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The Benefits of Acupuncture for Piriformis Syndrome

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Can individuals with piriformis syndrome incorporate acupuncture with various therapies to reduce sciatic nerve pain and other symptoms?

Introduction

As many individuals move around from one location to another thanks to the lower body extremities, the surrounding muscles, ligaments, nerve roots, and tissues help contribute to the sensory-motor function of the hips, legs, buttocks, and feet. All these muscle groups factor in to ensure they can be mobile without the effects of pain or discomfort. However, many factors and issues can cause the surrounding muscles to develop musculoskeletal problems over time, affecting a person’s mobility. One of the muscles that helps share the responsibility for mobility to hips and buttocks is the piriformis muscle, which is often overlooked when various injuries or repetitive motions start to affect a person’s ability to walk. Today’s article examines how piriformis syndrome affects mobility, how sciatic pain correlates with piriformis syndrome, and how therapies like acupuncture can help reduce piriformis syndrome. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to minimize piriformis syndrome affecting a person’s mobility. We also inform and guide patients on how treatments like acupuncture can help reduce sciatic nerve pain associated with piriformis syndrome. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from piriformis syndrome that is affecting their ability to walk. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

Piriformis Syndrome Affecting Mobility

Have you been experiencing muscle tightness in your hips or buttock region, affecting your walking ability? Do you feel sensations of numbness, tingling, or burning pain traveling down to your knees and feet? Or, after a long day of work, do you feel pain when you are sitting down? Most of these symptoms are often correlated with piriformis syndrome. The six surrounding muscles surrounding the gluteal region of the thighs and hips all work together to provide lower body movement while stabilizing the hips and rotating the thighs. The piriformis muscle is a small, flat, pear-shaped muscle that runs on top of the sciatic nerve. Piriformis syndrome is a clinical musculoskeletal condition that causes sciatic nerve entrapment that causes many individuals to report shooting and burning pain down to their buttock region. (Hicks et al., 2024) This causes many people to think they are dealing with low back pain associated with sciatica. When a person is dealing with piriformis syndrome, they will experience limited mobility in their hips, which, over time, if not treated, will affect the thighs and legs. 

 

How Does Sciatic Nerve Pain correlate with Piriformis Syndrome?

 

Additionally, since piriformis syndrome is correlated with sciatic nerve pain, some clinical findings causing overlapping risk profiles include restricted external hip rotation and muscle tightness of the lumbosacral muscles. Other clinical findings range from palpatory pain over the greater sciatic notch to aggravated pain in a seated position. (Sharma et al., 2023) Since sciatic nerve entrapment is correlated with piriformis syndrome, it is still regarded as the non-discogenic cause of sciatica. (Son & Lee, 2022) When that sciatic nerve gets trapped within the piriformis muscle, many people will experience numbness, tingling sensations, and similar pain patterns in the legs, just like sciatica; however, when individuals are looking for treatments to reduce the sciatic nerve pain and improve the piriformis muscle.

 

Acupuncture Therapy Reduces Piriformis Syndrome

 

When people are looking for treatments to reduce their sciatic nerve pain correlated with piriformis syndrome, they are seeking treatments that are affordable and can reduce the pain through consecutive sessions. Acupuncture therapy can help reduce the effects of piriformis syndrome. Acupuncture is a complementary and alternative therapy from China that uses solid, thin needles to be placed on the acupoints in the body. Additionally, highly trained professionals can incorporate various acupuncture methods to treat and reduce the effects of piriformis syndrome. (He et al., 2023) At the same time, when a person is being treated for piriformis syndrome, an acupuncturist uses ultrasound-guided techniques to allow accurate needle placement within the deep muscles to provide an effective treatment response. (Fusco et al., 2018) This allows the affected surrounding muscles to relax and reduce sciatic nerve pain.

 

Acupuncture Reducing Sciatic Nerve Pain

Since sciatic nerve pain and piriformis syndrome have overlapping risk profiles, they can also be associated with other musculoskeletal pain conditions that can affect a person’s mobility. Acupuncture can help mitigate the pain signals causing motor or sensory disturbances within the pelvic and hip regions. (Kvorning et al., 2004) Acupuncture is one of the oldest forms of non-surgical therapy that can be combined with other various therapies to help remobilize the hips and decompress the pain affecting the sciatic nerve while providing relief. (Vij et al., 2021) By incorporating acupuncture as part of a person’s health and wellness treatment plan, they will begin to gradually manage the associated symptoms and reduce the chances of piriformis syndrome from returning to cause sciatic nerve pain in the lower extremities. This allows people to be more mindful and help restore the body’s natural healing process over time.

Reclaim Your Mobility- Video

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

References

Fusco, P., Di Carlo, S., Scimia, P., Degan, G., Petrucci, E., & Marinangeli, F. (2018). Ultrasound-guided Dry Needling Treatment of Myofascial Trigger Points for Piriformis Syndrome Management: A Case Series. J Chiropr Med, 17(3), 198-200. https://doi.org/10.1016/j.jcm.2018.04.002

He, Y., Miao, F., Fan, Y., Zhang, F., Yang, P., Zhao, X., Wang, M., He, C., & He, J. (2023). Acupuncture Methods for Piriformis Syndrome: A Protocol for Systematic Review and Network Meta-Analysis. J Pain Res, 16, 2357-2364. https://doi.org/10.2147/JPR.S417211

Hicks, B. L., Lam, J. C., & Varacallo, M. (2024). Piriformis Syndrome. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/28846222

Kvorning, N., Holmberg, C., Grennert, L., Aberg, A., & Akeson, J. (2004). Acupuncture relieves pelvic and low-back pain in late pregnancy. Acta Obstet Gynecol Scand, 83(3), 246-250. https://doi.org/10.1111/j.0001-6349.2004.0215.x

Sharma, S., Kaur, H., Verma, N., & Adhya, B. (2023). Looking beyond Piriformis Syndrome: Is It Really the Piriformis? Hip Pelvis, 35(1), 1-5. https://doi.org/10.5371/hp.2023.35.1.1

Son, B. C., & Lee, C. (2022). Piriformis Syndrome (Sciatic Nerve Entrapment) Associated With Type C Sciatic Nerve Variation: A Report of Two Cases and Literature Review. Korean J Neurotrauma, 18(2), 434-443. https://doi.org/10.13004/kjnt.2022.18.e29

Vij, N., Kiernan, H., Bisht, R., Singleton, I., Cornett, E. M., Kaye, A. D., Imani, F., Varrassi, G., Pourbahri, M., Viswanath, O., & Urits, I. (2021). Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review. Anesth Pain Med, 11(1), e112825. https://doi.org/10.5812/aapm.112825

Disclaimer

Acupuncture for Arthritis: Can It Help Manage Symptoms?

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Close up of a needle and hands of physiotherapist doing a dry needling in a physiotherapy center.

“For individuals with arthritis, can incorporating acupuncture with other therapies help manage pain and other symptoms?”

Acupuncture for Arthritis: Can It Help Manage Symptoms?

Acupuncture For Arthritis

Acupuncture has been around for thousands of years and is a form of traditional Chinese medicine that utilizes needles inserted into various parts of the body to relieve pain and inflammation. The practice is based on the concept of life energy that flows throughout the body along pathways called meridians. When the energy flow becomes disrupted, blocked, or injured, pain or illness can present. (Arthritis Foundation. N.D.) Further research is needed to determine how the acupuncture therapeutic mechanisms work and the overall effectiveness. However, there is emerging evidence suggesting that acupuncture can provide symptom relief for individuals with joint pain, especially those with osteoarthritis and rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Benefits

The actual method that reduces the pain and inflammation is still unclear. Theories include that the needles suppress inflammatory responses, improve blood flow, and relax muscles. Although acupuncture cannot cure or reverse arthritis, it may be useful for managing pain and decreasing associated symptoms, especially in combination with other therapies. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Rheumatoid Arthritis

A systematic review of 43 studies, including humans and animals with rheumatoid arthritis, demonstrated varied results. Several studies showed improvement in symptoms and decreased biological markers of rheumatoid arthritis following one to three sessions of acupuncture for four weeks or more. (Sharon L. Kolasinski et al., 2020) Beneficial outcomes following acupuncture treatment for rheumatoid arthritis include:

  • Reduced pain
  • Reduced joint stiffness
  • Improved physical function

The results of the human and animal studies suggested that acupuncture has the potential to down-regulate:

  • Levels of interleukins
  • Levels of tumor necrosis factor
  • Specific cell signaling proteins/cytokines involved in the inflammatory response, which become elevated in autoimmune conditions like rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)
  • Most of the study subjects were also receiving other forms of treatment, especially medication. Therefore, it is difficult to conclude how beneficial acupuncture is alone or as a supplemental addition to other medical treatments. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Osteoarthritis

Acupuncture for osteoarthritis of the hand, hip, and knee is recommended, according to the American College of Rheumatology and Arthritis Foundation, meaning that it may be worth trying, although more research is needed to confirm its effectiveness. However, since the risk is relatively minor, acupuncture is generally considered a safe alternative treatment option for managing the symptoms. (Sharon L. Kolasinski et al., 2020)

Chronic Pain

As clinical trials suggest that acupuncture may be effective in providing pain relief, it may be a recommended option for individuals suffering from chronic pain. A recent systematic review of 20,827 patients and 39 trials concluded that acupuncture is effective for the treatment of chronic musculoskeletal pain, headache, and osteoarthritis pain. (Andrew J. Vickers et al., 2018)

Other possible benefits include the antioxidative effects: (Pei-Chi Chou, Heng-Yi Chu. 2018)

  • Alleviating oxidative stress and inflammation
  • Improving energy metabolism
  • Triggering the release of endorphins/hormones that help reduce pain.

Safety

  • Acupuncture is considered a safe procedure by a licensed and certified professional.
  • To practice acupuncture in the United States, an acupuncturist needs a minimum of a master’s degree from a program accredited by the American Academy of Acupuncture and Oriental Medicine and a license in the state where they received their acupuncture treatment.
  • Doctors with an MD or DO degree licensed in the United States to practice medicine can also be licensed by the American Academy of Medical Acupuncture after additional training.

Risks

Risks associated with acupuncture are bleeding and bruising, especially for individuals who have a bleeding disorder like hemophilia or take a blood thinning medication. Individuals are recommended to talk to their healthcare provider to determine if acupuncture is a safe option.

