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Joint Dislocation Chiropractor: Sciatica Clinic

Close-up image of doctor showing model of joint to patient

Dislocations impact the joint and are injuries that force/knock the bones out of position. Dislocations can be caused by a motor vehicle collision, falls, sports trauma, or weakened muscles and tendons. However, less impact/force is needed to dislocate smaller joints. Dislocations commonly occur at the shoulders, ankles, knees, hips, elbows, fingers and toes, and the jaw. The experience causes swelling, inability to move, and pain. A joint dislocation chiropractor can manipulate, reset, rehabilitate and strengthen the affected area and rebalance the body.

Joint Dislocation Chiropractor

Joint Dislocation

The region where two or more bones come together is a joint. Each has a primary function, but their functions overlap. The joints allow the bones to move/articulate the skeletal system. Maintaining the body’s balance requires mobility and stability.

  • Mobility is the ability to move the body without restriction.
  • Stability is maintaining equilibrium, healthy posture, and support during movement.
  • The stable joints do not dislocate easily because their structures are not as flexible.
  • Mobile joints are at an increased risk, as they can move in almost any direction.

The stability joints include the following:

  • Cervical spine
  • Elbow
  • Lumbar spine
  • Knee
  • Foot

The mobility joints include:

  • Shoulder
  • Wrist
  • Thoracic spine
  • Hip
  • Ankle

The kinetic chain is a sequence of joints forming an alternating pattern of stability and mobility that create a solid platform for dynamic movement. However, any joint can become dislocated, causing the affected area to become unsteady or immobile, strain or tear the surrounding muscles, nerves, and tendons which are the tissues that connect the bones to a joint.

  • A joint can be partially dislocated/subluxation or fully dislocated.
  • Joints dislocated previously have an increased risk of re-dislocating because the surrounding tissues that hold the joint have been torn or overly stretched.

Symptoms

Symptoms vary depending on the severity and location of the injury. Common symptoms include:

  • Instability
  • Loss of ability to move
  • Swelling
  • Bruising
  • Pain
  • Visible deformation

Increased Risk

Various factors can lead to joint dislocation, including:

  • Weakness of the supporting ligaments and muscles from natural wear and tear/age or lack of physical conditioning.
  • Older individuals with poor balance are more vulnerable to falls that can knock joints out of place.
  • Young children developing have more elastic supporting ligaments and are prone to falls, collisions, and other injuries.
  • Previous dislocations with overstretched or torn supporting tissues.
  • Repeated dislocations are likely to follow the shoulder, knee, and hip.
  • Inherited conditions can cause the elastic tissues to overstretch. Examples include Ehlers-Danlos syndrome and Marfan syndrome.
  • Physical activities like extreme sports, contact sports, or sports that involve quick body shifts, twists, and turns on the feet.
  • Physically demanding job.
  • Operating heavy machinery/equipment.
  • Joint hypermobility is common in children and around 5% of adults. It can be caused by weak or loose ligaments, weak or loose muscles, and/or shallow joint sockets.

Joint Dislocation Chiropractic

Treatment will vary based on the severity of the injury and the dislocated joint. Depending on the location and severity, a chiropractor will perform different movements/manipulations to realign the joint and strengthen the area.

  • Significant force could be necessary to pull the bones apart to realign them back into their proper position.
  • The joint may need to be pulled out and rotated slightly before being put back.
  • The focus is on increasing ligament strength.
  • Once the joint is back in place, it may need to remain immobile, possibly using a sling or splint to help fully heal the injury.
  • Physical therapy exercises will be recommended to strengthen the muscles and ligaments around the joint to support it optimally.

Shoulder Pain Chiropractic


References

Dizdarevic, Ismar, et al. “Epidemiology of Elbow Dislocations in High School Athletes.” The American journal of sports medicine vol. 44,1 (2016): 202-8. doi:10.1177/0363546515610527

Hodge, Duncan K, and Marc R Safran. “Sideline management of common dislocations.” Current sports medicine reports vol. 1,3 (2002): 149-55. doi:10.1249/00149619-200206000-00005

Prechel, Ulla et al. “The Treatment of Temporomandibular Joint Dislocation.” Deutsches Arzteblatt international vol. 115,5 (2018): 59-64. doi:10.3238/arztebl.2018.0059

Skelley, Nathan W et al. “In-game Management of Common Joint Dislocations.” Sports health vol. 6,3 (2014): 246-55. doi:10.1177/1941738113499721

A Look Into Chronic Inflammatory Response On Joints

Introduction

The body has a defensive response known as the immune system that comes to the rescue when traumatic events or injuries impact certain areas of the body. The immune system releases inflammatory cytokines to the affected area and begins the healing process to repair the damage while also getting rid of the foreign intruders in the body. Inflammation can be potentially beneficial and harmful to the body, depending on how severe the injury has potentially impacted the area. When inflammation begins to cause an impact on the surrounding muscles, ligaments, and joints, it can lead to chronic issues associated with pain. To that point, it causes the body to be dysfunctional while mimicking other symptoms. Today’s article examines how chronic inflammatory responses affect the joints, their associated symptoms, and how to manage chronic joint inflammation. We refer patients to certified providers specializing in anti-inflammatory treatments to help many individuals dealing with chronic inflammation of the joints. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

How Does Chronic Inflammatory Response Affect The Joints?

Have you been experiencing pain in some regions of your body? What about experiencing tenderness in your muscles? Do your joints ache when you are doing everyday activities? If you have been dealing with these issues, it might be due to chronic inflammatory responses affecting your musculoskeletal joints. As stated earlier, inflammation can be both beneficial and harmful to the body, depending on the severity of the impact the body has taken. In its beneficial form, the body activates the immune system and eliminates pathogens from bacteria, viruses, and other environmental triggers to promote healing and tissue repair. This potentially makes the affected area red and inflamed, thus repairing the damaged cells.

 

However, in its harmful form, studies reveal that chronic inflammatory responses can break down immune tolerance, causing significant alterations to all the tissues, organs, and joints. To that point, the residual effects of high inflammation can cause harm to the joints and cartilage, making them potentially involved with pain and possibly deformity over time. The joints help keep the body moving, surrounded by connective muscle tissue that helps stabilize the body; when chronic inflammatory responses start to affect the joints, they can become a mediator for pain and discomfort while triggering musculoskeletal disorders. Studies reveal that inflammation in the joints can cause damage to the cartilage and result in degenerative changes to the body. This includes functionality loss, joint instability, and other symptoms associated with chronic joint inflammation.

 

The Symptoms Associated With Chronic Joint Inflammation

When it comes to chronic joint inflammation, it can mimic other chronic conditions that present joint instability while overlapping different chronic disorders. This makes diagnosing difficult, especially if the person is dealing with inflammation on one side of their body, but it affects another part. This is known as referred pain, and studies reveal that most inflammatory forms that affect the joints are sometimes arthritic and have systemic symptoms that may occur in different body areas. Some of the symptoms associated with chronic joint inflammation can include:

  • Swelling
  • Stiffness
  • Grinding sounds
  • Difficult mobility
  • Numbness
  • Joint deformity 

 


The Difference Between Healthy Joints & Inflamed Joints-Video

The Difference Between a Healthy Joint and a Joint Destroyed by Inflammation

Have you been dealing with joint pain throughout your life? Do you feel muscle stiffness in certain areas when you move around? Or do you feel muscle tenderness in certain areas? Many of these symptoms are associated with joint inflammation, potentially overlapping with musculoskeletal pain. The video above explains the difference between healthy joints and inflamed joints. Healthy joints are utilized when the surrounding muscles are strong and functional while no pain is inflicted on the body. Inflamed joints may be caused by numerous factors like lifestyle habits, physical inactivity, or previous conditions associated with inflamed joint pain. Studies reveal that inflammatory cytokines may potentially amplify musculoskeletal discomfort that affects the musculoskeletal tissues that surround the joints. To that point, inflammation of the musculoskeletal system may overlap with joint pain, thus directly impacting a person’s quality of life. Fortunately, there are ways to manage chronic joint inflammation and restore a person’s health and wellness.


Managing Chronic Joint Inflammation

 

Since inflammation is beneficial and harmful to the body, there are different ways to manage chronic inflammatory markers triggering joint pain. Many individuals who want to lower inflammation in their joints will begin to incorporate natural ways to lessen the pain. Eating foods high in fiber may potentially help lower inflammatory markers, including physical activities to improve musculoskeletal and joint stability and utilizing chiropractic care. Studies reveal that chronic joint inflammation associated with pain does affect a person’s ability to sleep and emotional health. To that point, incorporating treatments to manage inflammatory effects may potentially improve a person’s self-efficacy. Now how does chiropractic care help manage chronic joint inflammation? Chiropractic care includes inflammation reduction techniques that help loosen the stiff muscles that surround the inflamed joints. Joint inflammation may also be due to subluxation (spinal misalignment) associated with environmental factors. Utilizing chiropractic care not only alleviates the symptoms caused by joint inflammation but may potentially alleviate the cause of inflammation. Once a person has completed their chiropractic care treatment, they can return to normal activities without the risk of re-injury and re-inflammation. 

