Maintaining Gut Flora Balance

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

Conception of healthy eating. With woman. Doctor in formal clothes is working in the cabinet.

For individuals with stomach issues, can maintaining gut flora balance promote and improve gut health?

Table of Contents

Gut Flora Balance

Maintaining gut flora balance is part of optimal digestive health. Gut microbiota, gut microbiome, or gut flora, are the microorganisms, including bacteria, archaea, fungi, and viruses that live in the digestive tract. The type and amount of bacteria present depend on their location in the body which could be the small intestine and colon. This is the storage housing for waste/stool, and the colon comprises hundreds of different types of bacteria, which have specific jobs and functions.

Unhealthy Flora

The more common pathogens are bacteria that can cause illness if left unchecked, including germs like streptococcus/strep throat or E. coli/urinary tract infections and diarrhea. Other common germs found in the colon include: (Elizabeth Thursby, Nathalie Juge. 2017)

Clostridioides Difficile

C. diff overgrowth can cause watery foul-smelling stools daily, and abdominal pain and tenderness.

Enterococcus Faecalis

Enterococcus faecalis is a cause of post-surgical abdominal and urinary tract infections.

Escherichia Coli

E. coli is the most common cause of diarrhea in adults.
This bacteria is present in almost every healthy adult’s colon.

Klebsiella

Klebsiella overgrowth is associated with a Western diet that consists of various meat and animal products.

Bacteroides

Bacteroide overgrowth is associated with colitis, which causes painful inflammation of the colon.

Healthy Flora

Healthy bacteria like Bifidobacteria and Lactobacillus, help maintain gut flora balance and keep the unhealthy bacteria in check. Without healthy flora, the entire colon can become overrun by bad flora, which can result in symptoms like diarrhea and/or illness. (Yu-Jie Zhang, et al., 2015) These protective, microscopic germs have important functions that include:

Assisting with vitamin synthesis – vitamins B and K in the small intestine.
Increases immune system function.
Maintaining regular bowel movements.
Maintaining a clean colon naturally without the need for colon cleansers.
Destroying the unhealthy bacteria.
Preventing unhealthy bacteria overgrowth.
Breaking up gas bubbles from food fermentation.

Bacterial Dismantling

Whether labeled as healthy bacteria or unhealthy, they are both single-celled organisms that can be destroyed quite easily. Sometimes, it is necessary, like when having to take antibiotics to kill a strep throat infection. However, the antibiotics also kill the beneficial bacteria, which can lead to compounding problems that can include: (Mi Young Yoon, Sang Sun Yoon. 2018)

Bowel irregularity – diarrhea and constipation.
Yeast overgrowth – can cause itching, burning around the anus and lead to vaginal and oral yeast infections.
Dysbiosis – the technical name for a lack of healthy bacteria or a bacterial imbalance.
Complications for individuals suffering from irritable bowel syndrome.

There are different ways to destroy bacteria including.

Individuals who need to take antibiotics to cure an infection. (Eamonn M M Quigley. 2013)
Chronic laxative use.
Fiber supplementation overuse.
Prolonged diarrhea – can flush out the bad and good bacteria.
Stress
Completing a bowel prep, like those required for a colonoscopy.

Diagnosing Gut Flora Issues

Many times, problems with gut flora will correct themselves, and no action is required. However, individuals facing chronic bowel problems, like colitis or inflammatory bowel disease, may require medical intervention of their colon’s bacteria.

Comprehensive Digestive Stool Analysis/CDSA is a stool test that checks what type and amount of bacteria are present, nutrient absorption rates/digestion speed, and how well food is digested.
If there is a significant difference in the proportion of unhealthy versus beneficial bacteria, a healthcare provider may suggest taking a probiotic or a live microbial supplement to help repopulate and maintain gut flora balance.

Gut Dysfunction

References

Thursby, E., & Juge, N. (2017). Introduction to the human gut microbiota. The Biochemical journal, 474(11), 1823–1836. https://doi.org/10.1042/BCJ20160510

Zhang, Y. J., Li, S., Gan, R. Y., Zhou, T., Xu, D. P., & Li, H. B. (2015). Impacts of gut bacteria on human health and diseases. International journal of molecular sciences, 16(4), 7493–7519. https://doi.org/10.3390/ijms16047493

Yoon, M. Y., & Yoon, S. S. (2018). Disruption of the Gut Ecosystem by Antibiotics. Yonsei medical journal, 59(1), 4–12. https://doi.org/10.3349/ymj.2018.59.1.4

Quigley E. M. (2013). Gut bacteria in health and disease. Gastroenterology & hepatology, 9(9), 560–569.

Tennis Weight Training

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

“Tennis requires strength, power, and endurance. Can combining tennis weight training into a player’s fitness regimen that is broken up into phases achieve optimal results?”

Tennis Weight Training

In professional sports that utilize weight lifting, the training is often broken up into seasonal phases. (Daniel S Lorenz, Michael P Reiman, John C Walker. 2010) Each phase consists of specific objectives that contribute to and build upon the previous phase. This is known as periodization. Tennis is played year-round indoors and outdoors. This is an example of a tennis weight training program to build up strength.

Pre-Season

In the early pre-season, players prepare to rebuild their strength after a break.
The emphasis is on building functional strength and some muscle.

Late Pre-Season

In late pre-season, players workout to get ready for the start of the season.
Here, the emphasis is on building maximum power.

In Season

In season, regular practice, play, and competition get underway and players are in top condition.
In this phase, strength and power maintenance is the focus.

Season Break

This is when players need to relax for a while.
However, players need to keep active if they want to maintain some level of fitness.
The emphasis is on rest and recovery with the maintenance of light activity, like cross-training and light gym workouts.
Research has shown that taking a break from serious strength training does help the body recover and rebuild. (Daniel Lorenz, Scot Morrison. 2015)

This is a three-phase all-around program.
The first phase concentrates on building basic strength and muscle
The second phase on power delivery.
Players who play year-round can continue with the power program once they build the basics.
Players who take a break for longer than six weeks should start again with the strength program.

Pre-Season – Phase One

Strength and Muscle

The focus is on lifting heavy weights, but not going full force to begin training the nervous system to work with the muscle fibers.
Some muscle building or hypertrophy/building muscle size will happen during strength development.
Strength is the foundation for the power development phase.

Exercises:

Duration: 6-8 weeks
Workout Days: 2-3, with at least one day, however, two are recommended between sessions.
Reps: 8-10
Sets: 2-4
Rest between sets: 1-2 minutes

Barbell squat, dumbbell squat, or sled hack squat
Romanian deadlift
Dumbbell bent-over row
Dumbbell triceps extension or machine pushdown
Cable wood chop
Lat pulldown to the front with a wide grip
Reverse crunch

Things to Remember

Use the Proper Weight

Adjust the weight so that the last reps are heavy but don’t cause a complete failure.

Balance the Lower Half

The posterior chain of the hips, the gluteals/buttocks, the upper legs, and the abdominals are of equal importance and require equal attention. (Eline Md De Ridder, et al., 2013)
Squats and deadlifts build strength and power in this region.

Follow Proper Form

For upper body exercises like the dumbbell press, lat pulldown, and wood chops the proper form needs to be followed.
Keep the forearms in a vertical plane with the upper arms.
Do not extend excessively at the bottom of the movement.
Remember to protect the vulnerable shoulder joint.

Listen to The Body

Strength training is physically and mentally challenging.
Individuals who are not able to recover from a session with only one rest day are recommended to move the program to two sessions per week.
Muscle soreness or delayed onset muscle soreness – DOMS – is normal, however, joint pain is not.
Monitor arm and shoulder reactions during this phase.
Stop if any joint pain or discomfort is felt.

Late Pre-Season – In-Season – Phase Two

Power

Power is the ability to move the heaviest loads in the shortest time and is the combination of strength and speed. In this phase, the player builds on the strength developed in phase one with tennis weight training that will increase the ability to move a load at high velocity.

Power training requires lifting weights at high velocity and with explosiveness.
The body needs to rest adequately between repetitions and sets so that each movement is done as fast as possible.
The number of sets can be less than phase one because there is no point in training at this level when the body is fatigued.

Exercises

Duration: Ongoing
Days per week: 2
Reps: 8 to 10
Sets: 2-4
Rest between repetitions: 10 to 15 seconds
Rest between sets: at least 1 minute or until recovered

Barbell or dumbbell hang clean
Cable push-pull
Cable wood chop
One arm cable raises
Medicine ball push press
Medicine ball standing twist with a partner or alone – 6×15 repetitions fast and recover between sets.

Reminders When Preparing For the Season

Recovery Time

In power training, it’s important that the body has relatively recovered for each repetition and set so that the individual can maximize the movement.
The weights should not be as heavy and the rest periods sufficient.

Push When Possible

Rest is important, at the same time, the player needs to push through reasonably heavy loads to develop power against significant resistance.
When doing medicine ball twists, do a full set at maximum, then sufficiently rest before the next one.
If doing the medicine ball exercises alone, use a lighter ball and keep the ball in your hands while twisting.

In Season – Phase Three

When the season begins training does not stop in order to help maintain strength and power.

Strength and Power Maintenance

Alternate phase one and phase two for a total of two sessions each week.
Every fifth week, skip weight training to achieve optimal recovery.

Key Points

Things to keep in mind during the season.

Avoid Overscheduling

Avoid strength training on the same day when practicing on the court.
If the weight training has to be both on the same day, try to separate the workouts into morning and afternoon sessions.

Plan Time

Rest completely from strength training one week out of every six.
Light gym work is fine.
During the season, use intuition when it comes to working out at the gym.
Individuals with limited time, stick to court skills training instead of tennis weight training.

Off Season

If there is an off-season, this is the time for emotional and physical decompression and full-body recovery.

For several weeks, forget about weight training and do other things.
Stay fit and active with cross-training or other physical activities but keep it light to prevent injuries.

It is recommended to consult a coach, trainer, sports chiropractor, and/or physical therapist to develop a program specific to an individual’s needs, fitness goals, and access to resources.

Spine Injuries In Sports

References

Lorenz, D. S., Reiman, M. P., & Walker, J. C. (2010). Periodization: current review and suggested implementation for athletic rehabilitation. Sports health, 2(6), 509–518. https://doi.org/10.1177/1941738110375910

Lorenz, D., & Morrison, S. (2015). CURRENT CONCEPTS IN PERIODIZATION OF STRENGTH AND CONDITIONING FOR THE SPORTS PHYSICAL THERAPIST. International journal of sports physical therapy, 10(6), 734–747.

De Ridder, E. M., Van Oosterwijck, J. O., Vleeming, A., Vanderstraeten, G. G., & Danneels, L. A. (2013). Posterior muscle chain activity during various extension exercises: an observational study. BMC musculoskeletal disorders, 14, 204. https://doi.org/10.1186/1471-2474-14-204

Fixed Sagittal Imbalance

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

Back pain often occurs with employees who work in warehouses, Because they have to pull, lift, and push goods throughout the day of work.

