cause various symptoms. These symptoms can range from mild to severe and can be brief or long-lasting. Signs can include: (National Institute of Neurological Disorders and Stroke. 2023)

  • Tingling
  • Pins and needles sensations
  • Feeling like the arm or leg has fallen asleep.
  • Numbness
  • Itching.
  • Burning sensations.
  • Difficulty contracting the muscles.
  • Difficulty using the affected arm or leg.
  1. The symptoms typically last for 30 minutes or less.
  2. Shaking the affected limb often relieves the sensations.
  3. Paresthesia usually affects only one arm or leg at a time.
  4. However, both arms and legs can be affected, depending on the cause.

Consult a healthcare provider if the symptoms last for more than 30 minutes. Treatment may be required if paresthesia body sensations are brought on by a serious underlying cause.

Causes

Sitting with incorrect and unhealthy postures can compress a nerve and generate symptoms. However, some causes are more concerning and can include:

Seeking Medical Assistance

If the symptoms don’t go away after 30 minutes or keep returning for unknown reasons, call a healthcare provider to find out what is causing the abnormal sensations. A worsening case should be monitored by a healthcare provider.

Diagnosis

A healthcare provider will work with the individual to understand the symptoms and perform the appropriate diagnostic tests to determine the cause. A healthcare provider will choose the tests based on a physical examination. Common diagnostic procedures include: (Merck Manual Professional Version. 2022)

  • Magnetic resonance imaging – MRI of the spine, brain, or extremities.
  • X-ray to rule out bone abnormalities, like a fracture.
  • Blood tests.
  • Electromyography – EMG studies.
  • Nerve conduction velocity – NCV test.
  1. If paresthesia is accompanied by back or neck pain, a healthcare provider may suspect a compressed/pinched spinal nerve.
  2. If the individual has a history of diabetes that is poorly controlled, they may suspect peripheral neuropathy.

Treatment

Treatment for paresthesia depends on the diagnosis. A healthcare provider can help determine the best course of action for the specific condition.

Nervous System

  • If symptoms are triggered by a central nervous condition like MS, individuals will work closely with their healthcare provider to get the appropriate treatment.
  • Physical therapy could be recommended to help improve overall functional mobility. (Nazanin Razazian, et al., 2016)

Spinal Nerve

  • If paresthesia is caused by compression of a spinal nerve, like sciatica, individuals may be referred to a chiropractor and physical therapy team to release the nerve and pressure. (Julie M. Fritz, et al., 2021)
  • A physical therapist may prescribe spinal exercises to relieve compression of the nerve and restore normal sensations and motion.
  • Strengthening exercises to restore flexibility and mobility may be prescribed if weakness presents along with paresthesia body sensations.

Herniated Disc

  • If a herniated disc is causing the abnormal sensations, and there has been no improvement with conservative measures, a healthcare provider may suggest surgery to relieve pressure on the nerve/s. (American Association of Neurological Surgeons. 2023)
  • In surgical procedures like a laminectomy or discectomy, the objective is to restore nerve function.
  • Post-surgery, individuals may be recommended to a physical therapist to help regain mobility.

Peripheral Neuropathy

What Is Plantar Fasciitis?

References

National Institute of Neurological Disorders and Stroke. (2023) Paresthesia.

American Association of Neurological Surgeons. (2023) Herniated disc.

National Institute of Diabetes and Digestive and Kidney Diseases. (2018) Peripheral neuropathy.

Merck Manual Professional Version. (2022) Numbness.

Razazian, N., Yavari, Z., Farnia, V., Azizi, A., Kordavani, L., Bahmani, D. S., Holsboer-Trachsler, E., & Brand, S. (2016). Exercising Impacts on Fatigue, Depression, and Paresthesia in Female Patients with Multiple Sclerosis. Medicine and science in sports and exercise, 48(5), 796–803. doi.org/10.1249/MSS.0000000000000834

Fritz, J. M., Lane, E., McFadden, M., Brennan, G., Magel, J. S., Thackeray, A., Minick, K., Meier, W., & Greene, T. (2021). Physical Therapy Referral From Primary Care for Acute Back Pain With Sciatica : A Randomized Controlled Trial. Annals of internal medicine, 174(1), 8–17. doi.org/10.7326/M20-4187

Bulging Disc Symptoms, Treatment, & Pain Relief Options

By
Dr. Alex Jimenez
-
Back pain, physical therapy and chiropractor with patient, spine injury and healthcare with help an.