Conclusion

Inflammation in the body can be beneficial and harmful depending on the impacted area. The body unleashes inflammatory cytokines when a traumatic event or injury has occurred in certain body areas. This is due to the immune system naturally responding to the damaged cells, thus causing the area to be red, hot, and swollen to promote healing. To that point, inflammation can impact the surrounding muscles, ligaments, and joints, which can lead to chronic issues associated with pain. Chronic joint inflammation is residual high inflammatory effects that cause harm to the cartilage and joint structures, thus making them potentially involved with pain and possible deformity. Fortunately, treatments like high fiber and anti-inflammatory foods, getting enough exercise, and chiropractic care may help manage chronic joint inflammation and its associated pain symptoms. This way, many individuals can resume their normal activities.

 

References

Furman, David, et al. “Chronic Inflammation in the Etiology of Disease across the Life Span.” Nature Medicine, U.S. National Library of Medicine, Dec. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC7147972/.

Kim, Yeesuk, et al. “Diagnosis and Treatment of Inflammatory Joint Disease.” Hip & Pelvis, Korean Hip Society, Dec. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5729162/.

Lee, Yvonne C. “Effect and Treatment of Chronic Pain in Inflammatory Arthritis.” Current Rheumatology Reports, U.S. National Library of Medicine, Jan. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3552517/.

Poudel, Pooja, et al. “Inflammatory Arthritis – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 21 Apr. 2022, www.ncbi.nlm.nih.gov/books/NBK507704/.

Puntillo, Filomena, et al. “Pathophysiology of Musculoskeletal Pain: A Narrative Review.” Therapeutic Advances in Musculoskeletal Disease, SAGE Publications, 26 Feb. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC7934019/.

Disclaimer

Skateboarding Injuries Chiropractor: Sciatica Clinic

A young man doing an ollie 360 flip with his skateboard on some bleachers

Skateboarding is a popular activity among children, teenagers, and young adults. It is recreational, competitive, fun, and exciting but, like any sport, carries a risk of injury. There are around 70,000 skateboarding injuries requiring a visit to the emergency room every year. The most common injuries involve the shins, ankles, forearms, wrists, elbows, face, and skull, with many left untreated that worsen as they heal improperly, leading to further damages and complications. Chiropractic can treat the injuries, rehabilitate the muscles and joints, and strengthen the body to get the skater back on their board.

Skateboarding Injuries Chiropractor

Skateboarding Injuries

Skateboarding injuries can range from scrapes, cuts, and bruises to sprains, strains, broken bones, and concussions.

  • Shin injuries often happen during flip/twist tricks where the board or axle hits the shin causing bruising and swelling.
  • Shoulder, wrist, and hand injuries are common when skaters lose their balance and fall with outstretched arms.
  • Ankle injuries include rolls/sprains, as well as dislocations and fractures.
  • Dislocations usually happen to the shoulders, wrists, and fingers.
  • Facial injuries include teeth knocked out, broken nose, or jaw are typically caused by fast forward hard falls.
  • Severe injuries include concussions and head injuries.

Injury causes

Skateboarding injuries typically occur from:

  • Skating on irregular surfaces locks up wheels and affects balance, causing falls.
  • Losing balance or losing control of the board and falling hard/slamming into the pavement.
  • Inexperience, slow reaction times, and less coordination lead to falls and slams.
  • Skating into another skater, a person walking or cycling, a car, or a road hazard.
  • Trying an advanced trick/maneuver too soon and beyond their skill level.
  • The inexperience of knowing how to fall to prevent injuries.

Chiropractic Therapy

A chiropractor can work with other doctors and specialists to:

  • Assess and treat the skateboarding injury/s.
  • Reset the spine, hips, arms, hands, and feet.
  • Rehabilitate and strengthen the body.
  • Recommend safety and prevention education.
  • Help prevent further injuries and long-term effects.

Chiropractic Skateboarding Injury Treatment


References

Forsman, L, and A Eriksson. “Skateboarding injuries of today.” British journal of sports medicine vol. 35,5 (2001): 325-8. doi:10.1136/bjsm.35.5.325

Hunter, Jamie. “The epidemiology of injury in skateboarding.” Medicine and sport science vol. 58 (2012): 142-57. doi:10.1159/000338722

Partiali, Benjamin, et al. “Injuries to the Head and Face From Skateboarding: A 10-Year Analysis From National Electronic Injury Surveillance System Hospitals.” Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons vol. 78,9 (2020): 1590-1594. doi:10.1016/j.joms.2020.04.039

Shuman, Kristin M, and Michael C Meyers. “Skateboarding injuries: An updated review.” The Physician and sportsmedicine vol. 43,3 (2015): 317-23. doi:10.1080/00913847.2015.1050953

An Overview Of Polymyalgia Rheumatica

Introduction

The body is exposed to various environmental factors daily. Whether it is the environment that a person is living, the foods being consumed, or the level of physical activities a person has plays a part in the body. Many individuals that want to live a healthier lifestyle will start small by incorporating nutritious foods they can add, sticking to an exercise regime they might enjoy, and finding time to meditate. Those who don’t want to change their lifestyle habits will continue eating foods that are high in fats, not exercising enough, or have problems sleeping. Over time, the body will be at risk of developing autoimmune disorders associated with musculoskeletal symptoms when exposed to environmental factors that impact a person’s lifestyle. Today’s article looks at an autoimmune disorder that causes inflammatory effects on the joints, known as polymyalgia rheumatica, the symptoms associated with this disorder, and how chiropractic care can help manage the symptoms of polymyalgia rheumatica. We refer patients to certified providers specializing in autoimmune treatments to help many individuals with autoimmune diseases associated with musculoskeletal disorders. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

What Is Polymyalgia Rheumatica?

 

Have you been experiencing pain along your shoulders, neck, hips, or thighs? Does your body feel stiff in the morning and better throughout the day? Or have you been experiencing a limited range of motion in certain areas of your body? Many of these symptoms are signs that you might be at risk of developing polymyalgia rheumatica in your joints. Polymyalgia rheumatica is defined as a rheumatic disorder that is common in elderly adults over the age of 50. Polymyalgia rheumatica is an inflammatory musculoskeletal disorder that induces muscle pain and stiffness around the joints, especially in the morning. Studies reveal that polymyalgia rheumatica is often characterized by aching muscle pain in the shoulders, pelvis, and neck; it can mimic other rheumatic diseases like RA (rheumatoid arthritis), SLE (systemic lupus erythematosus), and polymyositis. When the body is dealing with the inflammatory effects of polymyalgia rheumatica, many people believe they are dealing with a different disorder affecting their bodies. To that point, diagnosing polymyalgia rheumatica is difficult.

 

The Symptoms Associated With Polymyalgia Rheumatica

Since polymyalgia rheumatica can mimic other rheumatic diseases, some of the symptoms associated with this inflammatory musculoskeletal disorder are similar to other chronic common diseases in the body. Studies reveal that the cause of polymyalgia is unknown, but environmental and genetic factors contribute to this inflammatory disease. Another disease that shares similar symptoms with polymyalgia is a disease known as giant cell arteritis. Giant cell arteritis causes inflammatory effects along the lining of the arteries, and individuals with this disease may have polymyalgia rheumatica. Some of the symptoms associated with polymyalgia rheumatica include:

  • Shoulder pain
  • Pelvic pain
  • Limited range of motion
  • Muscle stiffness
  • Joint pain
  • Inflammation
  • Neck pain

 


An Overview Of Polymyalgia Rheumatica- Video

Polymyalgia Rheumatica: Visual Explanation for Students

Have you been experiencing pain in some regions of your body, like the shoulders, pelvis, and neck? Do you feel muscle stiffness every morning, but does it get better throughout the day? Have you been dealing with joint inflammation? If you have been experiencing these musculoskeletal symptoms, you might be at risk of developing polymyalgia rheumatica. The video above gives an insightful overview of what polymyalgia is and the symptoms associated with this inflammatory musculoskeletal disorder. Polymyalgia rheumatica is an auto-inflammatory musculoskeletal disorder that affects many adults over 50 and causes muscle stiffness in the body’s neck, shoulder, and pelvic regions. This inflammatory musculoskeletal disorder does mimic other rheumatic disorders like RA (rheumatoid arthritis) and lupus. The symptoms associated with polymyalgia rheumatica are generally similar to other common chronic disorders, making diagnosis challenging to pinpoint. Luckily there are ways to manage polymyalgia rheumatica and its associated musculoskeletal symptoms.


Managing Polymyalgia Rheumatica With Chiropractic Care

 

Since the body is dealing with symptoms from polymyalgia rheumatica is challenging to diagnose since it mimics other rheumatic disorders and their associated symptoms. When the body is suffering from joint pain associated with polymyalgia rheumatica, the surrounding muscles, and ligaments that help stabilize the joints become inflamed and cause discomfort to the body. Fortunately, treatments like chiropractic care are available to help manage the joint inflammation associated with polymyalgia rheumatica. Chiropractic care utilizes spinal manipulation of the body by manipulating spinal subluxation or misalignment of the joints. Spinal manipulation helps the body relax and incorporates healing properties into the inflamed joints. Chiropractic care helps loosen up the stiff muscles and ligaments surrounding the joints to reduce pressure on the nerves and help bring the range of motion back to the joints. Many individuals who incorporate chiropractic care to help manage musculoskeletal symptoms associated with rheumatic disorders like polymyalgia rheumatica will be pain-free on their wellness journey.