“Individuals with fixed sagittal imbalance, a condition where the normal curve of the lower spine is greatly reduced or absent altogether that can cause pain and difficulty balancing. Can chiropractic treatment, physical therapy, and exercise help improve the condition?”

Table of Contents

Fixed Sagittal Imbalance

The condition is commonly known as flat back syndrome and can be present at birth or can happen as a result of surgery or a medical condition.

It can also happen for other reasons, including degenerative disc disease, traumatic injury, or as a result of spinal surgery. (Columbia University Irving Medical Center. 2023)
Individuals with flat back syndrome position their head and neck too far forward.
A major symptom is difficulty standing for long periods of time.

Symptoms

The spine has two curves. The lumbar spine in the lower back and cervical spine in the neck curve inward. The thoracic spine in the upper back curves outward. The curves are part of the spine’s natural alignment. They help the body balance and maintain the center of gravity.

If these curves begin to disappear the body can have trouble and difficulty standing up straight.
The loss of curvature causes the head and neck to pitch forward, making it hard to walk and do regular normal activities.
Individuals have to flex their hips and knees and adjust their pelvis in order to stand up straight. (Columbia University Irving Medical Center. 2023)
There is a tendency to stoop forward which gradually increases and can even feel like the body is falling forward.
By the end of the day, the body is exhausted from the strain of trying to maintain balance.

Causes

Some causes of fixed sagittal imbalance include: (Columbia University Irving Medical Center. 2023)

Congenital – present at birth.
Degenerative disc disease.
Ankylosing spondylitis – a type of inflammatory arthritis of the spine.
Compression fractures of the vertebrae – for example, caused by osteoporosis.
The condition used to be common after spine surgery to correct scoliosis/abnormal curvature of the spine.
The devices implanted could cause flat back syndrome, especially for older individuals.
However, new and updated surgical techniques have decreased the complications.

Diagnosis

A doctor will ask about medical history, injuries, or back surgery. This will followed by a physical exam, that can include:

A musculoskeletal exam.
A neurologic exam.
A gait examination will assess standing and walking ability.
The gait exam is done because the gait can change to compensate for the loss of the curvature.
X-ray imaging will show spinal alignment.
Other possible sources of symptoms will be considered before a diagnosis can be confirmed.

Treatment

Treatment often involves physical therapy and exercise, bracing to provide increased support, and sometimes surgery.

Physical therapy typically begins with stretching and targeted strengthening exercises to improve posture.
The goal is to reverse the pattern of muscle imbalance that keeps the lower back flat.
Exercises to strengthen the neck, rear shoulder muscles, back, core, and buttocks can include: (National Health Service. n.d.)
Abdominal stretches
Hamstring stretches.

Hamstring stretches improve the alignment of the lumbar spine.
Hold the stretch for about 30 seconds at a time.
Repeat three to five times once or twice a day.

Back extensions
Chest stretches
Planking
Side-lying leg raises
Seated rows in a gym or pull-ups

In severe cases, patients may need corrective surgery. A few options include: (Columbia University Irving Medical Center. 2023)

Polysegmental wedge osteotomy.
Pedicle subtraction osteotomy.
Posterior vertebral column resection. (Byoung Hun Lee, et al., 2018)

A chiropractor and/or physical therapist can recommend exercises and other forms of treatment. (Won-Moon Kim, et al., 2021)

Life-Changing Chiropractic Relief

References

Columbia University Irving Medical Center. Flatback syndrome.

National Health Service. Common posture mistakes and fixes.

Lee, B. H., Hyun, S. J., Kim, K. J., Jahng, T. A., Kim, Y. J., & Kim, H. J. (2018). Clinical and Radiological Outcomes of Posterior Vertebral Column Resection for Severe Spinal Deformities. Journal of Korean Neurosurgical Society, 61(2), 251–257. https://doi.org/10.3340/jkns.2017.0181

Kim, W. M., Seo, Y. G., Park, Y. J., Cho, H. S., & Lee, C. H. (2021). Effect of Different Exercise Types on the Cross-Sectional Area and Lumbar Lordosis Angle in Patients with Flat Back Syndrome. International journal of environmental research and public health, 18(20), 10923. https://doi.org/10.3390/ijerph182010923

Sciatic Endometriosis

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

Young woman with back spine pain ache sitting on sofa. — Young woman with back spine pain ache sitting on sofa

“Can combining chiropractic treatment with the common therapies of medication, exercise, and/or physical therapy help relieve sciatic endometriosis pain symptoms?”

Table of Contents

Sciatic Endometriosis

Sciatic endometriosis is a condition in which endometrial cells (tissue that resembles the lining of the uterus) grow outside of the uterine lining and compress the sciatic nerve. This places stress and pressure on the nerve causing back, pelvic, hip, and leg pain, especially before and during the menstrual cycle. It can also cause pain, irregular periods, and infertility. (The American College of Obstetricians and Gynecologists. 2021)

These areas of endometrial tissue growth are also known as lesions or implants.
Women with sciatic endometriosis often experience leg pain and weakness around the time of their menstrual cycle. (Lena Marie Seegers, et al., 2023)
Sciatic endometriosis can also cause pain when urinating, during a bowel movement, during sex, and fatigue, and irregular vaginal bleeding.

The Sciatic Nerve

Typically, endometrial lesions grow and attach to the ovaries, fallopian tubes, bladder, intestines, rectum, or peritoneum/abdominal cavity lining. (The American College of Obstetricians and Gynecologists. 2021)
The abnormal growth may be caused by higher-than-normal levels of estrogen.
Researchers believe that endometriosis is related to retrograde menstruation, which causes menstrual blood to flow back into the pelvis instead of out through the vagina. (World Health Organization. 2023)
Sometimes, the cells grow in the area of the pelvis right above the sciatic nerve. (Adaiah Yahaya, et al., 2021)
The sciatic nerve is the longest nerve in the body and travels down the back of each leg. (Johns Hopkins Medicine. 2023)
When endometrial lesions place pressure on the sciatic nerve, they can cause irritation and inflammation leading to severe pelvic pain, which makes it harder to conceive. (Liang Yanchun, et al., 2019)

Symptoms

Some women with endometriosis experience no symptoms or misinterpret the symptoms as typical premenstrual syndrome/PMS signs. The most common signs and symptoms of sciatic endometriosis include:

Difficulty walking or standing.
Loss of sensation, muscle weakness, and reflex alteration.
Limping.
Balance problems.
Bloating and nausea.
Constipation or diarrhea before or after a period.
Painful, heavy, and/or irregular periods.
Bleeding between periods.
Pain during sex, urination, and bowel movements.
Pain in the stomach, pelvis, lower back, hips, and buttocks. (MedlinePlus. 2022)
Weakness, numbness, tingling, burning, or dull aching sensations in the back of one or both legs.
Foot drop or trouble lifting the front of the foot. (Center for Endometriosis Care. 2023)
Infertility.
Fatigue.
Depression and anxiety.

Diagnosis

Endometriosis, including sciatic endometriosis, typically cannot be diagnosed with a pelvic examination or ultrasound by themselves. A healthcare provider may need to perform a biopsy using laparoscopy and discuss menstrual cycles, symptoms, and medical history.

The laparoscopy procedure involves making tiny incisions and taking a tissue sample with tools attached to a thin tube with a camera. (MedlinePlus. 2022)
Imaging tests, like magnetic resonance imaging/MRI, and computed tomography/CT scans, can help provide essential information about the location and size of any endometrial lesions. (The American College of Obstetricians and Gynecologists. 2021)

Treatment

Symptoms can sometimes be temporarily relieved with over-the-counter/OTC pain relievers. Depending on the condition and severity a healthcare provider may prescribe hormonal treatment to prevent new endometrial implants from growing. These can include:

Hormonal birth control.
Progestin – a synthetic form of progesterone.
Gonadotropin-releasing hormone – GnRH agonists.
If pain persists or worsens, individuals may need to undergo surgery to remove the tissue.
In severe cases, a hysterectomy or surgical removal of the uterus may be recommended. (The American College of Obstetricians and Gynecologists. 2021)
Physical therapy, gentle targeted exercises, and applying heat or cold to the affected area may also help. (Johns Hopkins Medicine. 2023)

Sciatica In Depth

References

The American College of Obstetricians and Gynecologists. Endometriosis.

Seegers, L. M., DeFaria Yeh, D., Yonetsu, T., Sugiyama, T., Minami, Y., Soeda, T., Araki, M., Nakajima, A., Yuki, H., Kinoshita, D., Suzuki, K., Niida, T., Lee, H., McNulty, I., Nakamura, S., Kakuta, T., Fuster, V., & Jang, I. K. (2023). Sex Differences in Coronary Atherosclerotic Phenotype and Healing Pattern on Optical Coherence Tomography Imaging. Circulation. Cardiovascular imaging, 16(8), e015227. https://doi.org/10.1161/CIRCIMAGING.123.015227

World Health Organization. Endometriosis.

Yahaya, A., Chauhan, G., Idowu, A., Sumathi, V., Botchu, R., & Evans, S. (2021). Carcinoma arising within sciatic nerve endometriosis: a case report. Journal of surgical case reports, 2021(12), rjab512. https://doi.org/10.1093/jscr/rjab512

Johns Hopkins Medicine. Sciatica.

Yanchun, L., Yunhe, Z., Meng, X., Shuqin, C., Qingtang, Z., & Shuzhong, Y. (2019). Removal of an endometrioma passing through the left greater sciatic foramen using a concomitant laparoscopic and transgluteal approach: case report. BMC women’s health, 19(1), 95. https://doi.org/10.1186/s12905-019-0796-0

MedlinePlus. Endometriosis.

Center for Endometriosis Care. Sciatic endometriosis.

Chen, S., Xie, W., Strong, J. A., Jiang, J., & Zhang, J. M. (2016). Sciatic endometriosis induces mechanical hypersensitivity, segmental nerve damage, and robust local inflammation in rats. European journal of pain (London, England), 20(7), 1044–1057. https://doi.org/10.1002/ejp.827

Siquara de Sousa, A. C., Capek, S., Howe, B. M., Jentoft, M. E., Amrami, K. K., & Spinner, R. J. (2015). Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases. Neurosurgical focus, 39(3), E15. https://doi.org/10.3171/2015.6.FOCUS15208

Garlic Tea Health Benefits

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

“Garlic tea is an herbal tonic made from garlic, lemon, and honey. What medicinal uses and benefits can garlic provide that is supported by scientific research?”

Table of Contents

Garlic Tea

Garlic tea:

Garlic – Allium sativum – is a perennial plant from Central Asia.
The plant produces a bulb that is used in cooking and in health remedies all over the world.
Garlic powder, oil, and supplements are available.
Supplements can be made from garlic oil or from fresh, dried, or aged garlic.
Each form may have a different effect on the body. (National Center for Complementary and Integrative Health. 2020)
The tea is commonly made with garlic, lemon, and honey, but can be made with a variety of different ingredients.
It is used for cold symptoms like congestion and cough.