Side Effects

Most individuals do not experience any side effects, although possible reactions can include: (Shifen Xu et al., 2013)

  • Soreness
  • Bruising
  • Scarring
  • Needle shock: a vasovagal response that presents as feeling faint, clammy hands, chills, and slight nausea.

Acupuncture Session

  • During the initial treatment, individuals will discuss their medical history and what joints and areas of their bodies are presenting with symptoms.
  • After a physical exam, the individual will lie on a treatment table.
  • Individuals may be face up or down depending on what areas of the body the acupuncturist needs to access.
  • It is recommended to wear loose clothing that can be rolled up or moved out of the way to access different areas easily.
  • Depending on what areas need to be accessed, individuals may be asked to change into a medical gown.
  • The acupuncturist will use alcohol swabs to disinfect the area before inserting the needles.
  • The needles are made of stainless steel and are extremely thin.
  • Individuals may feel a slight pinch in sensitive areas like the hands and feet, but needle insertion should be comfortable and well-tolerated without significant discomfort.
  • For electroacupuncture, the acupuncturist will pass a mild electric current through the needles, typically 40 to 80 volts.
  • The needles stay in place for 20 to 30 minutes.
  • After the treatment is finished, the acupuncturist will remove the needles and dispose of them.

Frequency

  • The frequency of acupuncture sessions will vary depending on the severity of the symptoms and whether the visits are approved and reimbursed by the health insurance company.

Cost and Insurance

  • Costs for acupuncture can vary from $75 to $200 per session.
  • The first session, which involves an initial assessment and evaluation, usually costs more than follow-up visits.
  • Whether the health insurance will cover some or all of the costs of acupuncture sessions depends on the individual insurance company and the condition being treated.
  • Medicare currently covers acupuncture services up to 12 visits within a 90-day period for chronic low back pain only.
  • Medicare will not cover acupuncture for other conditions. (Medicare.gov. N.D.)

Acupuncture is not a cure for arthritis, but it may be a useful tool to help manage pain and other symptoms. Make sure to consult a healthcare provider if acupuncture is safe to try based on medical history.

Arthritis Explained

References

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

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

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

Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists’ Collaboration (2018). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The journal of pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005

Xu, S., Wang, L., Cooper, E., Zhang, M., Manheimer, E., Berman, B., Shen, X., & Lao, L. (2013). Adverse events of acupuncture: a systematic review of case reports. Evidence-based complementary and alternative medicine : eCAM, 2013, 581203. https://doi.org/10.1155/2013/581203

Medicare.gov. (N.D.). Acupuncture. Retrieved from https://www.medicare.gov/coverage/acupuncture

FOOSH Injuries: How to Heal & Get Back on Track

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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attractive doctor looking at handsome man with broken arm

“During a fall, individuals tend to automatically outstretch their hands to help break a fall, which can slam onto the ground, causing a falling onto an outstretched hand or FOOSH injury. Should individuals get checked by a healthcare provider if they believe there is no injury?”

FOOSH Injuries: How to Heal & Get Back on Track

FOOSH Injuries

Falling down usually results in minor injuries. A FOOSH injury occurs when falling down and trying to break the fall by reaching out with the hand/s. This can result in an upper extremity injury like a sprain or a fracture. But sometimes, falling on one’s hands can lead to serious injuries and/or create future musculoskeletal issues. Individuals who have fallen or suffered a FOOSH injury should consult their healthcare provider and then a physical therapist or chiropractor to safely develop a treatment plan to rehabilitate, strengthen, and expedite recovery.

After The Injury

For individuals who have fallen down and landed on their hand, wrist, or arm, here are a few things to ensure the proper care for the injury, including:

  • Follow the R.I.C.E. protocol for acute injuries
  • Visit a healthcare provider or local emergency clinic
  • Contact a physical therapist

A FOOSH injury could be or become serious, so to avoid letting small issues become big problems, get examined by a musculoskeletal specialist. The healthcare provider will obtain an imaging scan of the injured and surrounding areas. They will perform a physical examination to determine the type of injury, like a sprain or muscle strain. Not getting appropriate medical treatment after a fall can result in chronic pain and loss of function. (J. Chiu, S. N. Robinovitch. 1998)

Common Injuries

A FOOSH injury can injure different areas. These usually involve the wrist and hand, but the elbow or shoulder can also be injured. Common injuries include:

Colles’ fracture

  • A wrist fracture where the end of the arm bone is displaced backward.

Smith’s fracture

  • A wrist fracture, similar to a Colles’ fracture, is where the end of the arm bone is displaced towards the front of the wrist.

Boxer’s fracture

  • A fracture of the small bones in the hand.
  • Typically, it occurs after punching something, but it can happen from falling on an outstretched fist.

Elbow dislocation or fracture

  • The elbow can pop out of the joint or can break a bone in the elbow.

Collarbone fracture

  • The force from falling with the hands and arms outstretched can travel up to the collarbone, causing a fracture.

Proximal humeral fracture

  • Falling onto an outstretched hand injury can cause the arm bone to get jammed into the shoulder, causing a proximal humeral fracture.

Shoulder dislocation

  • The shoulder can pop out of the joint.
  • This can cause a rotator cuff tear or labrum injury.

Regardless of the injury, individuals should visit a healthcare provider to evaluate the damage. If the injury is serious, the practitioner can make an accurate or differential diagnosis and develop a treatment plan. (William R. VanWye et al., 2016)

Physical Therapy

Individuals can benefit from physical therapy to help recover and return to their previous level of function. Physical therapy varies depending on the specific injury, but generally, a physical therapist can help individuals return to function after a fall on an outstretched hand. (William R. VanWye et al., 2016) Common treatments can include:

  • Treatments and modalities to decrease pain, inflammation, and swelling.
  • Instruction on how to wear an arm sling properly.
  • Exercises and stretches to improve the range of motion, strength, and functional mobility.
  • Balance exercises.
  • Scar tissue management if surgery was necessary.

The therapy team will ensure the proper treatment is utilized to quickly and safely return to normal activities.

Chiropractic Care For Healing After Trauma

References

Chiu, J., & Robinovitch, S. N. (1998). Prediction of upper extremity impact forces during falls on the outstretched hand. Journal of biomechanics, 31(12), 1169–1176. https://doi.org/10.1016/s0021-9290(98)00137-7

VanWye, W. R., Hoover, D. L., & Willgruber, S. (2016). Physical therapist screening and differential diagnosis for traumatic-onset elbow pain: A case report. Physiotherapy theory and practice, 32(7), 556–565. https://doi.org/10.1080/09593985.2016.1219798

Overcoming Low Back Pain with Acupuncture: Expert Advice

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Can individuals dealing with low back pain find the relief they are looking for by incorporating acupuncture to reduce muscle spasms?

Introduction

Around the world, many individuals, young and old, have dealt with low back pain, which has an impact on their lives and affects their routines. Since low back pain is a multifactorial musculoskeletal issue, it can range from acute to chronic, depending on the severity and environmental factors that are in play. The lower back or the lumbar spinal region has thicker joints and helps stabilize the upper body portion’s weight. However, it is more susceptible to injury, and it causes the surrounding ligaments, soft tissues, and muscles to be overstretched, tight, and weak. When a person is in excruciating pain from the effects of low back pain, it can impact their day and cause them to be miserable. Today’s article focuses on how lower back pain is associated with pain-like symptoms like muscle spasms and how treatments like acupuncture can help reduce muscle spasms associated with lower back pain. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve low back pain correlated with muscle spasms. We also inform and guide patients on how treatments like acupuncture can help minimize the pain in their lower back. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from low back pain that is affecting their daily routine. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

Low Back Pain Associated With Muscle Spasms

Do you feel radiating or localized pain in your lower back after a long workday? Do you feel stiffness in your lower back region after stretching in the morning? Or have you noticed you are more tense in the different areas of your back and looking for relief? While it is a common problem that many people experience, low back pain can occur to many individuals worldwide and can significantly impact a person. As a major public health concern, low back pain globally transcends through ages, occupations, and socio-economic backgrounds, causing pain-like symptoms to develop over time. (Emorinken et al., 2023) Numerous factors can lead to low back pain and the symptoms that can occur in the lumbar region. Since low back pain can affect many individuals worldwide, this musculoskeletal condition can cause activity limitations in people. It can progressively increase spine degeneration, affecting the joints, bones, and discs. (Hauser et al., 2022) Some of the symptoms that correlate with low back pain include:

  • Stiffness
  • Gait instability
  • Numbing or tingling sensations in the extremities
  • Myofascial referred pain
  • Muscle spasms

 

 

The painful effects of low back pain can cause muscle spasms in the lumbar region as many people continuously make repetitive motions that cause the surrounding muscles to become overworked and develop trigger points to cause muscle spasms. When a person goes to a doctor to treat their lower back pain, they undergo a physical examination to evaluate their lower extremities’ strength, sensation, and reflexes. These examinations help doctors determine the proper protocol for low back pain through inspection, palpation, and range of motion of the lumbosacral musculature to identify point tenderness, restriction, and muscle spasms. (Will et al., 2018) These identity markers allow doctors to devise a personalized plan to reduce the effects of low back pain and help individuals regain their health.

 

Exploring Integrative Medicine- Video

Exploring Integrative Medicine | El Paso, Tx (2024)

Acupuncture Effects On Low Back Pain

When people with back pain are looking for treatment, they are looking for something affordable and can work with their busy schedule. Hence, non-surgical treatments could be the answer to reducing low back pain. Numerous non-surgical treatments can help individuals with specific pain-like symptoms that correlate with various factors. Each treatment, from chiropractic care to traction therapy, is personalized for the individual. Now, one of the oldest forms of non-surgical treatment is acupuncture. Originating from China, acupuncture incorporates solid thin needles at specific body points to balance the energy flow in the body that highly trained professionals perform. The effects of acupuncture can help stimulate the release of adenosine at the sight of needle stimulation while increasing local blood flow to the affected area to promote natural healing. (Mu et al., 2020) So, how does acupuncture help individuals reduce low back pain? 

 

 

Since low back pain can cause a socio-economic burden many people are affected by, acupuncture can help reduce pain and disability in the affected muscle areas while improving the person’s quality of life. (Baroncini et al., 2022) Acupuncture for low back pain benefits individuals by releasing endorphins and other neurohumoral factors that change brain and spinal cord processing. At the same time, acupuncture can also increase microcirculation and reduce the inflammatory effects of low back pain. (Sudhakaran, 2021) Acupuncture can also be part of a person’s personalized treatment plan, as physical and massage therapy can help strengthen the affected muscles caused by low back pain. When people dealing with low back pain are finally getting the relief they need, they can get their quality of life back through small changes to better themselves. This allows them to be more mindful of the various factors that can cause their bodies pain and prevent them from returning over time.