 

Conclusion

Polymyalgia rheumatica is an inflammatory musculoskeletal disorder common in elderly adults that induces muscle pain and stiffness around the joints. This inflammatory musculoskeletal disorder affects the shoulder, neck, and pelvic region while mimicking other rheumatic disorders like RA (rheumatoid arthritis) and lupus. Since the body is exposed to various environmental daily, over time may be at risk of developing autoimmune diseases associated with musculoskeletal symptoms that can impact the individual. To that point, making it difficult to diagnose. Fortunately, treatments like chiropractic care can help manage the musculoskeletal symptoms associated with polymyalgia rheumatica. Chiropractic care can help reduce stiff joint inflammation by manipulating the body, causing the aching muscles to relax and increase their range of motion. Utilizing chiropractic care can help a person get back to their health and wellness journey.

 

References

Acharya, Saurav, and Rina Musa. “Polymyalgia Rheumatica – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 21 June 2022, www.ncbi.nlm.nih.gov/books/NBK537274/.

Al-Kaabi, Juma, et al. “Non-Hodgkin Lymphoma Mimicking Polymyalgia Rheumatica in a Young Patient.” Oman Medical Journal, OMJ, July 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC3282323/.

Michet, Clement J, and Eric L Matteson. “Polymyalgia Rheumatica.” BMJ (Clinical Research Ed.), BMJ Publishing Group Ltd., 5 Apr. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2287267/.

Milchert, Marcin, and Marek Brzosko. “Diagnosis of Polymyalgia Rheumatica Usually Means a Favourable Outcome for Your Patient.” The Indian Journal of Medical Research, Medknow Publications & Media Pvt Ltd, May 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5644293/.

Disclaimer

When You’re Seeing A Top Chiropractic Team: Sciatica Clinic

Multiracial professional team of newest modern clinic or hospital having breefing, happy doctors men and women in workwear attending team-building or medical conference, smiling at camera

Health care should not be subpar; with so many choices, advertisements, reviews, word of mouth, etc., finding quality health care can be challenging. This can be a physician, dentist, nutritionist, or chiropractor. How to know when a top chiropractic team is treating you?

A Top Chiropractic Team

When Chiropractic Care Is Necessary

Individuals wonder when they should see a chiropractor. Signs and symptoms that could indicate you should see a chiropractor include:

  • Trouble standing, walking, bending, or performing daily activities.
  • Discomfort or pain when sitting or lying down.
  • Headaches.
  • Neck pain.
  • Shoulder, arm, or hand tingling or pain.
  • Back pain.
  • Hip pain.
  • Pain that runs down one or both legs.
  • Knee pain.
  • Foot problems like numbness, tingling, or pain.

Top Chiropractic Team

A top chiropractic team will harmoniously perform their jobs; even with obstacles, they will get it done. They will communicate effectively with each other and the patients, explain the whole process, provide personalized treatments and not a one size fits all approach, and value the patients’ time.

Communication

Communication is vital for individuals to understand and have confidence in their personalized treatment plan.

  • The chiropractor and supporting staff will ensure the patient understands what will happen and how it will affect their injury/condition.
  • The doctor and staff will continually ask how you are doing.
  • The team’s ultimate goals are to get the healing process activated and the patient’s satisfaction.

Offered Multiple Treatment Options

Spinal adjustments are not the only thing individuals should think of when considering treatment. Multiple treatment approaches have been found to achieve the best results when dealing with musculoskeletal conditions and disorders. The chiropractor will discuss and offer specific treatment options that can include:

Patient’s Time

A top chiropractic clinic doesn’t feel like the doors are just revolving with patients rushing in and out like a grocery store.

  • Every patient’s appointment is their time with:
  • A detailed consultation
  • Therapeutic prep-massage to loosen muscles and joints before the adjustments.
  • Thorough chiropractic adjustments
  • After-care patient questions – The chiropractor or staff will take the time to answer all your questions and not waste your time waiting around.
  • Recommended stretching exercises
  • Body analysis
  • Nutritional advice

Treatments Are Working

Chiropractic care can take some time to treat, rehabilitate, and heal the injury or condition.

  • The treatments work, and you see and feel the progress.
  • You can move around without fear of triggering pain.
  • Your confidence grows in yourself and the team.
  • If treatment is not working or producing lasting results, the chiropractor will refer you to another medical professional.
  • A top chiropractic team wants the best medical treatment for each patient, even if they cannot provide it.

Patient Satisfaction

When treated by a top chiropractic team from the front desk, patient care coordinator, massage therapists, nutritionist, and clinic manager, the overall experience is positive and pleasant; you can feel the difference and leave exhilarated.


Functional Medicine


References

Clijsters, Mattijs et al. “Chiropractic treatment approaches for spinal musculoskeletal conditions: a cross-sectional survey.” Chiropractic & manual therapies vol. 22,1 33. 1 Oct. 2014, doi:10.1186/s12998-014-0033-8

Eriksen, K., Rochester, R.P. & Hurwitz, E.L. Symptomatic reactions, clinical outcomes and patient satisfaction associated with upper cervical chiropractic care: A prospective, multicenter, cohort study. BMC Musculoskelet Disord 12, 219 (2011). doi.org/10.1186/1471-2474-12-219

Gary Gaumer, Factors Associated With Patient Satisfaction With Chiropractic Care: Survey and Review of the Literature,
Journal of Manipulative and Physiological Therapeutics, Volume 29, Issue 6, 2006, Pages 455-462, ISSN 0161-4754, doi.org/10.1016/j.jmpt.2006.06.013 (www.sciencedirect.com/science/article/pii/S0161475406001588)

Kerns, R.D., Krebs, E.E. & Atkins, D. Making Integrated Multimodal Pain Care a Reality: A Path Forward. J GEN INTERN MED 33, 1–3 (2018). doi.org/10.1007/s11606-018-4361-6

Pribicevic, M., Pollard, H. A multi-modal treatment approach for the shoulder: A 4 patient case series. Chiropr Man Therap 13, 20 (2005). doi.org/10.1186/1746-1340-13-20

The Mechanics Of Toxic Metals In The Immune System

Introduction

The immune system‘s role is to be the “protectors” of the body by attacking invaders that enter the body, cleaning up old cells, and making room for new cells to flourish in the body. The body needs the immune system to function and be healthy from many environmental triggers the body is exposed to daily. When environmental triggers come in contact with the body, it can cause many disruptive factors over time and causes the immune system to mistakenly attack healthy, normal cells as they see it as a foreign invader, thus causing the body to develop autoimmune diseases. Some environmental triggers like toxic metals could be associated with autoimmune diseases that can affect the body, causing various symptoms to affect the body. Today’s article looks at the effects of toxic metals on the body, how it affects the immune system, and ways to manage the impact of toxic metals on the immune system. We refer patients to certified providers specializing in autoimmune treatments to help many individuals with autoimmune diseases associated with toxic metals. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

The Effects of Toxic Metals On the Body

 

Have you been experiencing abdominal pain in your gut? Do you have a bitter metallic taste in your mouth? What about experiencing inflammation affecting not only your joints but your gut as well? Many of these symptoms are signs correlating that you might suffer from toxic metals in your body. The body is constantly exposed to various environmental factors that affect many individuals over time. It can be the foods consumed, the environment a person is exposed to, and their physical activity. Studies reveal that heavy metal pollutants from environmental pollution can enter the human body through various pathways like the respiratory, cutaneous, and gastrointestinal paths and begin to accumulate in different organs. When the body suffers from autoimmune diseases associated with toxic metals, symptoms of inflammation will start to affect the joints in the body. To that point, toxic metals will begin to facilitate their interaction with the immune system, causing the development of autoimmune disease symptoms.

 

How Does It Affect The Immune System

So how do toxic metals affect the immune system, thus causing symptoms associated with autoimmunity? As stated earlier, the immune system is the body’s protector and, when exposed to environmental disruptors over time, leads to the development of autoimmune diseases. For toxic metals, many people are usually exposed to low levels of metals through consuming fish and shellfish (containing low levels of mercury). However, when individuals are exposed to high levels of heavy metals, studies reveal that certain metals can seriously affect the immune system by overstimulating the different muscle tissues and soluble mediators that cause chronic-inflammatory reactions associated with heavy metals. Some of the symptoms associated with toxic metals causing autoimmunity in the body include:

  • Numbness
  • Prickly sensation down hands or feet
  • Abdominal pain
  • Inflammation
  • Joint pain
  • Muscle weakness

 


Introduction The Immune System-Video

YouTube player

Have you been experiencing inflammation in your joints? How about feeling muscle weakness in your back, arms, legs, or neck? Or have you been feeling overall discomfort in your body? Many of these symptoms are signs of autoimmune diseases associated with toxic metals. The video above introduces the immune system and how it plays its role in the body. When the body gets exposed to environmental factors like heavy toxic metals, it can cause the development of autoimmune diseases associated with chronic issues like joint inflammation and muscle pain. Different heavy toxic metals can affect other body parts, as studies reveal that these different heavy toxic metals are systemic toxicants that induce adverse health effects on the body. When an individual has been exposed to high levels of heavy toxic metals, chronic issues like joint inflammation can progressively cause pain over time unless treated early on. Luckily, treatments are available to help manage the effects of toxic metals in the immune system associated with joint inflammation.


