Unraveling the Stages of Frozen Shoulder: A Closer Look

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Advanced Shoulder Mobilization Technique — Physiotherapist applying advanced mobilization on athlete's shoulder to aid recovery during a rehabilitation session.

For individuals with shoulder pain and problems, what are the stages of a frozen shoulder, how long do they last, and what can be done to relieve pain?

Table of Contents

Frozen Shoulder Stages

A frozen shoulder, also called adhesive capsulitis, is a very common cause of shoulder pain. It causes severe pain and limited mobility. The condition progresses through stages and can take up to two years to resolve completely. The stages of frozen shoulder include pre-freezing, freezing, freezing, and thawing.

Stage 1

Pre-Freezing – 1 month to 3 months

Pre-freezing describes the earliest stage of a frozen shoulder. This is when individuals first start to notice pain in their shoulder. (Soussahn, S. et al., 2024) Many in this stage will first experience the pain at night while changing sleeping positions. As the condition progresses, individuals may notice pain when they move their shoulders, especially when raising their arms or reaching behind them. Individuals may also find reduced mobility in that shoulder and may ache even when not using it. Because motion may be only slightly restricted in this stage, an early frozen shoulder can be mistaken for a rotator cuff problem. (Chan H. B. Y., Pua P. Y., & How C. H. 2017)

Root Cause

A frozen shoulder happens when there is inflammation in the tissue that surrounds the shoulder joint. Although the specific causes aren’t known, immobilization after an injury and other shoulder conditions, like bursitis, may play a role. (Johns Hopkins Medicine, 2025)

Stage 2

Freezing – 10 weeks to 8 months

The freezing stage is the most painful. The shoulder capsule becomes inflamed and can thicken and stiffen. As this happens, shoulder movements become increasingly difficult and painful. (Soussahn, S. et al., 2024)

Stage 3

Frozen – 4 months to 12 months

The third stage of a frozen shoulder is known as the frozen phase, where the shoulder is stiff. The examination finding confirming the frozen shoulder diagnosis is that neither the individual nor another person can move the shoulder. (UpToDate, 2024) With a rotator cuff issue, a patient cannot move their arm normally, but the healthcare provider can. This distinguishes between a frozen shoulder and a rotator cuff injury. The frozen stage is typically much less painful than freezing, but pain can result from simple activities. (Soussahn, S. et al., 2024) Rotation of the shoulder joint is limited, making activities like washing hair or reaching painful or difficult.

Stage 4

Thawing – 5 months to 2 years

In this phase, the shoulder joint capsule becomes thickened and stiff but gradually loosens with time. (Soussahn, S. et al., 2024) Stretching the shoulder capsule, even allowing for some discomfort, is important to ensure the shoulder joint’s mobility continues to recover. Not having the extreme pain associated with freezing the joint and seeing gradual gains in mobility make this stage tolerable.

Treatment

Frozen shoulder treatment starts with physical therapy and joint stretching. Anti-inflammatory medications, ice and heat application, and alternative therapies can all help manage the discomfort. A healthcare provider may also recommend a corticosteroid injection to reduce inflammation, relieve pain, and expedite improved mobility. Redler L. H. & Dennis E. R. 2019)

Surgery is seldom needed but is an option for treating a frozen shoulder. It is usually only considered if prolonged efforts at therapy have failed to improve symptoms. One of the problems is that surgery could worsen shoulder problems. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017)

Prognosis

The timeline for recovery can be long, measured in months and possibly years. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017) Expecting a quick recovery can cause more frustration. However, individuals can take steps to speed their recovery and reduce discomfort. Physical therapy can be beneficial, and a healthcare provider can suggest treatments to help alleviate pain while recovering. Over time, almost all patients will find complete relief and a normal or near-normal range of motion in their shoulder joints.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Motion Key To Healing

References

Soussahn, S., Hu, D., Durieux, J., Kosmas, C., & Faraji, N. (2024). Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support. Current problems in diagnostic radiology, 53(4), 464–469. doi.org/10.1067/j.cpradiol.2024.03.005

Chan, H. B. Y., Pua, P. Y., & How, C. H. (2017). Physical therapy in the management of frozen shoulder. Singapore Medical Journal, 58(12), 685–689. doi.org/10.11622/smedj.2017107

Johns Hopkins Medicine. (2025). Frozen shoulder. www.hopkinsmedicine.org/health/conditions-and-diseases/frozen-shoulder

UpToDate. (2024). Patient education: Frozen shoulder (beyond the basics). www.uptodate.com/contents/frozen-shoulder-beyond-the-basics

Redler, L. H., & Dennis, E. R. (2019). Treatment of Adhesive Capsulitis of the Shoulder. The Journal of the American Academy of Orthopaedic Surgeons, 27(12), e544–e554. doi.org/10.5435/JAAOS-D-17-00606

Le, H. V., Lee, S. J., Nazarian, A., & Rodriguez, E. K. (2017). Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder & elbow, 9(2), 75–84. doi.org/10.1177/1758573216676786

Maximize Your Workout with Healthy Nutritional Snacks

By

Dr. Alex Jimenez

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Can individuals incorporate nutritional snacks to consume before and after to have an effective workout and abundant energy?

Table of Contents

How Can Exercise Help The Body?

When many people start thinking about their health and how to improve it, they usually begin exercising and eating healthier around the last week before the new year to jumpstart their health and wellness journey. These small changes can help the body tremendously as environmental factors like stress, physical inactivity, and various lifestyles can negatively impact the body, thus leading to stress and environmental factors. For individuals dealing with musculoskeletal disorders or autoimmune disorders, exercises and a healthy diet filled with nutritional foods can help mitigate pain-like symptoms and overlapping risk profiles. For individuals with low back pain, core stabilization exercises can help reduce pain and disability while improving core muscle activation to strengthen weak muscles. (Nayyab et al., 2021) As a non-surgical therapy, everyone can exercise for the body, which can help many people reduce any chronic diseases and issues they are dealing with. (Vina et al., 2012) At the same time, a person can exercise at any fitness level by incorporating the right amount of healthy snacks before and after a good workout. We associate with certified medical providers who inform our patients of the importance of having healthy snacks before and after working out to replenish the body and have energy throughout the day. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily routine to restore energy through healthy snacking. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Secrets of Optimal Wellness- Video

Secrets of Optimal Wellness | El Paso, Tx (2023)

Pre- & Post Workout Benefits

When starting to work out, it is important to ensure that the body is properly fueled with the proper carbohydrates, proteins, and healthy fats that can be converted into energy to perform any exercise routines at full capacity. For athletic individuals, nutrition is closely connected with physical activity and the timing of when the body uses that energy. (Januszko & Lange, 2021) Hence, it is important for individuals starting to work out to consume enough energy through nutritional foods in a pre-workout environment. Pre-workout supplementation can help significantly improve greater changes in body composition and strength. (Cabre et al., 2022) Pre-workouts have benefited from increasing energy, enhancing strength and endurance, and reducing muscle fatigue through supplementation and healthy snacks that give people energy. Post-workouts can help with muscle recovery, and post-workout snacks can help maintain the body’s energy levels throughout the day.

Pre-Workout Snacks

Many dietary supplements for pre-workouts can help with health and performance improvement as they help increase muscle mass and strength while providing energy when exercising. (Brisebois et al., 2022) At the same time, incorporating carbohydrates can provide glycogen energy stored in the liver to provide muscle energy. (Henselmans et al., 2022) It is important to note that eating an hour before working out can give beneficial results. Some of the snacks many people can make and eat before working out include:

Chocolate milk with banana
Frozen grapes
Granola bar
Pretzels

Post Workout Snacks

It is important to restore and maintain that energy in the body when it comes to post-workout snacks after an intense workout. Many athletic and non-athletic individuals can incorporate nutritional carbohydrates and proteins to improve their physiological and biochemical adaptations to promote faster recovery and maintain the body’s hydration status. (Baroni et al., 2023) For instance, coconut water can be an alternative to sports drinks to replenish the body’s electrolytes. (O’Brien et al., 2023) Some of the post-workout snacks that are packed with protein and healthy carbs include:

Smoothies made with fruits, Greek yogurt, and protein powders
Chocolate milk with almonds
Crackers with string cheese
Cottage cheese

References

Baroni, L., Pelosi, E., Giampieri, F., & Battino, M. (2023). The VegPlate for Sports: A Plant-Based Food Guide for Athletes. Nutrients, 15(7). doi.org/10.3390/nu15071746

Brisebois, M., Kramer, S., Lindsay, K. G., Wu, C. T., & Kamla, J. (2022). Dietary practices and supplement use among CrossFit(R) participants. J Int Soc Sports Nutr, 19(1), 316-335. doi.org/10.1080/15502783.2022.2086016

Cabre, H. E., Gordon, A. N., Patterson, N. D., & Smith-Ryan, A. E. (2022). Evaluation of pre-workout and recovery formulations on body composition and performance after a 6-week high-intensity training program. Front Nutr, 9, 1016310. doi.org/10.3389/fnut.2022.1016310

Henselmans, M., Bjornsen, T., Hedderman, R., & Varvik, F. T. (2022). The Effect of Carbohydrate Intake on Strength and Resistance Training Performance: A Systematic Review. Nutrients, 14(4). doi.org/10.3390/nu14040856

Januszko, P., & Lange, E. (2021). Nutrition, supplementation and weight reduction in combat sports: a review. AIMS Public Health, 8(3), 485-498. doi.org/10.3934/publichealth.2021038

Nayyab, I., Ghous, M., Shakil Ur Rehman, S., & Yaqoob, I. (2021). The effects of an exercise programme for core muscle strengthening in patients with low back pain after Caesarian-section: A single blind randomized controlled trial. J Pak Med Assoc, 71(5), 1319-1325. doi.org/10.47391/JPMA.596

O’Brien, B. J., Bell, L. R., Hennessy, D., Denham, J., & Paton, C. D. (2023). Coconut Water: A Sports Drink Alternative? Sports (Basel), 11(9). doi.org/10.3390/sports11090183

Vina, J., Sanchis-Gomar, F., Martinez-Bello, V., & Gomez-Cabrera, M. C. (2012). Exercise acts as a drug; the pharmacological benefits of exercise. Br J Pharmacol, 167(1), 1-12. doi.org/10.1111/j.1476-5381.2012.01970.x

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Break the Cycle: Managing Myofascial Pain Syndrome Spasms

By

Dr. Alex Jimenez

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Assisting Woman in Physical Therapy Session with Focus — Assisting woman in a physical therapy session, focusing on her shoulder movements and rehabilitation techniques. Man standing behind while holding her arm

For individuals who have to be in one position for long periods, have poor postural alignment, and perform repetitive motions, what are myofascial pain syndrome spasm cycles?

