Managing Back Spasms: Effective Strategies and Techniques

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

Female manual therapist rubbing shoulders of patient lying on belly — Female osteopath in white uniform massaging shoulders of woman lying on belly with hands behind head during physiotherapy treatment

“Learning the cause of the problem and how to manage it effectively can help individuals experiencing back spasms quickly and safely return to previous levels of function and activity.”

Table of Contents

Back Spasm

Individuals dealing with back pain or sciatica usually describe the symptoms as the back muscles tightening or spasming. A back spasm can feel mild, like a fist pressing into one side of the spine or an intense pain that prevents the individual from sitting, standing, or walking comfortably. Bask spasms can become severe, causing difficulty maintaining normal upright posture.

What Is A Spasm

A back spasm is a sudden onset of back muscle tightness. Sometimes, the tight sensation becomes so intense and severe that it prevents the individual from moving normally. Some individuals have difficulty bending forward because of the pain and tightness.

Symptoms

Most episodes last several hours to several days. Severe cases can last about six to eight weeks, but the spasms and pain subside gradually, allowing the individual to move normally and resume normal activity. Common sensations and symptoms can include:

Difficulty bending.
A tight sensation in the back.
Pulsing pains and sensations.
Pain on one or both sides of the back.

Sometimes, the spasm can cause radiating pain in the buttocks and hips. When severe, it can be accompanied by nerve pain, numbness, and tingling that radiates down one or both legs. (Medline Plus. 2022)

Causes

Back spasms are caused by tight muscle tissue, which often results from some mechanical stress. The stress causes the muscle tissue near the spine to be pulled abnormally. As a result of the pulling, the muscle fibers become taut and painful. Mechanical causes of back spasms may include: (Merck Manual, 2022)

Poor sitting and/or standing posture.
Repetitive overuse injury.
Lumbar strains.
Lumbar disc herniations.
Low back osteoarthritis.
Spondylolisthesis – vertebrae shift out of position, including anterolisthesis and retrolisthesis.
Spinal stenosis

All these can place increased stress on the anatomical structures in the spine. The lower back muscles near these structures may go into a protective spasm that can also cause a tight and painful sensation in the back. Other non-mechanical causes of low back spasms include: (Merck Manual, 2022)

Stress and anxiety
Lack of physical activity and exercise
Fibromyalgia

Risk Factors

Risk factors for back spasms include: (National Institute of Neurological Disorders and Stroke, 2023)

Age
Job-related factors – constant lifting, pushing, pulling, and/or twisting.
Poor sitting posture or sitting for long periods without back support.
Lack of physical conditioning.
Being overweight or obese.
Psychological conditions – anxiety, depression, and emotional stress.
Family medical history of ankylosing spondylitis.
Smoking

Individuals can stop smoking, start exercising, or engage in positive activities to help manage stress. Individuals dealing with back spasms may need to see a healthcare provider for a proper diagnosis and treatment.

Treatment

Treatment for back spasms can include home remedies or therapies from medical providers. The treatments are designed to relieve the spasms and manage the mechanical stresses that may have caused them. Medical professionals can also show strategies to prevent spasms. Home remedies can include: (Merck Manual, 2022)

Application of heat or ice
Low back massage
Postural adjustments
Gentle stretching
Analgesic medication
Anti-inflammatory medication (Anuj Bhatia et al., 2020)

If self-care strategies are unable to provide relief, individuals may need to visit a medical professional for treatment. Medical treatments can include: (Merck Manual, 2022)

Physical therapy
Chiropractic care
Acupuncture
Non-surgical decompression
Transcutaneous electrical neuromuscular stimulation
Steroid injections
Lumbar surgery is a last resort treatment.

Most individuals are able to manage symptoms with physical therapy or chiropractic, which includes learning exercises and posture adjustments to relieve tightness.

Prevention

Simple lifestyle adjustments can have a significant effect on back spasms. Ways to prevent back spasms can include: (Medline Plus. 2022) (Merck Manual, 2022)

Maintaining hydration throughout the day.
Modifying movements and bending and lifting techniques.
Practicing postural correction techniques.
Performing daily stretching and strengthening exercises.
Engaging in cardiovascular exercise.
Performing meditation or other stress management techniques.

Personal Injury Rehabilitation

References

Medline Plus. (2022). Low back pain—acute. Retrieved from https://medlineplus.gov/ency/article/007425.htm

Merck Manual. (2022). Low back pain. Merck Manual Consumer Version. https://www.merckmanuals.com/home/bone,-joint,-and-muscle-disorders/low-back-and-neck-pain/low-back-pain

National Institute of Neurological Disorders and Stroke. (2023). Back pain. Retrieved from https://www.ninds.nih.gov/health-information/disorders/back-pain?

Bhatia, A., Engle, A., & Cohen, S. P. (2020). Current and future pharmacological agents for the treatment of back pain. Expert opinion on pharmacotherapy, 21(8), 857–861. https://doi.org/10.1080/14656566.2020.1735353

Exploring the Role of Spinal Decompression in Treating Lumbar Spinal Stenosis

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

Can individuals with lumbar spinal stenosis utilize spinal decompression to reduce low back pain and restore mobility?

Table of Contents

Introduction

Many individuals worldwide have dealt with low back pain at some point in their lives that has affected their mobility and impacted their routine. Numerous environmental factors can lead to low back pain development, like improper heavy lifting, poor posture, traumatic injuries, and accidents that can affect the surrounding muscles, spinal cord, and nerve roots. When this happens, it can lead to lumbar spinal stenosis and cause overlapping risk profiles that are correlated with low back pain. When people are dealing with lumbar spinal stenosis, they could be thinking that their pain is in the lower extremities. To that point, many individuals seek treatment to not only reduce low back pain but also reduce the effects of lumbar spinal stenosis. Some treatments, like spinal decompression, which is a non-surgical treatment, can help restore mobility to the body. Today’s article looks at how lumbar spinal stenosis affects the lower back and its diagnosis while looking at how spinal decompression can provide relief to the individual and have positive benefits in restoring mobility. We talk with certified medical providers who consolidate our patients’ information to assess how lumbar spinal stenosis correlates with lower back pain, causing mobility issues. We also inform and guide patients on how spinal decompression is an excellent form of treatment that can be combined with other therapies. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating decompression therapy to relieve the pain effects caused by lumbar stenosis while reducing the overlapping pain effects like lower back pain to regain a person’s mobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

How Lumbar Spinal Stenosis Affects the Lower Back

Do you feel tingling sensations in the back of your legs affecting your ability to move around? Or does your lower back feel less mobile than it is used to? When many individuals are experiencing low back pain during their lifetime, it can often correlate with lumbar spinal stenosis. Lumbar spinal stenosis usually occurs when the spinal canal in the lower back becomes constricted, leading to degenerative changes. When the spinal canal starts to narrow in the spine, it can cause significant discomfort, interfere with daily activities, and may result in progressive disability for many individuals. (Munakomi et al., 2024) The symptoms caused by lumbar spinal stenosis range from mild to severe, and on which environmental factors correspond to the issue. At the same time, lumbar spinal stenosis is characterized by symptoms like low back pain that can cause spondylotic changes that induce low back pain that can negatively impact a person’s quality of life. (Ogon et al., 2022) This causes many people to go to their primary doctors to get a diagnosis and learn how to manage the pain associated with lumbar spinal stenosis.

The Diagnosis Of Lumbar Spinal Stenosis

When it comes to diagnosing lumbar spinal stenosis, many healthcare providers will incorporate a comprehensive evaluation, which includes a physical examination to see how mobile a person’s back is and imaging testing like MRIs and CT scans to visualize the spinal canal and assess the extent of the narrowing that is causing pain in the lower extremities. This is because when individuals deal with lumbar spinal stenosis, it can manifest with neurogenic claudication in the lower extremities, especially when a person is standing or sitting. The pain is decreased when their position is changed. (Sobanski et al., 2023) Additionally, lumbar spinal stenosis is one of the most commonly diagnosed spinal disorders that many healthcare professionals assess and evaluate. When there is a narrowing in the spinal canal, leading to the development of lumbar spinal, simple motions like walking can exacerbate the symptoms to the lower extremities and increase the oxygen in the spinal nerves, which may exceed the available blood flow to the extremities. (Deer et al., 2019) To that point, treatments like spinal decompression can help reduce lower back pain associated with lumbar spinal stenosis.

The Non-Surgical Approach To Wellness- Video

The Non-Surgical Approach to Wellness with Chiropractic Care | El Paso, Tx (2024)

A Path To Relief Using Spinal Decompression

When it comes to individuals experiencing the pain caused by lumbar spinal stenosis, many individuals can seek out non-surgical treatments like spinal decompression to relieve lower back pain. Spinal decompression has emerged as a non-invasive, effective treatment option for lumbar spinal stenosis. It utilizes gentle mechanical traction on the spine to be stretched, relieving the spinal nerves by creating more space within the spinal canal. Spinal decompression decreases the degenerative process while the surrounding muscles are gently stretched, and the spinal disc height increases due to negative pressure. (Kang et al., 2016)

The Benefits Of Spinal Decompression & Restoring Mobility

Additionally, the gentle traction from spinal decompression helps enhance the production flow of nutrients and oxygen back to the affected spinal discs and spine to foster a better healing environment for the body. Since spinal decompression can be combined with other non-surgical treatments, like physical therapy and spinal manipulation, it can provide long-lasting positive effects for individuals with lumbar spinal stenosis. (Ammendolia et al., 2022) Some of the beneficial results of spinal decompression include:

Pain relief by alleviating pressure off the spinal nerves to reduce pain and discomfort in the lower extremities significantly.
Improved mobility allows the individual to return to their daily activities with ease.

Many people can benefit from spinal decompression to reduce the effects of lumbar spinal stenosis and have their lower extremity mobility restored after consecutive sessions to reduce the chances of the pain from coming back. By thinking more about their health and wellness, many people can make small routine changes in their activities to mitigate the pain and remain mobile throughout their lives. This allows them to have a sense of hope to relieve them from the pain they have been under.