Managing The Effects Of Toxic Metals In The Immune System

 

Since the body is exposed to environmental factors constantly, if it is not treated right away, it can lead to autoimmunity associated with chronic symptoms like joint inflammation. Fortunately, there are ways to manage the effects of environmental factors, like lowering the impact of toxic metals on the body system. Studies reveal that incorporating essential minerals protects the DNA sequence from further oxidative damage in the body’s immune system. Other treatments like chiropractic care utilize spinal manipulation on spinal subluxation or spinal misalignment on the joints to reduce inflammation associated with toxic metal autoimmunity. Since there are many ways that autoimmunity can affect the body through environmental triggers, the symptoms associated with autoimmunity are treated through chiropractic care. Chiropractic care not only utilizes spinal manipulation but can help improve the immune system in the body by increasing lymphatic fluid circulation and loosening stiff muscles surrounding the joints. To that point, it allows the body to get rid of toxins and waste that is in the body. Incorporating treatments like chiropractic care can help restore the body to its functional state.

 

Conclusion

The immune system is the body’s protector from foreign invaders that enter the body. When there are environmental triggers that the body is being exposed to, it can put the body at risk of developing autoimmune disease associated with chronic symptoms like inflammation of the joints. Environmental triggers like heavy metals can be associated with joint inflammation and cause pain in the body. When this happens, the body experiences pain and dysfunction due to inflamed joints. Fortunately, chiropractic treatments utilize spinal manipulation on subluxation (spinal misalignment) to reduce joints’ inflammation and improve lymphatic system circulation. These treatments can help the body manage autoimmunity associated with heavy metals and their symptoms.

 

References

Ebrahimi, Maryam, et al. “Effects of Lead and Cadmium on the Immune System and Cancer Progression.” Journal of Environmental Health Science & Engineering, Springer International Publishing, 17 Feb. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7203386/.

Jan, Arif Tasleem, et al. “Heavy Metals and Human Health: Mechanistic Insight into Toxicity and Counter Defense System of Antioxidants.” International Journal of Molecular Sciences, MDPI, 10 Dec. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4691126/.

Lehmann, Irina, et al. “Metal Ions Affecting the Immune System.” Metal Ions in Life Sciences, U.S. National Library of Medicine, 2011, pubmed.ncbi.nlm.nih.gov/21473381/.

Tchounwou, Paul B, et al. “Heavy Metal Toxicity and the Environment.” Experientia Supplementum (2012), U.S. National Library of Medicine, 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC4144270/.

Disclaimer

Massage Chair: Back Pain and Sciatica Clinic

Many individuals deal with sciatic nerve discomfort and pain that radiates from the lower back down through the glutes, legs, and feet. It can affect anyone and be challenging to deal with because it can be sudden and unpredictable. A professional hands-on therapeutic massage can play a vital role in alleviating back and sciatic pain but is not always available. This is when a quality massage chair can provide pain relief and relaxation at home.

Massage Chair For Sciatica and Back Pain

Sciatica

Not everyone who has sciatica will have the same symptoms. But common symptoms include:

  • Tingling, numbing sensations in the lower back and down the leg.
  • Electrical sensations running down the leg.
  • Lower back pain that spreads into the buttocks, thighs, calves, and feet.
  • Pain may be described as mild, dull, achy, and sharp.
  • Sneezing or coughing can increase the pain.
  • Weakness in the leg.

Massage Chair

A massage chair can assist with sciatic pain by soothing tense muscles and relieving the pressure on the surrounding tissues. When the back muscles are tense, they contract and compress down on the nerves, including the sciatic nerve. Massaging the tight muscles minimizes the pressure on the sciatic nerve and helps alleviate pain. Research has shown the main reasons why massage is beneficial:

Improves Circulation

  • Massaging the muscles increases blood flow.
  • Increasing blood circulation facilitates the absorption of nutrients into the muscles and tissues.
  • Increasing lymphatic circulation clears toxins out of the painful areas.
  • Revitalizes the area.

Decreases Tension and Improves Flexibility

  • Massaging helps loosen tight and strained muscles.
  • Percussive kneading and rolling allow muscles to relax and increase endorphin levels.
  • Endorphins are the body’s natural pain killer chemicals.
  • Increased endorphin levels expedite recovery and decrease anxiety.

Features and Functions

Massage chairs have come a long way and vary in their capabilities, features, and functions.

Body Scanning

  • High-end massage chairs often include a body scan mode.
  • The chair has a built-in computer that scans the individual’s body shape to deliver a customized massage to the different body areas.

Multiple Massage

  • Most massage chairs come with rollers and nodes to access the sore muscles.
  • Many chairs offer a variety of pre-programmed massages.
  • Higher-end programmable chairs provide kneading, reflexology, and Shiatsu, to name a few.
  • The massaging action is designed to help alleviate muscle discomfort.

Heated Massage

  • Many high-end chairs offer an optional heated seat and/or back.
  • Some chairs provide full-body infrared heat to relax the muscles.

Reclining Function

  • Most chairs feature multiple recline functions.
  • Zero-gravity recline is a popular option.
  • However, all recline options enhance relaxation.

Options

Choosing one will be based on specific needs and budget. Some tips to help figure out which is the most beneficial massage chair include:

Consult A Doctor

  • A doctor, spine specialist, or chiropractor can recommend the best type of massage chair for the individual’s specific injury, condition, and/or disorder.
  • A doctor will inform the individual if a massage chair is a safe option for their sciatica pain if they have health conditions like high blood pressure or neuropathy.

Chair Objectives

  • Figure out what the chair will help with short and long-term before shopping.
  • For example, if the goal is to relieve sciatica and lower back tension, an L-Track massage chair can go further down the spine to the glutes and hamstrings.

Injury Medical DOC Spinal Decompression Table


References

Cygańska, Anna, et al.” Impact of Exercises and Chair Massage on Musculoskeletal Pain of Young Musicians” International journal of environmental research and public health vol. 17,14 5128. 16 Jul. 2020, doi:10.3390/ijerph17145128

de Souza, Talita Pavarini Borges et al.”“The effectiveness of Chair Massage on Stress and Pain in Oncology” International journal of therapeutic massage & bodywork vol. 14,3 27-38. 2 Sep. 2021, doi:10.3822/ijtmb.v14i3.619

Hand, Mary et al.” “Massage Chair Sessions: Favorable Effects on Ambulatory Cancer Center Nurse” Perceived Level of Stress, Blood Pressure, and Heart Rate” Clinical journal of oncology nursing vol. 23,4 (2019): 375-381. doi:10.1188/19.CJON.375-381

Kim, Seung-Kook, et al.” “Clinical outcomes and cost-effectiveness of massage chair therapy versus basic physiotherapy in lower back pain patients: A randomized controlled trial.” Medicine vol. 99,12 (2020): e19514. doi:10.1097/MD.0000000000019514

Kumar, Saravana, et al. “The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews.” International journal of general medicine vol. 6 733-41. 4 Sep. 2013, doi:10.2147/IJGM.S50243

 

How Insulin Resistance Affects The Body

Introduction

The body needs the energy to get through the entire day. Energy can come in various foods consumed and converted into three molecules: carbohydrates, proteins, and fats. Carbohydrates convert into glucose, which becomes energy used for bodily function. At the same time, protein helps repair and build body tissues that allow metabolic reactions and coordinate physical function. Healthy fats in the body help support cell function, provide energy, and produce essential hormones that the body needs. When the body has too much glucose, it can cause various metabolic factors to take over the body, resulting in metabolic disorders associated with chronic conditions over time. This is known as insulin resistance and today’s article looks at how insulin resistance is detected, the signs and symptoms, and treatments to manage insulin resistance. We refer patients to certified providers specializing in metabolic treatments to help many individuals with insulin resistance. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

How Is Insulin Resistance Detected?

 

Have you been feeling a tingling sensation along your hands and feet? Have you been experiencing headaches that go away when you eat food or drink something? Do you constantly go to the bathroom? Many of these issues are signs that you might be at risk of developing insulin resistance. Insulin resistance is an impaired biological response in the body that requires insulin stimulation to the targeted tissues: the liver, muscle, and adipose tissue. The liver supplies the glucose to the body by secreting it into the bloodstream to be used for energy. So when there is a high glucose level in the bloodstream, the pancreas, which is between the liver and the stomach, sends out insulin to help the glucose be absorbed into the body cells. Many individuals don’t realize their insulin levels are high until they go in for routine check-ups with their primary physicians.