Myofascial Pain Syndrome Spasm Cycles

Myofascial pain syndrome is a common condition that causes pain symptoms in a particular body area (Jafri M. S. 2014). A myofascial pain syndrome spasm cycle is a recurring pattern in which muscle tension and spasms in affected regions, caused by myofascial pain syndrome, lead to pain, triggering more muscle spasms. This creates a vicious cycle of discomfort and tightness that can be difficult to break without treatment; the pain perpetuates muscle spasms and vice versa.

Spasm Pain Cycle

Left untreated, myofascial pain is often experienced as a recurring cycle of spasm, pain, and spasm. (Kojidi M. M. et al., O2016) The exact cause of the spasm is not known. It may be related to excessive accumulation and release of acetylcholine, which causes sustained muscle contraction. (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Another theory is that repetitive small muscle trauma helps create a trigger point or knot in the muscle. (Thorne. 2021)

Active trigger points in muscles characterize myofascial pain syndrome. (Shah J. P. et al., 2015) These trigger points cause pain in the area where they are located and sometimes in other places, known as referred pain. Each muscle has a particular referral pattern of pain that goes from a trigger point in that muscle to another place in the body. (Shah J. P. et al., 2015) Medical providers and massage therapists trained in this area can identify trigger points by their pain patterns. With myofascial pain syndrome, muscles tense, and joint range of motion may decrease. (Jafri M. S. 2014)

Trigger Points

Myofascial pain syndrome is characterized by trigger points and sensitive knots within muscles that can cause referred pain when pressed, contributing to the spasm cycle.

Muscle Tension

A repeatedly tense or injured muscle can develop trigger points, which can lead tocle tightness and potential spasms.

Pain-Spasm-Pain Cycle

The pain from a trigger point can cause the muscle to further contract and spasm, leading to even more pain and perpetuating the cycle.

How Spasms and Pain Present

Myofascial pain is often caused by long periods of poor postural alignment, muscle injury, and repetitive motions. (Cleveland Clinic, 2023) For example, the upper body slumps forward when sitting at a desk workstation all day. The upper section of the trapezius muscle is located on the back of the neck and the top of the shoulder. The upper trapezius muscle works to raise the head. (Yoo W. G. 2015) The trapezius muscle now has to work more than it is used to. This overuse may cause microscopic muscle injury, leading to muscle spasms and pain. (Bron C., & Dommerholt J. D. 2012) (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Without treatment, the muscle spasms, pain, and microscopic muscle injury may persist or worsen, leading to trigger points and chronic pain. (Jafri M. S. 2014)

Causes

Repetitive Motions

Repeating the same movement, like typing on a computer, can trigger muscle tension and points.

Poor Posture

Maintaining incorrect posture for extended periods can strain muscles and contribute to trigger point development.

Muscle Injury

Past injuries can leave muscles susceptible to developing trigger points and pain cycles.

Stress

Psychological stress can lead to muscle tension and exacerbate existing trigger points.

Break the Cycle

Physical Therapy

A physical therapist can use stretching, massage, and trigger point therapy to release muscle tension and address trigger points.

Exercise

Regular exercise, including gentle stretching, can help improve muscle flexibility and reduce tension.

Heat Therapy

Applying heat to affected areas can help relax muscles and alleviate pain.

Ergonomics

Modifying work habits and posture to reduce strain on muscles.

Stress Management

Techniques like deep breathing and meditation can help reduce stress-related muscle tension.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Personal Injury Rehabilitation

References

Jafri M. S. (2014). Mechanisms of Myofascial Pain. International scholarly research notices, 2014, 523924. doi.org/10.1155/2014/523924

Kojidi, M. M., Okhovatian, F., Rahimi, A., Baghban, A. A., & Azimi, H. (2016). Comparison Between the Effects of Passive and Active Soft Tissue Therapies on Latent Trigger Points of Upper Trapezius Muscle in Women: Single-Blind, Randomized Clinical Trial. Journal of Chiropractic Medicine, 15(4), 235–242. doi.org/10.1016/j.jcm.2016.08.010

Nicol A, C. M., Hsu E, Ferrante M. (2018). Myofascial Pain Syndrome. Science Direct, 207-212. doi.org/https://doi.org/10.1016/B978-0-323-40196-8.00025-5

THORNE. (2021). Understanding Muscle Pain, Fascia, and Myofascial Release. www.thorne.com/take-5-daily/article/understand-muscle-pain-fascia-and-myofascial-release?srsltid=AfmBOop3Pp0wWEeiQEqpfPgAaTOpLvU7lOAGUv5VRYQdoH8OBcW4D_wk

Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM & R: the journal of injury, function, and rehabilitation, 7(7), 746–761. doi.org/10.1016/j.pmrj.2015.01.024

Cleveland Clinic. (2023). Chronic myofascial pain (CMP). my.clevelandclinic.org/health/diseases/12054-myofascial-pain-syndrome

Yoo W. G. (2015). Comparison of activation and change in the upper trapezius muscle during painful and non-painful computer work. Journal of Physical Therapy Science, 27(10), 3283–3284. doi.org/10.1589/jpts.27.3283

Bron, C., & Dommerholt, J. D. (2012). Etiology of myofascial trigger points. Current pain and headache reports, 16(5), 439–444. doi.org/10.1007/s11916-012-0289-4

Natural Ways to Alleviate Thigh Pain Associated with Sciatica

By

Dr. Alex Jimenez

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Can individuals dealing with sciatica incorporate nonsurgical treatments to reduce thigh pain and restore mobility in the legs and hips?

Table of Contents

The Tensor Fascia Latae

Do you feel stiffness or tightness in your legs, feet, and hips? Have you experienced walking crookedly when running errands? Or have you experienced radiating pain from your gluteal region down to your feet? The hips, thighs, and legs have numerous muscles, tissues, and ligaments surrounding the skeletal bone in the body’s lower extremities. These components allow the lower half of the body to stabilize the upper body’s weight and enable the individual to be mobile throughout the day. One muscle that works together is the tensor fasciae latae (TFL) muscle. The TFL muscle is part of the proximal anterolateral thigh between the deep fibers of the iliotibial (IT) band. It works with the gluteal muscles in various hip movements and assists with the knees. (Trammell et al., 2025) This muscle is poorly misunderstood as it helps with the hips and knee joint and pelvic stability. (Iyengar et al., 2022) At the same time, it has a casual relationship with the IT band.

The Iliotibial Band (ITB)

The iliotibial (IT) band is part of the lower extremities as it is a tough, fibrous fascial tissue that works together with the TFL muscle and has various functional roles that are dependent on posture and allows the individual to be mobile via walking, sprinting, and running. (Hutchinson et al., 2022) However, this muscle’s main function is knee flexion. When environmental factors affect the body, it can cause irritation and inflammation to the IT band, causing knee pain. (Martinez-Velez et al., 2020) When dealing with issues within their lower extremities, they affect the IT band, TFL muscle, and the thighs. Environmental factors can also affect the lower extremities as the surrounding muscles can aggravate the nerve roots, thus leading to sciatica pain. We associate with certified medical providers who inform our patients of how sciatica can negatively impact the lower extremities, especially the thighs. While asking important questions to our associated medical providers, we advise patients to integrate various non-invasive treatments to reduce sciatica and help regain mobility back to the lower body. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Reclaim Your Mobility: Chiropractic Care For Sciatica Recovery-Video

Reclaim Your Mobility: Chiropractic Care for Sciatica Recovery | El Paso, Tx (2024)

Sciatica & Thigh Pain

When the general population hears about sciatica, it is a frequent diagnosis associated with low back pain, which causes discomfort within the lower extremities, especially in the thighs. Sciatica is a debilitating condition where the sciatic nerve is often compressed and irritated, causing pain. (Davis et al., 2025) Many influences cause sciatica to develop, and it can cause the individual to deal with a spinal imbalance, which correlates with walking incorrectly, causing the accessory muscles to work overtime and compressing the sciatic nerve, causing thigh pain. (Wang et al., 2022) With thigh pain correlating with sciatica, many symptoms can range from muscle weakness, absence of tendon reflexes to the knees, and sensory deficit. (Fairag et al., 2022) Luckily, treatments are available to reduce thigh pain associated with sciatica and regain mobility back to the lower extremities.

Treatments For Sciatica-Thigh Pain

When treating the lower extremities, especially when experiencing sciatica-thigh pain, many individuals with thigh pain associated with sciatica can incorporate non-invasive treatments to reduce the pain. Many athletic and non-athletic individuals can utilize PRICE (protection, rest, ice, compression, and elevation) to the affected muscles that can minimize the injuries causing pain. (Lempainen et al., 2022) This can help reduce the inflammatory effects causing issues to the thighs and lower extremities. Many non-surgical treatments like physio-exercise therapy, massages, stretching, and spinal stabilization therapies can improve core strength and posture and help with range of motion to relieve sciatica pain affecting the lower extremities. (Aguilar-Shea et al., 2022) Other non-surgical treatments like yoga, physical therapy, and chiropractic care can help improve joint and lower extremity motions, stretch and strengthen weak muscles surrounding the thighs, and relieve sciatic nerve pain. (Kim & Yim, 2020) When people start thinking about their bodies and how pain is affecting their quality of life, many can incorporate non-surgical treatments to reduce the pain associated with sciatica. Many people can make small positive changes in their routine by becoming more physically active, stretching more, eating healthier, and being more mindful of what they are doing, which can reduce the chances of sciatica returning and affecting the lower extremities. This can help them achieve a healthier, better life.

