The Importance of the Parasympathetic Nervous System

just-a-little-more-cropped-shot-of-a-young-female-2023-11-27-05-03-25-utc_02 — Just a little more. Cropped shot of a young female physiotherapist treating a mature male patient

Can individuals support their parasympathetic nervous system to maintain a relaxed state and avoid excessive agitation, stress, anxiety, and dysregulation?

Table of Contents

Parasympathetic Nervous System

The parasympathetic nervous system (PSNS) involves organs and cells that release neurotransmitters that help the body maintain essential functions like heart rate, breathing, digestion, relaxation, thinking, and sleep. It is part of the autonomic nervous system, which includes the nerves and neurotransmitters that control the body’s internal organs to maintain reliable function. The autonomic nervous system regulates a continual balance between the parasympathetic nervous system’s rest-and-digest functions and the sympathetic nervous system’s fight-or-flight responses.

Functions and Responses

The parasympathetic nervous system includes nerves and neurotransmitters (chemical messengers) distributed throughout the body and is often described as promoting the body’s rest-and-digest state. The body’s needs regulate the control and effects of the system. Certain medications and health issues can modify or alter the function of the autonomic nervous system, including sympathetic and parasympathetic areas. The parasympathetic and sympathetic nervous systems collaborate to control cells, tissues, and organs. The body requires constant functioning and adjustment of both systems. (McQuade J. D. et al., 2017) Functions include: (Valenti V. E. et al., 2024)

Saliva secretion to break down food.
Maintaining blood pressure, resting heart, and breathing rate.
Producing enzymes in the stomach and intestines to break down food further and absorb nutrients.
Kidney balancing of fluid and mineral levels by producing urine.
Constricting pupils (making the dark circle in the eye smaller) to see details up close.
Maintaining focus and concentration to think, remember, and make decisions.
Releasing hormones to fall asleep and stay asleep.
Providing consistent muscle stimulation to maintain endurance for muscle activity.

All functions are adjusted based on the body’s needs.

Activation

The parasympathetic response constantly works to keep the body active, engaged, and healthy and can be stimulated simply by relaxing and resting. Individuals can sometimes focus on promoting their body’s parasympathetic activity through stretching, slow movements, relaxing sounds or music, meditation, and similar activities. Individuals who frequently feel anxious or stressed and have difficulty relaxing could benefit from guidance from a therapist or coach on learning to engage the parasympathetic nervous system. (Goren O. et al., 2024) This can involve activities such as guided meditation or talk therapy, which can help individuals work through fears and anxieties.

Dysregulation

Some medical conditions are associated with dysregulation. Heart disease, respiratory disease, sleep disorders, mental health conditions, and behavioral conditions can be associated with overactive or underactive parasympathetic or sympathetic nervous system regulation. (Veerakumar A. et al., 2022) Various mental health and physical health disorders can involve symptom fluctuations that affect the autonomic nervous system. For example, anxiety disorders can cause periods of overeating as well as loss of appetite and episodic indigestion, nausea, and vomiting. Symptoms of dysregulation can include: (McQuade J. D. et al., 2017)

Excessive sleepiness
Insomnia
Difficulty concentrating
Confusion
Anxiety – nervousness or agitation
A feeling of a rapid heart rate
Shortness of breath
Dry mouth
Throat tightness
Indigestion
Stomachaches
Nausea
Vomiting
Cold hands and feet
Sweating or clammy hands
Sadness
Depression
Dizziness or feeling physically off-balance

Any of these symptoms can develop and resolve quickly. Most individuals experience symptoms or parasympathetic nervous system dysfunction when an unexpected stressful event occurs, and the response is considered normal in traumatic, shocking, sad, or high-stress circumstances. (Veerakumar A. et al., 2022)

Medications may induce parasympathetic overactivity or underactivity until the medicine is broken down and removed from the body. (Valenti V. E. et al., 2024)

Nerves

The system comprises nerves that release hormones and neurotransmitters and nerves that respond to the hormones and neurotransmitters. Parasympathetic activation and response include: (Valenti V. E. et al., 2024)

The nerves that activate the parasympathetic nervous system run throughout the body, primarily in the brain, heart, lungs, stomach, and intestines.
The brain, heart, lungs, stomach, intestines, muscles, liver, kidneys, reproductive organs, eyes, and mouth are among the areas of the body that respond to stimulation.

The vagus nerve, one of the cranial nerves, is closely associated with parasympathetic nervous system activity. It runs from the brainstem down into the throat, heart, lungs, and digestive system. (Valenti V. E. et al., 2024) Surgical, medical, and alternative interventions are used to regulate the activity of the parasympathetic nervous system and are targeted toward regulating and controlling the activity of the vagus nerve. (Hernández-Domínguez R. A. et al., 2024)

PSNS Support

Living with any parasympathetic nervous system dysfunction can be challenging. For individuals with heart or lung disease, healthcare providers will evaluate the medical condition and recommend surgery or medication to control symptoms and avoid complications. (Hernández-Domínguez R. A. et al., 2024) Individuals who are living with a mental health disorder or behavioral disorder that is associated with any dysregulation of the parasympathetic nervous system activity may benefit from a combination of behavioral interventions and medication to help control symptoms long term. (Goren O. et al., 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

The spinal cord has multiple functions in restoring, rejuvenating, and strengthening the nervous system. Chiropractic care has a highly responsive therapeutic effect on the nervous system because of its focus on the spine. Spinal decompression, traction, soft tissue manipulation, and other treatments help regulate and restore the function of the nervous system. Chiropractic benefits:

Reduce and/or eliminate pain.
Improves the quality of sleep.
Increases energy.
Improves cognition and clarity.
Reduces or eliminates headaches and migraines.
Improves digestive function.
Improves balance and coordination.
Increases flexibility and mobility.
Regulates respiration.
Regulates lower heart rate.

At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness & Nutrition, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for every patient to restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, or ailment.

Chiropractic Secrets Exposed

References

McQuade, J. D., Penzel, T. E., Silk, J. S., & Lee, K. H. (2017). Parasympathetic Nervous System Reactivity Moderates Associations Between Children’s Executive Functioning and Social and Academic Competence. Journal of abnormal child psychology, 45(7), 1355–1367. doi.org/10.1007/s10802-016-0246-5

Valenti, V. E., Vanderlei, L. C. M., & Godoy, M. F. (2024). Editorial: Understanding the role of the autonomic nervous system in health and disease. Frontiers in neuroscience, 18, 1446832. doi.org/10.3389/fnins.2024.1446832

Goren, O., Paz, A., Bar-Kalifa, E., Gilboa-Schectman, E., Wolff, M., & Atzil-Slonim, D. (2024). Clients’ and therapists’ parasympathetic interpersonal and intrapersonal regulation dynamics during psychotherapy for depression. Psychotherapy research : journal of the Society for Psychotherapy Research, 1–15. Advance online publication. doi.org/10.1080/10503307.2024.2378038

Veerakumar, A., Yung, A. R., Liu, Y., & Krasnow, M. A. (2022). Molecularly defined circuits for cardiovascular and cardiopulmonary control. Nature, 606(7915), 739–746. doi.org/10.1038/s41586-022-04760-8

Hernández-Domínguez, R. A., Herrera-Orozco, J. F., Salazar-Calderón, G. E., Chávez-Canales, M., Márquez, M. F., González-Álvarez, F., Totomoch-Serra, A., Reyes-Cruz, T., Lip, F., & Aceves-Buendía, J. J. (2024). Optogenetic modulation of cardiac autonomic nervous system. Autonomic neuroscience : basic & clinical, 255, 103199. doi.org/10.1016/j.autneu.2024.103199

Maximize Your Core Strength with an Ab Roller

Dr. Alex Jimenez

Close up of young woman exercising in the gym

Can incorporating an ab roller help individuals achieve their fitness goal of building stronger core muscles?

Table of Contents

Ab Roller

An ab roller is exercise equipment that helps build core strength and stability by engaging the core, including the abs, obliques, and lower back. It’s a small, robust wheel with handles on each side that glides along surfaces. An ab roller makes an excellent addition to any workout routine and benefits those who do not have an established workout routine. Strengthening the core muscles will help in other areas, whether achieving further exercise goals or reducing injuries. It works by holding on to the handles and rolling the entire body forward over the wheel, improving abdominal strength and endurance while activating the shoulders, arms, and upper back muscles. These movements target different areas, including the obliques, rectus abdominis, and serrated anterior muscles.

Benefits

Enhanced Core Muscle Strength

The primary benefit of using an ab roller is improved core strength, which can help build a solid foundation for various other exercises and physical activities that might be done daily. The body uses its core when moving other muscle groups. Strengthening core muscles increases sports performance, speed, and consistency.

Decrease Injury Risks

Building a strong abdominal core will help stabilize other body areas, such as hip flexors and hamstrings, ultimately reducing the likelihood of injuries. (Huxel Bliven, K. C. and Anderson B. E. 2013) This improved strength and stability is especially beneficial as a strong core can help reduce the chance of an exercise, sports, or work-related injury.

Posture Improvement

Most of us know posture is important but may not realize it (Wilkes C. et al., 2017). A healthy posture can help reduce back pain and even boost energy levels. Performing regular abdominal workouts using an ab roller helps to reinforce proper posture. Healthy posture is more than just standing up straight—it involves incorporating core abdominal activity to help strengthen the muscle endurance of the hips and trunk regions, enabling individuals to stand up straight without much effort.

Tips and Advice

It is important to introduce an ab roller gradually into a workout regimen. Here are a few tips for incorporating one.

Duration

As a beginner, start by trying to do one to two sets with six to 10 repetitions. Individuals may notice that their muscles are sore after doing this for the first time. If the soreness is too much, cut back for the next workout and ease into it more gradually. After a few weeks, the body will start getting used to the movement and may be ready to level up to two to four sets. Speed and performing the exercise as fast as possible is not the goal. Individuals should focus on slow but steady motions, core stability, and proper form. Rushing through a workout could increase the chance of an injury.

Frequency

When starting an ab roller workout, the recommendation is to do it once or twice a week, ideally combined with other workouts like walking, running, swimming, or cycling. This will allow the body to get used to the motion. Because this exercise is difficult and requires balance, some may need to adjust to the training, which is perfectly normal.

Intensity

How intense individuals go with the ab roller depends on current activity and fitness level. It takes time to adapt to this particular exercise. For a beginner, start at a mild intensity by kneeling on the ground. As the core gets used to the motion, individuals can progress to putting their legs straight and omit kneeling. This advanced motion will incorporate posture, strength, endurance, and proprioception.

Injury Medical Chiropractic and Functional Medicine Clinic

Ask a qualified fitness coach or personal trainer if you are unsure where to begin. As with any exercise or fitness program, always talk with your healthcare provider. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to integrate into a treatment plan to improve the body’s flexibility and mobility and resolve musculoskeletal issues.