 

The Signs & Symptoms Of Insulin Resistance

Various factors could lead to insulin resistance when the body has high glucose levels in the bloodstream. Many individuals do develop habits that do contribute to insulin resistance. Some of the signs that indicate that a person may have insulin resistance include:

  • Excess body fat
  • Physical inactivity
  • High-carb diet 
  • Hormone disorder

Studies reveal that obesity is considered the triggering factor for individuals with insulin resistance associated with diabetes. Since obesity is a factor that escalates the pathogenesis of diabetes through the stimulation of insulin resistance. When the body becomes overstimulated, the body starts to release elevated levels of pro-inflammatory cytokines that can lead to various abnormalities like organ dysfunction and tissue injury associated with insulin resistance. Studies show that chronic low-grade inflammation associated with obesity is responsible for the body to have a decrease in insulin sensitivity. Some of the risk factor symptoms related to insulin resistance include:

  • Increased thirst and hunger
  • Blurred vision
  • Obesity
  • Gut inflammation
  • Weight gain
  • Fatigue
  • Acanthosis nigricans
  • Numbness or tingling sensation on hands and feet
  • Thyroid issues
  • Metabolic syndrome

 


What Is Insulin Resistance-Video

What is Insulin Resistance?

Have you been feeling a tingling sensation on your hands or feet? Have you noticed your midsection becoming more prominent than normal? Or have you been feeling depressed or constantly more tired than usual? Many of these symptoms are signs that you could be at risk of developing insulin resistance. The video above explains insulin resistance and how it affects the body. Many symptoms like obesity and inflammation do play a factor in contributing to insulin resistance associated with weight gain. Studies reveal the association between obesity and insulin resistance through the link between visceral adipose tissue accumulation in the liver. When there is an accumulation of excess lipids in the liver makes the visceral adipose tissue prone to inflammatory cytokine production, which then contributes to insulin signaling impairment. Fortunately, there are available treatments to help manage insulin resistance.


Treatments To Manage Insulin Resistance

 

Some treatments available to manage insulin resistance can help many individuals feel better by making small changes in their lifestyle habits. Many individuals utilize the Mediterranean diet as it has many beneficial properties in lowering insulin resistance and managing diabetes by incorporating healthy polyunsaturated fatty acids from olive oil and seeds, resveratrol from grapes, and other anti-inflammatory foods to reduce inflammation associated with insulin resistance. Since other symptoms are associated with insulin resistance, like metabolic syndrome, getting a chiropractic adjustment may help lower the effects of inflammation associated with metabolic syndrome and manage insulin resistance. Chiropractic care is commonly used for musculoskeletal issues; however, since metabolic syndrome is a mediator for musculoskeletal problems like neck pain, shoulder pain, and back pain, it can make the body dysfunctional. To that point, it becomes a cross-link for insulin resistance, causing the body to have reduced mobility. Chiropractic care uses spinal manipulation to adjust the subluxation or spinal misalignment in the body and help improve mobility back to the joints.

 

Conclusion

The body needs the energy to get through the entire day by consuming various foods. When these foods are consumed, they are converted into three molecules:

  • Carbohydrates convert to glucose for bodily function.
  • Protein repairs and builds muscle tissues.
  • Healthy fats produce essential hormones and support cell function.

Watching the foods we consume can help us in the long run. When the body has too much glucose in its system, it can lead to insulin resistance and cause various metabolic factors like obesity and weight gain, resulting in metabolic disorders associated with chronic conditions. Insulin resistance can affect the body over time if not treated right away. Incorporating a healthy diet like the Mediterranean diet, chiropractic care, and physical activities into a person’s lifestyle can help manage insulin resistance from escalating to dangerous levels like diabetes affecting a person’s life.

 

References

Chen, Li, et al. “Mechanisms Linking Inflammation to Insulin Resistance.” International Journal of Endocrinology, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4468292/.

Freeman, Andrew M, and Nicholas Pennings. “Insulin Resistance – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, www.ncbi.nlm.nih.gov/books/NBK507839/.

Hardy, Olga T, et al. “What Causes the Insulin Resistance Underlying Obesity?” Current Opinion in Endocrinology, Diabetes, and Obesity, U.S. National Library of Medicine, Apr. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC4038351/.

Wondmkun, Yohannes Tsegyie. “Obesity, Insulin Resistance, and Type 2 Diabetes: Associations and Therapeutic Implications.” Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy, Dove, 9 Oct. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7553667/.

Disclaimer

Sticking To A Fitness Regimen: Sciatica Clinic

Young hispanic fitness man in gym sitting on bench, working out with weights. working on fitness machine at the gym. butterfly machine with weights in a gym

Everybody understands that exercise is necessary for optimal physical and mental health. Beginning a workout routine can be simple, but sticking with it long-term is the challenge. Knowing how to stay motivated can be overwhelming when facing various fitness options. Understanding the benefits of exercise and identifying the most significant motivating factors will help stick to the fitness plan.

Sticking To A Fitness Regimen

Benefits of Exercise

The first step is identifying why you want to start exercising and the principal motivator/s. For most individuals exercising regularly helps:

  • Contribute to weight loss
  • Decrease risk of disease
  • Increase lifespan
  • Improve the quality of life
  • Improve mental health

Sticking to a plan tends to dissolve after a few months without serious motivation. It is recommended to focus on making the why as specific and personal as possible. The more specific the why, the less likely the individual will stray from the plan. For example, a middle-aged father wants to get and stay in shape because he wants to keep up with his kids and set a healthy example.

Starting Out

A small amount of regular exercise positively affects the body’s health. This is a common cause of burnout and is not necessary. Those who have never exercised or worked out regularly are often tempted to start with intense hours-long exercise routines.

That means that 30 minutes a day of moderate exercise/activity or 15 minutes a day of vigorous exercise/activity is the recommended amount to see and feel health benefits like improved metabolism and mental health.

  • Getting the body physically fit is a long-distance marathon, not a quick sprint.
  • Consistency is the objective.
  • Increasing the frequency and/or duration of workouts is fine, but doing it in a way where the exercise is still enjoyable and not a chore is recommended.
  • Individuals who work out too hard and need to rest for a few days risk losing motivation.

Daily Activities

Becoming more active throughout the day outside of the workout regimen is recommended to increase physical activity levels and build and reinforce healthy habits. If exercising is too strenuous for the individual, start with increasing physical daily activities. This is an effective way to ease into regular exercise. Examples of physical activities include:

Develop Healthy Habits

Developing healthy habits, physical and nutritional are the goals, which is why it is essential to find an exercise approach that doesn’t lose its appeal and continues to develop. One study found that working out with friends or joining group sports can generate greater enjoyment. There are a variety of activities that can include:

  • Structured workouts
  • HIIT
  • Yoga
  • Pilates
  • Strength training
  • Cycling
  • Running
  • Biking
  • Hiking
  • Organized sports leagues:
  • Soccer
  • Basketball
  • Softball
  • Volleyball
  • Tennis
  • Golf
  • Low-impact options:
  • Walking
  • Stretching
  • Water aerobics

What is essential is to find something that you will want to continue to do.


Personalized Training and Rehabilitation


References

Barranco-Ruiz, Yaira et al. “Dance Fitness Classes Improve the Health-Related Quality of Life in Sedentary Women.” International journal of environmental research and public health vol. 17,11 3771. 26 May. 2020, doi:10.3390/ijerph17113771

Dalle Grave, Riccardo. “Nutrition and Fitness: Mental Health.” Nutrients vol. 12,6 1804. 17 Jun. 2020, doi:10.3390/nu12061804

Higgins, John P. “Smartphone Applications for Patients’ Health and Fitness.” The American journal of medicine vol. 129,1 (2016): 11-9. doi:10.1016/j.amjmed.2015.05.038

Yang, Yun Jun. “An Overview of Current Physical Activity Recommendations in Primary Care.” Korean journal of family medicine vol. 40,3 (2019): 135-142. doi:10.4082/kjfm.19.0038

The Role Of Central Sensitization In Myofascial Pain Syndrome

Introduction

The muscles, tissues, and ligaments help stabilize the joints and structure of the spine so that the body can function. These muscles are layered and interwoven in the spine and joints that help facilitate movement. When the body suffers from injuries or traumatic events, the muscles, tissues, and ligaments become affected, causing muscle pain and discomfort. This causes the muscles to be tender to the touch and sensitive. This is known as myofascial pain syndrome. Today’s article looks at myofascial pain syndrome, how it is linked with central sensitization, and ways to manage myofascial pain syndrome. We refer patients to certified providers specializing in musculoskeletal treatments to help many individuals with myofascial pain syndrome associated with central sensitization. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

What Is Myofascial Pain Syndrome?