References

Baroncini, A., Maffulli, N., Eschweiler, J., Molsberger, F., Klimuch, A., & Migliorini, F. (2022). Acupuncture in chronic aspecific low back pain: a Bayesian network meta-analysis. J Orthop Surg Res, 17(1), 319. https://doi.org/10.1186/s13018-022-03212-3

Emorinken, A., Erameh, C. O., Akpasubi, B. O., Dic-Ijiewere, M. O., & Ugheoke, A. J. (2023). Epidemiology of low back pain: frequency, risk factors, and patterns in South-South Nigeria. Reumatologia, 61(5), 360-367. https://doi.org/10.5114/reum/173377

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

Mu, J., Furlan, A. D., Lam, W. Y., Hsu, M. Y., Ning, Z., & Lao, L. (2020). Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev, 12(12), CD013814. https://doi.org/10.1002/14651858.CD013814

Sudhakaran, P. (2021). Acupuncture for Low-Back Pain. Med Acupunct, 33(3), 219-225. https://doi.org/10.1089/acu.2020.1499

Will, J. S., Bury, D. C., & Miller, J. A. (2018). Mechanical Low Back Pain. American Family Physician, 98(7), 421-428. https://www.ncbi.nlm.nih.gov/pubmed/30252425

https://www.aafp.org/pubs/afp/issues/2018/1001/p421.pdf

Disclaimer

Achilles Tendon Injury: Causes, Symptoms & Treatments

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Football, men and exercise with action, grass and health with workout goal, fitness and motion. Mal.

“Individuals participating in physical and sports activities could suffer an Achilles tendon tear. Can understanding the symptoms and risks help in treatment and return the individual back to their sports activity sooner?”

Achilles Tendon Injury: Causes, Symptoms & Treatments

Achilles Tendon

This is a common injury that occurs when the tendon attaching the calf muscle to the heel gets torn.

About the Tendon

  • The Achilles tendon is the largest tendon in the body.
  • In sports and physical activities, intense explosive movements like running, sprinting, quickly shifting positions, and jumping are exerted on the Achilles.
  • Males are more likely to tear their Achilles and sustain a tendon rupture. (G. Thevendran et al., 2013)
  • The injury often occurs without any contact or collision but rather the running, starting, stopping, and pulling actions placed on the feet.
  • Certain antibiotics and cortisone shots can increase the likelihood of Achilles tear injuries.
  • A specific antibiotic, fluoroquinolones, has been shown to increase the risk of Achilles tendon problems.
  • Cortisone shots are also associated with Achilles tears, which is why many healthcare providers don’t recommend cortisone for Achilles tendonitis. (Anne L. Stephenson et al., 2013)

Symptoms

  • A tendon tear or rupture causes sudden pain behind the ankle.
  • Individuals may hear a pop or a snap and often report the feeling as being kicked in the calf or heel.
  • Individuals have difficulty pointing their toes downward.
  • Individuals may have swelling and bruising around the tendon.
  • A healthcare provider will examine the ankle for continuity of the tendon.
  • Squeezing the calf muscle is supposed to cause the foot to point downwards, but in individuals with a tear, the foot will not move, resulting in positive results on the Thompson test.
  • A defect in the tendon can usually be felt after a tear.
  • X-rays may be used to rule out other conditions, including ankle fracture or ankle arthritis.

Risk Factors

  • Achilles tendon ruptures are most seen in men around 30 or 40. (David Pedowitz, Greg Kirwan. 2013)
  • Many individuals have symptoms of tendonitis prior to sustaining a tear.
  • The majority of individuals have no history of previous Achilles tendon problems.
  • The majority of Achilles tendon tears are associated with ball sports. (Youichi Yasui et al., 2017)

Other risk factors include:

  • Gout
  • Cortisone injections into the Achilles tendon
  • Fluoroquinolone antibiotic use

Fluoroquinolone antibiotics are commonly used for the treatment of respiratory infections, urinary tract infections, and bacterial infections. These antibiotics are associated with Achilles tendon rupture, but further research is needed to determine how they affect the Achilles tendon. Individuals taking these medications are advised to consider an alternative medication if Achilles tendon problems begin to develop. (Anne L. Stephenson et al., 2013)

Treatment

Depending on the severity of the injury, treatment can consist of non-surgical techniques or surgery.

  • The benefit of surgery is there is usually less immobilization.
  • Individuals can often return to sports activities sooner, and there is less chance of re-rupturing the tendon.
  • Non-surgical treatment avoids the potential surgical risks, and the long-term functional results are similar. (David Pedowitz, Greg Kirwan. 2013)

Treating Ankle Sprains

References

Thevendran, G., Sarraf, K. M., Patel, N. K., Sadri, A., & Rosenfeld, P. (2013). The ruptured Achilles tendon: a current overview from biology of rupture to treatment. Musculoskeletal surgery, 97(1), 9–20. https://doi.org/10.1007/s12306-013-0251-6

Stephenson, A. L., Wu, W., Cortes, D., & Rochon, P. A. (2013). Tendon Injury and Fluoroquinolone Use: A Systematic Review. Drug safety, 36(9), 709–721. https://doi.org/10.1007/s40264-013-0089-8

Pedowitz, D., & Kirwan, G. (2013). Achilles tendon ruptures. Current reviews in musculoskeletal medicine, 6(4), 285–293. https://doi.org/10.1007/s12178-013-9185-8

Yasui, Y., Tonogai, I., Rosenbaum, A. J., Shimozono, Y., Kawano, H., & Kennedy, J. G. (2017). The Risk of Achilles Tendon Rupture in the Patients with Achilles Tendinopathy: Healthcare Database Analysis in the United States. BioMed research international, 2017, 7021862. https://doi.org/10.1155/2017/7021862

What You Need to Know About Degenerative Pain Syndrome Relief

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Can working individuals dealing with degenerative pain syndrome incorporate decompression to provide body relief and mobility?

Introduction

As part of the musculoskeletal system, the spine allows the body to stand vertically and helps protect the spinal cord from injuries. Since the central nervous system provides neuron signals from the brain to the nerve roots, the human body can be mobile without pain or discomfort. This is due to the spinal discs between the facet joints, which can be compressed, absorb the vertical axial pressure, and help distribute the weight to the lower and upper extremity muscles. However, as many people realize, repetitive movements and wear and tear on the spinal structure can lead to overlapping risk profiles that can cause the spinal disc to degenerate and invoke pain in the musculoskeletal system. To that point, it can cause the individual to be in extreme pain and discomfort over time. Today’s article looks at how degenerative pain syndrome affects the spine, the symptoms it’s associated with, and how decompression can reduce degenerative pain syndrome. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve degenerative pain syndrome that is causing mobility issues on the spine. We also inform and guide patients on how decompression can help reduce the pain-like symptoms correlating with degenerative pain syndrome. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from degenerative pain that is affecting their quality of life. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

Degenerative Pain Syndrome On The Spine

 

Do you feel muscle aches or pains in your back after an extended period of lying down, sitting, or standing? Do you feel constant pain after carrying a heavy object from one location to another? Or does twisting or turning your torso provide temporary relief? Many people often don’t realize that many of these pain-like issues are associated with degenerative pain syndrome that affects the spine. Since the body ages naturally, the spine does as well through degeneration. When the spinal discs start to degenerate, it can cause the vertical axial pressure to flatten and squeeze the disc, disrupting its ability to keep hydrated and causing it to protrude out of its original position. At the same time, the height of the spinal disc will gradually fall, and the consequence is a change in dynamics in the affected spine segments. (Kos et al., 2019) Degeneration can cascade down to the surrounding ligaments, muscles, and joints when degeneration starts to affect the spine. 

 

The Symptoms Associated With Degenerative Pain

When the surrounding joints, muscles, and ligaments are affected by degenerative disc pain, it can be due to multiple factors contributing to the pain-like symptoms. Inflammation is one of the symptoms that are associated with degenerative pain syndrome, as disturbances can affect the circadian rhythm and disrupt homeostasis, which then leads to increased stress on the spinal disc, which then contributes to the degenerative process. (Chao-Yang et al., 2021) Inflammation can cause the affected muscles to be inflamed and cause more overlapping risk profiles, as it can affect the upper and lower extremities. Additionally, mechanical loading may affect disc degeneration in various ways at the different vertebral levels. (Salo et al., 2022) This can lead to pain-like symptoms like:

  • Arm and leg tenderness
  • Nerve pain
  • Loss of sensory functions on the upper and lower extremities
  • Tingling sensations
  • Muscle pain

However, numerous treatments can help restore spinal mobility and lessen the painful effects of the degenerative pain syndrome of the spine.

 

The Non-Surgical Approach To Wellness- Video

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

When it comes to seeking treatment for degenerative pain syndrome, many individuals will do research on which treatment is affordable for their pain, hence why many people opt for non-surgical treatment to alleviate their pain. Non-surgical treatments are customized to the individual’s pain. They can help kickstart the person’s wellness journey, which can include a combination of exercise, manual therapy, and lifestyle modifications. (Brogger et al., 2018) The video above shows how a non-surgical approach can benefit someone with degenerative pain syndrome affecting their spine. 

Decompression Reducing Degenerative Pain Syndrome

 

With many available treatments to reduce pain-like symptoms affecting the spine, non-surgical treatments can be an option. Ranging from chiropractic care to acupuncture, non-surgical treatments can be combined to minimize the pain-like effects. Decompression, as part of the non-surgical treatment options, is an excellent way to reduce the degenerative pain process in the spine. Decompression allows the spinal column to be gently pulled through a traction machine to relieve the spinal disc. When a traction machine decomposes the spine, the pain intensity is significantly reduced in all body parts. (Ljunggren et al., 1984) This is due to negative pressure being reinstated back to the spine to increase disc height and restore the nutrients back to the affected disc and rehydrate them. (Choi et al., 2022) When people start incorporating decompression through consecutive treatment, their pain intensity is reduced, and their spine is mobile again while slowing down the degenerative process on the spine. This allows them to take better care of their bodies by making small changes in their health and wellness.