“Individuals dealing with back pain problems could be suffering from a bulging disc. Could knowing the difference between slipped and herniated disc symptoms help with treatments and finding relief?”

Bulging Disc Symptoms, Treatment, & Pain Relief Options

Bulging Disc Pain

Back pain can become debilitating if not treated properly. A bulging disc is a common cause of cervical, thoracic, and lower back pain symptoms. It happens when one of the fluid-filled cushions between the vertebrae begins to shift out of place. Instead of being aligned with the edges, the disc bulges over. This begins to generate pressure on the nerves causing pain and inflammation.

  • Bulging discs are often caused by age, but repetitive movements and/or lifting heavy objects can contribute to the condition.
  • Symptoms can resolve on their own, but individuals are recommended to consult with a physical therapist and/or chiropractor to make sure the disc healed properly, otherwise, it can lead to worsening and/or further injuries.

Bulging Disc vs. Herniated Disc

Bulging and herniated discs cause pain symptoms.

  1. Bulging – the intervertebral disc moves out of place but stays intact.
  2. Herniated – the thick outer layer of the disc ruptures, causing the cushioning gel inside to leak onto the spinal nerves.

Location of Symptoms

  • A bulging disc can happen anywhere along the spine.
  • However, most occur between the last five vertebrae in the lower back.
  • This is the lumbar spine. (American Academy of Orthopaedic Surgeons. 2022)
  • This is because the lower back is subject to all kinds of pressure and movement with daily activities, increasing the chances of pain and injuries.
  • The next most common place is the neck/cervical spine where there are constant movements making it prone to injury and pain symptoms.

Causes

Bulging discs are most often caused by body aging and normal wear and tear. As time goes on the intervertebral discs naturally degenerate, known as degenerative disc disease. This can cause the discs to pull downward, causing them to bulge from their placement. (Penn Medicine. 2018) Factors that can cause or worsen the condition include:

  • Practicing unhealthy postures.
  • Repetitive motions.
  • Lifting heavy objects
  • Spinal injuries.
  • Medical history of spinal or disc disease in the family.

Treatment

Treating a bulging disc takes time and patience. (American Academy of Neurological Surgeons. 2023)

Examination

Individuals with back pain that interferes with daily functions or has lasted longer than six weeks, should see a healthcare provider for a diagnosis. They will order a magnetic resonance imaging scan/MRI, which can show where a disc is protruding. (American Academy of Neurological Surgeons. 2023)

Rest

  • For bulging disc pain, resting the back is necessary. However,
  • Many patients benefit from a day or two of bed rest. (American Academy of Orthopaedic Surgeons. 2022)
  • After that, start light activities like walking. Avoid any movements that make your pain worse.

NSAIDs

  • NSAID pain medications like Advil, Motrin, or Aleve can keep pain symptoms and inflammation reduced.
  • However, this is for short-term use, as the underlying cause still needs to be addressed.
  • A healthcare provider will recommend safe dosage and how long these medications should be taken. (American Academy of Orthopaedic Surgeons. 2022)

Physical Therapy

Steroid Injection

  • An epidural steroid injection can provide relief for individuals still experiencing symptoms after six weeks.
  • A healthcare provider will inject cortisone into the spine to reduce inflammation and pain. (American Academy of Orthopaedic Surgeons. 2022)

Surgery

  • If conservative treatments don’t work, a healthcare provider may recommend surgery, like a microdiscectomy.
  • This procedure uses small incisions to remove all or part of a bulging disc.
  • Most individuals with a bulging disc will not require surgery. (American Academy of Neurological Surgeons. 2023)

Inflammation: Integrative Medicine Approach

References

Penn Medicine. (2018) Bulging disc vs. herniated disc: What’s the difference?

American Academy of Orthopaedic Surgeons. (2022) Herniated disk in the lower back.

American Academy of Neurological Surgeons. (2023) Herniated disc.

National Institutes of Health. (2022) Spinal Manipulation: What You Need To Know.