Core Exercises and Back Pain

References

Huxel Bliven, K. C., & Anderson, B. E. (2013). Core stability training for injury prevention. Sports health, 5(6), 514–522. doi.org/10.1177/1941738113481200

Wilkes, C., Kydd, R., Sagar, M., & Broadbent, E. (2017). Upright posture improves affect and fatigue in people with depressive symptoms. Journal of behavior therapy and experimental psychiatry, 54, 143–149. doi.org/10.1016/j.jbtep.2016.07.015

Selenium: The Powerful Micronutrient for Health and Longevity

Dr. Alex Jimenez

Healthy food containing natural selenium and other vitamins and minerals — Healthy nutritious food containing natural selenium and other vitamins and minerals

Can incorporating selenium-rich foods into one’s diet improve overall health?

Table of Contents

Selenium

Selenium is a chemical element and a micronutrient with antioxidant properties that protect cells from damage and increase immune function (University of Florida Health, 2023). It has also been linked to heart health and longevity. Most individuals in the U.S. can acquire a healthy amount of selenium through a balanced diet. Research has shown that selenium supports healthy aging and reduces the risk of heart disease. (Alehagen U. et al., 2021) (Zhang Y. et al., 2024) A recent study found a region in China where residents have sustained longevity with soil that is rich with selenium. (Li B. et al., 2024) The body does not produce the chemical, so it must be obtained through food or supplements. (National Institutes of Health Office of Dietary Supplements, 2024) However, excessive amounts can build up in the body and be toxic, causing gastrointestinal problems, hair loss, kidney failure, neurological issues, and death. (National Institutes of Health Office of Dietary Supplements, 2024)

Only A Small Amount Is Needed

The body only needs small amounts of selenium to support bodily functions, including thyroid hormone metabolism and antioxidant defense. Most adults need 55 micrograms daily, and pregnant and lactating adults require an additional 5–15 micrograms daily (National Institutes of Health Office of Dietary Supplements, 2024). Individuals can get selenium from many food sources, including Brazilian nuts, meat, seafood, vegetables, and grains. A large hard-boiled egg comprises 15 micrograms, a cup of cooked spaghetti provides 33 micrograms, and 3 ounces of cooked shrimp offer 42 micrograms of selenium. (National Institutes of Health Office of Dietary Supplements, 2024)

Individuals who eat healthy and eat various foods will meet their selenium needs. However, in some parts of the world, poor selenium soil may not provide enough of this mineral for individuals through their diet. (National Institutes of Health Office of Dietary Supplements, 2024) Low selenium intake is linked to a heart condition called Keshan disease, which may weaken the heart’s ability to pump blood. (National Library of Medicine, 2023) However, individuals are recommended not to take more than 400 micrograms daily.

Longevity

Various researchers are trying to understand the link between selenium and aging. A study associated dietary intake with increased telomere length (protein structures at the ends of chromosomes that protect DNA and help control cell division), a biological marker that may indicate aging and other health conditions. (Liang C. et al., 2024) Shorter telomeres generally indicate aging and disease progression. Another study suggests moderate amounts of dietary selenium may protect against cardiovascular disease and death. However, the observational study included data from over 25,000 adults but did not prove a cause-and-effect relationship between selenium and improved longevity. (Zhang Y. et al., 2024) Further research is needed before experts recommend selenium as an anti-aging dietary component.

Injury Medical Chiropractic and Functional Medicine Clinic

Selenium helps with cell growth and thyroid function and is known to increase immune system function. However, avoiding excessive intake is important, as high levels can be harmful. Injury Medical Chiropractic and Functional Medicine Clinic providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, chiropractic adjustments, functional medicine, acupuncture, Electroacupuncture, and various medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician, as Dr. Jimenez has teamed with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Smart Choices Better Health

References

University of Florida Health. (2023). Selenium in diet. ufhealth.org/conditions-and-treatments/selenium-in-diet

Alehagen, U., Opstad, T. B., Alexander, J., Larsson, A., & Aaseth, J. (2021). Impact of Selenium on Biomarkers and Clinical Aspects Related to Ageing. A Review. Biomolecules, 11(10), 1478. doi.org/10.3390/biom11101478

Zhang, Y., Meng, S., Yu, Y., Bi, L., Tian, J., & Zhang, L. (2024). Associations of dietary selenium intake with the risk of chronic diseases and mortality in US adults. Frontiers in nutrition, 11, 1363299. doi.org/10.3389/fnut.2024.1363299

Li, B., Liu, X., Yu, T., Lin, K., Ma, X., Li, C., Yang, Z., Tang, Q., Zheng, G., Qin, J., & Wang, Y. (2024). Environmental selenium and human longevity: An ecogeochemical perspective. Chemosphere, 347, 140691. doi.org/10.1016/j.chemosphere.2023.140691

National Institutes of Health Office of Dietary Supplements. (2024). Selenium: fact sheet for health professionals. Retrieved from ods.od.nih.gov/factsheets/Selenium-HealthProfessional/

National Library of Medicine: MedlinePlus. (2023). Selenium in diet. Retrieved from medlineplus.gov/ency/article/002414.htm

Liang, C., Zhao, R., Du, J., Zhao, G., & Zhang, Y. (2024). The association between dietary selenium intake and telomere length in hypertension. Journal of clinical hypertension (Greenwich, Conn.), 26(8), 990–996. doi.org/10.1111/jch.14861

Enhancing Fitness Components for Optimum Performance

Dr. Alex Jimenez

For athletes and individuals who want to engage in physical and sports activities, can focusing on health-related fitness components improve overall fitness and conditioning so that they can participate in various sports and other forms of exercise?

Fitness Components For Improved Physical and Sports Performance

Improving cardiovascular fitness, muscular strength and endurance, and flexibility will enhance athletes’ abilities and the daily lives of individuals who exercise and play sports. When enhancing performance in a specific activity, skill-related fitness training that focuses on that activity will be most beneficial. For instance, cardiovascular endurance and flexibility are necessary to play sports that require a lot of running, jumping, and changing positions quickly and to be able to play for the entire time, along with various skills that need to be practiced for agility, power, speed, and hand-eye coordination. Activity-related skills can differentiate two areas of fitness.

Getting In Shape and Improving Performance

Health-related fitness components are important for everyone in all walks of life, regardless of competition in or performing physical activities at an optimum level. These are:

Cardiovascular endurance
Flexibility
Muscle endurance
Muscle strength
Body composition

When improving cardiovascular endurance, the risk of heart disease is reduced. When improving flexibility, a healthy range of motion is maintained, enhancing the ability to perform activities of daily living, like household chores and tasks. These fitness components are crucial for physical health and contribute to positive lifestyle outcomes. (Garber C. E. et al., and American College of Sports Medicine 2011) The American College of Sports Medicine recommends:

Moderate-intensity Cardio

30 minutes a day, five days a week for a total of 150 minutes/week or

Vigorous-intensity Cardio

For 20 minutes a day, three days a week, or

A Combination

Moderate- and vigorous-intensity exercise, plus

Resistance Training

Two to three days a week, along with

Flexibility Training

Two days a week

Skill Related Components

Skill-related fitness components are:

Agility
Balance
Coordination – hand-eye and/or foot-eye
Power
Reaction time
Speed

The skill-related fitness components can help those who want more training for a specific fitness-related goal.(Zemková E. and Hamar D. 2018) For example, while everyone can benefit from daily walks, weightlifters can focus most of their effort on power, balance, and strength.

Power

Power combines speed and strength, which is how fast maximal force can be generated. Athletes exert maximum strength in short, all-out efforts. Jumping requires leg power, while jumping and striking involve a combination of upper- and lower-body power. Power can be improved by combining resistance and speed with fast-paced strength-training exercises that include:

Kettlebell swings
Clean lifts
Jerk lifts
Plyometric box jumps
Pushing a weighted sled
Sprinting

Speed

Athletes train differently but with a similar goal: to become faster in their sport. Speed training will differ based on the sport being trained for. High-intensity interval training, or HIIT, is one of the best ways to improve speed. Training involves working at an all-out or near all-out effort for set periods, followed by set rest periods. (Alansare A. et al., 2018) It repeatedly challenges the aerobic and anaerobic systems, teaching the muscles, heart, and lungs to grow accustomed to working at higher intensity levels. Depending on the sport, the length and intensity of the intervals will be longer or shorter, less challenging, or more difficult. Runners can try these example HIIT speed drills:

Marathon Training

Mile repeats – a style of interval training where the runner goes all-out for a full mile before resting and doing it again.

Sprint Training

Focuses on shorter, more intense intervals.
Ranging from 40 to 400 meters, running all out and resting before repeating.

These same concepts apply to other sports as well.

Agility

Agility is the ability to move and change direction quickly and easily. For example, soccer, basketball, football, and tennis players are incredibly agile and have to move in every direction, jumping, sliding, twisting, and backpedaling in quick response to the ball’s movement and other players. Their bodies must be trained to respond and change course. Agility drills commonly involve exercises that develop foot speed and direction change, that include:

Ladder Drills

Using an agility ladder can help develop quick and specific foot placement.

Cone Drills

Set up cones in a T shape, then sprint, slide, backpedal, or change direction depending on the cone.

Coordination

Sports and physical activities require well-honed hand-eye and foot coordination. They require seeing an external object and responding precisely with the hands and/or feet. Think of hitting a ball, running and catching a ball, throwing a frisbee, or blocking a shot. To improve coordination, try skill-related fitness exercises like:

Playing catch
Jumping rope
Dribbling a ball
Throwing or hitting balls or specific sports objects at targets

Balance

Balance refers to the ability to adjust the body position to remain upright. It involves proprioception, or knowing where the body is in space and being able to adjust position as the center of gravity changes during movement. (Aman J. E. et al., 2015) Sports and daily physical activities require balance for performance and safety. Jumping on a trampoline or rebounder, for example, can help individuals better sense where their bodies are as they move. To improve balance, try these exercises:

Practice standing on one foot.
Practice standing yoga poses.
BOSU balance ball workouts.
Use balance discs to perform squats, lunges, and push-ups.

Reaction Time

Reaction time refers to how quickly one responds to an external stimulus and focuses on the mind-body connection. The eyes see a stimulus, the mind interprets the stimulus, and the body reacts to that interpretation. This mind-body reaction relates to knowledge of the sport or activity and enables individuals to respond more quickly and accurately to the stimulus. Reaction-time training tends to be sport-specific, but skill-related fitness activities can help and include:

Using tools like reaction balls
Fielding a ball
Protecting a goal as other players try to score
Playing table tennis
Playing hacky sack

Injury Medical Chiropractic and Functional Medicine Clinic

Ask a qualified fitness coach or personal trainer if you are unsure where to begin. Other athletes, local teams, gyms, athletic clubs, and healthcare organizations can direct individuals in the right direction. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain, restore function, and prevent injury. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Improving Athletic Performance Through Chiropractic

References

Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., Nieman, D. C., Swain, D. P., & American College of Sports Medicine (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and science in sports and exercise, 43(7), 1334–1359. doi.org/10.1249/MSS.0b013e318213fefb

Zemková, E., & Hamar, D. (2018). Sport-Specific Assessment of the Effectiveness of Neuromuscular Training in Young Athletes. Frontiers in physiology, 9, 264. doi.org/10.3389/fphys.2018.00264

Alansare, A., Alford, K., Lee, S., Church, T., & Jung, H. C. (2018). The Effects of High-Intensity Interval Training vs. Moderate-Intensity Continuous Training on Heart Rate Variability in Physically Inactive Adults. International journal of environmental research and public health, 15(7), 1508. doi.org/10.3390/ijerph15071508

Aman, J. E., Elangovan, N., Yeh, I. L., & Konczak, J. (2015). The effectiveness of proprioceptive training for improving motor function: a systematic review. Frontiers in human neuroscience, 8, 1075. doi.org/10.3389/fnhum.2014.01075

Get a Strong and Healthy Spine with These 7 Exercises

Dr. Alex Jimenez

Can incorporating these 7 exercises help individuals dealing with back pain help promote a healthy spine and functionality?