References

Ammendolia, C., Hofkirchner, C., Plener, J., Bussieres, A., Schneider, M. J., Young, J. J., Furlan, A. D., Stuber, K., Ahmed, A., Cancelliere, C., Adeboyejo, A., & Ornelas, J. (2022). Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review. BMJ Open, 12(1), e057724. https://doi.org/10.1136/bmjopen-2021-057724

Deer, T., Sayed, D., Michels, J., Josephson, Y., Li, S., & Calodney, A. K. (2019). A Review of Lumbar Spinal Stenosis with Intermittent Neurogenic Claudication: Disease and Diagnosis. Pain Med, 20(Suppl 2), S32-S44. https://doi.org/10.1093/pm/pnz161

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

Munakomi, S., Foris, L. A., & Varacallo, M. (2024). Spinal Stenosis and Neurogenic Claudication. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/28613622

Ogon, I., Teramoto, A., Takashima, H., Terashima, Y., Yoshimoto, M., Emori, M., Iba, K., Takebayashi, T., & Yamashita, T. (2022). Factors associated with low back pain in patients with lumbar spinal stenosis: a cross-sectional study. BMC Musculoskelet Disord, 23(1), 552. https://doi.org/10.1186/s12891-022-05483-7

Sobanski, D., Staszkiewicz, R., Stachura, M., Gadzielinski, M., & Grabarek, B. O. (2023). Presentation, Diagnosis, and Management of Lower Back Pain Associated with Spinal Stenosis: A Narrative Review. Med Sci Monit, 29, e939237. https://doi.org/10.12659/MSM.939237

Disclaimer

Relieving Leg Pain: Exploring Neurogenic Claudication

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

Physiotherapist working at woman's legs for wellness and disability support.

“Individuals experiencing shooting, aching pain in the lower extremities, and intermittent leg pain could be suffering from neurogenic claudication. Can knowing the symptoms help healthcare providers develop an effective treatment plan?”

Table of Contents

Neurogenic Claudication

Neurogenic claudication occurs when spinal nerves become compressed in the lumbar or lower spine, causing intermittent leg pain. Compressed nerves in the lumbar spine can cause leg pain and cramps. The pain usually worsens with specific movements or activities like sitting, standing, or bending backward. It is also known as pseudo-claudication when the space within the lumbar spine narrows. A condition known as lumbar spinal stenosis. However, neurogenic claudication is a syndrome or group of symptoms caused by a pinched spinal nerve, while spinal stenosis describes the narrowing of the spinal passages.

Symptoms

Neurogenic claudication symptoms can include:

Leg cramping.
Numbness, tingling, or burning sensations.
Leg fatigue and weakness.
A sensation of heaviness in the leg/s.
Sharp, shooting, or aching pain extending into the lower extremities, often in both legs.
There may also be pain in the lower back or buttocks.

Neurogenic claudication is different from other types of leg pain, as the pain alternates – ceasing and beginning randomly and worsens with specific movements or activities. Standing, walking, descending stairs, or flexing backward can trigger pain, while sitting, climbing stairs, or leaning forward tends to relieve pain. However, every case is different. Over time, neurogenic claudication can affect mobility as individuals try to avoid activities that cause pain, including exercise, lifting objects, and prolonged walking. In severe cases, neurogenic claudication can make sleeping difficult.

Neurogenic claudication and sciatica are not the same. Neurogenic claudication involves nerve compression in the central canal of the lumbar spine, causing pain in both legs. Sciatica involves compression of nerve roots exiting from the sides of the lumbar spine, causing pain in one leg. (Carlo Ammendolia, 2014)

Causes

With neurogenic claudication, compressed spinal nerves are the underlying cause of the leg pain. In many cases, lumber spinal stenosis – LSS is the cause of pinched nerve. There are two types of lumbar spinal stenosis.

Central stenosis is the main cause of neurogenic claudication. With this type, the central canal of the lumbar spine, which houses the spinal cord, narrows, causing pain in both legs.
Lumbar spinal stenosis can be acquired and develop later in life due to spine deterioration.
Congenital means the individual is born with the condition.
Both can lead to neurogenic claudication in different ways.
Foramen stenosis is another type of lumbar spinal stenosis that causes the narrowing of spaces on either side of the lumbar spine where nerve roots branch off the spinal cord. The associated pain is different in that it is either in the right or left leg.
The pain corresponds to the side of the spinal cord where the nerves are being pinched.

Acquired Lumbar Spinal Stenosis

Lumbar spinal stenosis is usually acquired due to the degeneration of the lumbar spine and tends to affect older adults. The causes of the narrowing can include:

Spinal trauma, such as from a vehicle collision, work, or sports injury.
Disc herniation.
Spinal osteoporosis – wear-and-tear arthritis.
Ankylosing spondylitis – a type of inflammatory arthritis that affects the spine.
Osteophytes – bone spurs.
Spinal tumors – non-cancerous and cancerous tumors.

Congenital Lumbar Spinal Stenosis

Congenital lumbar spinal stenosis means an individual is born with abnormalities of the spine that may not be apparent at birth. Because the space within the spinal canal is already narrow, the spinal cord is vulnerable to any changes as the individual ages. Even individuals with mild arthritis can experience symptoms of neurogenic claudication early on and develop symptoms in their 30s and 40s instead of their 60s and 70s.

Diagnosis

Diagnosis of neurogenic claudication is largely based on the individual’s medical history, physical examination, and imaging. The physical examination and review identify where the pain is presenting and when. The healthcare provider may ask:

Is there a history of lower back pain?
Is the pain in one leg or both?
Is the pain constant?
Does the pain come and go?
Does the pain get better or worse when standing or sitting?
Do movements or activities cause pain symptoms and sensations?
Are there any usual sensations while walking?

Treatment

Treatments can consist of physical therapy, spinal steroid injections, and pain meds. Surgery is a last resort when all other therapies are unable to provide effective relief.

Physical Therapy

A treatment plan will involve physical therapy that includes:

Daily stretching
Strengthening
Aerobic exercises
This will help improve and stabilize the lower back muscles and correct posture problems.
Occupational therapy will recommend activity modifications that cause pain symptoms.
This includes proper body mechanics, energy conservation, and recognizing pain signals.
Back braces or belts may also be recommended.

Spinal Steroid Injections

Healthcare providers may recommend epidural steroid injections.

This delivers a cortisone steroid to the outermost section of the spinal column or the epidural space.
Injections can provide pain relief for three months to three years. (Sunil Munakomi et al., 2024)

Pain Meds

Pain medications are used to treat intermittent neurogenic claudication. These include:

Over-the-counter analgesics like acetaminophen.
Nonsteroidal anti-inflammatory drugs or NSAIDs like ibuprofen or naproxen.
Prescription NSAIDs may be prescribed if needed.
NSAIDs are used with chronic neurogenic pain and should only be used when required.
The long-term use of NSAIDs can increase the risk of stomach ulcers, and the overuse of acetaminophen can lead to liver toxicity and liver failure.

Surgery

If conservative treatments are unable to provide effective relief and mobility and/or quality of life are affected, surgery known as a laminectomy may be recommended to decompress the lumbar spine. The procedure may be performed:

Laparoscopically – with small incisions, scopes, and surgical instrumentation.
Open surgery – with a scalpel and sutures.
During the procedure, facets of the vertebra are partially or completely removed.
To provide stability, the bones are sometimes fused with screws, plates, or rods.
Success rates for both are more or less the same.
Between 85% and 90% of individuals undergoing the surgery achieve long-lasting and/or permanent pain relief. (Xin-Long Ma et al., 2017)

Movement Medicine: Chiropractic Care

References

Ammendolia C. (2014). Degenerative lumbar spinal stenosis and its imposters: three case studies. The Journal of the Canadian Chiropractic Association, 58(3), 312–319.

Munakomi S, Foris LA, Varacallo M. (2024). Spinal Stenosis and Neurogenic Claudication. [Updated 2023 Aug 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430872/

Ma, X. L., Zhao, X. W., Ma, J. X., Li, F., Wang, Y., & Lu, B. (2017). Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials. International journal of surgery (London, England), 44, 329–338. https://doi.org/10.1016/j.ijsu.2017.07.032

How Kinesiology Tape Can Help Alleviate Sacroiliac Joint Pain

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

back view of woman on appointment with doctor who putting kinesio tapes on her body, healthcare

For individuals experiencing sacroiliac joint/SIJ dysfunction and pain, could applying kinesiology tape help bring relief and manage symptoms?

Table of Contents

Kinesiology Tape For Sacroiliac Joint Pain

A lower back ailment that is common during pregnancy. The pain is usually on one or both sides of the back, just above the buttocks, that comes and goes and can limit the ability to bend, sit, and perform various physical activities. (Moayad Al-Subahi et al., 2017) The therapeutic tape provides support while allowing for movement and may help treat and manage sacroiliac joint/SIJ pain by:

Decreasing muscle spasms.
Facilitating muscular function.
Increasing blood circulation to and around the pain site.
Decreasing muscle trigger points.

Mechanism

Some studies have found that taping the SI joint has benefits that include:

Improved joint function
Increased lumbar flexibility
Reduced pain and disability. (Do-Yun Shin and Ju-Young Heo. 2017)

One theory is it helps lift and hold the overlying tissues off of the SI joint, which helps decrease the pressure around it.
Another theory is that lifting the tissues helps create a pressure differential under the tape, like non-surgical decompression, allowing increased circulation to the tissues surrounding the sacroiliac joint.
This floods the area with blood and nutrients, creating an optimal healing environment.

Application

A sacroiliac joint on the right and left sides connects the pelvis to the sacrum or the lowest part of the spine. To apply the kinesiology tape correctly, locate the lowest part of the back within the pelvic area. (Francisco Selva et al., 2019) Ask a friend or family member for help if you can’t reach the area.

Taping steps:

Cut three strips of tape, each 4 to 6 inches long.
Sit in a chair and bend the body slightly forward.
If someone is helping, you can stand and slightly bend forward.
Remove the lift-off strip in the middle and stretch the tape to expose several inches, leaving the ends covered.
Apply the exposed tape at an angle over the SI joint, like making the first line of an X, just above the buttocks, with full stretch on the tape.
Peel the lift-off strips from the ends and adhere them with no stretching.
Repeat the application steps with a second strip, adhering at a 45-degree angle to the first strip, making the X over the sacroiliac joint.
Repeat this with the final strip horizontally across the X made from the first two pieces.
There should be a tape pattern of star shape over the sacroiliac joint.

Kinesiology tape can stay over the sacroiliac joint for three to five days.
Watch for signs of irritation around the tape.
Remove the tape if the skin becomes irritated, and consult your primary healthcare provider, physical therapist, or chiropractor for other treatment options.
Some individuals with specific conditions should avoid using the tape and get confirmation that it’s safe.
Individuals with severe sacroiliac pain where self-management is not working should see a healthcare provider, physical therapist, and or chiropractor for an evaluation and to learn therapeutic exercises and treatments to help manage the condition.