Health Benefits

Some, but not all benefits are supported by scientific evidence. It is important to keep in mind that these studies are analyzing garlic, and not necessarily garlic tea. The dose of garlic in tea may not be the same as a more concentrated dose that is used in the studies. Also, cooking or boiling garlic can change its therapeutic effects.

Potential Benefits

However, some of these are not backed up by research: (Leyla Bayan, Peir Hossain Koulivand, Ali Gorji. 2014)

Improves immune health
Prevents and treats cancer
Helps with Weight loss
Helps fight infections
Helps reduce cholesterol
Helps to disinfect wounds
Helps treat vaginal yeast infections
Relief from mouth ulcers
Improves exercise performance
Treatment for atherosclerosis
Helps to ward off mosquitos

Research-Backed Benefits of Garlic

The scientific evidence about garlic’s benefits. Garlic is a healthy source of organosulfur compounds, including alliinase, which is released when it is crushed or chopped. (Leyla Bayan, Peir Hossain Koulivand, Ali Gorji. 2014)
Organosulfur compounds are believed to provide health benefits.
An overview of garlic studies found that there are promising health benefits, however, the researchers caution that larger studies are needed to confirm the results and verify the right dosage to get the results. (Johura Ansary, et al., 2020)

The current studies show the following possible benefits:

Raw garlic could be beneficial in reducing high blood pressure. (Shunming Zhang, et al., 2020)
Some studies have also shown that garlic could be able to stimulate the immune system and decrease tumor growth in certain cancers, like colorectal cancer.
However, research investigating the cancer-preventing benefits has shown mixed results. (Xi Zhou, et al., 2020)
Garlic does have antioxidant and anti-inflammatory properties. (Aslihan Avci, et al., 2008)
A study in animals found that garlic has antifungal properties. (J P Burian, L V S Sacramento, I Z Carlos. 2017)

Honey and Lemon

Honey and lemon provide their own health benefits.

Lemon is a healthy source of vitamin C.
Research has found that lemons may help reduce blood pressure when combined with walking. (Yoji Kato, et al., 2014)
Honey can help soothe cold and flu symptoms, including cough and congestion.
It is also an antioxidant, anti-inflammatory, and antimicrobial. (Saeed Samarghandian, et al., 2017)

Side Effects

According to the NIH, garlic is safe for most individuals in moderate amounts. ((National Center for Complementary and Integrative Health. 2020)

Common side effects of garlic consumption include bad breath, upset stomach, and body odor.
Garlic can also cause bloating, gas, and heartburn for some.
There are allergies to garlic and individuals with an allergy can experience more severe symptoms.
The NIH also advises that taking garlic may increase your risk of bleeding.
Individuals taking a blood thinner like warfarin or about to undergo surgery should discuss taking supplements or drinking garlic tea with their healthcare provider.
Garlic has been found to interfere with the effectiveness of some drugs that are used to treat HIV infection.
Lemon can cause tooth erosion so it is recommended to rinse teeth after drinking.
Honey has sugar content so it is recommended to use it in small quantities.

Healthy Diet and Chiropractic

References

National Center for Complementary and Integrative Health. Garlic.

Bayan, L., Koulivand, P. H., & Gorji, A. (2014). Garlic: A review of potential therapeutic effects. Avicenna journal of phytomedicine, 4(1), 1–14.

Ansary, J., Forbes-Hernández, T. Y., Gil, E., Cianciosi, D., Zhang, J., Elexpuru-Zabaleta, M., Simal-Gandara, J., Giampieri, F., & Battino, M. (2020). Potential Health Benefit of Garlic Based on Human Intervention Studies: A Brief Overview. Antioxidants (Basel, Switzerland), 9(7), 619. https://doi.org/10.3390/antiox9070619

Zhang, S., Liu, M., Wang, Y., Zhang, Q., Liu, L., Meng, G., Yao, Z., Wu, H., Xia, Y., Bao, X., Gu, Y., Wang, H., Shi, H., Sun, S., Wang, X., Zhou, M., Jia, Q., Song, K., & Niu, K. (2020). Raw garlic consumption is inversely associated with prehypertension in a large-scale adult population. Journal of human hypertension, 34(1), 59–67. https://doi.org/10.1038/s41371-019-0257-0

Zhou, X., Qian, H., Zhang, D., & Zeng, L. (2020). Garlic intake and the risk of colorectal cancer: A meta-analysis. Medicine, 99(1), e18575. https://doi.org/10.1097/MD.0000000000018575

Avci, A., Atli, T., Ergüder, I. B., Varli, M., Devrim, E., Aras, S., & Durak, I. (2008). Effects of garlic consumption on plasma and erythrocyte antioxidant parameters in elderly subjects. Gerontology, 54(3), 173–176. https://doi.org/10.1159/000130426

Burian, J. P., Sacramento, L. V. S., & Carlos, I. Z. (2017). Fungal infection control by garlic extracts (Allium sativum L.) and modulation of peritoneal macrophage activity in a murine model of sporotrichosis. Brazilian journal of biology = Revista brasleira de biologia, 77(4), 848–855. https://doi.org/10.1590/1519-6984.03716

Kato, Y., Domoto, T., Hiramitsu, M., Katagiri, T., Sato, K., Miyake, Y., Aoi, S., Ishihara, K., Ikeda, H., Umei, N., Takigawa, A., & Harada, T. (2014). Effect on blood pressure of daily lemon ingestion and walking. Journal of nutrition and metabolism, 2014, 912684. https://doi.org/10.1155/2014/912684

Samarghandian, S., Farkhondeh, T., & Samini, F. (2017). Honey and Health: A Review of Recent Clinical Research. Pharmacognosy Research, 9(2), 121–127. https://doi.org/10.4103/0974-8490.204647

A Focus On Non-Surgical Therapeutic Options For Low Back Pain

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

Can non-surgical options be beneficial for many working individuals with low back pain than surgical therapeutic options?

Table of Contents

Introduction

Many working individuals will experience pain in their lower backs due to their demanding workloads that are causing unwanted pressure load on the lumbar region of the spine. With the spine’s main job to support the body’s upper and lower quadrants, many individuals with demanding jobs are either constantly sitting down at their desks or carrying heavy objects to different locations. With low back pain being a normal problem for everyone at some point, many individuals find temporary solutions to relieve the pain, only to repeat the factors. To that point, this leads to chronic musculoskeletal disorders that can cause referred pain to the lower and upper extremities and can be pricey when going into treatment. However, there are numerous options for working individuals that are cost-effective and safe on their lower backs. Today’s article examines how low back pain affects the working individual and how non-surgical treatment options vary with surgical possibilities when dealing with low back pain. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to ease low back pain associated with musculoskeletal disorders. We also inform them that there are non-surgical options to reduce the effects of low back pain and restore their quality of life. We encourage our patients to ask amazing educational questions to our associated medical providers about their musculoskeletal symptoms correlating with low back pain. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer

How Does Low Back Pain Affect The Working Individual?

Have you been dealing with constant radiating pain in your lower back, legs, or feet after a long workday? Do you feel pain when moving around, only to find relief when resting? Or do you and your loved ones feel muscle aches and strains when stretching in the morning? Many individuals, especially working individuals, deal with low back pain daily when dealing with these musculoskeletal issues. Low back pain is extremely common for working individuals as it can affect their job performance and be an economic burden when treated. Low back pain is a multifactorial problem that has an increased rate of affecting individuals and contributes to the growth of numerous health problems. Low back pain can cause many individuals to miss work due to the lack of clarity on the causes, treatments, and factors contributing to this musculoskeletal disorder. (Pai & Sundaram, 2004)

So, how would low back pain affect the working individual? Since many people have demanding jobs, it can cause the surrounding muscles, ligaments, and tissues in the lumbar region to be overworked, and the spinal discs degenerate over time. When there are unrelenting changes within the spine, it can be associated with affecting the lumbar structures of the spine to degenerate over time. This, in turn, causes the lumbar spine to go through biochemical changes that can generate pain-like symptoms in the lumbar region and cause structural changes to the spine, leading to lower back pain. (Benoist, 2003)

Additionally, there are many causes and factors that many working individuals will do that lead to low back pain. Normal factors like improper lifting, stepping wrong, or sitting down excessively can contribute to lower back pain. At the same time, traumatic factors like accidents, injuries, or playing sports can also lead to lower back pain. When musculoskeletal conditions like low back pain become an issue, it can become a major burden to health and social care systems for many individuals, with indirect costs that can be pricey when treated. (Woolf & Pfleger, 2003)

Chiropractic Care After Accidents & Injuries-Video

Chiropractic Care After Accidents and Injuries | El Paso, Tx (2023)

Now, with low back pain being a nuisance to many, individuals will seek out treatment to reduce the pain they are experiencing in their lower back and mitigate the residual symptoms they have been dealing with in the other body extremities. Sadly, low back pain, especially in its chronic state, can become a diagnosis of convenience for many people, affecting their socioeconomic, work, and psychosocial lifestyles. (Andersson, 1999) Many individuals will seek out numerous treatment opportunities to reduce low back pain. Surgical treatments for low back pain are great for individuals when regular home therapies don’t work but can be pricey. Many will opt for non-surgical therapies when it comes to finding cost-effective treatments for treating low back pain. Non-surgical treatments, including chiropractic care and spinal decompression, are excellent for treating low back pain. Pain specialists like chiropractors and massage therapists utilize various techniques (mechanical and manual) to realign the body and stretch out the affected muscles that are affected by low back pain. The video explains how these treatments can reduce low back pain associated with accidents and injuries.

Non-Surgical Options For Low Back Pain

As stated earlier, non-surgical treatments can help reduce low back pain and can be combined with other therapies to manage the pain. Non-surgical treatments can be personalized to the person’s pain and can provide pain relief to the body. When individuals undergo a non-surgical treatment, pain specialists incorporate mechanical and manual manipulation to restore joint and spinal motion to the lower back. (Park et al., 2023) Additionally, individuals with low back pain include an exercise regime to effectively increase the person’s range of motion while increasing the person’s chances to return to normal daily activities and work. (van Tulder et al., 2000)

Non-Surgical Options Vs. Surgical Options

There is a vast difference between non-surgical and surgical options for treating low back pain. Anyone can personalized non-surgical options to provide more effective improvement in reducing pain, restoring lumbar range of motion, and improving back muscle endurance within a few sessions. (Amjad et al., 2022) Now, when home remedies and non-surgical options do not reduce pain, surgical options are only effective for low back pain. This is due to the psychological component that causes individuals to have persistent back pain that is not causing the relief that the person needs. (Corp et al., 2021) But both options are excellent when reducing low back pain as many doctors tell their patients to be more mindful about how they are using the muscles in their bodies and make small changes to reduce the chances of the pain from returning. When many working individuals start to think more about their pain and how to minimize its chances of returning, they can continue to live life to the fullest pain-free.