Discover the Health Benefits of Onions

By
Dr. Alex Jimenez
-

“For individuals looking to maintain wellness or begin their wellness journey like increasing antioxidants, protection against cancer, immune system support, and other health benefits, can adding onions be a nutritious way to improve overall health?”

Discover the Health Benefits of Onions

Onions

Onions are nutritious vegetables like garlic, chives, leeks, and shallots. The most common types are red, white, yellow, and Spanish onions. They have antifungal, antibacterial, anti-inflammatory, and other healthful properties.

  • Whichever way they are prepared they do lose some of their nutritional value when cooked.
  • They contain flavonoids, glutathione, selenium compounds, vitamin E, and vitamin C.
  • When selecting onions, look for those without blemishes or discoloration, that are firm, and have dry, papery skins.

Benefits

They contain phytochemicals – compounds plants produce to fight off harmful bacteria, viruses, and fungi. These phytochemicals provide health benefits when consumed and provide the following properties: (Xin-Xin Zhao, et al., 2021)

  • Anti-obesity
  • Antioxidants
  • Antidiabetic
  • Anti-inflammatory
  • Antimicrobial
  • Anticancer
  • Protect the cardiovascular, digestive, respiratory, reproductive, and neurological systems.
  • Protect against liver disease.
  • Support a healthy immune system.

Types and Varieties

They belong to the Allium plant genus which includes plants like garlic, leeks, and chives. (Oregon State University. 2022)

  • They vary in flavor and can be sweet, tangy, and sour.
  • Different varieties combined with farming practices contribute to the flavor profile of onions.
  • There are many varieties of onions.
  • The most common and widely available are red, white, yellow, and Spanish.
  • Other types include cipollini, pearl, and Vidalia.

Raw or Cooked

They are beneficial whether eaten raw or cooked, cooking them reduces the number of thiosulfinates – compounds that provide antimicrobial, antifungal, and antibiotic properties.

  • Research shows that onions that are crushed before cooking retain their health benefits. (Holly L. Nicastro, et al., 2015)
  • Boiling and frying onions has been shown to cause the most significant loss in nutritious value.
  • Other preparation methods that decrease health benefits include sautéing, steaming, and microwaving.
  • Baking onions is shown to increase flavonoid levels.
  • Consuming dried, powdered onions can also provide nutritious value to foods, especially if the powder is freeze-dried. (Damini Kothari, et al., 2020)

Nutrition Facts

Onions can contribute to a healthy diet. The flavonoids, glutathione, selenium compounds, vitamin E, and vitamin C, contribute to the antioxidant properties of the vegetable. (Holly L. Nicastro, et al., 2015) The nutrition information for one medium onion: (U.S. Department of Agriculture. N.D.)

  • Total calories: 44
  • Total fat: 0 grams
  • Cholesterol: 0 milligrams
  • Carbohydrates: 10 grams
  • Dietary fiber: 2 grams
  • Total sugars: 5 grams
  • Protein: 1 grams
  • Calcium: 2 milligrams
  • Sodium: 4 milligrams
  • Iron: 1 milligrams
  • Vitamin D: 0 micrograms

When Selecting

Onions can contain pesticide residue, heavy metals, microbial contamination, and nitrate accumulation. Knowing where the onions come from can help ensure there was no incorrect use of pesticides or that the soil they were grown in was not enriched with heavy metals. When possible, purchase from reputable sources with transparent farming practices, like the farmers markets. (Xin-Xin Zhao, et al., 2021)

  • Onions found in environments that have not been effectively sterilized have an increased risk of growing harmful bacteria.
  • To avoid contamination of Escherichia. coli or E. coli, salmonella, and mold, it’s safest to purchase whole onions and cut them at home rather than purchasing pre-chopped onions. (Xin-Xin Zhao, et al., 2021)
  • Select those that feel firm, have little to no bruises or discolored spots, and have dry papery skin.
  • Avoid those that show evidence of mold, like white or black spots on the surface or inside the layers, and those with green shoots, which means the onion is still edible but won’t last that long.

Hypertension Diet

References

Zhao, X. X., Lin, F. J., Li, H., Li, H. B., Wu, D. T., Geng, F., Ma, W., Wang, Y., Miao, B. H., & Gan, R. Y. (2021). Recent Advances in Bioactive Compounds, Health Functions, and Safety Concerns of Onion (Allium cepa L.). Frontiers in nutrition, 8, 669805. doi.org/10.3389/fnut.2021.669805

Oregon State University. Types of onions and varieties.