 

References

Brogger, H. A., Maribo, T., Christensen, R., & Schiottz-Christensen, B. (2018). Comparative effectiveness and prognostic factors for outcome of surgical and non-surgical management of lumbar spinal stenosis in an elderly population: protocol for an observational study. BMJ Open, 8(12), e024949. https://doi.org/10.1136/bmjopen-2018-024949

Chao-Yang, G., Peng, C., & Hai-Hong, Z. (2021). Roles of NLRP3 inflammasome in intervertebral disc degeneration. Osteoarthritis Cartilage, 29(6), 793-801. https://doi.org/10.1016/j.joca.2021.02.204

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, 1-9. https://doi.org/10.1155/2022/6343837

Kos, N., Gradisnik, L., & Velnar, T. (2019). A Brief Review of the Degenerative Intervertebral Disc Disease. Med Arch, 73(6), 421-424. https://doi.org/10.5455/medarh.2019.73.421-424

Ljunggren, A. E., Weber, H., & Larsen, S. (1984). Autotraction versus manual traction in patients with prolapsed lumbar intervertebral discs. Scand J Rehabil Med, 16(3), 117-124. https://www.ncbi.nlm.nih.gov/pubmed/6494835

Salo, S., Hurri, H., Rikkonen, T., Sund, R., Kroger, H., & Sirola, J. (2022). Association between severe lumbar disc degeneration and self-reported occupational physical loading. J Occup Health, 64(1), e12316. https://doi.org/10.1002/1348-9585.12316

Disclaimer

Heat Cramps: Causes, Symptoms and Prevention Tips

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Shot of an unrecognisable woman experiencing stomach ache while working out in nature.

“Individuals that engage in heavy exercise can develop heat cramps from overexertion. Can knowing the causes and symptoms help prevent future episodes from happening?”

Heat Cramps: Causes, Symptoms and Prevention Tips

Heat Cramps

Heat cramps can develop during exercise from overexertion or prolonged exposure to high temperatures. The muscle cramps, spasms, and pain can range from mild to severe.

Muscle Cramps and Dehydration

Heat cramps often develop because of dehydration and electrolyte loss. (Robert Gauer, Bryce K. Meyers 2019) Symptoms include:

Electrolytes like sodium, calcium, and magnesium are important for properly functioning muscles, including the heart. The primary role of sweating is to regulate the body’s temperature. (MedlinePlus. 2015) Sweat is mostly water, electrolytes, and sodium. Excessive sweating from physical activity and exertion or a hot environment can cause electrolyte imbalances that lead to cramps, spasms, and other symptoms.

Causes and Activities

Heat cramps most commonly affect individuals who sweat excessively during strenuous activity or are exposed to hot temperatures for prolonged periods. The body and organs need to cool down, which causes sweat production. However, too much sweating can lead to dehydration and electrolyte depletion. (Centers for Disease Control and Prevention. 2022)

Risk Factors

Factors that can increase the risk of developing heat cramps include: (Robert Gauer, Bryce K. Meyers 2019)

  • Age – Children and adults 65 years and older have the highest risk.
  • Excessive sweating.
  • Low sodium diet.
  • Preexisting Medical Conditions – heart disease, diabetes mellitus, and obesity are conditions that can increase the risk of muscle cramping.
  • Medications – blood pressure, diuretics, and antidepressants can affect electrolyte balance and hydration.
  • Alcohol consumption.

Self-Care

If heat cramps begin, immediately stop the activity and look for a cool environment. Rehydrate the body to replenish the fluid loss. Staying hydrated and drinking fluids regularly during intense activity or in a hot environment can help prevent the body from cramping. examples of beverages that increase electrolytes include:

Gently applying pressure and massaging affected muscles can help reduce pain and spasms. As symptoms resolve, it is recommended to not return to strenuous activity too soon because additional exertion can progressively lead to heatstroke or heat exhaustion. (Centers for Disease Control and Prevention. 2021) Heatstroke and heat exhaustion are two heat-related illnesses. (Centers for Disease Control and Prevention. 2022)

  • Heatstroke is when the body loses the ability to regulate temperature and can cause dangerously high temperatures.
  • Heat exhaustion is the body’s response to excessive fluid and electrolyte loss.

Symptom Timing

The timing and length of heat cramps can determine whether medical attention is necessary. (Centers for Disease Control and Prevention. 2022)

During or After Activities

  • The majority of heat cramps develop during activities because of the exertion and sweating, causing more electrolytes to be lost and the body to become more dehydrated.
  • Symptoms can also develop minutes to hours after activity has ceased.

Duration

  • Most heat-related muscle cramps will resolve with rest and hydration within 30–60 minutes.
  • If muscle cramping or spasms do not subside within one hour, seek professional medical attention.
  • For individuals with heart conditions or on a low-sodium diet who develop heat cramps, regardless of duration, medical help is necessary to ensure there are no complications.

Prevention

Tips for preventing heat cramps include: (Centers for Disease Control and Prevention. 2022)

  • Drink plenty of fluids before and during physical activities.
  • Avoid alcohol and caffeinated beverages.
  • Avoid exercising or exposure to extreme heat during peak sunlight hours.
  • Avoid tight and dark-colored clothing.

Assessing Patients In A Chiropractic Setting

References

Gauer, R., & Meyers, B. K. (2019). Heat-Related Illnesses. American family physician, 99(8), 482–489.

Centers for Disease Control and Prevention. (2022). Heat stress — heat related illness. The National Institute for Occupational Safety and Health (NIOSH) Retrieved from https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html#cramps

MedlinePlus. (2015). Sweat. Retrieved from https://medlineplus.gov/sweat.html#cat_47

FoodData Central. (2019). Nuts, coconut water (liquid from coconuts). Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/170174/nutrients

FoodData Central. (2019). Milk, nonfat, fluid, with added vitamin A and vitamin D (fat free or skim). Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/746776/nutrients

Centers for Disease Control and Prevention. (2012). Frequently asked questions (FAQ) about extreme heat. Retrieved from https://www.cdc.gov/disasters/extremeheat/faq.html

The Benefits of Acupuncture for Sciatica Pain Relief

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

Can individuals dealing with sciatica pain find the relief they need from acupuncture to restore low back mobility?

Introduction

The body’s lower extremities provide stability and movement to the individual as they are moving from one location to another without pain or discomfort. The lower extremities consist of the hips, lower back, legs, thighs, pelvis, knees, and feet; each has various muscles, nerve roots, and ligaments with a specific job to each muscle quadrant. The spinal column in the musculoskeletal system helps provide proper posture while protecting the spinal cord from injuries. However, more often than not, the lower extremities can succumb to injuries as many individuals incorporate repetitive motions that can compress the nerve roots that are spread out to the lower extremities, which can invoke pain. The most common pain that seems to affect the lower back and legs is sciatica, and when not treated, it can cause overlapping risk profiles to the lower extremities. Today’s article examines how sciatica is correlated with the lower back and how non-surgical treatments can help reduce the effects of sciatic pain. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve sciatica pain affecting their lower extremities. We also inform and guide patients on how non-surgical treatments can help reduce sciatica pain from the lower musculoskeletal extremities. We encourage our patients to ask their associated medical providers intricated and important questions about the pain-like symptoms they are experiencing from sciatica that are causing them pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

How Does Sciatica Correlate With The Lower Back?

Do you often experience numb or tingling sensations running down your leg that cause your leg or foot to lose sensation briefly? Do you feel shooting pain in your lower back after excessive sitting at your desk? Or do you find that stretching your legs or back temporarily relieves the pain, only for it to come back? Many individual who are experiencing shooting pain running down their legs are dealing with sciatica. When it comes to the lower extremities in the musculoskeletal system, many individuals make repetitive motions on their spine that can cause the spinal discs to become compressed and herniated under pressure. When the spinal disc is herniated in the lumbar spine, that disc will start to press on the surrounding nerve roots, thus sending radiating pain down the legs. Sciatica is defined as when individuals are experiencing pain coming from the lumbosacral nerve root and causing either a burning, heaviness, or tightness sensation. (Aguilar-Shea et al., 2022) Sciatica can range from mild to severe, forcing many individuals to think their foot is asleep. However, the sciatic nerve root is compressed, trapped, stuck, or pinched, which causes muscle spasms within the lower back, buttock, or legs. Hence, many individuals will explain that they are experiencing low back or leg pain when it is sciatica. 

 

 

Since the sciatic nerve is a long, thick nerve in the human body, it travels from the lumbar region down to the knee and connects to other nerves to reach the foot. Sciatica pain can be two conditions with the same pain-like symptom effects known as true or sciatica-like conditions. True sciatica is where an injury is directly affecting the sciatic nerve. This can relate to a slipped disc caused by environmental factors like lifting a heavy object, aggravating the sciatic nerve root, and causing pain that worsens. (Siddiq et al., 2020) For sciatica-like conditions, this is where other musculoskeletal conditions are causing sciatic pain-like symptoms on the lower extremities. Musculoskeletal conditions like piriformis syndrome can cause sciatica pain-like symptoms where the piriformis muscle is irritated or inflamed, pressing on the sciatic nerve, which causes many people to report pain along the gluteal region that may shoot a burning, aching sensations down the back of the legs. (Hicks et al., 2024) However, there are ways to treat sciatica and reduce the pain-like effects causing mobility issues.

 

Sciatica, Causes, Symptoms and Tips- Video

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

Non-surgical Treatments For Sciatica

When it comes to reducing sciatica pain, many individuals will seek out treatment that is cost-effective and customized to the person’s pain. Some treatments, like neural mobilization, can apply mechanical forces to the nerve roots to restore healthy movement to the legs and lower extremities. (Peacock et al., 2023) Other treatments, like spinal decompression, use gentle traction on the spinal disc to lay off the pressure on the sciatic nerve to provide relief. Non-surgical treatments are favorable to many people due to how affordable it is and personalized to the person’s pain as they help reduce pain and disability. (Liu et al., 2023) Luckily, a form of non-surgical treatment can help relieve sciatica and its associated pain-like symptoms.

 

Acupuncture Relieving Sciatic Pain

Acupuncture is one of the oldest forms of non-surgical treatments in which trained professionals use thin, solid needles to be inserted and placed on the affected area, causing pain. Acupuncture can help reduce the distortion of the affected nerve roots, and local inflammatory cytokines correlated with sciatica. (Yu et al., 2021) What this does is that it normalizes the neuron signals to a default mode from aggravating the surrounding muscle fibers and descending the pain. Additionally, acupuncture can help restore the body’s qi or energy by reducing the pain by placing the needles on the acupoint of the vital organs that share a relationship with the sciatic nerve. (Yu et al., 2022) This is known as somato-visceral, where the vital organs could be the affected area, causing overlapping muscle and nerve risk profiles. Acupuncture is an excellent form of non-surgical treatment that can be combined with other various therapies to help restore the body’s natural healing factor and allow people to be more mindful of how to take care of their bodies easily to prevent sciatica pain-like symptoms from arising.