References

Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-Gonzalez, R., & Paredes, I. (2022). Sciatica. Management for family physicians. J Family Med Prim Care, 11(8), 4174-4179. doi.org/10.4103/jfmpc.jfmpc_1061_21

Davis, D., Maini, K., Taqi, M., & Vasudevan, A. (2025). Sciatica. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/29939685

Fairag, M., Kurdi, R., Alkathiry, A., Alghamdi, N., Alshehri, R., Alturkistany, F. O., Almutairi, A., Mansory, M., Alhamed, M., Alzahrani, A., & Alhazmi, A. (2022). Risk Factors, Prevention, and Primary and Secondary Management of Sciatica: An Updated Overview. Cureus, 14(11), e31405. doi.org/10.7759/cureus.31405

Hutchinson, L. A., Lichtwark, G. A., Willy, R. W., & Kelly, L. A. (2022). The Iliotibial Band: A Complex Structure with Versatile Functions. Sports Med, 52(5), 995-1008. doi.org/10.1007/s40279-021-01634-3

Iyengar, K. P., Azzopardi, C., Kiernan, G., & Botchu, R. (2022). Isolated pathologies of Tensor Fasciae Latae: Retrospective cohort analysis from a tertiary referral centre. J Clin Orthop Trauma, 29, 101870. doi.org/10.1016/j.jcot.2022.101870

Kim, B., & Yim, J. (2020). Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial. Tohoku J Exp Med, 251(3), 193-206. doi.org/10.1620/tjem.251.193

Lempainen, L., Mecho, S., Valle, X., Mazzoni, S., Villalon, J., Freschi, M., Stefanini, L., Garcia-Romero-Perez, A., Burova, M., Pleshkov, P., Pruna, R., Pasta, G., & Kosola, J. (2022). Management of anterior thigh injuries in soccer players: practical guide. BMC Sports Sci Med Rehabil, 14(1), 41. doi.org/10.1186/s13102-022-00428-y

Martinez-Velez, A., Suwan, P., & Dua, A. (2020). Iliotibial band syndrome in non-athletes. Minerva Anestesiol, 86(10), 1111-1112. doi.org/10.23736/S0375-9393.20.14194-4

Trammell, A. P., Nahian, A., & Pilson, H. (2025). Anatomy, Bony Pelvis and Lower Limb: Tensor Fasciae Latae Muscle. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/29763045

Wang, L., Li, C., Wang, L., Qi, L., & Liu, X. (2022). Sciatica-Related Spinal Imbalance in Lumbar Disc Herniation Patients: Radiological Characteristics and Recovery Following Endoscopic Discectomy. J Pain Res, 15, 13-22. doi.org/10.2147/JPR.S341317

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The Health Benefits of Mustard: An Overview

By

Dr. Alex Jimenez

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Yellow mustard and whole grain mustard. — Yellow mustard and whole grain mustard on kitchen table.

Can mustard be a low-calorie alternative to higher-fat condiments for individuals trying to reduce calorie intake?

Table of Contents

Mustard

Prepared mustard is a common condiment used around the country. It is a low-calorie, highly flavored condiment that can replace more calorie-dense options. The familiar condiment combines mustard seeds with vinegar, salt, lemon, and other ingredients. There are also different varieties made from brown or black mustard seeds.

Health Benefits

Mustard is considered healthy because it contains antioxidants that provide various health benefits, including anti-cancer, antibacterial, antiviral, antifungal, anti-inflammatory, and wound-healing properties. (Mazumder A., Dwivedi A., & du Plessis J. 2016) Although not associated with significant health benefits, mustard is a low-calorie alternative to many higher-fat condiments, like mayonnaise. Different types of mustard seeds are used for health purposes. For example, some herbalists use white mustard seeds to clear the throat when mixed with honey (Ewing, Sarah, 1999). Antioxidants include isothiocyanates and sinigrin.

Isothiocyanates, the oil that gives mustard its pungent taste, have anti-cancer properties for breast, lung, GI tract, and prostate cancers.
However, the mechanism remains unclear, and more research is needed to determine the efficacy of mustard’s health benefits for cancer.
Isothiocyanates may also help manage diabetes and reduce unhealthy cholesterol, providing cardiovascular protection and neurological benefits that may help autistic individuals. More research is needed. (Palliyaguru D. et al., 2018)
Sinigrin is another antioxidant. Research shows this antioxidant has anti-cancer, antibacterial, antiviral, antifungal, anti-inflammatory, and wound-healing properties. (Mazumder A., Dwivedi A., & du Plessis J. 2016)

Nutrition

A single serving is usually about a teaspoon. A serving of prepared yellow and spicy mustard provides only about three calories. (U.S. Department of Agriculture, 2019) Its nutritional profile includes a rich supply of essential minerals, including calcium, iron, manganese, phosphorus, and zinc. It is also a good source of omega-3 fatty acids, tryptophan, phosphorus, iron, and protein. The seeds are also a very good source of selenium. Most calories come from carbohydrates, but because the calorie count is so low, these carbohydrates are not likely to significantly affect daily intake. Dijon mustard may provide more calories. A single serving of Dijon may contain up to 10 calories.

Preparation and Storage

Yellow mustard and Dijon are easy to find. Try course mustard varieties with distinct textures and seeds. Buy in small quantities, as mustard can lose flavor with time. Once opened, store in the refrigerator for up to one year. Mustard imparts a strong, spicy taste that pairs well with meat and seafood and can also be used to make salad dressings.

Side Effects

The U.S. Food and Drug Administration recognizes mustard as safe (GRAS). Eating too much can cause abdominal pain, diarrhea, and gut inflammation. However, mustard and mustard seed allergies are not uncommon. Symptoms may be mild or severe and generally appear shortly after consuming the product. Individuals may experience a rash or a tingly, itchy feeling in the mouth. Difficulty breathing is also possible. Other foods derived from the mustard plant, including leaves, seeds, flowers, sprouted seeds, oil, and foods that contain these, are likely to cause reactions in those with mustard allergies.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Enhancing Health Together

References

Mazumder, A., Dwivedi, A., & du Plessis, J. (2016). Sinigrin and Its Therapeutic Benefits. Molecules (Basel, Switzerland), 21(4), 416. doi.org/10.3390/molecules21040416

Ewing, Sarah. (1999). Black Mustard (Brassica nigra). opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1421&context=ebl

Palliyaguru, D. L., Yuan, J. M., Kensler, T. W., & Fahey, J. W. (2018). Isothiocyanates: Translating the Power of Plants to People. Molecular nutrition & food research, 62(18), e1700965. doi.org/10.1002/mnfr.201700965

U.S. Department of Agriculture. (2019). Mustard, prepared, yellow. Retrieved from fdc.nal.usda.gov/food-details/326698/nutrients

Trapezius Self Massage: Relax and Unwind Your Upper Body

By

Dr. Alex Jimenez

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physiotherapy-back-massage-and-patient-man-at-con-2025-01-02-20-35-20-utc_02 — Physiotherapy, back massage and patient man at consultation for spinal problem or inflammation. Per.

Can individuals who sit for long hours daily prevent tight neck and shoulder muscles by improving their posture, regularly stretching, and massaging their trapezius muscles?

Table of Contents

Trapezius Self Massage

The trapezius muscle is a triangle-shaped muscle in the upper back that starts at the base of the neck, spans the length of the upper shoulders, and extends into the middle back. This muscle’s main function is stabilizing and moving the scapula/shoulder blade. The trapezius also helps to move the head, neck, arms, shoulders, and torso, stabilizes the spine, and plays an important role in posture. Physical and mental stress can tighten the trapezius muscle, leading to neck and shoulder pain. Learning to perform a trapezius self-massage can ease tension and provide pain relief. (Domingo A. R. et al., 2017)

Anatomy

The trapezius consists of three parts in three different areas of the back. The bottom of the skull, across the shoulders, and down to the mid back. A trapezius self-massage focuses on the upper portion of the traps. This part is located at the top of the shoulders. To find the upper trapezius, cross one arm in front of your body so that you can place the palm on top of the other shoulder.

For a trapezius self-massage, you need to know that there are two areas where your upper traps start and where the muscle connects to a bone. The first point is on the bottom of the skull, close to the center of the back of the skull. Start there with your fingers and trace the muscle down the back of the neck to where the shoulders widen. If you get lost, You can walk your fingers up or down the muscle on either side to relocate its origin at the base of the skull, the vertebra at the base of your neck that sticks out. This is C-7, another of the upper trapezius’s origin sites. (University of Washington Department of Radiology, 2025)

Massage Technique

Massage oil is optional but can hydrate the skin during a massage. You can perform the trapezius self-massage using your hands.

Start at the Base of The Neck

Choose one shoulder to work at a time.

Raise the arm on the opposite side of your body.
Reach this arm across your body and fold it around your neck so that your fingers rest at the back base of your neck.
Apply a decent amount of pressure to the muscle while moving your fingers in a circular motion.
The action is similar to kneading dough.
Massage this area at the base of your neck for about 30 seconds to start.
If this part of your muscle is sore, you can massage it longer.

Slowly Work Out Towards The End of The Shoulder

Once you have spent about 30 seconds massaging the muscle at the base of the neck, work your way out toward the end of your shoulder.

In close increments, in your fingers across the trapezius muscle, spending at least 30 seconds at each point.
Follow the muscle until you reach the end of the shoulder.
Apply enough pressure, and use slow, rhythmic movements so that you feel relief.
If the pressure is not relieving or makes you wince, it’s too much.

Repeat as Needed

Repeat each side two to three times before switching to the other shoulder. After massaging, you may notice a certain trapezius area is particularly sore or tense. Zero in on those areas a little longer. Remember to relax throughout the trapezius self-massage. This is an opportunity to learn where tension is in your neck and shoulders and how to apply pressure to relieve it. This knowledge can also help you be mindful throughout your day, whether sitting, doing chores, or other physical activities. If you notice scrunching or slouching, massage the trapezius and remind yourself to keep your shoulders relaxed.