Table of Contents

Introduction

Many individuals have dealt with back pain in their body’s upper, middle, and lower portions, which can correlate with other issues in the upper and lower body extremities. This is due to how many environmental factors affect a person’s daily routine. From stressful days that impact a person’s day to physical inactivity or even spinal issues that have developed over time can cause back pain. When individuals decide to make changes in their health and wellness journey to not only reduce back pain but also improve how they present themselves. Many individuals can start with exercises to reduce back pain and help their spinal health by making sure that they are doing it correctly to prevent injuries. Today’s article looks at how spinal issues correlate with back pain and how these seven simple exercises and stretches can help reduce lower back pain and help you have a healthy spine. We talk with certified associated medical providers who provide our patients’ information to assess back pain correlated with their spine. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce back pain by integrating exercises to help reduce the pain and promote wellness. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.

Spinal Issues Correlating To Back Pain

Do you feel stiffness or muscle aches in your back’s upper, middle, or lower areas? Have you noticed that your posture is hunched more than normal when looking at the phone or being on the computer for an extended period? Or does your back ache from lifting a heavy object or sleeping incorrectly? More often than not, these pain-related scenarios are associated with back pain combined with spinal issues. As one of the leading causes of disability, loss of productivity, and more visits to a health clinic, back pain can impact the body and cause individuals to be miserable. (Bang et al., 2021) Back pain can be specific or non-specific and can cause a person’s spine to degenerate through the spinal disc. The spinal disc provides stability, flexibility, and mobility to the spine, which then helps keep the host upright. However, as the body ages, so does the spine, as lower back pain is multifactorial. When the spinal disc degenerates, the spine has a reduced capacity for intrinsic self-repair within the tissues. (Mohd Isa et al., 2022)

At the same time, when many individuals are dealing with low back pain, depending on the severity of the issue, they will often change their gait mechanics by adapting different strategies to mitigate the loading on the primary muscles associated with the locomotion that protects the pain-producing tissues. (Smith et al., 2022) When that happens, the pain from the lower back muscles can aggravate the spine further and lead to more chronic issues; however, there are ways to reduce the effects of lower back pain and to help keep the spine healthy.

Can Core Exercises Help with Back Pain?-Video

Can Core Exercises Help with Back Pain? | El Paso, Tx (2023)

The 7 Exercises To Incorporate For Back Pain

When it comes to making sure that lower back pain can be reduced and to help with keeping a healthy spine, many people often seek out physical therapy to reduce the pain. Since low back pain is costly in a clinical approach, physical therapy is cost-effective, non-invasive, and can help individuals get a kick start in their health journey. Physical therapy involves whole-body movement that emphasizes breathing coordination, reducing pain from the lower back, and helping stabilize the lumbar spine to improve physical function. (Li et al., 2023) By going through a treatment plan that incorporates physical therapy, many individuals will begin to notice their pain is improving and their quality of life is getting better. (Fischer et al., 2021) Additionally, stretching and core stability exercises can activate the deep and superficial spinal muscles by strengthening them and help stretch out sore muscles affected by low back pain to help many individuals recover. (Calatayud et al., 2019) Below are seven exercises that can help reduce back pain and, when done correctly and consecutively, can help many individuals have a healthier spine while being more mindful of their bodies.

Knee-To-Chest Exercise

This knee-to-chest exercise can help stretch the lower back muscles and can be done in the morning or evening.

Lying on your back with knees bent and feet flat for stability.
Pull one knee up with both hands and press it towards your chest.
Keep the stomach muscles tight while pressing your spine to the floor, holding for at least 30 seconds before returning to position.
Repeat with the other knee and do each stretch 2-3 times.

Lower Back Rotational Stretch (On the Floor)

This lower back rotational stretch can help stretch tight muscles in the lower back.

Laying on the mat, ensure you are on your back with knees bent and feet flat.
Make sure the shoulders are firmly on the floor, and slowly roll the knees to one side until 45 degrees.
Hold that position for 30 seconds before slowly rotating the knees back to the starting position.
Repeat on the other side and do each stretch 2-3 times.

Lower Back Flexibility Exercise

This lower back flexibility will help stretch and strengthen the lower back and core muscles.

Lay flat on the mat. For stability, make sure that the knees are bent with feet are flat on the floor.
Tighten the stomach muscles so the lower back can be pulled away from the floor.
Hold the position for 5 seconds and relax, slowly lowering to the floor.
Flatten the back as your belly button starts to go towards the floor, and hold the position for 5 seconds before relaxing.
Do five repetitions a day to slowly work up to 30 reps.

Bridge Exercise

The bridge exercise can help with core stability and help strengthen core muscles.

Laying flat on your back on the floor, with knees bent and feet flat. Make sure that your shoulders and head are relaxed.
Tighten the core and glute muscles while slowly raising from the hips to form a straight line from the knees to the shoulders.
Stay in that position for 30 seconds while taking deep breaths.
Slowly go down to the floor and relax.
Do five repetitions a day to slowly work up to 30 reps.

Cat-To-Cow Stretch

The cat-to-cow stretch helps with shoulders, upper back, and lower back muscles.

On your hands and knees, hip-width apart on the mat, be in a neutral spine position.
Slowly arch your back by pulling your belly towards the ceiling and your head down for 30 seconds.
Then, slowly let the back and belly sag towards the floor as the head rises for 30 seconds.
Return to the neutral spine position and repeat about 3-5 times twice daily.

Lower Back Rotational Stretch (Seated)

This lower back rotational stretch is seated if the floor is uncomfortable for individuals with severe back pain.

Sitting in an armless chair or stool in a seated upright position, cross one leg over the other.
Then, place the left elbow against the outside of the right knee and twist and stretch the side.
Hold the postion for 10 seconds before slowly returning to a seated position.
Repeat the stretch on the opposite side.
Do this stretch 3-5 times on each side to stretch tight back muscles about twice daily.

Shoulder Blade Squeeze

This shoulder blade squeeze helps individuals properly posture while stretching and strengthening tight upper back and shoulder muscles.

Start in a seated upright position on an armless chair or stool.
Slowly pull the shoulder blades together in the upright position and hold for 5-30 seconds.
Relax, return to the upright position, and repeat 3-5 times twice daily.

References

Bang, A. A., Bhojraj, S. Y., & Bang, A. T. (2021). Back pain and musculoskeletal pain as public health problems: Rural communities await solution. J Glob Health, 11, 01007. doi.org/10.7189/jogh.11.01007

Calatayud, J., Escriche-Escuder, A., Cruz-Montecinos, C., Andersen, L. L., Perez-Alenda, S., Aiguade, R., & Casana, J. (2019). Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain. Int J Environ Res Public Health, 16(19). doi.org/10.3390/ijerph16193509

Fischer, S. C., Calley, D. Q., & Hollman, J. H. (2021). Effect of an Exercise Program That Includes Deadlifts on Low Back Pain. J Sport Rehabil, 30(4), 672-675. doi.org/10.1123/jsr.2020-0324

Li, Y., Yan, L., Hou, L., Zhang, X., Zhao, H., Yan, C., Li, X., Li, Y., Chen, X., & Ding, X. (2023). Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis. Front Public Health, 11, 1155225. doi.org/10.3389/fpubh.2023.1155225

Mohd Isa, I. L., Teoh, S. L., Mohd Nor, N. H., & Mokhtar, S. A. (2022). Discogenic Low Back Pain: Anatomy, Pathophysiology and Treatments of Intervertebral Disc Degeneration. Int J Mol Sci, 24(1). doi.org/10.3390/ijms24010208

Smith, J. A., Stabbert, H., Bagwell, J. J., Teng, H. L., Wade, V., & Lee, S. P. (2022). Do people with low back pain walk differently? A systematic review and meta-analysis. J Sport Health Sci, 11(4), 450-465. doi.org/10.1016/j.jshs.2022.02.001

Disclaimer

Unveiling the Nutritional Benefits of Ghee in Cooking

Dr. Alex Jimenez

homemade ghee in container on a table , — homemade ghee in container on a table

Can using ghee improve diet and overall health for individuals looking to cook healthier?

Table of Contents

Ghee

Ghee is a type of clarified butter that is commonly used in Indian and Middle Eastern cooking. It’s made by heating butter to remove water and milk solids, a clarification process that results in a golden, pure fat with a high smoke point. The butter is cooked longer than in clarified butter, allowing milk solids to brown before being strained, giving ghee a richer, nuttier flavor than traditional clarified butter. The clarification process is believed to remove impurities, creating a healthier product. The clarification removes milk solids, decreasing ghee’s lactose and casein content. This could benefit people with a milk allergy or sensitivity.

Nutrition

Nutrition information for one tablespoon or 15 grams of ghee. (U.S Department of Agriculture, 2019)

Calories – 130
Fat – 15 grams
Sodium – 0 milligrams
Carbohydrates – 0 grams
Fiber – 0 grams
Sugars – 0 grams
Protein – 0 grams
Vitamin A – 107.5 micrograms
Vitamin E – 0.4 milligrams
Vitamin K – 1.1 micrograms

Carbohydrates

Ghee is almost completely pure fat, so it contains no carbohydrates.

Fats

Ghee is nearly 100% fat; one tablespoon has 15 grams, 9 of which are saturated fat. The remaining fat content is divided between 5 grams of healthier monounsaturated fat and less than one gram of polyunsaturated fat. Ghee is more concentrated than butter, containing more calories and fat.

Protein

Ghee may contain trace amounts of leftover protein if the milk solids or whey have not been completely removed in the clarification process.

Vitamins and Minerals

The micronutrient content can vary by brand and the supplied milk. A one-tablespoon serving contains about 8% of the recommended daily intake of vitamin A, 2% of vitamin E, and 1% of vitamin K. It’s recommended to use a small amount when cooking vegetables and other foods with fat-soluble nutrients so the body can better absorb them.

Benefits

Ghee has been used to improve memory, increase flexibility, and promote healthy digestion. However, further research is needed and ongoing to obtain scientific evidence to support health claims. For example, one animal study found no difference in memory or cognition from a diet that included ghee instead of regular butter, and there is no research on how ghee can help with memory. (Karandikar Y. S. et al., 2016)

Skin Health

Some individuals apply ghee topically as a salve for wounds, burns, or rashes. Research has confirmed that ghee has healing properties for the skin due to its antimicrobial and antioxidant activity, more than likely because of its vitamin A and E content. However, some studies examined ghee combined with honey, which provides other benefits. (Udwadia T. E. 2011) (Kotian S. et al., 2018)

Produces Less Acrylamide

Acrylamide is a potentially toxic and carcinogenic compound. It is produced when cooking fats are exposed to high heat. (American Cancer Society, 2019) A study found that ghee produces much less acrylamide when heated than vegetable oils and other saturated fats. (Daniali G. et al., 2016)

Allergies

Ghee is a dairy-based product. Individuals with a milk protein allergy could provoke an immune response, such as a rash, hives, vomiting, or diarrhea. Likewise, for individuals with lactose intolerance, consuming ghee could lead to symptoms of bloating, gas, or upset stomach. However, it may be less likely to cause allergic symptoms than butter since the clarification removes most lactose and casein components that typically cause adverse reactions. Talk to a doctor, dietitian, or allergist about whether ghee could be beneficial.