 

References

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

Hicks, B. L., Lam, J. C., & Varacallo, M. (2024). Piriformis Syndrome. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/28846222

Liu, C., Ferreira, G. E., Abdel Shaheed, C., Chen, Q., Harris, I. A., Bailey, C. S., Peul, W. C., Koes, B., & Lin, C. C. (2023). Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials. BMJ, 381, e070730. https://doi.org/10.1136/bmj-2022-070730

Peacock, M., Douglas, S., & Nair, P. (2023). Neural mobilization in low back and radicular pain: a systematic review. J Man Manip Ther, 31(1), 4-12. https://doi.org/10.1080/10669817.2022.2065599

Siddiq, M. A. B., Clegg, D., Hasan, S. A., & Rasker, J. J. (2020). Extra-spinal sciatica and sciatica mimics: a scoping review. Korean J Pain, 33(4), 305-317. https://doi.org/10.3344/kjp.2020.33.4.305

Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., . . . Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ Open, 12(5), e054566. https://doi.org/10.1136/bmjopen-2021-054566

Yu, F. T., Ni, G. X., Cai, G. W., Wan, W. J., Zhou, X. Q., Meng, X. L., Li, J. L., Tu, J. F., Wang, L. Q., Yang, J. W., Fu, H. Y., Zhang, X. C., Li, J., Wang, Y. F., Zhang, B., Zhang, X. H., Zhang, H. L., Shi, G. X., & Liu, C. Z. (2021). Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial. Trials, 22(1), 34. https://doi.org/10.1186/s13063-020-04961-4

Disclaimer

What is a Nerve Block? How it Helps Alleviate Pain Symptoms

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Elderly male complains to the doctor about back pain, the men are located in the ultrasound room

“For individuals dealing with chronic pain, can undergoing a nerve block procedure help alleviate and manage symptoms?”

What is a Nerve Block? How it Helps Alleviate Pain Symptoms

Nerve Blocks

A nerve block is a procedure done to interrupt/block pain signals due to nerve dysfunction or injury. They can be used for diagnostic or treatment purposes, and their effects can be short or long-term, depending on the type being used.

  • A temporary nerve block may involve the application or injection that stops pain signals from transmitting for a short time.
  • For example, in pregnancy, an epidural injection can be used during labor and delivery.
  • Permanent nerve blocks involve cutting/severing or removing certain parts of a nerve to stop pain signals.
  • These are used in cases with severe injuries or other chronic pain conditions that have not improved with other treatment approaches.

Treatment Usage

When healthcare providers diagnose a chronic pain condition caused by nerve injury or dysfunction, they may use a nerve block to locate the area generating pain signals. They may perform electromyography and/or a nerve conduction velocity/NCV test to pinpoint the cause of chronic nerve pain. Nerve blocks can also treat chronic neuropathic pain, such as pain caused by nerve damage or compression. Nerve blocks are regularly used to treat back and neck pain caused by herniated discs or spinal stenosis. (Johns Hopkins Medicine. 2024)

Types

Three types include:

  • Local
  • Neurolytic
  • Surgical

All three can be used for conditions that cause chronic pain. However, neurolytic and surgical blocks are permanent and are only used for severe pain that has worsened with other treatments unable to provide relief.

Temporary Blocks

  • A local block is done by injecting or applying local anesthetics, like lidocaine, to a certain area.
  • An epidural is a local nerve block that injects steroids or analgesics into an area around the spinal cord.
  • These are common during pregnancy, labor, and delivery.
  • Epidurals can also be used to treat chronic neck or back pain due to a compressed spinal nerve.
  • Local blocks are usually temporary, but in a treatment plan, they can be repeated over time to manage chronic pain from conditions like arthritis, sciatica, and migraines. (NYU Langone Health. 2023)

Permanent Blocks

  • A neurolytic block uses alcohol, phenol, or thermal agents to treat chronic nerve pain. (National Institute of Neurological Disorders and Stroke. 2023) These procedures damage certain areas of the nerve pathway on purpose so that pain signals cannot be transmitted. A neurolytic block is mainly used for severe chronic pain cases, like pain from cancer or complex regional pain syndrome/CRPS. They are sometimes used to treat ongoing pain from chronic pancreatitis and pain in the chest wall after surgery. (Johns Hopkins Medicine. 2024) (Alberto M. Cappellari et al., 2018)
  • The neurosurgeon performs a surgical nerve block that involves surgically removing or damaging specific areas of the nerve. (National Institute of Neurological Disorders and Stroke. 2023) A surgical nerve block is only used for severe pain cases, such as cancer pain or trigeminal neuralgia.
  • Although neurolytic and surgical nerve blocks are permanent procedures, pain symptoms, and sensations can come back if the nerves are able to regrow and repair themselves. (Eun Ji Choi et al., 2016) However, symptoms and sensations may not return months or years after the procedure.

Different Body Areas

They can be administered in most body areas, including: (Hospital for Special Surgery. 2023) (Stanford Medicine. 2024)

  • Scalp
  • Face
  • Neck
  • Collarbone
  • Shoulders
  • Arms
  • Back
  • Chest
  • Ribcage
  • Abdomen
  • Pelvis
  • Buttocks
  • Legs
  • Ankle
  • Feet

Side Effects

These procedures can have the potential risk of permanent nerve damage. (Anthem BlueCross. 2023) Nerves are sensitive and regenerate slowly, so a tiny error can cause side effects. (D O’Flaherty et al., 2018) Common side effects include:

  • Muscle paralysis
  • Weakness
  • Frequent numbness
  • In rare cases, the block could irritate the nerve and cause added pain.
  • Skilled and licensed health practitioners like surgeons, pain management physicians, anesthesiologists, and dentists are trained to perform these procedures carefully.
  • There is always a risk of nerve damage or injury, but the majority safely and successfully decrease and help manage chronic pain. (Anthem BlueCross. 2023)

What to Expect

  • Individuals may feel numbness or soreness and/or notice redness or irritation near or around the area that is temporary.
  • There can also be swelling, which compresses the nerve and requires time to improve. (Stanford Medicine. 2024)
  • Individuals may be asked to rest for a certain amount of time after the procedure.
  • Depending on the type of procedure, individuals may have to spend a few days in a hospital.
  • Some pain may still be present, but that does not mean the procedure did not work.

Individuals should consult with a healthcare provider about the risks and benefits to ensure it is the right treatment.

Sciatica, Causes, Symptoms, and Tips

References

Johns Hopkins Medicine. (2024). Nerve blocks. (Health, Issue. https://www.hopkinsmedicine.org/health/conditions-and-diseases/nerve-blocks

NYU Langone Health. (2023). Nerve block for migraine (Education and Research, Issue. https://nyulangone.org/conditions/migraine/treatments/nerve-block-for-migraine

National Institute of Neurological Disorders and Stroke. (2023). Pain. Retrieved from https://www.ninds.nih.gov/health-information/disorders/pain#3084_9

Johns Hopkins Medicine. (2024). Chronic pancreatitis treatment (Health, Issue. https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pancreatitis/chronic-pancreatitis-treatment

Cappellari, A. M., Tiberio, F., Alicandro, G., Spagnoli, D., & Grimoldi, N. (2018). Intercostal Neurolysis for The Treatment of Postsurgical Thoracic Pain: a Case Series. Muscle & nerve, 58(5), 671–675. https://doi.org/10.1002/mus.26298

Choi, E. J., Choi, Y. M., Jang, E. J., Kim, J. Y., Kim, T. K., & Kim, K. H. (2016). Neural Ablation and Regeneration in Pain Practice. The Korean journal of pain, 29(1), 3–11. https://doi.org/10.3344/kjp.2016.29.1.3

Hospital for Special Surgery. (2023). Regional anesthesia. https://www.hss.edu/condition-list_regional-anesthesia.asp

Stanford Medicine. (2024). Types of nerve blocks (For Patients, Issue. https://med.stanford.edu/ra-apm/for-patients/nerve-block-types.html

Anthem BlueCross. (2023). Peripheral nerve blocks for treatment of neuropathic pain. (Medical Policy, Issue. https://www.anthem.com/dam/medpolicies/abc/active/policies/mp_pw_c181196.html

O’Flaherty, D., McCartney, C. J. L., & Ng, S. C. (2018). Nerve injury after peripheral nerve blockade-current understanding and guidelines. BJA education, 18(12), 384–390. https://doi.org/10.1016/j.bjae.2018.09.004

Stanford Medicine. (2024). Common patient questions about nerve blocks. (For Patients, Issue. https://med.stanford.edu/ra-apm/for-patients/nerve-block-questions.html

Get Rid of Hip Pain with Spinal Decompression Therapy

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

Can individuals dealing with hip pain, find the relief they are looking for from spinal decompression to reduce their sciatica pain?