Sciatica During Pregnancy

References

Al-Subahi, M., Alayat, M., Alshehri, M. A., Helal, O., Alhasan, H., Alalawi, A., Takrouni, A., & Alfaqeh, A. (2017). The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. Journal of physical therapy science, 29(9), 1689–1694. https://doi.org/10.1589/jpts.29.1689

Do-Yun Shin and Ju-Young Heo. (2017). The Effects of Kinesiotaping Applied onto Erector Spinae and Sacroiliac Joint on Lumbar Flexibility. The Journal of Korean Physical Therapy, 307-315. https://doi.org/https://doi.org/10.18857/jkpt.2017.29.6.307

Selva, F., Pardo, A., Aguado, X., Montava, I., Gil-Santos, L., & Barrios, C. (2019). A study of reproducibility of kinesiology tape applications: review, reliability and validity. BMC musculoskeletal disorders, 20(1), 153. https://doi.org/10.1186/s12891-019-2533-0

Is Mayonnaise Healthy? Exploring the Nutritional Benefits

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

Chef making sandwich with fresh ingredient.Delicious nutrition

“For individuals who want to eat healthier, can selection and moderation make mayonnaise a delicious and nutritious addition to a low-carbohydrate diet?”

Table of Contents

Mayonnaise Nutrition

Mayonnaise is used in various recipes, including sandwiches, tuna salad, deviled eggs, and tartar sauce. It is often considered unhealthy, as it is mostly fat and, as a result, calorie-dense. Calories and fat can quickly add up when not paying attention to portion sizes.

What Is It?

It is a blend of different ingredients.
It combines oil, egg yolk, an acidic liquid (lemon juice or vinegar), and mustard.
The ingredients become a thick, creamy, permanent emulsion when blended slowly.
The key is in the emulsion, combining two liquids that would otherwise not naturally come together, which turns the liquid oil into a solid.

The Science

Emulsification happens when an emulsifier – the egg yolk – binds the water-loving/hydrophilic and oil-loving/lipophilic components.
The emulsifier binds the lemon juice or vinegar with the oil and does not allow separation, producing a stable emulsion. (Viktoria Olsson et al., 2018)
In homemade mayonnaise, the emulsifiers are mainly the lecithin from the egg yolk and a similar ingredient in mustard.
Commercial mayonnaise brands often use other types of emulsifiers and stabilizers.

Health

It contains health-promoting properties, such as vitamin E, which improves heart health, and vitamin K, which is important for blood clotting. (USDA, FoodData Central, 2018)
It can also be made with healthy fats like omega-3 fatty acids, which maintain brain, heart, and skin health.
It is mostly an oil and high-fat calorie-dense condiment. (H R Mozafari et al., 2017)
However, it is mostly unsaturated fat, which is a healthier fat.
To maintain nutrition goals in mind when selecting mayonnaise.
For individuals on a low-fat or low-calorie diet, portion control is important.

Oil

Almost any edible oil can be used to make mayonnaise, making the oil the biggest factor in the recipe’s healthfulness.
Most commercial brands are made with soy oil, which some nutrition experts believe can be problematic because of the high levels of omega-6 fats.
Canola oil has a lower omega-6 content than soy oil.
Individuals who make the mayonnaise can use any oil, including olive or avocado oil.

Bacteria

The concern about bacteria comes from the fact that homemade mayonnaise is usually made with raw egg yolks.
Commercial mayonnaise is made with pasteurized eggs and is produced in a way that keeps it safe.
The acids, vinegar, or lemon juice can help keep some bacteria from contaminating the mayonnaise.
However, a study found that homemade mayonnaise may still contain salmonella bacteria despite the acidic compounds. (Junli Zhu et al., 2012)
Because of this, some prefer to pasteurize an egg in 140°F water for 3 minutes before making the mayonnaise.
Regardless of the type of mayonnaise, food safety guidelines should always be followed (United States Department of Agriculture, 2024).
Mayonnaise-based dishes should not be left outside refrigeration for more than two hours.
Opened commercial mayonnaise should be stored in the refrigerator after opening and discarded after two months.

Reduced-Fat Mayonnaise

Many nutritionists recommend reduced-fat mayonnaise for individuals on a low-calorie, low-fat, or exchange diet. (Institute of Medicine (US) Committee on Dietary Guidelines Implementation, 1991)
While reduced-fat mayonnaise has fewer calories and less fat than regular mayonnaise, the fat is often replaced with starches or sugar to improve texture and flavor.
For individuals watching carbohydrates or sugar in their diet, check the nutrition label and ingredients before deciding on the right mayonnaise.

Body In Balance: Chiropractic, Fitness, and Nutrition

References

Olsson, V., Håkansson, A., Purhagen, J., & Wendin, K. (2018). The Effect of Emulsion Intensity on Selected Sensory and Instrumental Texture Properties of Full-Fat Mayonnaise. Foods (Basel, Switzerland), 7(1), 9. https://doi.org/10.3390/foods7010009

USDA, FoodData Central. (2018). Mayonnaise dressing, no cholesterol. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/167736/nutrients

Mozafari, H. R., Hosseini, E., Hojjatoleslamy, M., Mohebbi, G. H., & Jannati, N. (2017). Optimization low-fat and low cholesterol mayonnaise production by central composite design. Journal of food science and technology, 54(3), 591–600. https://doi.org/10.1007/s13197-016-2436-0

Zhu, J., Li, J., & Chen, J. (2012). Survival of Salmonella in home-style mayonnaise and acid solutions as affected by acidulant type and preservatives. Journal of food protection, 75(3), 465–471. https://doi.org/10.4315/0362-028X.JFP-11-373

United States Department of Agriculture. Food Safety and Inspection Service. (2024). Keep Food Safe! Food Safety Basics. Retrieved from https://www.fsis.usda.gov/food-safety/safe-food-handling-and-preparation/food-safety-basics/steps-keep-food-safe

Institute of Medicine (U.S.). Committee on Dietary Guidelines Implementation., Thomas, P. R., Henry J. Kaiser Family Foundation., & National Cancer Institute (U.S.). (1991). Improving America’s diet and health : from recommendations to action : a report of the Committee on Dietary Guidelines Implementation, Food and Nutrition Board, Institute of Medicine. National Academy Press. http://books.nap.edu/books/0309041392/html/index.html
https://www.ncbi.nlm.nih.gov/books/NBK235261/

The Role of Acupuncture in Alleviating Chronic Fatigue Symptoms

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

Young woman doctor has a conversation with a patient

“For individuals dealing with chronic fatigue syndrome, can incorporating acupuncture with other treatment protocols help regain functionality and improve quality of life?”

The Role of Acupuncture in Alleviating Chronic Fatigue Symptoms

Table of Contents

Acupuncture For Chronic Fatigue Syndrome

Research is looking at how acupuncture can help manage symptoms of chronic fatigue. These studies focused on specific acupoints and techniques and how they affected certain symptoms or abnormalities linked to the condition. The researchers found that acupuncture may help manage and alleviate some symptoms (Qing Zhang et al., 2019). However, they were still unable to determine the mechanisms of how acupuncture exactly works.

Symptom Relief

Various studies showed that acupuncture could improve physical and mental fatigue symptoms, including:

Quality of life (Jessica Frisk et al., 2012)
Mental health
Physiological function (Dan-Xia Gao, Xing-Hua Bai, 2019)

There Were Also Improvements In

Pain sensation/s
GERC (gastroesophageal reflux) symptoms and living quality (Dan-Xia Gao, Xing-Hua Bai, 2019)

Other studies Found How Acupuncture Helped In

Pain reduction
Increased energy
Insomnia improvements (Sibel Mandıroğlu, Cigdem Ozdilekcan, 2017)
Relieving gut issues like diarrhea (Lingping Zhu et al., 2018)

Treatments Vary by Study

One case study showed improvements in groups of athletes who were put through a series of exhaustive physical exercises and short-term rest. One group of athletes was treated with acupuncture on selected acupoints while the others were given an extended rest. Analysis was applied to the metabolic profiles of urine samples collected from the athletes at three points: before the exercises, before and after the acupuncture treatment, or taking extended rest. The results indicated that the recoveries of disturbed metabolites in the athletes treated with acupuncture were significantly faster than in those who only took extended rest. (Haifeng Ma et al., 2015)
Researchers said studies involving acupuncture alone or in combination with other treatments appear to show that it is effective at lessening fatigue. (Yu-Yi Wang et al., 2014) However, further studies are needed to confirm the benefits. This is a significant change from a review that found limited evidence for the effectiveness of alternative treatments for relieving chronic fatigue symptoms. (Terje Alraek et al., 2011)
Another review of alternative therapies found acupuncture and certain meditation techniques showed the most promise for future investigation. (Nicole S. Porter et al., 2010)
Another study compared prednisone, a steroid, with an acupuncture technique called coiling dragon and an additional treatment called cupping. It suggested that acupuncture and cupping treatments surpassed the steroid regarding fatigue. (Wei Xu et al., 2012)
Another study found that needling with heat application or moxibustion produced better results than standard acupuncture regarding physical and mental fatigue scores. (Chen Lu, Xiu-Juan Yang, Jie Hu 2014)

From Consultation to Transformation: Assessing Patients In A Chiropractic Setting

References

Zhang, Q., Gong, J., Dong, H., Xu, S., Wang, W., & Huang, G. (2019). Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 37(4), 211–222. https://doi.org/10.1136/acupmed-2017-011582

Frisk, J., Källström, A. C., Wall, N., Fredrikson, M., & Hammar, M. (2012). Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 20(4), 715–724. https://doi.org/10.1007/s00520-011-1134-8

Gao, D. X., & Bai, X. H. (2019). Zhen ci yan jiu = Acupuncture research, 44(2), 140–143. https://doi.org/10.13702/j.1000-0607.170761

Mandıroğlu, S., & Ozdilekcan, C. (2017). Impact of Acupuncture on Chronic Insomnia: A Report of Two Cases with Polysomnographic Evaluation. Journal of acupuncture and meridian studies, 10(2), 135–138. https://doi.org/10.1016/j.jams.2016.09.018

Zhu, L., Ma, Y., Ye, S., & Shu, Z. (2018). Acupuncture for Diarrhoea-Predominant Irritable Bowel Syndrome: A Network Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2018, 2890465. https://doi.org/10.1155/2018/2890465

Ma, H., Liu, X., Wu, Y., & Zhang, N. (2015). The Intervention Effects of Acupuncture on Fatigue Induced by Exhaustive Physical Exercises: A Metabolomics Investigation. Evidence-based complementary and alternative medicine : eCAM, 2015, 508302. https://doi.org/10.1155/2015/508302

Wang, Y. Y., Li, X. X., Liu, J. P., Luo, H., Ma, L. X., & Alraek, T. (2014). Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials. Complementary therapies in medicine, 22(4), 826–833. https://doi.org/10.1016/j.ctim.2014.06.004

Alraek, T., Lee, M. S., Choi, T. Y., Cao, H., & Liu, J. (2011). Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC complementary and alternative medicine, 11, 87. https://doi.org/10.1186/1472-6882-11-87

Porter, N. S., Jason, L. A., Boulton, A., Bothne, N., & Coleman, B. (2010). Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia. Journal of alternative and complementary medicine (New York, N.Y.), 16(3), 235–249. https://doi.org/10.1089/acm.2008.0376

Lu, C., Yang, X. J., & Hu, J. (2014). Zhen ci yan jiu = Acupuncture research, 39(4), 313–317.