Benefits

Tension and tightness in the trapezius muscle are common, particularly among individuals who work in an office, do manual labor, or deal with a lot of stress. (Marker R. J. Campeau S., & Maluf K. S. 2017) Trapezius strains are a common overuse injury that is more likely to happen when the muscle is tight. (Salavati M. et al., 2017) The injury can cause unhealthy posture to avoid the pain. This poor posture will place more stress on the muscles, leading to a cycle of poor posture and chronic pain. A trapezius self-massage can benefit in many ways, including:

Improved blood circulation
Better quality of sleep
Improved posture
Improved range of motion
Decreased swelling
Faster recovery after workouts
Reduced risk of injury

Seeing a Healthcare Provider

Like any other muscle in the body, the trapezius can be injured and requires special treatment to recover. Sometimes, the neck or shoulder pain may not come from the trapezius muscle. Consider seeing a healthcare provider if you have pain in your neck or shoulder that doesn’t get better within a week or two, especially if it isn’t responding to at-home treatment. Regardless of how long you have been experiencing pain or stiffness, contact a healthcare provider if it prevents you from getting adequate sleep or interfering with daily activities. Reasons to see a healthcare provider immediately for neck or shoulder pain include: (Mount Sinai, 2025)

There is sudden pressure or pain in the left shoulder, which can sometimes signal a heart attack.
A fall or accident resulted in pain, swelling, or problems moving the neck or arm.
If there is shoulder pain, a fever, swelling, or redness.
The skin on the shoulder area appears discolored.

It’s important to take regular breaks to stretch and move your muscles. You can release tension in the trapezius by doing shoulder shrugs throughout the day and stretching regularly. When the trapezius feels tight or sore, give yourself a massage.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Whiplash Chiropractic Massage Therapy

References

Domingo, A. R., Diek, M., Goble, K. M., Maluf, K. S., Goble, D. J., & Baweja, H. S. (2017). Short-duration therapeutic massage reduces postural upper trapezius muscle activity. Neuroreport, 28(2), 108–110. doi.org/10.1097/WNR.0000000000000718

University of Washington Department of Radiology. (2025). Trapezius. rad.washington.edu/muscle-atlas/trapezius/

Marker, R. J., Campeau, S., & Maluf, K. S. (2017). Psychosocial stress alters the strength of reticulospinal input to the human upper trapezius. Journal of Neurophysiology, 117(1), 457–466. doi.org/10.1152/jn.00448.2016

Salavati, M., Akhbari, B., Ebrahimi Takamjani, I., Ezzati, K., & Haghighatkhah, H. (2017). Reliability of the Upper Trapezius Muscle and Fascia Thickness and Strain Ratio Measures by Ultrasonography and Sonoelastography in Participants With Myofascial Pain Syndrome. Journal of Chiropractic Medicine, 16(4), 316–323. doi.org/10.1016/j.jcm.2017.06.003

Mount Sinai. (2025). Shoulder pain. www.mountsinai.org/health-library/symptoms/shoulder-pain

How Outcome Measurement Tests Benefit Physical Therapy

By

Dr. Alex Jimenez

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A physiotherapist helps an elderly woman in a rehabilitation center

Can individuals experiencing difficulty with functional mobility benefit from physical therapy to help them return to normal activities?

Table of Contents

Outcome Measurement Tests

Outcome measurement tests assess the effects of a treatment plan on a patient. They can be used to determine a patient’s baseline function, monitor their progress, and evaluate the effectiveness of treatment. They also give the therapy team an effective way to measure mobility, flexibility, and range of motion.

Function and Purpose

Outcome measurement tests serve various purposes. These include: (American Physical Therapy Association, N.D.)

To assist in goal-setting
Provide motivation
To guide treatment
To give a prognosis for the specific condition
To justify the treatment

The physical therapist may use other functional outcome measurements to help assess physical therapy progress.

They may measure your strength and range of motion.
Balance and posture may be evaluated.

Effective functional outcome measurement tests must meet certain criteria to be useful in a physical therapy clinic. First, they must be reliable, meaning the results must be consistent with each patient and within groups of patients. They must also be valid to measure exactly what they are intended to measure. An effective measurement test must also be easy to administer, so it must be practical and simple. Outcome measurement tests must also be purposeful. For example, a balance test must reflect a patient’s current function and be related to their balance ability.

Common Outcome Measurement Tests Used

Common functional outcome measurement tools that a physical therapist may use include:

The timed up-and-go or TUG test is a simple assessment used to evaluate a person’s mobility and balance by measuring how long it takes them to stand up from a chair, walk a short distance, turn around, walk back, and sit down again; it’s often used to identify potential fall risks in older adults, particularly those with mobility concerns, as a longer time to complete the task may indicate increased fall risk. (Centers for Disease Control and Prevention, 2017)
The Tinetti balance and gait evaluation, also known as the Performance-Oriented Mobility Assessment (POMA), is a clinical test used to assess balance and gait abilities, particularly in older adults. It evaluates stability during various standing and walking tests and provides a score that indicates a person’s fall risk potential.
The Berg Balance Scale (BBS) is a standardized test for adults that measures balance and the risk of falling. It’s widely used and can be performed in various settings.
The six-minute walk test (6MWT) is a medical assessment in which a person walks as far as they can in a designated area for exactly six minutes. This allows healthcare providers to evaluate their functional exercise capacity. It is particularly useful for assessing patients with lung or heart conditions where walking ability might be compromised. The distance covered during the six minutes is the key measurement used to interpret the test results. (Ferreira M. B. et al., 2022)
The functional reach test (FRT) is a clinical assessment that measures an individual’s dynamic balance by determining the maximum distance they can reach forward while standing in a fixed position. It assesses their risk of falling by evaluating how far they can extend their arm before losing stability. The FRT is often used to assess older adults or individuals with potential balance issues.
The Oswestry low back pain disability questionnaire is a self-administered questionnaire used to measure the level of disability a person experiences due to low back pain. It assesses how the pain impacts their daily activities in various aspects of life, such as personal care, work, and social life; a higher score indicates greater disability.
The functional independence measure (FIM) assesses a patient’s ability to perform daily activities independently. It also measures the patient’s disability level and how much assistance is needed.

Functional outcome measurement tests provide a starting point for developing physical therapy goals. For example, if the TUG test takes 19 seconds, individuals may aim for 10 seconds. A TUG score that falls at or over 10 seconds indicates reduced physical capacity (Kear B. M., Guck T. P., & McGaha A. L. 2017). This can be the motivation needed to reach physical therapy goals.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Understanding The Effects of Personal Injury

References

American Physical Therapy Association. (N.D.). Outcome Measures in Patient Care. www.apta.org/your-practice/outcomes-measurement

Centers for Disease Control and Prevention. (2017). Timed Up & Go Assessment. Retrieved from www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf

Ferreira, M. B., Saraiva, F. A., Fonseca, T., Costa, R., Marinho, A., Oliveira, J. C., Carvalho, H. C., Rodrigues, P., & Ferreira, J. P. (2022). Clinical associations and prognostic implications of 6-minute walk test in rheumatoid arthritis. Scientific reports, 12(1), 18672. doi.org/10.1038/s41598-022-21547-z

Kear, B. M., Guck, T. P., & McGaha, A. L. (2017). Timed Up and Go (TUG) Test: Normative Reference Values for Ages 20 to 59 Years and Relationships With Physical and Mental Health Risk Factors. Journal of primary care & community health, 8(1), 9–13. doi.org/10.1177/2150131916659282

Facet Arthropathy: Managing Arthritis in the Spine

By

Dr. Alex Jimenez

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Providing Physical Therapy for Shoulder Pain Relief — Physical therapist helping patient with shoulder pain in clinic, assisting with movement and providing therapy techniques, in calm and supportive environment

Can individuals managing facet arthropathy treat the condition with over-the-counter pain relievers, prescription muscle relaxers, exercise, and chiropractic spinal manipulation?

Table of Contents

Facet Arthropathy

Facet arthropathy, or facet osteoarthritis, is arthritis that affects the facet joints in the spine. It causes pain and stiffness due to cartilage degeneration within these joints, often resulting from wear and tear associated with aging. Essentially, it occurs when the small joints in the back of the spine become arthritic and rub against each other painfully.

It affects the bony protrusions, called facet joints, that connect the spine’s bones.
Symptoms include neck and back pain that can worsen with standing, bending, or twisting.
Facet arthropathy is diagnosed using X-rays and other imaging studies.
Severe cases may require surgery.

Facet Joints

Twenty-four vertebrae form the spine, with two facet joints between each. Facet joints are small joints located at the back of each vertebra in the spine. They allow movement and stability, help maintain the alignment of the spinal bones/vertebrae, and limit excessive motion. The joints and the cushioning intervertebral disc form a three-joint complex between each vertebra.

The three-joint complex allows the spine to move, including bending, rotating, and extending.
Synovial fluid lubricates the joints so they can move.
The intervertebral disc provides flexibility and dissipates compressive loads.
The facet joints stabilize the spine by constraining rotation and bending.

Symptoms

Arthropathy refers to any disease affecting a joint, including arthritis. Osteoarthritis, also known as arthrosis, is a specific type of arthropathy. It is a non-inflammatory, degenerative arthritis. Pain is the main symptom that is typically worse in the morning when awakening, and in the evening, the pain can also get worse when twisting or bending backward. The symptoms can vary based on the part of the affected spine. Low back pain is the most common, a condition referred to as lumbar facet arthropathy because it affects the lumbar spine of the lower back. (Perolat R. et al., 2018) Common Symptoms include:

Muscle spasms or cramps.
Pain that may come in periodic flare-ups
Pain that worsens with standing or inactivity.
Dull pain on both sides of the spine.
Aching pain on both sides of the spine.
Pain in the lower back, buttocks, shoulders, or back of the skull
Radiating pain to the buttocks and legs.
Pain that improves with sitting, leaning forward, or changing positions.
Pins-and-needles sensations in the hands or feet.
Clicking sounds when moving the spine.
Catching sensations when moving the spine.
Muscle weakness.

Causes

Facet arthropathy causes progressive damage to the spine. Spinal osteoarthritis, aka spondylosis, is the most common cause, but it can also occur with a severe form of spinal arthritis known as ankylosing spondylitis. It is primarily due to age-related wear and tear, but injuries or repetitive stress on the spine can also cause it. Arthritis in the facet joints can develop due to:

Aging-related wear and tear
Disc problems
A previous back injury
Torn ligaments
Spinal fractures

Deterioration of facet joints can also cause bony overgrowths called osteophytes or bone spurs, which can cause radiating pain and restrict the spine’s range of motion.

Degeneration

The facet joints and intervertebral discs degenerate due to age-related wear and tear.
The cartilage in the facet joints can dry out, crack, and wear down.
The joint capsule and synovial membrane can inflame or tear, affecting synovial fluid production.
The loss of cartilage can lead to hypermobility, and the joint can stiffen over time.