Nicastro, H. L., Ross, S. A., & Milner, J. A. (2015). Garlic and onions: their cancer prevention properties. Cancer prevention research (Philadelphia, Pa.), 8(3), 181–189. doi.org/10.1158/1940-6207.CAPR-14-0172

Kothari, D., Lee, W. D., & Kim, S. K. (2020). Allium Flavonols: Health Benefits, Molecular Targets, and Bioavailability. Antioxidants (Basel, Switzerland), 9(9), 888. doi.org/10.3390/antiox9090888

U.S. Department of Agriculture. Onions.

Combatting Exercise Burnout – Tips and Strategies

By
Dr. Alex Jimenez
-
Young attractive sporty tired african american woman in sportswear having morning workout at modern light apartment. Healthy athletic female doing cardio on stationary bike.

“Individuals that engage in a regular fitness regimen can begin to lose interest and motivation. Can knowing the signs of exercise burnout help individuals rediscover their motivation?”

Combatting Exercise Burnout - Tips and Strategies

Exercise Burnout

When maintaining fitness and health becomes a chore and doing anything else is better than working out, individuals could be experiencing exercise burnout. Here are a few signs an individual is getting burned out.

Procrastination

One sign is constantly putting things off.

  • An individual may put on workout clothes, set up the equipment, etc.
  • However, the workout never happens as the individual continues to find other things to do.
  • At some point, they decide it’s too late and they’ll work out tomorrow.

Solution

Simplify the workout. Make some small goals or adjustments and keep the workout light. (Nemanja Lakicevic, et al., 2020) An example could be:

  • Focus only on stretching.
  • Take a walk around the block.
  • Go up and down some stairs equivalent to a few laps.
  • Do 10 pushups, 10 squats, and 10 lunges, or other exercises and that’s it.

No Longer Interesting

When burned out, exercise is not interesting and disenchanting. (Franklin Velasco, Rafael Jorda. 2020) Trainers will suggest finding something positive about the workouts.

Solution

Switch to a new or different activity. (Nemanja Lakicevic, et al., 2020)

  • When the interest and passion are nowhere to be found don’t engage in the usual workouts, as this can further decrease motivation.
  • This is the time to change up the routine and go for a leisurely bicycle or rollerblade, skateboard, etc., session.
  • Go to a park, just walk around, and forget about exercise just taking in everything.
  • Play a game with a friend or toss a ball around.

Exhaustion

Not just physical, but mental fatigue could be a sign of exercise burnout.

Solution

  • Rest.
  • Individuals may think they have to work out every day and stick to the regimen or else they’ve failed.
  • This type of mindset can lead to burnout and added stress.
  • The body and mind require adequate recovery time.
  • Forget about structured exercise for a day, and see how the mind and body feel the next day.
  • Two or three days off in a row can make a significant difference in motivation and offer a new perspective on the workout routine.

Low Energy Levels After Exercise

Workouts, although tiring in a good way, should energize the individual. Most workouts should leave the body feeling better than before. When the body feels worse or energy levels are low, this could be a sign of overtraining that could lead to exercise burnout.

Solution

  • This could be the time to ease off of the fitness regimen.
  • Forget intense workouts and/or heavy-weight training.
  • This is the time to soothe the body.
  • Light yoga workouts or Pilates could help.
  • This is a form of active recovery, allowing the mind and body to rest from the overwork.

Mood Changes and/or Irritability

When the mind and body are overworked and over-trained, it can cause moodiness, irritability, and frustration that leads to burnout.

Solution

Do something that feels good. This could include:

  • A therapeutic massage.
  • A spa session.
  • Taking a long nap.
  • Soaking the feet.
  • Taking a therapeutic bath.
  • Meditation

Burnout can happen, the objective is to keep the solutions simple like taking a few days off or trying something new to come back feeling refreshed and energized.