Adverse Effects

Since saturated fat is associated with the development of heart disease, the American Heart Association recommends reducing saturated fat to 5% to 6% of total daily calories for individuals who need to lower their cholesterol. A tablespoon of ghee contains about 40 milligrams of cholesterol, or 13% of the recommended daily intake, slightly higher than butter, 30 milligrams, or 10% RDI of the recommended daily intake. Recommendations are to use small quantities to enhance other foods, such as butter or oils.

Storage and Safety

Ghee usually comes in a glass jar. Depending on how quickly it will be used, it can be kept in a cool, dark place at room temperature, where it will be good for about three months. To extend its shelf life, it can be stored in the refrigerator for up to one year. While it will solidify when cooled, it will return to a liquid state once removed from the fridge. Ghee is available year-round at Indian and mainstream stores and sold online. However, it will probably be more expensive than regular butter because it takes more time and requires 16 ounces of butter to create 12oz. of ghee.

Preparation

Ghee has a nuttier flavor, higher density, and oilier texture, so individuals may not want to use it in the same ways that regular butter is, like spreading it on toast or baking it into pastries. For example, substituting ghee for shortening for pie dough may result in a richer flavor but a greasier texture. However, using ghee in baked goods can yield a crispier crust in certain recipes. A small serving can be used to enhance vegetable dishes. Its high smoke point makes it ideal for sautéing and stir-frying.

Smoke Point

The smoke point is the temperature at which fat starts to burn and smoke.

Butter 302 degrees F.
Olive oil 400 degrees F.
Ghee 482 degrees F

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, chiropractic adjustments, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician, as Dr. Jimenez has teamed with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Learning About Food Substitutions

References

U.S Department of Agriculture. FoodData Central. (2019). Ghee. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/718294/nutrients

Karandikar, Y. S., Bansude, A. S., & Angadi, E. A. (2016). Comparison between the Effect of Cow Ghee and Butter on Memory and Lipid Profile of Wistar Rats. Journal of clinical and diagnostic research: JCDR, 10(9), FF11–FF15. doi.org/10.7860/JCDR/2016/19457.8512

Udwadia T. E. (2011). Ghee and honey dressing for infected wounds. The Indian journal of surgery, 73(4), 278–283. doi.org/10.1007/s12262-011-0240-7

Kotian, S., Bhat, K., Pai, S., Nayak, J., Souza, A., Gourisheti, K., & Padma, D. (2018). The Role of Natural Medicines on Wound Healing: A Biomechanical, Histological, Biochemical and Molecular Study. Ethiopian journal of health sciences, 28(6), 759–770. doi.org/10.4314/ejhs.v28i6.11

American Cancer Society. (2019). Acrylamide and cancer risk. www.cancer.org/cancer/risk-prevention/chemicals/acrylamide.html

Daniali, G., Jinap, S., Hajeb, P., Sanny, M., & Tan, C. P. (2016). Acrylamide formation in vegetable oils and animal fats during heat treatment. Food Chemistry, 212, 244–249. doi.org/10.1016/j.foodchem.2016.05.174

Understanding Hip Bursitis: Causes, Symptoms, and Treatment

Dr. Alex Jimenez

shot-of-an-older-woman-doing-light-exercises-durin-2023-11-27-04-55-56-utc_02 — Shot of an older woman doing light exercises during a session with a physiotherapist inside.

Individuals with hip bursitis often experience discomfort during physical activity, walking, and pain when lying on the affected side. What treatment options are available to control and manage the condition?

Table of Contents

Hip Bursitis

Hip bursitis, also known as trochanteric bursitis, is a common condition that causes pain and discomfort in the hip and upper thigh along the outside of the hip joint. It occurs when one of the hip’s bursae, or fluid-filled sacs cushion joints, becomes inflamed. Treatment for hip bursitis is to control the inflammation caused by this condition.

Causes

Hip bursitis can be caused by injury or overuse of the hip, such as repetitive activities, twisting, or rapid joint movement. It can also be caused by a direct blow or fall to the side of the hip.

Symptoms

Pain from hip bursitis can be sharp at first and may feel dull and achy later.
It may be worse when standing up after sitting, moving, or using the hip.
Individuals may also notice pain when lying on the affected side or sitting for a long time.

Rest

This means a period of not participating in physical, exercise, and sports activities that aggravate symptoms. Any activity that causes hip pain should be avoided as this only contributes to inflammation of the bursa. (American Academy of Orthopaedic Surgeons, 2022) Modifying how particular activities are performed can help alleviate pressure on the inflamed bursa. Working with a physical therapist can also be recommended. They are experts in movement and alignment, and if certain muscles are overused compared to others, this can lead to unhealthy movement patterns, causing bursa irritation.

Anti-Inflammatory Medications

Nonsteroidal anti-inflammatory drugs, such as Motrin, Aleve, Naprosyn, etc., will help control inflammation (American Academy of Orthopaedic Surgeons, 2022). Anti-inflammatory medications can be extremely effective but should be taken cautiously. The instructions on the label need to be followed unless directed otherwise by a healthcare provider. Be aware of side effects and inform the healthcare provider if side effects present.

Cold Therapy

Applying ice to the hip area often helps alleviate the symptoms (National Library of Medicine, 2022). Ice can control inflammation by decreasing blood circulation to the area, especially after physical activity and exercise.

Aspiration

A needle is placed into the bursa to drain the fluid for those with a significant amount of fluid collected within the bursa. (National Library of Medicine, 2022) This is rarely needed in cases of hip bursitis, but when it is done, it can be combined with a cortisone injection.

Cortisone Injections

A cortisone injection may also be given into the bursa to alleviate pain. (American Academy of Orthopaedic Surgeons, 2022) The cortisone injection is helpful because it can be a diagnostic and therapeutic tool. In cases where hip bursitis may be one of several diagnoses being considered, cortisone can be given to see if it helps alleviate symptoms. Cortisone is a powerful anti-inflammatory medication that can be administered directly to the problem area. These injections are well-tolerated, but there can be possible side effects. Once the initial symptoms are under control, physical therapy strengthening and stretching exercises may be recommended.

Stretching

Most find relief by stretching the muscles and tendons over the outside of the hip, specifically the iliotibial band. The goal is for a better-conditioned muscle and tendon to glide more easily and not cause inflammation. Proper stretching techniques and posture are important in re-injury prevention.

Physical Therapy

Working with a physical therapist is an effective adjunct treatment for bursitis (American Academy of Orthopaedic Surgeons, 2022). Physical therapists correct muscle imbalances through stretching and exercise and improve alignment to prevent bursa irritation from reoccurring.

Surgery

Most patients get better with conservative treatment within about six weeks. Surgical treatment for hip bursitis is rarely needed (UCSF Health, 2024). Those who do not rest from their activities until the inflammation subsides often have a return of bursitis symptoms, and those who return too aggressively to activities and do not gradually build up also find that their symptoms return. In cases where surgery is needed, the healthcare provider may recommend an arthroscopic bursectomy. (American Academy of Orthopaedic Surgeons, 2022) The surgery is an outpatient minimally invasive procedure in which the bursa is removed through a small incision. After a short healing period, the individual can return to normal activity. Crutches may be used for a few days. Common complications are anesthetic-related complications and infection.

Injury Medical Chiropractic and Functional Medicine Clinic

As with any treatment program, always talk with your healthcare provider before initiating specific treatments. Fortunately, treatment of hip bursitis is generally accomplished with conservative therapies. Efforts to limit pressure directly on the bursa, alleviate inflammation, and restore normal movement to the hip joint will typically resolve symptoms. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain and restore function. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to integrate into a treatment plan to improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.

The Chiropractic Approach for Pain Relief

References

American Academy of Orthopaedic Surgeons. (2022). Hip bursitis. orthoinfo.aaos.org/en/diseases–conditions/hip-bursitis

National Library of Medicine. (2022). Bursitis: Learn More – How can bursitis be treated? InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). www.ncbi.nlm.nih.gov/books/NBK525763/

UCSF Health. (2024). Trochanteric bursitis treatments. www.ucsfhealth.org/conditions/trochanteric-bursitis

Why Stress Reduction is Key to Restoring Gut Health

Dr. Alex Jimenez

Can individuals reduce stress affecting their daily routine through treatments to restore their gut health?

Table of Contents

Introduction

Everybody in the entire world has dealt with stress at some point in their lives and has experienced general aches and pains in their bodies. This is due to the hormone cortisol, which helps regulate the entire body’s response. Stress has two forms, acute and chronic, and depending on the scenario a person is under, it correlates with stress and can even impact the major body systems. When dealing with acute stress, the muscles start to tense up at the stressor and go into a fight-or-flight mode until the stressor is gone and the individual can begin to relax. However, if the individual is dealing with chronic stress, it can cause numerous overlapping issues that can lead to digestive issues affecting the gut system. When the gut system is acting up from the cortisol hormone in its chronic form, many people will begin to notice small changes that are affecting their health and well-being. Today’s article examines why gut issues induce stress, how individuals can reduce stress naturally, and how people can restore their gut health. We talk with certified associated medical providers who provide our patients’ information to assess gut issues associated with stress that is affecting their health and wellness. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce the effects of stress correlating to gut health. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.

Why Gut Issues Induced Oxidative Stress?

How often does your body tense up and slowly relax after a stressful situation? Do you experience general aches or pains in your muscles and joints? Or do you feel tenderness and discomfort in your gut? When people are experiencing chronic oxidative stress in their bodies, they sometimes don’t realize that their gut also plays a part. This is because the gut is known as “the second brain” and helps regulate the immune response while protecting the body from unwanted pathogens. However, dealing with a large amount of stress from environmental factors can cause alterations in the immune system’s response and disrupt the delicate balance between the individual and the gut microbiota. (Sharifa et al., 2023) Since gut issues can vary from person to person, it is important to note that when environmental factors cause overlapping risk profiles, it can modify or change the gut microbiota composition of the host.

The gut system, which harbors a large number of beneficial microbial cells, plays a crucial role in the human body. These cells help stimulate the immune system’s maturity and play a role in cognitive performance and stress tolerance. (Marttinen et al., 2020) However, when a person has a poor diet, not physically active, or leads a stressful lifestyle due to their jobs, these environmental factors can cause the development of gut issues over time and contribute to the increase of oxidative stress in the body. (Vasquez et al., 2019) Additionally, many people dealing with chronic stress will often notice their skin feeling a bit warmer, they feel bloated, they will often experience fatigue throughout the day, and experience weight changes. So when the gut system is experiencing high levels of stress from environmental factors, the intestinal epithelial permeability will begin to activate the T-cells that will destroy the immunosuppressive cytokines which leads to systemic inflammation to the body. (Ni et al., 2022) However, there are numerous ways to reduce stress and to help restore gut health naturally.