Diagnosis

Imaging studies are important to the diagnosis. Several types confirm the diagnosis and also characterize the nature and severity of the condition:

X-rays provide a plain, black-and-white image of the spinal column.
CT scan composites multiple X-rays to create a three-dimensional image of the spinal column.
MRI uses magnetic and radio waves to generate images of soft tissues like ligaments and cartilage.

To confirm the diagnosis, a diagnostic block, which is a small amount of local anesthetic, is injected into a facet joint. The needle placement is directed either with an ultrasound or a CT scan. Facet arthroplasty is confirmed if the injection provides immediate relief (American Academy of Orthopaedic Surgeons, 2022). The healthcare provider will want to exclude other possible causes as part of the differential diagnosis. Conditions that mimic facet arthropathy include:

Herniated disc
Psoriatic arthritis
Reactive arthritis
Spinal gout
Spinal compression fracture

Treatment

The treatment varies depending on the location and severity of the condition. Generally, conservative treatments are used before more invasive procedures are considered.

Lifestyle Changes

Initially, a healthcare provider may recommend rest and avoiding aggravating movements, including any activity that involves bending or twisting.
Activities that take the weight off the facet joint, such as sitting, leaning forward, or changing positions, may help ease the pain.
Patients may also be advised to adjust their sleep positions to take the pressure off facet joints.
Options included curling up on your side or lying on your back with the knees supported with pillows.

Medications

If a diagnostic block is used, a patient may not need medications immediately. However, as the anesthetic starts to wear off, the patient may be prescribed over-the-counter or prescription pain relievers based on the severity of the pain. These can include:

Analgesics like Tylenol
Nonsteroidal anti-inflammatory drugs like Advil or Aleve
Muscle relaxants like Lloresal for acute back pain
Antidepressants like Cymbalta for chronic back pain

Physical Therapy

Physical therapy is a major part of the treatment of lower back pain. The treatment plan will include personalized exercises to strengthen the core muscles and avoid stress on the spine. Examples include:

Mechanical traction and non-surgical spinal decompression.
Knee-to-chest stretches, hugging your knees for 30 to 60 seconds.
Walking 10 to 20 minutes per day.
Aquatic therapy to alleviate pressure on the spine.

Surgery

If conservative measures don’t work or provide sufficient relief, a healthcare provider may recommend specialist procedures or surgeries that include:

Lumbar intra-articular injections deliver an anesthetic or corticosteroid into the spine for longer-lasting pain relief.
Sinuvertebral nerve ablation destroys spinal nerves with a strong electrical current.
Extracorporeal shockwave therapy ESWT delivers low- or high-energy electrical pulses to help ease pain.
Spinal fusion surgery involves fusing two or more vertebrae to eliminate movement and pain in the facet joints.
Facet rhizotomy is a surgical procedure used to sever one of the nerves supplying the facet joint.
Stem cell regeneration is an experimental procedure in which stem cells are harvested and injected into damaged joints to restore function.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Facet Syndrome Pain 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

American Academy of Orthopaedic Surgeons. (2022). Spinal injections. orthoinfo.aaos.org/en/treatment/spinal-injections/

The Ultimate Guide to Warming Up Before a Run

By

Dr. Alex Jimenez

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Horizontal shot of motivated sporty woman stretches legs and arms does warming up exercises before workout looks forward dressed in sportsclothes poses outside on big stadium. Exercising concept

Should individuals wanting to engage in the exercise start with a warm-up and end with a cooldown to prepare the muscles for optimal performance and post-workout recovery?

Table of Contents

Warming Up, Cooling Down

Warming up 5 to 10 minutes before exercise is beneficial for pumping blood to the muscles and preparing them for a run. Dynamic or active stretching and light aerobic activity are a few ways to warm up. This could be active stretching, such as walking lunges, brisk walking, or riding a stationary bike for a few minutes before running. However, individuals should avoid static stretches before running, as they can increase the risk of injury. The minimum length of time for an effective cooldown session is five minutes. Depending on the intensity of the workout, individuals may choose to extend that to 10 minutes.

Steps for a Running Warmup

Do five to 10 minutes of light aerobic exercise to loosen up muscles.
Walk briskly, march, jog slowly, or cycle on a stationary bike.
Don’t rush.
Perform dynamic stretches and movements during the warmup, including walking lunges, jumping jacks, or toe touches.
Begin the run with a slow jog and gradually increase speed.
Slow down if you run out of breath.
This is part of knowing how fast you should run; starting too fast is a common mistake.
Pay attention to posture and form.
Ensure you are using the best technique before speeding up.

Warm Up Benefits

When warming up, the blood vessels dilate. The increased blood flow primes the muscles with oxygen and prepares them to perform at their best. Blood flow also increases the temperature in the muscles for enhanced flexibility. Allowing the heart rate to increase gradually is beneficial, instead of going full max heart output by jumping full speed into the running. (The American Heart Association, 2024)

Properly Cooling Down

At the end of the run:

Cool down by walking or slowly jogging for five to 10 minutes.
Breathing and heart rate should gradually return to normal.
Drink water or an electrolyte-infused drink to rehydrate the body.

Benefits of a Cooldown

The cool-down keeps blood flowing throughout the body at a consistent level. Stopping immediately can cause light-headedness because heart rate and blood pressure can drop rapidly. Winding down slowly allows heart rate and blood pressure to fall gradually. The cooldown is also a good mental transition from the intensity and accomplishing the workout.

Before or After Stretching

Stretching evidence shows it doesn’t have the benefits once thought. Static stretching before, during, or after exercise has not been shown to prevent injury or delayed onset muscle soreness. (Herbert R. D., de Noronha M., & Kamper S. J. 2011) Stretching cold muscles is not recommended. However, there is some evidence that dynamic or active stretching after a warmup can benefit performance. Active stretching is done with exercises that take the muscles through their full range of motion and mimic the actions that will be done during the workout. (Van Hooren B., & Peake J. M. 2018)

Stretching After Running

Standard stretching includes the hamstring stretch, quad stretch, calf stretch, low lunge stretch, IT band stretch, butterfly stretch, hip and backstretch, arms and abs stretch, and triceps stretch. Tips for proper stretching:

Don’t Bounce

Avoid bouncing, as this mimics pulling a rubber band back and forth. You want the muscle to stay stretched.
Hold the stretch for 15 to 30 seconds.

Don’t Stretch Through Pain

Don’t stretch beyond the point where tightness is felt in the muscle.
Do not push through muscle resistance.
Never stretch to the point of pain.

Stretch Whole Body

Don’t just stretch the areas with tightness and/or soreness.
Stretch the whole body equally to prevent injury.

Don’t Hold Your Breath

Take deep breaths during the stretch.
Stay relaxed and breathe in and out slowly.

If starting a new fitness routine, consult your healthcare provider to determine the optimal running warmups and stretching exercises.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

The Science of Motion

References

The American Heart Association. (2024). Warm up, cool down. www.heart.org/en/healthy-living/fitness/fitness-basics/warm-up-cool-down

Herbert, R. D., de Noronha, M., & Kamper, S. J. (2011). Stretching to prevent or reduce muscle soreness after exercise. The Cochrane database of systematic reviews, (7), CD004577. doi.org/10.1002/14651858.CD004577.pub3

Van Hooren, B., & Peake, J. M. (2018). Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports medicine (Auckland, N.Z.), 48(7), 1575–1595. doi.org/10.1007/s40279-018-0916-2

Unlocking the Power of Probiotic and Prebiotic for Optimal Body Function

By

Dr. Alex Jimenez

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Can individuals dealing with gut issues incorporate the beneficial properties of probiotics and prebiotics to improve body function?

Table of Contents

How The Gut Works Together With The Body

When many individuals are dealing with chronic issues that are causing referred pain in their bodies, it could be an issue that is affecting their gut system. Have you experienced unpredictable food reactions that make you unable to enjoy your favorite meal or food item anymore? Do you notice any abdominal swelling after a heavy meal? Or have you been more constipated and found it difficult to go to the bathroom? This is because the gut system is the second brain of the human body. The gastrointestinal (GI) system provides many beneficial properties to the host and the human body. It helps strengthen the gut’s integrity, harvest and give energy, protect the body from foreign pathogens, and regulate the immune system. (Thursby & Juge, 2017) Inside the gut system is home to trillions of bacteria that help transport the nutrients and vitamins of food to different areas of the body. This, in turn, gives the individual the energy to be mobile and complete their daily activities. However, environmental factors like illnesses, stress, bad dietary habits, and lifestyles can cause the gut ecosystem to undergo abnormal changes, causing gut dysbiosis. (Zhang et al., 2015)

When environmental factors impact the body, especially the gut system, the immune system produces inflammatory cytokines caused by certain bacteria. Once certain structural component bacteria strains trigger inflammation, it can cause a cascade of inflammatory pathways to affect the entire body, causing the individual to experience pain and discomfort. (Al Bander et al., 2020) Additionally, gut dysbiosis can also be associated with the occurrence of several chronic metabolic diseases that are developed. (Xiong et al., 2023) Fortunately, there are numerous ways people can reduce the impact of gut dysbiosis and help restore normal body function by including probiotics and prebiotics. We associate with certified medical providers who inform our patients of how the gut system can affect the body when environmental factors impact it. While asking important questions to our associated medical providers, we advise patients to integrate various probiotic and prebiotic foods to help regulate healthy bacteria back to the gut and reduce pain and discomfort in the body. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Nutrition Fundamentals- Video

Nutrition Fundamentals | El Paso, Tx (2023)

Probiotic & Prebiotic Foods For The Gut

Now, when it comes to the gut system, it is important to know that trillions of bacteria help with gut regulation. When environmental factors cause various issues, it can cause pain and discomfort to the rest of the body. Hence, incorporating probiotics and prebiotics can help regulate the gut and reduce the impact of harmful bacteria from affecting the body. As part of a healthy diet, probiotics have the potential to regulate gut microbiota by affecting the intestinal microbial dynamics and homeostasis, thus influencing the intestines and distill organs physiology. (Kim et al., 2021) Additionally, when a person is incorporating probiotics and prebiotics to regulate their gut, it can be used to help manipulate the host’s microbiota while being used for potential therapeutic strategies. (Radford-Smith & Anthony, 2023) Some of the foods that have probiotics and prebiotics include:

Jicama
Bananas
Garlic
Miso
Kimchi
Yogurt

How Probiotics & Prebiotics Improve Body Function

When people start to incorporate prebiotics and probiotics, they will notice an increased abundance of health-promoting bacteria that can increase microbiome diversity and metabolic pathways that can affect the qualitative and quantitative changes of the gut composition. (Jager et al., 2019) Different bacterial strains can have various properties that can help with the gastrointestinal microbiome diversity and improve the body through metabolic support.