References

Amjad, F., Mohseni-Bandpei, M. A., Gilani, S. A., Ahmad, A., & Hanif, A. (2022). Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord, 23(1), 255. https://doi.org/10.1186/s12891-022-05196-x

Andersson, G. B. (1999). Epidemiological features of chronic low-back pain. Lancet, 354(9178), 581-585. https://doi.org/10.1016/S0140-6736(99)01312-4

Benoist, M. (2003). Natural history of the aging spine. Eur Spine J, 12 Suppl 2(Suppl 2), S86-89. https://doi.org/10.1007/s00586-003-0593-0

Corp, N., Mansell, G., Stynes, S., Wynne-Jones, G., Morso, L., Hill, J. C., & van der Windt, D. A. (2021). Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines. Eur J Pain, 25(2), 275-295. https://doi.org/10.1002/ejp.1679

Pai, S., & Sundaram, L. J. (2004). Low back pain: an economic assessment in the United States. Orthop Clin North Am, 35(1), 1-5. https://doi.org/10.1016/S0030-5898(03)00101-9

Park, S. C., Kang, M. S., Yang, J. H., & Kim, T. H. (2023). Assessment and nonsurgical management of low back pain: a narrative review. Korean J Intern Med, 38(1), 16-26. https://doi.org/10.3904/kjim.2022.250

van Tulder, M., Malmivaara, A., Esmail, R., & Koes, B. (2000). Exercise therapy for low back pain: a systematic review within the framework of the cochrane collaboration back review group. Spine (Phila Pa 1976), 25(21), 2784-2796. https://doi.org/10.1097/00007632-200011010-00011

Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bull World Health Organ, 81(9), 646-656. https://www.ncbi.nlm.nih.gov/pubmed/14710506

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572542/pdf/14710506.pdf

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Reducing Low Back Inflammation With Traction

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

Can traction therapy help many individuals dealing with low back pain reduce inflammation and improve quality of life?

Table of Contents

Introduction

When many individuals do everyday activities, if they are not careful, they can cause pain-like issues such as muscle strain, stiffness, and aches in different locations in the upper and lower portions of their bodies. When this happens, it can lead to the body’s natural defense, known as inflammation. Inflammation is the immune system’s natural defense to heal the affected area in the body naturally. However, depending on the severity of the issue causing the person to be in pain, inflammation can be beneficial or harmful. When many individuals start to make repetitive motions to their bodies, it can cause the muscle and tissue fibers to be overstretched and ache. To that point, these repetitive motions to the body could potentially lead to low back pain. Have you or your loved ones experienced inflammatory effects that lead to low back pain? When this happens, many individuals seek non-surgical treatments to reduce inflammation in the lower back, which can help restore their quality of life. Today’s article post looks at the correlation between inflammation and low back pain and how non-surgical treatments like traction therapy can reduce inflammation and restore a person’s quality of life. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to ease low back pain associated with inflammation that leads to the development of musculoskeletal disorders. We also inform them that non-surgical treatments like traction therapy can help reduce the chronic inflammatory effects in the body. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with low back pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer

Inflammation Correlating With Low Back Pain

Do you often experience muscle aches in your lower back after a long, hard workday? Do you feel your skin is so hot to the touch that it is causing your muscles to ache constantly? Or did you injure your back due to improper lifting, so the pain is unbearable? Many individuals don’t often realize that the scenarios they are doing in their daily lives correspond to the development of low back pain. Low back pain is a multifactorial musculoskeletal disorder with many symptoms that are often correlated with inflammation. Inflammation is the body’s immune defense that starts to heal the affected area where the body has succumbed to injuries. Inflammation can be beneficial and harmful in its acute and chronic form while correlating with low back pain. When it comes to low back pain, its factors can lead to lumbar disc herniation, which then can be highly associated with inflammation. (Cunha et al., 2018) This is due to the surrounding nerve roots being entrapped, and the adverse symptoms of the lower back start to stimulate the nerve fibers to evoke inflammation, leading to pain-like issues in the lower extremities. When the lower extremities are associated with lower back pain, the lumbar components will start to degenerate over time, activating the inflammatory cytokine pathways that can directly damage the nerves and lower nociceptors, causing pain to the legs and lower back. (Li et al., 2021) When inflammation correlates with low back pain, it is a recurrent condition that many individuals seek treatment from their primary doctors. (Von Korff & Saunders, 1996) When this happens, many individuals incorporate these treatments to reduce inflammation and restore their quality of life.

Fighting Inflammation Naturally-Video

Fighting Inflammation Naturally *Chiropractic Care* | El Paso, Tx (2023)

When inflammation is correlated with low back pain, many individuals will seek affordable treatment that works with their hectic schedules. Non-surgical treatments can work around a person’s schedule and are cost-effective. Treatments like traction therapy, massage therapy, chiropractic care, physical therapy, and spinal decompression are all non-surgical treatments that utilize manual and mechanical manipulation to relieve people suffering from low back pain and reduce the effects of inflammation affecting the lower extremities. These non-surgical treatments can relieve many individuals after a few consecutive sessions and slowly reduce the inflammatory effects. The video above shows how non-surgical treatment can help restore the body while naturally reducing inflammatory outcomes in a personalized treatment plan.

How Traction Reduces Inflammation

When it comes to treating low back pain correlating with inflammation, traction therapy, a form of non-surgical treatment, can be beneficial in reducing these pain-like issues. The pain specialist first assesses individuals with inflammation correlating with low back pain as they note where the pain affects them in their bodies. Afterward, they will be strapped into a traction machine, gently pulling their spines to reduce pain involving the aggravated nerves and muscles. The intervertebral discs will also be increased during traction to improve the spinal disc height. (Andersson, Schultz, & Nachemson, 1983) This allows the affected nerve roots to stop pain signals from affecting the lower extremities and promote healing. Traction therapy can even decompress the nucleus pulposus, one of the effects of low back pain, by pulling it back to its original position. (Ramos & Martin, 1994) This, in turn, reduces the inflammatory effects and allows the body to heal itself naturally.

Traction Therapy Restoring Quality Of Life

When many individuals incorporate traction therapy, it can restore their quality of life. Traction therapy can help reduce the symptoms of inflammation and pain by minimizing the chances of needing surgery. (Wang et al., 2022) Traction therapy can also be combined with manual therapy to stretch and strengthen the surrounding weak muscles and help restore the joint’s mobility. (Kuligowski, Skrzek, & Cieslik, 2021) To that point, many individuals dealing with inflammation correlating with low back pain can notice their pain being diminished and be more mindful of what habits are the root causes of their pain and how to reduce them from causing the pain to return.

References

Andersson, G. B., Schultz, A. B., & Nachemson, A. L. (1983). Intervertebral disc pressures during traction. Scand J Rehabil Med Suppl, 9, 88-91. https://www.ncbi.nlm.nih.gov/pubmed/6585945

Cunha, C., Silva, A. J., Pereira, P., Vaz, R., Goncalves, R. M., & Barbosa, M. A. (2018). The inflammatory response in the regression of lumbar disc herniation. Arthritis Res Ther, 20(1), 251. https://doi.org/10.1186/s13075-018-1743-4

Kuligowski, T., Skrzek, A., & Cieslik, B. (2021). Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature. Int J Environ Res Public Health, 18(11). https://doi.org/10.3390/ijerph18116176

Li, W., Gong, Y., Liu, J., Guo, Y., Tang, H., Qin, S., Zhao, Y., Wang, S., Xu, Z., & Chen, B. (2021). Peripheral and Central Pathological Mechanisms of Chronic Low Back Pain: A Narrative Review. J Pain Res, 14, 1483-1494. https://doi.org/10.2147/JPR.S306280

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

Von Korff, M., & Saunders, K. (1996). The course of back pain in primary care. Spine (Phila Pa 1976), 21(24), 2833-2837; discussion 2838-2839. https://doi.org/10.1097/00007632-199612150-00004

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

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Cervical Acceleration – Deceleration – CAD

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

Medical staff helping asian patient with neck brace removing cervical neck collar after injury accident during consultation.. Injured young adult healing fracture and trauma in hospital waiting area

“Individuals who have suffered cervical acceleration-deceleration/CAD more commonly known as whiplash, can experience headaches, and other symptoms like neck stiffness, pain, fatigue, and shoulder/neck/back discomfort. Can non-surgical and conservative treatments help alleviate the symptoms?”

Table of Contents

Cervical Acceleration – Deceleration or CAD

Cervical acceleration-deceleration is the mechanism of a neck injury caused by a forceful back-and-forth neck motion. It happens most commonly in rear-end vehicle collisions when the head and neck whip forward and backward with intense acceleration and/or deceleration causing the neck to flex and/or extend rapidly, more than normally, straining and possibly tearing muscle tissues and nerves, ligaments, dislocation of spinal discs and herniations, and cervical bone fractures.

For symptoms that do not improve or worsen after 2 to 3 weeks, see a healthcare provider or chiropractor for further evaluation and treatment.
Whiplash injuries strain or sprain the neck muscles and/or ligaments, but can also affect the vertebrae/bones, disc cushions between the vertebrae, and/or the nerves.
For individuals who experience a headache that starts at the base of the skull following a motor vehicle accident is more than likely a whiplash headache. (National Institute of Neurological Disorders and Stroke. 2023)

Symptoms

Whiplash symptoms can present right away, or after several hours to a few days after the incident, and tend to worsen in the days after the injury. Symptoms can last a few weeks to a few months, and can severely limit activity and range of motion. Symptoms can include: (National Institute of Neurological Disorders and Stroke. 2023)

Pain that extends into the shoulders and back.
Neck stiffness
Limited neck motion
Muscle spasms
Numbness and tingling sensations – paresthesias or pins and needles in the fingers, hands, or arms.
Sleep problems
Fatigue
Irritability
Cognitive impairment – memory and/or concentrating difficulties.
Ringing in the ears – tinnitus
Dizziness
Blurred vision
Depression
Headaches – A whiplash headache usually starts at the base of the skull and can vary in intensity. Most individuals experience pain on one side of the head and toward the back, though some can experience symptoms all over their head, and a small number experience headaches on the forehead or behind the eyes. (Monica Drottning. 2003)
The headaches can become aggravated by moving the neck around, especially when looking up.
Headaches are often associated with shoulder pain along with sensitive neck and shoulder muscles that when touched can increase pain levels.
Whiplash headaches can lead to chronic neck-related headaches known as cervicogenic headaches. (Phil Page. 2011)

Causes

The most common cause of whiplash is rear-end automobile accidents and collisions. (National Institute of Neurological Disorders and Stroke. 2023)
However, cervical acceleration-deceleration injuries can also occur from:

Playing sports – hockey, martial arts, boxing, tackle football, gymnastics, basketball, volleyball, soccer, and baseball.
A slip and fall that causes the head to suddenly jolt forward and back.
Physical assault – getting punched or shaken.
Being struck on the head by a heavy or solid object.