Fighting Inflammation Naturally- Video

Fighting Inflammation Naturally | El Paso, Tx (2023)

How To Reduce Stress Naturally

When it comes to reducing stress naturally, the first step is to recognize the stressors. Many individuals can start off small by making small changes to their health and wellness. Incorporating meditation, journalling, chiropractic care, acupuncture, massage therapy, and exercise can help relax the mind, reduce stress from the body, and alleviate musculoskeletal issues that are correlated with the gut and stress. These treatments can help reduce the tension from the muscles being affected by stress, while stretching and relaxing them. Additionally, these therapies are non-surgical, customized to the patient, and help realign the spine to promote healing. By recognizing the stressor, many individuals can make the small changes they need to reduce their stress and prevent them from returning.

How To Restore Gut Health

Restoring gut health is crucial to prevent inflammatory issues from reoccurring in the body. The gut microbiota, which contains trillions of bacteria aiding in digestion and nutrient transport, needs to be replenished with good bacteria and reduced bad bacteria to dampen the inflammatory effects caused by stress. One effective way to restore gut health in the body is by incorporating probiotic-rich foods into your diet. These include yogurt, kefir, sauerkraut, and kimchi. These dietary modifications can influence the gut bacteria and restore the gut structure. (Madison & Kiecolt-Glaser, 2019)

At the same time, probiotics can help stabilize stress cortisol levels and boost the good bacterial microbiota to improve body function by lowering the inflammatory cytokines. (Madabushi et al., 2023) This, in turn, helps restore the gut flora to the gut system. At the same time, when individuals incorporating a healthy diet filled with anti-inflammatory foods and pro/prebiotics can help not only reduce oxidative stress correlated with gut issues but also implement management techniques for stress and exercises that can help improve a person’s quality of life, reduce inflammation from the gut and body, and help enhance the immune response. (Jawhara, 2024) When individuals start to think about their health and well-being, making small changes can lead to positive results and help make sure that no gut issues associated with stress can reoccur. Figuring out what stressors are impacting the gut and making these changes can help prevent them from returning in the future and help that individual live a healthier lifestyle.

References

Jawhara, S. (2024). How Do Polyphenol-Rich Foods Prevent Oxidative Stress and Maintain Gut Health? Microorganisms, 12(8). doi.org/10.3390/microorganisms12081570

Madabushi, J. S., Khurana, P., Gupta, N., & Gupta, M. (2023). Gut Biome and Mental Health: Do Probiotics Work? Cureus, 15(6), e40293. doi.org/10.7759/cureus.40293

Madison, A., & Kiecolt-Glaser, J. K. (2019). Stress, depression, diet, and the gut microbiota: human-bacteria interactions at the core of psychoneuroimmunology and nutrition. Curr Opin Behav Sci, 28, 105-110. doi.org/10.1016/j.cobeha.2019.01.011

Marttinen, M., Ala-Jaakkola, R., Laitila, A., & Lehtinen, M. J. (2020). Gut Microbiota, Probiotics and Physical Performance in Athletes and Physically Active Individuals. Nutrients, 12(10). doi.org/10.3390/nu12102936

Ni, Q., Zhang, P., Li, Q., & Han, Z. (2022). Oxidative Stress and Gut Microbiome in Inflammatory Skin Diseases. Front Cell Dev Biol, 10, 849985. doi.org/10.3389/fcell.2022.849985

Sharifa, M., Ghosh, T., Daher, O. A., Bhusal, P., Alaameri, Y. A., Naz, J., Ekhator, C., Bellegarde, S. B., Bisharat, P., Vaghani, V., & Hussain, A. (2023). Unraveling the Gut-Brain Axis in Multiple Sclerosis: Exploring Dysbiosis, Oxidative Stress, and Therapeutic Insights. Cureus, 15(10), e47058. doi.org/10.7759/cureus.47058

Vasquez, E. C., Pereira, T. M. C., Campos-Toimil, M., Baldo, M. P., & Peotta, V. A. (2019). Gut Microbiota, Diet, and Chronic Diseases: The Role Played by Oxidative Stress. Oxid Med Cell Longev, 2019, 7092032. doi.org/10.1155/2019/7092032

Disclaimer

Maximize the Freshness of Almonds with Correct Storage Methods

Dr. Alex Jimenez

hand hold a jar of a almond nuts with copy space .

Fans of almonds may have noticed that they can go stale and taste awful. Can knowing how to store almonds help extend their shelf life?

Table of Contents

Almonds

Almonds are a healthy, satisfying snack rich in nutrients, including fiber and protein. However, they can go stale and should not be eaten. Whole almonds stay fresh the longest because chopped, roasted, or ground almonds release their oils, which are exposed to more oxygen and go rancid more quickly.

Storage

They should be stored in an airtight container in the refrigerator or freezer for extended life. They are not recommended to be stored at room temperature for long periods, so storing them in the pantry is not recommended. However, enough for a snack can be taken from storage for a day or two while keeping the rest safe and fresh.

Shelf-Life

The shelf-life depends on how they’re produced, processed, and packaged. (Almond Board of California, 2024)

Natural almonds can be stored in the refrigerator or freezer for two years or more.
Roasted almonds can stay fresh for up to a year in an airtight container in the refrigerator or freezer.
Almond paste is recommended to be refrigerated and can stay fresh for 2 to 2 1/2 years.

Rancidity

Almonds are rich in omega-3 and monounsaturated fats, so they are recommended for heart health. (Cleveland Clinic, 2023) However, the fats become rancid if the almonds are exposed to oxygen, especially at room temperature. Rancid oil gives the stale almonds a bad taste. Spoiled almonds are not poisonous, but the fats no longer benefit health. It is possible that rancid fat could contribute to chronic health problems if consumed regularly. (Estévez M. et al., 2017) Almonds last longer than other nuts because they contain some phytochemical antioxidants that protect the nuts. So, if they taste bad, it’s time to throw them out. (University of California Agriculture and Natural Resources, 2010)

Salmonella

Salmonella is a bacteria that causes symptoms of food-borne illness, including upset stomach, vomiting, diarrhea, and fever. Almonds are generally safe from salmonella. However, raw almonds were responsible for two salmonella outbreaks in the United States and Canada. Salmonella outbreaks have also been reported in Australia. In response to those cases, the nuts now must be roasted, blanched, processed, steamed, or treated with a gas called propylene oxide. And none of these treatments remove the nutritional benefits.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, chiropractic adjustments, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Functional Nutrition

References

Almond Board of California. (2024). Shelf Stability and Shelf Life. www.almonds.com/tools-and-resources/food-safety-and-quality/shelf-stability-and-shelf-life

Cleveland Clinic. Clinic, C. (2023). Nutrition: Nuts & Heart Health. health.clevelandclinic.org/benefits-of-nuts

Estévez, M., Li, Z., Soladoye, O. P., & Van-Hecke, T. (2017). Health Risks of Food Oxidation. Advances in food and nutrition research, 82, 45–81. doi.org/10.1016/bs.afnr.2016.12.005

University of California Agriculture and Natural Resources. (2010). Nuts: Safe Methods for Consumers to Handle, Store, and Enjoy. ucfoodsafety.ucdavis.edu/sites/g/files/dgvnsk7366/files/inline-files/44384_0.pdf

Diagnosing and Treating Finger Injuries

Dr. Alex Jimenez

Concept Women's sport. Hands hold the ball. One hand in tapes. Second hand with manicure

For individuals dealing with finger injuries, which can occur from various causes, including overuse, jobs, sports, and more, can knowing the cause of finger pain help healthcare providers determine what steps to take for treatment?

Table of Contents

Finger Injuries

Finger injuries are common and can range from minor to serious. (van Veenendaal L. M. et al., 2014) Symptoms can result from an acute injury, including broken fingers and sprains, or chronic conditions like arthritis.

Fractures

Finger fractures can vary and can be serious and lead to permanent damage, deformity, and loss of function if not treated properly. What is important is that fractures are appropriately diagnosed so the proper treatment plan can be initiated. Most finger fractures can be addressed with simple treatments, while others may require surgery. (Oetgen M. E., and Dodds S. D. 2008)

Sprain and Dislocation

Sprains and dislocations are common finger injuries. (Prucz R. B. and Friedrich J. B. 2015) Both damage the ligaments that support the finger joints. In more severe injuries, a dislocation can occur, necessitating the finger to be put back into place or reduced. Individuals with a sprain or dislocation often notice finger swelling or stiffness for months after the injury.

Ligament Damage

Some call this injury skier’s or gamekeeper’s thumb, which results from a specific type of thumb dislocation. Here, the ulnar collateral ligament of the thumb is damaged. This ligament helps keep the thumb stable and supports grip and hand strength. However, this type of ligament injury often requires surgery. (Christensen T. et al., 2016)

Arthritis

Arthritis causes damage to normal joint surfaces where two bones come together. Fingers are one of the most common locations where arthritis occurs. (Spies C. K. et al., 2018) Two types of arthritis commonly affect the fingers: osteoarthritis and rheumatoid arthritis.

Arthritis of The Thumb

Arthritis of the thumb usually occurs at the joint where the thumb meets the wrist. This joint called the carpometacarpal/CMC joint, helps with gripping and pinching. Thumb arthritis is more common in women than men and increases in frequency over 40. (Deveza L. A. et al., 2017)

Trigger Finger

Trigger finger or stenosing tenosynovitis, is a common injury that causes pain and snapping of the fingers’ tendons, resulting in a sensation of locking or catching when bending and straightening the digits. (Makkouk A. H. et al., 2008) Other symptoms include pain and stiffness in the fingers and thumb. Treatments can vary from observation, rest, splinting, injections, and surgery.

Tendon Injuries

Mallet finger

A mallet finger is an injury to the tip of the finger. Usually, it occurs when the end of a straightened finger or thumb is hit, jamming the finger. After the injury, the individual may notice that they cannot fully straighten the tip of the finger. Treatment almost always uses a splint that has to stay on for about six weeks without removal. (Alla, S. R., Deal, N. D., and Dempsey, I. J. 2014) Very rarely is a surgical procedure necessary.

Jersey Finger

This is an injury to the finger flexor tendon. The flexor tendon pulls the finger into the palm when contracting the forearm flexor muscles. The injury occurs at the tip of the finger; typically, the tendon snaps back to the finger’s base or into the palm.

Ring Injuries

Injuries to the finger while wearing wedding bands or other finger jewelry can lead to serious complications. Even minor injuries can have devastating complications if the severity of the injury is not recognized and addressed. If an injury occurs while wearing the jewelry and there is soft tissue damage, including blood circulation being cut off, immediate medical attention is necessary.

Other Injuries

Bruises

The most common finger injury is caused by direct trauma to the skin and muscles. Symptoms include pain, swelling, tenderness, and discoloration of the skin.

Cuts and Scrapes

These can range from minor to more serious, such as injuries that cut through blood vessels, nerves, and tendons.