Multidisciplinary Evaluation and Treatment

References

Lakicevic, N., Gentile, A., Mehrabi, S., Cassar, S., Parker, K., Roklicer, R., Bianco, A., & Drid, P. (2020). Make Fitness Fun: Could Novelty Be the Key Determinant for Physical Activity Adherence?. Frontiers in psychology, 11, 577522. doi.org/10.3389/fpsyg.2020.577522

Velasco, F., & Jorda, R. (2020). Portrait of Boredom Among Athletes and Its Implications in Sports Management: A Multi-Method Approach. Frontiers in psychology, 11, 831. doi.org/10.3389/fpsyg.2020.00831

What You Need to Know About Small Fiber Neuropathy

By
Dr. Alex Jimenez
-
Its a long road to recovery. Shot of an elderly man having a physiotherapy session

“Individuals diagnosed with peripheral neuropathy, or with small fiber neuropathy, can understanding symptoms and causes help with potential treatments?”

What You Need to Know About Small Fiber Neuropathy

Small Fiber Neuropathy

Small fiber neuropathy is a specific classification of neuropathy, as there are different types, which are nerve injury, damage, disease, and/or dysfunction. Symptoms can result in pain, loss of sensation, and digestive and urinary symptoms. Most cases of neuropathy like peripheral neuropathy involve small and large fibers. Common causes include long-term diabetes, nutritional deficiencies, alcohol consumption, and chemotherapy.

  • Small fiber neuropathy is diagnosed after diagnostic testing showing it is clear that the small nerve fibers are involved.
  • The small nerve fibers detect sensation, temperature, and pain and help regulate involuntary functions.
  • Isolated small-fiber neuropathy is rare, but research is ongoing on the type of nerve damage and potential treatments. (Stephen A. Johnson, et al., 2021)
  • Small fiber neuropathy is not specifically dangerous but is a sign/symptom of an underlying cause/condition that is damaging the body’s nerves.

Symptoms

Symptoms include: (Heidrun H. Krämer, et al., 2023)

  • Pain – symptoms can range from mild or moderate discomfort to severe distress and can happen at any time.
  • Loss of sensation.
  • Because the small nerve fibers help with digestion, blood pressure, and bladder control – symptoms of autonomic dysfunction can vary and can include:
  • Constipation, diarrhea, incontinence, urinary retention – the inability to completely drain the bladder.
  • If there is progressing nerve damage, the intensity of the pain can decrease, but the loss of normal sensation and autonomic symptoms can worsen. (Josef Finsterer, Fulvio A. Scorza. 2022)
  • Hypersensitivity to touch and pain sensations can cause pain without a trigger.
  • The loss of sensation can make individuals unable to accurately detect sensations of touch, temperature, and pain in affected areas, which can lead to various types of injuries.
  • Although more research is needed, certain disorders that were not considered neuropathies may have small fiber neuropathy components involved.
  • A study suggested that neurogenic rosacea, a skin condition, could have some elements of small fiber neuropathy. (Min Li, et al., 2023)

Small Nerve Fibers

  • There are several types of small nerve fibers; two in small fiber neuropathy include A-delta and C (Josef Finsterer, Fulvio A. Scorza. 2022)
  • These small nerve fibers are distributed throughout the body including the tops of the fingers and toes, trunk, and internal organs.
  • These fibers are usually located in the superficial areas of the body, such as close to the skin’s surface. (Mohammad A. Khoshnoodi, et al., 2016)
  • The small nerve fibers that get damaged are involved in transmitting pain and temperature sensations.
  • Most nerves have a special type of insulation called myelin that protects them and increases the speed of nerve impulses.
  • Small nerve fibers may have a thin sheath, making them more susceptible to injury and damage at earlier stages of conditions and diseases. (Heidrun H. Krämer, et al., 2023)

Individuals At Risk

Most types of peripheral neuropathy cause damage to the small and large peripheral nerve fibers. Because of this, most neuropathies are a mix of small-fiber and large-fiber neuropathy. Common risk factors for mixed fiber neuropathy include: (Stephen A. Johnson, et al., 2021)

  • Diabetes
  • Nutritional deficiencies
  • Overconsumption of alcohol
  • Autoimmune disorders
  • Medication toxicity

Isolated small-fiber neuropathy is rare, but there are conditions that are known to contribute to the cause and include: (Stephen A. Johnson, et al., 2021)

Sjogren Syndrome

  • This autoimmune disorder causes dry eyes and mouth, dental problems, and joint pain.
  • It can also cause nerve damage throughout the body.