Treatment

Symptoms usually resolve within 2 to 3 weeks.
Icing the neck for 10 minutes several times a day can help reduce pain and inflammation. (National Institute of Neurological Disorders and Stroke. 2023)
It is also important to rest your neck area following the injury.
A cervical collar can be utilized temporarily to stabilize the neck, but for long-term recovery, it is recommended to keep the area mobile.
Physical activity reduction until the individual can look over both shoulders, and tilt their head all the way forward, all the way back, and from side to side without pain or stiffness.

Additional Treatments

Traction and decompression therapies.
Chiropractic adjustments
Therapeutic various massage techniques.
Electronic nerve stimulation
Posture retraining
Stretching
Sleep position adjustments.
Non-steroidal anti-inflammatories – NSAIDs – Ibuprofen or Naproxen.
Muscle relaxers

If symptoms do not improve, a healthcare provider may recommend physical therapy and/or stronger pain medications. For whiplash headaches that last for several months, acupuncture, or spinal injections may be recommended.

Neck Injuries

References

National Institute of Neurological Disorders and Stroke. Whiplash Information Page.

Drottning M. (2003). Cervicogenic headache after a whiplash injury. Current pain and headache reports, 7(5), 384–386. https://doi.org/10.1007/s11916-003-0038-9

Page P. (2011). Cervicogenic headaches: an evidence-led approach to clinical management. International journal of sports physical therapy, 6(3), 254–266.

Trunk Muscle Response To Lumbar Traction Therapy

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

Can lumbar traction therapy alleviate an individual’s lower back pain by restoring weak trunk muscles over time?

Table of Contents

Introduction

The trunk muscles are the body’s main stabilizers that support upper body weight and stabilize the lower body weight. These muscles work with the lumbar back muscles so the individual can maintain good posture and be mobile when in motion without pain. However, when traumatic or normal forces start to affect the trunk muscles, it can lead to unwanted musculoskeletal pain that can lead to a life of disability and affect their performance in their routine. Weak truck muscles can lead to low back pain issues while causing referred pain to the lower extremities. However, many individuals are finding ways to strengthen their trunk muscles by slowly integrating core exercises and going to non-surgical treatments to reduce the pain they have been experiencing. Today’s article looks at how weak truck muscles correlate with low back pain and how non-surgical treatments like lumbar traction can reduce pain associated with weak trunk muscles. Additionally, we communicate with certified medical providers who incorporate our patients’ information to ease low back pain associated with weak trunk muscles, causing many musculoskeletal issues in the lower body. We also inform them that non-surgical treatments can help re-strengthen the truck muscles. We encourage our patients to ask amazing educational questions for our associated medical providers about their symptoms correlating with weak trunk muscles. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer

Weak Trunk Muscles Correlate With Low Back Pain

Do you often experience low back pain after carrying a heavy object from one location to another at work? Do you slouch more than usual when you are relaxing at home? Or have you noticed that you can’t hold a plank for less than 30 seconds during a workout? Many individuals dealing with these issues in these scenarios could be dealing with weak core muscles that can lead to low back pain. Since low back pain is a common problem that many people have, some of the correlating factors could be weak trunk muscles. Weak trunk muscles in the body can be due to the body naturally degenerating, causing the intervertebral disc to deteriorate. When the water content and spinal disc height begin to go through mechanical changes from unwanted pressure loads, it can cause the intervertebral discs to bulge out of the spine more and cause the surrounding ligaments and muscles to deal with more stress and become weak over time. (Adams et al., 1990) When the trunk muscles weaken, the lower extremities will start to develop musculoskeletal conditions that can lead to pain. Spinal disorders develop over time when normal or traumatic forces begin to affect the quality and quantity of the trunk muscle functions for its range of motion, strength, and endurance when a person is doing normal activities. (Allen, 1988)

So how would weak trunk muscles and low back pain have this relationship to affect a person’s spine? When muscle activity begins to be reduced within the trunk region, symptoms like stiffness and pain can cause postural shrinkage to the spinal disc in the lumbar region. (Cholewicki, 2004) Additionally, when dealing with low back pain, their trunk muscles undergo structural changes that can affect their stability. These changes can lead to reduced movement speed and range of motion, which then causes many of the accessory muscles to compensate for the pain that the person is experiencing. (Van Dieën, Cholewicki, & Radebold, 2003) However, numerous individuals will opt for a treatment plan to reduce low back pain and also help strengthen weak core muscles.

Can Core Exercises Help With Back Pain?-Video

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

When it comes to strengthening and restoring weak muscles to reduce low back pain, many individuals will try exercising to lessen the pain they are experiencing in their lumbar spine and strengthen their weakened core muscles. The video above indicates that including core strengthening workouts in a workout routine can be essential to pain management. Exercising alone can be challenging without the right motivation, but it can be included in a personalized treatment plan that can be effective and customizable to manage lumbar impairment. (Li & Bombardier, 2001) Many individuals opt for non-surgical treatments due to their cost-effectiveness and how safe it is on the spine to reduce muscle weakness within the trunk muscles.

Lumbar Traction Restoring Weak Trunk Muscles

When dealing with weak trunk muscles correlating with low back pain, incorporating non-surgical treatment could be the answer to reducing the pain they have been experiencing. Non-surgical treatments like lumbar traction, spinal decompression, massage therapy, physical therapy, and chiropractic care utilize mechanical and manual techniques to reduce pain in the upper and lower body portions, help stretch out shortened and tight muscles, and kick-start the body’s natural healing process. Since lumbar traction is a non-surgical treatment, it can help restore muscle strength within the trunk region. Lumbar traction can be used manually or mechanically to increase intervertebral disc space, decrease mechanical stress, and reduce muscle spasms. (Wegner et al., 2013) When many individuals feel relief from their pain and strengthen their trunk muscles gradually, they will notice a difference in their routine and continue to be pain-free after a few session treatments.

References

Adams, M. A., Dolan, P., Hutton, W. C., & Porter, R. W. (1990). Diurnal changes in spinal mechanics and their clinical significance. J Bone Joint Surg Br, 72(2), 266-270. https://doi.org/10.1302/0301-620X.72B2.2138156

Allen, M. E. (1988). Clinical kinesiology: measurement techniques for spinal disorders. Orthop Rev, 17(11), 1097-1104. https://www.ncbi.nlm.nih.gov/pubmed/3205587

Cholewicki, J. (2004). The effects of lumbosacral orthoses on spine stability: what changes in EMG can be expected? J Orthop Res, 22(5), 1150-1155. https://doi.org/10.1016/j.orthres.2004.01.009

Li, L. C., & Bombardier, C. (2001). Physical therapy management of low back pain: an exploratory survey of therapist approaches. Phys Ther, 81(4), 1018-1028. https://www.ncbi.nlm.nih.gov/pubmed/11276184

Van Dieën, J. H., Cholewicki, J., & Radebold, A. (2003). Trunk Muscle Recruitment Patterns in Patients With Low Back Pain Enhance the Stability of the Lumbar Spine. Spine, 28(8), 834-841. https://doi.org/10.1097/01.brs.0000058939.51147.55

Wegner, I., Widyahening, I. S., van Tulder, M. W., Blomberg, S. E., de Vet, H. C., Bronfort, G., Bouter, L. M., & van der Heijden, G. J. (2013). Traction for low-back pain with or without sciatica. Cochrane Database Syst Rev, 2013(8), CD003010. https://doi.org/10.1002/14651858.CD003010.pub5

Disclaimer

Peanut Butter Sandwich Alternatives

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

Healthy open sandwiches — Various kind of bread, such as wholegrain, rice crakers, crispbreads and different nut butter, such as peanut, crunchy cashew and almond butter

For individuals with peanut allergies, can finding a peanut alternative be as satisfying as a real creamy or crunchy peanut butter sandwich?

Table of Contents

Peanut Butter Sandwich Alternatives

For individuals who are unable to have a peanut butter sandwich due to an allergy, there are healthy satisfying alternatives. Tree nut butter, seed butter, and deli meats can all satisfy sandwich cravings and provide nutrition. Here are a few healthy, nutritious alternatives to try out:

Sunflower Seed Butter and Jam, Jelly, or Preserves

This butter is made from sunflower seeds.
It is considered a safe alternative for individuals with peanut and tree nut allergies. (Elana Lavine, Moshe Ben-Shoshan. 2015)
Sunflower seed butter is a healthy source of vitamin E, iron, and fiber. (U.S. Department of Agriculture: FoodData Central.)
It can be substituted for a PBJ with jam, jelly, and preserves.

Ham and Cheese, Grainy Mustard on Rye Bread

Getting ham and cheese from the deli can potentially have cross-contamination with allergens during slicing and packaging.
Prepackaged and sliced ham and cheese is a safer bet in terms of allergens.
It is recommended to read the ingredient label for potential allergens, as processing in facilities can have cross-contamination issues. (William J. Sheehan, et al., 2018)

Turkey, Tomato, Lettuce, and Hummus on Whole Grain Bread

The same is true for turkey and is recommended to buy prepackaged and sliced.
Check the ingredients for possible allergens.
Hummus is made from chickpeas/garbanzo beans and tahini/ground sesame seeds.
Hummus comes in a variety of flavors that can be used as a dip or spread.
Although chick peas’ are a member of the legume family, hummus can be tolerated with peanut allergies. (Mathias Cousin, et al., 2017)
Check with a healthcare provider if unsure.

Pita Pocket with Salad and Hummus

Pita pockets are great with hummus stuffed with vegetables.
This is a delicious crunchy pocket sandwich loaded with protein, fiber vitamins, and minerals.

Soy Butter and Banana Slices on Whole Wheat Bread

Soy butter is a popular alternative to peanut butter. (Kalyani Gorrepati, et al., 2014)
Made from soybeans, the butter is full of fiber, protein, and healthy fats.
The butter can be spread on whole wheat bread and topped with banana slices for breakfast or lunch.

Tahini Sesame Seed Butter On A Roll with Shredded Broccoli and Carrots

Tahini is made from sesame seeds.
It can be spread on a roll with shredded broccoli and carrots for a healthy crunchy, fiber-rich, protein-filled sandwich.

Almond Butter and Sliced Apples

Try a non-sandwich option for lunch or as a snack.
This butter is made from almonds, which are tree nuts.
Almond butter is rich in fiber, vitamin E, and healthy fats.
Almonds contain the most nutrients per calorie of tree nuts. (Almond Board of California. 2015)

Cashew Butter on an English Muffin with Raisins

This butter is made from cashews, a tree nut, so it is safe for individuals with peanut allergies but not for individuals with nut allergies. (American Academy of Allergy, Asthma and Immunology. 2020)
Cashew butter on a hot English muffin with raisins on top for a boost of iron is reminiscent of a cinnamon roll.

Pumpkin Seed Butter and Honey Sandwich

Pumpkin butter is made from the orange flesh of the pumpkin.
Pumpkin seed butter is made by roasting pumpkin seeds and grinding them to a butter consistency.
The seed butter can be spread on bread and drizzled with some honey on top for a nutritious and delicious snack.