 

Have you been experiencing muscle tightness in different areas of your body? Have you felt your muscles tender to the touch? Or have you been having trouble sleeping? Many of these overlapping risk factors are signs that you might have myofascial pain syndrome. The term “myofascial” is split into two parts. “Myo” refers to the muscles, while “fascia” refers to the connective tissues found throughout the body. So myofascial pain syndrome is where there is muscle pain in various forms, which includes the muscle tissues, connective tissues, or both. Studies reveal that myofascial pain syndrome originates from trigger points in the skeletal muscle, causing the affected muscle to be in pain. The trigger points in the body’s skeletal muscles are the “knots” people feel when their muscles feel tight. These trigger points are challenging to identify because they occur in different areas causing referred pain (pain in one place but in another body area). 

 

How Central Sensitization Link To Myofascial Pain Syndrome?

Studies reveal that central sensitization in the body is represented as an enhancement in neuron function and circuits in the nociceptive pathways that increases membrane excitability and synaptic efficacy. To that point, it reduces inhibition and manifests the remarkable plasticity of the somatosensory nervous system. The nociceptor inputs can trigger and manifest central sensitization as pain hypersensitivity when the body suffers from an injury. So how is central sensitization linked to myofascial pain syndrome? Let’s use fibromyalgia as an example. Many individuals dealing with myofascial pain may be potentially involved with fibromyalgia. This is due to fibromyalgia being a chronic condition that features widespread pain, and this causes the body to be more sensitive to pain. Central sensitization linked to myofascial pain syndrome can mimic fibromyalgia symptoms in the body, causing muscle pain and discomfort. 

 


An Overview Of Myofascial Pain Syndrome-Video

#010  What is Myofascial Pain Syndrome?

Are you experiencing muscle weakness or soreness in some regions of your body? Have you dealt with chronic fatigue or poor sleep quality? Or have you been dealing with headaches constantly throughout the entire day? Many of these symptoms are signs that you might be at risk of developing myofascial pain syndrome. The video above explains myofascial pain syndrome, the symptoms, and the causes that affect the body. Studies reveal that myofascial pain has two types of trigger points:

  • Active trigger points associated with muscle pain without movement
  • Latent trigger points associated with muscle pain with movement

Myofascial pain syndrome can vary in acute or chronic forms and can range from mild to severe while being in different locations, making it very difficult to pinpoint where the pain is localized. Fortunately, there are ways to manage myofascial pain syndrome in the body that can help with the pain.


Ways To Manage Myofascial Pain Syndrome

 

When managing myofascial pain syndrome, many individuals dealing with muscle pain will take pain medication to alleviate it; however, that only minimizes the pain for a short period. One way to manage myofascial pain syndrome is by utilizing chiropractic care as part of treatment. Chiropractic care is non-invasive and often the preferred treatment for individuals with myofascial pain syndrome due to its effectiveness and drug-free approach. Chiropractors are not only good at finding the trigger points, but they are good when it comes to treating them using various techniques. Studies reveal that chiropractors use direct pressure on the trigger points to relieve the pain with their hands or specific tools. Incorporating chiropractic care provides the body with an increase in muscle strength, flexibility, and range of motion. Since chiropractic care is a whole-body approach, it allows many people with myofascial pain syndrome to have a better quality of life and learn healthy habits, which include diet, exercise, and mental health, while living with less or no pain at all.

 

Conclusion

The body has muscles, tissues, and ligaments that help stabilize the joints and structure of the body, so there is functionality. These muscles help facilitate movement since the muscles are interwoven in the spine and joints. When the body suffers from a traumatic event or an injury, the muscles, tissues, and ligaments become affected. This causes muscle pain and discomfort, known as myofascial pain, where the trigger points cause pain in the body and can occur in different areas. Myofascial pain can be challenging to diagnose since it can be on one side of the body but affects a different section, known as referred pain. Fortunately, treatments like chiropractic care can help manage myofascial pain by treating the pain and using direct pressure to alleviate the pain. Incorporating chiropractic care to manage myofascial pain can help many individuals be pain-free on their health and wellness journey.

 

References

Bordoni, Bruno, et al. “Myofascial Pain – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 18 July 2022, www.ncbi.nlm.nih.gov/books/NBK535344/.

Desai, Mehul J, et al. “Myofascial Pain Syndrome: A Treatment Review.” Pain and Therapy, Springer Healthcare, June 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC4107879/.

Latremoliere, Alban, and Clifford J Woolf. “Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity.” The Journal of Pain, U.S. National Library of Medicine, Sept. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2750819/.

Morgan, William. “Chiropractic Treatment for Myofascial Pain Syndrome.” Spine, Spine-Health, 24 Sept. 2014, www.spine-health.com/treatment/chiropractic/chiropractic-treatment-myofascial-pain-syndrome.

Disclaimer

Knee Discomfort and Pain: Chiropractic Therapy

handsome doctor touching knee of mature patient on step platform

Many live with chronic discomfort and pain regularly in one or both knees. This could be from past injuries, being overweight, lack of physical conditioning, degeneration, or arthritis. Many take prescription or over-the-counter pain medication to deal with the discomfort. Pain medications only dull and mask the pain and discomfort associated with the symptoms. As a result, living with masked knee pain can worsen the condition, and the surrounding bones, joints, and tissues can begin to deteriorate. Chiropractic combined with massage, decompression, and traction therapy can significantly reduce or eliminate knee pain.

Knee Discomfort and Pain Chiropractor

Knee Discomfort and Pain

The knee’s joint and ligaments need to be strong and healthy to support activities. The most common issues that individuals develop include:

Acute Injuries

  • Knee injuries can be caused by auto accidents, physical strain, playing sports, work accidents, workplace ergonomics, and walking up and down stairs.
  • The most common acute knee injuries include:
  • Knee contusions.
  • Ligament sprain.
  • Muscle strains.
  • Puncture injuries.

Chronic Injuries

  • Chronic or inflammatory medical conditions can wear down the cartilage cushion between the upper and lower leg bones.
  • Most common include gout, septic arthritis, osteoarthritis, and rheumatoid arthritis.
  • Unhealthy postures and obesity can also contribute to the chronic degradation of the knee joint.

Knee discomfort and pain can present in various ways. Some might hear an acute popping in the knee followed by swelling. Others might notice the gradual development of stiffness and weakness over time. When injured or compromised, localized pain is one of the first indicators. Chronic knee and joint pain can lead to weakness, nerve damage, or create new injuries/problems. Not all knee pain is caused by injury; in many cases, a triggering incident, like an awkward step or misstep, a stretch that went too far, or a walk, can create an injury. Even a sedentary lifestyle can contribute to knee degeneration as the surrounding muscles can lose strength, placing unnecessary strain on the joints when movement is necessary.

Chiropractic

A chiropractor will examine the knee through a series of analyses, including x-rays, digital imaging, and a physical exam. The chiropractor will develop a personalized treatment plan to treat, rehabilitate, and strengthen the knee. The treatment can include:

  • Physical therapy
  • Trigger point therapy
  • Myofascial release
  • Massage therapy
  • Hip manipulation
  • Knee manipulation
  • Posture correction to distribute body weight evenly, lessening the stress on an affected knee.
  • Targeted exercises and nutritional recommendations will ensure long-term healing.

Q Angle of the Knee


References

Cimino, Francesca, et al. “Anterior cruciate ligament injury: diagnosis, management, and prevention.” American family physician vol. 82,8 (2010): 917-22.

Donnell-Fink, Laurel A et al. “Effectiveness of Knee Injury and Anterior Cruciate Ligament Tear Prevention Programs: A Meta-Analysis.” PloS one vol. 10,12 e0144063. 4 Dec. 2015, doi:10.1371/journal.pone.0144063

Hoskins, Wayne, et al. “Chiropractic treatment of lower extremity conditions: a literature review.” Journal of manipulative and physiological therapeutics vol. 29,8 (2006): 658-71. doi:10.1016/j.jmpt.2006.08.004

Neogi, Tuhina, et al. “Sensitivity and sensitization in relation to pain severity in knee osteoarthritis: trait or state?.” Annals of the rheumatic diseases vol. 74,4 (2015): 682-8. doi:10.1136/annrheumdis-2013-204191

The Link Between Neuroinflammation & Neurodegenerative Diseases

Introduction

The brain sends neuron signals to the body to function for everyday movements like walking, running, or resting. These signals travel from the spinal cord through the numerous nerve roots connected to the muscles, tissue, and ligaments that support the joints and organs from multiple factors. However, these factors do affect the body over time, triggering issues that cause pain and discomfort to the body. When this happens, it disrupts the signals from traveling to and forth in the brain, causing dysfunction in the body and leading to neurological disorders associated with neuroinflammation. Today’s article looks at neuroinflammation, how it affects the body, and what is the link between neuroinflammation and neurodegenerative diseases. We refer patients to certified providers specializing in neurological treatments to help many individuals dealing with neuroinflammation associated with neurodegenerative diseases. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

What Is Neuroinflammation?