Fabry Disease

  • This condition causes a buildup of certain fats/lipids in the body that can lead to neurological effects.

Amyloidosis

  • This is a rare disorder that causes a buildup of proteins in the body.
  • The proteins can damage tissues like the heart or nerves.

Lewy Body Disease

  • This is a neurological disorder that causes dementia and impaired movement and can lead to nerve damage.

Lupus

  • This is an autoimmune disease that affects joints, skin, and sometimes nerve tissue.

Viral Infection

  • These infections typically cause a cold or gastrointestinal/GI upsetness.
  • Less often they can cause other effects like small fiber neuropathy.

These conditions have been seen to cause isolated small-fiber neuropathy or begin as small-fiber neuropathy before progressing to the large nerve fibers. They can also begin as a mixed neuropathy, with small and large fibers.

Progression

Often the damage progresses at a relatively moderate rate, leading to added symptoms within months or years. The fiber nerves that are affected by the underlying condition usually progressively deteriorate, regardless of where they are located. (Mohammad A. Khoshnoodi, et al., 2016) Medications can help alleviate damage to the peripheral nerves. For individuals that are diagnosed in the early stage, it is possible to stop the progression, and potentially prevent involvement of the large fibers.

Treatments

Treatment toward preventing the progression requires controlling the underlying medical condition with treatment options depending on the cause. Treatments that can help prevent the progression include:

  • Blood sugar control for individuals with diabetes.
  • Nutritional supplementation for the treatment of vitamin deficiencies.
  • Quitting alcohol consumption.
  • Immune suppression for control of autoimmune diseases.
  • Plasmapheresis – blood is taken and the plasma is treated and returned or exchanged for the treatment of autoimmune diseases.

Symptom Treatment

Individuals can get treatment for the symptoms that will not reverse or cure the condition but can help with temporary relief. Symptomatic treatment can include: (Josef Finsterer, Fulvio A. Scorza. 2022)

  • Pain management can include medications and/or topical analgesics.
  • Physical therapy – stretching, massage, decompression, and adjustments to keep the body relaxed and flexible.
  • Rehabilitation to help improve coordination, which can be impaired by loss of sensation.
  • Medications to relieve GI symptoms.
  • Wearing specialized clothes such as neuropathy socks to help with foot pain symptoms.

Treatment and medical management of neuropathies usually involve a neurologist. A neurologist may prescribe medication to help alleviate pain symptoms and provide medical interventions like immunotherapy if there is concern that an autoimmune process could be the cause. Additionally, treatment could include the care of a physical medicine and rehabilitation physician or a physical therapy team to provide stretches and exercises to help strengthen the body and maintain mobility and flexibility.

Peripheral Neuropathy Myths & Facts

References

Johnson, S. A., Shouman, K., Shelly, S., Sandroni, P., Berini, S. E., Dyck, P. J. B., Hoffman, E. M., Mandrekar, J., Niu, Z., Lamb, C. J., Low, P. A., Singer, W., Mauermann, M. L., Mills, J., Dubey, D., Staff, N. P., & Klein, C. J. (2021). Small Fiber Neuropathy Incidence, Prevalence, Longitudinal Impairments, and Disability. Neurology, 97(22), e2236–e2247. doi.org/10.1212/WNL.0000000000012894

Finsterer, J., & Scorza, F. A. (2022). Small fiber neuropathy. Acta neurologica Scandinavica, 145(5), 493–503. doi.org/10.1111/ane.13591

Krämer, H. H., Bücker, P., Jeibmann, A., Richter, H., Rosenbohm, A., Jeske, J., Baka, P., Geber, C., Wassenberg, M., Fangerau, T., Karst, U., Schänzer, A., & van Thriel, C. (2023). Gadolinium contrast agents: dermal deposits and potential effects on epidermal small nerve fibers. Journal of neurology, 270(8), 3981–3991. doi.org/10.1007/s00415-023-11740-z

Li, M., Tao, M., Zhang, Y., Pan, R., Gu, D., & Xu, Y. (2023). Neurogenic rosacea could be a small fiber neuropathy. Frontiers in pain research (Lausanne, Switzerland), 4, 1122134. doi.org/10.3389/fpain.2023.1122134

Khoshnoodi, M. A., Truelove, S., Burakgazi, A., Hoke, A., Mammen, A. L., & Polydefkis, M. (2016). Longitudinal Assessment of Small Fiber Neuropathy: Evidence of a Non-Length-Dependent Distal Axonopathy. JAMA neurology, 73(6), 684–690. doi.org/10.1001/jamaneurol.2016.0057

Low Back Pain: A Chiropractor’s Guide to Spinal Decompression

By
Dr. Alex Jimenez
-

Can individuals with low back pain find relief with spinal decompression combined with chiropractic care to reduce muscle pain?