Injury Medical Chiropractic and Functional Medicine Clinic

After the initial inflammation and swelling have subsided, a doctor will recommend a treatment plan that usually involves physical therapy, self-performed physical rehabilitation, or supervision by a physical therapist or team. At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness & Nutrition, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to relieve pain and restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Sports Injury Rehabilitation

References

van Veenendaal, L. M., de Klerk, G., & van der Velde, D. (2014). A painful finger as first sign of a malignancy. Geriatric orthopaedic surgery & rehabilitation, 5(1), 18–20. doi.org/10.1177/2151458514522125

Oetgen, M. E., & Dodds, S. D. (2008). Non-operative treatment of common finger injuries. Current reviews in musculoskeletal medicine, 1(2), 97–102. doi.org/10.1007/s12178-007-9014-z

Prucz, R. B., & Friedrich, J. B. (2015). Finger joint injuries. Clinics in sports medicine, 34(1), 99–116. doi.org/10.1016/j.csm.2014.09.002

Christensen, T., Sarfani, S., Shin, A. Y., & Kakar, S. (2016). Long-Term Outcomes of Primary Repair of Chronic Thumb Ulnar Collateral Ligament Injuries. Hand (New York, N.Y.), 11(3), 303–309. doi.org/10.1177/1558944716628482

Spies, C. K., Langer, M., Hahn, P., Müller, L. P., & Unglaub, F. (2018). The Treatment of Primary Arthritis of the Finger and Thumb Joint. Deutsches Arzteblatt international, 115(16), 269–275. doi.org/10.3238/arztebl.2018.0269

Deveza, L. A., Hunter, D. J., Wajon, A., Bennell, K. L., Vicenzino, B., Hodges, P., Eyles, J. P., Jongs, R., Riordan, E. A., Duong, V., Min Oo, W., O’Connell, R., & Meneses, S. R. (2017). Efficacy of combined conservative therapies on clinical outcomes in patients with thumb base osteoarthritis: protocol for a randomised, controlled trial (COMBO). BMJ open, 7(1), e014498. doi.org/10.1136/bmjopen-2016-014498

Makkouk, A. H., Oetgen, M. E., Swigart, C. R., & Dodds, S. D. (2008). Trigger finger: etiology, evaluation, and treatment. Current reviews in musculoskeletal medicine, 1(2), 92–96. doi.org/10.1007/s12178-007-9012-1

Alla, S. R., Deal, N. D., & Dempsey, I. J. (2014). Current concepts: mallet finger. Hand (New York, N.Y.), 9(2), 138–144. doi.org/10.1007/s11552-014-9609-y

Effective Strategies for Addressing SIBO, Gut Health, and Back Pain

Dr. Alex Jimenez

Can individuals dealing with back pain find treatment to reduce gut pain associated with SIBO to improve body health?

Table of Contents

Introduction

Many individuals have noticed that when it comes to improving their health and well-being, many will incorporate small changes into their daily routines. From exercising for at least 30 minutes to incorporating healthy nutritional foods into their diet, many people don’t realize that the best way to have a healthy style starts with the gut. The gut system helps the body digest food and nutrients to be transported to the body, helps regulate growth and metabolism, and provides immune support to all the organ systems. However, when harmful pathogens and environmental factors start to impact the gut, it can cause the development of harmful pathogens inside the gut system and, over time, cause overlapping risk profiles in the body. This leads to gut dysfunction and musculoskeletal issues in the individual and can cause pain and discomfort if not treated right away. Luckily, numerous ways exist to improve gut health and reduce musculoskeletal issues. Today’s article focuses on a gut issue known as SIBO, how SIBO is correlated with back pain, and what treatments can help reduce SIBO. We talk with certified associated medical providers who provide our patients’ information to assess and identify how SIBO is correlated with back pain. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce the effects of SIBO and help restore gut health. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.

What is SIBO?

How often do you feel general aches or pain in your gut or around your lower back? Do you constantly feel tired throughout the day, even after a full night’s rest? Or have you been constantly feeling constipated or bloated after eating a meal? Many of these scenarios are associated with a gut issue known as SIBO or small intestinal bacterial overgrowth. Before diving into what SIBO is, it is important to see the gut’s main function to the body. Known as the second brain of the body, the gut system is home to trillions of good bacteria that help with food digestion and protect the body from bad bacteria. When environmental factors like poor dieting, physical inactivity, or inflammatory effects affect the body, the gut’s delicate ecosystem is also affected. This can cause gut dysfunction to the body and, over time, when it is not being treated, lead to SIBO.

SIBO is the presence of excess bad bacteria in the small intestines, which causes protective barriers that help the small intestines weaken. (Sorathia et al., 2024) Additionally, SIBO can correlate with conditions as it can accompany other gut issues by stimulating the immune system. (Banaszak et al., 2023) When the immune system becomes hyperactively stimulated by SIBO, it can cause the inflammatory cytokines to mass produce and cause a ripple effect on the entire body. Since inflammation is the body’s natural response to remove harmful pathogens that cause issues, mass production of inflammatory cytokines in the gut can cause toxins and bad bacteria to enter the bloodstream and travel to different body areas to cause pain. At the same time, SIBO can disrupt the gut-brain axis, which leads to intestinal motility changes and secretion, thus causing overlapping risk profiles like back pain to affect the body. (Carter et al., 2023)

Eating Right to Feel Better- Video

Eating Right to Feel Better | El Paso, Tx (2023)

How Does Back Pain Correlate With SIBO?

Now, many people are wondering how back pain is correlated with SIBO. Since SIBO causes the immune system to be hyperactive and mass-produce inflammatory cytokines to reduce the integrity and function of the gastrointestinal barrier, it can cause chronic inflammation and induce pain, which includes musculoskeletal conditions like back pain. (Hui et al., 2023) Additionally, the gut-brain axis being over-runed by SIBO and chronic inflammation being an overlapping risk factor can cause negative influences on the gut microbiome composition, and how the individual reacts to the changes can lead to abnormal bone growth and reabsorption due to the excess bacteria. (Geng et al., 2023) The excess bacteria produced by SIBO can affect intervertebral disc homeostasis and, when combined with environmental factors, can further enhance the inflammatory damage to the back muscles. (Yao et al., 2023) However, there are ways to not only reduce the back pain but also treat SIBO from causing more issues in the gut.

Treatments To Reduce SIBO

When it comes to treating SIBO, it depends on what treatment a person will be combined. The main goals for creating a treatment plan for SIBO are:

Reducing the bad bacteria
Bio-transform the gut
Preventing a relapse

Additionally, many individuals can make small changes in their routine by making dietary changes that can modify the intestinal microbiota. (Souza et al., 2022) This, in turn, helps promote gut health and replenish the nutrients while restoring the good bacteria to the gut. Regarding back pain associated with SIBO, chiropractic care can help individuals decrease or alleviate musculoskeletal symptoms by realigning the spine while massaging the muscles. This can help increase circulation while soothing the inflammatory effects caused by SIBO. Chiropractic care can be implemented as part of a person’s customizable treatment plan through a whole body approach by incorporating lifestyle changes and restoring gut health. By making these small changes with the right treatments to manage the overlapping symptoms caused by SIBO, many individuals can make these small changes to their routine to prevent SIBO from reappearing and causing issues in the body.

References

Banaszak, M., Gorna, I., Wozniak, D., Przyslawski, J., & Drzymala-Czyz, S. (2023). Association between Gut Dysbiosis and the Occurrence of SIBO, LIBO, SIFO and IMO. Microorganisms, 11(3). doi.org/10.3390/microorganisms11030573

Carter, J., Bettag, J., Morfin, S., Manithody, C., Nagarapu, A., Jain, A., Nazzal, H., Prem, S., Unes, M., McHale, M., Lin, C. J., Hutchinson, C., Trello, G., Jain, A., Portz, E., Verma, A., Swiderska-Syn, M., Goldenberg, D., & Kurashima, K. (2023). Gut Microbiota Modulation of Short Bowel Syndrome and the Gut-Brain Axis. Nutrients, 15(11). doi.org/10.3390/nu15112581

Geng, Z., Wang, J., Chen, G., Liu, J., Lan, J., Zhang, Z., & Miao, J. (2023). Gut microbiota and intervertebral disc degeneration: a bidirectional two-sample Mendelian randomization study. J Orthop Surg Res, 18(1), 601. doi.org/10.1186/s13018-023-04081-0

Hui, J., Chen, Y., Li, C., Gou, Y., Liu, Y., Zhou, R., Kang, M., Liu, C., Wang, B., Shi, P., Cheng, S., Yang, X., Pan, C., Jia, Y., Cheng, B., Liu, H., Wen, Y., & Zhang, F. (2023). Insight into the Causal Relationship between Gut Microbiota and Back Pain: A Two Sample Bidirectional Mendelian Randomization Study. Adv Genet (Hoboken), 4(4), 2300192. doi.org/10.1002/ggn2.202300192

Sorathia, S. J., Chippa, V., & Rivas, J. M. (2024). Small Intestinal Bacterial Overgrowth. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/31536241

Souza, C., Rocha, R., & Cotrim, H. P. (2022). Diet and intestinal bacterial overgrowth: Is there evidence? World J Clin Cases, 10(15), 4713-4716. doi.org/10.12998/wjcc.v10.i15.4713

Yao, B., Cai, Y., Wang, W., Deng, J., Zhao, L., Han, Z., & Wan, L. (2023). The Effect of Gut Microbiota on the Progression of Intervertebral Disc Degeneration. Orthopaedic Surgery, 15(3), 858-867. doi.org/10.1111/os.13626

Disclaimer

Using Blood Tests to Determine the Underlying Cause of Back Pain

Dr. Alex Jimenez

Medical report with tubes of blood — Coronavirus, COVID-19, 2019-nCoV. Positive Blood Sample in Doctors Hand with gloves. Respiratory Syndrome. Coronavirus outbreaking

Are there blood tests for individuals with chronic and severe back pain symptoms that can help healthcare providers diagnose?

Table of Contents

Blood Tests To Help Diagnose Back Pain

If a healthcare provider suspects an infection or inflammatory arthritis is the cause of back pain, blood tests may be used to diagnose. When trying to find the cause of back pain, a healthcare provider will examine the patient’s medical history, perform a physical examination, and, if necessary, order diagnostic tests. (Dansie E. J. and Turk D. C. 2013) For example, the National Institute of Arthritis and Musculoskeletal and Skin Diseases says that MRIs can reveal abnormalities in the spine. Still, a person may not feel pain or experience any other symptoms. The NIAMS also says healthy, pain-free individuals can have elevated SED levels. A high sedimentation rate or sed rate, also known as an erythrocyte sedimentation rate (ESR) test, can indicate inflammation in the body. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023)

Commonly Used Tests

Blood tests that can help diagnose back pain include:

Complete Blood Count – CBC

This test can indicate inflammation or infections.

Sed Rate or Erythrocyte Sedimentation Rate

This test measures inflammation by analyzing how red blood cells settle through plasma.
Inflammation could point to an infection. (Harrison M. 2015)
If the SED rate indicates that inflammation is present, the possibility of an underlying cause may be some form of arthritis or a tumor, which is rare.