Conclusion

So, when people think about their health and wellness, the best place to start is with the gut by adding prebiotics and probiotics as part of a healthy diet. This, in turn, can help the loss of beneficial bacteria that have been affected by environmental factors and can help reduce the inflammatory effects of chronic illnesses. Making these small changes can be helpful to one’s health and well-being and allow many people to come up with tasty food combinations to improve gut health and metabolic pathways.

References

Al Bander, Z., Nitert, M. D., Mousa, A., & Naderpoor, N. (2020). The Gut Microbiota and Inflammation: An Overview. Int J Environ Res Public Health, 17(20). doi.org/10.3390/ijerph17207618

Jager, R., Mohr, A. E., Carpenter, K. C., Kerksick, C. M., Purpura, M., Moussa, A., Townsend, J. R., Lamprecht, M., West, N. P., Black, K., Gleeson, M., Pyne, D. B., Wells, S. D., Arent, S. M., Smith-Ryan, A. E., Kreider, R. B., Campbell, B. I., Bannock, L., Scheiman, J.,…Antonio, J. (2019). International Society of Sports Nutrition Position Stand: Probiotics. J Int Soc Sports Nutr, 16(1), 62. doi.org/10.1186/s12970-019-0329-0

Kim, C. S., Cha, L., Sim, M., Jung, S., Chun, W. Y., Baik, H. W., & Shin, D. M. (2021). Probiotic Supplementation Improves Cognitive Function and Mood with Changes in Gut Microbiota in Community-Dwelling Older Adults: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. J Gerontol A Biol Sci Med Sci, 76(1), 32-40. doi.org/10.1093/gerona/glaa090

Radford-Smith, D. E., & Anthony, D. C. (2023). Prebiotic and Probiotic Modulation of the Microbiota-Gut-Brain Axis in Depression. Nutrients, 15(8). doi.org/10.3390/nu15081880

Thursby, E., & Juge, N. (2017). Introduction to the human gut microbiota. Biochem J, 474(11), 1823-1836. doi.org/10.1042/BCJ20160510

Xiong, R. G., Li, J., Cheng, J., Zhou, D. D., Wu, S. X., Huang, S. Y., Saimaiti, A., Yang, Z. J., Gan, R. Y., & Li, H. B. (2023). The Role of Gut Microbiota in Anxiety, Depression, and Other Mental Disorders as Well as the Protective Effects of Dietary Components. Nutrients, 15(14). doi.org/10.3390/nu15143258

Zhang, Y. J., Li, S., Gan, R. Y., Zhou, T., Xu, D. P., & Li, H. B. (2015). Impacts of gut bacteria on human health and diseases. Int J Mol Sci, 16(4), 7493-7519. doi.org/10.3390/ijms16047493

Disclaimer

How Knee Braces Provide Support and Stability for Healing

By

Dr. Alex Jimenez

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Orthopedist woman putting a knee brace on a young client — Interior of an orthopedics store with a female orthopedist putting a knee brace on a young woman

Can a knee brace relieve discomfort, provide support, and expedite recovery for individuals recovering from an injury or surgery?

Table of Contents

Knee Brace

A knee brace is a medical device that supports and stabilizes the knee joint to help with pain and recovery after an injury or surgery. Many knee braces are made of various materials and offer a range of support levels. A healthcare provider or physical therapist can recommend the appropriate one for your condition and suggest the best one. Ask a healthcare provider if you’re unsure, as wearing a knee brace correctly and for the recommended time is important for healing. They are generally safe. However, individuals with health conditions such as poor circulation should be cautious when using them and consult their healthcare provider.

What They Do

The knee joint comprises bones, cartilage, ligaments, tendons, and muscles. A knee brace stabilizes these structures, preventing them from moving too much or too fast. Some braces redistribute the knee joint’s weight, decreasing the force the knee absorbs. (American Academy of Family Physicians, 2020)

Conditions

A knee brace is used after surgery to aid in healing and following an injury. This can be:

Sprain
Ligament injury
Patellar/kneecap dislocation

They are also used to support the knee and relieve pain from some chronic conditions including: (Sprouse R. A., McLaughlin A. M., & Harris G. D. 2018)

Tendonitis
Patellar tendinopathy
Chondromalacia patellae
Patellofemoral stress syndrome
Medial knee osteoarthritis

Types

Knee braces differ in function and support level. Some stabilize the knee, while others completely immobilize the joint. A healthcare provider and/or physical therapist will explain what support is needed and how to use it. They can also check the brace’s fit and determine if adjustments or a different size are required.

Most Commonly Used

Prophylactic Brace

This is a protective knee pad that shields the kneecap from direct impact.
It’s used by athletes who play contact sports, like football. (American Academy of Pediatrics, 2019)

Unloader

This brace helps rebalance the weight and shift the pressure on the knee joint to other parts of the leg, reducing pain. (American Academy of Family Physicians, 2020)
A knee unloader is typically used to control discomfort due to inflammatory conditions like tendonitis and osteoarthritis.

Functional

This brace limits motion in the joint after an injury or prevents dislocation.

Bledsoe Brace

This brace has straps to wrap around the thigh and shin and support brackets on the inside and outside of the knee joint.
A small mechanism locks the knee into full extension or allows the knee to bend a specific amount.

Knee Immobilizer

A knee immobilizer keeps the knee in one position.
It is a long cloth brace that runs the length of the shin and thigh.

Knee Brace vs Knee Support

A knee support or sleeve is usually a tight-fitting fabric garment. It provides compression to help reduce swelling and discomfort. A knee brace offers more support and can also be set to limit mobility.

Wearing The Brace

Individuals may need to wear a knee brace all day or only when performing specific tasks and operations. It depends on the individual and the condition the brace is being used for. Some may only need to wear a knee brace during certain activities or a flare-up of pain. (Mayo Clinic, 2022) Wearing a brace for unnecessarily long periods can cause skin abrasion, joint stiffness, and muscle atrophy. (American Academy of Family Physicians, 2020) Conversely, neglecting to wear it can cause more susceptibility to injury or extend and or impair healing time. Ask a healthcare provider when you should and should not wear the brace. This could be when:

Sitting
Walking
Driving
Sleeping
Stretching

Contraindications

Some medical conditions can make an individual susceptible to injury and adverse effects from wearing a knee brace. These include: (Holden, M. A. et al., 2021)

Poor circulation
Superficial wounds on the knee
Psoriasis
Eczema
Arterial insufficiency
Severe varicose veins
A history of thrombophlebitis

Injury Medical Chiropractic and Functional Medicine Clinic

If you have one of these conditions, a healthcare provider will decide if a knee brace is safe. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Best Knee Injury Chiropractor

References

American Academy of Family Physicians. (2020). Knee Bracing: What Works? familydoctor.org/knee-bracing-what-works/

Sprouse, R. A., McLaughlin, A. M., & Harris, G. D. (2018). Braces and Splints for Common Musculoskeletal Conditions. American family physician, 98(10), 570–576.

American Academy of Pediatrics. (2019). Knee pain: how to choose the right knee brace for your child. www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Knee-Pain-and-braces.aspx

Mayo Clinic. (2022). To brace or not to brace: What’s the best answer? www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/to-brace-or-not-to-brace#:~:text=If%20you%20have%20early%20onset%2C%20mild%20arthritis,below%20the%20knee%20for%20compression%20and%20comfort.

Holden, M. A., Callaghan, M., Felson, D., Birrell, F., Nicholls, E., Jowett, S., Kigozi, J., McBeth, J., Borrelli, B., Jinks, C., Foster, N. E., Dziedzic, K., Mallen, C., Ingram, C., Sutton, A., Lawton, S., Halliday, N., Hartshorne, L., Williams, H., Browell, R., … Peat, G. (2021). Clinical and cost-effectiveness of bracing in symptomatic knee osteoarthritis management: protocol for a multicentre, primary care, randomised, parallel-group, superiority trial. BMJ open, 11(3), e048196. doi.org/10.1136/bmjopen-2020-048196

Enhance Spine and Back Health with these Simple and Effective Exercises

By

Dr. Alex Jimenez

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Can individuals incorporate these simple but effective exercise routines to reduce pain and discomfort in their spine and back?

Table of Contents

Why It’s Important To Keep The Back Mobile

When many individuals are dealing with back pain from their upper, middle, and lower portions, it can put a halt to a person’s routine. When back pain becomes present, it causes the person to find a comfortable place like a couch or a bed and lie down. However, this can cause more issues than the original one, affecting the individual. Back pain is a common worldwide problem and is the leading issue of disability associated with a high socio-economic cost. (Chou, 2021) Additionally, when a person is dealing with back pain, they are also dealing with degenerative issues that are also affecting their spines, thus causing problems to their joints, discs, and bones. (Hauser et al., 2022) This is because back pain is a multifactorial musculoskeletal disorder that can cause referred pain to different body locations. So when a person dealing with back pain rests, it can become an issue as inflammation builds up and swelling in the affected areas. Hence, many doctors, chiropractors, physical therapists, and spine specialists recommend keeping mobile to allow blood flow and the body’s natural healing response to reduce pain and speed up recovery. Since back pain relief is challenging through visceral-somatic disturbances, it is important to find various treatment options to aid the person’s specific condition. As a person goes to get treatment for their back pain, it is important to note that the causes of their back pain can help determine which exercises can be most effective within their treatment plan. We associate with certified medical providers who inform our patients of the benefits of incorporating simple but effective exercises for their back pain. While asking important questions to our associated medical providers, we advise patients to integrate an exercise routine to reduce the chances of environmental factors causing back pain to return. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Understanding Academic Low Back Pain- Video

Understanding Academic Low Back Pain: Impact and Chiropractic Solutions | El Paso, Tx (2024)

Effective But Simple Exercises For The Back

Many people often wonder, “If I am dealing with back pain, why should I exercise to reduce this pain?” The answer is simple: since the affected back muscles are tight and weakened, simple but effective exercises can help recover. Exercise therapy can help increase muscle-joint strength in the body while improving muscle function and increasing range of motion. This boosts a speedy recovery and allows the individual to return to their usual activities. (Hayden et al., 2021) At the same time, with a customized treatment plan, exercise therapy can incorporate other non-surgical treatments with one goal: to restore normal musculoskeletal function and reduce the pain caused by environmental factors, diseases, or injuries. (Karlsson et al., 2020) Now, depending on the severity of the back pain, there are simple but effective exercises below to help reduce the pain and restore mobility to the back.