Introduction

Everyone worldwide has dealt with low back pain, a multifactorial common problem that can mask other musculoskeletal disorders. Low back pain can develop naturally through spinal degeneration, normal environmental factors people put their bodies through, or traumatic factors that can gradually affect the lumbar region over time. The lower back is part of the lumbar spine region as it takes most of the upper body’s weight and stabilizes the lower body when in motion. The lumbar region is thick to support the upper body’s weight and is protected by the surrounding ligaments, muscles, and tissues; however, it is the most susceptible to injury. Many people don’t realize they are experiencing low back pain until an accident or repetitive motions begin to affect the surrounding ligaments or the lumbar intervertebral discs are severely compressed. To that point, many individual are experiencing radiating pain in their lower extremities. However, all is not lost, as there are numerous ways to alleviate low back pain and provide relief to many individuals. Today’s article focuses on the factors that lead to the development of low back pain and how treatments like chiropractic care and spinal decompression can help reduce low back pain and its symptoms. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to ease low back pain and its associated symptoms. We also inform our patients that there are non-surgical options like chiropractic care and spinal decompression to minimize the radiating pain associated with low back pain. 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

 

Factors That Lead To The Development Of Low Back Pain

Do you feel muscle aches and pains in your lower back when stretching? Does the pain cause issues in your mobility when going to run errands? Or do you feel sudden or gradual pain after a long workday of carrying heavy objects or excessively sitting at your desk? When many individuals are experiencing pain in these various scenarios, it can lead to the development of a lower back that correlates with these environmental factors. Low back pain is a common nuisance that many working and non-working individuals experience occasionally. When various risk factors are associated with low back pain, it can cause many individuals to deal with the physical and psychological demands that cause them to do multiple things like heavy lifting, awkward positions, and excessive bending, which can develop pain-like symptoms in the lumbar region. (To et al., 2021) At the same time, compared with other health conditions, low back pain is the highest global burden, causing many individuals to miss out on important events like work and daily activities. (Petrozzi et al., 2020) This causes them to live a life of disability and causes them to feel miserable. Low back pain can affect a person’s socioeconomic demographic and the functionality that they seek the treatment they deserve. 

 

 

Many individuals who experience low back pain will often lead a life of disability and socioeconomic burden correlated with these factors. (Wong et al., 2022) Many people often think that low back pain only happens to older adults, but low back pain can happen to anybody at any age. Many factors that correlate to the development of low back pain include:

  • Improper heavy lifting
  • Walking incorrectly
  • Being in a slouched or hunched position
  • An auto accident
  • Obesity 
  • Gastrointestinal issues
  • Referred musculoskeletal disorders
  • Physical inactivity

Many of these environmental factors are associated with low back pain that many people are unaware of when doing their routine. This is due to the surrounding tissues, ligaments, and muscles being overused and affected and the intervertebral disc being constantly compressed from repetitive motions. When this happens, many individuals will often seek treatment to reduce the painful effects of low back pain.

 

How Chiropractic Care Can Transform Pain Into Relief- Video

How can Chiropractic Care transform pain into relief | El Paso, Tx (2023)

When it comes to reducing low back pain, many individuals will try home remedies to mitigate muscle pain and reduce inflammation associated with low back pain. This provides temporary relief to acute low back pain, but many will seek non-surgical treatment when it comes to chronic low back pain. Non-surgical treatments can help reduce low back pain and its associated symptoms through mechanical and manual techniques. Non-surgical treatments, which include chiropractic care and spinal decompression, could help alleviate low back pain. Since low back pain is associated with altered motor control within the lumbar region, it can hinder lumbar stability, cause impaired detection of passive motion, and affect postural stability. (Fagundes Loss et al., 2020) With non-surgical treatments, many pain specialists can incorporate vertebral mobilizations and manipulation procedures to improve spinal mobility and reduce pain in the lumbar region. The video above explains how chiropractic care and spinal decompression can alleviate lower back pain and help restore functionality in the body. 