Introduction

When it comes to individuals doing everyday movements, the body can be in weird positions without pain or discomfort. Hence, people can stand or sit for prolonged periods and feel all right when doing strenuous activities. However, as the body ages, the surrounding muscles and ligaments can become weak and tight, while the spinal joints and discs start to be compressed and wear and tear. This is because many individuals make repetitive motions on their bodies that cause pain-like symptoms in the back, hips, neck, and body extremities, leading to referred pain in different body locations. When individuals are experiencing musculoskeletal pain in their bodies, it can cause overlapping risk profiles that can hinder the individual and cause them to be miserable. Additionally, when people experience musculoskeletal pain in their bodies, many will seek treatment to reduce the referred pain-like symptoms associated with the musculoskeletal pain. Today’s article will examine one type of musculoskeletal pain on the hips, how it can cause sciatica pain-like problems, and how treatments like decompression can reduce the pain-like effects of hip pain correlated with sciatica. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve hip pain associated with sciatica. We also inform and guide patients on how decompression can help reduce pain-like symptoms like sciatica and restore hip mobility. We encourage our patients to ask their associated medical providers intricated and important questions about the pain-like symptoms they are experiencing from hip pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

Hip Pain Associated With Sciatica

Do you often experience stiffness in your lower back and hips after sitting down for an excessive period? How about feeling radiating pain running down from your lower back to your legs? Or do you think your hip and thigh muscles become tight and weak, which is affecting your gait stability? Many individuals experiencing these pain-like issues are experiencing hip pain, and it can be an issue when it is not treated over time. Since hip pain is a common and disabling condition that is challenging to diagnose, many individuals often express localized pain in one of the three anatomic regions: the anterior, posterior, and lateral hip sections. (Wilson & Furukawa, 2014) When individuals are dealing with hip pain, they will also experience referred pain in their lower backs, which causes them to be in distress and miserable. At the same time, simple ordinary movements like sitting or standing can affect the muscles and ligaments surrounding the hips and can be damaging. This can cause hip pain to be referred from the lumbar spine and spine problems, which then cause musculoskeletal issues in the lower extremities. (Lee et al., 2018) 

 

 

So, how would hip pain be associated with sciatica and causing pain in many lower extremities? The hip areas in the musculoskeletal system have numerous muscles surrounding the pelvic bone area that can become tight and weak, causing referred musculoskeletal pain from intrapelvic and gynecologic issues. (Chamberlain, 2021) This means that musculoskeletal disorders like piriformis syndromes associated with hip pain can lead to sciatica. The sciatic nerve travels down from the lumbar region and the buttocks and behind the leg. When a person is dealing with sciatica and is going to their primary doctor to get treated for the pain, their doctors will do a physical examination to see what factors are causing the pain. Some of the common findings during a physical exam were tenderness and palpation of the greater sciatic notch and the reproduction of pain along the hips. (Son & Lee, 2022) This causes associated symptoms that correlate with sciatica and hip pain, including:

  • Tingling/numbing sensations
  • Muscle tenderness
  • Pain while sitting or standing
  • Discomfort

 

Is Motion The Key To Healing- Video

Is Motion Key to Healing? | El Paso, Tx (2023)

Spinal Decompression Reducing Hip Pain

However, many individuals will find non-surgical treatments to help reduce sciatica associated with hip pain. Non-surgical treatments are customized to a person’s pain and are cost-effective while being gentle on the spine. Spinal decompression can help reduce hip pain associated with sciatica. Decompression on the spine allows gentle traction to stretch out weak muscles along the lower back and hips while the spinal discs are experiencing negative pressure. When a person is dealing with sciatica pain associated with hip pain and trying decompression for the first time, they are provided with the relief they deserve. (Crisp et al., 1955)

 

 

Additionally, many individuals who incorporate decompression for their hip pain can begin to feel its effects as it helps improve blood flow circulation back to the hips to start the natural healing process. (Hua et al., 2019) When people begin incorporating decompression for their hip pain, they can relax as they feel all their aches and pain gradually disappear as mobility and rotation are back on the lower extremities.

 

References

Chamberlain, R. (2021). Hip Pain in Adults: Evaluation and Differential Diagnosis. American Family Physician, 103(2), 81-89. https://www.ncbi.nlm.nih.gov/pubmed/33448767

https://www.aafp.org/pubs/afp/issues/2021/0115/p81.pdf

Crisp, E. J., Cyriax, J. H., & Christie, B. G. (1955). Discussion on the treatment of backache by traction. Proc R Soc Med, 48(10), 805-814. https://www.ncbi.nlm.nih.gov/pubmed/13266831

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1919242/pdf/procrsmed00390-0081.pdf

Hua, K. C., Yang, X. G., Feng, J. T., Wang, F., Yang, L., Zhang, H., & Hu, Y. C. (2019). The efficacy and safety of core decompression for the treatment of femoral head necrosis: a systematic review and meta-analysis. J Orthop Surg Res, 14(1), 306. https://doi.org/10.1186/s13018-019-1359-7

Lee, Y. J., Kim, S. H., Chung, S. W., Lee, Y. K., & Koo, K. H. (2018). Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study. J Korean Med Sci, 33(52), e339. https://doi.org/10.3346/jkms.2018.33.e339

Son, B. C., & Lee, C. (2022). Piriformis Syndrome (Sciatic Nerve Entrapment) Associated With Type C Sciatic Nerve Variation: A Report of Two Cases and Literature Review. Korean J Neurotrauma, 18(2), 434-443. https://doi.org/10.13004/kjnt.2022.18.e29

Wilson, J. J., & Furukawa, M. (2014). Evaluation of the patient with hip pain. American Family Physician, 89(1), 27-34. https://www.ncbi.nlm.nih.gov/pubmed/24444505

https://www.aafp.org/pubs/afp/issues/2014/0101/p27.pdf

 

Disclaimer

Colon Cleanse: Benefits, Side Effects, and What You Need to Know

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Male patient on appointment with gastroenterologist at medical office. Doctor with man during medical consultation

“For individuals experiencing frequent bloating or constipation, could performing a colon cleanse help alleviate your symptoms?”

Colon Cleanse: Benefits, Side Effects, and What You Need to Know

Colon Cleanse

Individuals can clean out their bowels, colon, or large intestine by drinking more water and adding certain foods to their diet, like whole grains, fruits, and vegetables. Some may find that the practice helps decrease bloating or other digestive issues. While a colon cleanse is safe for most, the practice can cause side effects, like nausea or dehydration.

Benefits

Natural colon cleanses can provide various benefits that include:

  • Reducing bloating.
  • Improving the immune system.
  • Removing toxins from the body.
  • Helping with weight loss.
  • Decreasing the risk of colon cancer.
  1. While individuals may feel better after a natural colon cleanse, there is currently no research to support the medical benefits. (Cedars Sinai. 2019)
  2. Another type is known as hydrotherapy of the colon or irrigation.
  3. A healthcare provider performs this type of cleansing and sends water into the colon with instrumentation.
  4. This type of cleanse is not used to prepare individuals for a colonoscopy.

Cleansing

Cleansing the body safely can be done with ingredients from the local grocery store.

Thorough Hydration

  • Water will improve body function, including digestion and elimination.
  • Use the color of urine as a guide.
  • If it’s pale yellow, the body is getting enough water.
  • If it’s darker, the body needs more.

Increasing Fiber Consumption

Fiber is a type of carbohydrate that the body cannot digest but influences:

  • The rate of digestion.
  • The absorption of nutrients.
  • Waste movement, by helping to soften the stool. (Cornell University. 2012)
  • Fiber can be found in fruits, vegetables, oats, lentils, peas, and almonds.
  • Increasing fiber intake will help regulate the bowels and maintain overall colon health. (Cornell University. 2012)

Probiotics

Probiotics are live bacteria and yeasts that have health and digestion benefits.

  • Researchers believe they help to replace healthy bacteria and balance the healthy and unhealthy bacteria in the body, which maintains smooth digestion. (Mount Sinai. 2024)
  • Fermented foods like yogurt, kimchi, sauerkraut, and pickles are healthy sources of probiotics.
  • They also come as supplements.

Apple Cider Vinegar and Honey

  • Both ingredients contain probiotics, and mixing them can help improve gut health.
  • Individuals also believe that this concoction can help remove toxins from the body, but there’s no scientific evidence to support this.
  • Individuals can try 1 tablespoon of raw honey and 2 tablespoons of apple cider vinegar in a warm glass of water.

Juice and Smoothies

  • Adding more fruits, including juice and smoothies, is a healthy way to stay hydrated.
  • It also adds fiber and other nutrients to improve gut health.
  • Bananas and apples are a healthy source of probiotics.
  • Individuals can also add yogurt to the smoothies for extra probiotics.
  • These elements can help improve the gut microbiome and regulate bowel movements.

Precautions

Doing a colon cleanse should be safe for most, as long as the individual is not fasting at the same time or performing them too frequently. However, it’s recommended to consult a healthcare provider before changing eating patterns or trying new treatments or supplements, including a colon cleanse, especially for individuals who have an underlying condition.

Side Effects

Colon cleansing can come with risks that can include: (Cedars Sinai. 2019)

  • Dehydration
  • Cramping
  • Nausea
  • Electrolyte imbalance

Doing occasional colon cleanses may not result in side effects, but the chances of side effects increase the longer or more often cleanses are performed. It’s recommended to consult a healthcare provider if experiencing any symptoms.

Improving Colon Health

The best way to improve colon health is by drinking enough water and eating foods that promote a healthy digestive system. Healthy approaches include:

  • Increasing fruit and vegetable intake.
  • Increasing whole grain intake provides fiber and more nutrients.
  • Eating ground flaxseed improves digestion and elimination.

Integrative Medicine

References

Rosenblum, C. S. K. (2019). Ask a doc: Are colon cleanses healthy? (Cedars-Sinai Blog, Issue. https://www.cedars-sinai.org/blog/colon-cleansing.html

University., C. (2012). Fiber, digestion, and health. (Health Services, Issue. https://health.cornell.edu/sites/health/files/pdf-library/fiber-digestion-health.pdf

Sinai., M. (2024). Lactobacillus acidophilus. (Health Library, Issue. https://www.mountsinai.org/health-library/supplement/lactobacillus-acidophilus

Say Bye to Fibromyalgia Pain with Acupuncture

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

For individuals dealing with fibromyalgia, can incorporating acupuncture as part of integrative treatment help with pain relief?

Introduction

The musculoskeletal system helps the various muscles, tendons, and ligaments be mobile while stabilizing the vertical pressure. The upper and lower extremities work together, enabling the host to be mobile without feeling pain and discomfort. However, many individuals have dealt with pain, whether it is acute or chronic, at one point in their lives. When the body is dealing with pain, the response signal from the brain will show where the pain is located, which causes muscle soreness. To that point, the immune system will start to heal the affected area naturally. However, when a person has an autoimmune disease, the body will be impacted for no reason, which then causes the immune system to release inflammatory cytokines to healthy cells and muscular structures. When this happens, it can affect their quality of life and cause painful sensations to the musculoskeletal system, forcing individuals to seek treatment. Today’s article focuses on the correlation between the musculoskeletal system and fibromyalgia and how treatments like acupuncture can help reduce the pain-like symptoms that are caused by fibromyalgia. We talk with certified medical providers who utilize our patients’ information to provide acupuncture treatments to lessen the overlapping risk profiles associated with fibromyalgia. We also inform and guide patients on how various treatments can help reduce the pain-like symptoms related to fibromyalgia. We encourage our patients to ask their associated medical providers intricated and important questions about the pain-like symptoms they are experiencing from fibromyalgia. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

The Musculoskeletal System & Fibromyalgia

Have you been experiencing tingling sensations in your arms, legs, feet, and hands? Do you feel your muscles and joints lock up and feel stiff constantly in the morning? Or have you been dealing with unquestionable pain in your body that is affecting your daily routine? Many of these pain-like symptoms are associated with an autoimmune disease known as fibromyalgia. Fibromyalgia is often characterized by widespread chronic musculoskeletal pain that is associated with neurosensory disorders. People with fibromyalgia will have musculoskeletal pain symptoms from muscle and joint stiffness to fatigue and myofascial pain. (Siracusa et al., 2021) This is because the vagus nerve in the parasympathetic autonomic nervous system is in constant “fight or flight” mode, which causes many individuals to become hypersensitive and experience amplified painful sensations. This forces the muscle fibers in the musculoskeletal system to develop tiny nodules known as trigger points in the soft tissues. This causes muscle pathophysiology as a primary mechanism that mediates the onset of symptoms that pertain to fibromyalgia. (Geel, 1994) Unfortunately, fibromyalgia is a challenge to diagnose when comorbidities factors start to overlap and can play a role in this autoimmune disease. 