Physical Therapy & At-Home Workouts

Physical therapy and at-home exercises can help many individuals with back pain. They can help figure out which position can help centralize the pain and correct any restricted motions. Many physical therapists incorporate the McKenzie method to strengthen and support the spine while decreasing pain and inflammation. At-home exercises can be combined with a series designed to be practical, assessable, and feasible for therapeutic gain or even to improve physical capacity to maximum effort. (Quentin et al., 2021)

Water Exercises

Water exercises are amazing exercises that can help lessen the body’s weight to take pressure and stress off the spine. This is because water is supposed to help cleanse and rejuvenate the body. When individuals are experiencing chronic back pain, aquatic physical therapy can help relieve pain intensity, relax the aching muscles, and even promote a positive workout experience for the individual. (Ma et al., 2022) After a few consecutive sessions, many individuals can see improvement in pain intensity and restored mobility function in their routines.

Tai Chi & Stabalizing Exercises

Now, another simple and effective exercise routine can help stabilize the surrounding muscles in the back and spine and become effective as part of a health and well-being routine. Tai chi and Qigong practices can help the individual emphasize stillness and controlled movements to promote calmness, resilience, body awareness, and relaxation for proper body alignment. (Yang et al., 2024) Tai chi and Qigong can also help support immune function in the body while regulating inflammation, which can help reduce and prevent diseases. (Oh et al., 2020) At the same time, yoga can help improve flexibility, mobility, and stability within the muscles and joints while also improving spinal alignment, which can help many individuals have proper posture. (Zhu et al., 2020) Depending on which exercise a person prefers for their treatment plan and to reduce their back pain; it is important to make these small changes to achieve optimal results. Making these small changes can help many individuals reduce the chances of their back pain returning and help them along with their health and wellness journey.

References

Chou, R. (2021). Low Back Pain. Ann Intern Med, 174(8), ITC113-ITC128. doi.org/10.7326/AITC202108170

Hauser, R. A., Matias, D., Woznica, D., Rawlings, B., & Woldin, B. A. (2022). Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review. J Back Musculoskelet Rehabil, 35(4), 701-712. doi.org/10.3233/BMR-210097

Hayden, J. A., Ellis, J., Ogilvie, R., Malmivaara, A., & van Tulder, M. W. (2021). Exercise therapy for chronic low back pain. Cochrane Database Syst Rev, 9(9), CD009790. doi.org/10.1002/14651858.CD009790.pub2

Karlsson, M., Bergenheim, A., Larsson, M. E. H., Nordeman, L., van Tulder, M., & Bernhardsson, S. (2020). Effects of exercise therapy in patients with acute low back pain: a systematic review of systematic reviews. Syst Rev, 9(1), 182. doi.org/10.1186/s13643-020-01412-8

Ma, J., Zhang, T., He, Y., Li, X., Chen, H., & Zhao, Q. (2022). Effect of aquatic physical therapy on chronic low back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord, 23(1), 1050. doi.org/10.1186/s12891-022-05981-8

Oh, B., Bae, K., Lamoury, G., Eade, T., Boyle, F., Corless, B., Clarke, S., Yeung, A., Rosenthal, D., Schapira, L., & Back, M. (2020). The Effects of Tai Chi and Qigong on Immune Responses: A Systematic Review and Meta-Analysis. Medicines (Basel), 7(7). doi.org/10.3390/medicines7070039

Quentin, C., Bagheri, R., Ugbolue, U. C., Coudeyre, E., Pelissier, C., Descatha, A., Menini, T., Bouillon-Minois, J. B., & Dutheil, F. (2021). Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health, 18(16). doi.org/10.3390/ijerph18168430

Yang, Y., McCluskey, S., Bydon, M., Singh, J. R., Sheeler, R. D., Nathani, K. R., Krieger, A. C., Mehta, N. D., Weaver, J., Jia, L., DeCelle, S., Schlagal, R. C., Ayar, J., Abduljawad, S., Stovitz, S. D., Ganesh, R., Verkuilen, J., Knapp, K. A., Yang, L., & Hartl, R. (2024). A Tai chi and qigong mind-body program for low back pain: A virtually delivered randomized control trial. N Am Spine Soc J, 20, 100557. doi.org/10.1016/j.xnsj.2024.100557

Zhu, F., Zhang, M., Wang, D., Hong, Q., Zeng, C., & Chen, W. (2020). Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLOS ONE, 15(9), e0238544. doi.org/10.1371/journal.pone.0238544

Disclaimer

Relief for Back Spasms: Understanding Muscle Relaxers

By

Dr. Alex Jimenez

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Chiropractic spinal adjustment on a patient lying on a therapy table, focusing on realigning the spine to relieve back pain and improve mobility

For individuals who injure their neck or back, the muscles may spasm or seize up, making it difficult to get through the day, exercises, physical activities, etc. Can skeletal muscle relaxers help relieve pain and reduce frequency?

Table of Contents

Back Spasms Muscle Relaxers

Back muscle spasms are common back pain that feels like a sudden tightness or contraction in the back muscles. They can range from minor twinges to severe pain.

Causes

Poor posture: Sitting or standing with bad posture can strain the back muscles.
Overuse: Picking something up, bending, or lifting can cause a spasm.
Dehydration: Not drinking enough water can cause electrolyte imbalances, leading to spasms.
Underlying conditions: A herniated disc or degenerative disc disease can cause back spasms.
Muscle imbalances: Weak muscles or muscles that are too tight can cause spasms.

Treatments

Home treatments: You can apply heat or ice, take over-the-counter pain medication, try gentle stretching, or massage the area.
Exercise: Improve your back’s strength and flexibility with exercise or physical therapy.
Hydration and nutrition: Drink enough water and eat foods rich in magnesium and calcium.
Chiropractic Adjustments: These can realign the spine to the correct position and muscles to relax.
Non-surgical Decompression: Decompression of the spine will allow more blood and nutrients to heal any painful areas.

Skeletal Muscle Relaxers

A healthcare provider may prescribe skeletal muscle relaxers. These medications are not available over the counter and must be prescribed by a healthcare provider.

Skeletal muscle relaxers will probably cause drowsiness.
Individuals should not drive, operate heavy machinery, or engage in other physical activities while taking back spasm muscle relaxers.
Skeletal muscle relaxers are not recommended for 65 or older because safer, effective alternatives exist.
Also, women who are pregnant or breastfeeding should not take these medications.
Discuss these issues with your healthcare provider.

Carisoprodol

Carisoprodol is available generically and as Soma and Vanadom brands. It works by suppressing nerve impulses located in the brain and spinal cord. Healthcare providers prescribe this medication in combination with physical therapy for the healing release of any muscle spasm and management of musculoskeletal injuries and/or pain. (Witenko C. et al., 2014) It’s not about having to continue taking the medication to feel better but more as a jump start to help with the physical therapy program.

Back muscle spasms are a perfect example of a condition that may benefit from carisoprodol in the short term.
Carisoprodol can be habit-forming.
Be sure to talk to a healthcare provider before suddenly going off this medication.
Carisoprodol can cause side effects that may impair thinking or reactions.
Avoid drinking alcohol as it may increase drowsiness and dizziness that are often caused by carisoprodol. (Zacny J. P., Paice J. A., & Coalson D. W. 2012)
Inform your healthcare provider of any drug allergies, kidney disease, or liver disease, or if you get seizures.

Cyclobenzaprine

Cyclobenzaprine is available as Amrix and in generic form. Like other muscle relaxers, cyclobenzaprine may cause dizziness or drowsiness. The sedation effects are how it works on painful, tension-filled muscles. Cyclobenzaprine is used together with physical therapy to treat skeletal muscle-related conditions and/or injuries, especially when pain or spasm is involved. When used in conjunction with physical therapy, it can help expedite recovery.

Cyclobenzaprine is chemically related to tricyclic antidepressants.
Although it is considered a derivative of the tricyclic antidepressant class, it does not pose the same risk to liver health.
According to the National Institutes of Health, reasons not to take this medication include having a thyroid disorder, heart block, congestive heart failure, a heart rhythm disorder, or having recently had a heart attack. (Witenko C. et al., 2014)

Metaxalone

Skelaxin is the brand name for metaxalone. As with the other muscle relaxers, metaxalone is used in combination with physical therapy and rest when muscles get too tight. (Witenko C. et al., 2014) It works by suppressing nerve impulses in the brain and spinal cord. In addition to older individuals and pregnant women, metaxalone is usually not prescribed for those with kidney disease, liver disease, seizures, or blood disorders.

Injury Medical Chiropractic and Functional Medicine Clinic

Back spasms: Muscle relaxers could help individuals, along with a personalized physical therapy treatment program. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Thoracic Spine Pain

References

Witenko, C., Moorman-Li, R., Motycka, C., Duane, K., Hincapie-Castillo, J., Leonard, P., & Valaer, C. (2014). Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. P & T: a peer-reviewed journal for formulary management, 39(6), 427–435.

Zacny, J. P., Paice, J. A., & Coalson, D. W. (2012). Subjective and psychomotor effects of carisoprodol in combination with oxycodone in healthy volunteers. Drug and alcohol dependence, 120(1-3), 229–232. doi.org/10.1016/j.drugalcdep.2011.07.006

Effective Natural Botanicals for Sleep Issues

By

Dr. Alex Jimenez

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Can many individuals with sleep issues incorporate natural botanicals to get a good night’s sleep and reduce stress?

Table of Contents

Why Sleep Is Important?