CRP or C-reactive Protein

Another test that measures inflammation that could indicate an infection or some form of arthritis. (Sproston N. R. and Ashworth J. J. 2018)

HLA-B27

A genetic marker in the blood that is more common in individuals with ankylosing spondylitis and reactive arthritis. (McMichael A. and Bowness P. 2002)
This marker may be tested if the healthcare provider suspects either disease.
Ankylosing spondylitis is an inflammatory arthritis affecting the sacroiliac joints, hips, and spine. (Sieper J. et al., 2002)
Reactive arthritis is a type that occurs after an infection in a different body system or area. (Hamdulay S. S., Glynne S. J., and Keat A. 2006)

Injury Medical Chiropractic and Functional Medicine Clinic

At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain and restore function. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. Our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, severe sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness and nutrition, Functional Medicine Treatments, and in-scope care protocols. They can also work with other associated medical professionals to develop a personalized treatment plan to help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.

Integrative Medicine Approach

References

Dansie, E. J., & Turk, D. C. (2013). Assessment of patients with chronic pain. British journal of anaesthesia, 111(1), 19–25. doi.org/10.1093/bja/aet124

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Back Pain. Retrieved from www.niams.nih.gov/health-topics/back-pain

Harrison M. (2015). Erythrocyte sedimentation rate and C-reactive protein. Australian prescriber, 38(3), 93–94. doi.org/10.18773/austprescr.2015.034

Sproston, N. R., & Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Frontiers in immunology, 9, 754. doi.org/10.3389/fimmu.2018.00754

McMichael, A., & Bowness, P. (2002). HLA-B27: natural function and pathogenic role in spondyloarthritis. Arthritis research, 4 Suppl 3(Suppl 3), S153–S158. doi.org/10.1186/ar571

Sieper, J., Braun, J., Rudwaleit, M., Boonen, A., & Zink, A. (2002). Ankylosing spondylitis: an overview. Annals of the rheumatic diseases, 61 Suppl 3(Suppl 3), iii8–iii18. doi.org/10.1136/ard.61.suppl_3.iii8

Hamdulay, S. S., Glynne, S. J., & Keat, A. (2006). When is arthritis reactive?. Postgraduate medical journal, 82(969), 446–453. doi.org/10.1136/pgmj.2005.044057

Implementing a Heart-Clinical Approach to Trafficking: Key Strategies for Success

Dr. Alex Jimenez

Can healthcare professionals implement H.E.A.R.T. protocols for trafficked individuals while providing a safe space?

Table of Contents

Introduction

Across the world, many local media and organizations are paying close attention to a phenomenon that many people should be aware of. This phenomenon is known as trafficking, and it can be associated with numerous activities, from forced labor to sex labor, and can affect a person’s sense of self-worth. While many people will correlate that trafficking affects many women and children, it can affect many individuals regardless of age, gender, and background. While many survivors of trafficking are dealing with the psychological and physical injuries that they obtain from their traffickers, many medical professionals can implement protocols and roles through the implementation of H.E.A.R.T. to provide a safe space for individuals suffering from trafficking. Today’s article focuses on the definition of trafficking, what H.E.A.R.T. is, and how it is used in a clinical setting. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in a clinical approach while providing a safe space. We also inform and guide patients while asking their associated medical provider intricate questions to formulate customized treatment plans for their pain and provide them with a safe space and positive experience. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

The Definition Of Trafficking

When it comes to defining trafficking, it can be challenging as it is frequently associated with other issues. However, the main definition for trafficking is “recruiting, transporting, transferring, or harboring many individuals or a person that are threatened or forced to achieve the consent of a person having control of the individuals for exploitation.” With human trafficking being a pressing public concern that affects all races, social classes, demographics, and genders, it can impact society and the individual who is being trafficked. (Toney-Butler et al., 2024) Additionally, many people often mistake trafficking and smuggling as they are completely different. Smuggling requires a person to be transported into a nation through voluntary illicit means. While trafficking can come in two forms, which are labor and commercial sex, it can happen within the person’s own home. (Rambhatla et al., 2021) This is because many survivors who are going to get healthcare services will feel various emotions of fear or shame that can prevent them from asking for help due to what they have been through with their trafficker. However, when many individuals who are trafficking survivors are suffering from significant physical, mental, and social health problems and are seeking healthcare services, many healthcare professionals play an important role by creating a safe and responsive space for them. (The Lancet Regional Health-Western, 2022)

Beyond the Surface: Understanding the Effects of Personal Injury- Video

Beyond the Surface: Understanding the Effects of Personal Injury | El Paso, Tx (2024)

What is H.E.A.R.T In A Clinical Setting

When it comes to creating a safe and positive space in a clinical setting, many healthcare professionals often miss the signs of trafficking due to a lack of training or confidence to identify and treat patients who are trafficking victims. (Lee et al., 2021) However, healthcare protocols should be implemented, and H.E.A.R.T. should be incorporated into a clinical approach to assess and develop a customized treatment plan for the patient. Healthcare professionals can engage with the patient in a one-on-one discussion away from their trafficker and can offer important medical and psychological care resources. (Exeni McAmis et al., 2022) By incorporating H.E.A.R.T. protocols in a healthcare clinic, many doctors and medical professionals can help many patients be in a safe environment. Below is what H.E.A.R.T. stands for.

H-Hearing

The “H” in H.E.A.R.T. is for hearing as many medical professionals not only to hear but to see what is going on in the clinic and to establish environmental awareness. This is due to looking at the patient and who is accompanied by them. With healthcare providers being at the front, they interact with patients and may not know what health concerns are affecting them. This could be due to the following:

Language or cultural barriers
Fear of criminal repercussions
Fear of the trafficker
Distrust of the healthcare provider (Gutfraind et al., 2023)

By incorporating the hearing aspect in H.E.A.R.T., many healthcare professionals can provide a safe, thoughtful, and engaging approach to the patient and know what to look for when a patient is coming in for treatment.

E-Evaluating

The “E“ in H.E.A.R.T. is used to evaluate its importance in enhancing patient interactions in a trauma-informed care facility. This is highly important because the individual is seeking health care. For the patients being trafficked, it is important to notice the red flags the individual is experiencing. Some of the red flags that many healthcare providers should look for are:

Physical health
Behavioral Health
The patient is with a controlling person
The patient does not have possession of their I.D.

Additionally, it is always important to show compassion, be sensitive to the individual while addressing their needs and concerns, and use a non-judgmental approach during the interview process. This helps the individual ensure they are in a safe environment when discussing sensitive topics. At the same time, it is important not to let the patient be re-traumatized while avoiding the impulse to rescue and overpromise the patient to mental health as we want them to have their self-worth. At the same time, it is best to remember the four “Rs“ when doing a trauma-informed approach; they are:

Realize: Understanding how trauma can affect people.
Recognize: Recognizing the signs of trauma.
Respond: Have all staff trained, use evidence-based practices, and provide a safe environment.
Resist Re-trauma: Recognizing how some practices may trigger painful memories while avoiding re-traumatizing the patient.

By implementing the four “Rs“ and the “E“ in H.E.A.R.T., many healthcare professionals can provide valuable resources to trafficking survivors with a strong support system.

A-Activating

The “A“ in H.E.A.R.T. stands for activating, where healthcare professionals must have proper protocols to engage all employees. This allows the healthcare providers to understand how beneficial it is to develop a protocol for a person who is being trafficked, understand their state and federal reporting laws, and list key elements of effective trauma-informed screening procedures when assessing the patient. This allows a foundational structure to support a response for suspected patients who are being trafficked. At the same time, by following HIPAA laws and organization policies, many healthcare providers must explain the reporting process to the right officials. Additionally, the benefits of developing a protocol for trafficking are by:

Clarifying procedures
Enhance staff training
Optimize the interactions with the trafficking patients
Improve staff confidence
Prepare for any threatening situations
Maximizing preparedness to aid trafficking patients
Optimize support for patients
Develop collaborative outside resources

R-Resourcing

The “R“ in H.E.A.R.T. stands for resourcing, as many healthcare providers must identify the referral systems. This allows healthcare professionals to understand the important message to convey when assessing trafficking victims and the importance of responding to safety, emergency, and reporting requirements. When assessing and interviewing the patient, many will have to recognize that their patient may be a possible victim of trafficking, what their immediate needs are, and what long-term resources can help.

T-Training

The “T” in H.E.A.R.T. stands for training, as it is important that many healthcare providers continuously train to spot trafficking; this provides confidence to many healthcare workers and can help save a person’s life. By implementing H.E.A.R.T. protocols, the “T” allows the doctor to respect the individual’s decision to want help, providing a positive support system while encouraging them to come back, offering to help with a safety plan, and building a resource network. This is because if the patient is accompanied by someone who is controlling and answering for the patient, handing out information discreetly can provide a bit of hope to the individual to make the move. At the same time, providing local and immediate assistance resources can help the individual in the long run. This allows healthcare providers to build a trusting relationship and even help individuals to have a safe and positive experience on their health and wellness journey.

References

Exeni McAmis, N. E., Mirabella, A. C., McCarthy, E. M., Cama, C. A., Fogarasi, M. C., Thomas, L. A., Feinn, R. S., & Rivera-Godreau, I. (2022). Assessing healthcare provider knowledge of human trafficking. PLOS ONE, 17(3), e0264338. doi.org/10.1371/journal.pone.0264338

Gutfraind, A., Yagci Sokat, K., Muscioni, G., Alahmadi, S., Hudlow, J., Hershow, R., & Norgeot, B. (2023). Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes. Front Public Health, 11, 1243413. doi.org/10.3389/fpubh.2023.1243413

Lee, H., Geynisman-Tan, J., Hofer, S., Anderson, E., Caravan, S., & Titchen, K. (2021). The Impact of Human Trafficking Training on Healthcare Professionals’ Knowledge and Attitudes. J Med Educ Curric Dev, 8, 23821205211016523. doi.org/10.1177/23821205211016523

Rambhatla, R., Jamgochian, M., Ricco, C., Shah, R., Ghani, H., Silence, C., Rao, B., & Kourosh, A. S. (2021). Identification of skin signs in human-trafficking survivors. Int J Womens Dermatol, 7(5Part B), 677-682. doi.org/10.1016/j.ijwd.2021.09.011

The Lancet Regional Health-Western, P. (2022). Human trafficking is more than a crime. Lancet Reg Health West Pac, 20, 100444. doi.org/10.1016/j.lanwpc.2022.100444

Toney-Butler, T. J., Ladd, M., & Mittel, O. (2024). Human Trafficking. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/28613660

Disclaimer

The Benefits of Walking with a Cane for Injury Recovery

Dr. Alex Jimenez

Elderly patient trying to stand and walking with caregiver nurse — Senior man with knee problems, Elderly patient on sofa trying to stand and walking with caregiver nurse at home, Young physiotherapist taking care and supporting senior man to exercise

Can using a cane help individuals after an injury, living with chronic pain or balance issues, or post-surgery?

Table of Contents

Walking With A Cane

A cane is an assistive device that can help individuals walk after injury or surgery and aids with balance and stability. It can be used for:

Balance or Stability Issues

Canes can help with minor balance or stability issues, such as weakness in the leg or trunk, or after an injury.