 

 

Fibromyalgia is an autoimmune condition that increases a person’s sensitivity to pain while including multiple tender points at specific areas of the body, causing widespread chronic musculoskeletal pain. Many individuals dealing with chronic musculoskeletal pain are unaware of the proper pathway to care as it generates a negative impact on pain, disability, and quality of life. (Lepri et al., 2023) Since fibromyalgia is associated with musculoskeletal pain, it can be combined with myofascial pain syndrome since both are characterized by muscle tenderness. (Gerwin, 1998) However, there are numerous treatments available to reduce the painful effects of fibromyalgia and help restore a person’s quality of life.

From Inflammation to Healing- Video

From Inflammation to Healing | El Paso, Tx (2023)

Do you feel muscle pain and tenderness in various areas of your body? Do you feel muscle and joint stiffness in your upper and lower extremities? Or do you feel numbing or tingling sensations in your arms, hands, legs, and feet? Many people dealing with these pain-like issues are experiencing an autoimmune disorder known as fibromyalgia. Fibromyalgia is a challenging autoimmune disorder to diagnose. However, the symptoms are often correlated with muscular pain. This can cause many individuals to reduce their quality of life. Fibromyalgia can cause the body to be hypersensitive to pain and can cause chronic inflammation of the joints. However, some treatments are non-surgical, cost-effective, and can help provide the pain relief many people deserve. The video above explains how various non-surgical treatments can help reduce inflammatory and pain effects on the body through various treatments that can be combined to minimize the pain-like symptoms of fibromyalgia.

Acupuncture Reducing Fibromyalgia Pain

When it comes to treating fibromyalgia and reducing pain-like symptoms, many people will seek out non-surgical treatments to manage and improve the symptoms correlating with fibromyalgia. Acupuncture can help ease the pain-like symptoms that are affecting the body and reduce the myofascial trigger points correlating with fibromyalgia. Since acupuncture originated in China, it is one of the most popular sensory stimulation therapies that are non-surgical; acupuncturists who are highly trained use various techniques to insert and manipulate fine needles to stimulate specific anatomic trigger points in the body to restore balance to the body. (Zhang & Wang, 2020) For individuals dealing with fibromyalgia pain, acupuncture can be combined with other therapies as part of the individual’s personalized treatment plan. Acupuncture helps improve muscle pain caused by fibromyalgia.

 

 

Additionally, acupuncture can assist in regulating the somatosensory function of the body and reduce symptoms of muscle stiffness while enhancing a person’s quality of life. (Zheng & Zhou, 2022) Fibromyalgia is a chronic autoimmune disorder that can affect the musculoskeletal system and can cause unbearable pain to many people by disrupting a person’s quality of life. When combined with other therapies, acupuncture can provide a significant positive effect on managing fibromyalgia and enhancing a person’s quality of life. (Almutairi et al., 2022)

 

References

Almutairi, N. M., Hilal, F. M., Bashawyah, A., Dammas, F. A., Yamak Altinpulluk, E., Hou, J. D., Lin, J. A., Varrassi, G., Chang, K. V., & Allam, A. E. (2022). Efficacy of Acupuncture, Intravenous Lidocaine, and Diet in the Management of Patients with Fibromyalgia: A Systematic Review and Network Meta-Analysis. Healthcare (Basel), 10(7). https://doi.org/10.3390/healthcare10071176

Geel, S. E. (1994). The fibromyalgia syndrome: musculoskeletal pathophysiology. Semin Arthritis Rheum, 23(5), 347-353. https://doi.org/10.1016/0049-0172(94)90030-2

Gerwin, R. D. (1998). Myofascial pain and fibromyalgia: Diagnosis and treatment. J Back Musculoskelet Rehabil, 11(3), 175-181. https://doi.org/10.3233/BMR-1998-11304

Lepri, B., Romani, D., Storari, L., & Barbari, V. (2023). Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review. Int J Environ Res Public Health, 20(5). https://doi.org/10.3390/ijerph20054098

Siracusa, R., Paola, R. D., Cuzzocrea, S., & Impellizzeri, D. (2021). Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. Int J Mol Sci, 22(8). https://doi.org/10.3390/ijms22083891

Zhang, Y., & Wang, C. (2020). Acupuncture and Chronic Musculoskeletal Pain. Curr Rheumatol Rep, 22(11), 80. https://doi.org/10.1007/s11926-020-00954-z

Zheng, C., & Zhou, T. (2022). Effect of Acupuncture on Pain, Fatigue, Sleep, Physical Function, Stiffness, Well-Being, and Safety in Fibromyalgia: A Systematic Review and Meta-Analysis. J Pain Res, 15, 315-329. https://doi.org/10.2147/JPR.S351320

Disclaimer

Healing Plantar Fasciitis with Acupuncture: A Guide for Patients

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
A acupuncture needle therapy in the studio. High quality photo

“For individuals dealing with plantar fasciitis, every step can be painful. Can taking an integrative approach and utilizing acupuncture help treat this condition and accelerate symptom relief?”

 

Acupuncture Plantar Fasciitis

Plantar fasciitis occurs when the supportive tissue running along the sole of the foot, from the heel to the base of the toes, becomes irritated and painful. The disorder can be difficult to manage, but there are alternative treatment options. Acupuncture for plantar fasciitis therapy is one potential method of relief, alleviating pain and helping the individual return to regular activities. Acupuncture involves inserting extremely thin needles into specific points in the body to restore and balance the body’s energy flow and improve overall health. (Johns Hopkins University. 2024) In traditional Chinese medicine (TCM), the body comprises a series of meridians (channels) that carry the flow of energy, or qi/chi.

Facts

Plantar fasciitis is a common disorder affecting the foot. The condition occurs when the plantar fascia, which is designed to absorb forces transmitted through the foot’s arch, becomes overloaded. When the bottom of the foot is constantly subjected to high levels of strain, it can lead to ligament degeneration, pain, and inflammation. The most common symptom is heel pain, the first thing an individual experiences in the morning or after a long day of work and activities. Anyone can get plantar fasciitis, but those who are more prone to the condition include individuals with:

  1. The disorder is first treated conservatively with physical therapy focusing on relieving the pain symptoms and restoring foot and ankle flexibility.
  2. Orthotics or custom-fabricated shoe inserts can help protect the foot and correct foot positioning.
  3. Night splints help hold the foot in a flexed position at night.
  4. Anti-inflammatory medications may also be used. (American Academy of Orthopaedic Surgeons. 2022)

Benefits of Acupuncture

Acupuncture and its effectiveness are still being studied, but there is evidence suggesting it is beneficial for treating plantar fasciitis.

  • One review found significant improvements in pain among individuals who received acupuncture for the condition compared with those who received standard treatments such as stretching, orthotics, and strengthening. (Anandan Gerard Thiagarajah 2017) The same review also found benefits when comparing acupuncture to a placebo, further reinforcing the findings.
  • Another medical review found that acupuncture helped alleviate heel pain and improve daily function when combined with nonsteroidal anti-inflammatory medications/NSAIDs such as ibuprofen or naproxen. (Richard James Clark, Maria Tighe 2012)

Side Effects

While acupuncture plantar fasciitis therapy is beneficial, it is important to remember that there can be potential side effects that can include:

  • Pain in the area where the needles were placed.
  • Bleeding in the area where the needles were placed.
  • Bruising or skin discoloration.
  • Allergic reaction or contact dermatitis/itchy rash.
  • Dizziness or light-headedness.
  • Nausea or vomiting (Malcolm W C Chan et al., 2017)

The risk of a serious adverse effect is relatively low when undergoing acupuncture on the foot.

Acupuncture Points and Sensations

The ways acupuncture works are not yet fully understood, but, like other neuromusculoskeletal therapies, it activates the body’s healing properties.

  • Inserting a needle into the body’s points stimulates the central nervous system.
  • This leads to the release of chemicals in the brain, spinal cord, and muscles that promote healing.
  • These same chemicals and reactions also reduce the body’s sensation of pain. (Teng Chen et al., 2020)

Number of Sessions

The number of sessions that acupuncture takes to provide pain relief varies from person to person and case to case.

Individuals are recommended to consult a healthcare provider about personalized treatment plans and if they have a bleeding disorder, are on blood-thinning medications, or are pregnant.

Understanding Plantar Fasciitis

References

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

American Academy of Orthopaedic Surgeons. (2022). Plantar fasciitis and bone spurs. (Diseases and Conditions, Issue. https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs

Thiagarajah A. G. (2017). How effective is acupuncture for reducing pain due to plantar fasciitis?. Singapore medical journal, 58(2), 92–97. https://doi.org/10.11622/smedj.2016143

Clark, R. J., & Tighe, M. (2012). The effectiveness of acupuncture for plantar heel pain: a systematic review. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 30(4), 298–306. https://doi.org/10.1136/acupmed-2012-010183

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

Chen, T., Zhang, W. W., Chu, Y. X., & Wang, Y. Q. (2020). Acupuncture for Pain Management: Molecular Mechanisms of Action. The American journal of Chinese medicine, 48(4), 793–811. https://doi.org/10.1142/S0192415X20500408

The Benefits of Acupuncture for Neck Pain Relief

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

Can individuals dealing with neck pain incorporate acupuncture as part of their health and wellness treatment to relieve headaches?