Chiropractic Care & Low Back Pain

When it comes to reducing low back pain associated with environmental factors, many pain specialists can look at the physical distress cognitive, and functional patterns that are correlated with faulty lumbar movement. (Khodadad et al., 2020) This allows the pain specialist to create a personalized treatment plan for low back pain. Non-surgical treatments like chiropractic care are excellent for reducing low back pain. Chiropractic care incorporates spinal manipulation techniques to realign the spine and help stretch the affected surrounding muscles. Many individuals who include chiropractic care in their routine find significant pain reduction and reduced disability after a few consecutive treatments. (Gevers-Montoro et al., 2021) Chiropractic care can be combined with physical and massage therapy to stretch and strengthen the affected muscles. This, in turn, helps the individual regain spinal mobility and reduce pain.

 

Spinal Decompression & Low Back Pain

Spinal decompression is another non-surgical treatment that can help alleviate low back pain, like chiropractic care. Spinal decompression utilizes gentle traction on the lumbar spine to be gently pulled to relieve the affected muscles causing lower back pain. Spinal decompression can also ease leg pain associated with low back pain and reduce referred pain affecting the lower extremities. (Wang et al., 2022) Spinal decompression can also improve spinal disc height and help improve muscle strength and trunk endurance. (Kang et al., 2016) The combination of spinal decompression and chiropractic care to reduce lower back pain is effective as these two forms of non-surgical treatments can effectively reduce many people’s musculoskeletal pain and make them aware of the environmental factors that are the root causes of their lower back pain and prevent it from returning.

 

References

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

 

Gevers-Montoro, C., Provencher, B., Descarreaux, M., Ortega de Mues, A., & Piche, M. (2021). Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain. Front Pain Res (Lausanne), 2, 765921. doi.org/10.3389/fpain.2021.765921

 

Kang, J.-I., Jeong, D.-K., & Choi, H. (2016). Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk. Journal of Physical Therapy Science, 28(11), 3125-3130. doi.org/10.1589/jpts.28.3125

 

Khodadad, B., Letafatkar, A., Hadadnezhad, M., & Shojaedin, S. (2020). Comparing the Effectiveness of Cognitive Functional Treatment and Lumbar Stabilization Treatment on Pain and Movement Control in Patients With Low Back Pain. Sports Health, 12(3), 289-295. doi.org/10.1177/1941738119886854

 

Petrozzi, M. J., Rubinstein, S. M., Ferreira, P. H., Leaver, A., & Mackey, M. G. (2020). Predictors of low back disability in chiropractic and physical therapy settings. Chiropr Man Therap, 28(1), 41. doi.org/10.1186/s12998-020-00328-3

 

To, D., Rezai, M., Murnaghan, K., & Cancelliere, C. (2021). Risk factors for low back pain in active military personnel: a systematic review. Chiropr Man Therap, 29(1), 52. doi.org/10.1186/s12998-021-00409-x

 

Wang, W., Long, F., Wu, X., Li, S., & Lin, J. (2022). Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis. Comput Math Methods Med, 2022, 5670303. doi.org/10.1155/2022/5670303

 

Wong, C. K., Mak, R. Y., Kwok, T. S., Tsang, J. S., Leung, M. Y., Funabashi, M., Macedo, L. G., Dennett, L., & Wong, A. Y. (2022). Prevalence, Incidence, and Factors Associated With Non-Specific Chronic Low Back Pain in Community-Dwelling Older Adults Aged 60 Years and Older: A Systematic Review and Meta-Analysis. J Pain, 23(4), 509-534. doi.org/10.1016/j.jpain.2021.07.012

 

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STOP SUFFERING! We specialize in advanced non-surgical approaches in treating sciatica. Our focus is to stop the pain, remove the cause and prevent chronic recurrence of complex sciatica pain syndromes. We treat with advanced protocols and supportive care plans. Blessings - Dr. Alex Jimenez DC, MSACP, IFMCP, CIFM, ATN
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