The Role of IASTM in Rehabilitating Musculoskeletal Injuries

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

Woman visiting IASTM procedure in osteopath office close-up — Woman visiting IASTM procedure in osteopath office, during instrumental mobilization procedures tone of soft tissues is regulated directly by the nervous system

“Can physical therapy with instrument-assisted soft tissue mobilization or IASTM improve mobility, flexibility, and health for individuals with musculoskeletal injuries or illnesses?”

Table of Contents

Instrument Assisted Soft Tissue Mobilization

Instrument-assisted soft tissue mobilization or IASTM is also known as the Graston technique. It is a myofascial release and massage technique used in physical therapy where the therapist uses metal or plastic tools to improve soft tissue mobility in the body. The ergonomically shaped tool is gently or vigorously scraped and rubbed across the injured or painful area. The rubbing is used to locate and release tightness in the fascia/collagen covering the muscles and the tendons. This helps reduce pain and improve movement.

Massage and Myofascial Release

Instrument-assisted soft tissue mobilization rehabilitation helps:

Improve soft tissue mobility.
Release of restrictions in tight fascia.
Decrease muscle spasms.
Improve flexibility.
Increased circulation to the tissues.
Relieve pain. (Fahimeh Kamali et al., 2014)

Individuals often develop tissue tightness or restrictions in the muscles and fascia after an injury. These soft tissue restrictions can limit the range of motion – ROM and can trigger pain symptoms. (Kim J, Sung DJ, Lee J. 2017)

History

The Graston technique of instrument-assisted soft tissue mobilization was developed by an athlete who created their instruments to treat soft tissue injuries. The practice has grown with input from medical experts, trainers, researchers, and clinicians.

Physical therapists use different types of tools to perform IASTM.
These massage instruments comprise various types for specific massage and release.
The Graston company designs some of the tools.
Other companies have their version of metal or plastic scraping and rubbing tools.
The objective is to help release soft tissue and myofascial restrictions to improve body movement. (Kim J, Sung DJ, Lee J. 2017)

How It Works

The theory is that scraping the tissues causes microtrauma to the affected area, activating the body’s natural inflammatory response. (Kim J, Sung DJ, Lee J. 2017)
The body activates to reabsorb the tightened or scar tissue, causing the restriction.
The therapist can then stretch the adhesions to alleviate pain and improve mobility.

Treatment

Certain conditions respond well to instrument-assisted soft tissue mobilization, including (Kim J, Sung DJ, Lee J. 2017)

Limited mobility
Decreased muscle recruitment
Loss of range of motion – ROM
Pain with movement
Excessive scar tissue formation

Augmented soft tissue mobilization or ASTM techniques can treat certain injuries and medical conditions that include:

Musculoskeletal imbalance/s
Ligament sprains
Plantar fasciitis
Myofascial pain
Tendonitis and tendinopathy
Scar tissue from surgery or trauma (Morad Chughtai et al., 2019)

Benefits and Side Effects

Benefits include: (Kim J, Sung DJ, Lee J. 2017)

Improved range of motion
Increased tissue flexibility
Improved cell activity at the site of injury
Reduced pain
Reduced scar tissue formation

Side effects may include:

Redness of the skin at the treatment site
Bruising(Kim J, Sung DJ, Lee J. 2017)
Worsening of the pain

Research

A review compared hands-on myofascial release to instrument myofascial release for chronic low back pain. (Williams M. 2017)
Little difference was found between the two techniques for pain relief.
Another review compared IASTM to other methods for treating pain and function loss. (Matthew Lambert et al., 2017)
The researchers concluded that IASTM could positively affect blood circulation and tissue flexibility and reduce pain.
Another study examined the use of IASTM, pseudo-fake ultrasound therapy, and spinal manipulation for patients with thoracic/upper back pain. (Amy L. Crothers et al., 2016)
All groups improved over time with no significant negative events.
The researchers concluded that instrument-assisted soft tissue mobilization is no more or less effective than spinal manipulation or pseudo-ultrasound therapy for thoracic back pain.

Every case is different, and musculoskeletal conditions respond differently to various treatments. For any questions or concerns, contact your primary healthcare provider to determine if IASTM is an appropriate treatment that can help.

From Injury To Recovery

References

Kamali, F., Panahi, F., Ebrahimi, S., & Abbasi, L. (2014). Comparison between massage and routine physical therapy in women with sub acute and chronic nonspeciﬁc low back pain. Journal of back and musculoskeletal rehabilitation, 27(4), 475–480. https://doi.org/10.3233/BMR-140468

Kim, J., Sung, D. J., & Lee, J. (2017). Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. Journal of exercise rehabilitation, 13(1), 12–22. https://doi.org/10.12965/jer.1732824.412

Chughtai, M., Newman, J. M., Sultan, A. A., Samuel, L. T., Rabin, J., Khlopas, A., Bhave, A., & Mont, M. A. (2019). Astym® therapy: a systematic review. Annals of translational medicine, 7(4), 70. https://doi.org/10.21037/atm.2018.11.49

Williams M. (2017). Comparing pain and disability outcomes of instrumental versus hands-on myofascial release in individuals with chronic low back pain: a meta-analysis. Doctoral dissertation, California State University, Fresno. https://repository.library.fresnostate.edu/bitstream/handle/10211.3/192491/Williams_csu_6050D_10390.pdf?sequence=1

Matthew Lambert, Rebecca Hitchcock, Kelly Lavallee, Eric Hayford, Russ Morazzini, Amber Wallace, Dakota Conroy & Josh Cleland (2017) The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review, Physical Therapy Reviews, 22:1-2, 76-85, DOI: 10.1080/10833196.2017.1304184

Crothers, A. L., French, S. D., Hebert, J. J., & Walker, B. F. (2016). Spinal manipulative therapy, Graston technique® and placebo for non-specific thoracic spine pain: a randomised controlled trial. Chiropractic & manual therapies, 24, 16. https://doi.org/10.1186/s12998-016-0096-9

Exploring the Potential of Acupuncture for Ulcerative Colitis

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

A acupuncture needle therapy in the studio. High quality photo

“For individuals dealing with ulcerative colitis, can acupuncture treatment benefit those with UC and other GI-related issues?”

Table of Contents

Acupuncture For Ulcerative Colitis

Acupuncture has been used to treat symptoms related to pain and inflammation. Studies suggest it may help reduce inflammation and symptoms like diarrhea and abdominal pain, which could benefit individuals with inflammatory bowel disease. Individuals with ulcerative colitis, an inflammatory bowel disease/IBD affecting the large intestine, may find acupuncture beneficial in managing symptoms, including pain and gastrointestinal symptoms. (Crohn’s and Colitis Foundation, 2019)

There are 2,000 acupoints in the body connected by pathways known as meridians. (Wilkinson J, Faleiro R. 2007)
The pathways connecting the acupoints generate energy, which contributes to overall health.
A disruption to the energy flow can cause injury, illness, or disease.
When acupuncture needles are inserted, energy flow and health are improved.

Benefits

Acupuncture can be used for the relief of various conditions. Studies have shown that acupuncture can reduce inflammation and disease activity in individuals with an IBD, like UC and Crohn’s disease. It can help with: (Gengqing Song et al., 2019)

Pain symptoms
Gut microbiome imbalances
Gut motor dysfunction
Intestinal barrier function
Anxiety
Depression

Studies suggest the use of acupuncture with heat, known as moxibustion, can improve several GI symptoms including (Crohn’s and Colitis Foundation, 2019)

Bloating
Abdominal pain
Constipation
Gas
Diarrhea
Nausea

It is effective in the treatment of digestive issues that include: (Johns Hopkins Medicine. 2024)

Gastritis
Irritable bowel syndrome/IBS
Hemorrhoids
Hepatitis

Reduces Pain and Inflammation

Acupuncture treatment works by releasing endorphins, which help reduce pain. (Harvard Medical School. 2016)
Applying pressure to acupoints triggers the central nervous system.
This is believed to cause the release of chemicals that stimulate the body’s healing mechanisms. (Johns Hopkins Medicine. 2024)
Studies have also found acupuncture can trigger the production of cortisol.
This hormone helps control inflammation. (Arthritis Foundation. N.D.)
Studies found the use of acupuncture along with moxibustion reduced inflammation in individuals with Crohn’s disease and ulcerative colitis. (Crohn’s and Colitis Foundation, 2019)

Stress and Mood

Chronic conditions like ulcerative colitis can cause feelings of depression and/or anxiety. Acupuncture may be used to address symptoms related to stress and mood and can benefit emotional health issues that include: (Johns Hopkins Medicine. 2024)

Insomnia
Anxiety
Nervousness
Depression
Neurosis – mental health condition characterized by chronic distress and anxiety.

Side Effects

Acupuncture is considered a safe practice. The most common side effects are: (GI Society. 2024)

Bruising
Minor bleeding
Increased pain
Fainting can occur due to needle shock.
Needle shock can cause dizziness, feeling faint, and nausea. (Harvard Medical School. 2023)
Needle shock is rare but more common in individuals:
Who are regularly nervous.
Who are nervous around needles.
Who are new to acupuncture.
Who have a history of fainting.
Who are extremely fatigued.
Who have low blood sugar.

For some, GI symptoms may worsen before they improve. It is recommended to try at least five sessions as this is part of the healing process. (Cleveland Clinic. 2023) However, individuals should contact their doctor if symptoms become severe or last more than two days. (GI Society. 2024) Individuals considering acupuncture to help manage symptoms of ulcerative colitis should speak with their healthcare provider to help determine the appropriate treatment and where to start.

Gastro-Intestinal Dysfunction Treatment

References

Crohn’s and Colitis Foundation. (2019). Acupuncture in Inflammatory Bowel Disease. IBDVisible Blog. https://www.crohnscolitisfoundation.org/blog/acupuncture-inflammatory-bowel-disease

Wilkinson J, Faleiro R. (2007). Acupuncture in pain management. Continuing Education in Anaesthesia, Critical Care and Pain. 7(4), 135-138. https://doi.org/10.1093/bjaceaccp/mkm021

Johns Hopkins Medicine. (2024). Acupuncture (Health, Issue. https://www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture

Song, G., Fiocchi, C., & Achkar, J. P. (2019). Acupuncture in Inflammatory Bowel Disease. Inflammatory bowel diseases, 25(7), 1129–1139. https://doi.org/10.1093/ibd/izy371

Harvard Medical School. (2016). Relieving pain with acupuncture. Harvard Health Blog. https://www.health.harvard.edu/healthbeat/relieving-pain-with-acupuncture

Arthritis Foundation. (N.D.). Acupuncture for Arthritis. Health Wellness. https://www.arthritis.org/health-wellness/treatment/complementary-therapies/natural-therapies/acupuncture-for-arthritis

Harvard Medical School. (2023). Acupuncture: what is it? Harvard Health Publishing Harvard Medical School Blog. https://www.health.harvard.edu/a_to_z/acupuncture-a-to-z#:~:text=The%20most%20common%20side%20effects,injury%20to%20an%20internal%20organ.