Pain

Canes can help reduce stress on painful joints or limbs.

Independence

Canes can help people continue living independently, especially the elderly.

There are different types of canes, including single-point and quad canes. Single-point canes are generally the least expensive. Quad canes have four points and can provide more stability. It is important to use it correctly to prevent falls and injuries.

Post-surgery or Injury

A cane can help reduce pressure on the leg or back after surgery or injury. Healthcare providers may recommend a cane as a step-down device after using a walker or crutches. Before walking with the cane, ensure it is at the right height. Hold the cane in the hand on the opposite side of the injury. Hold the cane’s handle at the level of the bend in the wrist when standing with the elbow slightly bent. (American Academy of Orthopaedic Surgeons, 2020) If there are issues in both legs or a cane is used after back surgery, keep the cane in the hand with the most support.

Practicing Taking Steps

To practice taking steps with a cane, try the following (American Academy of Orthopaedic Surgeons, 2020)

Place the cane firmly on the ground.
Take a small step forward with the injured leg.
Step the opposite foot forward to meet the injured leg.
Continue this process until you can take multiple steps in a row with balance.

Progress to a step-to-walking pattern (Hirayama K. et al., 2022)

Step forward with the cane and injured leg at the same time.
Step the non-injured leg up with the cane firmly on the ground to meet the injured leg.
The feet should be side by side.

Walking Normally

Once comfortable taking practice steps, try walking normally with the cane. Step forward with the cane and injured leg simultaneously. The cane should be off the ground when the wounded leg is in the air. Firmly plant the cane when stepping onto the injured leg. Step forward with the cane and the injured leg first, then step past the injured leg with the good leg.

Using The Stairs

When walking up and down stairs, it’s important to use proper technique to prevent losing balance. (American Academy of Orthopaedic Surgeons, 2020)

Walking Up the Stairs

Step up with the good leg.
Bring the injured leg and cane up to the step.

Walking Down the Stairs

Step down with the injured leg while lowering the cane to the step below.
Make sure the cane is firmly on the stairs.
Bring the good leg down to the same step.

If a handrail is available, use it. Although doing so may require moving the cane to the other hand, even if it’s on the same side as the injured leg, it will improve stability and reduce the risk of falling. Once proficient on the stairs, individuals may alternate placing one foot on each step.

Walking With Chronic Pain

Walking with a cane with a chronic pain condition is similar to using it with an injury. The location of the pain will determine which hand the cane is held in. If the pain is on the right side of the body, keep the cane on the left side or vice versa. If chronic pain is not in the legs but, for example, back pain makes it difficult to walk, hold the cane on either side, whichever feels more supportive and comfortable. If there is weakness on one side of the body or decreased sensation/numbness in one of the legs or feet, hold the cane on the opposite side of the pain, weakness, or numbness. Walking with a cane can also benefit individuals with other medical conditions. For example, assistive devices may be recommended for those with balance issues. (National Library of Medicine, 2023)

Cane Types

There are two primary types of canes, characterized by their points, and choosing the right one depends on the reason it’s needed. (Arthritis Foundation, N.D.)

Single-point

Single-point canes have one tip at the end.
These are recommended for those who need to relieve some pressure off an injured leg or need support due to occasional difficulties with balance.

Quad

Quad canes have four tips or feet to provide more stability.
They provide more support and are recommended for those with significant weakness in one leg or difficulty maintaining their balance while walking.

The traditional cane has a rounded C handle. Other types have contoured handles for a more secure grip. Talk to a doctor, physical therapist, or other health care professional for suggestions on which cane is right for you.

Losing Balance

A potential risk of using a cane is losing balance. If unable to maintain balance with a cane, individuals may want to consider a different walking device, such as a walker or crutches. To reduce the risk of falls, consider the following tips (American Academy of Orthopaedic Surgeons, 2020)

Wear shoes with nonskid soles.
Add lighting so you can see where you are walking.
Remove throw rugs or objects that can cause tripping.
Arrange furniture to allow for wide walking paths throughout the home.
Carry objects in a backpack or fanny pack rather than holding them.

Injury Medical Chiropractic and Functional Medicine Clinic

Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to develop a personalized treatment plan to help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.

Osteoporosis

References

American Academy of Orthopaedic Surgeons. (2020). How to use crutches, canes, and walkers. orthoinfo.aaos.org/en/recovery/how-to-use-crutches-canes-and-walkers/

Hirayama, K., Otaka, Y., Kurayama, T., Takahashi, T., Tomita, Y., Inoue, S., Honaga, K., Kondo, K., & Osu, R. (2022). Efficiency and Stability of Step-To Gait in Slow Walking. Frontiers in human neuroscience, 15, 779920. doi.org/10.3389/fnhum.2021.779920

National Library of Medicine. (2023). Using a cane. Retrieved from medlineplus.gov/ency/patientinstructions/000343.htm

Arthritis Foundation. (N.D.). How to choose the right cane. www.arthritis.org/health-wellness/healthy-living/managing-pain/joint-protection/how-to-choose-the-right-cane

A Comprehensive Guide to Anterolisthesis and its Implications

Dr. Alex Jimenez

Back is hurting, spine pain. Foreman is in the storehouse, shipping distribution business.

Individuals who have experienced spinal or back trauma, suffered fractures, are going through spinal degeneration, or are dealing with a spinal condition have an increased risk of anterolisthesis, where a vertebra slips forward relative to the vertebra below it. Can healthcare providers help prevent and treat the condition?

Anterolisthesis

The spine consists of 33 individual bones or vertebrae stacked on one another. Anterolisthesis occurs when one vertebral segment slips forward over another. The condition can be mild, asymptomatic, or cause significant pain and neurological symptoms. Many different things, including osteoarthritis, osteoporosis, trauma, or a fracture, can cause this vertebral shifting. (Cedars Sinai, 2022) Spondylolisthesis is a general term for shifting a spinal vertebra over the one below it. It includes anterolisthesis, forward moving, and the less common retrolisthesis, or backward shifting.

Grades

Anterolisthesis is typically graded using the Meyerding scale, which assigns one of five grades according to how much slippage has occurred. These grades include:

Grade 1

0 to 25% slippage

Grade 2

25 to 50% slippage

Grade 3

50 to 75% slippage

Grade 4

75 to 100% slippage

Grade 5

More than 100% slippage or spondyloptosis

Grade 1 and 2 cases are generally mild, while grades 3, 4, and 5 are more severe. (Koslosky E., and Gendelberg D. 2020)

Symptoms

Anterolisthesis can lead to various symptoms, depending on the severity and if the surrounding spinal nerves have been affected. The most common complaints include:

Lower back stiffness
Lower back pain
Shooting pain into the leg
Weakness when standing or walking for a long time
Cramping in the leg muscles
Numbness or tingling in the leg that improves when sitting or bending forward (American Academy of Orthopaedic Surgeons, 2021)

Causes

Cases of anterolisthesis are also typically categorized based on what led to the condition. The most common causes include:

Degenerative anterolisthesis

Shifting occurs when arthritis (spondylosis) causes the spine’s joints and discs to deteriorate.
The degenerative version of the anterolisthesis is the most common, particularly in women and adults over 50.
African Americans tend to experience this condition at a higher rate than the general population. (American Academy of Orthopaedic Surgeons, 2021)

Isthmic anterolisthesis

Slippage is caused by a fracture in a portion of the spine called the pars, also known as a pars defect.

Congenital or Dysplastic anterolisthesis

Slippage is caused by a condition present at birth or spinal abnormality.

Traumatic anterolisthesis

Acute shifting of the vertebrae caused by a traumatic injury.

Pathologic anterolisthesis

Anterolisthesis occurs because of a bone disease like osteoporosis.

Iatrogenic – Postsurgical anterolisthesis

Slippage that occurs as a result of a prior spinal decompression surgical procedure. (Hospital for Special Surgery, 2023)

Diagnosis

Diagnosis begins with a subjective evaluation and a physical examination. During these, the healthcare provider will assess sensation, strength, and reflexes and will order one of several diagnostic tests, including:

X-rays

Visualizes the vertebrae in the spine and their position relative to those above and below.
Also provides a clear picture of spinal arthritis or disc degeneration.

Magnetic Resonance Imaging – MRI

Allows the spinal cord, nerves, muscles, and discs to be assessed for compression or damage.

Computed Tomography – CT scan

Provides a cross-sectional image of the spine in very clear detail. (American Academy of Orthopaedic Surgeons, 2021)

Treatment

Several factors determine how the condition is treated, including:

The grade of the slippage.
The cause.
The symptoms.
The presence of instability on a diagnostic test such as an X-ray.

Stable and mildly symptomatic cases are usually treated with a combination that can involve:

Physical therapy
Activity modification
Bracing
Nonsteroidal anti-inflammatory medications/NSAIDs like ibuprofen.
Spinal injections

In more severe cases in which spinal instability or significant neurological symptoms are present, surgery may be recommended. This commonly involves a spinal decompression or fusion procedure. The technique varies based on the surgeon’s preferences and anatomy. (Koslosky E., and Gendelberg D. 2020)

Prognosis

Most individuals with this condition don’t know they have it until it is found accidentally on an X-ray or an MRI for something else. Mild cases can cause minimal symptoms and can be well-managed with conservative treatments. Cases of unstable anterolisthesis or those with neurological compression often require surgical intervention. These surgeries restore stability to the spine and alleviate any pressure on the nerves. More than 85% of individuals who need surgery have a successful outcome. (American Academy of Orthopaedic Surgeons, 2021)

Self-Care and Management

For individuals experiencing pain, numbness, or tingling from anterolisthesis, getting symptoms evaluated by a healthcare provider is an important first step. The healthcare provider may suggest one of several management strategies, which include:

Core Strengthening

To alleviate symptoms, exercises targeting the core muscles in the hips, pelvis, abdomen, and lower back are recommended.
Formal physical therapy may also be recommended.

Over-the-counter Meds

A healthcare provider may suggest pain-relieving medications like ibuprofen or naproxen to reduce soreness.

Activity Modification

Sticking to gentle, pain-free activities and avoiding excessive or repetitive extension of the spine can help prevent symptom aggravation. (American Academy of Orthopaedic Surgeons, 2021)

Injury Medical Chiropractic and Functional Medicine Clinic

At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness & Nutrition, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to relieve pain and restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Degenerative Disc Disease Treatment

References

Cedars Sinai. (2022). Anterolisthesis. www.cedars-sinai.org/health-library/diseases-and-conditions/a/anterolisthesis.html

Koslosky, E., & Gendelberg, D. (2020). Classification in Brief: The Meyerding Classification System of Spondylolisthesis. Clinical orthopaedics and related research, 478(5), 1125–1130. doi.org/10.1097/CORR.0000000000001153

American Academy of Orthopaedic Surgeons. (2021). Adult spondylolisthesis in the low back. orthoinfo.aaos.org/en/diseases–conditions/adult-spondylolisthesis-in-the-low-back

Hospital for Special Surgery. (2023). Spondylolisthesis. www.hss.edu/condition-list_spondylolisthesis.asp