There are tasty healthy peanut butter alternatives that can be mixed, matched, and reinvented into various satisfying sandwiches. Individuals are recommended to consult their healthcare provider or a dietician or nutritionist to find what works for them.

Smart Choices, Better Health

References

Lavine, E., & Ben-Shoshan, M. (2015). Allergy to sunflower seed and sunflower butter as a proposed vehicle for sensitization. Allergy, asthma, and clinical immunology: Official Journal of the Canadian Society of Allergy and Clinical Immunology, 11(1), 2. https://doi.org/10.1186/s13223-014-0065-6

U.S. Department of Agriculture: FoodData Central. Seeds, sunflower seed butter, with salt added (Includes foods for USDA’s Food Distribution Program).

Sheehan, W. J., Taylor, S. L., Phipatanakul, W., & Brough, H. A. (2018). Environmental Food Exposure: What Is the Risk of Clinical Reactivity From Cross-Contact and What Is the Risk of Sensitization. The journal of allergy and clinical immunology. In practice, 6(6), 1825–1832. https://doi.org/10.1016/j.jaip.2018.08.001

Gorrepati, K., Balasubramanian, S., & Chandra, P. (2015). Plant-based butters. Journal of food science and technology, 52(7), 3965–3976. https://doi.org/10.1007/s13197-014-1572-7

Cousin, M., Verdun, S., Seynave, M., Vilain, A. C., Lansiaux, A., Decoster, A., & Sauvage, C. (2017). Phenotypical characterization of peanut-allergic children with differences in cross-allergy to tree nuts and other legumes. Pediatric allergy and immunology: Official publication of the European Society of Pediatric Allergy and Immunology, 28(3), 245–250. https://doi.org/10.1111/pai.12698

Almond Board of California. Nutrient comparison chart for tree nuts.

American Academy of Allergy, Asthma and Immunology. Everything you need to know about a tree nut allergy.

Innovated Non-Surgical Treatment For Cervical Spinal Pain

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

How does innovated non-surgical treatment help assist individuals with cervical spinal pain to reduce headaches?

Table of Contents

Introduction

Do you or your loved ones often experience headaches that don’t disappear? Do you often feel your shoulder and neck muscles ache after looking down at your cell phone? Or do you feel aches after being slouched for an extended period? Many of these scenarios correlate with referred pain in the cervical spinal region, which can develop into neck pain. The neck region is located in the upper body portion and provides mobility for the head without pain and discomfort. The neck region also has surrounding muscles and ligaments that support the spine and protects the thyroid and spinal cord. However, just like the back region, it is susceptible to pain as many individuals can overstretch the neck muscles, and it can cause referred pain to the shoulders and head, leading to pain-like symptoms that can lead to a life of disability. However, non-surgical treatments can minimize the pain and help strengthen the surrounding muscles in the neck region. Today’s article focuses on how cervical spinal pain connects with headaches and how decompression can reduce headaches while relieving neck pain. Additionally, we communicate with certified medical providers who incorporate our patients’ information to reduce cervical spinal pain associated with headaches, causing many musculoskeletal issues in the upper body portion. We also inform them that non-surgical treatments can help relieve headaches and provide relief to the neck region. We encourage our patients to ask amazing educational questions for our associated medical providers about their symptoms correlating with cervical spinal pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer

Cervical Spinal Pain & Headache Connection

Throughout the world, neck pain (cervical spinal pain) is the second most common problem that can affect many individuals throughout their lives. It can lead to a life of disability and pain if not treated immediately. Many individuals often experience non-specific neck pain, as it can be through a postural or mechanical basis that can cause muscle strain in the surrounding muscles or compress the spinal canal to cause headaches that can last throughout the entire day. (Binder, 2008) Additionally, neck pain, like back pain, is a multifactorial disease with common risk factors like lack of physical activity, duration of computer usage, and perceived stress. (Kazeminasab et al., 2022) Many of these risk factors are normal as they can also affect the surrounding muscles in the lower back region and shoulder region, as many people often do repetitive motions that can naturally be overstretched and cause pain-like issues to the neck region. With neck pain connected with headaches, it can cause overlapping risk profiles and be costly. Neck pain associated with headaches can be a frequent and expensive occupational health problem as symptoms of pain, disability, reduced life quality, and, for adults, time lost for work. (Ben Ayed et al., 2019)

The correlation between headaches and neck pain is that the spinal canal is compressed from traumatic forces that can lead to cervicogenic headaches. Cervicogenic headaches usually aggravate neck mobility, thus reducing the ROM of the neck. (Verma, Tripathi, & Chandra, 2021) This can lead to many individuals suffering from migraine-like headaches and muscle stiffness in the upper regions of the body. When many individuals are dealing with headaches associated with cervical spinal pain, many will find treatments to mitigate the pain-like symptoms affecting the upper body region.

The Benefits Of Stretching-Video

The Benefits of Stretching | El Paso, Tx (2023)

When it comes to neck pain, it can be either acute or chronic depending the factors that cause it or the severity of the pain. Many individuals sought treatment that can alleviate the pain in the upper regions that are non-surgical and beneficial to their health and well-being. Non-surgical treatments can help stretch the tight and short muscles in the neck region and can reduce headaches affecting the person. Additionally, having the neck muscles professionally stretched by a massage therapist can relieve the neck and reduce headaches. The video above explains the benefits of stretching and describes how many people don’t stretch their bodies often to prevent pain-like issues from reoccurring in the future.

Spinal Decompression For Cervical Pain

Non-surgical treatments are excellent when it comes to reducing neck pain. When relieving neck pain, healthcare professionals must use the best available evidence to enhance clinical decision-making and improve the quality of care for people with neck pain. (Misailidou et al., 2010) Spinal decompression can help many people with neck pain by reducing the issues through gentle spinal traction. What spinal decompression does for the cervical spine is that it can realign the disc that is aggravating the neck region and causing headaches by stretching the surrounding muscles. This causes muscle improvement for the neck as it can change the patient’s pain outcome. (Youssef et al., 2019) Additionally, spinal decompression is safe, cost-effective, and gentle on the spine as it can be combined with other therapies to mitigate any residual pain that can relieve the neck and back. (Flynn, 2020) Many people who incorporate spinal decompression as part of their routine can benefit from their outcome as they return to their routine.

References

Ben Ayed, H., Yaich, S., Trigui, M., Ben Hmida, M., Ben Jemaa, M., Ammar, A., Jedidi, J., Karray, R., Feki, H., Mejdoub, Y., Kassis, M., & Damak, J. (2019). Prevalence, Risk Factors and Outcomes of Neck, Shoulders and Low-Back Pain in Secondary-School Children. J Res Health Sci, 19(1), e00440. https://www.ncbi.nlm.nih.gov/pubmed/31133629

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6941626/pdf/jrhs-19-e00440.pdf

Binder, A. I. (2008). Neck pain. BMJ Clin Evid, 2008. https://www.ncbi.nlm.nih.gov/pubmed/19445809

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907992/pdf/2008-1103.pdf

Flynn, D. M. (2020). Chronic Musculoskeletal Pain: Nonpharmacologic, Noninvasive Treatments. American Family Physician, 102(8), 465-477. https://www.ncbi.nlm.nih.gov/pubmed/33064421

https://www.aafp.org/dam/brand/aafp/pubs/afp/issues/2020/1015/p465.pdf

Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord, 23(1), 26. https://doi.org/10.1186/s12891-021-04957-4

Misailidou, V., Malliou, P., Beneka, A., Karagiannidis, A., & Godolias, G. (2010). Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med, 9(2), 49-59. https://doi.org/10.1016/j.jcm.2010.03.002

Verma, S., Tripathi, M., & Chandra, P. S. (2021). Cervicogenic Headache: Current Perspectives. Neurol India, 69(Supplement), S194-S198. https://doi.org/10.4103/0028-3886.315992

Youssef, J. A., Heiner, A. D., Montgomery, J. R., Tender, G. C., Lorio, M. P., Morreale, J. M., & Phillips, F. M. (2019). Outcomes of posterior cervical fusion and decompression: a systematic review and meta-analysis. Spine J, 19(10), 1714-1729. https://doi.org/10.1016/j.spinee.2019.04.019

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Q/Quadriceps Angle Knee Injuries In Women Athletes

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

Doctor using machine to treat the knee joints of a patient. — Electromagnetic therapy of the knee joints, physiotherapist doctor uses medical equipment for highly effective pain treatment and inflammation, the magnetic field, rehabilitation.

The Q or quadriceps angle is a measurement of pelvic width that is believed to contribute to the risk of sports injuries in women athletes. Can non-surgical therapies and exercises help rehabilitate injuries?

Table of Contents

Quadriceps Q – Angle Injuries

The Q angle is the angle where the femur/upper leg bone meets the tibia/lower leg bone. It is measured by two intersecting lines:

One from the center of the patella/kneecap to the anterior superior iliac spine of the pelvis.
The other is from the patella to the tibial tubercle.
On average the angle is three degrees higher in women than men.
Average 17 degrees for women and 14 degrees for men. (Ramada R Khasawneh, et al., 2019)
Sports medicine experts have linked a wider pelvis to a larger Q-angle. (Ramada R Khasawneh, et al., 2019)

Women have biomechanical differences that include a wider pelvis, making it easier to give birth. However, this difference can contribute to knee injuries when playing sports, as an increased Q angle generates more stress on the knee joint, as well as leading to increased foot pronation.

Injuries

Various factors can increase the risk of injury, but a wider Q angle has been linked to the following conditions.

Patellofemoral Pain Syndrome

An increased Q angle can cause the quadriceps to pull on the kneecap, shifting it out of place and causing dysfunctional patellar tracking.
With time, this can cause knee pain (under and around the kneecap), and muscle imbalance.
Foot orthotics and arch supports could be recommended.
Some researchers have found a link, while others have not found the same association. (Wolf Petersen, et al., 2014)

Chondromalacia of the Knee

This is the wearing down of the cartilage on the underside of the kneecap.
This leads to degeneration of the articular surfaces of the knee. (Enrico Vaienti, et al., 2017)
The common symptom is pain under and around the kneecap.

ACL Injuries

Women have higher rates of ACL injuries than men. (Yasuhiro Mitani. 2017)
An increased Q angle can be a factor that increases stress and causes the knee to lose its stability.
However, this remains controversial, as some studies have found no association between the Q angle and knee injuries.

Chiropractic Treatment

Strengthening Exercises

ACL injury prevention programs designed for women have resulted in reduced injuries. (Trent Nessler, et al., 2017)
The vastus medialis obliquus or VMO is a teardrop-shaped muscle that helps move the knee joint and stabilize the kneecap.
Strengthening the muscle can increase the stability of the knee joint.
Strengthening may require a specific focus on muscle contraction timing.
Closed-chain exercises like wall squats are recommended.
Glute strengthening will improve stability.

Stretching Exercises

Stretching tight muscles will help relax the injured area, increase circulation, and restore range of motion and function.
Muscles commonly found to be tight include the quadriceps, hamstrings, iliotibial band, and gastrocnemius.