Often, many people are constantly on the move and trying to find ways to rest and relax; however, in today’s world, many individuals are still experiencing various sleep issues that are not fulfilling them to achieve the full 8 hours of restful sleep. How often have you experienced fatigue throughout the day due to staying up late working on a project? Do you doom scroll on your phone while lying in bed at night that you accidentally stayed up late? Or do chronic health issues keep you up at night, which makes sleep difficult? When it comes to understanding why sleep is important, many people do not realize that sleep plays a huge role in cognitive functioning, mental health, and creativity. (Charest & Grandner, 2020) When environmental factors start to impact the body over time, it can lead to the development of sleep disorders. Environmental factors like stress can affect the circadian rhythm, causing dysregulation and sleep disorders. (Agorastos & Olff, 2021) However, there is some good news: there are various natural ways to help relax the body, get the full recommended amount of sleep without medications, and even help many people stay asleep longer. We associate with certified medical providers who inform our patients of the benefits of getting the full recommended amounts of sleep to reduce the stress affecting the body. While asking important questions to our associated medical providers, we advise patients to integrate natural ways to reduce stress and sleep disorders to ensure proper sleeping habits. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Balancing Body & Metabolism- Video

Balancing Body and Metabolism | El Paso, Tx (2023)

Natural Botanicals & Remedies To Promote Sleep

When it comes to incorporating healthy sleeping habits, many individuals have found natural remedies to not only stay asleep but also reduce any stressors associated with environmental factors. Many people trying to make small changes in their sleeping habits can do some of the following:

Find the right mattress and pillows
Turning off electronics an hour before bedtime
Have the room be in a comfortable, cool temperature

Additionally, herbal botanicals can help relax the body and ensure proper sleep. Almost all natural botanicals are found in teas and supplements at the local grocery store. Below are some botanicals that can help many individuals get quality sleep.

Valerian

As a native to Europe and Asia, valerian is a perennial flowering plant with a unique and long history in traditional medicine, as it is used as a sedative and an anxiolytic. However, it has many sleep-promoting effects. (Yeom & Cho, 2024) The unique characteristic of valerian is that it interacts with the neurotransmitter GABA, as it is used to reduce sleep onset latency and increase sleep quality. (Bruni et al., 2021) The valerian plant can be utilized in a tea or a supplement as it is given to individuals for about 2 weeks at a time for its beneficial effects to start to work.

Ashwagandha

Known as winter cherry and located in India, ashwagandha has numerous health properties that can help many people with multiple ailments. The entire plant has been marketed in many forms and is common in pills and capsules as it possesses anti-inflammatory and antioxidant properties. (Cheah et al., 2021) Additionally, ashwagandha in small dosages can help improve cognitive function and immunity and reduce cortisol levels to help relax the body. (Park et al., 2023) Sleep can come easily to the individual when the body is relaxed after taking ashwagandha.

Chamomile

A common herb that can be used in teas, oils, or extracts, chamomile has been used as a sedative, mild analgesic, and sleep medication as it induces relaxation. (“Chamomile,” 2012) In tea form, this herb can become the most relaxing drink to sip at night and make a person sleepy. At the same time, when people drink chamomile, its soothing, beneficial properties can relieve and target the receptors in their central nervous system, causing them to be stressed and anxious, thus calming them down.

Lavender

As one of the most popular herbs everyone uses, from teas to aromatherapy, lavender is a multipurpose plant with many beneficial properties that can help anyone. Lavender has two main components, linalool, and linalyl, with sedative, antinociceptive, and anti-spasmolytic effects to stimulate the parasympathetic system. (Hamzeh et al., 2020) This, in turn, can help relax the body with its calming aroma and provide beneficial results for individuals dealing with insomnia. In its essential oil form, lavender can help increase the total amount of NREM (non-rapid eye movement) and reinforce a person’s sleep ability. (Ren et al., 2025) By making small changes and incorporating these natural botanicals to provide better sleep quality, many people will notice their bodies becoming more relaxed, their minds less anxious, and finally get that full 8 hours of sleep they deserve because sleep is for everyone, not the weak.

References

Agorastos, A., & Olff, M. (2021). Sleep, circadian system and traumatic stress. Eur J Psychotraumatol, 12(1), 1956746. doi.org/10.1080/20008198.2021.1956746

Bruni, O., Ferini-Strambi, L., Giacomoni, E., & Pellegrino, P. (2021). Herbal Remedies and Their Possible Effect on the GABAergic System and Sleep. Nutrients, 13(2). doi.org/10.3390/nu13020530

Chamomile. (2012). In LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. www.ncbi.nlm.nih.gov/pubmed/31643492

Charest, J., & Grandner, M. A. (2020). Sleep and Athletic Performance: Impacts on Physical Performance, Mental Performance, Injury Risk and Recovery, and Mental Health. Sleep Med Clin, 15(1), 41-57. doi.org/10.1016/j.jsmc.2019.11.005

Cheah, K. L., Norhayati, M. N., Husniati Yaacob, L., & Abdul Rahman, R. (2021). Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. PLOS ONE, 16(9), e0257843. doi.org/10.1371/journal.pone.0257843

Hamzeh, S., Safari-Faramani, R., & Khatony, A. (2020). Effects of Aromatherapy with Lavender and Peppermint Essential Oils on the Sleep Quality of Cancer Patients: A Randomized Controlled Trial. Evid Based Complement Alternat Med, 2020, 7480204. doi.org/10.1155/2020/7480204

Park, C. W., Hong, K. B., Suh, H. J., & Ahn, Y. (2023). Sleep-promoting activity of amylase-treated Ashwagandha (Withania somnifera L. Dunal) root extract via GABA receptors. J Food Drug Anal, 31(2), 278-288. doi.org/10.38212/2224-6614.3456

Ren, Y. L., Chu, W. W., Yang, X. W., Xin, L., Gao, J. X., Yan, G. Z., Wang, C., Chen, Y. N., Xie, J. F., Spruyt, K., Lin, J. S., Hou, Y. P., & Shao, Y. F. (2025). Lavender improves sleep through olfactory perception and GABAergic neurons of the central amygdala. J Ethnopharmacol, 337(Pt 3), 118942. doi.org/10.1016/j.jep.2024.118942

Yeom, J. W., & Cho, C. H. (2024). Herbal and Natural Supplements for Improving Sleep: A Literature Review. Psychiatry Investig, 21(8), 810-821. doi.org/10.30773/pi.2024.0121

Disclaimer

Exploring the Use of Acupuncture for Anxiety and Panic Disorders

By

Dr. Alex Jimenez

-

Acupunturist treating patient chronic back pain

Can acupuncture be an effective treatment for anxiety and panic disorders in addition to other treatments, like therapy and/or medication?

Table of Contents

Acupuncture For Anxiety and Panic Disorders

Considered one of the most popular types of alternative medicine, acupuncture has grown in popularity as a way to treat a variety of mental health conditions, including depression, post-traumatic stress disorder (PTSD), and other anxiety disorders. With the growth in popularity, more research has been focused on treatment for panic and anxiety symptoms. (Pilkington K. 2010)

Acupuncture can enhance personal wellness.
Acupuncture is generally safe and has few side effects.
It can help reduce physical and mental symptoms like tension, pain, and rapid heart rate.

Other alternative medicine practices include yoga, therapeutic massage, herbal medicines, and aromatherapy.

Traditional Chinese Medicine

Acupuncture is a healing technique originating from traditional Chinese medicine (TCM). The practice is based on the concept that medical conditions and mental health disorders are caused by an imbalance in the energy and circulation of the body’s vital life energy, known as chi or qi (National Institute for Complementary and Integrative Health, 2022). When the body and mind function properly, energy flows optimally through the channels/meridians at certain points throughout the body. Like tight or spasming muscles, energy or circulation becomes congested in different meridian pathways, leading to disease or disorders. The goal of acupuncture is to restore the health and balance of these channels.

How It Works

During acupuncture treatment sessions, small needles are placed along specific body areas, known as acupuncture points. These areas are thought to be where energy blockage occurs. The needles, which come in various thicknesses and lengths, stimulate and open blocked energy channels. Experts have conceptualized acupuncture from a neuroscience perspective, where nerves, muscles, and connective tissues are stimulated, and neurochemicals are released.

Acupuncture can help regulate the nervous system.
It can stimulate the body’s feel-good hormones and reduce stress hormones.
It can help deactivate the analytical brain, which is responsible for anxiety and worries.

Acupuncture is recognized by the National Institutes of Health (NIH) for treating pain management and other medical conditions. (National Institute for Complementary and Integrative Health, 2022)

Effectiveness

Clinical trials examining acupuncture for anxiety and panic disorders have shown some positive results. (Pilkington K. 2010) Acupuncturists and medical professionals are still not clear exactly why it may help with anxiety, but some research has noted that acupuncture appears to have a calming effect. More research studies are needed to prove the effectiveness of acupuncture for anxiety disorders. (Kim Y. K. 2019)

Getting Treated

What it can help with:

Agoraphobia
Generalized anxiety disorder (GAD)
Panic disorder
Phobias
Selective mutism
Separation anxiety disorder
Social anxiety disorder

If you are interested in treating your anxiety and panic symptoms through acupuncture, the first step is to consult your main healthcare provider. Professional acupuncture practitioners are on websites, including the National Certification Commission for Acupuncture and Oriental Medicine and the American Academy of Medical Acupuncture. The use of acupuncture continues to rise, making it more readily available. Since it has been evaluated for effectiveness and is available through many hospitals, some insurance policies may cover some acupuncture treatments.

Injury Medical Chiropractic and Functional Medicine Clinic

Acupuncture can help relieve symptoms of anxiety, stress, pain, discomfort, tightness, and poor circulation. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Discovering The Benefits of Chiropractic Care

References

Pilkington K. (2010). Anxiety, depression, and acupuncture: A review of the clinical research. Autonomic neuroscience : basic & clinical, 157(1-2), 91–95. doi.org/10.1016/j.autneu.2010.04.002

National Institute for Complementary and Integrative Health. (2022). Acupuncture: Effectiveness and Safety. Retrieved from www.nccih.nih.gov/health/acupuncture-effectiveness-and-safety

Kim Y. K. (2019). Panic Disorder: Current Research and Management Approaches. Psychiatry investigation, 16(1), 1–3. doi.org/10.30773/pi.2019.01.08