Cleveland Clinic. (2023). Acupuncture. Health Library. https://my.clevelandclinic.org/health/treatments/4767-acupuncture

GI Society. (2024). Acupuncture and Digestion. badgut.org. https://badgut.org/information-centre/a-z-digestive-topics/acupuncture-and-digestion/

Incorporating Moderate Exercise for a Healthy Lifestyle

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

Father and son playing basketball on court outdoors

“Can understanding moderate exercise and how to measure the amount of exercise help expedite individuals’ health goals and well-being?”

Table of Contents

Moderate Exercise

Various physical activity guidelines recommend regular, moderate exercise for achieving and maintaining health and wellness. Getting the minimum, moderate weekly physical activity can help prevent disease, increase mental well-being, support weight loss and maintenance, and improve quality of life.

What Is It?

Anything that gets the heart pumping and beating faster is considered moderate exercise. (U.S. Department of Health and Human Services, 2018)
Moderate-intensity cardiovascular exercise includes – brisk walking, yard work, mopping, vacuuming, and playing various sports that require consistent movement.
When engaged in moderate exercise, individuals should breathe harder but still be able to carry a conversation. (American Heart Association, 2024)
The talk test is a way to monitor whether the exercise is at moderate intensity.

Benefits

Regular moderate exercise can help (American Heart Association, 2024)

Decrease the risk of developing conditions like heart disease, type 2 diabetes, and dementia.
Improve sleep and help with sleep disorders.
Improve brain functions like memory, focus, and processing.
With weight loss and/or maintenance.
Improve bone health.
Reduce depression, anxiety, and other mental health symptoms.

How Much Exercise?

The prescription for moderate exercise includes:

30 minutes a day for five days a week, or two hours and 30 minutes per week. (U.S. Department of Health and Human Services, 2018)
Physical activity needs to continue for at least 10 minutes to be considered an exercise session.
Individuals can break up their 30 daily minutes into two to three shorter sessions, each 10 minutes long.
As the ability to exercise increases, aim to increase moderate activities.
Individuals will reap even more health benefits if they increase moderate aerobic exercise time to 300 minutes or five hours weekly. (U.S. Department of Health and Human Services, 2018)

Measuring Exercise

A moderate level of activity noticeably increases heart and breathing rate.
Individuals sweat but can still carry on a conversation.
Individuals can talk but can’t sing.
Individuals will feel the exercise but are not huffing and puffing.
Individuals can use different scales to measure exercise intensity.

Heart Rate

A moderate-intensity heart rate is 50% to 70% of an individual’s maximum heart rate. (Centers for Disease Control and Prevention, 2022)
An individual’s maximum heart rate varies by age.
A heart rate chart or calculator can determine an individual’s maximum heart rate.
To measure heart rate mid-exercise, individuals can take their pulse or use a heart rate monitor, app, fitness tracker, or smartwatch to ensure they stay at a moderate intensity.

MET

M.E.T. stands for Metabolic Equivalent for Task and refers to the amount of oxygen the body uses during physical activity.
Assigning METs to an activity allows individuals to compare the amount of exertion an activity takes.
This works for individuals with different weights.
During moderate physical activity, breathing and heart rate increase, and the body burns around 3.5 to 7 calories a minute.
The actual number burned depends on your weight and fitness level.
The body uses 1 MET for basic functions like breathing.
Grades of activity:

1 MET – Body at rest
2 METs – Light activity
3-6 METs – Moderate activity
7 or more METs – Vigorous activity

Perceived Exertion Scale

Individuals can also check their activity level using the Borg Rating of Perceived Exertion scale/RPE. (Centers for Disease Control and Prevention, 2022) Using this scale involves monitoring how an individual feels about how hard their body is working during physical activity. The scale starts at 6 and ends at 20. A perceived exertion between 11 and 14 is considered moderate physical activity.

6 – No exertion – sitting still or sleeping
7-8 – Extremely light exertion
9-10 – Very light exertion
11-12 – Light exertion
13-14 – Somewhat hard exertion
15-16 – Heavy exertion
17-18 – Very heavy exertion
20 – Maximum exertion

Examples

Many activities are counted as moderate-intensity exercise. Choose some appealing and learn to add them to a weekly routine.

Ballroom dancing
Line dancing
Gardening
House chores that get the heart pumping.
Softball
Baseball
Volleyball
Doubles tennis
Brisk walking
Light jogging
Walking or jogging on a treadmill
Using an elliptical trainer
Bicycling under 10 miles an hour on ground level
Leisurely swim
Water aerobics

Mobility Challenges

Individuals with mobility issues can achieve moderate intensity using a manual wheelchair or a handcycle and swimming or water aerobics.
Individuals who can use their legs but can’t tolerate walking or jogging can try bicycling or swimming.

Getting More Exercise

There are different ways to incorporate and increase moderate physical activities. These include:

10-minute Activity Bursts

Walk briskly for at least 10 minutes at a time.
Walk at an easy pace for a couple of minutes.
Pick up the pace for 10 minutes.
Try to walk during work breaks or lunch and/or before or after work.

Walking Workouts

Individuals can walk indoors, outdoors, or on a treadmill.
Proper posture and walking techniques make it easier to achieve a brisk pace.
Once comfortable walking briskly for 10 minutes, begin to extend walking time.
Try different walking workouts that offer fast walks, jogging intervals, and/or adding hills or treadmill inclines.

New Activities

Individuals are recommended to experiment with various exercises to find what works for them.
Consider roller skating, blading, or skateboarding to increase heart rate.

Moderate physical activity will get and keep the body in shape. Individuals should not become distressed if they can only do a little at first. Allow time to build endurance and gradually make time each day for enjoyable physical activities.

Transform Your Body

References

U.S. Department of Health & Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition. Retrieved from https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf

American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids. (Healthy Living, Issue. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Centers for Disease Control and Prevention. (2022). Target heart rate and estimated maximum heart rate. Retrieved from https://www.cdc.gov/physicalactivity/basics/measuring/heartrate.htm

Centers for Disease Control and Prevention. (2022). Perceived exertion (Borg Rating of Perceived Exertion Scale). Retrieved from https://www.cdc.gov/physicalactivity/basics/measuring/exertion.htm

The Role of Acupuncture in Improving Eye Health

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

Up of a woman getting acupuncture on her face at an acupuncture clinic

“For individuals experiencing eye problems, can acupuncture treatment help and benefit overall eye health?”

Table of Contents

Acupuncture For Eye Health

Acupuncture is an alternative medical practice that involves inserting thin needles at specific points on the body. The objective is to restore balance and health by restoring and balancing energy circulation through pathways throughout the body. These pathways, known as meridians, are separate from nerve and blood pathways.

Studies have shown that the insertion of needles manipulates accumulations of certain neurotransmitters by nearby nerves and may be what causes beneficial health effects of acupuncture. (Heming Zhu 2014)
Scientists are not sure exactly how acupuncture works, but it has been shown to provide pain relief and alleviation of cancer treatment nausea. (Weidong Lu, David S. Rosenthal 2013)
Studies have shown that acupuncture can help treat conditions like dry eye syndrome. (Tae-Hun Kim et al., 2012)

Eye Problems

For some individuals, a body imbalance can be caused by eye problems or disease. With acupuncture, imbalance-causing symptoms are addressed. Acupuncture promotes the circulation of energy and blood around the eyes.

Acupuncture has been used as an alternative treatment for chronic dry eye syndrome. (Tae-Hun Kim et al., 2012)
Studies have shown acupuncture helps reduce the eye surface’s temperature to reduce the evaporation of tears.
The procedure is also sometimes used to treat glaucoma.
Glaucoma is an optic nerve disease usually caused by above-normal eye pressure levels.
One study found eye pressure significantly decreased after acupuncture. (Simon K. Law, Tianjing Li 2013)
Another study showed successful reduced allergic and inflammatory eye disease symptoms. (Justine R. Smith et al., 2004)

Eye Acupoints

The following acupoints are for eye health.

Jingming

Jingming – UB-1 is located in the inner corner of the eye.
This point is thought to increase energy and blood and to help with problems such as blurry vision, cataracts, glaucoma, night blindness, and conjunctivitis. (Tilo Blechschmidt et al., 2017)

Zanzhu

The Zanzhu point – UB-2 is in the crease at the inner end of the eyebrow.
This acupoint is used when individuals complain of headaches, blurred vision, pain, tearing, redness, twitching, and glaucoma. (Gerhard Litscher 2012)

Yuyao

Yuyao is in the middle of the eyebrow, above the pupil.
This point is used for treating eye strain, eyelid twitching, ptosis, or when the upper eyelid droops over, cloudiness of the cornea, redness, and swelling. (Xiao-yan Tao et al., 2008)

Sizhukong

The Sizhukog – SJ 23 area is in the hollow area outside the eyebrow.
It is thought to be a point where acupuncture can help with eye and facial pain, including headaches, redness, pain, blurred vision, toothache, and facial paralysis. (Hongjie Ma et al., 2018)

Tongzilia

The Tongzilia – GB 1 is located on the outside corner of the eye.
The point helps brighten the eyes.
Acupuncture also helps treat headaches, redness, eye pain, light sensitivity, dry eyes, cataracts, and conjunctivitis. (GladGirl 2013)

Early studies with acupuncture have shown promise for improving eye health. Individuals considering acupuncture are recommended to consult their primary healthcare provider to see if it can be an option for those who have not found a resolution by traditional means.