Foot Orthotics

Custom-made, flexible orthotics decrease the Q angle and reduce pronation, relieving the added stress on the knee.
A custom orthotic ensures that the foot and leg dynamics are accounted for and corrected.
Motion-control shoes can also help correct overpronation.

Knee Rehabilitation

References

Khasawneh, R. R., Allouh, M. Z., & Abu-El-Rub, E. (2019). Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PloS one, 14(6), e0218387. https://doi.org/10.1371/journal.pone.0218387

Petersen, W., Ellermann, A., Gösele-Koppenburg, A., Best, R., Rembitzki, I. V., Brüggemann, G. P., & Liebau, C. (2014). Patellofemoral pain syndrome. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA, 22(10), 2264–2274. https://doi.org/10.1007/s00167-013-2759-6

Vaienti, E., Scita, G., Ceccarelli, F., & Pogliacomi, F. (2017). Understanding the human knee and its relationship to total knee replacement. Acta bio-medica : Atenei Parmensis, 88(2S), 6–16. https://doi.org/10.23750/abm.v88i2-S.6507

Mitani Y. (2017). Gender-related differences in lower limb alignment, range of joint motion, and the incidence of sports injuries in Japanese university athletes. Journal of Physical Therapy Science, 29(1), 12–15. https://doi.org/10.1589/jpts.29.12

Nessler, T., Denney, L., & Sampley, J. (2017). ACL Injury Prevention: What Does Research Tell Us? Current reviews in musculoskeletal medicine, 10(3), 281–288. https://doi.org/10.1007/s12178-017-9416-5

What Not To Do With Temporomandibular Joint Disorder

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

Sensitive Teeth. Young arab woman drinking water with ice and touching cheek — Sensitive Teeth. Young arab woman drinking water with ice and touching her cheek, sick middle eastern female frowning and rubbing inflamed area, suffering dental pain, emotionally reacting to cold

Temporomandibular joint disorder causes pain and jaw locking that can be worsened with certain activities. How individuals can manage and prevent flare-ups by learning what not to do to worsen the condition?

Table of Contents

What Not To Do Temporomandibular Joint Disorder

Tenderness, aching, pain, and jaw locking are symptoms of temporomandibular joint disorder or TMJ. The temporomandibular joint connects the jaw to the skull. It is used daily for eating, drinking, and talking. It is a small disc in the joint that allows the jaw bones to slip and slide correctly. With TMJ, the disc shifts out of place, leading to clicking, snapping, and limited jaw movement. It can also cause pain in the jaw and face, neck pain, and headaches, and the muscles around the jaw and neck can become sore and/or go into spasm. Any type of activity that stresses or overworks the joint can trigger a flare-up and worsen TMJ symptoms. (Schiffman E, et al. 2014) This article looks at avoiding activities that make TMJ worse and what not to do to help keep TMJ symptoms in check.

Chewing Gum

Gum chewing is not recommended for individuals with TMJ.
The jaw is one of the most used joints in the body.
Limiting excessive use alleviates pressure allowing the joints and muscles to rest.
Resting sore muscles and joints is the first step in injury recovery.

Eating Chewy and Hard Foods

Chewy and hard foods make the jaw have to work overtime.
Avoid eating hard foods like chewy candies, hard and chewy breads, and vegetables like corn on the cob, and fruits like apples.
These foods can place excessive stress on the jaw, and prevent the joint from properly resting and healing.

Chewing Only On One Side

Many individuals chew their food on only one side of the mouth.
This can stress out one side of the temporomandibular joint and surrounding muscles, leading to pain and dysfunction. (Urbano Santana-Mora, et al., 2013)
Stay aware of chewing habits and make sure to utilize both sides of the mouth.
Individuals with dental issues or tooth pain are recommended to see a dentist.

Non-Functional Jaw Activities

Going through each day, individuals tend to do things unconsciously or out of habit.
For example, individuals:
Reading or writing might chew on a pen or pencil.
Bite their nails or chew on the inside of their mouth while watching TV or internet browsing.
These activities can place stress on the joint, worsen the condition, and extend the healing process.

Resting on The Chin

Individuals will rest their jaw in their hands while studying, on social media, or watching TV.
This position can be comfortable, but it can affect the jaw.
This position can build pressure against the side of the jaw and push against the joint, causing the disc to shift out of place affecting how the jaw opens and closes.
Breaking the chin resting habit can allow the joint to relax and heal correctly.

Teeth Clenching

Bruxism is the medical term for clenching the teeth.
This can occur during the day or during sleep.
Teeth clenching is often brought on by stress and can place incredible pressure on the jaw’s muscles and worsen TMJ.
A dentist can prescribe a mouth guard to be worn while sleeping to protect the teeth from excessive clenching. (Miriam Garrigós-Pedrón, et al., 2019)

Slouching

The function of the jaw is closely related to body posture.
The jaw operates optimally when the head is above the cervical spine and the posture is upright.
Slouching can change how the jaw muscles work and the way the jaw opens and closes.
Part of physical therapy for TMJ is working on posture adjustments and training.
This can involve strengthening the back and shoulder muscles and setting up posture reminders.
Sitting and standing correctly can keep the jaw operating properly.

Postponing Treatment

Many with musculoskeletal issues and symptoms wait for the pain to go away.
Individuals having problems with their jaw should not wait to get treatment.
TMJ has a positive rate of recovery with conservative treatment, which is all the more reason to seek treatment. (G Dimitroulis. 2018)
A dentist or healthcare provider can provide an accurate diagnosis if TMJ is suspected.
Individuals can benefit from visiting a physical therapist to learn exercises and strategies to self-treat the condition. (Yasser Khaled, et al., 2017)

Treatment

Treatment can involve:

Initial treatment focuses on pain relief and jaw function opens and closes improvement.
Exercises to get the jaw moving normally.
Joint mobilizations.
Treatments to maintain proper muscle function. (Amira Mokhtar Abouelhuda, et al., 2018)
A guard can help with night teeth grinding/bruxism.
Anti-inflammatory treatments.
In severe cases, surgery may be recommended to correct the problem, as a last resort. (Meghan K Murphy, et al., 2013)
Follow recommendations on what not to do and avoid certain activities.

Quick Patient Initiation

References

Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J. P., List, T., Svensson, P., Gonzalez, Y., Lobbezoo, F., Michelotti, A., Brooks, S. L., Ceusters, W., Drangsholt, M., Ettlin, D., Gaul, C., Goldberg, L. J., Haythornthwaite, J. A., Hollender, L., Jensen, R., … Orofacial Pain Special Interest Group, International Association for the Study of Pain (2014). Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of oral & facial pain and headache, 28(1), 6–27. https://doi.org/10.11607/jop.1151

Santana-Mora, U., López-Cedrún, J., Mora, M. J., Otero, X. L., & Santana-Penín, U. (2013). Temporomandibular disorders: the habitual chewing side syndrome. PloS one, 8(4), e59980. https://doi.org/10.1371/journal.pone.0059980

Garrigós-Pedrón, M., Elizagaray-García, I., Domínguez-Gordillo, A. A., Del-Castillo-Pardo-de-Vera, J. L., & Gil-Martínez, A. (2019). Temporomandibular disorders: improving outcomes using a multidisciplinary approach. Journal of multidisciplinary healthcare, 12, 733–747. https://doi.org/10.2147/JMDH.S178507

Dimitroulis G. (2018). Management of temporomandibular joint disorders: A surgeon’s perspective. Australian Dental Journal, 63 Suppl 1, S79–S90. https://doi.org/10.1111/adj.12593

Khaled Y, Quach JK, Brennan MT, NapeÑas JJ. Outcomes after physical therapy for the treatment of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017;124(3: e190. doi:10.1016/j.oooo.2017.05.477

Abouelhuda, A. M., Khalifa, A. K., Kim, Y. K., & Hegazy, S. A. (2018). Non-invasive different modalities of treatment for temporomandibular disorders: a review of the literature. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 44(2), 43–51. https://doi.org/10.5125/jkaoms.2018.44.2.43

Murphy, M. K., MacBarb, R. F., Wong, M. E., & Athanasiou, K. A. (2013). Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. The International journal of oral & maxillofacial implants, 28(6), e393–e414. https://doi.org/10.11607/jomi.te20

Non-Surgical Mechanical Reduction & Repair For Herniated Discs

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

In individuals with herniated discs, how does non-surgical decompression compare to traditional surgery repair the spine?

Table of Contents

Introduction

When many individuals begin to add unnecessary pressure on their backs, it can lead to damaging results to their spine. The spine is the backbone of the body, allowing the upper and lower sections to be mobile and stabilizing the axial weight overload without the person feeling pain or discomfort. The spinal structure is surrounded by muscles, soft tissues, ligaments, nerve roots, and joints that support the spine. In between the spinal facet joints and structure are flat discs that absorb the shock and pressure from the axial overload. However, when unwanted stress starts to compress the disc, it can lead to the development of herniation. Depending on the location, it can cause pain-like symptoms like lower back and neck pain or sciatica. Other times, herniated discs can be due to natural degeneration, where the spinal disc height decreases, and it can crack under pressure, leading to disc dehydration, which, to this point, causes spinal issues to many individuals, thinking they are experiencing referred pain in different body locations. Coincidentally, many people can find the relief they seek through non-surgical treatments to restore the disc height and repair herniated discs. Today’s article focuses on the casing effects of herniated discs and how spinal decompression, a form of non-surgical treatment, can help reduce pain-like symptoms associated with herniated discs. Additionally, we communicate with certified medical providers who incorporate our patients’ information to reduce herniated disc pain, causing many musculoskeletal issues. We also inform them that non-surgical treatments can help mitigate the referred pain-like symptoms related to herniated discs and restore disc height in their spines. We encourage our patients to ask amazing educational questions for our associated medical providers about their referred pain correlating with herniated discs. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer

The Changing Effects Of Herniated Discs

Have you experienced unwanted pain in your upper and lower extremities after a long work day? What about experiencing pain within your spines that are causing symptoms of numbness or tingling sensations in your hands, feet, or legs? Or are you dealing with excruciating lower back pain that is affecting your ability to work? Many individuals don’t realize that the pain-like symptoms they are experiencing are not low back, neck, or shoulder pain, but they correlate to herniated discs in their spines. Herniated discs are when the nucleus pulposus (inner disc portion) starts to protrude out of its original position from the intervertebral space. (Dydyk, Ngnitewe Massa, & Mesfin, 2023) Herniated discs are one of the common causes of lower back pain, and often, many individuals will remember what caused the herniation in their spine.