Introduction

As part of the musculoskeletal system, the neck allows the head to go into full rotation without feeling discomfort or pain. The neck is part of the cervical spine region and is surrounded by numerous ligaments, muscles, and tissues that help protect the spinal cord and the spinal column. However, the neck is also the most susceptible to injury neck to back pain as it is one the top three complaints many individuals suffer from at some point in their lives. When people experience neck pain, numerous causes can contribute to developing neck pain, while pain-like symptoms like headaches contribute to the body. This causes many individuals to seek treatment and find the relief they are looking for to reduce neck pain while continuing their daily routine. Today’s article looks at how neck pain is associated with headaches and how treatments like acupuncture can help with neck pain and reduce the painful effects of headaches. We talk with certified medical providers who utilize our patients’ information to provide acupuncture treatments to lessen the impact of headaches caused by neck pain. We also inform patients how multiple non-surgical treatments can help reduce headaches and pain-like symptoms associated with neck pain. We encourage our patients to ask their associated medical providers intricated and important questions about the pain-like symptoms they are experiencing from neck pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

Neck Pain & Headaches

Have you been experiencing unexplained stiffness along the sides of your neck? Do you feel a dull ache at the base of your neck or skull after looking down at your phone for an extended period? Or do you experience frequent headaches that are constant throughout the day? Many people dealing with these pain-like issues are associated with neck pain that is affecting their quality of life. Neck pain is amongst the top three complaints many people have experienced at some point. Neck pain has common presenting symptoms that are diagnosed, and the prevalence is much higher in older adults due to degenerative spinal changes in the facet joints and spinal discs. (Childress & Stuek, 2020) Many individuals experience common musculoskeletal pain conditions like muscle strains and stiffness when this happens. At the same time, neck pain can also be associated with neurological conditions that cause overlapping risk profiles, forcing many individuals to miss out on important events. Neck pain is a multifactorial musculoskeletal condition affecting many individuals as it induces them to miss work. This is because various modifiable and non-modifiable risk factors contribute to developing neck pain. (Kazeminasab et al., 2022) These risk factors can range from physical inactivity to poor posture, causing overlapping risk profiles that can trigger neck pain to advance over time. 

 

 

So, how are headaches associated with neck pain? When a person is experiencing a headache, many would often think that the headaches are caused by not eating enough food or drinking enough water. Those are some of the factors that contribute to headaches, but they can also be due to the stress and comorbidities that are associated with neck pain. This is due to the risk factors many individuals don’t realize contribute to neck pain. Factors like the forward head position from smartphone usage cause tension on the cervical structures, generating potential degeneration and tearing of the neck structures. (Maayah et al., 2023) As repetitive motions affect the neck structure more over time, the nerve roots that surround the spine and spread through the upper extremities can become aggravated, and cause referred pain to different areas of the body, leading to headaches. When dealing with headaches associated with neck pain, they will feel stress, affecting their productivity. The headaches can range from acute to chronic, depending on the severity. Fortunately, many individuals dealing with headaches associated with neck pain will seek treatment to reduce the pain-like symptoms and feel the relief to return to their daily routine.

Healing After Trauma- Video

Chiropractic Care for Healing After Trauma | El Paso, Tx (2024)

Many individuals who are dealing with neck pain often deal with headaches as a sign that risk factors are in play, like poor posture, slouching, or traumatic injuries that can affect their ability to work or participate in activities. This can cause many people to feel miserable and decrease their quality of life, thus causing them to seek out treatment for their pain, hence why many individuals opt for non-surgical treatments due to them being affordable and personalized. Non-surgical treatments range from chiropractic care to acupuncture, depending on the severity and location of where the pain is in the body. The video above shows how non-surgical treatments can help many individuals positively influence healing after a traumatic injury and restore a person’s well-being.

Acupuncture For Neck Pain

Non-surgical treatments are excellent for individuals trying to find the relief they seek in their neck pain. As stated earlier, non-surgical treatments are cost-effective and tailored to the person’s pain. Acupuncture is a form of non-surgical treatment that can help reduce the comorbidities associated with neck pain. Acupuncture is a medical practice in which highly trained, licensed, and certified professionals use solid, super-thin needles to be placed at specific points to treat the body. What this does is that when the needles are penetrating the points, it will begin to open any blockage or excess energy to flow correctly, restore balance to the body, and relieve the individual’s symptoms. (Berger et al., 2021) Some of the beneficial results that acupuncture can provide individuals with neck pain is a reduction of pain and disability to the neck while treating referred pain that is causing overlapping risk profiles to induce headaches. (Peron et al., 2022) 

 

Acupuncture Relieving Headaches

Since headaches are associated with neck pain, acupuncture can help relieve the headaches from progressing further and enable many individuals to get back to their routine. Some overlapping risk profiles contributing to headaches include trigger points on the neck muscles that can cause non-dermatomal referral pain and discomfort. (Pourahmadi et al., 2019) When an acupuncturist is treating individuals for their headaches, many individuals will begin to feel the relief after a few consecutive sessions, and, combined with physical therapy to strengthen neck and shoulder muscles, will notice that the pain has been reduced significantly. Acupuncture is a safe, helpful, and available alternative treatment that is beneficial for many individuals dealing with headaches associated with neck pain. (Urits et al., 2020) By incorporating acupuncture as part of a person’s treatment plan, they can begin to feel the relief they deserve while also being more mindful of how they are treating their bodies to prevent pain-like symptoms from returning.

References

Berger, A. A., Liu, Y., Mosel, L., Champagne, K. A., Ruoff, M. T., Cornett, E. M., Kaye, A. D., Imani, F., Shakeri, A., Varrassi, G., Viswanath, O., & Urits, I. (2021). Efficacy of Dry Needling and Acupuncture in the Treatment of Neck Pain. Anesth Pain Med, 11(2), e113627. https://doi.org/10.5812/aapm.113627

Childress, M. A., & Stuek, S. J. (2020). Neck Pain: Initial Evaluation and Management. American Family Physician, 102(3), 150-156. https://www.ncbi.nlm.nih.gov/pubmed/32735440

https://www.aafp.org/pubs/afp/issues/2020/0801/p150.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

Maayah, M. F., Nawasreh, Z. H., Gaowgzeh, R. A. M., Neamatallah, Z., Alfawaz, S. S., & Alabasi, U. M. (2023). Neck pain associated with smartphone usage among university students. PLOS ONE, 18(6), e0285451. https://doi.org/10.1371/journal.pone.0285451

Peron, R., Rampazo, E. P., & Liebano, R. E. (2022). Traditional acupuncture and laser acupuncture in chronic nonspecific neck pain: study protocol for a randomized controlled trial. Trials, 23(1), 408. https://doi.org/10.1186/s13063-022-06349-y

Pourahmadi, M., Mohseni-Bandpei, M. A., Keshtkar, A., Koes, B. W., Fernandez-de-Las-Penas, C., Dommerholt, J., & Bahramian, M. (2019). Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: protocol for a systematic review. Chiropr Man Therap, 27, 43. https://doi.org/10.1186/s12998-019-0266-7

Urits, I., Patel, M., Putz, M. E., Monteferrante, N. R., Nguyen, D., An, D., Cornett, E. M., Hasoon, J., Kaye, A. D., & Viswanath, O. (2020). Acupuncture and Its Role in the Treatment of Migraine Headaches. Neurol Ther, 9(2), 375-394. https://doi.org/10.1007/s40120-020-00216-1

Disclaimer

Understanding the Splenius Capitis Muscle for Lifelong Strength

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Crop anonymous female manual therapist massaging neck of young woman lying on couch during rehabilitation session

“For individuals dealing with neck or arm pain and migraine headache symptoms, it could be a splenius capitis muscle injury. Can knowing the causes and symptoms help healthcare providers develop an effective treatment plan?”

Understanding the Splenius Capitis Muscle for Lifelong Strength

Splenius Capitis Muscles

The splenius capitis is a deep muscle located on the upper back. Along with the splenius cervicis, it comprises the superficial layer – one of the three – of intrinsic back muscles. The splenius capitis works with the splenius cervicis, a smaller muscle located below it, to help rotate the neck and lower the chin to the chest, known as flexing. Maintaining a healthy posture is important because it helps keep the head in a neutral position.

  • Starting at the midline of the spine at C3 to T3, the splenius capitis spans the levels between the 7th cervical vertebra to the 3rd or 4th thoracic vertebrae, which varies for different individuals.
  • The muscle inserts at the nuchal ligament, which is a strong ligament of the neck.
  • The splenius capitis muscle angles up and out, attaching to the skull.
  • The splenius capitis and cervicis cover the vertical paraspinals, which are deeper and comprise the intermediate layer of the intrinsic back muscles.
  • The splenius muscles look like a bandage for the paraspinals and the vertical muscles that comprise the deepest layer.
  • The splenius muscles hold these deeper layers in the correct position.
  • These muscles start at the center of the spine and together form a V shape.
  • The sides of the V are thick, and the central indentation is shallow.

Pain

It’s common for individuals to experience pain associated with injury to the splenius capitis. This type of pain is known as splenius capitis syndrome. (Ernest E, Ernest M. 2011)

Symptoms

A headache stemming from injury often mimics a migraine headache. Symptoms of splenius capitis syndrome include: (Ernest E, Ernest M. 2011)

  • Neck pain
  • Arm pain
  • Pain at the back of the head
  • Headache at the temples
  • Pressure behind the eye
  • Pain behind, above, or under the eye
  • Sensitivity to light

Causes

Injury to the splenius capitis can result from: (Ernest E, Ernest M. 2011)

  • Unhealthy posture for prolonged periods
  • Constantly flexing or rotating the neck
  • Sleeping in awkward positions
  • Falling injuries
  • Automobile collision
  • Sports injuries

Treatment

It’s recommended to contact a healthcare provider if experiencing symptoms that interfere with daily activities or quality of life. A healthcare provider will:

  • Review the individual’s medical history
  • Ask questions about the injury
  • Perform a physical exam (Ernest E, Ernest M. 2011)

Treatment protocols and approaches to relieve symptoms and restore function can involve one or a combination of treatments that include:

  • Ice and heat applications
  • Physical therapy
  • Therapeutic massage
  • Chiropractic realignment
  • Non-surgical decompression
  • Acupuncture
  • Neck stretches
  • Pain medication (short-term)
  • Injections
  • Minimally invasive surgery

Neck Injuries

References

Ernest E, Ernest M. Practical Pain Management. (2011). Splenius Capitis Muscle Syndrome.

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