Neck Injuries

References

Zhu H. (2014). Acupoints Initiate the Healing Process. Medical acupuncture, 26(5), 264–270. https://doi.org/10.1089/acu.2014.1057

Lu, W., & Rosenthal, D. S. (2013). Acupuncture for cancer pain and related symptoms. Current pain and headache reports, 17(3), 321. https://doi.org/10.1007/s11916-013-0321-3

Kim, T. H., Kang, J. W., Kim, K. H., Kang, K. W., Shin, M. S., Jung, S. Y., Kim, A. R., Jung, H. J., Choi, J. B., Hong, K. E., Lee, S. D., & Choi, S. M. (2012). Acupuncture for the treatment of dry eye: a multicenter randomised controlled trial with active comparison intervention (artificial teardrops). PloS one, 7(5), e36638. https://doi.org/10.1371/journal.pone.0036638

Law, S. K., & Li, T. (2013). Acupuncture for glaucoma. The Cochrane database of systematic reviews, 5(5), CD006030. https://doi.org/10.1002/14651858.CD006030.pub3

Smith, J. R., Spurrier, N. J., Martin, J. T., & Rosenbaum, J. T. (2004). Prevalent use of complementary and alternative medicine by patients with inflammatory eye disease. Ocular immunology and inflammation, 12(3), 203–214. https://doi.org/10.1080/092739490500200

Blechschmidt, T., Krumsiek, M., & Todorova, M. G. (2017). The Effect of Acupuncture on Visual Function in Patients with Congenital and Acquired Nystagmus. Medicines (Basel, Switzerland), 4(2), 33. https://doi.org/10.3390/medicines4020033

Litscher G. (2012). Integrative laser medicine and high-tech acupuncture at the medical university of graz, austria, europe. Evidence-based complementary and alternative medicine : eCAM, 2012, 103109. https://doi.org/10.1155/2012/103109

Tao, X. Y., Sun, C. X., Yang, J. L., Mao, M., Liao, C. C., Meng, J. G., Fan, W. B., Zhang, Y. F., Ren, X. R., & Yu, H. F. (2008). Zhongguo zhen jiu = Chinese acupuncture & moxibustion, 28(3), 191–193.

Ma, H., Feng, L., Wang, J., & Yang, Z. (2018). Zhongguo zhen jiu = Chinese acupuncture & moxibustion, 38(3), 273–276. https://doi.org/10.13703/j.0255-2930.2018.03.011

GladGirl The Lash & Brow Expert Blog. Acupuncture for Eye Health. (2013). https://www.gladgirl.com/blogs/lash-brow-expert/acupuncture-for-eye-health

Managing Deep Buttock Pain: Insights into Piriformis Syndrome

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

Female patient being manipulated by physiotherapist — Female physiotherapist giving curative osteopathic treatment to woman lying on couch during rehabilitation process in light hospital room

“Can physical therapy treatment protocols aimed at improving range of motion and flexibility around the hip and relieving inflammation around the sciatic nerve help individuals experiencing deep buttock pain or piriformis syndrome?”

Table of Contents

Deep Buttock Pain

Piriformis syndrome, a.k .a. deep buttock pain, is described as sciatic nerve irritation from the piriformis muscle.
The piriformis is a small muscle behind the hip joint in the buttocks.
It is about one centimeter in diameter and functions in the hip joint’s external rotation or turning outward.
The piriformis muscle and tendon are close to the sciatic nerve, which supplies the lower extremities with motor and sensory functions.
Depending on an individual’s anatomic variation of the muscle and tendon:
The two cross over, under, or through each other behind the hip joint in the deep buttock.
This relationship is thought to irritate the nerve, leading to sciatica symptoms.

Piriformis Syndrome

When diagnosed with piriformis syndrome, it is thought that the muscle and tendon bind to and/or spasm around the nerve, causing irritation and pain symptoms.
The theory supported is that when the piriformis muscle and its tendon tighten, the sciatic nerve becomes compressed or pinched. This decreases blood circulation and irritates the nerve from the pressure. (Shane P. Cass 2015)

Symptoms

Common signs and symptoms include: (Shane P. Cass 2015)

Tenderness with pressure on the piriformis muscle.
Discomfort in the back of the thigh.
Deep buttock pain behind the hip.
Electric sensations, shocks, and pains travel down the back of the lower extremity.
Numbness in the lower extremity.
Some individuals develop symptoms abruptly, while others go through a gradual increase.

Diagnosis

Doctors will order X-rays, MRIs, and nerve conduction studies, which is normal.
Because piriformis syndrome can be challenging to diagnose, some individuals with minor hip pain may receive a piriformis syndrome diagnosis even if they don’t have the condition. (Shane P. Cass 2015)
It is sometimes referred to as deep buttock pain. Other causes of this type of pain include back and spinal problems like:

Herniated discs
Spinal stenosis
Radiculopathy – sciatica
Hip bursitis
A piriformis syndrome diagnosis is usually given when these other causes are eliminated.

When the diagnosis is uncertain, an injection is administered in the area of the piriformis muscle. (Danilo Jankovic et al., 2013)
Different medications can be used, but the injection itself is used to help determine the specific location of the discomfort.
When an injection is given into the piriformis muscle or tendon, it is often administered by ultrasound guidance to ensure the needle delivers the medication to the correct location. (Elizabeth A. Bardowski, J. W. Thomas Byrd 2019)

Treatment

Common treatments include the following. (Danilo Jankovic et al., 2013)

Rest

Avoiding activities that cause symptoms for at least a few weeks.

Physical Therapy

Emphasize stretching and strengthening the hip rotator muscles.

Non-Surgical Decompression

Gently pulls the spine to release any compression, allowing optimal rehydration and circulation and taking the pressure off the sciatic nerve.

Therapeutic Massage Techniques

To relax and release muscle tension and increase circulation.

Acupuncture

To help relax the piriformis muscle, sciatic nerve, and surrounding area.
Relieve pain.

Chiropractic Adjustments

Realignment rebalances the spine and musculoskeletal system to alleviate pain.

Anti-Inflammatory Medication

To decrease inflammation around the tendon.

Cortisone Injections

Injections are used to decrease inflammation and swelling.

Botulinum Toxin Injection

Injections of botulinum toxin paralyze the muscle to relieve pain.

Surgery

Surgery can be performed in rare cases to loosen the piriformis tendon, known as a piriformis release. (Shane P. Cass 2015)
Surgery is a last resort when conservative treatments have been tried for at least 6 months with little to no relief.
Recovery can take several months.

Sciatica Causes and Treatment

References

Cass S. P. (2015). Piriformis syndrome: a cause of nondiscogenic sciatica. Current sports medicine reports, 14(1), 41–44. https://doi.org/10.1249/JSR.0000000000000110

Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 60(10), 1003–1012. https://doi.org/10.1007/s12630-013-0009-5

Bardowski, E. A., & Byrd, J. W. T. (2019). Piriformis Injection: An Ultrasound-Guided Technique. Arthroscopy techniques, 8(12), e1457–e1461. https://doi.org/10.1016/j.eats.2019.07.033

Exploring the Benefits of Acupuncture for Insomnia

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

Sitting and talking. Young woman have a visit with female doctor in modern clinic.

“Can acupuncture treatment help individuals dealing with or experiencing insomnia and sleep issues and/or disorders?”

Table of Contents

Acupuncture For Insomnia

Acupuncture is a type of holistic medicine that involves inserting sterile, disposable, thin needles at specific points known as acupoints on the body. Each needle is inserted into a different area to stimulate symptom relief of various conditions, like chronic pain and nausea. (Johns Hopkins Medicine. 2024) Recent research has looked into acupuncture for insomnia and found that it may be an effective alternative. (Mingming Zhang et al., 2019)

Insomnia

Insomnia causes individuals to have trouble falling or staying asleep. Individuals who have insomnia tend to wake up earlier than they intend to and find it difficult to impossible to get back to sleep once they are awake. The sleep disorder is quite common, with around 10% of individuals experiencing it at some point. (Andrew D. Krystal et al., 2019) There are three categories, all characterized by the duration of the disorder. They include: (Andrew D. Krystal et al., 2019)

Acute/Short-Term

Lasting less than three months.

Episodic

Happens once in a while for less than three months.

Chronic

Lasting more than three months.

Health Issues

Insomnia can cause various health issues, and individuals can develop mood changes, irritability, fatigue, and problems with memory, impulse control, and concentration. (Andrew D. Krystal et al., 2019)
Insomnia has also been shown to increase the risk of heart failure, heart attack, and other chronic health conditions. (Mingming Zhang et al., 2019)

Benefits

Studies on the use of acupuncture for insomnia have found that it may improve sleep because of its influence on certain neurotransmitters. One review noted that specific neurotransmitters involved in the sleep-wake cycle are positively affected by acupuncture. (Kaicun Zhao 2013) The neurotransmitters include:

Norepinephrine

Helps with waking up and staying alert.

Melatonin

A hormone that helps the body calm down and prepare for sleep.

Gamma-aminobutyric acid – GABA

Helps the body fall asleep and stay asleep.

However, more research is needed to confirm the benefits of acupuncture for insomnia further.

Conditions

Certain conditions can contribute to insomnia, including:

Mood disorders
Chronic pain
Other sleep disorders

Acupuncture can help lower the effects of these disorders.

Pain

Because of the way acupuncture affects certain chemicals, it is a proven complementary treatment for pain.

The needles enhance chemicals like endorphins, dynorphins, and encephalins.
Acupuncture also releases corticosteroids, which are stress hormones.
Each of these chemicals has a role in pain symptoms.
Adjusting their levels helps reduce pain. (Shilpadevi Patil et al., 2016)

Anxiety

Studies have found that individuals with anxiety can also benefit from acupuncture to help reduce symptoms. (Meixuan Li et al., 2019)

Sleep Apnea

Sleep apnea is a sleep-breathing disorder that causes an individual to stop breathing during the night temporarily.
The muscles in the nasal cavity, nose, mouth, or throat become overly relaxed.
Acupuncture can help stimulate the muscles and prevent over-relaxation, preventing apneas.
Data suggests that acupuncture may affect the apnea-hypopnea index, the number of times an individual stops and starts breathing during sleep. (Liaoyao Wang et al., 2020)

Session

Individuals should not feel pain and just a small amount of pressure in the needles’ insertion area.
If pain is present, it could be because the needles are not inserted in the right spot.
It’s essential to tell the acupuncturist so they can reset and re-insert them correctly. (Malcolm W. C. Chan et al., 2017)

Side Effects

Side effects are rare but can occur. These include: (G. Ernst, H. Strzyz, H. Hagmeister 2003)

Dizziness
Bleeding or bruising where the needle was inserted.
Nausea
Fainting
Pins and needles sensation
Feeling more pain treatment

Prior to getting acupuncture, individuals are recommended to speak to their healthcare provider. They can advise on how it can help and any side effects that may occur due to the individual’s health, underlying conditions, and medical history. Once cleared, they can recommend a licensed acupuncturist.