Some of the effects that lead to disc herniation are that many people will carry heavy objects constantly from one location to another, and the shifting weight can cause the disc to be continuously compressed and thus lead to herniation. Additionally, when the intervertebral disc starts showing signs of stiffness, it can result in abnormal spinal motion. (Haughton, Lim, & An, 1999) This causes morphologic changes within the intervertebral disc and causes it to be dehydrated. The chondroitin sulfation of the proteoglycan in the disc goes through changes in the disc itself, and when degeneration is associated with herniated discs, it can lead to musculoskeletal disorders. (Hutton et al., 1997)

The Root Cause Of Pain- Video

The Root Causes of Pain | El Paso, Tx (2023)

When degenerative changes start to affect the intervertebral discs, it can lead to intervertebral height loss, abnormal pain signaling, and nerve root entrapment associated with disc disruption. (Milette et al., 1999) This causes a cascading effect as the outer annulus of the spinal disc is cracked or ruptured, causing pain to the spine. When the outer annulus of the spinal disc starts to have nerve ingrowth in the affected discs, which then leads to individuals dealing with musculoskeletal disorders associated with pain. (Freemont et al., 1997) Many people will seek non-surgical therapies when finding treatment to alleviate the pain caused by herniated discs due to their cost-effectiveness and how it’s safe for their spine. Chiropractic care, massage therapy, spinal decompression, and traction therapy are available treatments that can be used in a personalized, inclusive treatment care plan to mitigate any pain the person is dealing with. The video explains how these treatments can use functional wellness principles to identify where the pain is located and treat any health issues with any potential underlying causes.

Spinal Decompression Reducing Herniated Disc

Regarding non-surgical treatments reducing herniated discs, spinal decompression can help mitigate the pain affecting the spine’s mobility. Spinal decompression utilizes mechanical traction to gently stretch the spine and allow the herniated disc to return to its original position. Spinal decompression incorporates negative pressure, which helps the nutrients increase the disc’s regenerative factors. (Choi et al., 2022) This allows the facet joints and aggravated nerves to have reduced pressure and increased disc space height. At the same time, spinal decompression can be combined with physical therapy to reduce the pain-like symptoms associated with herniated discs and provide beneficial results. (Amjad et al., 2022) Some of the beneficial factors related to spinal decompression include:

Pain improvement in the upper and lower extremities
Spinal range of motion
Muscle endurance restored
Joint ROM restored

When many individuals become more mindful of how different factors are causing spinal issues, they can make small routine changes in their daily lives, and that can reduce the chances of pain from returning. This allows them to enjoy life fully and continue their health and wellness journey.

References

Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P.-B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 6343837. https://doi.org/10.1155/2022/6343837

Dydyk, A. M., Ngnitewe Massa, R., & Mesfin, F. B. (2023). Disc Herniation. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/28722852

Freemont, A. J., Peacock, T. E., Goupille, P., Hoyland, J. A., O’Brien, J., & Jayson, M. I. (1997). Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet, 350(9072), 178-181. https://doi.org/10.1016/s0140-6736(97)02135-1

Haughton, V. M., Lim, T. H., & An, H. (1999). Intervertebral disk appearance correlated with stiffness of lumbar spinal motion segments. AJNR Am J Neuroradiol, 20(6), 1161-1165. https://www.ncbi.nlm.nih.gov/pubmed/10445464

https://www.ajnr.org/content/ajnr/20/6/1161.full.pdf

Hutton, W. C., Elmer, W. A., Boden, S. D., Horton, W. C., & Carr, K. (1997). Analysis of chondroitin sulfate in lumbar intervertebral discs at two different stages of degeneration as assessed by discogram. Journal of Spinal Disorders, 10(1), 47-54. https://www.ncbi.nlm.nih.gov/pubmed/9041496

Milette, P. C., Fontaine, S., Lepanto, L., Cardinal, E., & Breton, G. (1999). Differentiating lumbar disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. Spine (Phila Pa 1976), 24(1), 44-53. https://doi.org/10.1097/00007632-199901010-00011

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MET Treatment Strategies To Reduce Pelvic Pain

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

For individuals with pelvic pain, how does MET treatment strategies reduce muscle weakness in the hips region?

Table of Contents

Introduction

The pelvis’s main job is to ensure that the person’s body weight is distributed evenly for everyday movement within the upper and lower body. At the same time, the core muscles, ligaments, and joints surround the skeletal structure of the pelvis, which provides normal function while protecting the vital organ systems within the pelvic region. When normal or traumatic factors start to affect the body’s pelvic area, many individuals will often mistake the pain for low back pain, and the core muscles surrounding the pelvic bone can become weak and lead to pelvic pain. At the same time, normal factors like improper posture can cause anterior pelvic tilt and develop into other musculoskeletal disorders with overlapping risk profiles. When pelvic pain affects the lower extremities, it can also lead to reproductive issues that can cause even more stress to the individual. Luckily, many people opt for non-surgical treatments to reduce pelvic pain and its associated musculoskeletal condition by strengthening the weakened core muscles and reducing muscle weakness. Today’s article examines how referred pain symptoms affect the pelvis and how non-surgical treatments like MET therapy can reduce muscle weakness correlating with pelvic pain. Additionally, we communicate with certified medical providers who incorporate our patient’s information to reduce muscle weakness associated with pelvic pain. We also inform them that MET therapy can help mitigate the referred pain-like symptoms related to pelvic pain. We encourage our patients to ask amazing educational questions for our associated medical providers about their pelvic pain. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer

Referred Pain Symptoms Affecting The Pelvis

Have you noticed that you are taking more frequent trips to the bathroom and that your bladder still feels full? Do you experience muscle stiffness within your lower back or pelvic region from excessive sitting at your desk during work? Or do you notice that you are experiencing weak core muscles affecting your workout routine? These scenarios are associated with pelvic pain and can cause issues within the lower body extremities, affecting the person’s performance when doing normal activities. Pelvic pain is a multifactorial musculoskeletal disorder that can affect the corresponding body systems to induce referred pain. (Grinberg, Sela, & Nissanholtz-Gannot, 2020) Pelvic pain can cause referred pain to the gastrointestinal, pelvic musculoskeletal, and nervous systems, which then causes anatomic malfunction to the pelvic floor muscles. Pelvic pain can easily be mistaken for low back pain since the lumbar spine creates stressors for the muscles surrounding the pelvis.

When the pelvis is affected by mechanical stressors associated with the lumbar spine, it can cause pelvic dysfunction and causes the individual to be unbalanced when in motion. At the same time, the pelvic muscle structures will be overworked, leading to hip and joint destabilization, causing them to be weak. (Lee et al., 2016) When the pelvic muscle structures begin to destabilize, it can lead to sciatic nerve entrapment to the lower extremities, which leads to overlapping risk profiles for musculoskeletal disorders. When the surrounding pelvic muscles begin to entrap the pelvic nerve roots causing radiating pain down the legs. (Kale et al., 2021) However, there are ways to reduce referred pain affecting the pelvic region and restore muscle strength.

Sciatica, Causes, Symptoms, & Tips- Video

Sciatica, Causes, Symptoms and tips| El Paso, Tx (2023)

Since pelvic pain is a multifactorial musculoskeletal disorder that can lead to the development of referred pain to the lower body extremities, many individuals often think it is low back pain or sciatica. Referred pain is when pain affects a body location instead of where the source originated. Not treated immediately causes nerve entrapment, muscle weakness, and chronic pain within the reproductive and urinary organs. Many individuals seek non-surgical treatments to alleviate the pain and restore muscle strength to the body’s pelvic region. Non-surgical treatments like MET(muscle energy techniques) can help restore muscle strength to the pelvis through soft tissue stretching. Pain specialists specializing in MET therapy, like chiropractors and massage therapists, use hands-on maneuvers to relax, elongate, stretch, and massage the affected tight muscles and reduce any tender points that may have developed over time. (Grinberg et al., 2019) MET therapy can help stretch the pelvic stabilizing muscles. It can be combined with physical therapy and chiropractic care to realign the body and reduce nerve entrapment caused by pelvic pain. Check out the video above to learn more about the causes of sciatica and how non-surgical treatments may be the answer to alleviate pain.

MET Treatment Strategies For Pelvic Pain

MET therapy can reduce the effects of pelvic pain by including soft tissue manipulation methods to use controlled isometric and isotonic contraction to improve the normal physiologic function of the surrounding pelvic muscles and decrease pain and help stabilize the alternating structures within the pelvic region. (Sarkar, Goyal, & Samuel, 2021) MET therapy can also encourage self-regulating influences to reduce pain within the pelvic area, resulting in a greater range of motion. (Chaitow, 2009)

MET Treatment Reducing Muscle Weakness

MET therapy can also be part of a personalized health plan that can help restore muscle strength in the core and stabilize muscle within the pelvis. The positive effects of the combination of MET therapy and exercise, it can be more effective in reducing pain while improving physical function. (Hu et al., 2020) This allows the pelvis to realign itself and help stretch the shortened muscles. MET therapy can help restore low extremity function and improve a person’s quality of life. (Danazumi et al., 2021) MET therapy is an excellent way to stretch out tired muscles and restore pelvic function, as it can make individuals more mindful of their bodies while reducing the chances of pelvic pain associated with musculoskeletal disorders reoccurring again in the lower extremities.

References

Chaitow, L. (2009). Ligaments and positional release techniques? J Bodyw Mov Ther, 13(2), 115-116. https://doi.org/10.1016/j.jbmt.2009.01.001

Danazumi, M. S., Yakasai, A. M., Ibrahim, A. A., Shehu, U. T., & Ibrahim, S. U. (2021). Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome. J Osteopath Med, 121(8), 693-703. https://doi.org/10.1515/jom-2020-0327

Grinberg, K., Sela, Y., & Nissanholtz-Gannot, R. (2020). New Insights about Chronic Pelvic Pain Syndrome (CPPS). Int J Environ Res Public Health, 17(9). https://doi.org/10.3390/ijerph17093005

Grinberg, K., Weissman-Fogel, I., Lowenstein, L., Abramov, L., & Granot, M. (2019). How Does Myofascial Physical Therapy Attenuate Pain in Chronic Pelvic Pain Syndrome? Pain Res Manag, 2019, 6091257. https://doi.org/10.1155/2019/6091257

Hu, X., Ma, M., Zhao, X., Sun, W., Liu, Y., Zheng, Z., & Xu, L. (2020). Effects of exercise therapy for pregnancy-related low back pain and pelvic pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore), 99(3), e17318. https://doi.org/10.1097/MD.0000000000017318

Kale, A., Basol, G., Topcu, A. C., Gundogdu, E. C., Usta, T., & Demirhan, R. (2021). Intrapelvic Nerve Entrapment Syndrome Caused by a Variation of the Intrapelvic Piriformis Muscle and Abnormal Varicose Vessels: A Case Report. Int Neurourol J, 25(2), 177-180. https://doi.org/10.5213/inj.2040232.116

Lee, D. W., Lim, C. H., Han, J. Y., & Kim, W. M. (2016). Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis. The Korean Journal of Pain, 29(4), 274-276. https://doi.org/10.3344/kjp.2016.29.4.274

Sarkar, M., Goyal, M., & Samuel, A. J. (2021). Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol. Asian Spine Journal, 15(1), 54-63. https://doi.org/10.31616/asj.2019.0300