 

Are you experiencing fatigue and losing focus from your brain? Do you constantly feel stressed or overworked? Or how about developing the risk of Alzheimer’s or other neurological diseases? Many of these symptoms are correlated with neuroinflammation in the brain. Neuroinflammation is defined as an inflammatory response that affects either the brain or the spinal cord. The body has an extensive network known as the immune system, which produces cytokines, antibodies, white blood cells, and other chemicals that protect the body from foreign invaders. Producing cytokines triggers inflammation in the body where the alien invaders are eliminated. The brain surprisingly has its immune system, which provides maintenance and plasticity. When traumatic factors begin to affect the brain’s immune system, the nociceptors become hypersensitive and overexcited due to the results of tissue injuries and inflammation in the peripheral nervous system. Studies reveal that inflammation in the peripheral nervous system results from hyperactivity in the nervous system, which implicates either a positive or negative outcome for the brain.

 

How Does Neuroinflammation Affect The Body?

Since neuroinflammation has positive or negative outcomes in the nervous system, it can also trigger the body, making it dysfunctional. Studies reveal that neuroinflammation is mediated by the production of cytokines, ROS (reactive oxygen species), and secondary messengers that becomes the consequences of neuroinflammatory responses. This means that the inflammatory effects are taken into account depending on the intensity and duration of the immune signals in the nervous system, which can be either negative or positive. The positive aspects of neuroinflammation include:

  • Reorganization of host priorities (immune-brain communication)
  • Tissue repair (reducing injuries)
  • Neuro-protection (pre-conditioning immunity)
  • Enhance neuro-plasticity (development, memory function)

While the negative aspects of neuroinflammation include:

  • Cognitive impairment (aging)
  • Collateral damage( traumatic injuries)
  • Neuronal damage (neurodegenerative diseases)
  • Repeated social defeat stress (anxiety, depression)

 


Simplified Explanation On Neuroinflammation-Video

Neuroinflammation Simplified – The Link Between the Immune System and The Brain - Dr Sanil Rege

Have you been feeling anxious or depressed? Have you been forgetful as of late? Are you experiencing inflammatory effects in your brain? Many of these symptoms are signs that you could suffer from neuroinflammation in the brain. The video above explains neuroinflammation and how it is linked to the immune system affecting the body. Since neuroinflammation may cause various health issues such as anxiety, stress, depression, and other well-known symptoms, studies reveal that neuroinflammation is a common feature of neurodegenerative diseases. To that point, the relationship between neuroinflammation and neurodegenerative diseases shows that neuroinflammation has been responsible for the abnormal secretion of proinflammatory cytokines to trigger the signaling pathways to the brain, making it dysfunctional. 


The Link Between Neuroinflammation & Neurodegenerative Diseases

 

Since the brain is the primary command center for the body, the link between neurodegenerative diseases and neuroinflammation overlap and cause havoc in the body. Studies reveal that inflammatory and neurotoxic mediators are released in the brain, thus viciously triggering neuroinflammation and neurodegeneration in the body. When the body is dealing with neuroinflammation, one of the symptoms that are prominent in the body is chronic oxidative stress. Research studies have revealed that neuroinflammation has been associated with chronic oxidative stress, a vital feature of all neurodegenerative diseases causing genetic structural alterations. To that point, it results in neurodegeneration. Fortunately, there are ways to lower neuroinflammation associated with neurodegenerative diseases. Some of the ways that many people utilize to reduce neuroinflammation include:

  • Anti-inflammatory foods (avocados, oily fish, cacao, ginseng, Ginkgo Biloba, etc.)
  • Controlling blood sugar
  • Exercising
  • Managing stress
  • Adequate sleep
  • Chiropractic care

 All these small changes are remarkable in reducing neuroinflammation and managing neurodegenerative diseases in the body. This will help many individuals dealing with neuroinflammation associated with neurodegenerative diseases and can regain their health and wellness by managing it.

 

Conclusion

The brain is the primary command center that sends neuron signals to the body to function in everyday movement. The neuron signals travel from the brain to the spinal cord through the numerous nerve roots connected to the muscles, tissues, and ligaments to support the organs and joints. When environmental factors affect the body over time, it risks developing neuroinflammation associated with neurodegenerative diseases. Neuroinflammation is when the inflammatory mediators start to affect the brain, it can make the brain disrupt the neuron signals from traveling to the body and cause issues associated with neurodegeneration. Fortunately, incorporating different ways to reduce neuroinflammation can help manage neurodegenerative diseases and benefit the body.

 

References

Chen, Wei-Wei, et al. “Role of Neuroinflammation in Neurodegenerative Diseases (Review).” Molecular Medicine Reports, D.A. Spandidos, Apr. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4805095.

DiSabato, Damon J, et al. “Neuroinflammation: The Devil Is in the Details.” Journal of Neurochemistry, U.S. National Library of Medicine, Oct. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5025335/.

Guzman-Martinez, Leonardo, et al. “Neuroinflammation as a Common Feature of Neurodegenerative Disorders.” Frontiers in Pharmacology, Frontiers Media S.A., 12 Sept. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6751310/.

Kempuraj, D, et al. “Neuroinflammation Induces Neurodegeneration.” Journal of Neurology, Neurosurgery and Spine, U.S. National Library of Medicine, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5260818/.

Matsuda, Megumi, et al. “Roles of Inflammation, Neurogenic Inflammation, and Neuroinflammation in Pain.” Journal of Anesthesia, U.S. National Library of Medicine, Feb. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6813778/.

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Anti-Inflammatory Diets: Sciatica Clinic Chiropractic Nutrition

Mexican food tacos in human hand on dark wooden table, top view

Around 60% of individuals have a condition caused by or complicated by chronic inflammation. The body reacts with acute inflammation, which is beneficial as the immune system fights off bacteria that could infect the injury. Examples could be getting a cut on the finger that swells for a day or so to repair the wound or catching a cold and coughing up mucus to expel the germs. However, acute inflammation only lasts as long as necessary; chronic inflammation can last for weeks, months, and years. Individuals can have chronic inflammation and not know the damage being done to arteries and organs until pain or other issues begin to present. There are a few anti-inflammatory diets, which are nutrition plans that can help reduce inflammation.

Anti-Inflammatory Diets Chiropractic Nutrition

Anti-Inflammatory Diets

Health-promoting substances include vitamins, minerals, fiber, omega-3 fatty acids, flavan-3-ols in tea and cocoa, and anthocyanins in blueberries, strawberries, raspberries, and other red and purple plant foods. Certain chemicals in the body cause inflammation, and naturally-occurring chemicals in foods, can prevent and combat inflammation by providing essential nutrients.

Nordic Diet

This includes Denmark, Sweden, and Finland, which each have different cuisines, but traditionally, they share healthy foods that provide anti-inflammatory benefits, including:

  • Apples
  • Berries
  • Broccoli
  • Cabbage
  • Carrots
  • Canola oil is the principal oil
  • Fish
  • Pears
  • Potatoes
  • Sauerkraut
  • Whole rye

Rye is a grain shown to help reduce blood sugar, the inflammatory marker C-reactive protein. Individuals that follow this way of eating have lower blood levels of C-reactive protein and other inflammation markers. A randomized study was done in various Nordic countries and lasted six to 24 weeks. One group was assigned a healthy Nordic diet while the other stayed on the country’s modern, less healthy diet. The studies found that individuals that practiced a healthy Nordic diet even for a short while improved inflammatory markers and lost weight.

Mexican Diet

Research has linked a traditional Mexican diet to lower inflammation. Staple foods of a traditional Mexican diet include:

  • Cheese
  • Corn tortillas
  • Fruits and vegetables, including hot peppers
  • Rice – brown and white
  • Legumes/Beans

Legumes/beans are linked to protection from inflammatory-related conditions that include:

  • Obesity
  • High blood pressure
  • High blood cholesterol
  • Type 2 diabetes
  • Cardiovascular disease

Legumes are high in fiber, which helps:

 A National Cancer Institute study of post-menopausal women of Mexican descent living in the U.S. found that those following a more traditional Mexican diet averaged 23% lower C-reactive protein levels.

Nutritionist Health Coach and Chiropractic

In some instances, chronic inflammation can come from acute inflammation that does not turn off, which can happen when the body does not make enough chemical substances responsible for turning off the immune response. Blood tests for inflammation can include tests that detect the C-reactive protein and the erythrocyte sedimentation rate, which measures the speed red blood cells settle in a test tube that shows if more inflammatory compounds are present. A combined approach and team of medical professionals, including chiropractic, massage therapy, health coaching, and nutrition, can help relieve and prevent inflammation.

Nutritionist

  • Consulting a nutritionist is recommended to figure out and determine the best diet/nutrition plan for the individual.
  • A nutritionist may also suggest supplementation like vitamin D, magnesium, and fish oil supplements.
  • Body composition analysis breaks down the body elements of water, protein, minerals, and fat that can also discover inflammation markers.

Chiropractic

Chiropractic adjustments help reduce the production of cytokines or proteins that regulate the cells of the immune system. Overproduction of cytokines can cause a severe inflammatory response. Chiropractic’s purpose is to rebalance the body by realigning the vertebrae to reduce pressure on the nerves and promote a healthy nervous system. When the spine and other joints are correctly aligned, the nerves function correctly, returning the body’s biomechanics to normal.