Tension Headaches

References

Johns Hopkins Medicine. (2024). Acupuncture (Health, Issue. https://www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture

Zhang, M., Zhao, J., Li, X., Chen, X., Xie, J., Meng, L., & Gao, X. (2019). Effectiveness and safety of acupuncture for insomnia: Protocol for a systematic review. Medicine, 98(45), e17842. https://doi.org/10.1097/MD.0000000000017842

Krystal, A. D., Prather, A. A., & Ashbrook, L. H. (2019). The assessment and management of insomnia: an update. World psychiatry: official journal of the World Psychiatric Association (WPA), 18(3), 337–352. https://doi.org/10.1002/wps.20674

Zhao K. (2013). Acupuncture for the treatment of insomnia. International review of neurobiology, 111, 217–234. https://doi.org/10.1016/B978-0-12-411545-3.00011-0

Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. https://doi.org/10.1007/s11916-016-0552-1

Li, M., Xing, X., Yao, L., Li, X., He, W., Wang, M., Li, H., Wang, X., Xun, Y., Yan, P., Lu, Z., Zhou, B., Yang, X., & Yang, K. (2019). Acupuncture for treatment of anxiety, an overview of systematic reviews. Complementary therapies in medicine, 43, 247–252. https://doi.org/10.1016/j.ctim.2019.02.013

Wang, L., Xu, J., Zhan, Y., & Pei, J. (2020). Acupuncture for Obstructive Sleep Apnea (OSA) in Adults: A Systematic Review and Meta-Analysis. BioMed research international, 2020, 6972327. https://doi.org/10.1155/2020/6972327

Chan, M. W. C., Wu, X. Y., Wu, J. C. Y., Wong, S. Y. S., & Chung, V. C. H. (2017). Safety of Acupuncture: Overview of Systematic Reviews. Scientific reports, 7(1), 3369. https://doi.org/10.1038/s41598-017-03272-0

Ernst, G., Strzyz, H., & Hagmeister, H. (2003). Incidence of adverse effects during acupuncture therapy-a multicentre survey. Complementary therapies in medicine, 11(2), 93–97. https://doi.org/10.1016/s0965-2299(03)00004-9

Unlocking the Potential of Green Powder Supplements

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

Blend of vegetable Superfoods for making smoothies. Healthy fresh green vegetables.

“For individuals that have difficulty getting plenty of fruits and vegetables, can incorporating green powder supplements increase nutritional levels for a balanced diet?”

Table of Contents

Green Powder Supplements

Meeting daily nutrient needs through whole, unprocessed foods can’t always be met when access is limited or for other reasons. A green powder supplement is a great way to fill in the gaps. Green powder supplements are a daily supplement that helps increase vitamin, mineral, and fiber intake and enhances overall health. Green powders are easy to mix in water with a favorite beverage or smoothie or bake into a recipe. They can help:

Increase energy
Nourish the immune system
Improve digestion
Promote mental clarity
Contribute to healthy blood sugar levels
Reduce the risk of chronic disease
Promote optimal liver and kidney function

What Are They?

Green powder supplements are forms of vitamins, minerals, fiber, antioxidants, phytochemicals, and other bioactive compounds.
They are derived from fruits, vegetables, herbs, and algae to combine ingredients into a convenient supplement. (Giulia Lorenzoni et al., 2019)

Nutrients

Because most green powders comprise a combination of ingredients, the nutrient density is high. Green powder supplements can be considered a vitamin and mineral product. They typically contain:

Vitamins A, C, and K
Iron
Magnesium
Calcium
Antioxidants

The recommended daily intake of vitamins and minerals can be helpful for individuals with limited access to produce or who want to supplement their diet with additional nutrients.

Energy

The phytochemicals found in fruits and vegetables have been shown to improve energy levels. Studies on their effects on physical performance and endurance have resulted in positive outcomes. Researchers found that phytonutrients like those in green powders helped to increase energy, improve agility, reduce fatigue perception, improve memory, and decrease recovery time. (Nicolas Monjotin et al., 2022)

Digestive Health

Green powders are rich in soluble and insoluble fiber, which contribute to feeling full and satisfied after a meal and are important for healthy digestion and regular bowel movements. Eating fiber-rich foods is associated with optimal blood sugar control and improved gut microbiota diversity. These factors are important for maintaining a healthy body weight and decreasing the risk of chronic disease, for example, type 2 diabetes. (Thomas M. Barber et al., 2020) Phytochemicals, including flavonoids, have been shown to have therapeutic effects on gas, bloating, constipation, and diarrhea associated with IBS. Other phytonutrients have been shown to reduce certain symptoms of ulcerative colitis. (Nicolas Monjotin et al., 2022)

Immune System Function

Supplemental green powder supplements have shown the ability to maintain a healthy immune system and reduce inflammation by their antioxidant content. Green powders containing seaweed or algae are rich in phytochemical and poly-unsaturated fatty acids that have antioxidant properties to reduce inflammation and prevent oxidative damage to cells. (Agnieszka Jaworowska, Aliza Murtaza 2022) A randomized trial found that a fruit, berry, and vegetable powder concentrate blend decreased oxidation and reduced inflammation, attributed to the phytochemicals found in fruits and vegetables.(Manfred Lamprecht et al., 2013)

Detoxification

The liver and kidneys are the main organs of natural detoxification. The liver helps the body absorb nutrients from consumed foods and removes waste and toxins through the kidneys. (National Library of Medicine. 2016) Plants are packed with antioxidants and phytochemicals that protect the liver and kidneys from free radical damage and oxidative stress. (Yong-Song Guan et al., 2015) The green powder supplements are made from these plants. When drinking green powders, fluid intake naturally increases as a standard serving of green powder is mixed with 8 to 12 ounces of water.

Whether mixed, blended, or made into a shake, powdered greens are a convenient and efficient way to get the daily dose of antioxidants, vitamins, minerals, and other nutrients.

The Healing Diet: Combat Inflammation, Embrace Wellness

References

Lorenzoni, G., Minto, C., Vecchio, M. G., Zec, S., Paolin, I., Lamprecht, M., Mestroni, L., & Gregori, D. (2019). Fruit and Vegetable Concentrate Supplementation and Cardiovascular Health: A Systematic Review from a Public Health Perspective. Journal of clinical medicine, 8(11), 1914. https://doi.org/10.3390/jcm8111914

Monjotin, N., Amiot, M. J., Fleurentin, J., Morel, J. M., & Raynal, S. (2022). Clinical Evidence of the Benefits of Phytonutrients in Human Healthcare. Nutrients, 14(9), 1712. https://doi.org/10.3390/nu14091712

Barber, T. M., Kabisch, S., Pfeiffer, A. F. H., & Weickert, M. O. (2020). The Health Benefits of Dietary Fibre. Nutrients, 12(10), 3209. https://doi.org/10.3390/nu12103209

Jaworowska, A., & Murtaza, A. (2022). Seaweed Derived Lipids Are a Potential Anti-Inflammatory Agent: A Review. International journal of environmental research and public health, 20(1), 730. https://doi.org/10.3390/ijerph20010730

Lamprecht, M., Obermayer, G., Steinbauer, K., Cvirn, G., Hofmann, L., Ledinski, G., Greilberger, J. F., & Hallstroem, S. (2013). Supplementation with a juice powder concentrate and exercise decrease oxidation and inflammation, and improve the microcirculation in obese women: randomised controlled trial data. The British journal of nutrition, 110(9), 1685–1695. https://doi.org/10.1017/S0007114513001001

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the liver work? 2009 Sep 17 [Updated 2016 Aug 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279393/

Guan, Y. S., He, Q., & Ahmad Al-Shatouri, M. (2015). Complementary and Alternative Therapies for Liver Diseases 2014. Evidence-based complementary and alternative medicine : eCAM, 2015, 476431. https://doi.org/10.1155/2015/476431

Training for Long Distance: Building Endurance Effectively

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

Fit african american woman wearing backpack nordic walking on coast. healthy lifestyle, exercising in nature.

“For individuals training for long-distance walking marathons and/or events, can focusing on building a walking foundation and then increasing mileage progressively help condition the body for overall readiness?”

Table of Contents

Long Distance Walking Training

Training helps individuals be comfortable and safe for long-distance walking and events.
Training should focus on building a walking pace and increasing mileage gradually.
Individuals need endurance, not speed, and want to build mental stamina for walking for hours at a steady pace.
To reduce the risk of training injuries, increasing the total mileage per week/the distance of the longest walk per week to no more than 10% is recommended.
Individuals should also train to wear the gear worn during long-distance walks.
Training could last a few months.
Being methodical allows the body time to repair and build new muscle, blood supplies, and endurance.

Example Training Plans

Following a marathon training plan for mileage building and determining the proper hydration, nutrition, and gear for multi-day walks and treks is recommended. However, individuals must build back-to-back long days into their training sessions to assess any issues or problems resulting from walking long distances on back-to-back days.

Example Walking Training Plans

Multi-Day Walks/Treks Training Schedule

13 miles per day/21 kilometers
Use this plan for marathons or other multi-day walks with hills and natural surfaces requiring a backpack.

Training to Walk a Marathon

26.2 miles/42 kilometers
This will condition the body to go longer distances.
When training for distances of 31 to 100 miles/50 to 161 kilometers, the longest distance to train should not need to exceed 20 to 25 miles,
These should be performed at least twice two months before the marathon or event.
Taper down the month before the event to a 12.4-mile/20-kilometer distance.

Gear

All clothing, shoes, sunscreen, backpacks, etc., must be tested on the longer training days before the event.

Given the climate and terrain, plan for what will be needed and removed.
Try things out, as individuals don’t want to be surprised with something unfamiliar at the event. From head to toe, test the gear, including:
Shoes/boots, socks, underwear, bra, shirt, pants, hat, jacket, and rain gear.
Choose shoes or walking boots and wear them on long training days to break them in and ensure they perform.
Backpacks should be tested on longer training days to ensure they can be carried comfortably over long distances and have the necessary capacity.
Choose wicking fabrics that allow the skin to breathe and cool, especially under layers. (Justin De Sousa et al., 2014)
Individuals will want to wear gear similar to marathon walkers if the walk will mostly be on pavement or asphalt.
Individuals can modify their gear if the route is off-road or during different seasons. Find out what other long-distance walkers have worn on the same route or event.

Individuals can connect with fellow walkers via social media or find answers to frequently asked questions on the event’s or destination’s website.
Individuals can also contact the event director via the website or social media.

Nutrition

Proper sports nutrition will prepare the body for endurance activity.

For example, individuals are recommended to follow a diet comprising 70% carbohydrates, 20% protein, and 10% fat.
Avoid high-protein diets, as they can cause hydration problems and strain your kidneys under endurance walking conditions. (Marta Cuenca-Sánchez et al., 2015)
Train with the water, sports drinks, food, and snacks taken to the event, and do not deviate from them during the event.
Water is needed for 20 kilometers and under events, but an electrolyte replacement sports drink may be better for longer walks.
Diluting or leaving out some sugar can be easier on the stomach.

Have snacks pre-packaged and labeled for the times to be eaten.
Individuals need to eat fat and protein for ultramarathon distances – this can come from trail mix, peanut butter sandwiches, and chocolate bars with nuts.
Carbohydrates can be provided by sports gels or energy bars.

It is recommended to avoid products made for short distances and power sports as they can cause digestive problems when walking longer distances.

Planning a Walk

Planning begins by setting goals. Considerations include:

Time of year
Distance
Transportation to the event
Event pace requirements
Altitude and hill profile
Climate

Individuals are recommended to:

Prepare by researching routes and trails.
Study the course maps to know what services are provided along the way and what individuals must bring.
Walk a long distance without a supporting event.
Contact individuals who have walked the course.
Know the terrain and areas of total sun, hills, pavement, natural trails, and shade.
If possible, drive the course to become familiar with it.
Individuals may be able to find apps designed for their route.

Taking Breaks and Resting

Regular breaks should be short – using the bathroom, eating a snack, rehydrating, tying shoes, or bandaging blisters.
The body can stiffen up quickly during breaks and take several minutes to regain walking pace after a long break.
Recommendations could be taking a walking break instead, which means continuing to walk but at a very slow pace.

Foot Care

Individuals will have found what works for them concerning shoes, boots, socks, etc., on the long training days to prevent blisters and injuries. It is recommended to try different strategies, which include:

Sports tape
Blister block pads
Sprays
Lubricants
Wicking and/or double-layered socks
Moleskin
Stop at the first sign of irritation along the walk and doctor the foot with tape, blister bandages, or whatever method works best.

The body was built for walking. Planning and training properly before taking a long-distance or multi-day walk will ensure a safe and enjoyable marathon.

Move Better, Live Better

References

De Sousa, J., Cheatham, C., & Wittbrodt, M. (2014). The effects of a moisture-wicking fabric shirt on the physiological and perceptual responses during acute exercise in the heat. Applied ergonomics, 45(6), 1447–1453. https://doi.org/10.1016/j.apergo.2014.04.006

Cuenca-Sánchez, M., Navas-Carrillo, D., & Orenes-Piñero, E. (2015). Controversies surrounding high-protein diet intake: satiating effect and kidney and bone health. Advances in nutrition (Bethesda, Md.), 6(3), 260–266. https://doi.org/10.3945/an.114.007716

The Effectiveness of Acupuncture for Knee Pain Relief

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

Acupuncture has done wonders for my knee. Shot of a acupuncturist treating a client

“For individuals dealing with knee pain symptoms from injury and/or arthritis, can incorporating an acupuncture and/or electroacupuncture treatment plan help in pain relief and management?”

Table of Contents

Acupuncture For Knee Pain

Acupuncture involves inserting very thin needles into the skin at specific acupoints on the body. It is based on the premise that the needles restore the flow of the body’s energy to activate and promote healing, relieve pain, and help the body relax.

Acupuncture can help address various health conditions, including knee pain caused by arthritis or injury.
Depending on the type and severity of pain, treatments can help reduce the pain for days or weeks.
Acupuncture is often used as a complementary therapy – treatment in addition to other treatment or therapy strategies like massage and chiropractic.

Acupuncture Benefits

Knee pain caused by osteoarthritis or injury can reduce flexibility, mobility, and quality of life. Acupuncture can help provide relief.

When the acupuncture needles are placed on the body, a signal is sent along the spinal cord to the brain, which triggers a release of endorphins/pain hormones. Medical researchers believe this helps reduce pain. (Qian-Qian Li et al., 2013) Acupuncture also helps decrease the production of cortisol, a hormone that helps control inflammation. (Qian-Qian Li et al., 2013) With reduced pain sensations and less inflammation after acupuncture treatments, knee function and mobility can be improved.

Various factors play a role in the pain relief experienced from acupuncture. Some evidence suggests that an individual’s expectations may impact the results of acupuncture treatment. (Stephanie L. Prady et al., 2015)
Researchers are currently assessing whether the expectation that acupuncture is beneficial contributes to a better outcome after treatment. (Zuoqin Yang et al., 2021)
In 2019, acupuncture was recommended in treating knee osteoarthritis in the American College of Rheumatology/Arthritis Foundation guidelines for hand, hip, and knee osteoarthritis pain management. (Sharon L. Kolasinski et al., 2020)

Research

Different clinical studies support acupuncture’s ability to help in knee pain relief and management.
One study found that acupuncture helps manage various conditions that cause chronic pain. (Andrew J. Vickers et al., 2012)
A scientific review analyzed previous studies on pain management interventions after knee surgery and found supporting evidence that the treatments delayed and reduced the use of medications for pain relief post-surgery. (Dario Tedesco et al., 2017)

Osteoarthritis

A systematic review analyzed randomized control studies to determine whether or not acupuncture reduced pain and improved joint function in individuals with chronic osteoarthritis knee pain. (Xianfeng Lin et al., 2016)
Individuals received six to twenty-three weekly acupuncture sessions for three to 36 weeks.
The analysis determined that acupuncture can improve short and long-term physical function and mobility and provide up to 13 weeks of pain relief in individuals with chronic knee pain caused by osteoarthritis.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease that affects joints, including the knee joint, causing pain and stiffness.
Acupuncture is beneficial in treating rheumatoid arthritis/RA.
A review found that acupuncture alone and in combination with other treatment modalities benefits individuals with RA. (Pei-Chi, Chou Heng-Yi Chu 2018)
Acupuncture is believed to have anti-inflammatory and antioxidant effects to help regulate immune system function.

Chronic Knee Pain

Various conditions and injuries can cause chronic knee pain, making mobility difficult.
Individuals with joint pain often turn to complementary therapies for pain relief management, with acupuncture being one of the popular modalities. (Michael Frass et al., 2012)
A study showed modest improvements in pain relief at 12 weeks. (Rana S. Hinman et al., 2014)
Acupuncture resulted in modest improvements in mobility and function at 12 weeks.

Safety

Acupuncture is considered safe when administered by a trained, licensed professional.
Few complications have been reported from the use of acupuncture. (National Center for Complementary and Integrative Health. 2022)

Side Effects

Side effects can include soreness, bruising, or bleeding at the site of needle insertion and dizziness.
Less common side effects include fainting, increased pain, and nausea. (Harvard Medical School. 2023)
Working with a licensed, professional acupuncture practitioner can reduce the risk of unwanted side effects and complications.

Types

Other acupuncture options that may be offered include:

Electroacupuncture

A modified form of acupuncture where a mild electrical current passes through the needles, providing additional stimulation to the acupoints.
In one research study, individuals with knee osteoarthritis reported significant improvements in their pain, stiffness, and physical function after electroacupuncture treatment. (Ziyong Ju et al., 2015)

Auricular

Auricular or ear acupuncture works on acupoints in the ear corresponding to the body’s different parts.
A research review analyzed several studies on auricular acupuncture for pain relief and found that it can provide relief within 48 hours of pain onset. (M. Murakami et al., 2017)

Battlefield Acupuncture

The military and veteran healthcare facilities use a unique form of auricular acupuncture for pain management.
Studies show that it is effective at providing immediate pain relief, but more research is necessary to determine long-term pain relief effectiveness. (Anna Denee Montgomery, Ronovan Ottenbacher 2020)

Before trying acupuncture, consult a healthcare professional for guidance, as it may be integrated with other therapies and lifestyle adjustments.

Overcoming an ACL Injury

References

Li, Q. Q., Shi, G. X., Xu, Q., Wang, J., Liu, C. Z., & Wang, L. P. (2013). Acupuncture effect and central autonomic regulation. Evidence-based complementary and alternative medicine : eCAM, 2013, 267959. https://doi.org/10.1155/2013/267959

Prady, S. L., Burch, J., Vanderbloemen, L., Crouch, S., & MacPherson, H. (2015). Measuring expectations of benefit from treatment in acupuncture trials: a systematic review. Complementary therapies in medicine, 23(2), 185–199. https://doi.org/10.1016/j.ctim.2015.01.007

Yang, Z., Li, Y., Zou, Z., Zhao, Y., Zhang, W., Jiang, H., Hou, Y., Li, Y., & Zheng, Q. (2021). Does patient’s expectation benefit acupuncture treatment?: A protocol for systematic review and meta-analysis. Medicine, 100(1), e24178. https://doi.org/10.1097/MD.0000000000024178

Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W. F., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., Wise, B., … Reston, J. (2020). 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis care & research, 72(2), 149–162. https://doi.org/10.1002/acr.24131

Vickers, A. J., Cronin, A. M., Maschino, A. C., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Witt, C. M., Linde, K., & Acupuncture Trialists’ Collaboration (2012). Acupuncture for chronic pain: individual patient data meta-analysis. Archives of internal medicine, 172(19), 1444–1453. https://doi.org/10.1001/archinternmed.2012.3654

Tedesco, D., Gori, D., Desai, K. R., Asch, S., Carroll, I. R., Curtin, C., McDonald, K. M., Fantini, M. P., & Hernandez-Boussard, T. (2017). Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review and Meta-analysis. JAMA surgery, 152(10), e172872. https://doi.org/10.1001/jamasurg.2017.2872

Lin, X., Huang, K., Zhu, G., Huang, Z., Qin, A., & Fan, S. (2016). The Effects of Acupuncture on Chronic Knee Pain Due to Osteoarthritis: A Meta-Analysis. The Journal of bone and joint surgery. American volume, 98(18), 1578–1585. https://doi.org/10.2106/JBJS.15.00620

Chou, P. C., & Chu, H. Y. (2018). Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 8596918. https://doi.org/10.1155/2018/8596918

Frass, M., Strassl, R. P., Friehs, H., Müllner, M., Kundi, M., & Kaye, A. D. (2012). Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. Ochsner journal, 12(1), 45–56.

Hinman, R. S., McCrory, P., Pirotta, M., Relf, I., Forbes, A., Crossley, K. M., Williamson, E., Kyriakides, M., Novy, K., Metcalf, B. R., Harris, A., Reddy, P., Conaghan, P. G., & Bennell, K. L. (2014). Acupuncture for chronic knee pain: a randomized clinical trial. JAMA, 312(13), 1313–1322. https://doi.org/10.1001/jama.2014.12660

National Center for Complementary and Integrative Health. (2022). Acupuncture in depth. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/acupuncture-what-you-need-to-know

Ju, Z., Guo, X., Jiang, X., Wang, X., Liu, S., He, J., Cui, H., & Wang, K. (2015). Electroacupuncture with different current intensities to treat knee osteoarthritis: a single-blinded controlled study. International journal of clinical and experimental medicine, 8(10), 18981–18989.

Murakami, M., Fox, L., & Dijkers, M. P. (2017). Ear Acupuncture for Immediate Pain Relief-A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain medicine (Malden, Mass.), 18(3), 551–564. https://doi.org/10.1093/pm/pnw215

Montgomery, A. D., & Ottenbacher, R. (2020). Battlefield Acupuncture for Chronic Pain Management in Patients on Long-Term Opioid Therapy. Medical acupuncture, 32(1), 38–44. https://doi.org/10.1089/acu.2019.1382

1...424344...151 Page 43 of 151