InBody Results


References

Galbete C, Kröger J, Jannasch F, et al. Nordic diet, Mediterranean diet, and the risk of chronic diseases: the EPIC-Potsdam study. BMC Med. 2018;16(1):99.

Lankinen M, Uusitupa M, Schwab U. Nordic Diet and Inflammation-A Review of Observational and Intervention Studies. Nutrients. 2019;11(6):1369.

Ricker MA, Haas WC. Anti-Inflammatory Diet in Clinical Practice: A Review. Nutrition in Clinical Practice. 2017;32(3):318-325.

Santiago-Torres M, Tinker LF, Allison MA, et al. Development and Use of a Traditional Mexican Diet Score in Relation to Systemic Inflammation and Insulin Resistance among Women of Mexican Descent. J Nutr. 2015;145(12):2732-2740.

Valerino-Perea, Selene, et al. “Definition of the Traditional Mexican Diet and Its Role in Health: A Systematic Review.” Nutrients vol. 11,11 2803. 17 Nov. 2019, doi:10.3390/nu11112803

Yang, Yoon Jung, et al. “Dietary flavan-3-ols intake and metabolic syndrome risk in Korean adults.” Nutrition research and practice vol. 6,1 (2012): 68-77. doi:10.4162/nrp.2012.6.1.68

A Look Into Pilates For Back Pain

Introduction

Many people worldwide know that exercising has impressive benefits that help improve the body’s overall wellness. The body has different muscle groups that have a casual relationship with the vital organs inside the body. Organs like the heart, lungs, gut, and bladder correlate with the different muscles through the nerve roots that connect them. When the body suffers from various factors that affect it, it causes referred pain to the body where one pain is at one location but radiates from the other side. Exercising can help the body recover through physical rehabilitation by reducing inflammation and scarring on the muscle tissues. One of the many exercises that helps strengthen the muscles, increase flexibility, and even improve posture is Pilates. Today’s article looks at Pilates, its benefits, and how it can help alleviate back pain. We refer patients to certified providers specializing in musculoskeletal treatments to help many individuals with low back pain issues affecting their bodies. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

What Is Pilates?

 

Have you been feeling sluggish or having low energy throughout the entire day? What about experiencing pain in your lower back? Have you experienced muscle stiffness in certain areas around your body? Many of these symptoms are associated with musculoskeletal issues that correlate with different factors that affect the body; why not try an exercise regime like Pilates? Pilates is a system of exercises that uses a particular machine or body to improve a person’s physical strength and posture while increasing the body’s flexibility and enhancing mental awareness. Joseph Pilates developed Pilates in the early 20th century as an exercise program to help World War I soldiers improve their physical fitness levels. Pilates was used as rehabilitation therapy for injured individuals by incorporating resistance, stretching, and target muscle strengthening. Pilates is now utilized for all individuals with different bodies and fitness levels and can provide tremendous benefits. 

 

What Are The Benefits?

Pilates, like any other form of exercise, has many beneficial properties that help improve a person’s health and wellness. Studies reveal that Pilates helps many individuals, including older adults, by improving their posture by decreasing thoracic flexion while increasing lumbar extension for pain relief. Some of the beneficial properties that Pilates offer to the body include:

  • Increasing core strength: The deep muscles in the abdomen, back, and pelvic regions become stronger and help stabilize the body more.
  • Strengthen muscle groups: Pilates helps make the muscles not only strong but also helps stretch them so that they can look long and lean. This makes the individual look toned.
  • It’s a whole body workout: As many exercises work on specific body parts, Pilates focuses on each muscle part of the body and helps muscle development.
  • Posture Improvement: Pilates help keep the spine aligned while strengthening the body and core. Over time a person’s posture will improve naturally, making them stand taller, stronger, and even more graceful.
  • Increases energy: Like all exercises, Pilates will give a person the energy boost they need. This is due to the focused breathing and increased blood circulation that stimulates the muscles and the spine.

 


Pilates Exercises For Back Pain-Video

Back Pain Relief Exercises - 10 Minute Pilates for Back Pain!

Are you looking for a new exercise to tone your muscles? Have you been dealing with pain in your lower back? Do you have muscle weakness in some regions of your body? If you have been experiencing pain-related issues, why not try Pilates? The video above goes through a 10-minute Pilates workout for back pain. Studies reveal that non-specific low back pain is a highly prevalent condition many individuals associate with disability and work absence worldwide. Many environmental factors affect many individuals, causing them to suffer back issues. Pilates can help encourage many individuals to regain their health and wellness by incorporating core strength and stability while improving their posture.


Pilates Alleviate Back Pain

 

Many people don’t realize that some low back pain symptoms are related to poor posture. Poor posture can lead to associated symptoms of headaches, back pain, improper balance, and pelvic issues. What Pilates does is that it creates body awareness and helps improve the lower back muscles by strengthening them and relaxing the stiff muscles. Studies reveal that incorporating Pilates as physical therapy for individuals suffering from low back pain can help address the mental and physical pain aspects with core strengthening, flexibility, and relaxing the tense muscles. Many individuals should never put off exercising when it comes to back pain. Incorporating an exercise routine can benefit the body and prevent future injuries.

 

Conclusion

An exercise regime can provide many beneficial results for those looking for ways to be healthy, those suffering from injuries, or those who want to add something else to their workout routine. Pilates is one of those exercises that incorporates resistance, stretching, and muscle targeting as it is a full-body workout. Pilates is used in rehabilitation therapy for injured individuals and can provide tremendous benefits. Pilates can help many individuals with back issues associated with environmental factors like poor posture. Many individuals that utilize Pilates as part of their exercise regime will begin to feel stronger and healthier as their backs will thank them.

 

References

Baker, Sara. “Pilates Exercise for a Healthy Spine – Spineuniverse.” Spineuniverse, 28 Dec. 2019, www.spineuniverse.com/wellness/exercise/pilates-exercise-healthy-spine.

Kuo, Yi-Liang, et al. “Sagittal Spinal Posture after Pilates-Based Exercise in Healthy Older Adults.” Spine, U.S. National Library of Medicine, 1 May 2009, pubmed.ncbi.nlm.nih.gov/19404180/.

Sorosky, Susan, et al. “Yoga and Pilates in the Management of Low Back Pain.” Current Reviews in Musculoskeletal Medicine, Humana Press Inc, Mar. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2684152/.

Yamato, Tiê P, et al. “Pilates for Low Back Pain.” The Cochrane Database of Systematic Reviews, John Wiley & Sons, Ltd, 2 July 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC8078578/.

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Pinched Nerve In The Hip Sciatica Clinic

Full body length of young exhausted lady having back ache from cleaning her apartment, washing floor, holding spray mop, touching spine. Tired housewife suffering from pain cleaning dirty living room

A pinched nerve in the hip can cause numbness, tingliness, weakness, and pain. A pinched/compressed nerve creates pressure that can result from a bone structural issue like hip misalignment or the nerve getting overly stretched, stuck, twisted, or kinked. The pressure obstructs the neural pathways and decreases neural activity. This causes pain. If discomfort or pain is present, chiropractic, physical rehabilitation, rest, exercise, and ice and heat can release and reset the nerve and help prevent re-injury.

Pinched Nerve In The Hip Chiropractor

Pinched Nerve In The Hip

A pinched or compressed nerve results from pressure being applied to the nerve. A pinched nerve in the hip often causes pain in the groin region, radiating down the inner thigh to the knee. The pain can feel like a dull ache or a sharp, burning pain. Individuals also report tightness, numbness, or a tingling sensation in the buttocks. The most common causes include:

  • Unhealthy posture.
  • Sitting for too long without moving around.
  • Misaligned bone or cartilage.
  • Muscle strain.
  • Pregnancy.
  • Obesity.
  • Inflamed tissue.
  • Herniated disc.
  • Arthritis.
  • Bone spurs.

Chiropractic

Different causes require different treatment approaches. For example, an obese individual could require chiropractic adjustments, specific exercises/stretches, and diet adjustments to address the whole body. The recommended treatment plans can vary but usually include:

  • Physical therapeutic massage.
  • Manipulative therapies of the joints and muscles.
  • Mobilization of the joints.
  • Soft tissue treatments.
  • Spinal decompression.
  • Exercise.

Walking and activity can worsen the pain when the hip presents with pain. This can cause the rest of the body to compensate by shifting the weight to the healthy side, which can cause even more pain in the back or legs or cause another injury. Regular chiropractic hip adjustments will improve posture, maintaining muscle and skeleton alignment that will prevent pinching nerves in the hip.


Chiropractic Hip Treatment


References

Ahuja, Vanita, et al. “Chronic hip pain in adults: Current knowledge and future prospective.” Journal of anaesthesiology, clinical pharmacology vol. 36,4 (2020): 450-457. doi:10.4103/joacp.JOACP_170_19

Christmas, Colleen, et al. “How common is hip pain among older adults? Results from the Third National Health and Nutrition Examination Survey.” The Journal of family practice vol. 51,4 (2002): 345-8.

“Free Communications: Case Reports: Hip.” Journal of Athletic Training vol. 38,2 Suppl (2003): S.73–S.74.